| Thomas Bacon, Chair,
welcomed persons attending the Council meeting. He gave a special
welcome to Van (Brock) Murray, who attended for the first time
and represented the NC Department of Public Instruction, and
to Judy Mann, representing the N.C. Community College System.
Following an opportunity for Council members, panel participants,
and guests to introduce themselves, the Council approved the
November 5 minutes.
Presentation on the Health Care Works! Coalition
Maggie McGlynn, of McGlynn Associates, provided an overview
of the Health Care Works! Coalition and their projects. The
coalition includes educators, employers, workforce development
agencies, community groups, and associations, McGlynn explained.
The coalition’s major goal is to have health care become
the industry of choice, McGlynn said. With that in mind, focus
is being placed on system change and asking people to “think
big” and leverage resources.
She said one project recently received partial support from
Duke Endowment, which identified Wake and Johnston counties
for funding. The goal of that project is to “design and
implement strategies to meet the growing demand for qualified
and trained health care workers, with special attention to radiography
and nursing …. (and) to engage in a regional forum to discuss
current and emerging workforce and employer needs of the healthcare
sector, and act as a team of industry leaders that can grow
in its enthusiasm and capacity to work collaboratively on behalf
of the whole.” (Handout: Overview of Health Care Works!
Support from Duke Endowment)
McGlynn said retention of students in health care programs
is sometimes problematic and that the coalition is placing attention
on retention strategies that work. Pooling resources can lead
to a better job of getting to the end product, she said. The
coalition’s strategy is “to be sure the big picture
stays on the table” and that people leverage their resources,
she explained.
McGlynn said hospitals put in about a 2/3 match for the coalition.
Bacon asked why Vance County was not included in the funding
and McGlynn answered that apparently some hospitals within the
Vance-Granville area are for-profit, which are not typically
chosen for funding. When Bacon noted that the area also includes
state hospitals, McGlynn said hospitals were invited, but there
was insufficient time to develop necessary relationships, adding
that this may be addressed later.
Bill Croft asked whether there is sufficient faculty for the
community college programs, noting that maintaining a sufficient
number of preceptors tends to be problematic. McGlynn agreed
the issue is important. She said it is necessary to have a commitment
on which people can follow through and that this is what people
from the hospitals are agreeing to do.
Jeanene Martin said the new chair of the hospital association
will champion the issue and that it will be important to find
ways to provide clinical rotations. Wake Med is taking aggressive
steps toward this now, she said.
Additional discussion focused on the issues of recruiting and
retaining faculty for health care programs and clinicals. Such
questions need to be addressed, McGlynn said. She added that
the coalition will provide a group that can be expanded, have
a more regional approach which will benefit communities, and
provide a leadership team to serve as a forum for such issues.
Responding to a concern expressed by David Wysocki about meeting
the increased community needs that will result from recent mental
health reform, McGlynn said the coalition has not yet addressed
that issue.
McGlynn also reviewed a project with the Capital Area Workforce
Development Board. She said efforts are underway to encourage
the Workforce Development Boards to actively support the health
care industry and to look at ways to create a level of influence
that can be sustained over time.
Announcements
Gary Bowers, Executive Director of the WNC Health Network, will
make a presentation at the March 3 Council meeting.
The Association Presidents’ meeting will be May 5 at the
Friday Center. Bacon said presidents will be invited to report
on the status of their associations and on critical issues facing
those associations. Also, elections will be held for filling
vacancies and completed terms. The completed two-year terms
are: Group 2, Wysocki; Group 4, Croft and Group 6, Marge Ottofy.
Libby Haile said the Council will have a booth at the Carolina
Clinical Connection, held in Wilmington, March 3-5.
Discussion and action
Bacon gave an update on efforts to obtain future funding for
the Council. Current Duke Endowment funding will end in May
2005. Bacon said he has worked with the advisory board, chaired
by Bill Pully, to look at potential funding opportunities. Also,
he and Yoder met with Dr. Gretchen Bataille, Sr. Vice President
for Academic Affairs, UNC General Administration, and Dr. Allen
Mabe, Vice President for Academic Planning, UNC General Administration,
regarding the possibility of including a request for funding,
potentially linked to AHEC, in the university’s 2005 budget.
Although a number of issues would have to be addressed, they
are supportive of the idea and are willing to consider it, Bacon
said.
Yoder noted that this is not the appropriate time to begin
lobbying efforts among legislators and asked that formal lobbying
efforts be ceased. In a related matter, he said work is underway
to complete a document containing brief descriptions of the
professional associations represented on the Council. The document
can then be presented to legislators at the appropriate time.
Rebecca Bullock noted that legislators may also want to know
how many people the associations represent. Yoder agreed, adding
that such numbers can be difficult to obtain for unlicensed
associations, but that he will attempt to secure such numbers.
