Given its emphasis on access to care and workforce development, it was a  natural fit for the New Hampshire State  Office of Rural Health (NH SORH) to be  a part of the NH Legislative Commission  on Primary Care Workforce Issues.  The five-year commission is working to coordinate workforce as a part of  Affordable Care Act (ACA) activities in  the state.

“What we’re finding is that because of the ACA, people are very interested in  talking about workforce development,  when maybe in the past they didn’t  have an understanding of these  issues,” said Alisa Druzba, director  of the NH SORH. “We’re focusing on using the resources we have in the  most efficient manner.” Druzba is the  NH Department of Health and Human  Services appointee. The Commission also includes individuals who represent  medical, oral health, and mental health  associations and providers in the  state. Additional members have been  requested to bring in more diversity  and non-rural representation, Druzba  said. Commission members meet  together on a monthly basis.

“What’s nice is that the Commission has been in a position to readily talk about  workforce, and about Marketplaces—if  the state does choose to do Medicaid  expansion,” Druzba said.

While Druzba brings the benefit of her expertise to the Commission,  there have been benefits for her  SORH as well. “When the Commission  first started, we put in legislation  that identified my office as a health  professions data center,” Druzba said.  Although the center was not funded, it  helped establish the idea in her SORH.  “I reallocated my money to bring a data  center into existence and was able to  hire a staff member this April to get  the surveying off and running. We get  to have a leadership role around the  kind of data that is collected and can  use it more efficiently for shortage  designation work.”

Another benefit has sprung from  the Commission’s emphasis on using  resources efficiently. “I report to  them on SORH grants and talk about  current uses of funding.” Druzba set  up a schedule to discuss SORH-related  topics at the Commission meetings, like  “What is a patient-centered medical  home?” In addition, she has been  discussing the difficulty of clinicians  obtaining training and residencies in  the state, since many sites there are too  small to take them on. “There’s been  lots of energy around this,” she said. As  a result, her Office is helping establish  a clinical placement program—a  contract went into effect in July. The  contracting agency now is looking at  how other states are doing this, looking  at site education curriculums and the  technology for managing it.

“It was just natural for us to take a leadership role when workforce came  up,” Druzba said. “It was mostly being ready at the right time.”