Vision 2020

Vision 2020

I don’t know about you but when I hear or see the phrase “20/20 Vision,” I immediately think about eye exams. In that context the phrase is used to describe visual acuity (the clarity or sharpness of vision) at a distance of 20 feet. But VISION can be deeper than a physical ability to see the world around us. Vision can also mean the ability to see beyond the current state to future possibilities. This type of visioning is critical to advancing policy and improving health.

 

The Rearview Mirror

Ten years ago, Indiana did not have a clear “picture” of the health care workforce. We reactively identified workforce shortages if and when a community member/advocate came forward and requested assessment. From anecdotal information we knew we had shortages, but we just didn’t have the workforce data to prove it. (See map of Dental Shortage Areas from 2009.)

Dental HPSA in 2009

Dental HPSA in 2019

Workforce in Focus

Today Indiana is in a very different place. Because of investments in health workforce data infrastructure, we know where our health care workforce is and where it is not. (See 2019 map of Dental Shortage Areas). It took vision to get here. A vision that began with seeing past the problem (we don’t have the health workforce data we need to ID our shortage areas) to opportunities (collecting the data we need during health professional license renewal) and solutions (2018 Senate Enrolled Act 223, which ensures we get the data we need). As a state, we are now able to proactively identify workforce shortages. Other states are now looking to Indiana to learn how they too can craft a vision for bringing their workforce into focus.

The View Ahead

As the Bowen Center looks ahead to 2020, our line of sight has expanded and so has our vision. We’ve sharpened Indiana’s health care workforce lens, and now we have set our sights on informing broader health care policy. Workforce shortage identification is critical, but it is just the tip of the iceberg. We are excited to “pull-up” a chair in new conversations, use our expertise to bring problems into focus, and turn health improvement visions into reality.

License Renewal Survey FAQs

Why is it needed?

Over the last several decades, information has been collected from health professionals during their online license renewal. In 2018, Senate Enrolled Act 223 identified this information (including educational and practice characteristics) as being critical to the State of Indiana for health workforce planning. Beginning in January 2019, health professionals are now required to provide this information.

Questions asked at the beginning of the online license initiating and renewal process provides information which is collected and maintained in the Indiana Health Professions Database by the Bowen Center for Health Workforce Research & Policy. This information will provide the State of Indiana with an accurate representation of the health workforce and will be used to inform: workforce shortage areas, recruitment incentives, policy and programming, profession-specific initiatives and health workforce evaluations.

Need a printable version of this document? Click here.

 

Survey Related

  1. I have answered every survey question and hit the submit button, why can’t I proceed?
    The system will not proceed unless each question has a response. Please review each individual question to verify that a response has been selected> Even if the question is not applicable to you, please select “not applicable”.
  1. I am retired. Some of these questions don’t apply to me.
    Please scroll down to the bottom of the survey options and select Not Applicable. For questions with a text box, type in NA.
  1. What if I practice in more than one location?
    The survey will allow you the opportunity to provide information on multiple practice locations.
  1. What if I do not know the percentage of Indiana Medicaid patients at my primary practice location?
    This question is used to inform health professional shortage area designations. Please estimate to the best of your ability or select “Not Applicable” if you are not actively practicing.
  1. What if I do not know if my primary practice location is accepting new Indiana Medicaid patients?
    Your practice administrators and staff may have the answer to this question.  Please ask to see if this information is available through them.
  1. What if I do not know the percentage of patients on a sliding fee scale at my primary practice location?
    Your practice administrators and staff may have the answer to this question.  Please ask to see if this information is available through them.
  1. I recently received additional health professional credentials, yet I am not currently practicing in that role. How do I respond when asked to indicate my health professional role along and specialty?
    Please provide information that responds to your current role.

 

Technical Issues

  1. Which is the recommended internet browser to use while completing my online license renewal?
    The Indiana Professional Licensing Agency recommends using Internet Explorer.
  1. Why am I being kicked out of the system?
    This may occur due to the high volume of simultaneous online users or a browser issue. The Indiana Professional Licensing Agency recommends using Internet Explorer. If you are currently using a browser other than Internet Explorer, proceed with the following steps:
  1. Close out of your current browser
  2. Open Internet Explorer in a new tab
  3. Sign into the IPLA license renewal system
  4. Proceed with the license renewal process
  5. If you are currently using Internet Explorer and continue to experience technical issues, please try again at another time. 
  1. Why are my survey responses being erased?
    This may occur due to the high volume of simultaneous online users or a browser issue. The Indiana Professional Licensing Agency recommends using Internet Explorer. If you are currently using a browser other than Internet Explorer, proceed with the following steps:
  1. Close out of your current browser
  2. Open Internet Explorer in a new tab
  3. Sign into the IPLA license renewal system
  4. Proceed with the license renewal process
  5. If you are currently using Internet Explorer and continue to experience technical issues, please try again at another time.

