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Rural Health Workforce Trends: A National Perspective

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Title: Rural Health Workforce Trends: A National Perspective


1
Rural Health Workforce Trends A National
Perspective
  • Pamela Smith, MA SORH
  • June 24, 2008

2
A Rural Health Workforce Partnership
3
Presentation Overview
  • Rural Health Workforce Summit
  • Recruitment, Retention, Collaboration Model
    programs
  • Key note Highlights
  • Breakout Highlights and recommendations
  • NOSORH Workforce Committee
  • Next Steps

4
Recruitment, Retention, Collaboration Program
models
  • Oregon - If you recruit without keeping your eye
    on retention, you are going to fail in the long
    run.
  • Recruitention
  • Tim Skinner
  • Colorado CoRRRN, CROP and CPR
  • Statewide Initiative

5
Recruitment, Retention, Collaboration Program
models
  • South Dakota - Healthcare Workforce Center
  • South Carolina
  • Noon conferences with resident physicians.

6
Rural Health Works Making the link to economic
impact and workforce
  • The impact of a medical practice on a rural
    community.
  • The economic impact of medical school on States
    economy

7
Keynote - Jack Dillenberg, DDS
  • Dean Arizona School of Dentistry and Oral Health
  • The School is unique in its commitment to train
    dentists who will provide care to underserved
    populations who have an understanding of the
    public health approach
  • There needs to be a paradigm shift move from
    primary care to comprehensive care to
    interdisciplinary care

8
Oral Health Challenges,
  • Gaps
  • - Less dentists per capita than 10 years ago.
  • - Some rural communities cannot support a
    dental practice due to low population.
  • - Definitions/scope of practice for dental
    hygienists vary greatly.

9
Oral Health Challenges,
  • Obstacles
  • - lack of a rural pipeline for dentists
  • - 3rd party payers
  • - Licensing boards
  • - Facilities/equipment that are inadequate
  • - Integration of dental and primary care and
    subsequent issues.
  • - All dental graduates are not created equally

10
Recommendations
  • Federal loan forgiveness increase
  • Graduate Medical Education money and how it
    relates to dental residencies
  • NHSC lower dental professions shortage area 18
    for scholars
  • Incentives to practice in rural areas (loans)

11
Health Information Technologies
  • HIT Workforce Crisis
  • Health care industry lags all other major
    industries in IT adoption even with advances.
  • Need for HIT management is increasing.
  • Health care facilities are struggling to staff
    HIT needs and also turnover.
  • Lack of interoperability because systems are
    different.

12
Recommendations
  • Loan repayment program recruitment and
    retention incentives
  • Job Corp
  • Signing bonus
  • State of the art technology
  • Pay for standardization of skill set/degree
  • Support for distance education
  • Technical assistance for HIT
  • Catalog of models
  • Grants for HIT network development

13
EMSA unique approach to addressing rural health
needs
  • Gaps
  • - Turn over Money not there move on to RN or
    go to urban communities for bigger salaries
  • - Paying for credentialing
  • Obstacles
  • - Lack of hospital support
  • - Equipment - get hand me downs
  • - Liability insurance

14
Recommendations
  • Need for distance learning opportunities for EMTs
    and Paramedics due to limited training
    facilities.
  • EMS is a local public service and needs to be
    supported and funded

15
Behavioral Health Workforce Trends
  • Gaps
  • - Licensure lists dont reflect who can practice
    and provide mental health care
  • - Impact of returning vets, supply of mental
    health providers employed by the VA
  • Obstacles
  • - Lack of rural training
  • - Lack of funding
  • - Territorialism of existing providers

16
Policy issues that impede workforce development
  • Policies need to reflect reality. Policies that
    allow mid levels, telemedicine, loan repayment
    policies etc. that allow providers to be
    reimbursed for offering rural care.
  • Recommendations
  • Policies need to be changed to reflect rural
    realities

17
Allied Health Training the Health Workforce
  • Gaps
  • Allied Health to big and becomes a catch all
  • Lack of data
  • Obstacles
  • Few distance learning opportunities
  • Salaries are too low
  • Lack of structured education for some of these
    professions

18
Recommendations
  • Identify models of articulation agreements that
    could be replicated for allied health
    professions.
  • More k-12 programs for allied health
    professionals utilizing AHECs with a rural focus.
  • Cross credentialing of health care specialist
    (WA) proposed legislation.
  • Improve dissemination of working models and best
    practices

19
NOSORH Workforce Committee
  • Purpose
  • To develop SORH expertise and understanding of
    workforce issues in order to provide the State
    Office of Rural Health perspective on workforce
    policy issues and serve as a link between State
    Offices of Rural Health, national partner
    organizations, the Federal Office of Rural Health
    Policy and other federal agencies.

20
Actions/Next Steps
  • Survey of SORHs for workforce activities
  • Provided input for Workforce Summit
  • Creating a model for cross-credentialing of
    Allied Health Professional
  • Survey of SORHs about knowledge of Allied Health
    programs in state.

21
Allied Health Workforce
  • What professions would you include under Allied
    Health?
  • Is Allied Health work part of your SORH work?
  • What type of work does that include?
  • Do you work with the Community Colleges on any
    workforce development?
  • Does the SORH have a role in developing allied
    health workforce?
  • Where does it fall on your list of priorities?
  • What health workforce issue ranks higher?
  • What should be the focus of the Workforce
    Committee?

22
Contact Information
  • Pamela E. Smith, Program Coordinator, MASS
    Department of Public Health, State Office of
    Rural Health
  • 23 Service Center
  • Northampton, MA. 01060
  • (413) 586- 7525
  • Pamela.Smith_at_state.ma.us
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