Rural Health Care Summit Discusses Workforce Policy Solutions – High Plains Journal

At the recent Future of Rural Health Care Summit, the legislative foresight session delved deeper into key health workforce policy solutions.

The panel included Clifton Porter, senior vice president of government affairs for the American Health Care Association and the National Center for Assisted Living, and Travis Robey, vice president of policy affairs for the American Hospital Association. Jerry Penso, president and CEO of the American Medical Group Association, moderated the discussion.

Nursing home staffing

As the rural population ages, one concern is nursing home care. The Biden administration has proposed several rules regarding minimum staffing levels for nursing homes. When asked how concerning this is for nursing homes in rural areas, Porter is not happy.

I have never seen a proposed rule be more out of touch with the realities of health care delivery than this one, he said. And I say that because I think optimism is important, but so is reality.

Looking at some of the elements of this proposed rule, Porter said it boils down to a single plan. This approach does not work and is basically what is proposed.

A comment period is currently underway for this proposed rule and Porter believes that once it is complete, the agency will review and summarize the comments.

Immigration

Another topic in rural America is immigration. Finding a long-term solution has been difficult, Penso said, but in health care, one in six registered nurses and one in four direct caregivers are immigrants.

Robey, when asked about some policy ideas and what Congress can do to streamline the immigration system to help solve labor problems, said it was difficult to reach a compromise on immigration, even in the context of health care.

It tends to get bogged down in border security policy, he said, where you simply can’t find common ground or create a divide between Republicans and Democrats.

Porter believes that immigration is probably one of the most frustrating issues he faces, mainly because of macroeconomic policies that stand in the way of common sense.

If we can’t agree on the big things, what can we actually agree on? he said. Politics is probably the most problematic issue than anything else in what I see as a sort of simple, very sensible approach that we can actually get results with.

When it comes to the medical workforce, especially in rural areas, what are some things that can help solve this problem? For Robey, continued expansion will help increase the number of Medicare-funded residency slots.

In rural communities, foreign-born doctors and nurses make up a very important part of the workforce. A proposed bill would allow 25 visas, or 25,000 for nurses and 15,000 for doctors.

It’s not the perfect solution, but perhaps it’s a way to thread the needle, Robey said.

It is also important to prioritize areas of greatest need by establishing new medical schools in rural areas where there is a shortage of health care.

As the data shows, if you train in a rural community, you’re more likely to stay in a rural community, Robey said. Just like if you train in underserved urban communities, you’ll be more likely to stay in those communities. So we want to make sure that we’re training people in rural communities.

Lifeline for providers

Telehealth waivers expire in 2025, and if Congress does not permanently extend the waivers and flexibilities granted during public health emergencies, they will expire. Penso said these telehealth visits serve as a lifeline for rural providers.

I consider telehealth one of the gems that has emerged after the pandemic, Porter said. We were in a situation where we are actually able to prove that telehealth is effective. Telehealth helps solve problems, meet the needs of rural communities in particular and, frankly, urban communities as well.

Much has been learned from this process, and the government must use common sense as groups work to make these particular exemptions permanent.

There are laws and efforts to make this happen, especially in long-term care, Porter said.

Telehealth could be a solution to some of the administration’s proposed mandatory staffing requirements. Porter said telehealth could be a potential solution if allowed in these facilities in rural areas, and could meet the standards needed to ultimately approve quality care. But he ultimately worries about the need for progress on some of these issues.

I think we’re going to make progress on telehealth under this bipartisan agreement, he said. Obviously this is a great solution to solving a lot of our problems, but again, we hope that the administration potentially sees a solution in this proposed rule, and perhaps proposes it as an idea rather than as R&D.

Kylene Scott can be reached at 620-227-1804 or [email protected].