Task Force
On Health
Care Workforce
Shortage

Members

Public Input Welcomed

Minutes
Aug. 20, 2002
July 16, 2002
May 30, 2002
April 12, 2002

Reports
Competing for
Quality Care -
Findings and Proposals
for Montana's Health
Care Worforce
- Final Report
(Adobe Acrobat format - 650KB)

MISSION OF THE TASK FORCE:

To accurately assess the shortage of health care workers, and to develop recommendations and strategies to effectively address the issue.

WORKFORCE MEMBERS:

Loren Soft, Chairperson, Billings
Jim Ahrens, Montana Hospitals Association
Sami Butler, Montana Nurses Association
Rose Hughes, Montana Health Care Association
Joyce Scott, Academic and Student Affairs
Sharon Kott, Area Health Education Center
Wendy Keating, Montana Department of Labor
Brian Zins, Montana Medical Association
Mary McCue, Montana Dental Association
Steve Yeakel, Helena, Montana
Representative Edith Clark, House District, 88
Joe McDonald, Salish Kootenai College
Jim McGarvey, Montana State AFL-CIO, MEA-MFT
Mike Hanshew, Montana DPHHS
Bob Bartholomew, Montana AARP
Jani McCall, Consulting with Communities
Desiree Taggart, Office of Economic Development
Jody Messinger, Office of Public Instruction
Patty Ehrhardt, Montana Clinical Laboratory Managers Association
Rita Harding, Billings Area Indian Health Service

STAFF:

Linda Ashworth, Secretary

CALL TO ORDER:

Chairman, Loren Soft, in room 317 of the State Capitol, called the meeting to order at 8:45 a.m.

INTRODUCTIONS:

Attendees: Chairman Loren Soft, Jody Messinger, Sami Butler, Bob Bartholomew, Sharon Kott, Rose Hughes, Jani McCall, Jean Branscum, Steve Yeakel, Patti Ehrhardt, Jim Ahrens, Joyce Scott

Guests: 

Barbara Swehla, Board of Nursing
Cheryl Smith, Board of Chiropractors, Funeral Services and Clinical Laboratory Science Practice
Cynthia Reichenbach, Licensed Addiction Counselors Program
Mary C. Hainlen, Board of Social Work Examiners and Prof. Counselors/Board of Physical Therapists
Helena Lee, Board of Occupational Therapy Prac. Board of Speech Pathologist and Audiologists, Board of Respiratory Care Practitioners, Board of Radiologic Technologists
Sharon McCullogh, Board of Dentistry
Linda Grief, Board of Optometry, Hearing Aid Dis. And Nursing Home Administration
Phil Brooks, Dept. of Labor and Industry, Research Analysis Bureau
Bob Rafferty, Dept. of Labor and Industry, Research and Analysis
Pat Hennessey, Nutrition Resource Project
Lisa Addington, Dept. of Labor and Industry, Bureau Chief
Rep. Bill Thomas, House District 93
Janet M. Thomas, Retired Dental Hygienist
Jeanine Worsech, Board of Medical Examiners
Audrey Conner Rosberg, Montana State University-Billings, College of Technology/Director of Practical Nursing

APPROVAL OF MINUTES:

It was moved and seconded to approve the minutes of the previous meeting, as corrected.

ADDITIONS TO AGENDA:

None

REVIEW OF DRAFT REPORT:

Jean Branscum reminded the members to refer to the written comments from Sally Klein, RN, MBA; Jodi Wardell, Addictive & Mental Disorders Division Chemical Dependency Bureau; and Marge Levine, DPHHS Primary Care Office, as they considered revisions to the document.

Laurie asked that the members look for typos or working changes that would need to be fixed as the members peruse the report.

