Business North talks about the scarcity of traditional healthcare access hurting rural communities in Minnesota…
The disparity of home health workers and personal care attendants is an ever-widening gap with no clear solutions in sight, and that is something Teri Fritsma Mogen, a Minnesota Department of Health senior workforce analyst, noted should be a major concern for the trickle-down effect it will have.
“If you don’t have enough home health workers to allow people to age in place, older folks will have to move to nursing homes or assisted living and that just moves the workforce shortage to another area,” she said.
Rural northeastern Minnesota has the highest need for specific mental health providers in the entire state, specifically alcohol and drug counselors and licensed mental health therapists, according to Fritsma Mogen.
“Including Duluth for alcohol and drug counselors the region has the second highest ratio in the state, and if you take Duluth out of that equation the ration is through the roof with 8,000 people to every one drug and alcohol counselor with the average in the metro roughly 2,000 to one,” Fritsma Mogen said.
Including Duluth and beyond, there is one psychiatrist for every 20,000 residents, far short of the statewide average of 11,000 residents to one psychiatrist.
And the impact of telehealth, especially since policy has helped offset costs of telehealth…
In 2015 the Minnesota legislature passed the Telemedicine Act, increasing the list of professionals eligible to bill for telemedicine practices, including physicians, nurse midwives, clinical nurse specialists, dentists and psychologists. The Telemedicine Act took effect at the beginning of 2016, with some provisions not fully operational until 2017.
Louise Anderson, director of the Carlton-Cook-Lake-St. Louis Community Health Board said the use of telemedicine to meet client needs is expanding significantly.
“Meeting remotely with clients is especially important in rural areas of the region where mental health providers are less accessible,” Anderson said.
She noted video conferencing technology is also serving to fill a crucial gap for public health nurses. Providing Direct Observed Therapy (DOT) via video conferencing to monitor patients taking oral medication for treatment of tuberculosis has fulfilled some need efficiently.
“One example of this in our region was public health staff time and travel savings of 2.5 hours per day by using (video) conferencing with a patient who lived in a remote area of the county,” Anderson said.
Carlton County Public Health and Human Services director Dave Lee has been an advocate of using the Health Insurance Portability and Accountability Act (HIPPA) compliant video conferencing technology called “Vidyo” in Northeast Minnesota.
In the Region 3 Adult Mental Health Initiative Area several counties are represented: St. Louis, Lake, Cook, Carlton and Koochiching, which comprises 23 percent of the state’s land and contains only 6 percent of the population. That geographical area also happens to represent an area where health challenges such as depression outstrip any other major health concerns two to one.
“All the data points to mental health being the number one chronic health condition in that part of Minnesota and the benefits of using telehealth tools to redirect resources quickly are huge,” Lee said.
Despite working on expanding video conferencing for mental health treatment over the last six years, Lee is frustrated with how slow the system has been to take hold. The technology exists, but he said attitudes are slow to change and minor legal and technical obstacles can take a long time to overcome.