Testing States


Colorado

Click Here for Updated State Plan
State's SIM website

  • By 2015, recruit and retain 148 primary care and dental providers through the Colorado Health Service Corps. (p.5)
  • Workforce Initiatives - Conducting a comprehensive review of current Colorado health professional practice acts, statutes regarding provider credentialing and empanelment and related issues. This will help clarify the perceived and real barriers to collaboration among professions and increases in administrative cost. As part of this effort, a Governor-appointed task force is in the final stages of an analysis of requirements for advance practice nurses to obtain prescriptive authority. It is likely they will recommend a statutory change to reduce barriers to entry for this authority. (p.35)
  • Gathering data on the readiness level of Colorado’s practicing behavioral health workforce to be trained to work in an integrated primary care setting in order to inform the scope and level of training efforts undertaken across the state, and help to target efforts. (p.35)
  • Assessing the workforce needed for both clinical needs and non-clinical needs, such as IT, administration and billing, discharge planning and health navigator services that may be needed to support the system. Creating learning opportunities for both primary care and behavioral health providers to learn how to best work with one another in both settings. Integrating providers requires addressing cultural elements; as such, we will offer opportunities for providers for team-based training, both in educational and “real world” settings. (p.27)
  • Colorado is one of seven states selected by the National Governors Association to implement a health workforce development plan that will create a centralize data and analytics hub, use data to drive statewide workforce planning that is responsive to local needs and build on Colorado’s nationally recognized loan repayment program to expand recruiting and retraining efforts. The Governor’s Office will work with the Colorado Department of Higher Education, the Community College System, and key health professions’ educators to ensure that team- based, integrated care delivery is a training priority. (p.27)

Connecticut

Click Here for Full State Plan
State's SIM website

  • On-going education and support of primary care practitioners. A Learning Collaborative will focus on the transformation needs of PCPs working with Medicaid patients and with federally qualified health centers (FQHCs). There is an extensive plan for community health workers (CHWs) and other team members, based in Area Health Education Centers. There is a plan for CT colleges and universities to produce and retain more PCP team members. (p. 13)

Delaware

Click Here for Full State Plan
State's SIM website

  • Healthy Neighborhoods will create an inter-professional forum that brings together workforce responsible for coordinating care, including care coordinators and community health workers. (p. 4)
  • Retraining current workforce, building sustainable workforce planning capabilities, training future workforce in skills needed to deliver integrated care. (p. 16)
  • Academic and healthcare communities will collaborate on multi-year curriculum that includes: simulation-based learning modules, facilitated workshops on team-based care, development of core competencies for new roles, symposia. (p. 16)
  • Statewide Telehealth Coalition: expanding practices for individuals with disabilities, mental health disorders, and chronic conditions. (p. 26)

Idaho

Click Here for Full State Plan
State's SIM website

  • The IHC will join forces with the Idaho Health Professions Education Council, Idaho Area Health Education Center, and the Idaho Telehealth Council to support workforce expansion efforts and develop innovative strategies to maximize the capacity of the State’s limited healthcare workforce. Some barriers caused by the State’s workforce shortages will be addressed through the use of multi-disciplinary teams in the PCMH. Each PCMH team member will practice at the top of their license and achieve efficiencies by delivering care at the appropriate level. (p. 4)
  • Physicians will be able to focus their time on clinical care requiring physician-level intervention while other staff, such as nurses and community health workers (CHWs), provides care within the appropriate scope of their practice. (p. 4)
  • Train over 550 CHWs and community health emergency medical services (CHEMS) to assist in providing rural patient access via virtual PCMHs. (p. 5)
  • Proposed CHW and CHEMS training programs will include staff training and on-site technical assistance to assure successful integration of these staff into the PCMH team. (p. 5)

Iowa

Click Here for Full State Plan
State's SIM website

  • Population health improvement plan - some of it will be driven by LPHAs, who will provide resources and collaborate with the ACOs through a community health worker/care coordination model. (p. 3)
  • Growing competition between ACOs should generate new workforce models that utilize lower levels of licensure. Expanding the team to include social workers, pharmacists, community health workers, nurses, and others, will mitigate access to care challenges resulting from medical provider shortages. IDPH also manages a variety of loan repayment and recruitment and retention programs supporting community delivery systems and will use the case studies to better inform policies. (p. 13)
  • During early SIM workgroup meetings, ACOs indicated that they have already begun re-training their workforce to engage in team-based care, telehealth, and practices that support a more effective system. IME supports the use of telemedicine and will work to identify levers to expand workforce reach. (p. 46)

