Ohio health workforce

1 in 3 Ohio nursing homes is facing staffing shortage, AARP dashboard reports

Over one-third of Ohio nursing homes and long-term care facilities faced a shortage of direct care workers in January, according to new data released this week (Source: “Staff shortages plague 1 in 3 Ohio nursing homes; nearly 1 in 4 in Kentucky struggle too,” Cincinnati Enquirer, Feb. 15).

The data is part of the AARP COVID-19 Dashboard, which uses information reported each week by nursing homes to the Centers for Disease Control and Prevention and released by the Centers for Medicare & Medicaid Services.

Long-term care facilities have made up almost half of Ohio’s COVID-19 deaths, despite combined resident and staff cases comprising only 8% of the state's total cases. 

And the solutions available to nursing homes to curb these shortages, such as bringing in temporary workers or extending hours of current staff, could potentially spread COVID-19 to both residents and staff, one expert said.

New HPIO, OSU policy brief explores link between clinician wellbeing and patient care and safety

The Health Policy Institute of Ohio, in partnership with the Ohio State University College of Nursing Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, has released a new policy brief titled A Call to Action: Improving Clinician Wellbeing and Patient Care and Safety.

A growing body of research indicates that healthcare clinicians face serious problems related to their overall health and wellbeing, including high rates of burnout, depression, addiction and suicide. Understanding the relationship between clinician well-being and patient care and safety enables state policymakers and healthcare leaders to implement evidence-informed policies and programs that improve outcomes for clinicians and their patients.

This brief serves as a call to action to improve clinician wellbeing and its impacts on patient care and safety, providing a:

  • Framework for the relationship between clinician wellbeing and patient care and safety
  • Summary of research findings
  • Review of evidence-informed policies, programs and practices that improve clinician wellbeing and support high-quality, safe patient care
  • Set of evidence-informed state policy options

Ohio bill would allow APRNs to practice independently

A new Ohio General Assembly bill would allow advanced practice registered nurses to work independently of physicians, an idea the Ohio State Medical Association calls potentially dangerous to patients  (Source: “Ohio bill would give advance practice registered nurses independence from doctors,” Cleveland Plain Dealer, Aug. 30, 2018).

Rep. Theresa Gavarone, a Bowling Green Republican, said House Bill 726 addresses primary care physician shortages throughout the state. But the medical association disputes there are shortages.

Advanced practice registered nurses, called APRNs, diagnose and treat diseases and can prescribe medicine. APRNs must enter mandatory collaboration agreements with doctors under current Ohio law. 

More than 20 U.S. states and the Veterans Administration allow APRNs to practice independently of doctors, Gavarone said.

The medical association, on the other hand, argues that physicians undergo expensive, intensive training to understand the human body. APRNs provide a valuable service, but physicians need to lead medical teams because of their extensive knowledge, said Reggie Fields, a spokesman for the medical association.

Proposed Ohio law would ban forced OT for nurses

A new Ohio bill could keep hospitals from requiring nurses to work overtime as a condition of employment (Source: “Proposed law would ban forcing Ohio nurses to work overtime,” Dayton Daily News, Jan. 3, 2018).

House Bill 456 was introduced by Rep. Robert Sprague, R-Findlay, in late December.

Hospitals across Ohio are facing a shortage of nursing staff and can require nurses to work longer hours and cover more shifts, but a nurses’ union said that creates dangerous conditions for patients who might get bad care from exhausted staff.  

But the Ohio Hospital Association said staffing is complicate  d and hospitals need to have the flexibility to schedule the nurses they need at the times that they are needed. The association said some of those factors include patient needs, volume and acuity, patient satisfaction, resources available, nursing staff competency and skill mix, availability of medical and support staff and a variety of staffing standards.

Study: ACA repeal could cost 126k jobs in Ohio

A national study released this week estimates that repealing the ACA will lead to the loss of 2.6 million jobs in the U.S. and 126,000 jobs in Ohio (Source: “Obamacare repeal could cost more than 100K Ohio jobs, report says,” Dayton Daily News, Jan. 6, 2017).

The majority of the job losses, according to the Commonwealth Fund study, would occur in 2019, resulting from a loss of $140 billion in federal funding for tax credits used to subsidize premium costs for people covered by private insurance under the health law, and federal funds used to expand Medicaid to millions of Americans with lower incomes. Total job losses could climb as high as 3 million positions in health care and other sectors by the year 2021, according to the study from the Milken Institute School of Public Health at the George Washington University and the Commonwealth Fund.

“Repealing key parts of the ACA could trigger massive job losses and a slump in consumer and business spending that would affect all sectors of state economies,” said Leighton Ku, lead author of the report.