In another matter, Bacon referred to discussion at the previous
meeting regarding asking a task force to look into the matter
of articulation of allied health programs in the community college
system with those represented in the four-year UNC system. He
said Elizabeth Isler and James Sadler had raised issues they
wanted addressed before the task force begins its efforts. He
said it is important to identify the critical professions where
the issues are most prescient and to be sure the group can work
without becoming “bogged down” on the matter. Bacon
added that Sadler had reminded him the matter should go through
the Transfer Advisory Committee of the UNC Board of Governors.
Bacon said the matter will be examined regarding the best way
to proceed and that this would be done in a conference call
to be arranged before the next council meeting.
On another issue, Yoder opened discussion on the possibility
of inviting additional allied health professions to participate
on the Council. He provided a list (handout)
of allied health professions in which people are trained and/or
work in North Carolina, but which are not members of the Council.
Noting that the Council is an inclusive group and that it would
be strengthened through inviting representatives of all allied
health professional who are educated and who work in the state,
Yoder asked members whether such an invitation should be extended
to the additional groups. The list of possible allied health
professions discussed is attached.
Wysocki said that there is no state association for rehabilitation
engineering. Yoder added that there is a Rehabilitation Engineer
Society of North America, of which he is a member. He also noted
that biomedical engineering training is offered at UNC-CH, Duke,
and ECU, and that biomedical engineering faculty sometimes serve
as faculty for Human Movement Science. Sadler said NC State
and UNC started a joint biomedical engineering program. He noted
that Human Movement Science frequently might involve the Department
of Physical Education, which leads to considering sports medicine.
He added that home health aides is a profession with an expected
high growth rate. The question, he said, is whether there is
a national definition of allied health. (Because the issue of
an allied health definition came up, it is added at the end
of the minutes.) Sadler said the issue might be considered in
terms of how to develop a cohesive presence and concept of allied
health and strengthening its overall presence and contribution.
Yoder noted that the IOM lists approximately 210 allied health
professions.
Croft said the term “emergency medical technician”
is a “catchall phrase and that the more appropriate term
is emergency medical science with emphasis on paramedics. He
said the paramedic program is now a two-year program. Croft
said the Surgical Technologist program at Sandhills Community
College had asked why they had not been invited to participate
on the Council. He added that the school’s Nursing Department
houses a program on massage therapy, a profession that is licensed
and is gaining greater presence in North Carolina. Yoder noted
that massage therapy will be included in AHEC’s new health
careers manual.
Ned Fowler said he endorses inviting additional groups and
asked whether consideration has been given to inviting the NC
Office of Emergency Medical Services, which would encompass
all the emergency medical professions.
Judith Mann asked whether “home health aides” referred
to nursing assistants. Discussion followed regarding the levels
of home health aides, nursing assistants, and mental health
professionals in terms of training and certification for each
and which groups are allied health professions.
Carolyn Mayo raised the issue of clusters on the Council. Yoder
said some reconfiguration would be needed and that a subcommittee
might be asked to work on the matter at the appropriate time.
Wysocki asked whether a representative for orthotists and prosthetists
should be included. Yoder indicated that they should be. Responding
to a question from Mayo, Yoder said biostasticians are included
in the allied health school at ECU.
The Council does not have to form an ultimate definition of
what constitutes allied health as requisite to being a member
of the Council, Bacon said. “We are a council that is representative
of a broad array of professions and groups and employers. And,
it seems to me, the more people we have a the table, the better
we are. We should think through it and do as clear a job as
we can, but we don’t have to get crazy about is this allied
health and what degree do we want to require. There is no easy
answer to any of that,” he said.
The Council has been configured to represent educators, employers,
and professional associations, Patricia Porter said. She suggested
that perhaps that configuration could be used for some sort
of criteria for entry to the Council. Then, if an employer includes
a group without an association, such as developmental technicians,
the group still could fit into the Council. Otherwise, the question
becomes how to give such professionals representation if they
do not have an association. Bacon noted that an entity such
as the State Office of EMS includes associations. Mann added
that the same could be true for nursing assistants.
Responding to a question from Bullock, Bacon said pharmacists
are not historically included as a part of allied health, but
that pharmacy technicians might be included. Yoder added that
traditionally social work is not considered to be part of allied
health, yet the Council has a specialty group, NC Society of
Social Work Leadership in Health Care.
Later in the meeting, Sadler asked whether gerontology should
be considered. Yoder and Bacon said it should be considered.
Susan Dyson asked how an increased number of professions represented
on the Council might impact the Council’s resources. Yoder
said it could mean conducting more workforce studies. Bacon
said that because of electronic communication, he does not think
the impact would
be great.
Bacon voiced his perception that there was a great deal of
interest among Council members in inviting additional allied
health participants to the Council. He said Karen Luken was
chair of an earlier committee that examined how to group professions
on the Council and that he will ask her to reconvene that committee
to look at how the Council addresses whom to invite and to recommend
a process for extending an invitation to other groups.