 

General

  1. Is there a paper license renewal form that I can complete and mail in?
    Yes. For each licensed health profession, there is an option of completing a paper license renewal document. The link to the renewal document is listed on each health professions board’s webpage. It is also linked below for easy access:

 

Print and mail the completed document, along with the required renewal fee, to the Indiana Professional Licensing Agency. The mailing address is found on the license renewal document.

 

Still Have Questions?

If you have additional questions, please contact the Bowen Center for Health Workforce Research & Policy at bowenctr@iu.ed or 317-278-0316

 

Need a printable version of this document? Click here.

Senate Enrolled Act 223 (2018): What does it mean for Indiana’s health workforce data?

What is it?

Over the last several decades, information has been collected from health professionals during online license renewal. In 2018, Senate Enrolled Act 223 identified selected pieces of information (including educational and practice characteristics) as critical to the state of Indiana (1). Beginning in 2019, it will now be required for health professionals to provide this information when they renew their license.

Who is affected?

This information will be collected from all licensees under the following boards:

  • Indiana Medical Licensing Board
  • Indiana State Board of Nursing
  • Indiana State Board of Dentistry
  • Behavioral Health and Human Services Licensing Board
  • Indiana State Psychology Board
  • Indiana Board of Pharmacy

How will it be implemented?

Information will be requested in the form of questions during the renewal process. The only difference from previous years is that these questions will have to be completed in order for an individual to proceed with license renewal. Don’t worry! The questions take approximately 5 minutes to complete. Any professional that is renewing their license but isn’t actively practicing will always have a response option that fits them (ex: a “not applicable” option is available).

The Governor’s Health Workforce Council serves as the reviewing and approval body for licensure survey questions. Approved questions can be found on the Council’s website at: https://www.in.gov/dwd/ghwc.htm or on each individual survey located under the “Publications” tab on the Bowen Portal. 

Why is it necessary? 

This information will provide Indiana with an accurate representation of the health workforce in the state. This data will be used to inform various initiatives. Check out the infographic below to learn more about how this information is used.

Where will this information go?

The information is collected by the Indiana Professional Licensing Agency and will be maintained in the Indiana Health Professions Database by the Bowen Center under contract with the State of Indiana. Information will be made publicly available through technical reports and briefs. Examples of these reports can be found at under the “Publications” tab of this website.

Want more info?

Please contact the Bowen Center for Health Workforce Research & Policy for any
questions (bowenctr@iu.edu or 317-278-0316).

 

 

References:
1- 2018 Indiana Senate Enrolled Act 223. Available at:
https://iga.in.gov/legislative/2018/bills/senate/223#document-b0603ddf

Health Workforce Warrior Spotlight: Social Work

We’re pleased to introduce you to our first #HealthWorkforceWarrior, Amanda H., LBSW. Amanda is a social worker currently serving the homeless veteran population in Indianapolis.

What did your road to becoming a Social Worker look like?

My attraction to social work came not only from wanting to help people, but to ensure that no one ever feels alone and my passion for social justice. To get my social work license I went to Wright State University in Dayton Ohio. Since graduating I’ve been in the field of social work for 7 years.

I love helping the clients who do not have a natural support system, no one to turn to in times of crisis. I get to show up for them and become a constant in their life.

What does a workday look like for you?

In my current role, I assist veterans experiencing homelessness. Using a strength-based approach, we assist veterans by helping them remove barriers to become self-sufficient and permanently housed. A typical day would include helping veterans move into transitional housing, linking them with community resources, aiding with applying for benefits, connecting them with medical, mental health and addiction recovery providers.

I am also able to connect the client to employment opportunities, which ultimately helps the client secure stable housing. Currently, I have started a project with clients to build a garden at a transitional housing center. Veterans can enjoy having fresh vegetables while building coping skills and learning about sustainability. They can then utilize these skills to plant patio gardens once they are permanently housed.

What are your favorite parts about being a social worker/what makes you excited to go to work?

In my current role, it is amazing to see a client transition from their lowest point and overcome the barriers that led to homelessness. It is especially exciting when they become permanently housed. Many of our clients have lived in the encampments around the city, on the streets, or in their cars for many years. Watching a person gain hope, safety and security is one of the most amazing experiences to witness. I consider it an honor to walk the path alongside them.