General Comments from the committee:

• Reprioritize the executive summary stating that the main reason for a health care work force shortage is that people are not entering the profession, not because of an aging population.
• Focus on the size of the document. It may be too lengthy to be of any use.
• The reason people are leaving is because salaries are higher in other states.
• Front and center is economic development. It is important that this issue does not die.
• Concern about the length. In trying to capture a large amount of information it has grown bigger than it can be useful.
• Cut redundancy. Include the term related human services along with the term health care throughout the document.
• Maintain the recommendation for an occupational health specialist even though there is concern with the lack of funding.
• The document needs to be specific in order for the Governor to glean the information quickly.
• Focus on significant general issues
• Acquire more data to back up specific recommendations.
• Look at adding loan forgiveness without it being counted as income
• A certain number of slots in nursing and pharmacy schools should be designated for non-traditional students.
• Need to reprioritize the causes of the work force shortage. Verbiage is good but bullets are understood more quickly.
• Include working conditions as part of the reason people are not going into the health care fields.
• Make sure the report has continuity.
• List the entire proposal on one page in the executive summary. Bullet the points of the proposals that should be included in the executive summary.
• The executive summary should be the heart of the report and listing the 15 bullet points will not take that much-added space.
• Be specific. Clearly define the items and make sure each item includes who is going to do this.

The committee members agree that Laurie Ekanger would make the changes to the document during discussion and her document would reflect the changes. The committee discussed each of the 5 issues included in the draft and the proposals under each issue. (The following is taken from the draft report, compiled by Laurie Ekanger after the meeting)

Issues and Proposals:

Five major issues were addressed by the Task Force and are listed below with the specific proposals for each issue. The Report also includes a number of specific action steps for accomplishing each proposal.

ISSUE 1: MONTANA’S HEALTH CARE CLIMATE

• Proposal 1: Lawmakers should establish in Montana statutes a statement of policy/philosophy for health care in Montana.
• Proposal 2: Health care professionals and policy makers should work to reduce demand for health care service by promoting healthy behaviors and illness/accident prevention.
• Proposal 3: The Governor should direct the Departments of Health & Human Services and Labor & Industry, in consultation with the Higher Education and professional associations, to educate the general public, potential workforce candidates and policy makers about the need for healthcare workers, the diverse opportunities available in the health care field, and the value and importance of health care workers to the Montana economy and citizens.

ISSUE 2: EDUCATIONAL OPPORTUNITIES

• Proposal 4: The education community should introduce health care occupations and integrate the skills necessary to attain them in K – 12 curricula.
• Proposal 5: The Commissioner of Higher Education should establish an integrated, “single point of contact” Distance Learning and Continuing Education Program for health professionals.
• Proposal 6: Policy makers should sustain Health Professions Training Programs Through Adequate Funding.
• Proposal 7: The Governor, through the Office of Economic Development and in accordance with SB469, should ensure that Montana’s existing state and federally funded career development and employment training programs place a high priority on training, preparing and supporting workers for potential careers in health care and human services.

ISSUE 3. THE HEALTH CARE WORK ENVIRONMENT

• Proposal 8: The Task Force encourages Montana health care employers to improve the workplace partnership by creating a culture in which health care staff – including clinical, support, and managerial staff – are valued, have a sustained voice in shaping institutional policies, and receive appropriate rewards and recognition for their efforts.
• Proposal 9: The Governor should direct the Departments of Public Health & Human Services and Labor & Industry to identify and take action to reduce those regulations which are excessive, overly complex, and duplicative.

ISSUE 4: REIMBURSEMENT & COMPENSATION

• Proposal 10: Policy makers should ensure that public health and health related human service funding sources pay the full cost of providing services, including the cost of staffing and training and of adequate wages and benefits paid to the workers providing the care.
• Proposal 11: The Governor should ensure that Montana pursues, and when possible takes advantage of, all public and private sources of additional funding or resources to help attract, train and retain health care and human services workers.

ISSUE 5: HEALTH CARE WORKFORCE DATA COLLECTION AND ANALYSIS

• Proposal 12: To enable government, employers, trainers and educators to plan for workforce supply and demand, the Governor should direct the Department of Labor and Industry should work with its federal counterparts to provide reliable, timely, consistent information that is regularly evaluated and updated.
• Proposal 13: The Governor should direct the Department of Labor and Industry should take the lead as a high priority to improve the condition of data resources across the professions in view of the interest in workforce and economic development issues.
• Proposal 14: The Office of the Commissioner of Higher Education (OCHE), in collaboration with health care program providers, should assess and report on the program capacity of Montana’s higher education system to meet health care workforce needs.

