Health facilities, especially in upstate communities, are getting creative to battle staffing shortages after many places more than doubled their labor costs since the start of the COVID-19 pandemic.

A shortage of workers in the health care industry was on the rise before the start of the COVID-19 pandemic, which exacerbated the long-sustained decline.

It has given rise to a recent boom in the dependency on the travel industry for health staff, with a 120% increase in listings for contract or travel nurses since January 2019, according to the American Hospital Association​.

"We have to learn to pivot and to be able to be open-minded to what we can do to attract and retain talented, talented folks," said Anne English, vice president of human resources at Oneida Health.

Oneida Health, like all hospitals, is feeling the pressure with the higher labor costs, turnover and about 20,000 open positions across upstate and Western New York regions.

The strain amid multiple crises led health leaders with the Iroquois Healthcare Alliance to form Upstate Works — its own staffing agency.

The online marketplace shows health facilities wage and administrative costs separately, making it possible for them to offer prospective employees pay competitive wages with traveling rates.

Traveling staffing agencies usually charge hospitals a flat, higher rate without distinguishing between wages and company fees.

"We've never been really privy to that type of information," English said Friday.

More than 50 facilities in 32 counties served by the Iroquois Healthcare Alliance in Central New York, the North Country and Capital Region have been using the new hiring model for about six weeks to fill staff for open positions. Eight additional hospitals have entered a contract to use the service.

CEO Gary Fitzgerald said the hospitals saw at a 50% increase in cost of agency staff the first six months of 2022 compared to last year.

"We've seen savings from 25 to 30% compared to the traditional model," Fitzgerald said. "It's a really good idea because we're never going to solve the staffing problems we have. ...We thought it was time to explore this new model and try to reduce the cost of staff that are going through agencies."

Some health workers are in the early stages of discussions with lawmakers about proposing changes to state law to require staffing agencies to tell hospitals the costs of wages and fees up front.

Fitzgerald has discussed the issues with the current staffing model with Gov. Kathy Hochul's office, and plans to continue conversations with the state Health Department next year to expand the practice.

"In the traditional model, there's no transparency involved at all," he said. "Everyone's got to see what people are paying." 

Hospitals say knowing that information makes it easier to recruit staff for positions often difficult to fill in upstate communities and cuts costs by reducing the overhead.

English said the hiring model has allowed the facility to better negotiate pay and attract labor while saving as much as $30 per hour on the overall rate.

"Obviously, our hope is that we convert them to more permanent placement at our hospital."

Former Gov. Andrew Cuomo signed legislation last year requiring hospitals to set staffing ratios and a plan to meet those care standards with the state Health Department.

Health workers plan to advocate for more guidance from the state Health Department about parameters for facilities to meet staffing requirements and avoid an unfunded mandate.