New England Rural Health Roundtable

1. New England Rural Health Roundtable Regional Healthcare Workforce Collaboration Meeting July 22nd Portsmouth, NH Presenters: Marion Pawlek, RHRT Executive Director Craig Stevens, Project Staff

2. 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

3. Regional Workforce Collaboration State Office of Rural Health National Organization of State Offices of Rural Health

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

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

6. Priority Setting Process Research Survey Draft Priority Activities Advisory Group Interviews

7. Advisory Group Membership Denis Barton Barbara Berger Susan Carll Liz Cote Charles Dwyer Carla Lundquist Tammy Mackenzie Cathleen Mcelligott

8. 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 Other Participants Approximately 60 individuals provided input either through a survey or interview. These individuals represented:

9. Priority Setting Process Research

10. 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

11. Priority Setting Process Research Survey

12. 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.

13. Priority Setting Process Research Survey Interviews

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

15. Priority Setting Process Research Survey Advisory Group Interviews

16. 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.

17. Priority Setting Process Research Survey Draft Priority Activities Advisory Group Interviews

22. 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

23. 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

24. 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

25. Findings: State Similarities and Differences • Retention • Magnet hospitals • Management training • Culture change • Loan repayment • Retraining older workers

26. 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

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

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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