Rural Health Workforce Trends: A National Perspective Pamela Smith, MA SORH June 24, 2008.
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Transcript of Rural Health Workforce Trends: A National Perspective Pamela Smith, MA SORH June 24, 2008.
Rural Health Workforce Rural Health Workforce Trends: A National Trends: A National
PerspectivePerspective
Pamela Smith, MA SORHPamela Smith, MA SORH
June 24, 2008June 24, 2008
A Rural Health Workforce A Rural Health Workforce Partnership Partnership
Presentation OverviewPresentation Overview
Rural Health Workforce SummitRural Health Workforce Summit– Recruitment, Retention, Collaboration …Recruitment, Retention, Collaboration …
Model programsModel programs– Key note HighlightsKey note Highlights– Breakout Highlights and Breakout Highlights and
recommendationsrecommendations NOSORH Workforce CommitteeNOSORH Workforce Committee Next StepsNext Steps
Recruitment, Retention, Recruitment, Retention, Collaboration – Program modelsCollaboration – Program models
Oregon - If you recruit without keeping Oregon - If you recruit without keeping your eye on retention, you are going your eye on retention, you are going to fail in the long run.to fail in the long run.
RecruitentionRecruitention
Tim SkinnerTim Skinner
Colorado – CoRRRN, CROP and CPRColorado – CoRRRN, CROP and CPR
Statewide InitiativeStatewide Initiative
Recruitment, Retention, Recruitment, Retention, Collaboration – Program modelsCollaboration – Program models
South Dakota - Healthcare Workforce South Dakota - Healthcare Workforce CenterCenter
South Carolina – South Carolina –
Noon conferences with resident Noon conferences with resident physicians.physicians.
Rural Health Works: Making the Rural Health Works: Making the link to economic impact and link to economic impact and
workforceworkforce
The impact of a medical practice on The impact of a medical practice on a rural community.a rural community.
The economic impact of medical The economic impact of medical school on State’s economyschool on State’s economy
Keynote - Jack Dillenberg, DDSKeynote - Jack Dillenberg, DDS
Dean Arizona School of Dentistry and Oral Dean Arizona School of Dentistry and Oral HealthHealth
The School is unique in it’s commitment to The School is unique in it’s commitment to train dentists who will provide care to train dentists who will provide care to underserved populations who have an underserved populations who have an understanding of the public health understanding of the public health approachapproach
There needs to be a paradigm shift – move There needs to be a paradigm shift – move from primary care to comprehensive care from primary care to comprehensive care to interdisciplinary careto interdisciplinary care
Oral Health: Challenges,Oral Health: Challenges,
Gaps Gaps
- Less dentists per capita than 10 years - Less dentists per capita than 10 years ago.ago.
- Some rural communities cannot support - Some rural communities cannot support a dental practice due to low population.a dental practice due to low population.
- Definitions/scope of practice for dental - Definitions/scope of practice for dental hygienists vary greatly.hygienists vary greatly.
Oral Health: Challenges,Oral Health: Challenges,
ObstaclesObstacles - lack of a rural pipeline for dentists- lack of a rural pipeline for dentists - 3- 3rdrd party payers party payers - Licensing boards- Licensing boards - Facilities/equipment that are - Facilities/equipment that are
inadequateinadequate - Integration of dental and primary care - Integration of dental and primary care
and subsequent issues.and subsequent issues. - All dental graduates are not created - All dental graduates are not created
equallyequally
RecommendationsRecommendations
Federal loan forgiveness increaseFederal loan forgiveness increase Graduate Medical Education money Graduate Medical Education money
and how it relates to dental and how it relates to dental residenciesresidencies
NHSC lower dental professions NHSC lower dental professions shortage area – 18 for scholarsshortage area – 18 for scholars
Incentives to practice in rural areas Incentives to practice in rural areas (loans)(loans)
Health Information TechnologiesHealth Information Technologies
HIT Workforce CrisisHIT Workforce Crisis Health care industry lags all other major Health care industry lags all other major
industries in IT adoption even with industries in IT adoption even with advances.advances.
Need for HIT management is increasing.Need for HIT management is increasing. Health care facilities are struggling to staff Health care facilities are struggling to staff
HIT needs and also turnover.HIT needs and also turnover. Lack of interoperability because systems Lack of interoperability because systems
are different.are different.
