In the September issue of Rural Health Delivery, the Montana AHEC/Montana Office of Rural Health Program Office announced the awarding of a Rural Health Workforce Development Program grant from HRSA.  A short time later, the AHEC/ORH was awarded a second grant with similar long-term goals and objectives.  The title of the latest grant is "State Health Care Workforce Development Planning Grant."  It is a one year grant which may result in the awarding of a longer term implementation grant.  The current planning grant is being managed by the Montana Healthcare Workforce Advisory Committee (MHWAC) and the Montana Department of Labor & Industry.  Additional participating organizations include: (1) Montana State Workforce Investment Board - SWIB, (2) Office of the Commissioner of Higher Education, (3) Billings Clinic, (4) Montana Nurses Association - MNA, (5) Montana Office of Public Instruction - OPI, (6) Montana State Federation of Labor - AFLCIO, (7) Blue Cross Blue Shield Foundation, (8) Montana State University-Bozeman, and (9) Montana State University-Great Falls College of Technology. 

The primary focus of the Health Care Workforce Development Planning Grant will be to address health workforce shortages by completion, publication and implementation of a comprehensive statewide health care workforce plan.  The process of developing the plan will include the following: (1) analysis of state labor market information to create health care career pathways for students, adults and dislocated workers, (2) identification of current and projected high need health providers to plan career pathways, (3) identification of existing federal, state and other resources to recruit, educate, train and retain a skilled health care workforce and strengthen partnerships, (4) descriptions of academic and health care industry skill standards for high school graduation, entry into colleges and universities, and requirements for credentialing and licensure, (5) descriptions of secondary and post-secondary education and training policies, models and practices for health professionals; including career information and guidance counseling, (6) identification of federal and state policies and rules necessary to develop a coherent and comprehensive health care workforce strategy, (7) development of a plan to resolve barriers to implementation of a state health care workforce strategy and (8) participation in programmatic evaluation and reporting activities.  

On November 24, 2010, HRSA announced the Basic/Core Area Health Education Center grant award for the Montana AHEC Program Office/College of Nursing at Montana State University.The project period for the grant is from September 1, 2010 through August 31, 2012.  The amount of the award for the first year of the grant period is $1,357,043 and for the second year the award is anticipated to be $1,516,424.The Basic/Core AHEC grant supports the Montana AHEC Regional Centers including: (1) Eastern Montana AHEC in Billings, (2) South Central Montana AHEC in Dillon, (3) Western Montana AHEC in Missoula and (4) North Central Montana AHEC in Fairfield/Choteau.  In addition, it provides funding for the staff and programmatic activities of the Montana AHEC Program Office at Montana State University.Funding for the Regional AHEC Program in Montana began on September 1, 2007.

The new Montana AHEC Infrastructure Development award will serve the Montana health care delivery system through community-based partnerships and programmatic activities in the following areas: (1) K-12 health careers information, demonstrations and other programs; including public health, (2) high school science curriculum in public schools, (3) summer institute for junior and senior health school students, (4) university-based health professions education and training, (5) health professions education and training in medicine, nursing, dentistry and allied health, (6) interdisciplinary education and training, (7) continuing education and services to health care providers, (8) recruitment and retention services to hospitals and clinics, and (9) planning, including continuous needs assessments, to preserve the infrastructure of the Montana health care delivery system. 

The AHEC Program Office and the Regional AHEC Centers have affiliations and/or collaborative activities with Critical Access Hospitals, Rural Health Clinics, Community Health Centers, Migrant Health Centers, Indian Health Service Hospitals/Clinics, Urban Indian Clinics and other health service programs to delivery community-based clinical training.  These rural/remote training sites address the need for multidisciplinary and diversity in health professions education and training at the community level.  The Montana WWAMI Medical Program, Division of Health Sciences and the University of Washington School of Medicine are collaborating partners in conducting clinical training in rural communities and in clinics caring for underserved populations.

The Montana Office of Rural Health (Montana ORH) received funding from the Federal Office of Rural Health Policy for the Small Rural Hospital Improvement Program (SHIP).The SHIP Program provides funding to meet some of the needs of Critical Access Hospitals in Montana and throughout the United States.For the grant period of September 1, 2010 through August 31, 2011 the Montana ORH received $411,485.In September, the process of making sub-awards to the Montana SHIP Hospitals - 47 Critical Access Hospitals was started.Each of the 47 hospitals will receive $8,305; 31 individual hospital sub-awards and 1 sub-award for $132,880 to the Montana Health Network for distribution to the 16 hospitals in its network. 