 

What are the biggest challenges you face day-to-day?

Social workers face many challenges every day. Between constant crisis management, timely documentation and the constant pressure we put on ourselves to serve some of the most vulnerable populations, it can be taxing.

We spend our days listening empathetically, worrying that we may have missed something concerning a person’s safety, being scared to go into homes of unknown people, questioning what we might find once we’ve entered, and managing angry families, yet still doing our best to help them. In addition, we witness and cope with trauma daily; all while trying to avoid burnout and staying sensitive to the needs of others. Finding a balance for self-care is the key and in my opinion one of the most challenging aspects we face every day.

What do you wish more people knew about social workers and what they do?

Often, I have heard that social workers just remove children from their families and work in the child welfare system. I wish more people understood that social work happens on every level: macro/political, micro/individual and the mezzo/community levels. Social Work is distinguished from other helping professions by its person-in-the-environment focus and its strong commitment on social and economic justice.

The primary mission of social work is to enhance human well-being, with a particular focus on those who are vulnerable, oppressed and living in poverty. Social Workers also emphasize a strength-based approach. We believe all individuals have strengths and resources and it is our duty to help build upon a person’s skills and support systems. Social work is dedicated to the pursuit of social justice through direct service and through advocacy on the local, national, and global levels.

 

It was great to hear from you, Amanda!

 

 

More Info on Indiana Behavioral Health Professionals

Want to learn more about Indiana’s Behavioral Health Workforce? Check out our Brief for quick illustrated facts or our Data Report for a deep-dive into the numbers.

Do you know a Health Workforce Warrior?

We’d love to hear about them. Give them a shout out and tag us on Twitter or Instagram @bowenctr and use the hashtags #INhealthworkforce and #HealthWorkforceWarrior!

Health Workforce Warrior Spotlight: Physician Assistant

In our new series, Health Workforce Warriors, we will be interviewing health care professionals that work every day to advance the health and well-being of Hoosiers. We hope that this series may provide a lens into the perspective and contributions of Indiana’s “boots on the ground” health professionals.

Our first guest is Kara who serves as a physician assistant (PA) in internal medicine at St. Vincent.

 What did your road to becoming a physician assistant look like?

I love medicine and have always wanted to go into some aspect of healthcare. My mom is a hospice nurse, my dad is a psychologist, one sister is a Physician Assistant and the other is about to graduate as a Nurse Practitioner! The thought of medical school felt daunting to me and I wasn’t sure I wanted to dedicate that much of my life to school. I heard more about PAs when my sister started at the IU program and realized it was the job for me!

I did my undergrad at IU Bloomington in psychology, which I had grow up loving due to my dad being in psychology. I worked as a scribe in the community emergency department for a couple of years and learned to love emergency medicine.

After undergrad, I went to PA school at IU Indianapolis, which was a new program at the time. After graduation, I began a position in orthopedic surgery, doing solely hip and knee replacements. I quickly became tired of the monotony and searched for another position. I eventually landed in internal medicine at St Vincent! It’s a lot of information but I am loving it and learning fast. It helps that I have the best faculty physicians helping me out. I have a strong passion for learning and am passionately curious. Because internal medicine requires you to know a little of everything instead of having specialized knowledge it’s been a perfect fit. It keeps me on my toes and always provides opportunities for learning.

 

What does a workday look like for you?

I work 7 days on and 7 days off, which has been interesting schedule to get used to. I am currently working 8am-6pm while I am still orienting and learning about internal medicine. My biggest job is to admit patients to the hospital, which is a long process of orders and researching and seeing the patients. I also sometimes work on the observation unit, which is for people staying less than 2 midnights. While there, I do patient rounds, catch up on their case, and discharge from there.

 

What are your favorite parts about being a PA? What makes you excited to go to work?

I like the ability to switch easily between fields. As I mentioned before, I started off in orthopedic surgery for a year then realized I didn’t feel like I was being mentally challenged and changed to my current position, which I started in April. I also like that school is much shorter than a physician’s, so I was able to get out and start working much earlier. In my current position, I love how admitting patients is like a puzzle you have to solve, what’s going on, what to order, etc. I also like that I get a good amount of autonomy and am very lucky that I have a great group of faculty physicians willing to help and teach me.

 

What are the biggest challenges you face day-to-day?

