AuthorsShawnda Schroeder (Co-PI), MA, PhDa Lynette Dickson (PI), MS, LRDa Research Associate Professor Associate Director shawnda.schroeder@UND.edu

Rebecca Quinn, MSW, LCSWa Shane Knutson, BSa

Brain Injury Program Director Research Specialist

Sonja Bauman, MSa Research SpecialistaCenter for Rural HealthUniversity of North Dakota School of Medicine & Health Sciences1301 North Columbia Road, Stop 9037Grand Forks, North Dakota 58202

ContributorsMandi Leigh-Peterson, MAa North Dakota RCORP Senior Research Analyst Consortium Members

Consortium’s Workforce Plan to Address Opioid Use Disorder and Substance Use Disorder in Rural North DakotaNorth Dakota Rural Community Opioid Response Program Planning Grant

September 2019

The Federal Office of Rural Health Policy, Health Resources and Services Administration under the Rural Community Opioid Response Program Planning Grant (HRSA-18-116) funded this project.

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GRANTEE INFORMATION GranteeOrganization CenterforRuralHealth,

UniversityofNorthDakotaSchoolofMedicine&HealthSciencesGrantNumber G25RH32483Address 1301N.ColumbiaRoad,Stop9037,GrandForks,NorthDakota58202ServiceArea Allruralcounties/areasinNorthDakota:StatewideapproachProjectDirector(s)

Name:LynetteDickson(L.D.),AssociateDirectorShawndaSchroeder(S.S),ResearchAssociateProfessor

Phonenumber: 701-777-6049(L.D.);701-777-0787(S.S.)

Emailaddress:Lynette.dickson@UND.edu;Shawnda.schroeder@UND.edu

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• CommunityHealthcareAssociationoftheDakotas• DepartmentofFamilyandCommunityMedicine,UniversityofNorth

DakotaSchoolofMedicine&HealthSciences• HeartviewFoundation• MountainPlainsAddictionTechnologyTransferCenter(ATTC)• NorthDakotaCriticalAccessHospitalQualityNetwork• NorthDakotaEmergencyMedicalServices(EMS)Association• NorthDakotaHealthInformationNetwork• NorthDakotaHIVRyanWhitePartBProgram,NorthDakotaDepartment

ofHealth• NorthDakotaStateAssociationofCityandCountyHealthOfficials• NorthDakotaStateUniversity,ExtensionServices• PrimaryCareOffice,NorthDakotaDepartmentofHealth• RegionalPublicHealthNetwork(eightcounties)• StandingRockReservation• NorthDakotaRuralHealthAssociation• MountainPlainsMentalHealthTechnologyTransferCenter(MHTTC)• QualityHealthAssociates,Inc.• NorthDakotaRuralDevelopment,USDA• CityCountyHealthDistrict,NorthDakota(ValleyCity/Jamestown)• LutheranSocialServices,NorthDakota• NorthDakotaDepartmentofHumanServices’BehavioralHealthDivision• NorthDakotaDepartmentofHealth• NorthDakotaAssociationofCounties

ConsortiumWebsite https://ruralhealth.und.edu/projects/community-opioid-response-program

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SERVICEAREASUMMARY

TheNorthDakotaRuralCommunityOpioidResponseProgram(RCORP)PlanninggrantidentifiedallruralcommunitiesinNorthDakotaastheservicearea.InNorthDakota,therearefourlargerurbancentersineachcornerofthestate.Thisprojectfocusedonidentifyingopioidusedisorder(OUD)andsubstanceusedisorder(SUD)needsandresourcesforallothercounties/citiesinNorthDakota,includingruraltribalcommunities.NorthDakotaisuniqueinitsruralculturebecausethestatehasasignificantlylargerproportionofresidentslivinginisolatedruralcommunitiesthanthenationalaverage.NorthDakotaalsoreports40(outof53)countiesthataredesignatedbytheHealthResourcesandServicesAdministration(HRSA)asruralcountiesorruralcensustractsinurbancounties.Additionally,therearefivefederallyrecognizedtribesinNorthDakota,allofwhichencompassruralcommunities.

