QUICK BITES Washington’s dental industry is in the midst of a severe shortage of dental hygienists, with 3-4 positions open for every hygienist seeking a position. With a typical hygienist’s schedule (10 patients per day, four days per week), each persistent opening translates into 160-200 patients not receiving care each month. To better meet the need of local dental employers, Peninsula College in Port Angeles is in the final stages of creating a new associate degree hygiene program. Once approved, it would be the 10th public college in Washington to offer such a program. Peninsula has worked in concert with representatives from WSDA, as well as dentists and hygienists from the Olympic Peninsula, in developing the program. Peninsula received program approval from the State Board of Community and Technical Colleges (SBCTC) in November and will submit a new academic program request to Northwest Commission on Colleges and Universities (NWCCU). The college intends to submit its application to the Commission on Dental Accreditation (CODA) in April 2023. Pending approval, the school plans to welcome its first cohort of 10 students in fall 2024.

The Olympic Peninsula ranks among Washington state’s most visited locales.

Bound by the Pacific Ocean to the west, the Strait of Juan de Fuca to the north and Hood Canal to the east, its remote beaches and lush forests make it a popular tourist destination.

Unfortunately, the geographic remoteness that attracts visitors, poses challenges for its communities and the workforce that supports them. Dr. Todd Irwin, former president of Olympic Peninsula Dental Society and a past WSDA Board member, knows this all too well.

Just over a year ago, Irwin employed five hygienists at his practice; he’s now down to three. The first hygienist moved home to care for an ailing family member. The second, a long-term employee presented with the prospect of a $10/hour increase, accepted a hygienist position with another dental practice two towns away.

“I can’t really blame her,” said Irwin. “I couldn’t increase salaries for all of my other hygienists by that same amount, so I had to say goodbye to someone who worked for me for more than 20 years.” 

Despite multiple and varied recruiting efforts – Craigslist, Indeed, contacting other hygiene programs in the state — hiring challenges remain in the Olympic Peninsula. Irwin acknowledges the area has always had less than ideal numbers when it comes to dental hygienists – those positions are either homegrown or filled by people whose family may have moved to the area and are looking for a career change. 

“You’ve always been lucky enough to have one hygienist. But in the last five years, we’ve started outbidding each other,” he said. “A hygienist could come to you and say I got an offer for X amount and you’d match it because it’s better than losing the person.”

A 2020 survey by WSDA, Delta Dental and the Washington Dental Hygienists’ Association reaffirmed what Irwin and others in dentistry are experiencing first-hand: Washington’s dental community is in the midst of a severe shortage of dental hygienists.

The survey found there are more open positions than hygienists seeking to fill them. For every hygienist seeking a position, there are approximately 3-4 positions available.  Statewide, hygienist positions are open an average of 4.2 months before being filled.

To remedy this shortage, Washington needs to train more hygienists each year. And in remote areas, the challenge is even greater. 

It was this bidding war that ultimately inspired Irwin to come up with a solution to the shortage for dentists in the Olympic Peninsula. As the advisor for a now-closed hygiene school in the area, he saw what was needed to operate a hygiene school. That gave him an idea.

“As this workforce challenge was unfolding, I realized that Peninsula College had the infrastructure to put [a hygiene program] in place — they just had to get the right people involved,” added Irwin, who asked for a meeting with the then-dean of the college, along with a hygienist working on becoming an instructor.

In 2020, he and a small group of dentists, a hygienist instructor and reps from the college met to discuss what it would take to start a program at Peninsula College.

Two years later, the college is in the final stages of creating a new associate degree hygiene program to better meet the need of local dental employers. It all goes to plan, the college welcome its first cohort of 10 students in fall of 2024. Irwin serves on the new hygiene school advisory committee.

“I’m really very proud of all the different people who picked it up and took the challenge on.”

AN INNOVATIVE APPROACH

Built in concert with dentists, hygienists and area employers like Irwin, the program is taking an innovative new approach, one that also considers the time and financial abilities of its prospective students who may also be juggling family or other responsibilities while furthering their education.

Dr. Mia Boster is Peninsula’s dean of workforce education.

“We were approached by local dentists and hygienists to meet the need – there is very high demand in our area. Because we are over 100 miles away from the nearest hygiene training program, there is a large employment gap,” she said. “Because Jefferson and Clallam counties are isolated, we don’t have the pool of hygienists available to meet the needs of the community.”

As a result, the school is minimizing the length of the program, offering the program in seven quarters with several pre-requisite courses folded directly into the hygiene program curriculum.

The school is also reconfiguring when key classes are offered, recognizing the challenges faced by  prospective students who find themselves trying to juggle work and family commitments to take a class offered in the middle of the day, three days a week.