The SHIP Program was authorized by the Balanced Budget Refinement Act of 1999 and was funded and expanded through the Labor/HHS Appropriations Act of 2002.The purpose of the SHIP grants are to help small rural hospitals pay or the costs of implementing the Prospective Payment System (PPS) and to pay for the costs related to delivery of system changes outlined in the Patient Protection and Affordable Care Act (PACA) including: (1) Prospective Payment Systems (PPS), (2) Value Based Purchasing (VBP), (3) Accountable Care Organizations (ACO), and (4) Payment Bundling. 

Progress reports from the 47 Critical Access Hospitals for the grant period of September 1, 2009 through August 31, 2010 showed that the SHIP hospitals spent $349,027 for Computer Software & Hardware, $53,457 for Staff Education & Training and $4,066 for implementation of Prospective Payment Systems.  The total expenditures were $427,729.

The final presentation/lecture in the WWAMI Medical School - Rural Health Care Delivery Systems course at Montana State University was given by Dr. Jim Ashcraft; a rural physician who practiced for 25 years in the small community of Sidney, Montana; located in Richland County and on the border of North Dakota.Dr. Ashcraft gave each of the 20 WWAMI medical students an autographed copy of his recently published book entitled "Reflections of a Country Doctor."  This presentation by Dr. Ashcraft served as the "capstone lecture" for the course that is intended to provide information to medical students about health care systems and encourage them to consider practicing in rural communities and providing care to underserved populations.The book includes nearly 100 short stories about patient care, teaching members of his health care team, interaction with physician colleagues in Sidney and in regional medical centers - and - being engaged with the community.  The medical students were delighted to meet Dr. Ashcraft and to learn that practicing in a small rural town can be fun, rewarding and essential to the health of patients and the community.  Dr. Ashcraft is "retired" and living in Billings, but he is still involved with patient care and teaching.

The South Central Montana AHEC has been spearheading the physician and mid-level recruitment efforts in Montana for over two years. Utilizing the web-based posting system, "3RNet", this office recruits for facilities state-wide at NO cost to the facility. Staff attend regional and national career fairs, promoting Montana positions and quality of life. In addition, print advertisements are placed in various journals and on-line sites to enhance the in-person recruiting done at the career fairs. The South Central Montana AHEC works as the coordinating body of the Montana Healthcare Recruitment Collaborative which pools together resources to assist our facilities state-wide with their recruitment needs. Tracking successful placements can be difficult, but since 2008 the South Central Montana AHEC has been involved with over 30 hires, including physicians, a dentist, RNs, PAs, NPs and a PT....all FREE of charge to the facility. These recruitment efforts continually grow and expand.

To take advantage of these services, please contact Lisa Benzel, 406.683.2790, [email protected] and visit www.3RNet.org

In the fall of 2010, the South Central Montana AHEC started allied health recruitment in addition to physician recruitment. Due to the healthcare workforce shortage in Montana we thought it was important to expand our recruitment efforts. As part of our allied health recruitment efforts we have attended six different career fairs and conferences around the state of Montana since September. We have attended fairs at the University of Montana-Missoula, Montana State University-Bozeman, Montana State University-Billings, and Montana State University-Northern. In the upcoming months we plan to attend fairs at Montana Tech-Butte, Carroll College-Helena, and Montana State University-Great Falls.As part of our recruitment efforts we currently utilize "3RNet" where facilities can post available positions and candidates can search for opportunities. We had a lot of traffic at most of the fairs and continue to spread the word out about 3Rnet to college students and different allied health professionals.            

LEAP launched at Community Hospital of Anaconda

This fall saw the launch of a new continuing education offering from Western Montana AHEC. The Leadership Education And Performance Program (LEAP) was developed in response to Critical Access Hospital administrators' observation that mid-level managers in small facilities are frequently promoted into management roles without having had training or experience with many aspects of these roles, including supervisory, administrative, and leadership skills. WMT-AHEC enlisted the expertise of Karen Marsolek and Mark Wilmarth, regionally renowned trainers in leadership and team-building, to develop a hybrid-format course (both in-person and via distance education) to address these challenges and others that are particular to Montana's Critical Access Hospitals- for example, how to "wear multiple hats" (team member AND team leader) effectively. The sixteen-week course is being piloted at Community Hospital of Anaconda, where twenty-five members of the staff are participating. Now in week nine, the course has received very positive feedback thus far.

Planning moving forward for
Western Montana Family Medicine Residency

Planning continues for a new Family Medicine Residency program in Montana to be located in Missoula. The Steering Committee, consisting primarily of family physicians, continues to meet monthly, and a Board of Directors has been assembled which meets monthly as well. The Board of Directors includes representation from The University of Montana, Saint Patrick Hospital, Community Medical Center, and Partnership Health Center. The Residency will be based at Partnership Health Center and is hoped to include rotations at Kalispell Regional Medical Center. Dr.Ned Vazquez, Lolo, has been selected to serve as Interim Director and began work in this capacity in November. It is anticipated that the first class would matriculate in July, 2013.

Healthcare Workforce Resource

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