Monday, July 14, 2014

Minnesota to test how emerging professionals impact health care teams

The Minnesota Department of Health (MDH) awarded $30,000 grants to five organizations to test the potential of emerging professionals to strengthen health care teams and improve access to care.

These awards were made possible through Minnesota’s $45 million State Innovation Model (SIM) testing grant. MDH and the Department of Human Services (DHS) jointly received this federal grant in 2013 and are using the funds to help implement the Minnesota Accountable Health Model. The model helps providers and communities work together to reduce costs and create healthier futures for Minnesotans. It supports community and provider partnerships, team care, care coordination, Accountable Care Organizations, payment reform, and health information technology investments.

The model also seeks to improve care by supporting a team approach. In this context, SIM Minnesota wants to test the effectiveness of community health workers, community paramedics, and dental therapist/advanced dental therapists in helping organizations achieve Minnesota’s goals related to health system transformation. The initiative chose to focus on these providers in part because they have the potential to increase access for low income and underserved populations and to help fill current gaps in primary health care and dental care.

As part of the SIM grant, MDH and DHS will evaluate how integrating emerging professions into a team environment changes the team’s overall capacity and the patient’s outcomes. For example, does bringing on a dental therapist to the dental team free up time for the dentist to work on more complicated dental issues (e.g. root canals) or does a community paramedic help to prevent hospital readmissions with the hospital discharge follow-up services they provide.  

The Minnesota Accountable Health Model will have three rounds of grant funding to support the integration of emerging professions into the health care workforce. The following organizations were awarded 12 months of start-up funding for round one. Each organization is also contributing funds toward the emerging professional they plan to hire (indicated below).  

• Children’s Dental Services, Minneapolis -- Advanced Dental Therapist

• HealthEast Care System, St. Paul -- Community Paramedic

• Minnesota Visiting Nurse Association, Minneapolis -- Community Health Worker

• Well Being Development, Ely -- Community Health Worker

• West Side Community, St. Paul -- Advanced Dental Therapist
Federal funds of $150,000 account for about 35 percent of this $425,000 project. Non-governmental sources, essentially salary match funds, account for 65 percent of the project.  

More about emerging professionals
Community Health Workers are frontline public health workers who are trusted members of the community or often have a close understanding of their community. This relationship enables them to serve as a liaison or intermediary between health care, social services and the community to increase cultural competence, improve access to health care for racial and ethnic minorities, improve the quality of care for chronically ill people, promote healthy communities, and educate clients and others about access to and use of health care resources.

Community Paramedics are advanced paramedics that work to increase access to primary and preventive care and decrease use of emergency departments, which in turn decreases health care costs.  Among other things, Community Paramedics may play a key role in providing follow-up services after a hospital discharge to prevent hospital readmission. Community Paramedics can provide health assessments, chronic disease monitoring and education, medication management, immunizations and vaccinations, laboratory specimen collection, hospital discharge follow-up care and minor medical procedures. Community Paramedics work under the direction of an Ambulance Medical Director.

Dental Therapists are mid-level practitioners licensed by the Board of Dentistry, who are members of an oral health care team and provide evaluative, preventive, restorative, and minor surgical dental care within their scope of practice. Dental Therapists (DT) work under the direction of a Dentist. Advanced Dental Therapists (ADT) are certified by the Board of Dentistry and, with their advanced training and clinical practice, are able to provide all the services that a Dental Therapist provides plus additional dental services such as oral evaluation and assessment, treatment plan formulation, non-surgical extraction of certain diseased teeth, and more. ADT’s also practice under the supervision of a dentist, but the dentist does not need to see the patient prior to receiving care or be on site during a procedure.  Minnesota is the first state to authorize the licensing of Dental Therapists and certification of Advanced Dental Therapists. Dental Therapists and Advanced Dental Therapists play a key role in increasing access to dental care and preventing emergency room visits for dental related problems.