Paula Watson, the school’s dental hygiene director and a 30-year hygienist, said there are fewer pre-reqs that have to be taken prior to applying for the program. And the school is strategically combining some courses to streamline the program.

“We have tried to shorten it, so that once students are in the program they will spend two years [rather than three] in the hygiene program,” she said. “One of the things we’ve tried to do is embed prerequisite courses into the program. For instance: We will be embedding biochemistry into a nutrition course – that way we can combine the two disciplines into one course,” she added.

“There has been a big paradigm shift on how to deliver to our students, trying to offer courses to as many students as we can to meet the needs of our geographic area.” 

With COVID, higher education has become more familiar with offering hybrid and virtual classes, minimizing the amount of time students have to be on campus – which is particularly helpful given the expansive geographic area served by the college.

“We are trying really hard to be innovative,” added Boster “We’re also hoping CODA will approve them – we do this in some other programs at the college. It really benefits the students and lowers the costs.”

UNIQUE FUNDING SOURCES

In addition to re-thinking the actual dental hygiene program, Peninsula is working to address costs for students to enroll and participate.

“One of the things that makes this AA degree program attractive is its lower costs,” said Boster.

Estimated Washington state resident tuition for the dental hygiene classes and prerequisites is $19,136 (133 credits at $143.88 per credit), exclusive of books and fees, which are still being finalized.

Dr. Steven Thomas, Peninsula’s vice president for instruction, said there are unique funding sources available to students pursuing AA degrees, in addition to a wide variety of state financial aid programs.

“There’s a trend across the state with BA degrees,” he noted. “There’s a certain amount of appeal for students conscious about cost. One of the things that makes this AA program attractive to students its lower costs and there are additional funding sources that can help subsidize the cost of a degree.” 

Boster noted that there are worker retraining dollars available for some students, which do not have to be paid back. Additional funds are available through workforce funding programs to students pursuing an AA degree. Perkins and funds through Labor & Industries are also available to prospective qualifying hygiene students.

Training people locally to fill local workforce needs will also provide a return on the investment in this new program, said Thomas.

“We shouldn’t overlook the economic contribution to the community,” he added. “One of the things we want to provide for the community is a way to train workers here and have them stay and work here. I’m sure there will be an economic contribution to the community as a result of that.”

DEI AND COMMUNITY NEEDS

Attracting and retaining a diverse student population is also a key component of Peninsula’s plan for the new hygiene program. The school is committed to its diversity, equity and inclusion work, which includes hiring outreach specialists to work with communities of color to increase their engagement.

Dr. Chris Delecki, another former WSDA President and member of Peninsula’s Dental Hygiene Advisory Committee, said the college, along with the local dental employer community, is actively taking steps to ensure individuals of all backgrounds can get into the program and advance.

“They’re very involved in looking at their programs and building equity into them – attempting to remove barriers that exist for individuals regardless of color or gender. Looking at the barriers women face as heads of households – and if they’re a dental assistant – the challenges with getting off work to advance and go up the career ladder,” Delecki said. “If you’re a dental assistant, there are so many barriers in the current education system. Unless you’re a unique individual, it’s hard to overcome them.”

The college is also working closely with area tribes and has a partnership with the Jamestown Family Health Clinic, operated by the Jamestown S’Klallam Tribe.

“We want to be sure we are connected to that community and can meet their needs,” added Thomas.

“There’s no doubt there’s a great need,” added Delecki, a long-time public health advocate. “What I like to emphasize is that we currently have a hygiene shortage and that’s with the current demand in our system. But there’s over a million Medicaid adults and senior citizens waiting in the wings for access. We need to train the workforce to remove barriers to access to care,” he added. 

“People get a little gun-shy about starting new programs. But the demand is there — you just don’t always see it. “

ON FINAL APPROACH

As of this writing, the college is putting the finishing touches on its Allied Health Building. Peninsula has set aside space for its future hygiene program in this new building, including one classroom (1,233 square feet), two lab spaces (119 and 131 square feet) and a reception area.

Peninsula received program approval from the State Board of Community and Technical Colleges (SBCTC) in November and will submit a new academic program request to Northwest Commission on Colleges and Universities (NWCCU). The college intends to submit its application to the Commission on Dental Accreditation (CODA) in April 2023.

Now, it awaits final review and accreditation.

“One of the great things about this entire process – from the first time talking with Dr. Irwin – we’ve always focused on the students and how we can support them while staying within the guidelines of CODA,” said Boster.

“We’re really focused on our community and making a difference in oral health care. We’ve looked at the data, and it really does point to a need that we can help address.”

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This article originally appeared in WSDA News, 2022 Issue 4.