| Thomas Bacon, Chair,
welcomed persons attending the Council meeting. He also recognized
Allied Health Professions Week and discussed the importance
of allied health professions. Following an opportunity for Council
members, panel participants, and guests to introduce themselves,
the Council approved the September 3 minutes.
Impact of the Allied Health Professions on the Health
Care System of North Carolina
Dr. Robert Thorpe, past Associate Chair of Allied Health Sciences,
UNC-CH, was introduced as chair of a panel on the Impact
of the Allied Health Professions on the Health Care System of
North Carolina. Thorpe noted that the AMA estimates that
approximately 60 percent of all health care providers are allied
health professionals. He presented panel members:
Thomas Bacon, Chair; Director, NC Area Health Education
Sylvia Flack, UNC Systems Allied Health Programs Rep.; Dean,
School of Health WSSU
Elizabeth Isler, NC Community College System Rep.
Marge Ottofy, Allied Health Professional Rep, Group 6; CMA
Bill Pully, President, NC Hospital Association, Chair of Advisory
Board for CAHNC
Flack explained that universities first serve the citizens
of North Carolina, particularly through programs in the rural
areas of the state. Such programs send students into mostly
underserved areas where they can utilize the facilities and
clients as a learning lab. The students learn and, simultaneously,
clients receive health care. She also reviewed the role of allied
health professions in research in the state’s universities and
colleges. Regarding the continuing need for health care professionals
and programs to train them, Flack discussed Winston-Salem State’s
internet-based clinical laboratory science curriculum and other
programs.
Pully spoke on behalf of the North Carolina Hospital Association,
which represents 137 hospitals in the state. He said the state’s
hospitals employ approximately 135,000 people and that there
are “clearly thousands” of allied health professionals included
in that number. He added that he expects an increase in the
demand for allied health professionals due to the state’s aging
population and influx of retirees. Pully said he applauds the
Council’s effort to ensure an adequate workforce to meet the
population’s health care needs in the coming years.
Isler said North Carolina’s Community College System includes
59 institutions with an institution located within 30 miles
every citizen. The system’s purpose is to ensure that every
citizen has access to an education, she explained, adding that
all health agencies have access to a major institution that
can provide training to prepare allied health workers. She noted
that community colleges offer more than 40 types of programs
in allied health.
Bacon reviewed the past four decades of the AHEC program and
recruitment efforts in North Carolina among health care disciplines.
In the 70’s, he said, when the focus was on recruiting physicians
to rural areas, a statement was made that it would be difficult
to recruit physicians unless attention was given to an array
of health professionals. During the 90’s there was a clear recognition
of shortages in allied health professions. Some legislation
and funding provided for the expansion of occupational therapy,
physical therapy, and speech-language pathology programs.
The last three years have been challenging, but productive,
Bacon said. The Council was granted some permanence through
the Duke endowment grant. New studies have been done on the
need for allied health professionals. And, he said, North Carolina
is providing leadership on an array of health care issues, including
the need for diversity.
Ottofy reviewed progress and developments for CMAs who, she
said, have high ethics, are compassionate, and are team players.
She outlined the varied roles the professionals play in health
care, particularly on patients’ behalf, noting that they do
“whatever it takes to get the job done in a cost-effective manner.”
As the panel presentations ended, Yoder recognized the important
role Thorpe has played in Allied Health Sciences as well as
in AHEC and statewide. “You have made a positive influence,”
he said. “And we expect you will continue to make a positive
influence.”
In response to questions following the panel presentation,
Pully said Bill Atkinson is chair-elect of the NC Hospital Association
board and that he anticipates a greater emphasis on providing
resources for preparing students entering health care and for
ensuring adequate facilities for training. He said individual
communities decide on needs and resources, but that he does
not think hospitals can afford to leave positions vacant for
long. Isler noted that hospitals not only assist students entering
health care, but also help with financial support for many training
programs.
Lee McLean noted the opportunities offered through programs
such as distance learning, adding that programs are “going and
growing” in spite of economic pressures.
Frances Apple thanked Ottofy for support of a radiologic science
bill on licensure before the
NC Legislature.
Wayne Foster noted the strength of professional associations
and boards in North Carolina, adding that many from the state
are seen as leaders nationally. Ottofy added that North Carolina
is second in the nation in the number of CMAs, with nearly 2,000
in the profession statewide.
Stephen Thomas said a strength of allied health professionals
is their responsiveness to health care needs in North Carolina
as well as in other states. He noted the usefulness of distance
learning which allows hospitals to keep their employees while
increasing learning opportunities.
