1. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Central Minnesota Area Health Education Center November 2007 Presented by:

2. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Introduction  Commissioned by Central Minnesota AHEC  Study of health professional workforce, community health needs and K-12 health careers courses  Focus on Central Minnesota; 14 counties  11 health care and mental health occupations  Conducted by the Rural Health Resource Center - Minnesota Center for Rural Health

3. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis To provide technical assistance, information, tools and resources for the improvement of rural health care. To serve as a national rural health knowledge center and strive to build state and local capacity. Mission

4. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Purpose To gather: data about current and projected health professional supply and demand community health needs health career opportunities in central MN For: workforce planning development of community-based education recruitment and health promotion activities

5. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Regional Definition Big Stone (5,820) Clay (51,229) Crow Wing (55,099) Douglas (32,821) Grant (6,289) Morrison (31,712) Otter Tail(57,159) Pope (11,236) Stearns (133,166) Stevens(10,053) Todd(24,426) Traverse(4,134) Wadena(13,713) Wilkin(7,138) Total region population = 443,995 Source: Minnesota State Demographic Center, Population Projections for Minnesota Counties, 2000 to 2030

6. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Study Objectives  Current Supply of Health Care Professionals  Potential Supply  Projected Supply  Current Demand  Projected Demand  Health Care Professional Compensation  Community Health Analysis  K-12 Health Careers Information and Courses

7. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Methodology  Primary data  School survey  Secondary data  MN Office of Rural Health and Primary Care  State of MN Health Professions Boards  MN Department of Employment & Economic Development  MN Department of Health  MN Department of Human Services  Medical Group Management Association  Analysis of Community Health Boards public health plans

8. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Current and Projected Supply and Demand for Health Care Professionals

9. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Supply and Demand  Current employment status  Current vacancies and shortages  Provider/Population ratios  Health Professional Shortage Areas  State workforce data  Projected future employment  Population projections  Age of health care workforce  Health care professional graduates

10. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Health Care Professionals  Certified Nurse Midwives  Clinical Laboratory Scientists (MLT)  Dentists  Dental Hygienists  Nurse Practitioners  Occupational Therapists  Pharmacists  Physical Therapists  Physicians  Physician Assistants  Veterinarians

11. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Current Supply of Health Care Professionals in Central MN 2006 Active, Licensed Physicians by County in Central MN * = Other specialties not included in Central AHEC Study ** 100% Response based on licensure database. Source: 2006 Physician Licensure Database, Office of Rural Health & Primary Care-Minnesota Department of Health.

12. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Current Supply of Health Care Professionals in Central MN 2004- 2006 Active Advanced Nursing Professions by County in Central MN *Source: Minnesota Registered Nurse Licensure Database, Minnesota Department of Health, Office of Rural Health and Primary Care. *All three CNMs practice in a clinic setting. *100% based on licensure response.

13. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Current Supply of Health Care Professionals in Central MN Active Health Professionals in Minnesota vs. Central MN AHEC Region Sources: Office of Rural Health & Primary Care-MDH, University of Minnesota-College of Pharmacy, MN Board of Veterinary Medicine. Health Professions Central MN Region Minnesota Percent of Health Professionals Working in Central MN Certified Nurse Midwives3744% Nurse Practitioners487037% Occupational Therapists1302,6025% Physical Therapists1431,5709% Veterinarians1741,8529% Dentists1992,4448% Dental Hygienists2432,9128% Pharmacists4167,3246% Physician Assistants879559% Primary Care Physicians2613,8617% Clinical Laboratory Scientists NA Total 170424,2977%

14. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Current Supply of Health Care Professionals in Central MN Source: Physician Compensation & Production Survey – 2006 Report, Medical Group Management Association http://www.salary.com/. Occupational Outlook Handbook, 2006-07 Edition, Department of Labor, Bureau of Statistics, http://www.stats.bls.gov/oco/reprints/ocor008.pdf http://www.salary.com/ http://www.stats.bls.gov/oco/reprints/ocor008.pdf Health Professions Compensation

15. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Health Care Professionals Enrolled in Central MN Region 2006-2007  Clinical Laboratory Scientists 12  Dentists 0  Dental Hygienists 0  Nurses  Master’s NP 0  Master’s CNM 0  Occupational Therapists 0  Pharmacists 0  Physical Therapists 0  Physicians – Family Medicine 4 (per year)  Physician Assistants 0  Veterinarians 0

16. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Health Care Professional Programs Offered in Central MN  Educational programs offered in Central MN Family Practice Physician (Residency Program) Clinical Laboratory Scientists (MLT)

17. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Projected Supply of Health Care Professionals in Central MN Provider Type# Practicing# 55 yr. & over% 55 yr. & over Certified Nurse Midwives3133% Dentists1996935% Dental Hygienists243187% Nurse Practitioners481735% Occupational Therapists130NA Pharmacists41613733% Physical Therapists143139% Physician Assistants871315% Physicians79121828% Veterinarians1744325% Number of Health Care Providers Age 55 and Older in Central MN Source: Office of Rural Health & Primary Care, MDH, University of Minnesota-College of Pharmacy, MN Board of Dentistry, and MN Board of Veterinary Medicine.

18. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Provider Type# of VacanciesVacancy Rate Healthcare Practitioners and Technical (Physicians, Dentists, RNs) 1641.4% Healthcare Support (CNA, Home Health Aides) 3714.8% Current Vacancies and Vacancy Rates of Health Care Professionals Health Care Vacancy Rates in Northwest Planning Region (Includes 12 of 14 Central MN AHEC counties) Source: Minnesota Department of Employment & Economic Development, Labor Market Information Office, Minnesota Job Vacancy Survey, second quarter, 2007.

19. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Central MN Health Professional Shortage Areas 12 counties are full county or partially designated Primary Care Health Professional Shortage Areas (HPSAs) 14 counties (all) are Mental Health Professional Shortage Areas (HPSAs) 6 counties are Dental Health Professional Shortage Areas (HPSAs)

20. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Central MN Population Projections Source: Minnesota State Demographic Center, Population Projections for Minnesota Counties, 2000 to 2030 Central MN Population Projections by County County 2000 Population Projected 2010 Population Projected 2020 Population % change + or - Big Stone5,8205,5705,450-6.4% Clay51,22952,59052,8103.1% Crow Wing55,09967,06079,39044.1% Douglas32,82136,94041,70027.1% Grant6,2896,3906,6706.1% Morrison31,71233,56035,58012.2% Otter Tail57,15963,24070,90024.0% Pope11,23611,54012,1207.9% Stearns133,166148,480163,17022.5% Stevens10,05310,11010,1200.7% Todd24,42625,64027,07010.8% Traverse4,1343,8303,730-9.8% Wadena13,71314,52015,21010.9% Wilkin7,1386,9306,990-2.1% Total443,995486,400530,91019.6%

21. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Projected Health Professional Demand Practitioner Type Actual # Licensed in Region Practitioner to 100,000 Population 2000 Practitioner to 100,000 Population Ratio 2010 Practitioner to 100,000 Population Ratio 2020 Primary Care Physicians26158.953.549.2 Dental Hygienists24354.949.845.8 Dentists19944.940.837.5 Nurse Practitioners4810.89.89.1 Certified Nurse Midwives3.67.61.56 Pharmacists41693.985.278.5 Physical Therapists14332.329.327.0 Occupational Therapists13029.326.624.5 Veterinarians17439.335.732.8 Source: Minnesota Department of Administration, Population Projections for Minnesota Counties, 2000 to 2030 and MN Office of Rural Health & Primary Care-MN Department of Health; MN Board of Veterinary Medicine and 2006 Minnesota Pharmacist Licensure Database, University of Minnesota, College of Pharmacy. Ratio of Health Care Professionals per 100,000 Individuals 2000-2020 in Central MN

22. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Community Health Analysis

23. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Regional Public Health Priorities by County, 2005-2009 Source: Minnesota Department of Health, Community and Family Health, Office of Public Health Practice, June 2007 County Alcohol,Tobacco &Other DrugsChild &AdolescentGrowth &DevelopmentChronic/NoninfectiousDiseaseDisability –DecreasedIndependenceEmergencyPreparednessEnvironmentalConditionsInfectiousDiseaseMental HealthPregnancy &BirthServiceDeliverySystemUnintentionalInjuryUnintendedPregnancyViolence Big Stone*********** Clay, Wilkin******** Crow Wing*********** Douglas******** Grant, Pope, Stevens, & Traverse CHB ********** Morrison********** Otter Tail*********** Stearns********** Todd************* Wadena***********

24. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Central MN Top Public Health Improvement Goals, 2005  Alcohol, tobacco and other drug use  Child & adolescent growth & development  Environmental conditions  Infectious Disease  Mental health  Pregnancy and Birth

25. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Central MN Behavioral Risk Factors of Adults Source: Minnesota Department of Health, 2006 Minnesota County Health Tables http://www.health.state.mn.us/divs/chs/countytables/profiles2006/D_Morbidity_Util_05.pdf

26. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Central MN Top Leading Causes of Death by Age Group (Includes all 14 Central MN AHEC Counties) Source: Minnesota Department of Health, Center for Health Statistics, 2005

27. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Central MN Health Care Facilities Source: Pharmacies: Minnesota Board of Pharmacy, Minnesota Department of Health, Health Care Facility and Provider Database http://www.health.state.mn.us/divs/fpc/directory/providerselect.cfmhttp://www.health.state.mn.us/divs/fpc/directory/providerselect.cfm *Includes St. Cloud VA Hospital

28. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis K-12 Health Professional Career Activities

29. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Target Population for Health Careers Information and Courses in Central MN Note: 246 Surveys mailed to Central MN Schools with 31 responses for a response rate of 13%.

30. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Health Career Information Provided in Central MN Health Care Professional Courses Offered by Schools in Central MN Type of Course Number of Responses Percent Medical Terminology516% Health Care Careers516% Certified Nursing Assistant13% Emergency Medical Technician00% Nursing (RN, LPN)00% First Aid619% CPR516% Other00%

31. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Summary  Gaps exist between health care professional supply and demand:  Most prevalent outside of Otter Tail, Crow Wing and Stearns Counties  Especially in non-primary care professions – dentists, and mental health professionals  Demand for health care services will increase as a result of the aging population  Population projected to grow by 19% in 2020

32. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Summary continued  Limited number of advanced health care educational programs in region (MLT, family medicine)  Lack of dentistry, advanced nursing, therapy, pharmacy and non-primary care medicine regionally  One-third of CNMs, NPs, pharmacists and dentists are age 55 and over

33. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Summary continued  Community health priorities identified:  Alcohol, Tobacco & Drug Use  Child & Adolescent Growth & Development  Chronic Disease  Mental Health  Heart disease was the leading cause of death in Central Minnesota

34. November 2007 Central Minnesota Health Professional Workforce and Community Health Analysis Summary continued  Most organizations target high school students when providing health care career information and courses  Nice mix of health career courses  Possible areas of health career expansion for Central MN AHEC include:  Professional and student leadership associations  Health career resource centers  Mentoring  Training and tuition assistance  Scholarship programs  Expand rural clinical rotations for medicine, pharmacy, dentistry, veterinary medicine, and therapy