Thereare27geographic/geographichighneedsmentalhealthHPSAs(HealthProfessionalShortageAreas)inNorthDakota.Theeasternandwesternhalvesofthestatehavetheirownuniquecultures,economies,needs,andaccessissues.Culturally,theeasternandwesternhalvesofthestatehavetheirownuniquecultures,economies,needs,andaccessissues.EasternNorthDakotahousesthestate’stwolargestpublicuniversities,whilethewesternhalfofthestatehasexperiencedexponentialgrowthinoilproductioninthelastdecade.Similarly,thefivefederallyrecognizedtribeseachcarrytheirownculture,needs,andcommunityassets. ThetribesincludetheSisseton-WahpetonOyateTribe,SpiritLakeNation,StandingRockNation,ThreeAffiliatedTribes(comprisedoftheMandan,HidatsaandArikaranations),andTurtleMountainBandofChippewa.

Figure1.CountyMetropolitanClassification:NorthDakotaNonmetropolitan,2013

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CONSORTIUMMEMBERS

• CommunityHealthcareAssociationoftheDakotas• DepartmentofFamilyandCommunityMedicine,UniversityofNorthDakotaSchoolof

Medicine&HealthSciences• HeartviewFoundation• MountainPlainsAddictionTechnologyTransferCenter(ATTC)• NorthDakotaCriticalAccessHospitalQualityNetwork• NorthDakotaEmergencyMedicalServices(EMS)Association• NorthDakotaHealthInformationNetwork• NorthDakotaHIVRyanWhitePartBProgram,NorthDakotaDepartmentofHealth• NorthDakotaStateAssociationofCityandCountyHealthOfficials• NorthDakotaStateUniversity,ExtensionServices• PrimaryCareOffice,NorthDakotaDepartmentofHealth• RegionalPublicHealthNetwork(eightcounties)• StandingRockReservation• NorthDakotaRuralHealthAssociation• MountainPlainsMentalHealthTechnologyTransferCenter(MHTTC)• QualityHealthAssociates,Inc.• NorthDakotaRuralDevelopment,UnitedStatesDepartmentofAgriculture(USDA)• CityCountyHealthDistrict,NorthDakota(ValleyCity/Jamestown)• LutheranSocialServices,NorthDakota• NorthDakotaDepartmentofHumanServices'BehavioralHealthDivision• NorthDakotaDepartmentofHealth• NorthDakotaAssociationofCounties

RURALOUD/SUDPREVENTION,TREATMENT,ANDRECOVERYWORKFORCENEEDS

ThecomprehensiveneedsassessmentdevelopedundertheRCORPPlanninggrantidentifiedseveralruralissues.TopicsaddressedincludedruralOUD/SUDworkforce;accesstomedicationassistedtreatment(MAT);OUD/SUDuseandtreatmentamonginmates;lackofdefinedrulesandregulationsaroundpeersupportservices;lackofclarityonexistingruralOUD/SUDprogramsfundedand/orimplementedinthelastthreeyears;andopportunitiesfortelebehavioralhealth.Afewkeypointsidentifiedintheneedsassessment:

• RuralcommunitiesinNorthDakotahaveidentifieddruguse/abuseasatopfiveconcernamongbothyouthandadultpopulationsasisevidentwhenreviewingallcommunityhealthneedsassessments(CHNAs)conductedbetweenSeptember2018andJune2019.CHNAsforNorthDakotaarefoundathttps://ruralhealth.und.edu/projects/community-health-needs-assessment/reports.

• AlsoidentifiedintheCHNAsarehealthservicestherespectivecommunitiesidentifyasingreatestneed.ServicescommonlyidentifiedintheruralCHNAsincludedtheneedforbehavioral/mentalhealthservicestooffersubstanceabusetreatmentprograms.

• Amajority(91%)ofNorthDakotacounties(47of53)reportednopsychiatristin2017.

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• ThereareonlyfourruralcountiesinNorthDakota(8.5%ofruralcounties)thatreportedhavingatleastonepsychiatristin2017.

• Only11ofthe53countiesindicatedatleastonebuprenorphineproviderin2018.o Only7ofthe47ruralcountiesinNorthDakotaindicateatleastone

buprenorphineproviderin2018.o Itisunknownhowmanyoftheruralwaiveredprovidersareactivelyprescribing.