The Task Force strongly believes that, if enacted, these proposals will contribute significantly to alleviating the current shortage of skilled health care workers, to improving Montana’s health care economy, and to averting a dangerous future for quality care for Montana citizens.

HEALTH OCCUPATIONS SPECIALIST UPDATE:

Jody Messinger introduced Representative Bill Thomas, Janet Thomas, Sheri Mahard, and CEO of St. Peter’s Hospital John Solheim. They were members of a group that accompanied Jody to the HOSA convention in Anaheim, California. All felt it was a worthwhile experience and exhorted praise for the program and encouraged the committee to maintain its support for a Health Occupations Specialist within the Office of Public Instruction.

Senator Bill Thomas reminded the committee that the 2001 Legislative Session had funded a dental hygienist program and asked the committee to continue its support of that program.

Jim Ahrens inquired into the proposed cost of the Health Care Curriculum Specialist. Jody Messinger reported that a tremendous amount could be done for $100,000 the first year. She stated her desire that the program be extended for a five-year period. She felt the position would sustain itself over time. She said that she has been investigating different options of funding the position. John Solheim thought the health industry could provide funds. Other suggested funding options included using tobacco fund trust interest monies and receiving federal matching funds.

Representative Bill Thomas reported on relating this to rural Montana. He cited the example of South Dakota partnering with South Miami University allowing easier accessibility to advanced courses. The committee recommended mentioning the information from South Dakota in the final report.

PUBLIC INPUT

Bob Rafferty, Workforce Services Division, Montana Department of Labor and Industry, clarified several points on the document regarding data. He informed the committee that periodic updates regarding the efforts of the department to prepare Montanans for careers in health care is currently provided on 300 sites. Bob also commended the committee for its suggestions to set a regular cycle for administration of surveys to update workforce information in the various health care fields.

Phil Brooks, Chief of the Research and Analysis Bureau, Workforce Services Division, Montana Department of Labor and Industry, made suggested updates to various data throughout the report. Phil said he would provide Laurie with any pertinent updates available to his office.

Lisa Addison, Bureau Chief for the Health Licensing Bureau of the Department of Labor and Industry commended the committee on its work. She delivered general information on the health care licensing bureau and offered the bureau’s help in observing and collecting data. She stated her willingness to work with Bob Rafferty and Phil Brooks.

Lisa also reported that the Department hopes to bring forth legislation in 2003 that would remove barriers that add to the hassle of licensing. The Board of Dentistry is hoping to set up a board of licensing for retired or volunteer dentists by the 2003 legislature. She maintained the statutes needed to be reviewed but funding was a concern.

Barb Swehla, Executive Director of the Montana State Board of Nursing, reported on on-line renewal, voicing her hope for 40% - 50% rate of adoption for the current year. Ms. Swehla presented written testimony regarding the Montana Board of Nurse’s undertaking to clarify issues about its legislative and rule-making authority related to approving nursing education programs.

Audrey ConnorRosberg, PhD in clinical Psychology, reported from the perspective of a nurse educator as well as a consumer. She felt there was a need for more balance within the report. She felt the report lined out the negatives, leaving the reader with a feeling of hopelessness and helplessness, which could influence a negative response to the solutions the committee would be seeking. She maintained that money would not solve all the problems and the report should focus on the positive reasons for being in Montana as well as the opportunities that are afforded those that choose to work in Montana.

Sami Butler asked to talk to her at another time concerning specifics that could be included in the report.

GENERAL DISCUSSION ON REPORT AND COMMENTS:

Loran Soft thanked the audience members for their input.

Jean Branscum reminded the committee that additional public comment would be due by August 1^st. The small working group would meet after that date in order to review the public comments and any outstanding work done by committee members to determine what should be included in the final report. The decisions of the small group will be passed on to Laurie who will make the needed changes to the report.

All Task Force members will be sent a final report during the week of August 12^th for review prior to the August 20^th meeting.

Laurie stated she still needed recommended action, page 20, Proposal #2 from Jean Branscum and Steve Yeakel. Also, she was waiting on recommended action, page 25, Proposal #6 from Joyce Scott.

There being no further business the meeting was adjourned at 4:00. The next meeting of the Task Force is scheduled for August 20^th, 9:00 a. m. - noon in the Wilderness Room at the Colonial Building.