In my current position, the clinical knowledge is challenging. A lot of PAs end up specializing, but general internal medicine means I must know some of everything. I know some PAs deal with a level of distrust between physicians and physician assistant, but luckily I haven’t run into this too much. Things like calling a consult or giving recommendations/orders to another physician can be difficult when a physician sees you as less or doesn’t trust you as much as they would another physician.

 

What do you wish you wish you would have known before becoming a PA?

I wish I would’ve known that when you are finished with PA school and start your first job, you’ll feel like you don’t know anything. It takes some adjusting to your specific workplace and willingness to learn continuously. We are essentially at the same knowledge level (or a little lower) than first year residents. However, unlike residents, we are finished with our learning and given full responsibilities and expectations, depending on where you are. Conversely, it can also be difficult to find a job in certain areas when employers realize that there is a significant amount of on the job training. Those employers either don’t want to train new PA staff or don’t have the time to do so. Sometimes, PAs are not fully respected, but I think that is mostly going away as the profession gets more popular (it’s more than doubled over the last seven years!).

What do you wish more people knew about PAs and what they do?

I wish people knew that becoming a PA is not a stop on the way to becoming a doctor. Many of my patients ask when I plan to finish and become a doctor, which is obviously not my end goal. I’ve gotten used to it and learned to brush it off. I also want people to realize that we do have ability to diagnose and treat patients much like physicians do. I imagine that again most of these issues will go away as the profession becomes bigger in Indiana.

Thanks for sharing your experience, Kara! You can follow her on Instagram @lifewithkb

 

 

More Info on Indiana PAs

Want to learn more about Indiana’s physician assistant workforce? Check out our Physician Assistant Workforce Brief for quick illustrated facts or our Physician Assistant Data Report for a deep-dive into the numbers.

Do you know a Health Workforce Warrior?

We’d love to hear about them. Give them a shout out and tag us on Twitter or Instagram @bowenctr and use the hashtags #INhealthworkforce and #HealthWorkforceWarrior!

Recap: 2019 Legislative Session in Indiana

What happened in health workforce policy and what’s on the docket?

The dust has settled from Indiana’s 2019 Legislative Session and we want to provide you with a recap of major changes in the health workforce policy realm. With 2019 being a “long session” (AKA a budget year), it was jam-packed with initiatives and much was accomplished. We hope you were able to follow along during the session using the Bowen Biweekly Bill Brief, or B4, Tracker. The B4 highlighted health workforce-specific bills and served to inform and update stakeholders on relevant initiatives. The latest version of the B4 is linked at the bottom of the post. (This was our first year implementing the B4 and we’d love to get your feedback on it. What worked? What didn’t? How can we make it better? Email us at bowenctr@iu.edu with your thoughts.)

Now, let’s jump into a summary of enacted health workforce related legislation from the 2019 General Session:

 Licensing/Regulation Changes

  • Nurse Licensure Portability: The Nurse Licensure Compact was signed into law and is set to go into effect in 2020. This will allow participating nurses to practice in any compact state under a single compact license. (HEA 1344 [1])
  • Behavioral Health Workforce License Requirements: Regulatory changes were made to select behavioral health professions. These changes impact education or experience requirements for licensure. (SEA 527 [2], HEA 1199 [3])
  • Regulation of Physical Therapists: Physical therapy now has its own licensing board (it was previously a committee under the medical licensing board). (SEA 586 [4])
  • Office-based Opioid Treatment Providers (OBOTs): Medication-Assisted Treatment, or MAT, is generally delivered in two types of settings:
    1) Opioid Treatment Programs, which are organizations regulated at both the federal and state levels, and 2) OBOTs, which are community-based providers with a federal waiver to prescribe associated medications (DATA 2000 [5]). Before 2019, there was minimal state regulation for OBOTs. Rules will now be created by the Medical Licensing Board (in consultation with Indiana State Department of Health, Family and Social Services Administration) for office-based opioid treatment (SEA 141) [6]. Federal code for OTPs outline staffing requirements.[7] It is unclear whether Indiana seeks to adopt staffing requirements for OBOTs.

Delivery/Practice Changes

  • Mobile Integration Programs: Emergency medical personnel are now permitted to provide (and be reimbursed through Medicaid for) expanded services including: transportation, acute care, chronic condition, or disease management services. This is consistent with national trends to allow and reimburse for community paramedicine services.[8] (SEA 498 [9])
  • Addressing Infant Mortality through Perinatal Care: HEA 1007[10] requires health care providers to screen and treat pregnant women for/with substance use disorder and SEA 416[11] requires Medicaid reimbursement for doula providers.
  • Telehealth: Psychologists may now deliver tele-psychology services to patients in Indiana (HEA 1200 [12]).

