According to the Health Resources and Services Administration (HRSA) about 106 million Americans live in a region in which there’s a clear shortage of health care professionals. That national issue is particularly acute in rural communities, which account for over 63 percent of the primary care problem.

In mid-May the National Governors Association published a brief that outlined some of the innovative approaches that states are using to help ameliorate this situation through the federal government’s Rural Health Transportation Program.

Career pathway programs are one major area in which states are moving forward and can “meaningfully increase educational progress and employment in targeted industries,” according to the brief.

For example, Minnesota plans “to increase high school student exposure to health care careers by expanding Health Occupations Students of America (HOSA) chapters, which provide career opportunities and leadership development for health sciences students, and Scrubs Camps, which offer workshops, simulations, and health care facility field trips.”

California, meanwhile, intends “to develop healthcare career pathways based on workforce gaps identified through a new mapping and planning tool. This information will also inform efforts to expand training and education capacity as well as “train-the-trainer” programs to cross-train and increase skills for medical and allied staff.”

A second path states are taking provides rural education and training opportunities. As the NGA explains, “Family physicians who train in rural areas are more likely to continue working in these communities, and states are expanding capacity for rural training programs to grow this workforce along with other health workers.”

Oklahoma, for example, will “expand rural residency programs for surgery, psychiatry and OBGYN specialties through state medical school and rural health care facility partnerships. The state will also provide startup funding for resident stipends, housing and preceptor support so additional rural clinics and hospitals can host residents.”

And Tennessee “will extend a rural dental workforce pilot, add clinicians and dental suites, and expand preventive oral health services to reduce emergency department visits and improve oral health access in Dental HPSAs.”

But creating career pathways and providing training opportunities are just the start. Efforts to recruit and retain people to work in healthcare in rural areas are essential.

Some state governments are providing incentives to bring people in the door. For example, the NGA points to Pennsylvania which “will treat Emergency Medical Services (EMS) workers as a professional provider workforce by providing rural service bonuses, training opportunities, tuition reimbursement for career advancement and mental health mentorship.”

Licensure can also be a challenge to bring in more healthcare workers. As a result “Many states included plans to join interstate licensure compacts in their . . . applications to offer health care workers a faster way to get licensed to work across state lines or in a new state. State legislation is usually required to participate in these compacts.”

Finally, “states are considering changes to healthcare provider practice authority to expand worker capacity and flexibility to meet patient needs while maintaining appropriate safeguards for quality care,” reports the NGA.

Oregon is one good example. It “plans to explore scope of practice changes to give pharmacists additional authority, including drug administration, laboratory testing and prescribing authority. This is part of a wider effort to expand pharmacy services to meet health care demand across the state.”

Vermont is also attempting to expand scope of practice by developing a “reimbursement model for paramedics to triage patients based on the severity of their condition and treat people in the community. This change will allow these workers to provide care in patients’ homes without needing to be transported to emergency departments.”

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