5/18/2015
Senator Al Franken
Rural Health Tour
2015
Rural Health Advisory Committee (RHAC) Meeting
May 19, 2015
Samantha Mills,MPH
Field Representative
Senator Al Franken
Senator Al Franken
Making rural health a top priority
“Rural communities in Minnesota
and across the country face unique
challenges when it comes to
ensuring access to quality health
care for residents. As the Co-Chair
of the Senate’s bipartisan Rural
Health Caucus, I want to make
addressing those challenges a top
Senate priority. My office’s Rural
Heath Tour is part of that important
effort.”
Overview of Challenges
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Workforce
Access to care
Community
Funding
Policies and requirements
Communication
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5/18/2015
Rural Health Stakeholders
• Health care providers and
administrators from nursing
homes, clinics, hospitals,
and EMS
• Health care educators
• Community leaders
• Home and community
based providers
• Patients/consumers
Clinics, Hospitals,
EMS, HCBS, and
Nursing Homes
Health
Care
Educators
Patients
Caregivers
Community Leaders
Rural Health Roundtables
• 24 Total
UofM, Alexandria, Duluth, Silver Bay,
Grand Marais, Virginia, New Ulm,
Melrose, Pine City, Brainerd, St. Cloud,
Perham, Fergus Falls, Moorhead,
Mahnomen, White Earth, Moose Lake,
Hibbing, Mankato, Red Lake Reservation,
Park Rapids, Leech Lake Reservation,
Bemidji, North Branch...
• 235 participants
Strategies
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Rural Health Roundtables
Focus on priority areas
Identify the challenges
Identify innovation/
initiatives
• Discuss opportunities to
pair current efforts with
public policy solutions
• Analyze content and
common themes
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Rural Health Challenges
Workforce
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Shortages
Competitive wages
Recruitment and retention
Training site availability
Aging workforce
Lack of capacity or training
Housing
Rapid changes in health care
Opportunity for continuing
education
WORKFORCE
Recommendations
• Address the local skills gap
• Use of emerging professions
• Ladder programs and early
exposure to health professions
• Loan forgiveness programs in
targeted fields
• Increase flexibility in the
workforce
• Delivering care in various
settings
• Collaboration, integration, and
coordination
Rural Health Challenges
Access
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Transportation
Distance to services
Availability of services
Health literacy
Cost of care
Confusion and fragmentation
Long wait times
Stigma
Crisis driven systems
Medication management
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ACCESS
Recommendations
• Expand services and locations
• Invest in community based
services
• Expand scope of practice and
cross sector training
• Increase use of technology
• Patient advocates and
Community Health Workers
• Increase consumer education
opportunities
• Flexible scheduling
Rural Health Challenges
Community
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Isolation
Broadband access
Affordable housing
Changing demographics
Aging populations
Level of complex conditions
Food deserts
Environmental challenges
COMMUNITY/ SOCIAL DETERMINANTS
Recommendations
• Make the healthy choice the easy
choice
• Emphasize public health and
prevention
• Establish co-located services
• Trauma informed care integrated in
program design
• Promote social impact/health
impact bonds
• Advance culturally competent
education and care
• Invest in environmental design
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Rural Health Challenges
Funding
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Reimbursement
Fragmented funding sources
Variation among payers
Infrastructure
Limited resources to implement
quality improvement
• Lack of grant opportunities
• Economies of scale challenges
FUNDING
Recommendations
• Sustainable payment and delivery
reform
• Emphasis and priority on
prevention and reaching people
upstream
• Mental health parity
• Support for emerging professions
and advances training
• Funding to support location
based services
• Flexible spending for grants
Rural Health Challenges
Policies and
requirements
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Outdated policies
Administrative burden
Credentials and training
CAH designation
Telemedicine
Meeting quality improvement
regulations
• Electronic Health Records and other
IT regulations
• Physician supervision and staffing
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POLICY AND REQUIREMENTS
Recommendations
• Review of policies and rules that
aren’t working for MN
• Streamline and simplification of
administrative needs
• Coordination of resources at the
local level
• Navigating incentive and penalty
systems
• Opportunities to advance telehealth and other technology
Rural Health Challenges
Communication
• Fragmented systems
• Interoperability of data systems
• Data privacy and protection
COMMUNICATION
Recommendations
• Integration, coordination, and
collaboration among systems
• Create mutual learning
opportunities
• Leverage local resources
• Review data sharing restrictions
• Regular meetings and face-toface encounters
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Limitations
• Roundtables were limited
to maximum of 16
participants
• Still in process
• Time and geographic
constraints
Conclusions
• Communities across rural
Minnesota are working
together to promote health and
improve overall well-being
• Through strong collaboration
and innovation, rural Minnesota
has overcome major barriers to
accessing and providing care
• BUT, Rural communities still
face challenges that need to
be addressed
• Next steps
Acknowledgements
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MDH, Office of Rural Health Primary Care
Minnesota Rural Health Association
HealthForce MN and MNSCU
UofM Rural Health Research Center
Special thanks to all the providers, administrators, law
enforcement, patients, community leaders, educators, and
caregivers who participated!
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5/18/2015
Questions?
Thank you!
Contact Information
Samantha Mills, Field Representative
Senator Al Franken
Email: [email protected]
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