TheNorthDakotaRCORPconsortiummembersreviewedacomprehensiveslidedeck(developedbytheRCORPPlanninggrantawardee,CenterforRuralHealth)presentingissuesaroundOUD/SUDreferral,prevention,treatment,andrecoveryinruralandtribalNorthDakota.TheneedsassessmentincludedacomprehensivereviewofallproviderworkforcedatacollectedbytheNorthDakotaHealthcareWorkforceGroup.RelevantslidesareincludedinAppendixA.TheslidedeckalsoincludesalistofallexistingreportscompletedbythestateandotherentitiesexploringNorthDakota’sbehavioralhealthneedsaswellasspecificneedsaroundOUD/SUD.Reportsreviewedin-linewithgoaltwooftheNorthDakotaRCORPPlanninggrantincluded:SubstanceUseinNorthDakota:DataBook2019

ReleaseDate:2019Agency:NorthDakotaDepartmentofHumanServices,NorthDakotaStateEpidemiologicalOutcomesWorkgroupLink:https://prevention.nd.gov/files/pdf/DataBooklet2019.pdfDescription:ThisbooklettellsthestoryofsubstanceuseinNorthDakotaandisbasedoffthe2018NorthDakotaEpidemiologicalProfile.YoumayalsovisittheSubstanceUseNorthDakotawebsite(www.sund.nd.gov)tosearchsubstanceusedatabasedonsubstancetype,region,gradelevel,age,andyear.

NorthDakotaBehavioralHealthSystemStudy:FinalReport

ReleaseDate:April2018Agency:HumanServicesResearchInstitutesandNorthDakotaDepartmentofHumanServicesLink:https://www.hsri.org/files/uploads/publications/ND_FinalReport_042318.pdfDescription:Themainaimsoftheprojectwere:1.Conductanin-depthreviewofNorthDakota’sbehavioralhealthsystem.2.Analyzecurrentutilizationandexpenditurepatternsbypayersource.3.Provideactionablerecommendationsforenhancingthecomprehensiveness,integration,cost-effectiveness,andrecoveryorientationofthebehavioralhealthsystemtoeffectivelymeettheneedsofthecommunity.4.EstablishstrategiesforimplementingtherecommendationsproducedinAim3.

BehavioralHealthAssessment:GapsandRecommendations

ReleaseDate:September2016Agency:NorthDakotaDepartmentofHumanServices’BehavioralHealthDivisionLink:https://www.nd.gov/dhs/info/pubs/docs/mhsa/nd-behavioral-health-assessment.pdfDescription:ThepurposeoftheNorthDakotaBehavioralHealthAssessmentistoidentifypriorityrecommendationstoenhancethefoundationofthestate’sbehavioralhealthsystem,withthegoalofsupportingNorthDakota’schildren,adults,families,andcommunitiesinhealthandwellnesstoreachtheirfullpotential.

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BehavioralHealthPlanningFinalReportReleaseDate:July2014Agency:SchulteConsultingLink:http://storage.cloversites.com/behavioralhealthsteeringcommittee/documents/ND%20Final%20Report.pdfDescription:Thisreportfocusesonsixmaingoalsandstrategiesforimprovementfollowedbyrecommendationsforcontinuedwork.Thegoalschosenincorporateissuesseenacrossgeographicareas,ageranges,anddemographics.Examplesandstrategiesareusedthroughouttohighlightthevariousregionaldiscussionsandgroups.

WORKFORCEPROBLEMSTATEMENT

GiventhelargeserviceareaofthisRCORPPlanninggrant(allruralandtribalcommunitiesinNorthDakota),theconsortiumfocusedworkforceproblemstatementsonissuesfacingamajorityofruralandtribalcommunities(asopposedtospecificissuesevidentinonecounty).Theintentwastoidentifyissuesthattheconsortiummemberscouldaddressthroughthedevelopmentofastatewideruralstrategicplan.ItisimportanttonotethatthestateofNorthDakotahasalreadydevelopedastatewidebehavioralhealthneedsreportandstrategicplanandisnowintheprocessofimplementingactivitiesoutlinedinthestrategicplan.Assuch,amajorityofthespecificworkforcetopicsdiscussedbytheconsortiumarebeingaddressedbythestateDHS,whichhastheninfluencedtheprioritytopicsfortheRCORPconsortium.Goalsandimplementationstrategiesastheyrelatetothestatewidebehavioralhealthworkforceplanareathttps://www.hsri.org/NDvision-2020.