Data Committee Report:
Alan Brown said efforts toward the State of Allied Health Report
are underway. He noted that Kathy Heilig had distributed surveys
to hospital human resource personnel to help determine which
professions should be targeted for the report. But, he said,
response has been poor. Dyson reported that while a firm decision
on which professions should be targeted has not been made, three
professions appear likely. They are clinical laboratory scientist,
medical laboratory technician, and respiratory therapist. Dyson
said she has begun to identify data sources for
the report.
NC Legislative Activity Report:
Porter reported that the General Assembly is in the period of
activity known as “the interim,” the time between
sessions. During this time, much work is done, including meetings
of standing committees, she said. Issues under consideration
include those related to Medicaid, malpractice, domestic abuse,
and companion animals. Active standing committees include Government
Operations, the Legislative Committee on Mental Health, and
Educational Oversight. Porter said some committees are required
to make reports when the next legislative session begins. Also,
she said, two special sessions have been held to discuss redistricting
and business incentives within the state.
The next legislative session, which begins in May, likely will
include some partisan issues since this is an election year,
Porter said. She added that the governor recently allocated
some special reserve dollars to provide additional pay to North
Carolina’s lowest-paid state employees.
On another topic, Frances Apple addressed the issue of radiologic
science licensure, noting that it remains “on the front
burner.” Porter said some legislators had asked about the
issue.
Porter also discussed the national initiative on therapy caps,
which affects occupational therapists, physical therapists,
and speech-language pathologists. She said the moratorium, which
was signed Dec. 8 and lasts through Dec 31, 2005, is a significant
and much-sought-after extension. She added that a PowerPoint
presentation on the issue is available at http://www.cms.hhs.gov/medlearn/therapy.
Porter also encouraged council members and guests to visit the
General Assembly website, http://www.ncga.state.nc.us,
for information on legislative activities. She noted that all
committee meetings are open to the public. One may ask to automatically
receive agendas and information or log onto sites of committees
of interest. Also, an individual may present to a committee
by contacting the committee’s legislative assistant. The
links will be put on the Council’s web site.
Bill Croft added that he has found North Carolina Watch to
be a helpful resource at a low cost.
Executive Director Report:
David Yoder reviewed efforts to collect survey data and to gather
summary statements about represented associations. In another
matter, he showed the Council a poster and brochure from the
Health Professions Network and provided information about the
organization. Yoder added the Council now is linked with the
organization’s site. Also, Yoder and Porter noted that
Western Carolina Center has been renamed as the J. Iverson Riddle
Development Center in honor of Iverson Riddle, the center’s
first and only director.
In other discussion:
Croft presented a position statement from the NC Respiratory
Care Board and the NC Association of Respiratory Educators,
which supports development of baccalaureate level education
in respiratory care and encourages respiratory care practitioners
to pursue advanced levels of education. Croft noted that many
educators in the profession are nearing retirement. He said
approximately 40 schools in 20 states offer advanced degrees
for respiratory therapists and that no baccalaureate or masters
degree programs in respiratory care are offered in
North Carolina.
Sadler said efforts toward establishing a baccalaureate program
generally would start at a university campus level. He offered
to assist Croft in making the appropriate contacts for working
toward establishing a baccalaureate program.
Mann noted that looking at the possibility of distance education
is important. She added that while community colleges do not
have bachelors degree programs on campus, they may allow others
to come on campus to provide such programs.
Bacon voiced on behalf of the Council a positive attitude toward
working with Croft on the issue of establishing a baccalaureate
program in Respiratory Therapy.
On another topic, Wysocki said the Common Practice Terminology
(CPT) code of Medicare for assistive technology is official
and falls under assistive technology assessment. He added that
it has a high relative value unit (RVU). Additional information
is available at http://www.cms.hhs.gov.
Also, Wysocki expressed concern about prior authorization for
Medicaid reimbursement, noting that the workload of dealing
with reimbursement issues falls on the practitioner, reducing
time for patient care.
In other matters:
- Yoder distributed a packet of information on the NC Nurse
Scholars program on behalf of Algie Gatewood, who was unable
to attend the meeting.
- Bacon reported that the North Carolina Health Careers book
is being updated for next summer. He said the upcoming print
run will be larger than those of the past so they can be more
available to counselors at community colleges. The publication
will include a section that addresses the Latino health workforce.
- Tara Owens announced that Duke AHEC has copies of Polyglot,
a Multimedia Medical Spanish Translation on CD-ROM. While
not designed as a substitute for an interpreter, the program
may help a practitioner learn basic greetings and some essential
phrases, she said.
- Bacon announced that the Greensboro AHEC Spring CE catalog
is available.
- Wayne Foster said the North Carolina Speech, Hearing and
Language Association will celebrate its 50th anniversary in
Asheville at the end of March.
- Yoder made a correction to the agenda, reminding the Council
that the meeting with Association Presidents will be May 5.
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