Recommendations Recommendations Loan repayment program – recruitment and Loan repayment program – recruitment and
retention incentivesretention incentives Job CorpJob Corp Signing bonusSigning bonus State of the art technologyState of the art technology Pay for standardization of skill set/”degree”Pay for standardization of skill set/”degree” Support for distance educationSupport for distance education Technical assistance for HITTechnical assistance for HIT Catalog of modelsCatalog of models Grants for HIT network developmentGrants for HIT network development
EMS:A unique approach to EMS:A unique approach to addressing rural health needsaddressing rural health needs
GapsGaps
- Turn over Money not there move on to - Turn over Money not there move on to RN or go to urban communities for bigger RN or go to urban communities for bigger salariessalaries
- Paying for credentialing- Paying for credentialing ObstaclesObstacles
- Lack of hospital support- Lack of hospital support
- Equipment - get hand me downs- Equipment - get hand me downs
- Liability insurance- Liability insurance
RecommendationsRecommendations
Need for distance learning Need for distance learning opportunities for EMTs and opportunities for EMTs and Paramedics due to limited training Paramedics due to limited training facilities.facilities.
EMS is a local public service and EMS is a local public service and needs to be supported and fundedneeds to be supported and funded
Behavioral Health Workforce Behavioral Health Workforce TrendsTrends
GapsGaps
- Licensure lists don’t reflect who can - Licensure lists don’t reflect who can practice and provide mental health carepractice and provide mental health care
- Impact of returning vets, supply of mental - Impact of returning vets, supply of mental health providers employed by the VAhealth providers employed by the VA
ObstaclesObstacles
- Lack of rural training- Lack of rural training
- Lack of funding- Lack of funding
- Territorialism of existing providers- Territorialism of existing providers
Policy issues that impede Policy issues that impede workforce developmentworkforce development
Policies need to reflect reality. Policies Policies need to reflect reality. Policies that allow mid levels, telemedicine, loan that allow mid levels, telemedicine, loan repayment policies etc. that allow repayment policies etc. that allow providers to be reimbursed for offering providers to be reimbursed for offering rural care.rural care.
RecommendationsRecommendations
Policies need to be changed to reflect rural Policies need to be changed to reflect rural realitiesrealities
Allied Health: Training the Health Allied Health: Training the Health WorkforceWorkforce
GapsGaps- Allied Health to big and becomes a catch Allied Health to big and becomes a catch
allall- Lack of dataLack of data
ObstaclesObstacles- Few distance learning opportunitiesFew distance learning opportunities- Salaries are too lowSalaries are too low- Lack of structured education for some of Lack of structured education for some of
these professionsthese professions
RecommendationsRecommendations
Identify models of articulation agreements Identify models of articulation agreements that could be replicated for allied health that could be replicated for allied health professions.professions.
More k-12 programs for allied health More k-12 programs for allied health professionals utilizing AHECs with a rural professionals utilizing AHECs with a rural focus.focus.
Cross credentialing of health care Cross credentialing of health care specialist (WA) proposed legislation. specialist (WA) proposed legislation.
Improve dissemination of working models Improve dissemination of working models and best practicesand best practices
NOSORH Workforce CommitteeNOSORH Workforce Committee
Purpose Purpose
To develop SORH expertise and To develop SORH expertise and understanding of workforce issues in order understanding of workforce issues in order to provide the State Office of Rural Health to provide the State Office of Rural Health perspective on workforce policy issues and perspective on workforce policy issues and serve as a link between State Offices of serve as a link between State Offices of Rural Health, national partner Rural Health, national partner organizations, the Federal Office of Rural organizations, the Federal Office of Rural Health Policy and other federal agencies.Health Policy and other federal agencies.
Actions/Next StepsActions/Next Steps
Survey of SORHs for workforce Survey of SORHs for workforce activitiesactivities
Provided input for Workforce SummitProvided input for Workforce Summit Creating a model for cross-Creating a model for cross-
credentialing of Allied Health credentialing of Allied Health ProfessionalProfessional
Survey of SORHs about knowledge of Survey of SORHs about knowledge of Allied Health programs in state.Allied Health programs in state.
Allied Health WorkforceAllied Health Workforce What professions would you include under Allied What professions would you include under Allied
Health?Health? Is Allied Health work part of your SORH work?Is Allied Health work part of your SORH work? What type of work does that include?What type of work does that include? Do you work with the Community Colleges on any Do you work with the Community Colleges on any
workforce development?workforce development? Does the SORH have a role in developing allied Does the SORH have a role in developing allied
health workforce?health workforce? Where does it fall on your list of priorities?Where does it fall on your list of priorities? What health workforce issue ranks higher?What health workforce issue ranks higher? What should be the focus of the Workforce What should be the focus of the Workforce
Committee?Committee?
Contact InformationContact Information
Pamela E. Smith, Program Pamela E. Smith, Program Coordinator, MASS Department of Coordinator, MASS Department of Public Health, State Office of Rural Public Health, State Office of Rural HealthHealth
23 Service Center23 Service Center
Northampton, MA. 01060Northampton, MA. 01060
(413) 586- 7525(413) 586- 7525 [email protected]@state.ma.us