NorthDakotaRCORPConsortiumWorkforceProblemStatement

RuralandtribalcommunitiesinNorthDakotalackbehavioralhealthproviders,including(butnotlimitedto)psychiatrists,buprenorphineprescribers,socialworkers,peersupportspecialists,andaddictioncounselors.Complicatingbehavioralhealthworkforceshortagesareissuesaroundstudentresidencyplacements,reimbursementandusetotelebehavioralhealth,reimbursementforcasemanagementandpeersupportservices,andlackofreferralresourcesandprotocolsrelevanttoruralandtribalSUD/OUDprevention,referral,treatment,andrecoveryprograms.Recognizingtheseconcerns,theconsortiumfocusedthelargerruralstrategicplanaroundthreeproblemstatements,allofwhichrelatetoconcernsfortheruralandtribalbehavioralhealthworkforce.Theseinclude:

1. Thereare189trainedpeersupportspecialistsinNorthDakotaasofMarch2019with81%locatedinruralareas.However,therearenopeersupportspecialistsemployedorworkinginruralcommunities(asofJune2019).NorthDakotaisalsooneofonlyninestatesthatcannotbillMedicaidforpeersupportservices.

2. NorthDakotareports40(outof53)countiesthatareHRSA-designatedruralcountiesorruralcensustractsinurbancounties.NorthDakotaalsohasalargefrontierpopulation.Thesecommunitiescannotsupportcomprehensiveopioidtreatmentprograms(OTPs)butstillhaveOUD/SUDprevention,referral,treatment,andrecoveryneeds.Althoughawareofservicesgaps,communitiesandstateagenciescannotclearlyidentifyruralservicegaps

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withinthecontinuumofSUD/OUDprevention,referral,treatment,andrecoverycare,norarethereclearreferralrelationshipsinplace.

3. Sixruralcommunitiesreceivedstatetargetedresponse(STR)dollarsin2017/18,sevenpublichealthunitsreceivedSTRfundingin2018/19,16communitiesholdstateopioidresponse(SOR)dollars,andfourtribalcommunitieswereawardedtribalopioidresponse(TOR)dollarsinfiscalyear2018.ThestatehasalsoexpandedOUD/SUDservicestoincludeadditionalsyringeexchangeprograms,takebacklocations,andpharmaciesparticipatingintheOneRxprogram.However,ruralpublichealthunits,communities,healthsystems,andotherentitiesdonotknowwheretobeginwhenlookingtoidentifyexistingOUD/SUDprevention,referral,treatment,andrecoveryservicesintheirruralareasnordotheyhavetheresourcestoresearchthisinformation.SeethecompleteRCORPConsortiumStrategicPlanforthegoals,activities,andtheassociatedtimelinesthatrelatetothethreeproblemstatements.

ACTIVITIESADDRESSINGRURALBHEAVIORALHEALTHWORKFORCEISSUES

TheRCORPPlanninggrantgoalstaskedtheconsortiumwith:

1. OutliningstrategiesforrecruitingandintegratingadditionalSUD/OUDproviders. 2. DetailingplanstotrainandretainnewandexistingSUD/OUDproviders.3. DescribingaplanforidentifyingandobtainingeligibilityforsitestoplaceNational

HealthServiceCorps(NHSC)cliniciansinfutureyears.

Earlyinthelargestatewideconsortiummeetings,itwasclearthattheseactivitieswerealreadyoccurringthroughoutthestatewithactiveengagementfromvariousconsortiummembers.TheseactivitieswillprogressthroughoutthestateasconsortiummembersandfacultyandstaffattheCenterforRuralHealth(CRH)continuetobeinvolved.

