Newsom asked California doctors and nurses to join his Health Corps. Why the plan flopped

In late March, as the state scrambled to prepare for the emerging pandemic, Gov. Gavin Newsom announced the creation of the California Health Corps to recruit and deploy thousands of retired doctors, newly graduated nurses and other medical professionals into COVID-19 hotspots.

Roughly 93,000 people signed up in the days after Newsom unveiled the program, signaling that a groundswell of workers was ready to meet the moment for hospitals and nursing homes. “If you have a background in health care, we need your help,” he declared.

But now, as the state faces another surge in COVID-19 and some hospitals are sounding the alarm about a dangerous lack of medical staffing, less than 1% of the people who originally signed up for the Health Corps are available to help.

It turns out, the vast majority of the tens of thousands of people who signed up were ineligible to work. Those who were qualified were at the mercy of a confusing technology system that hampered deployments.

Many stood by at mostly empty “surge” facilities, including the Sleep Train Arena in Sacramento, while some hospitals and nursing homes went without qualified the Health Corps workers they had requested, a Sacramento Bee review of state documents shows

When California flattened the curve on COVID-19 during the summer, many Health Corps members took jobs at hospitals or more lucrative traveling nurse programs, further dwindling the state’s recruitment pool.

All told, just 900 Health Corps members are now ready to be deployed.

“That’s kind of a drop in the bucket relative to our workforce size,” said Joanne Spetz, associate director of research at the Healthforce Center at the University of California, San Francisco.

There are roughly 300,000 nurses in California, she said. There is no good way to forecast the exact staffing help facilities could need in coming weeks, but Spetz said what’s concerning is how every corner of the state is seeing COVID-19 cases and hospitalizations surging simultaneously.

“The concern that we’re all having from a workforce standpoint is the prior surges were much more localized, so you could send people around,” Spetz said.

Administered by the California EMS Authority, the Health Corps was intended to address the very staffing woes threatening to hit some hospitals and healthcare facilities this winter. The group was designed to deploy frontline workers — including EMTs, administrative workers, nurses, doctors, respiratory therapists, behavioral health specialists and pharmacists — who would help handle a crush of patients and offset losses when employees got sick.

But with cases surging across the country, some hospitals, especially in rural California, are already feeling the crunch. That will worsen in the coming weeks.

“There’s been no progress whatsoever,” Stephanie Roberson, government relations director with the California Nurses Association, said about the Health Corps program.

Roberson described the original announcement as a “laudable effort.” But, she said, the state overestimated how many people would have both the qualifications and the experience necessary to help out in a meaningful way.

Not long after the launch, it became clear that tens of thousands of people who had applied didn’t actually have the proper certifications to get involved.

“That’s good that the governor went to the masses right away to see if folks who have other health experience can come and lend their time to this effort,” Roberson said. “It sounds great. But when you start to sift through the paperwork, you find out that people just aren’t qualified.”

Thousands of applicants who made it through the first round did not complete the process, possibly because they had second thoughts as more became known about the spread of COVID-19 in hospitals and nursing homes.

Many of those who were hired early on ended up staffing empty facilities, like Sleep Train Arena, waiting for a surge in patients that, fortunately, never arrived. The inconsistent schedule, lack of benefits and haphazard on-the-job training at facilities dealing with crises, like nursing homes, made it difficult to stick with the program, members said.

“If you think about nurses and physicians, you can work locum tenens, or temporary traveler, in a lot of different parts of the country,” Spetz said. “So it’s pretty easy to imagine that you’ve got a chunk that has kind of disappeared for that.

‘It didn’t work out great’

In response to a California Public Records Act request from The Bee, the EMS Authority, which administers the Health Corps and other state medical responses, provided deployment documents. The records show dozens of hospitals and nursing homes had requested Health Corps resources but received no help from the group or fewer people than they had requested.

The state later said that data might not mean facilities were actually denied any state resources. That’s because there’s a constellation of local and state emergency medical response teams that can respond during disasters. Some have been used in place of Health Corps requests during the pandemic.

One, California Medical Assistance Teams, is a disaster response program that helps during emergencies like wildfires — it helped prepare for a potential Ebola outbreak in 2014.

Throughout the pandemic, it is CAL-MAT personnel more than Health Corps volunteers who have been sent to nursing homes. (On its website, CAL-MAT says it is “conducting immediate hires to support COVID-19 response.”)