But Greg Lawson, policy director of the conservative Buckeye Institute, said there’s no reason to panic: “I don’t think there’s any serious consideration that the folks in Congress are going to immediately get rid of all of this. There will be significant reforms that will be forthcoming….but it’s not going to happen overnight like flipping a switch.”

Federal dollars aim to expand Ohio behavioral health workforce

The U.S. Department of Health and Human Services announced this week more than $1.6 million in awards to Ohio training programs to increase the number of mental health providers and substance abuse counselors in the state (Source: “Health and Human Services awards $1,615,720 to expand Ohio behavioral health workforce,” (Cambridge) Daily Jeffersonian, Sept. 22, 2016).

Nationally, the Health Resources and Services Administration and the Substance Abuse and Mental Health Services Administration are funding 144 new and continuing grants for a total of $44.5 million through the Behavioral Health Workforce Education and Training program, which supports clinical internships and field placements for an array of professional and paraprofessional behavioral health disciplines and occupations.

In Ohio, more than $686,000 will support new grantees Heidelberg College and Youngstown State University. An additional $929,000 will fund programs at current grantees Case Western Reserve University, Northern Ohio Recovery Association, Ohio University and the University of Cincinnati.

2016 state health assessment draft released

The Governor’s Office of Health Transformation and the Ohio Department of Health today released a draft of the 2016 state health assessment.

The state health assessment is a comprehensive and actionable picture of health and wellbeing in Ohio. The purpose of the state health assessment is to:

  • Inform identification of priorities for the upcoming state health improvement plan
  • Provide a template for state agencies and local partners (uniform set of categories and metrics to use in related assessments)

The report includes information from several sources in order to provide a comprehensive picture of health and wellbeing in Ohio. Using existing data, this document presents data profiles on health outcomes and a broad range of factors that impact health outcomes, healthcare spending and disparities. These data profiles are followed by summaries of new information collected for this assessment, including qualitative information gathered through key informant interviews and regional forums. The Health Policy Institute of Ohio was commissioned to facilitate the state health assessment process and produce the publication.

The public is invited to provide input on the state health assessment until noon on July 5, 2016.

The final state health assessment is expected to be released later this summer, followed by the release of the 2016 state health improvement plan later this year.

Ohio ranks high for physician access, survey finds

A national survey released this week found that Ohio ranks 13th in the nation when it comes to access to physicians (Source: “Ohio among better states for physician access, survey says,” Dayton Business Journal, Nov. 18, 2015)

The survey by physician search firm Merritt Hawkins is based on 33 variables including physicians per capita, medical residents per capita, urgent care centers, retail clinics, insurance rates per capita, and states that expanded Medicaid through the Affordable Care Act.

Massachusetts, New Hampshire, Vermont, Delaware and Maryland have the best physician access, according to the report.

Mississippi, Texas, New Mexico, Nevada and Oklahoma have the least access.

Ohio officials look to change funding formula for primary care doc training

Ohio officials are calling for changes to the formula used to distribute tax dollars paid to hospitals for a physician training program aimed at improving the accessibility and quality of primary care in the state (Source: “Millions of dollars misdirected for graduate medical education; state pursues reform,” Cleveland Plain Dealer, Nov. 6, 2015). 

The nearly $250 million in state funds that were spent in Ohio last year to help train young doctors were supposed to be equitably distributed among hospitals to ensure instruction in a variety of settings and specialties. But state records show millions of dollars was misdirected because of an outdated funding formula.

"It makes no sense at all," said Greg Moody, director of the Governor’s Office of Health Transformation. "A pattern is present throughout the state where hospitals that are essentially providing the same sorts of training programs for medical education receive drastically different amounts."
Moody is spearheading a committee established by the state legislature to recommend ways to improve the funding system by the end of the year. He and other officials said the most obvious problem is a 28-year-old payment formula that is distributing money unfairly among the state's hospitals.

Ohio GA to mull bill giving nurses more latitude

Ohio legislators are considering a bill aimed at enabling nurse practitioners and other advanced-practice nurses to practice with less physician oversight (Source: “Bill would give Ohio nurses more latitude in treating patients,” Columbus Dispatch, Oct. 26, 2015). 

Lawmakers are expected to begin hearings in January on a sweeping “modernization” bill introduced this year by Rep. Dorothy Pelanda, a Marysville Republican.

The Ohio State Medical Association, which represents doctors, is strongly opposed to the bill, saying that a team approach works well and leads to optimal patient care.

The nurses say they’re already making their own decisions in patient care and shouldn’t have to pay a physician as much as $25,000 a year for oversight that can amount to little actual collaboration or advice.