 Summer Session Legislative Initiatives

Indiana’s 2019 policy work does not stop at the spring general session. There were a number of health workforce initiatives that spilled into summer session agendas. The 2019 Interim Study Committee topics were announced at the end of May and can be found at: https://iga.in.gov/documents/4500c157.

  • Health Care Costs: There were a number of bills calling for a study of the contributing factors of health care costs. This topic made it onto the agenda of multiple interim study committees (Financial Institutions & Insurance; Fiscal Opportunities; Public Health, Behavioral Health, and Human Services)
    • What does this have to do with the health workforce?
      • Access to care in rural areas was one of the identified sub-topics. As Indiana seeks to address shortages of health care providers, wise allocation of workforce development funding will be critical.
      • As Indiana seeks to reduce health care costs, it is likely that alternative payment and/or delivery models may be explored. Many new mechanisms for care delivery require that a workforce is trained and ready to deliver care in an innovative way. This could be applied to technology innovations (such as telehealth) or emerging care team models/members (such as community health workers, paramedics in community settings, doulas, etc.).
    • Advanced Practice Registered Nurses (APRN) Operating without a Practice Agreement: Two bills this session sought to remove requirements for a practice agreement for APRNs delivering care (SB 394 [13], SB 343 [14]). There was a lot of discussion on both sides and from public testimony; ultimately, neither bill made it across the finish line. This topic will be studied by the Public Health, Behavioral Health, and Human Services Interim Committee.
      • What does this have to do with the health workforce?
        • This topic addresses the practice and supervisory provisions for advanced practice registered nurses in Indiana.
        • For information on the Advanced Practice Registered Nurse workforce in Indiana, check out the Data Report and Brief linked at the bottom of the post.

 

Save the Dates

Dates and agendas for interim study committees can be found at each committee’s respective homepage. Dates for the Public Health, Behavioral Health, and Human Services Interim Study Committee may be found below:

  • Wednesday, September 4: 9:00am in Senate Chamber | Agenda | Link to Watch Live
  • Wednesday, September 18: 10:00am in Room 431
  • Wednesday, October 2: 10:00am in Room 431
  • Wednesday, October 16: 10:00am in Room 431
  • Wednesday, October 30: 10:00am in Room 431

Resources Referenced in the Post:

Latest Version of the B4:
https://scholarworks.iupui.edu/bitstream/handle/1805/20130/2019%20Bowen%20Biweekly%20Bill%20Brief_8-1-19.pdf?sequence=1&isAllowed=y

2017 Nurse Data Report: https://scholarworks.iupui.edu/bitstream/handle/1805/17195/2017-Nursing-Data-Report-Final-RS_Authored%20Version.2.28.19.pdf?sequence=10&isAllowed=y

2017 Nurse Brief:  https://scholarworks.iupui.edu/bitstream/handle/1805/18302/RN%20Fact%20Sheet-FINAL%28revised%29.pdf?sequence=6&isAllowed=y

References

[1] https://www.iga.in.gov/legislative/2019/bills/house/1344

[2] https://www.iga.in.gov/legislative/2019/bills/senate/527

[3] https://www.iga.in.gov/legislative/2019/bills/house/1199

[4] https://www.iga.in.gov/legislative/2019/bills/senate/586

[5] U.S. Department of Justice, Drug Enforcement Administration. DEA Requirements for DATA Waivered Physicians. Available at: https://www.deadiversion.usdoj.gov/pubs/docs/dwp_buprenorphine.htm

[6] https://www.iga.in.gov/legislative/2019/bills/senate/141

[7] Minimum Standards for the Provision of Services by

Opioid Treatment Facilities and Programs. 440 IAC 10-4-13. Available at: https://iac.iga.in.gov/iac/T04400/A00100.PDF?

[8] https://www.hhs.gov/about/news/2019/02/14/hhs-launches-innovative-payment-model-new-treatment-transport-options.html

[9] https://www.iga.in.gov/legislative/2019/bills/senate/498

[10] https://www.iga.in.gov/legislative/2019/bills/house/1007

[11] https://www.iga.in.gov/legislative/2019/bills/senate/416

[12] https://www.iga.in.gov/legislative/2019/bills/house/1200

[13] https://www.iga.in.gov/legislative/2019/bills/senate/394

[14] https://www.iga.in.gov/legislative/2019/bills/senate/343