The Hidden Health Care Workforce: Recognizing, Understanding and Improving the Allied and Auxiliary Workforce


Jennifer Ruzek, Lindsey Bloor, Jennifer Anderson, Mai Ngo

Jul 1999

Allied and auxiliary health care workers play critical support roles in the health care system. Any significant reform in the way health care is delivered will require changes in their training and utilization. This comprehensive report by The California Twenty-First Century Workforce Project examines the supply and distribution of California’s allied and auxiliary health care workers, the educational system that readies these workers for careers, and the pressures that California's dynamic managed care environment exert on them. The Project's examination consisted of reviewing pertinent literature, collecting demographic data on California's health care workforce, and conducting qualitative surveys, interviews and focus groups throughout the state. The study finds an allied and auxiliary workforce suffering from high rates of turnover, ill-defined expectations, low pay and inadequate training. The allied and auxiliary workforce faces challenges brought on by changing environments of care delivery, education, and of the workforce itself. The Workforce Project has identified seven themes that permeate the challenge of reinventing the allied and auxiliary workforce. These seven themes are: New Divisions of Labor, Lower Pay With More Responsibility, The Struggle to Attract and Retain Quality Workforce, The Need to Tie Human Resources to a Quality Strategy, Regulatory and Oversight Inconsistency, A Widening Gap Between Education and the Needs of Industry, The Changing Nature of Work and Career Advancement. The challenges that the Project highlights are caused in large part because of the divisions between care delivery, education, labor unions and the workforce itself. The report provides recommendations which propose the use of partnerships among these sectors to address specific issues as well as the collection of data to evaluate the outcomes of these partnerships and recommended actions.