Responding to Susan Dyson’s questions regarding which allied
health needs are being filled and what professional and allied
health needs are greatest, Ottofy said there has been discussion
about a CMA program at the community college level. Pully added
that survey information has shown a tremendous shortage of radiologic
science personnel. He said a quarterly reporting system is being
put in place to better evaluate such needs and that in the coming
year a regular report on needs probably will be available.
Isler said that while community colleges are often seen as a
vehicle for providing training, they also are employers and
have a great need for instructors, with the highest vacancy
rate among radiologic science instructors. As faculty “age out,”
a large faculty shortage is developing, she said. Fowler voiced
agreement, noting that it is helpful to look at needs in specific
areas and how to respond in those areas.
Apple noted that a master’s degree is required for community
college faculty. But, she said, professionals with a master’s
degree can earn more outside the community college system. Also,
she said, there is a clinical component which must be addressed.
Referring to Pully’s statement that hospitals employ about
135,000 people, Yoder said that if allied health professionals
make up 60 percent of all health care employees, then 80,000
allied health professionals should be working in hospitals.
Pully said he does not think there are that many, but that the
association will try to get a count on the next survey. He added
that hospitals need to expand because of the aging population
and that all professions should consider ways to increase their
numbers. Pully said he will do all he can to secure permanent
funding for the Council, adding that he is optimistic about
the Council and its role in meeting health care needs in North
Carolina.
Libby Haile noted the vital role continuing education plays
in health care, adding that it is important that employers provide
employees time for such programs. Other discussion followed
regarding efforts to provide continuing education and professionals’
efforts to obtain training without leaving positions unstaffed.
Advisory Board Update:
Bacon said the AHEC board is “very supportive” of the Council’s
work and will assist in the Council’s efforts to obtain permanent
funding to supplement the Duke Endowment Grant, which ends in
2005. An important issue, he said, is how to approach the legislature
and what mechanism should be used for funding the Council. Bacon
explained that he and Yoder had thought it best to target the
2005 legislative session, but that the Advisory Board felt they
should be active in the 2004 session. He added that work should
begin immediately.
Yoder said he had met with Peyton Maynard to discuss strategies
on the matter. Maynard reviewed the Council’s guidelines and
said the group’s organization should remain as it is. If the
Senate and/or House decides it would like to have members sit
on the Council, the issue can be addressed at that time. Yoder
said discussions are focusing on best strategies for future
funding and that the goal is to move ahead with a bill in time
for the legislative short session.
Bacon added that it is important for the Council to look into
other grants and funding
sources, adding that Duke Endowment usually is reluctant to
extend grants beyond their three-year commitment.
Recognition of Elizabeth Isler:
Bacon presented a certificate of appreciation to Elizabeth Isler
and formally acknowledged her important contribution to the
Council and to allied health. He said she has been instrumental
in linking hospitals and community colleges and has sought opportunities
to create educational programs to meet needs. Isler thanked
the Council and noted the significance of its work.
Efforts to Standardize Transfer of Courses:
Regarding efforts to standardize the transfer of courses between
community colleges and universities, Isler recommended having
an ad hoc committee that would report to the Council. She explained
the difficulty involved with transferring credits among institutions
and outlined steps taken by the nursing profession to allow
credit transfer. Solving the problem would enhance all of the
educational developments and, if the Council and university
partners are willing to discuss it, the community college system
would be more than happy to do so, she said.
Responding to a question on the matter from Yoder, Jim Sadler
said a comprehensive articulation agreement was put in place
several years ago between the community college and university
systems that addressed lower-level general course transfer.
That agreement works reasonably well, he said. He outlined other
discussions dealing with course transfer, noting that it is
a complex issue. For accreditation, each school must have it
own philosophy. Taking the uniqueness of each school and trying
to standardize it across the state is a challenge, he explained,
adding that he would welcome discussion on the issue.
Isler said she had served on the transfer advisory committee
as a representative for the community college system when efforts
were underway to form transfer agreement for nursing. Although
she had been told of the difficulties in working out one standard,
with her insistence a successful program was developed. She
said a carrot might be found that would make the process palatable
to everyone.
Bacon said some other states have been more successful in transfer
programs than North Carolina. “We don’t make it easy for students,
many times, to move from one system to the next,” he said. Recognizing
a willingness by the Council to address the need, Bacon asked
for volunteers to work on the matter. Volunteers were Ned Fowler,
Sylvia Flack, Elizabeth Isler, Steve Thomas, and Jim Sadler
or another appropriate person. The Executive Committee will
discuss this issue and recommend names for a Task Force to work
on the problem.
