The Membership Organization of State Offices of Rural Health
By Beth Blevins
With an increasing shortage of rural healthcare workers, Iowa needs to recruit locally and early. That’s the idea behind the Opportunities in Health Sciences: Iowa Career Pathways, which helps high school students (and adult workers who are looking for a career change) navigate toward healthcare careers.
The Opportunities in Health Sciences project came about through the efforts of the Iowa State Office of Rural Health (IA SORH), which saw the need to recruit rural students to work in rural areas. The impetus for the project was a one-day workforce summit Iowa SORH held two years ago to gather information about the shortages and needs of the healthcare workforce in Iowa.
“Some of the recommendations at the summit came from people working at hospitals and clinics,” said Megan Hartwig, Iowa SORH Director. “Their concern was that we recruit students in healthcare careers but they end up leaving rural communities to work in urban centers. Or some rural schools don’t have the capacity to provide the curricula or experiences the kids need to help them consider further training and education in the health field.”
The “Opportunities in Health Sciences: Iowa Career Pathways” guide
What followed was a discussion on how to do a better job of communicating with Iowa high school students, how to provide resources to counselors so they can help steer those who show aptitude and interest into health sciences careers, Hartwig said.
“We wanted to provide a guide that helps students realize they don’t often have to go to school for more than two years to complete training for a successful career in healthcare,” she said. “We also wanted them to understand there are healthcare employment opportunities in their own communities, and that they don’t have to just be a doctor or nurse to work in healthcare.”
The Future Ready Iowa initiative had already been set up through the governor’s office, with the Iowa Department of Education (DOE) and Iowa Workforce Development as the main partners on the project, Hartwig said. “The Iowa DOE had put together an Iowa Pathways website and guide for a few career sectors, like energy and manufacturing, but healthcare hadn’t been developed,” she said.
To get momentum behind the ideas discussed in the workforce summit, Iowa SORH applied for special project funds through the Department of Public Health’s CDC Block Grant, Hartwig said. “Our intent was to develop resources for students who might be interested in health sciences, as well as to develop marketing material around healthcare careers, specifically more of those entry-level careers,” she said.
Hartwig worked on the project with the Iowa DOE and other health industry partners. Her time on the project was funded by IA SORH, but the project itself was funded through the CDC Block Grant, she said. The project was done in tandem with Future Ready Iowa. “The work we’re doing dovetails with Future Ready Iowa and can be used in conjunction with the Health Sciences section on its website,” she said.
Hartwig said it is important that the resulting publication is available both online and as a printed document, which is being distributed to community college and high school counselors. “Not every kid has access to a computer,” she explained.
The Opportunities in Health Sciences publication includes career sections arranged by topics like Direct Patient and Therapeutic Care (“The Caregivers”), Community and Behavioral Health (“The Supporters”), and Biotechnology Research and Development (“The Innovators”), as well as information on work environment options, and career interests based on personality types.
The project also included the creation of a video by Iowa Workforce Development that discusses apprenticeship programs for healthcare careers, Hartwig said. “We are also developing a toolkit with the DOE for schools to use with local healthcare employers, to create opportunities for students to shadow them to see if they want to pursue an education and career in health sciences,” she said.
It is not just future employees and employers who have benefited from the project. Hartwig said that it has fostered greater collaboration between IA SORH and other departments in the Iowa state government. “We now have connections across three departments—IDPH, DOE, and Iowa Workforce Development,” she said. “We pick up the phone and talk to each other now, which has opened doors for more coordination.”
Hartwig concluded, “We recognize that many students love their hometowns and want to stay in their communities, but they don’t think they can make a living there, or they think they have to go away for years and years of training. We hope this project will help students understand they have options— they can go through an Associate’s Degree or certificate program in two years or less and then have a great job helping people in their own communities.”
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If rural veterans are going to get more access to good care, there must be more collaboration between the Veterans Administration and non-VA providers, according to Gloria Vermie, Director of the Iowa State Office of Rural Health (IA SORH). To aid in that effort, Vermie has worked to develop a collaborative relationship between her Office and the Veterans Rural Health Resource Center-Central Region, (VRHRC-CR) located in Iowa City.
