Best Practices for Addressing Health Professional Shortages in Rural Communities

The Colorado TrustNancy Csuti and Laurel Petralia

Evaluation consultants Kaia Gallagher, Kim Riley

Health Professions InitiativeBuilding Colorado’s future health professions workforce

BEST PRACTICES FOR ADDRESSING HEALTH PROFESSIONAL SHORTAGES IN RURAL

COMMUNITIES

• OVERVIEW OF THE HEALTH PROFESSIONS INITIATIVE– What types of programs are being funded?– What types of students are being supported?

• EMERGING LESSONS RE BEST PRACTICES FOR ADDRESSING HEALTH PROFESSIONAL SHORTAGES– “Grow-your-Own”– Rural Immersion Training

THE COLORADO TRUSTHEALTH PROFESSIONS INITIATIVE

• Three year: (2005-2008), $10.2 million initiative

• Funding to increase the number of physicians, dentists, pharmacists, nurses and allied health professionals

• 21 grantee organizations: hospitals, universities, community colleges and community health centers

The Colorado Trust

Colorado Rural Health Center (CRHC)

Center for Research Strategies(CRS)

Colorado Health Institute(CHI)

Area Health Education Centers(AHEC)

21 Grantee Organizations

Health Professions Initiative Partnership

HOW DO THE TCT-HPI GRANTEES DIFFER FROM ONE ANOTHER?

• Train different types of health professionals

• Work at different points along a training continuum

• Represent different types of organizations and training institutions

COMMUNITY

Students

Training

Jobs

Crop of Healthcare Providers

COMMUNITY

Pre Career

Students

Training

Jobs

Allied Health Nursing Advanced

HPI Grantees with a Rural Focus by Professional Training Category

Pre-Career 2

Emergency Worker 3

Allied Health 9

Nursing 14

Mid-Level Provider 1

Psycho-Social Provider 2

Doctorate 4

HOW ARE THE HPI GRANTEES DEVELOPING A TRAINING INFRASTRUCTURE?

Direct Training 61%

Expanded Training to New Students

57%

Developing New Curriculum 30%

Offering Scholarships or Support

22%

Developing New Training Sites

22%

HOW WILL THE HPI IMPACT HEALTH PROFESSIONAL RECRUITMENT/RETENTION IN RURAL AREAS?

HPI GRANTEES ARE WORKING TO:• Increase the geographic accessibility of training programs in

rural/underserved areas

• Increase the financial accessibility of training to rural/underserved residents

• Meet the unique needs of non-traditional students

• Prepare students to work in rural/underserved settings

WHO ARE THE HPI STUDENTS?

Average Age 33

Percent Women 82%

Percent From a Rural Area 53%

Percent Who Want to Work in a Rural Area

38%

Percent in Nursing Training 33%

Percent in Allied Health Training

49%

GROW-YOUR-OWN STRATEGIES

• Begin with recruiting students into the health professions

• Develop and strengthen training capacity in rural settings

• Incorporate financial and other types of support for health professional students

• Focus on training students for a unique role in rural settings

PREPARING STUDENTS FOR A UNIQUE ROLE AS RURAL PROVIDERS

Health professionals in rural/ underserved communities are:

-- Likely to serve in a generalist role

-- Likely to have less support from other health professionals

-- Benefit from training opportunities that anticipate these types of roles

PROVIDING SUPPORT TO HEALTH PROFESSIONAL STUDENTS

• Most HPI students are “older”

• Many are seeking to advance their training (e.g., through career-lattice programs)

• Many are supporting families and need flexible training opportunities

• Many are returning to school and need academic support

IMPLICATIONS FOR COMMUNITY-BASED RURAL RECRUITMENT AND RETENTION

(R/R) STRATEGIES• R/R strategies need to encompass a long range perspective

starting with the recruitment of students into health careers.

• Communities should partner and support rurally based training programs.

• “Grow-your-own” students will be more successful when programs offer varied types of support, financial, academic and social.

• Students anticipating a rural career should be offered training opportunities to prepare them to work within rural settings.

CONTACT INFORMATION

Kaia Gallagher, Ph.D., PresidentCenter for Research Strategies225 East 16th Avenue, #1150Denver, Colorado 80203(303) 860-1705kaia.gallagher@crsllc.org

Laurel Petralia, MS Program OfficerThe Colorado Trust1600 Sherman StreetDenver, Colorado 80203(303) 837-1200laurel@coloradotrust.org