THE HEALTH CARE WORKFORCE SHORTAGE: Facing a crisis

BACKGROUND AND FOCUS:

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Prior to the pandemic, it was widely recognized there were serious workforce shortage issues facing health care delivery. Those concerns are now much worse. From physicians, to nurses, to behavioral health, to public health, to assisted living and long term care, every kind of licensed health care professional faces demand that far outstrips supply. This problem is trending steeply upward and can only manifest in serious negative outcomes. Lack of access creates higher cost, preventable increases in morbidity and mortality and systemic burnout.

OBJECTIVES: JOIN

Our expert panel will examine the root causes of the health care workforce shortage. From industry entrance barriers, to workplace dysfunction, to career satisfaction we will present examples and potential solutions. We will dissect the complex interactions between elements of health care governance and explore how industry sectors can work together more closely to solve shared problems. We will explore the numerous initiatives already underway to address these issues and share suggestions for how best to address them.

We invite you to participate in the conference development process. If you have questions you would like to pose to the panel or have topics you would like the panel discuss, we welcome your input.

Please email: Comments@mppub.com and put “Roundtable Question” in the subject line.

M Health Fairview Opening New Highland Park Facility

The existing Highland Park M Health Fairview Clinic is moving into a nearby new building with services opened in the last days of February. The 26,000-square foot facility, constructed by Ryan Development, will anchor the newly built Highland Bridge Medical Office on the corner of Ford Parkway and Mount Curve Boulevard in St. Paul. The existing clinic, located two blocks away, will close. The new clinic will provide primary care services – including family medicine, women’s health, mental health and urgent care. There will also be a Fairview pharmacy located on the first floor of the building. M Health Fairview Rehabilitation Services, which offers physical therapy and sports medicine for a variety of conditions, including pelvic health, space offers expanded women’s health and mental health services.

“We’re excited to expand our offerings in women’s health for residents of the growing Highland neighborhood and beyond,” said Heather Uhr, a women’s and children’s service line manager. “Expecting families will be able to access compassionate, personalized OB/GYN, midwifery, and family medicine care for all their needs from conception to well-child visits.” Behavioral health care and counseling for children, teens, and adults will be provided through virtual and in-person visits. In addition, Behavioral Health Home services will be provided for patients insured through Medical Assistance or a Prepaid Medical Assistance Plan (PMAP). This team-based service is designed to meet patients where they live, by addressing social determinants of health and setting realistic whole-person health goals. Our in the community that will make health care access easier than ever for the thousands of future residents in St. Paul’s Highland Park area, while ensuring uninterrupted care for existing patients. “Our Highland Park clinic has been at its current location for over 25 years, and we’ve been a part of the neighborhood for over three decades,” said Sara Johnson, MD, medical director of the Highland Park clinic. “We’re excited to grow into our new space down the street and continue to serve the growing Highland and Hiawatha neighborhoods for decades to come.”

Avera Grant Integrates Behavioral Health with Primary Care

Avera has received a $100,000 grant through the South Dakota Community Foundation’s Beyond Idea Grant (BIG) Program to further integrate behavioral health services into primary care visits in Brookings County. A concept known as Integrated Behavioral Health is the gold standard for behavioral health care in any setting, per the American Academy of Family Physicians. “Integrated Behavioral Health adds providers within primary care to increase access and care coordination while improving prevention and reducing barriers,” said Nikki Eining, outpatient clinical therapist for Avera Medical Group Behavioral Health in Brookings and project director. While 75% of primary care visits nationwide include a mental health component, most of South Dakota lacks access to behavioral health services in any setting. Brookings County is a federally designated Mental Health – Health Shortage Professional Area. Suicidality increased in 2022 to exceed the 10-year average of suicide attempts. By innovating via integrated behavioral health, this pilot will reduce the disparity while increasing ease and access to care. Training for clinicians will increase their knowledge about identifying and referring behavioral health concerns. Equity training will help support cultural sensitivity and referrals for Hispanic and Native American patients. Another aspect of this grant is collaboration with South Dakota State University to identify behavioral health access gaps for Native American students. “Mental health has long been identified as an urgent need across South Dakota. Suicidality, drug abuse and family crises are just a few of the societal problems that result. We want to prevent these tragedies and help individuals and families experience higher quality of life,” said Ginger Niemann, Senior Program Officer with the South Dakota Community Foundation. “Solving this issue will take innovation and collaboration. We selected this project for BIG funding because it not only will benefit Brookings County, but could serve as a model for making behavioral health services more accessible and timely for patients in need.” “We are incredibly grateful for the grant funding to launch this project and we are excited to see the difference it makes as this concept gains momentum,” Eining said.

Tri-County Rebrands as Astera, Opens New Hospital

Tri-County Health Care, serving central Minnnesota since 1925, has changed its name to Astera Health. With the name change comes the opening of the new 125,900 squarefoot Astera Health hospital. The new facility integrates technology with a healthy environment which improves the patient experience and efficiency for staff and ensures a sustainable future for health care in their service area. Astera Health hospital is located on a beautiful new property west of Wadena along Highway 10. When Tri-County Hospital was built 50 years ago, inpatient care accounted for 90 percent of its patients, and the facility design reflected that care. Patients expected to stay multiple days and needed the right care and environment for an extended stay. Improved technology and best medical practices have led to shorter hospital stays and allow many post-surgical patients to go home the same day. As a result, inpatients now only account for 13 percent of care provided. This shift means outpatient care is the primary focus. Astera now offers its patients a facility that reflects the strength of the communities it serves. The old facility, with its disjointed layout offering care in three separate buildings with multiple entry points, could not meet those expectations. At a recent ceremony President and CEO Joel Beiswenger shared his thoughts about the hardships endured throughout the construction process, including the COVID-19 pandemic and numerous supply chain issues. “This has liter