“Maybe because my dad was a veteran, it has kept it upfront for me,” Vermie said. When the Iowa City VA got a grant from the Veterans Health Administration’s (VHA) Office of Rural Health to be a resource center for the central region of the United States, Vermie contacted them. “I spent some time talking with them about rural health care in Iowa and about Critical Access Hospitals. I put them on my distribution list, and they invited me to meetings.” Since then, Vermie has been to meetings where she was one of the few non-VA people in attendance, and where she has served as a guest panelist speaking about rural Iowa.
The result of the collaboration, Vermie said, is that the SORH has a better understanding of VA resources, and the VA has a better understanding of rural Iowa and non-VA resources, as well as the barriers rural veterans may face in getting the care they need. For example, Vermie said, “if a veteran goes to a rural hospital and not a VA hospital, the rural hospital may not get paid. Also if an ER physician calls the VA for medical records on a veteran that has just come in, they can’t always get those records.”
The Co-Managed Care Toolkit, developed by the VRHRC-CR, helps to address such communication issues. The toolkit provides a set of resources and tools to help non-VA providers navigate the VA system when they have a patient who is seeing both a VA provider and a non-VA provider. Vermie recommends that CAHs and RHCs download the toolkit and put it in a binder. “I wish I could get it to all of them right now,” she said. The toolkit is for all non-VA providers, whether in the Central Region or not.
Additionally, the IA SORH has been involved and has supported VRHRC-sponsored trainings and community resource fairs, veterans’ foster care and mental health initiatives. “When they contacted me and said they were sponsoring a community resource fair on non-VA resources in the community, I recommended they provide information on dental care for children, including the I-Smile program,” Vermie said. To help the VA get the word out about the VA’s Medical Foster Homes program, the IA-SORH office has hosted webinars about it.
“Not all SORHs are involved with the VA—yet every state has veterans,” Vermie said. “I sensed there was a huge chasm that needed to be crossed between VA and non-VA providers tobetter coordinate our programs. I think the VA is doing huge things, trying to bridge a big divide. The relationship that the IA SORH has had with the VRHRC-CR has resulted in both groups continuing to move forward. I think it has been enlightening for them and us.
USDA Rural Development & Health IT – Case Studies from Iowa (B. Menner)
Iowa SORH Works for Rural Veterans Through Collaboration with VHA – The Branch: August 2013
Gloria Vermie is the director of the Iowa State Office of Rural Health. She also is serving as a Region C representative on the NOSORH Board this year.
Your SORH is currently engaged with several statewide partnerships, including the Iowa Rural HIT Collaborative and the Iowa VA Research Center. What is your role, as a SORH director, in fostering and sustaining partnership activities?
SORHs seem to have a talent for bringing people together for a cause, effort or project. When partnerships become strong collaborative efforts, personal relations and camaraderie often form, which sustain the partnerships. It is important to have others to call on and rely on. In turn, it is more important to be the resource and go-to person for your partners, stakeholders and constituents. Our partnerships are ongoing and spontaneous. On any given day, we reach out to each other for support and consultation, and sometimes just to say-“Hey, how are you doing?”
What are the benefits of partnership?
For the last two years the IA SORH has partnered with the Iowa Healthcare Collaborative (IHC) to implement the PfP (Partnership for Patients) program here. Involvement on the PfP advisory board and committees has helped ensure that rural hospitals are included and involved; IHC includes the SORH on their Board, in strategic planning and as a presenter at their annual conferences. In our partnership with Iowa’s Center for Agricultural Safety and Health, the IA SORH participates on the Board and two committees. This partnership has resulted in rural providers being included in a yearly agricultural medical training
course that helps providers to better diagnosis, treat and identify ag-related health risks.
What makes a successful partnership?
Wanting to be a partner and understanding the partnership’s mutual needs can help initiate and grow the partnership. Also it helps if you can consistently be “at the table.”
How important do you think partnerships are to the success of a SORH?
My experience is that very little can be done alone. Most SORHs do not have the funding, staff and time. In the work world of rural health, partnerships are like family, they are your foundation.