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99A92061FD4315D987258782006B723A Hearing Summary

PUBLIC
BILL SUMMARY For WORKFORCE PIPELINE INITIATIVES, EXPANDING THE WORKFORCE, AND DEVELOPING SOLUTIONS

INTERIM COMMITTEE STATEWIDE HEALTH CARE REVIEW COMMITTEE
Date Nov 3, 2021
Location HCR 0112

Workforce Pipeline Initiatives, Expanding the Workforce, and Developing Solutions - Committee Discussion Only


	01:33:38 PM	Ingrid Johnson, President and Chief Executive Officer, Colorado Center for Nursing Excellence, presented to the committee. She discussed the role of her organization in helping to develop the health care workforce and the need for health care workforce data. Ms. Johnson discussed a new grant program focusing on rural health care nursing residency and a geriatric workforce program, and highlighted the virtual dementia tour. She discussed an advanced practice registered nurse rural grow your own program. Ms. Johnson discussed training programs for preceptors and clinical training.
	01:43:52 PM	Dr. Mark Deutchman, Rural Program Director, University of Colorado School of Medicine, provided a presentation to the committee. His presentation can be found on the committee's website: https://leg.colorado.gov/sites/default/files/images/3_rural_program_for_hc_committee_2021.pdf. He highlighted the need in rural areas of the state and discussed the University of Colorado's School of Medicine Rural Program. Dr. Deutchman reviewed elements of the program's curriculum, which includes rural ethics, community engagement, and public health. He stated that the program has had 191 graduates from 2009 to 2021, and 57 are in practice in rural Colorado. Dr. Deutchman discussed how the model could be expanded to other professions, such as dentistry and physical therapy.
	01:51:55 PM	Michael Macklin, Associate Vice Chancellor of Workforce Partnership and Development, Colorado Community College System, presented to the committee on the Colorado Healthcare Experiential Pathways to Success (CO-HELPS) Program. He discussed how the program is funded through federal grants and the investment from the business community. He highlighted how the program helps address careers with high turnover. He highlighted the partnerships the program has with various health care providers and state agencies. Mr. Macklin discussed how the funding stream supports apprenticeships through wage funding. He also discussed the support services that are provided to students, such as transportation, child care, and uniforms. He said that the CO-HELPS Program currently has 12 career pathways established.
	02:03:10 PM	Dr. Jon Samet, Dean, Colorado School of Public Health, presented to the committee. He provided a copy of his comments and a journal article to the committee, which can be found on the committee's website: https://leg.colorado.gov/sites/default/files/images/4_colorado_school_of_public_health_presentation.pdf and https://leg.colorado.gov/sites/default/files/images/4.1_ajph_article_on_public_health_from_csph.pdf. He discussed the Colorado School of Public Health and the programs the school offers. Dr. Samet discussed a decline prior to the pandemic in the public health workforce and how it was exacerbated by the COVID-19 pandemic. He discussed how the school assembled a team to carry out epidemic modeling, collaborating with CDPHE and the Governorâs Office. He stated the the school's students were hired to work as contact tracers for the state and several local public health agencies. Dr. Samet discussed a new certificate program in rural public health that is based at the schoolâs University of Northern Colorado campus in Greeley.
	02:10:12 PM	Mr. Macklin responded to questions about concurrent enrollment programs and engaging high school students in health care careers. Dr. Samet responded to questions about how behavioral health intersects with public health.
	02:18:25 PM	Colin Laughlin, Deputy Office Director, Office of Community Living, HCPF, provided a presentation to the committee. His presentation can be found on the committee's webpage: https://leg.colorado.gov/sites/default/files/images/5_hcpf_presentation_on_workforce.pdf. He discussed the workforce need for direct care health care workers, such as home health aides and nursing aides. Mr. Laughlin discussed the need to expand cross-agency collaboration, recruit new individuals into the field, build career advancement opportunities, and improve retention. He discussed the Direct Care Workforce Collaborative, which is working to stabilize the direct care workforce. Mr. Laughlin discussed the American Rescue Plan Act funding that is supporting direct care workforce initiatives, including increasing payments to providers and workers, addressing data infrastructure, and further developing a centralized job hub.
	02:34:36 PM	Steve Holloway, Director, Health Access Branch, CDPHE, discussed practice incentives for workforce shortage areas. He discussed the Colorado Health Service Corps Program, which provides educational loan repayment for primary care providers working in designated health professional shortage areas. A handout on the program can be found on the committee's website: https://leg.colorado.gov/sites/default/files/images/5.1_cdphe_colorado_health_service_corps_fact_sheet_1.16.20.pdf. He also provided additional materials to the committee, which can be found on the committee's website: https://leg.colorado.gov/sites/default/files/images/5.2_cdphe_hpsa.pdf. Mr. Holloway discussed how the program is working to build diversity in the program by reaching out to students earlier in the their education and the challenges to offering scholarships instead of loan repayment.
	02:46:21 PM	Mr. Laughlin responded to questions about direct care workforce training and compensation.
	02:48:46 PM	Sarah Lampe, President and Executive Director, Trailhead Institute, provided a presentation to the committee. A copy of her presentation can be found on the committee's webpage: https://leg.colorado.gov/sites/default/files/images/6_trailhead_institute_presentation.pdf. She discussed the recent threats to public health officials, along with the burnout and turnover in the public health field. She discussed increases in the Colorado School of Public Health applications, the enactment of House Bill 21-1107, and the work of contact tracers during the pandemic. Ms. Lampe reviewed the specialized and strategic skills needed in public health. She provided recommendations to the committee about clearly defining and understanding the public health workforce and the need for data collection. She discussed developing a skills based workforce and investing in skills development through pre-apprenticeship and apprenticeship programs. Ms. Lampe discussed developing a surge workforce for public health, investing in the system as a whole, and the need for a common public health workforce development agenda.
	03:05:16 PM	Sara Leahy, Director of Member Services, Colorado Rural Health Center (CRHC), presented to the committee on workforce barriers and opportunities in rural health. She discussed the CRHC's role in workforce development, including the Colorado Provider Recruitment and Retention Program. She reviewed recent legislation that addresses rural health, including the Rural and Frontier Preceptor Tax Credit. Ms. Leahy discussed recruitment and retention barriers, including housing challenges, the impact of high salaries for traveling nurses, the need for primary care training, and lessening options for obstetrics practice opportunities. She discussed issues related to burnout, lack of diversity in rural areas, and employment needs for a rural provider's spouse or significant other. Ms. Leahy reviewed some solutions to rural workforce and retention issues, including the Community Apgar Program. She discussed the state funded locums support program that is operating in New Mexico that helps provide temporary personnel in rural areas. She discussed the need to increase Medicaid reimbursements, as well as addressing the need for child care and transportation in rural areas.
	03:20:00 PM	Kyle Rojas Legleiter, Senior Director of Policy, The Colorado Health Foundation, presented to the committee. He provided an overview of The Colorado Health Foundation and how the foundation is working to increase the primary health care workforce. Mr. Rojas Legleiter discussed the need for community ties, connectedness with providers, continuity in care, and cultural responsiveness. He discussed the focus on primary care by the foundation and the continuum of care. Mr. Rojas Legleiter discussed providing funding for loan repayment programs that is expanded beyond physicians. He discussed supporting "grow your own" programs in rural areas of the state.
	03:32:14 PM	In response to a question, Ms. Lampe discussed better communicating the need for public health and framing the field of public health. She discussed the need to introduce the field of public health into the education system earlier and further developing career pathways.