Rural Health Advisory Committee Meeting Minutes
RURAL HEALTH ADVISORY COMMITTEE
Tuesday, July 24, 2007 9:30 a.m.-2 p.m.
Minnesota Department of Health
Snelling Office Park
1645 Energy Park Dr., Red River Room
St. Paul, MN
Members Present: John Baerg (Butterfield),Thomas Boe (Moorhead), Debra Carpenter (Erhard), Darrell Carter (Granite Falls), Ray Christensen (Duluth), Tom Crowley (Wabasha), Representative Steve Gottwalt (St. Cloud), Margaret Kalina, Diane Muckenhirn, Chair (Hutchinson), Thomas Nixon (Deerfield), LaVonne Schlieman (Morris) and Senator Betsey Wergin (Princeton)
Members Absent: Representative Mary Ellen Otremba, Nancy Stratman and Senator Jim Vickerman.
MDH Staff Present: Doug Benson, Linda Norlander, Tamie Rogers, Mark Schoenbaum, Angie Sechler, Kristen Tharaldson, Office of Rural Health and Primary Care; Health Policy Division Director Jim Golden, Assistant Commissioner Scott Leitz and Commissioner Diane Mandernach.
Audience: Virginia Barzan, Minnesota Academy of Family Physicians
WELCOME AND INTRODUCTIONS
Diane Muckenhirn welcomed new members and visitors. New RHAC members include: John Baerg, Tom Boe, Deb Carpenter, Representative Steve Gottwald, Margaret Kalina and Tom Nixon.
John Baerg (Consumer Member)
New hospital is being built in St. James with funding assistance from the USDA. As a county commissioner, would like to see greater use of public health services in the area.
Rural areas also have a need for home care to fill the gap between one’s residence and going to a nursing home. More transportation is needed to get seniors to health care services. There is a lack of mental health services in the area with Mankato being the closest community for accessing the services of a mental health provider.
Thomas Boe (Licensed Health Care Professional)
Echoed a concern expressed by Dr. Carter at a previous RHAC meeting about dentists refusing Medicaid patients and those patients going to emergency rooms for acute dental needs. Noted that the dental workforce in rural Minnesota is aging—the average age is 53. An educational outreach program about the importance of dental care is being sponsored by the West Central Initiative, in Fergus Falls. Apple Tree and Smile Center are private ventures conducting similar programs. New Moorhead dental clinic was overwhelmed shortly after opening. The results of a new study about the adverse effects of soda on dental health were recently published in the Pioneer Press.
Deb Carpenter (Consumer Member)
The West Central Initiative is offering a workforce grant to increase the availability and development of preceptor program.
Darrell Carter (Physician)
The Trauma Care System needs support and encouragement as it rolls out in Minnesota, given that 60 percent of trauma deaths occur in rural areas and only 20 percent of the population lives there. Trauma care ensures quality assurance.
Ray Christensen (Higher Education member)
Gary Davis is new Dean of University of Minnesota Medical School - Duluth Campus. The summer medical intern program has grown from 15 to 69 students, many from the Twin Cities metro area. As many as 70 different hospital and clinic sites are participating.
The Area Health Education Consortium (AHEC) is sponsoring an Inter-Professional Education Conference in September that will include social service, nursing and pharmacy. The Duluth Rural Pharmacy program is graduating its first class. The Minnesota Rural Health Association will be having its Upper Midwest Rural Health Policy Summit in Crookston, Minnesota on August 17, 2007.
Thomas Crowley (Hospital Administrator)
The community outreach program addressing metabolic syndrome continues at St. Elizabeth’s Hospital and trend line data is now available for measuring progress. An appropriation of $500,000 to continue the program is pending in the federal health care bill co-sponsored by Senator Coleman and Representative Waltz. Expressed ongoing concern about the difficulty in recruiting family practice physicians. A nurse practitioner and geriatric nurse midwife have been recruited to fill the other two open positions.
Representative Steve Gottwalt (House of Representatives Member)
A member of the Health and Human Services committee, sits on the Legislature’s public health work group, and is especially interested in issues regarding telemedicine, volunteerism, senior home support, childhood obesity and dental health in rural areas. Also expressed interest in seeing regional health care systems reaching out to smaller Minnesota hospitals. Noted that his employer, Coburn’s grocery stores is currently establishing a childhood obesity reduction initiative.
Margaret Kalina (Registered Nurse Member)
Forty percent of the RN workforce is projected to be 55 years and older by the year 2015. Collaboration with academia to expand RN programs is underway to address the future need for nurses as older RNs leave the workforce. Delivery system is also striving to become more efficient.
Diane Muckenhirn (Mid-level Practitioner)
Recently returned from the National Nurse Practitioner Conference in Colorado, where the need for rural health care and collaboration among all health providers were priority topics. Noted the need for a call-to-action, involving the public and bringing health care issues to the forefront of the national agenda.
Thomas Nixon (Volunteer Ambulance Service Member)
Local response time for EMS can be up to two hours in some areas. Reported the shortage of EMS volunteers and the difficulty recruiting. Current volunteers are being called often because of the shortage.
LaVonne Schlieman (Consumer Member)
Concurred with Tom Nixon’s statements regarding the declining number of emergency service volunteers, having observed an inadequate number of first responders available to cover the local area. Also reported concerns over the lack of mental health care services for the National Guardsmen returning from Iraq.
Senator Betsy Wergin (Senate Member)
Came away impressed with the standardized communications and regional coordination of health care services recently observed between a rural and urban hospital setting.
Dianne Mandernach, Commissioner of Health
Discussed her controversial decision to wait to release data regarding the incidence of mesothelioma among miners on the iron range. Apologized for that decision and noted that follow up to these findings is now in place.
The latest community outreach efforts to help military adjust to returning from Iraq are being led by Chaplin John Morris of the National Guard. Additionally, county Veterans Services and local public health are resources to refer military families seeking assistance.
Long-term care and preparedness is the subject of an MDH meeting. There is a real need for inclusion of long-term care services, especially stand-alone nursing homes, in the statewide emergency preparedness program.
Working on making Transformation 2010 a major initiative, which is intended to prepare the state for the growing aging population.
OFFICE OF RURAL HEALTH AND PRIMARY CARE REPORT
Mark Schoenbaum, Director, ORHPC
RHAC Work Plan: Rural Health Issue Identification
Diane Muckenhirn, Chair-elect
Linda Norlander, Program Planning Supervisor, Office of Rural Health and Primary Care
Mark Schoenbaum, Director, Office of Rural Health and Primary Care
Rural issues ranging from lack of health professional workforce to financial stability for the rural health care system were discussed. RHAC members prioritized the issues. Top areas of concern included workforce development, need to look at new rural models of care delivery and population health including chronic disease management, disease prevention and the aging population.
Work plan priorities will be organized with staff suggestions on follow up. A draft of the work plan will be presented at the September meeting.
OTHER BUSINESS AND NEXT MEETING
Agreed to have the next RHAC meeting as a site visit to St. Elizabeth’s Hospital in Wabasha. Meeting will include a presentation by staff from St. Elizabeth’s on some of their projects as well as a tour of the facility.
The next Rural Health Advisory Committee meeting is scheduled for Tuesday, September 25, 2007, St. Elizabeth’s Hospital, 1200 West Grant Boulevard, Wabasha, Minnesota.
MEETING WAS ADJOURNED AT 1:10 p.m.