Michigan

Click Here for Full State Plan
State's SIM website

  • Verify that health care professionals practice at the top of their training and licensure, review the overall licensing scheme, while being attentive to the goal of avoiding unnecessary regulation. (p. 12)
  • A policy objective of the Blueprint is to incorporate Incorporate non-traditional professions, such as Community Health Workers, into service coordination while also supporting standards for the training and skill sets of these occupational groups. (p.12)

New York

Click Here for Full State Plan
State's SIM website

  • All workforce efforts focused on supporting primary care physicians, nurse practitioners and physician assistants: their education, distribution, scope of practice at top of license, and retention. (p.7)
  • For physicians the state has embarked on a Medical Residency Training State Matching Grants program to provide matching state funding to sponsors of accredited graduate medical education residency programs in this state to establish, expand, or support medical residency training programs. The program focuses on primary care physician and psychiatrist residencies. (p. 46)

Ohio

Click Here for Full State Plan
State's SIM website

  • Provide targeted capacity-building support for Patient-Centered Medical Home model (e.g., EHR implementation or performance measure education). (p. 10)
  • Comprehensive plan to support advanced primary care and recruitment and retention of minorities into health professions. (p. 14)


Rhode Island

State's SIM website
Click Here for Full State Plan

  • Within this broad-based authority there are numerous opportunities to promulgate regulations in support of the Value-Based Care Paradigm. Examples include utilizing the licensing authority to incentivize the Value-Based Care Paradigm, such as, offering discounts on fees to health professionals who certify as a care team; developing a regulatory “tunnel” to allow ACOs to apply for a single facility license rather than a separate license for each building and practice as current regulation requires; updating Emergency Medical Services (EMS) regulations to support use of EMS for both prevention and coordination of primary care; coordinating professional practice regulations to define team-based practices and develop professional alignment to improve public health outcomes. In addition to regulatory authority, DOH also leverages existing policies and practices to drive healthcare facilities and professionals towards a Value-Based Care Paradigm. (p 12)


Tennessee

Click Here for Full State Plan
State's SIM website

  • Development of a comprehensive training program for individuals paid to deliver long term services and support. (p. 12)
  • Tennessee law promotes a mix of professionals in its healthcare workforce, with an emphasis on integrative primary care. (p. 15)
  • Higher than average concentration of nurse practitioners. (p. 15)


Design States



American Samoa



More to come...



Arizona:

Click Here for Full State Plan

State's SIM website

  • Several programs are well-positioned to support the proposed SIM workforce efforts to analyze and assess the effectiveness of various models and expand provider training and education opportunities. (p. 8)
  • Develop an integrated behavioral health workforce and training for a variety of providers, including community-based behavioral health providers. (p. 8)

California

More to come...

District of Columbia

More to come...

Hawaii:
Click Here for Full State Plan
State's SIM website

  • Developing an interprofessional workforce center to serve as a data repository and neutral authority on workforce data with behavioral health provider data as its first priority. (p. 7)
  • Supporting state-owned academic institutions and rural hospitals to expand interprofessional medical education residency programs that integrate behavioral with primary care practice. (p. 7)

Kentucky
Click Here for Full State Plan
State's SIM website

  • Strategically assess workforce needs to leverage existing state-level, multi-stakeholder effort (e.g., NGA Academy). Transform state’s health care workforce scope and pipeline to provide modernized, holistic approach to health care in view of shifting models of care delivery. (p. 6)
  • Kentucky was one of seven states selected to participate in the National Governors Association Policy Academy "Building a Transformed Health Care Workforce: Moving From Planning to Implementation." (p. 9)


Illinois
Click Here for Full State Plan
State's SIM website
  • Ensure an adequate workforce with the appropriate education,
    training and compensation. (p. 1)
  • In the area of workforce (Plan objective # 4), Illinois has passed legislation to improve the effectiveness and efficiency of the health care workforce. The community health worker advisory board (HB5412) will develop recommendations for the certification process of community health workers. Clinical psychologists who have met specific training requirements can now prescribe controlled substances (Public Act 98-0668). A three-year pilot program for certified nursing assistants to also become certified medication aides (SB 2958) has been created. Telehealth services can be covered by insurance as if the services were rendered onsite (SB647). Dentists, with the appropriate training, can administer the flu vaccine to individuals 18 years of age and older. (Public Act 98-665). These laws expand the scope of practice, and allow Illinois residents in rural areas to receive better access to health care. (p. 13)
  • Illinois proposes to use the following outcome measure to monitor the impact of the Model: # of community health workers working in Model Test pilot sites. (p. 27)

Maryland:
State's SIM website

More to come....

