Workers’ concerns took center stage at the recent Dakota Conference on Rural and Public Health hosted by the Center for Rural Health
By Jena Pierce
If there was a theme for the 39th Dakota Annual Conference on Rural and Public HealthIt would be “How to Build a Healthier North Dakota.” In 1990, North Dakota was the healthiest state in the country, according to US Health RankingsBut in 2023, North Dakota was ranked 14th.
North Dakota’s Vision Ministry of Health and Social Services is to regain that prestigious spot and become the healthiest state in the country. Again.
Strengthening health personnel
Building a healthier state requires, in large part, a strong health care workforce, with a pipeline of future providers and employees. And efforts can’t focus solely on physical health, but must include behavioral health and economic health initiatives, according to Dr. Nizar Wehbi, the North Dakota state health officer who oversees the Department of Health and Human Services.
Wehbi’s keynote address, “North Dakota’s Vision for Public Health,” was one of four keynote addresses at the conference, which was held in early June and sponsored by the North Dakota Public Health Association.
The health care workforce was a hot topic at the two-and-a-half-day statewide conference. Many sessions, as well as Wehbi’s keynote, focused on how to recruit and retain the workforce needed now and in the future.
Pulling from all over the world
During the panel discussion on immigrant workers, Brock Sherva, CEO of Northwood Deaconess Health Center in Northwood, North Dakota, shared the challenge of recruiting employees for the health center. “There are several hospitals that are close together and we realized we can’t keep trying to steal employees from each other. We have to find a way to bring in more people to meet those needs,” he said.
For example, Northwood Deaconess decided to look for a foreign employee to fill a lab technician position. Among those interested was Alzandra Carmona, who had studied in the Philippines and wanted to work in the United States. Both Carmona and NDHC worked with international recruitment agencies and had to decipher the complexities of work visas and learn the ins and outs of the options available to them.
Sherva received three applications from the Philippines. After virtual interviews, they offered Carmona the job. She accepted. Four months later, she moved to Northwood on a work visa.
The experience has been positive for Sherva and Carmona, and Northwood Deaconess is working to hire additional international staff in the future. It’s a trend that’s slowly growing across the state.
Stacy Kusler is UND’s workforce specialist Rural Health Center and also works closely with the Office of Primary Care. She moderated the panel. “Hiring non-U.S. workforce should be viewed as a strategy rather than a barrier,” she said.
Kusler’s firm manages the J-1 visa program. “One way to use immigration as a strategy is to use the J-1 physician visa waiver program,” she noted. “Many of the 30 waivers are not used every year, and they are a valuable tool to increase the supply of qualified health care providers.”
Create a pool of labor
One of the conference sessions focused on how to address public health workforce needs in North Dakota. Speakers focused on exposing young people to potential careers in health and public health to inspire them to think about what they want to be when they grow up. Brittany Dryburghproject coordinator at the North Dakota State Office of Rural Health, spoke about the R-COOL Health Outfit ProgramR-COOL Health stands for Rural Collaborative Opportunities for Occupational Learning in Health. (The Center for Rural Health houses the state Office of Rural Health and two vocational training programs specifically for youth.)
Scrub camps Youth Health Camps are for rural students in grades 5-12. They are held in communities and require partnerships between schools, health facilities, and economic development or employment authorities. Each camp is a little different, but common features include local career options available in rural health fields including nursing, pharmacy, laboratory and radiology, public health, and more.
There are also two Scrubs Academies, which are four-day, three-night camps held in major cities. Scrubs Academy I The academy is held at UND and is open to students who have completed grades 6-8. This summer, the academy was held at UND from June 17-20. Students participated in hands-on activities and received information related to various health professions.
Additionally, students were certified in Friends and Family CPR and Health Insurance Portability and Accountability Act (HIPAA).
Scrubs Academy II The program will take place in Devils Lake, North Dakota from July 29 to August 1 and is open to students who have completed grades 9 through 11. Students will spend their days in a variety of healthcare settings (critical access hospitals, tertiary facilities, clinics, long-term care and assisted living facilities, ambulances, and treatment centers), enjoy fun evening activities, and spend the night in Lake Region State College dormitories. Students have the opportunity to shadow people in multiple professions during the academy.
Dryburgh said she’s heard stories of students who attended a camp or academy and went on to earn their certified nursing assistant certification. One student went to Northland Community & Technical College in East Grand Forks, Minn., and earned an associate’s degree in nursing. She’s currently a registered nurse in Grand Forks. Anecdotal stories like these show that filling the pipeline with potential employees works, and these efforts help students continue their careers in the rural communities where they grew up.
Cassandra Schock, Administrator of Nelson-Griggs District Health Unit Students in McVille, North Dakota, can attest to the power of Scrubs camps. Three years ago, the health department was invited to partner with the Nelson County Health Center for a camp, and the partnership has continued each year. The partnership has been helpful, and students learn about the different careers available, not only at the hospital, but also at the clinic and the health department, Schrock said.
For the health unit portion of the camp, Schock said they use oranges as “patients” to show students how to administer the shots, mimicking a technique that has been used for generations to train nursing students. But instructors also use the process to teach camp participants about the life cycle of vaccines, Schrock said.
Ideas and innovations
Another session at the Dakota Conference focused on artificial intelligence in workforce forecasting and preparation. An additional panel featured three state legislators who discussed health policy at the legislative level.
And Grand Forks Blue Zones The association held a session on its programme, complemented by a walk to promote physical activity and social wellbeing at the end of the second day of the conference. Blue Zones focuses on helping people live better and longer lives. Improving quality of life is important for the recruitment and retention of staff and their families.
Wehbi presented the State Health Improvement Plan (SHIP), which is a five-year cyclical plan (2021-2025). It includes four areas:
- Strengthening the workforce
- Cultivating well-being
- Expanding access and connection
- Strengthening community resilience
A steering committee is being set up to gather input from various stakeholders and communities are also being invited to share their ideas.
State Health Officer Wehbi spoke about the statewide health strategy grants that just closed at the end of May. “These grants are about stimulating local innovations that work for communities. We know that different communities have different needs and require different strategies to address those challenges.”
Whether it’s a rural hospital, a local public health department, a university or through a state department, everyone’s goal is to create a healthier place to live. It’s not just a village, it’s an entire state, with different approaches but all working toward the same goal: building a healthier North Dakota.
About the Author:
Jena Pierce is communications manager for UND’s Center for Rural Health.
