Affordable Care Act State Health Care Workforce Development Planning

1. Affordable Care Act State Health Care Workforce Development Planning Meeting the Demand for Primary care Services in Colorado’s Rural and Underserved Communities

2. Background • State Health Care Workforce Development Grants authorized under Section 5102 of the Affordable Care Act (P.L. 111-148) • Colorado is one of 25 states that received funding to planand implement activities leading to health care workforce development strategies at the State and local levels • Goal is a 10-25% increase in the primary care health workforce over a 10 year period

3. Background Primary Care means the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing asustained partnership with patients and practicing in the context of family and community. -Institutes of Medicine, 1996

4. Background • Family Medicine incl. Pediatrics (MD, DO) • Nursing (CNA, LPN, RN, CNM, Advanced Practice Nursing incl. Family Nursing Practitioners) • Physician’s Assistants • Physical Therapists • Dentists • Dental Hygienists • Clinical Pharmacists • Mental Health incl. Psychologists and Psychiatrists • Social Workers • Counselors (Addiction, Marriage and Family Therapy,

5. Methods-Stakeholders • Eligible State Partnership-required incl. State Workforce Development Board, Colorado Community Health Network, CDLE, AHEC, CDE, CDHE • Colorado Health Professions Workforce Policy Collaborative • Additional stakeholders identified and recommended by key informants

6. Methods-Inform and Inventory • Start date of January 3, 2011 (6-month planning project) • Engage stakeholders via the Colorado Health Professions Workforce Policy Collaborative • Organize workgroups around core planning themes (educational practices, recruitment and retention, labor trends, current and projected needs, policy) • Sixty stakeholder interviews (16 semi-structured survey interviews, 44 face-to-face interviews)

7. Result • Comprehensive primary care workforce planning document for Colorado • Foundation for future and ongoing primary care workforce development in Colorado • Sustainable, collaborative and coordinated structure through which future primary care workforce initiatives can develop, delivered and evolve • Colorado already has existing capacity and expertise to effect meaningful change to primary care workforce capacity

8. Plan in Brief-Data Collection and Needs Assessment • Priority Focus- empower primary care delivery in rural and underserved communities through educated, trained and retained primary care workforce • Priority Activities- data collection and needs assessment • Current and accurate count of the primary care workforce incl. location, services provides, time spent at each practice location per week, payer-mix • Combine existing quantitative measures with qualitative data regarding existing needs for primary care services in rural and underserved communities • Mechanisms for continual data collection

9. Plan in Brief-Educational Practices • Enhance collaboration and coordination across all aspects of the state’s health education and career pipeline from K-12 to secondary education and clinical placement and residency • Comprehensive and sustained outcome evaluation of total programs impact on state’s primary care workforce • Current and updated inventory of ALL health education and career pipeline activities in operation

10. Plan in Brief-Educational Practices • Incorporate of the evidence-base into programs design and delivery. • Balance to program’s target populations, primary care professions. • Tracking and social networking. • Hub/“portal” resource to existing web-based applications and pipeline resources (academic institutions, aptitude and career resources, college planning, etc). • Academic advising and guidance

11. Plan in Brief-Recruitment and Retention • K-12 health sciences enrichment and primary care professions exposure • Post-secondary education, occupational and primary care professions preparation and recruitment to rural and underserved practice • Clinical placement and residency • Loan forgiveness • Community and economic development

12. Policy Themes • Data collection • Reimbursement • Funding for health professions education programs • Clinical placement and residency • Scopes of practice and collaborative models of care

13. Primary Recommendation

14. First Iteration • Access the plan in its current form at: http://www.cdphe.state.co.us/pp/primarycare/planning/shcwdp.pdf

15. Next Steps • Plan will be revised and adjustments made as comments are received, through June 23rd. • Plan will be submitted to the Colorado Health Professions Workforce Policy Collaborative on June 24th for consensus vote. • Plan will be edited and prepared for formal public release and submission to HRSA (second iteration) • Begin state and nationwide funding search. • Begin foundational actions-assemble implementation leadership.

16. Contact Katie Koivisto, MSWWorkforce PlannerPrimary Care OfficeColorado Department of Public Health and Environment4300 Cherry Creek Drive SouthDenver, CO 80246desk: 303-691-4907fax: 303-782-5576katie.koivisto@state.co.us Rich Marquez, MPHWorkforce PlannerPrimary Care OfficeColorado Department of Public Health and Environment4300 Cherry Creek Drive SouthDenver, CO 80246desk: 303-691-4916fax: 303-782-5576richard.marquez@state.co.us