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Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

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Page 1: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Healthcare Workforce Issues in Montana

Cindra K. Stahl, MS, MBAMontana Office of Rural Health/ Area Health Education Center

Page 2: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Presentation overview

• Brief overview of Montana’s healthcare workforce• Oral health workforce in Montana• How do we assure a well-trained

healthcare workforce to meet the needs of all regions of the state?

Page 3: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Healthcare Workforce in MT• Healthcare sector is a robust component of

Montana’s economy, and represents roughly 15% of total workforce.• Continued to add jobs through the recession and

recovery (over 8,000 jobs added since 2007).• Offers above average salaries and safe, stable

work environment.• Projected to add about 2,100 jobs per year

through 2021 with a need for new workers (increasing demand) as well as replacements (aging/ retirement).

Page 4: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Department of Labor and Industry

• Two categories of workers that provide healthcare services:• Healthcare Practitioners and Technical occupations• Healthcare Support Occupations• Most jobs require post-secondary training (ties to

MT HealthCARE grant)• Non-health care occupations working within the health

care industry (45% of healthcare workers):• Accountants, HR specialists, billing

Page 5: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Community Benefits• Typical Critical Access Hospital• Employs 141 employees, generates $6.8 million in wages, salaries

and benefits • Generates a total annual impact of 248 jobs and $10.3 million in

wages, salaries and benefits from operations and construction(National Center for Rural Health Works)

• One practicing physician (in Montana)• Supports 9.8 jobs (including his/her own), generates an average

$740,979 per physician in wages and benefits, and generates $51,887 per physician in local and state taxes

• All Montana practicing physicians (2140 total)• Support 20,988 jobs, $1.6 billion total wages and benefits, and $111

million total local and state tax revenue(The Economic Impact of Physicians in Montana, IMS Health Report, March 2014)

Page 6: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Do we have enough supply? Concerns….

• Aging workforce across all professions, retirement• Increased demand• Affordable Care Act• Aging population utilizes increased healthcare

• Maldistribution of professionals• Frontier/rural areas are challenged to recruit

and retain their healthcare workforce

Page 7: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Oral Health professionals around the state• Maldistribution: • 14 counties with no active dentist licensees• 80 % dentists in just nine counties. Those nine counties compose 60% of

population• Health Professions Shortage Areas (Dental HPSAs are based on a dentist to population

ratio of 1:5,000).

• 10 counties are not considered HPSAs• Community Health Needs Assessments (MT Office of Rural Health)

• 23% of CAH implementation plans prioritized a need for local dental services. From survey responses: 45.7% adults say they have seen a dentists within the past three years (Reason? cost, distance to provider, no insurance)

• Education:• No dental education options in-state, few supported options out-of-state

(WICHE and U of MN)• Dental Hygiene through Great Falls College, accept 16 students into new class

each year

Page 8: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Other Considerations…• Lack consistent and reliable data about the healthcare

workforce.• Practice models are changing—moving away from sole

practitioner toward corporate, multi-office, employee dentists.• Dental students have greater debt.• Utilization trends—Children are increasing their dental visits

but adults are decreasing (why?).• Several new dental schools have been built in the last five

years—where do these students practice?• National Health Service Corps—Pay off debt, then enter sole

practice.

Page 9: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

How do we supply healthcare professionals, especially in Rural and Frontier communities?

Grow our own—with support from regional Area Health Education Centers around the state.

Page 10: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Area Health Education Centers

• The AHEC (Area Health Education Centers) program was developed by Congress in 1971 to recruit, train and retain a health professions workforce committed to underserved populations.• Montana regional AHECs were implemented in

2007 with four planned centers. The North East regional center was just added in September.

Page 11: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

AHEC regions

Page 12: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

AHEC overview• The purpose of the Montana AHEC is to expand and retain the

number of health professionals, particularly those in primary care, who are practicing in rural and underserved areas of Montana.

• The Montana AHEC: • supports medical, nursing, and allied health students; • provides education and outreach to K-12 students in rural and

underserved areas; • coordinates workforce development with the State Workforce

Investment Board and its one-stop centers; • and provides continuing education and training to health

professions throughout rural and underserved Montana.

Page 13: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Dental/Oral Health Example,Pipeline program s

• Through grant funding from DPHHS (Improving Oral Health in Montana), AHECs are sponsoring an Oral Health Careers presentation designed for high school students. The goal is to increase student awareness and interest in oral healthcare professions.• Since September, presentations have been given

at 11 high schools for 579 students (including Noxon, Augusta, Cut Bank and Fort Benton).

Page 14: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Pipeline activities continued• AHEC sponsored REACH (Research and Explore Awesome

Careers in Health) camps: a one-day program, taking place at the local healthcare facility that provides high school students the opportunity to explore the healthcare field through a variety of hands-on stations and activities. Professionals from the sponsoring healthcare facility lead the stations, volunteering their time and talent to mentor students and share their expertise.• Four REACH camps including oral health professions: 69

students (including Red Lodge and Lewistown).

Page 15: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Pipeline activities continued

The MedStart Summer Camp (sponsored by MT AHEC) is a week-long residential summer program for sophomores and juniors. The camp offers:• Hands-On Activities (oral health included)• Job Shadowing (oral health included)• Health Science Symposiums • Financial Aid Information• Recreational-Social Activities• Residential Life Experience• Medical Facility Tours• Career Personality Screening 

Page 16: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Additional Activities• Career Fairs• Anaconda—included middle school students (600

students)• Jobs for Montana’s Grads (500 students)

• Pathways to Oral Health Careers—brochure distributed to all high school guidance counselors, also offer general health professions education brochure

• HOSA—Future Health Professionals, 24 chapters in the state

Page 17: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Support for Dental Student Rotations

• 1st and 3rd year students from University of Washington Dental School

• Coordinate placement and housing in rural Montana, and ensure a welcoming and supportive experience in the community.

Page 18: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Oral Health professionals recruitment

• North and South Central AHECs specialize in recruitment of oral health professionals to rural/underserved Montana.

• AHECs participate in 3RNet—specific recruitment tools for rural healthcare professionals.

Page 19: Healthcare Workforce Issues in Montana Cindra K. Stahl, MS, MBA Montana Office of Rural Health/ Area Health Education Center

Thank You…

For additional information: Cindra Stahl

[email protected]