Due to another commitment, Bacon asked Vice Chair Kathy Heilig
to assume leadership role for the remainder of the meeting.
Data Committee Report:
Alan Brown gave an update on Data Committee activities. Audrey
Godwin discussed the implementation plans for the HIM study.
Frances Apple referred to the radiologic science study just
completed and said she accompanied Susan Dyson to the NC State
Health Coordinating Council (SHCC). The SHCC, along with the
Division of Facility Services, NC Department of Health and Human
Services, develops the annual State Medical Facilities Plan,
which projects need for specific health care facilities and
services including acute care hospitals, technology services,
and operating rooms, among others. The SHCC will convene new
workgroups/study groups to reevaluate the current methodologies
for determining MRI and PET scanners across the state. Apple
has spoken with staff at the Division of Facility Services to
request that a technologist representative be present on each
of the two new committees.
Apple reviewed efforts toward collecting data and to identify
needs without creating a cycles of glut and shortage among personnel.
Brown discussed the “new model,” referring to the State of
Allied Health Report, and said a formal data committee has not
been put in place. He said Council members may be called on
to help with portions of implementing the model.
Dyson reported that Erin Fraher presented on the Allied Health
Workforce Assessment Projects at the recent meeting of the Association
of Schools of Allied Health Professions in Toronto. The presentation
focused on the challenges in implementing recommendations of
the report and how the allied health professions could better
position themselves for effecting change. Erin received several
comments from attendees that many other states are facing similar
difficulties in assessing allied health. There was interest
in possibly conducting a method workshop to highlight North
Carolina’s process at a future meeting. Additionally, a paper
on the allied health workforce project, written by Dyson, Fraher,
and Sandra Green, has been accepted for publication in an upcoming
edition of the Journal of Allied Health.
Regarding the State of Allied Health, Dyson said the upcoming
focus will be a comprehensive snapshot of several professions.
Every allied health professional association president and employer
represented on the Council will receive a survey asking them
to rank allied health professions in terms of shortages. She
said additional secondary data will be collected from the Bureau
of Labor Statistics, American Hospital Association, national
professional associations, educational systems and possibly
the NC Hospital Association. Collected job vacancies for the
selected allied health professions may be tracked across the
state for a six-month period as another indicator of a shortage.
Brown said using the new model and secondary data should allow
a quicker turnaround of the report and that he hopes to complete
two reports annually.
Additional discussion focused on utilizing hospitals’ human
resource departments as well as health recruiters.
NC Legislative Activity Report:
Patricia Porter outlined the latest session of the General Assembly,
which was one of the “shortest long sessions” in history. She
said much was left undone. While the General Assembly will next
convene on May 10, much happens in committees and subcommittees
in the meantime, she said. Topics on which she provided information
include:
• Committee work on care, treatment, and shelters for animals
• Consideration of toll roads
• Committee work on the issue of domestic violence
• Information on bills at www.ncga.state.nc.us
• A PowerPoint presentation on legislation relating to education
• Legislative redistricting
Porter said General Assembly members have been told state funds
will be very limited and that discussions will include ways
to reorganize and obtain additional federal funding as well
as on ways to further reduce spending.
Rees asked whether the Council can add a link to the state’s
website. Porter indicated it should be possible to do so.
Heilig noted that a subcommittee from the educational malpractice
group will look at the issue of increasing medical malpractice
insurance. Porter said the focus is on the perceived failure
of the medical society to police its membership and that the
perception is that if ineffective physicians were not practicing,
there would be fewer lawsuits.
Executive Director Report:
Yoder introduced Vivian Lail-Davis as the Council’s administrative
assistant. He said Andrea Catenaro will continue to maintain
the Council’s website. Also, he said one of the Council’s goals
is to market itself more aggressively to the Legislature. He
said efforts are underway to obtain permanent funding for the
Council, adding that the Advisory Board wants to approach the
General Assembly in time for its short session.
Heilig asked the Council to forward suggestions and ideas that
the Executive Committee should discuss during its conference
call. Yoder noted that the next call will be December 8 at 9
a.m.
In other discussion:
Haile reported that Bill Milner, DDS, President of Access Dental
Care, who gave a presentation to the Council in January, has
an article on his program in the NC Dental Gazette. She said
the program was expanded to Cabarrus County and that one is
being considered for Chapel Hill.
Carolyn Taylor said Janice Cutchins’ (retired Allied Health
representative from Area L AHEC) husband, Lawrence MD, will
be installed as president of the N.C. Medical Society. He was
the first Area L AHEC director.
January Council Meeting:
The next Council meeting will be Wednesday, January 7, in Board
Room 1.
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