There are more than 2,200 job openings in Hawaii’s hospitals and health care facilities that are taking as long as a year to fill.

The state is facing shortages in 76 medical professions, with nearly half — 44% — of the unfilled positions in hospitals, according to the Healthcare Association of Hawaii’s first jobs report measuring vacant nonphysician positions between the last quarter of 2018 and this year’s first quarter.

What’s more, 19 of the 76 professions in the five-year demand survey have no local training programs. There is a great need for registered nurse case managers, occupational therapists, patient service representatives and physical therapists, who must go to the mainland to get their education.

“It’s definitely critical because we lose a lot of people who move to the mainland to go to school, and they don’t return home,” said Nalani Kunishige, a 38-year-old occupational therapist at Rehabilitation Hospital of the Pacific who was trained at the University of San Francisco. “And people who come here from the mainland, they only stay here a couple years and end up moving back home, whereas local people would stay because their families are here.”

“Our members need sufficient numbers of people with the right skills in order to provide high-quality and cost-effective care to the people of Hawaii,” the report said. “This is a big challenge because of the period of sustained low unemployment we are experiencing. Employers across all industry segments are competing for workers.”

Overall, the professions with the most vacancies include specialty registered nurses with 463 open jobs, followed by certified nursing assistants at 299, licensed practical nurses at 144, phlebotomists at 124 and clinical assistants/nurse aids at 118.

“It’s clear from this report that we must act now to address the growing need for health care employees,” said HAH President and CEO Hilton Raethel.

The Healthcare Association, which represents the state’s hospitals, skilled- nursing and assisted-living facilities, as well as home health programs and hospices, said it is working with high schools and colleges to “better align their programs, certificates, and degrees” with the needs of health care providers.

That includes working with at least two local colleges that are considering establishing a physical therapy program in the state. Over the past year, providers, high schools and community colleges also have created partnerships with medical assistant and nurse aide programs, and 14 Hawaii public high schools have Health Academies to encourage local students to go into the medical field after graduation.

There are also opportunities through Adventist Health Castle and an internship program at Hawaii Pacific Health, where students interested in the medical field can work alongside clinical and administrative professionals.

The state is also experiencing a severe shortage of doctors, particularly in rural areas on the neighbor islands. The shortage is estimated at nearly 800.

“As a sector, health care competes for employees just like other sectors do. We need to market health care to our children and portray it as a good, viable way to make a living,” said Carl Hinson, director of workforce development at Hawaii Pacific Health. “Students can, with the right training in high school, start working right after graduating and can go on to do well in various professions with additional education.”

The report, which included health care providers and educational institutions, will be updated every two years and likely will be expanded to include more medical professions starting at the end of 2020.