Public Input Welcomed
Aug. 20, 2002
July 16, 2002
May 30, 2002
April 12, 2002
Quality Care -
Findings and Proposals
for Montana's Health
- Final Report
(Adobe Acrobat format - 650KB)
Governor's Blue Ribbon Task Force On Health Care Workforce Shortage
Room 317, State Capitol
Thursday, July 16, 2002
MISSION OF THE TASK FORCE:
To accurately assess the shortage of health care workers, and to
develop recommendations and strategies to effectively address the
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
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.
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
Barbara Swehla, Board of Nursing
Cheryl Smith, Board of Chiropractors, Funeral Services and Clinical Laboratory
Cynthia Reichenbach, Licensed Addiction Counselors Program
Mary C. Hainlen, Board of Social Work Examiners and Prof. Counselors/Board of
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
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:
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
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
- 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
- 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
- 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
- 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
- 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
- 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
ISSUE 1: MONTANA’S HEALTH CARE
- Proposal 1: Lawmakers should establish in Montana
statutes a statement of policy/philosophy for health care in
- 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
ISSUE 5: HEALTH CARE WORKFORCE DATA COLLECTION AND
- 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
- 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
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.
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
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
Jean Branscum reminded the committee that additional public
comment would be due by August 1st. 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 12th for review prior to the August
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
There being no further business the meeting was adjourned at
4:00. The next meeting of the Task Force is scheduled for
August 20th, 9:00 a. m. - noon in the Wilderness
Room at the Colonial Building.