New England Rural Health Roundtable

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New England Rural Health Roundtable

• Regional Healthcare Workforce Collaboration
  Meeting
• July 22nd Portsmouth, NH
• Presenters
• Marion Pawlek, RHRT Executive Director
• Craig Stevens, Project Staff

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Goals for this Session

• Review Vision and Mission for project
• Orient to process for identifying priority topic
  areas
• Review thematic topic areas
• Develop and prioritize goal statements
• Set direction for afternoon strategic planning

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Regional Workforce Collaboration

• State Office of Rural Health
• National Organization of State Offices of Rural
  Health

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Vision

• Rural New England has an adequate supply and
  distribution of healthcare workforce.

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Project Mission

• Identify strategies which improve the healthcare
  workforce development, recruitment and retention
  capacity of New England stakeholders through
  regional projects, partnerships and
  collaborations.

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Priority Setting Process
Research
Survey
Draft Priority Activities
Advisory Group
Interviews
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Advisory Group Membership

• Denis Barton
• Barbara Berger
• Susan Carll
• Liz Cote
• Charles Dwyer
• Carla Lundquist
• Tammy Mackenzie
• Cathleen Mcelligott

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Other Participants

• Approximately 60 individuals provided input
  either through a survey or interview. These
  individuals represented

• Academic Institutions
• Area Health Education Center Program
• Community Health Centers
• Dental Society
• Department of Labor
• Emergency Medical Services
• Home Health
• Hospital Association
• Local Public Health Offices
• Medical Society

• Nurse Practitioner Association
• Nursing Homes
• Physician Assistant Association
• Primary Care Associations
• Primary Care Offices
• Rural Health Offices
• State Oral Health, Mental Health
• Workforce Development Organization

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Priority Setting Process
Research
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Research

• Review of existing healthcare workforce planning
  materials from New England states as well as
  comparable states (OR, MI, etc)
• Define the potential parameters of priority
  activities

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Priority Setting Process
Research
Survey
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Surveys

• From research, develop and disseminate surveys to
  capture information on state activities as well
  as perceived priorities.
• Develop state healthcare workforce development,
  recruitment and retention profiles.

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Priority Setting Process
Research
Survey
Interviews
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Interviews

• Discuss survey results with regional
  stakeholders.
• Discuss opportunities for state healthcare
  workforce activities.
• Identify priorities for regional collaboration.

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Priority Setting Process
Research
Survey
Advisory Group
Interviews
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Advisory Group

• Approved data collection instruments.
• Identified key state stakeholders for survey and
  interviews.
• Review preliminary findings.
• Shape strategic planning for July 22nd meeting.
• Recruit meeting participants.

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Priority Setting Process
Research
Survey
Draft Priority Activities
Advisory Group
Interviews
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Findings State Similarities and Differences

• Pipeline k-12
• Many similar activites enrichment, camps,
  awareness, shadowing
• AHECs major partner in healthcare workforce
  development in k-12
• Varying levels of capacity across states

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Findings State Similarities and Differences

• Pipeline Higher Ed and Training
• Capacity faculty, schools
• New England Dental Schools
• Nursing faculty
• Distance education for nursing students
• Electronic registries to manage inter and
  intrastate clinical placements
• Specialized rural health scholars programs
• Assisting front line, low wage staff with GED,
  literacy and moving up the career ladder
• New England Clinicians Forum to identify
  excellence among existing clinical providers in
  region working within public health setting
• Health careers investigation course

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Findings State Similarities and Differences

• Recruitment
• Recruitment centers
• Scholarships and loan forgiveness
• Tapping foreign trained professionals living in
  US combining with literacy programs
• Tapping older workers/second career workers
• Marketing to minority or underrepresented
  populations

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Findings State Similarities and Differences

• Retention
• Magnet hospitals
• Management training
• Culture change
• Loan repayment
• Retraining older workers

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Findings State Similarities and Differences

• Other
• Appropriations language for loan
  repayment/forgiveness
• Unfunded legislation (MA)
• Forming new professional associations
• Tax incentives/tax credits
• Regional Nursing Compact
• Varying levels of industry vs govt driven
  resources and programs
• Linking healthcare workforce development and
  economic development
• Varying levels of data and reports
• Model legislation for telehealth payment
• Change in scope of practice PA and NP,
  independent practice of Dental Hygienists

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Thematic Activities

• Review survey results
• Review interview responses
• Identify thematic areas
• Clarify, adjust with Advisory Cmte
• Integrate into strategic planning process

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Pipeline

• Improve guidance counselors understanding of
  highschool classes and the necessary preparation
  for health careers
• Develop post high school, preparatory classes
• Develop post career ladders (entry level CNA)
• Develop regional dental school or develop/improve
  reciprocal agreements
• Expand rural residency programs, across state
  placements
• Increase faculty capacity
• Promote collaboration among hospitals and
  universities to develop joint appointment of
  staff/faculty
• Regional marketing for students to enter health
  careers

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Recruitment and Retention

• Improve cross state licensing and credentialing
• Promote culture change to improve workplace
  environment
• Improve reimbursement
• Develop shared training opportunities
• Engage in group purchasing with headhunter firms
• Develop regional marketing for health
  professionals to come to New England
• Explore job redesign to keep older staff
  (nursing)
• Engage hospitals to support recruitment for rural
  practices
• Promote successful models such as recruitable
  communities
• Maintaining Federal designations for J-1,NHSC etc

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Coordination

• Assist with state coordination of workforce
  activities
• Assist with regional coordination of workforce
  activities governors, New England Board of
  Higher Education, regional medical society
  meetings, AHECs, PCOs etc
• Develop regional website, locus of information
  regarding New England development, recruitment
  and retention activities including best
  practices.
• US Dept of Labor WIRED initiatives want to fund
  multistate activities, develop cross state
  proposals

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Data

• Development of regional reports (comparison of
  workforce data, resources across regions)
• Development of communication tools regarding
  healthcare workforce, promoting models like Rural
  Health Works to help states communicate issue and
  related data
• Understand demand and production

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Scope of Practice

• Hold forums regarding the design of health care
  professions and service delivery to recommend
  changes in scopes of practice
• Models for use of PAs and NPs

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Strategic Planning Phase I Identifying Priority
Goals

• Self select groups
• Within each group
• Environmental scan/SWOT analysis
• Develop goal statement(s)
• A facilitator is assigned to each group who will
  also be responsible for scribing
• Report out to full group defend your topic area
• Full group votes to identify priority areas for
  the afternoon

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Strategic Planning Phase II Developing Strategic
Action Plans

• During lunch report what groups remain
• Convene with facilitator, each will receive
  guidance in terms of how to develop action plans
  90 minutes to develop
• After session, report to larger group
• Discussion
• Prioritize goals
• Review next steps