Officials say the Health Corps is a distinct part of the pandemic response because it is focused more on getting volunteer health workers, some of them lesser trained, into facilities that need them, rather than deploying highly skilled medical teams to crises.

Since it started, Health Corps personnel have worked 2,538 shifts, spanning 109 facilities statewide. The state has spent at least $2.2 million to staff it, budget records show.

When members did respond to nursing homes, well-intentioned Health Corps members were not always especially helpful, said one nursing home administrator who worked with its members.

During an outbreak at Saint Claire’s Nursing Center in Sacramento, Rusty Blankenfeld, the administrator, requested help as his team of nurses got sick or called out.

The state gave him three Health Corps members who had little experience working at a nursing home with a very different population than a hospital. In an interview, Blankenfeld said he appreciated the effort, but working in a nursing home is “a completely different beast.”

“You almost have to have someone here babysitting them,” Blankenfeld said of the Health Corps team that responded. “It didn’t work out great.”

Deborah Pacyna, spokeswoman for the California Association of Health Facilities, an industry group that represents about 80% of the state’s nursing homes, said she had not heard concerns from facilities about the Health Corps because, to her knowledge, facilities had not requested help from that program. The separate CAL-MAT teams, on the other hand, “have provided outstanding support.”

But having untrained people, like with the Health Corps, stepping into unfamiliar health care situations was a major concern from the onset, Roberson said.

“You just can’t say ‘Calling all nurses.’ You can’t say ‘Calling all doctors.’ ” Roberson said. “They’re a specialty.”

Consultant hired to study a revamp

Officials have been concerned about the Health Corps’ operations for months.

The Emergency Medical Services Authority noted in a June meeting that officials and health care providers were often confused about how the Health Corps differed from long-existing health care teams that respond during disasters and other public health emergencies, including to nursing homes during the coronavirus pandemic.

Taking on new Health Corps volunteers while also deploying existing medical personnel and overseeing medical responses across the state was overwhelming the EMS Authority, officials wrote.

“EMSA does not have adequate staffing to support large scale disaster responses without risking burning out existing staff,” they said.

Plus, the technology platform for disaster healthcare volunteers was also being used for the Health Corps. Tweaks to the system “created numerous problems for local coordinators.”

Efforts to revamp the Health Corps are ongoing. Officials at the California Department of Public Health recently signed a contract with Slalom LLC, a Seattle-based tech consultant firm, to help manage Health Corps staff deployments and improve data analysis during the state’s pandemic response.

Newsom on Monday warned of increasing pressures facing the health care system and said the state was working to revamp the Health Corps. “We’re going to be dusting that off,” he said.

Officials with the EMS Authority declined a request for an interview for this story. In a statement, the group said it has “maintained frequent, routine contact with local public health agencies and regional disaster medical health coordinators and specialists regarding meeting local needs related to COVID-19.”

They vowed to “work closely with local and regional stakeholders to respond to requests” and onboard additional members “should they be needed.”

‘Didn’t know what to expect’

Despite some challenges, the program has not been a failure, people who worked for it said.

“I was happy to help with the response,” said Hailey Van Vorhis, a nurse who graduated in February. Like many people who applied for jobs in a frozen-in-place pandemic economy, Van Vorhis struggled to find permanent work.

She signed up for the Health Corps and deployed to Sleep Train Arena in Sacramento. In the summer, she found a full-time job in her field and said she’s hopeful the Health Corps can operate smoothly in the future.

“I don’t think it’s easy to plan,” she said. “I feel like, because there were so many moving parts, we didn’t know what to expect.”

Will Cronan, who lives in San Diego County, also signed up after he graduated from nursing school this year. The Health Corps was an entry point in hospital-based health care for Cronan, who served more than two decades in the U.S. Navy SEALs as a combat medic.

He bounced between a hospital in hard-hit Imperial County and nursing homes in San Diego County, where he worked as the equivalent of a certified nursing assistant doing very basic care.

The hospital had a more robust orientation process, almost like what a new hire gets, he said. The nursing homes, on the other hand, were more informal and at short-staffed facilities with shoestring budgets that were “pretty low caliber.”

“Every facility was very gracious to get the help. And I personally thought that it was a great working relationship, because they were giving me experience,” he said. “The state was in a position that they needed as many hands on deck as they could get.”

Cronan said he does not plan to participate in the Health Corps anymore. He recently accepted an emergency room job at a hospital in San Diego County.