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DHS Announces $5.7M in Grants to Curb Opioid Addiction

The Minnesota Department of Human Services (DHS) has awarded $5.7 million to 12 grantees to expand the services available to support people suffering from opioid use disorder and make it easier to get help. Almost all the funding is going to organizations primarily serving Native communities, Black communities and communities of color disproportionately impacted by the opioid epidemic. The new investments will address gaps in Minnesota’s continuum of care for Native people and people of color with opioid use disorder and help better serve all Minnesotans. Organizations receiving grants serve the Twin Cities metropolitan area, greater Minnesota and Tribal Nations, while others provide services statewide. The number of opioid-involved deaths in Minnesota reached 924 in 2021, up from 343 in 2018. Native Americans and Black Minnesotans are experiencing the opioid epidemic more severely. Native Americans are seven times more likely to die from a drug overdose than White Minnesotans, while Black Minnesotans are twice as likely to die from a drug overdose. “Minnesota can not and will not accept this continued pain and heartbreak for families and communities,” said Human Services Commissioner Jodi Harpstead. “With this funding, our partners can save lives now and in the years to come through a range of programs that are person-centered, trauma-informed and culturally responsive.” The new grants will support culturally specific practices, including primary prevention and overdose prevention, workforce development and training and expansion and enhancement of the continuum of care. The funding includes $1 million for services focused on the East African population. The current grantees were selected after extensive review, with a focus on increasing access to treatment, reducing opioid overdose-related deaths and addressing unmet needs for prevention, treatment and recovery services. The Department of Human Services and the council requested proposals in April 2022. In the coming months, the Opioid Epidemic Response Advisory Council will announce additional funding recommendations and begin soliciting proposals for new funding.

Regions Hospital Receives $2.5M to Expand Clinical Simulation Training

The Ortto Bremer Trust recently donated $2.5 Milion to expand the HealthPartners Clinical Simulation Center located within Regions Hospital. This high-tech form of training allows a nurse to slip on a virtual reality headset and step into an emergency department where t hey prepare for a massive blood transfusion ahead of an imaginary trauma patient’s arrival. “The high-quality care that we deliver is supported by continuing education opportunities like those offered by the Clinical Simulation Center,” said Megan Remark, president of Regions Hospital. “This donation is going to improve the learning experience for the thousands of clinicians we train each year and ultimately contribute to a more prepared and effective workforce to care for our communities.” HealthPartners Institute’s Clinical Simulation Center trains 8,000 health care workers each year. Simulations include specific procedures performed on computerized mannequins to practicing for specific patient care situations. While many of these health care workers are part of HealthPartners, trainees also include local medical and nursing students, emergency medicine and fire department personnel and even local high school students who are exploring careers in health care. Research shows that simulation is associated with improved response times during emergency scenarios that require chest compressions and defibrillators, and it’s associated with better clinical performance outcomes. Three-dimensional printing is one of the notable upgrades to the simulation center’s equipment. These printers can be used to make replicas of patient’s body parts, giving clinicians an opportunity to practice surgical techniques and other procedures before conducting them in real life. “Simulation allows healthcare to create individual and team experiences that could take years to acquire otherwise,” said Dr. Benoit Blondeau, chair of the department of surgery at Regions Hospital. “It also creates a safe environment to frankly discuss what went wrong in real-time instead of a narrated review later.” Virtual reality headsets will also be part of the simulation center enhancements. These tools can be programmed with clinical scenarios that provide lifelike experiences in a low-stakes environment. Care team members can then rehearse best-practices to help prevent things like medication errors, the most common adverse event in hospitals, according to recent data published in the New England Journal of Medicine. The new simulation space will be almost 7,000 square feet on the first floor of Regions Hospital.

BC/BSMN Expands Rural Provider Network

Blue Cross and Blue Shield of Minnesota (BC/BSMN) and Homeward, a new company focused on improving nationwide rural health care delivery, recently announced a new value-based collaboration designed to increase access to health care for outstate Minnesotans. This spring, Blue Cross Medicare Advantage members in 24 Greater Minnesota counties will have access to Homeward’s services, which include in-home visits, community-based visits, and technology-enabled clinical services including telehealth. The two organizations are working together to identify qualifying patients who are not currently engaged to receive the care they need or have known gaps in care. Over time, Homeward and Blue Cross plan to continue expanding the offering to additional Minnesota counties. Through partnerships with regional health systems and providers, Homeward coordinates care, including high-quality referrals and additional support post-discharge, with a focus on delivering improved health outcomes across rural populations and communities. The company recruits locally and in a manner that supports local workforces, including existing clinics and hospitals. Homeward offers a full-risk value-based arrangement for Medicare Advantage members, meaning payment for care is 100 percent tied to improving health outcomes and reducing the total cost of care. “Our agreement with Homeward is another important step for Blue Cross’ nationally recognized Medicare Advantage plans,” said Dr. Mark Steffen, senior vice president and chief medical officer at Blue Cross and Blue Shield of Minnesota. “Blue Cross and Homeward will be working with local hospitals, clinics and care systems in each community to ensure that, together, we can work to solve one of the biggest challenges in the healthcare system today. We are excited for the opportunity to increase our support for populations and communities that are in need of more health care resources.”

“I cannot be more proud to partner with the largest health plan in my native state of Minnesota to deliver care,” said Dr. Jennifer Schneider, co-founder and CEO of Homeward, who grew up in Winona. “Homeward’s mission is personal, and the opportunity to provide an end-to-end care experience for deserving individuals is a privilege. I am grateful for Blue Cross’s innovative approach and commitment to delivering the best care experience and outcomes.”