Montana

More to come...

Nevada
Click Here for Full State Plan
State's SIM website

  • Health care workforce listed as one of three categories of innovation and systematic improvement areas. (p. 2)

New Hampshire:
Click Here for Full State Plan
State's SIM website

  • Eliminate waste and improve the efficiency and effectiveness of health care delivery through health care systems engineering (HSE) and implementation, evaluate workforce adequacy and use (p. 7)

New Jersey

More to come...

New Mexico
Click Here for Full State Plan
State's SIM website

  • Assessment of regulatory approaches to improve the health care workforce. (p. 8)
  • Greater use of CHWs is one key to improving the delivery system. One goal of statewide CHW certification is to provide opportunities for reimbursement through Medicaid for CHW services, thereby promoting growth of this critical component of the state’s healthcare workforce. As part of the Model Design plan, strategies will be developed with key stakeholders to link CHWs to primary care providers, to explore dual-training options and multiple CHW roles, to explore options to integrate public health essential services and primary care services, and to create a cohesive and integrated CHW workforce. Alternative reimbursement streams for CHWs will also be explored.(p. 5)
  • Community Health Workers (CHWs) provide services that span the life continuum. (p. 2)

Commonwealth of the Northern Mariana Islands

More to come...

Oklahoma
Click Here for Full State Plan
State's SIM website

  • One of the OHIP health transformation goals is to collect, host and analyze standard workforce data on healthcare professionals. This initiative seeks to create a repository accessible by all involved partners, which would provide capacity for data analysis and enhance the understanding of current workforce needs and strengths. A workforce repository could be provided by the VBA and would enable the identification of opportunities and allow for strategic planning efforts as health professional shortage areas emerge or recede. The implementation of this OSIM healthcare workforce project will receive added support in its alignment with the healthcare workforce goals and objectives identified by the Oklahoma National Governors Association Policy Academy (NGA). (p. 12)
  • $225,000 Health Workforce Assessment: The Contractor will conduct an assessment of and catalog health workforce data, to include: a description of various issues and influences affecting the health workforce, including the state’s legislative and regulatory history and its current programs, financing and policies affecting health professions, education, service placement and reimbursement, planning and monitoring, and licensure/regulation. The Contractor will also perform an assessment of the state’s internal capacity and existing strategies for addressing the above workforce issues and influences, and will provide a policy analysis on the implications of the current workforce data, issues, capacity and strategies. (p. 22)


Pennsylvania
Click Here for Full State Plan
State's SIM website

  • To meet the workforce needs of PCMHs and APOs, Pennsylvania will implement an enhanced Loan Repayment Program for geriatricians and behavioral health providers – physicians, nurse practitioners and physician assistants – serving underserved populations. (p. 8)
  • The DOH Center for Practice Transformation and Innovation (CPTI) , with direction from the Advisory Committee, will oversee the central office’s performance of the following functions: a) guiding the direction of the transformation process and overseeing the activities of the hubs; b) developing training materials and practice tools that promote capacity development; c) developing an interactive website to share materials and build a learning community; d) planning and holding regularly scheduled peer learning conferences for provider and APO staff, including care managers, medical assistants, data analysts, and clinicians; e) disseminating a monthly e-newsletter spotlighting transformation successes, summarizing relevant literature, and promoting upcoming training opportunities; f) training practice facilitators on effective coaching skills and elements of the transformation models, and g) evaluating hub and provider performance data to identify issues and make strategic and program adjustments. (p. 7)


Puerto Rico

More to come...

Utah

More to come...

Virginia

More to come...

West Virginia
Click Here for Full State Plan
State's SIM website

  • Invest in resources/programs to prepare professional; support continuous learning for providers; create virtual practice transformation support program. (p. 15)

Wisconsin
Click Here for Full State Plan
State's SIM website

  • The DHS and the SVC LC will identify possible solutions to expand access to clinical and community behavioral health services, including addressing workforce needs (including both para-professional and advanced licensed providers). (p. 6)