1.RecruitingandIntegratingAdditionalSUD/OUDProvidersinRuralNorthDakota

A. PeerSupportSpecialistsThestateofNorthDakotaisintheprocessofdevelopingadministrativerulesfortheuseofpeersupportspecialistsasmembersoftheSUD/OUDtreatmentand/orrecoveryteam,especiallyinruralcommunities.Theseserviceswillbereimbursable,andthestateBehavioralHealthDivisionishiringapeersupportservicescoordinator.Thispersonisresponsiblefortrackinglicensureandcoordinatingservicelocations.MoreinformationthroughtheNorthDakotaDepartmentofHumanServices’BehavioralHealthDivisionisfoundathttps://www.behavioralhealth.nd.gov/addiction/peer-support.

B. TheBehavioralHealthWorkforceEducationandTraining(BHWET)ProgramThisprogramaimstodevelopandexpandthebehavioralhealthworkforcethroughimprovedtrainingandbyprovidingstipendstograduatelevelstudentsintheUniversityofNorthDakota(UND)behavioralhealthprograms.Thegoalistosupportinterdisciplinarytrainingandintegrationofbehavioralhealthwithprimarycareandincreasethenumberoffieldplacementsandinternshipswithafocusonservingpersonsinrural,vulnerable,and/or

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medicallyunderservedcommunities.TraineeschoosingplacementsitesthatarelocatedinNorthDakotaandthatserveruralpopulationswillhaveprioritystatus.Moreinformationisavailableathttps://ruralhealth.und.edu/projects/behavioral-health-workforce-education.

C. NorthDakotaHealthcareProfessionalStudentLoanRepaymentProgramThisprogramisforhealthcareprofessionalswillingtoprovideservicesinthestate.Providersmustserveinareaswithadefinedneedfortheservices.Behavioralhealthdisciplines,suchasclinicalpsychologists,licensedaddictioncounselors,licensedprofessionalcounselors,andothers,areincludedinthisprogram.Theseprovidersmustofferservicesonafull-timebasisforuptofiveyears.TheNorthDakotaDepartmentofHealthadministersthisloanrepaymentprogram(http://ndhealth.gov/pco/hcps.asp).

D. FederalStateLoanRepaymentProgram(SLRP)ThisprogramisafederalstatepartnershiptoassistsitesinNorthDakotaintherecruitmentofhealthcareprofessionals.Behavioralhealthprofessionalsareincludedinthisprogram,andprovidersmustserveinaHealthProfessionalShortageArea(HPSA).Providersmustofferservicestotheseareasforaminimumoftwoyearsonafull-timeorpart-timebasis.TheNorthDakotaDepartmentofHealthadministersthisloanrepaymentprogram(https://www.ndhealth.gov/pco/slrp.asp).

E. ONERxONERx(OpioidandNaloxoneEducation)isaninnovativeapproachtoscreenandeducatepatientswhoreceiveprescribedopioidmedicationsatparticipatingcommunitypharmaciesinthestateofNorthDakota.Addressingopioidusepriortomisuseisacornerstonetohelpcommunities.Inaddition,throughpatientscreening,pharmacistscancompleteathoroughassessmenttodetermineifapatientismorelikelytoexperienceanaccidentaloverdose,eveniftakingthemedicationasprescribed.Underthismodel,pharmacistsarepartofthelargerpreventionandreferralnetworkforindividualsatriskofOUD/SUD.Additionally,pharmacistsareabletoprescribeandprovideNaloxoneandNaloxoneeducationtoindividualstheydeematriskofanopioidoverdose.Moreinformationisavailableathttps://www.nodakpharmacy.com/onerx/.

2.PlanstoTrainandRetainNewandExistingRuralSUD/OUDProviders

A. TheBehavioralHealthWorkforceEducationandTraining(BHWET)ProgramThisprogramaimstodevelopandexpandthebehavioralhealthworkforcethroughimprovedtrainingandbyprovidingstipendstograduatelevelstudentsintheUNDbehavioralhealthprograms.Thegoalistosupportinterdisciplinarytraining,integrationofbehavioralhealthwithprimarycare,andincreasethenumberoffieldplacementsandinternshipswithafocusonservingpersonsinrural,vulnerable,and/ormedicallyunderservedcommunities.TraineeschoosingplacementsitesthatarelocatedinNorthDakotaandthatserveruralpopulationswillhaveprioritystatus.Moreinformationisavailableathttps://ruralhealth.und.edu/projects/behavioral-health-workforce-education.

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B. ProjectECHOTheCenterforRuralHealthservesasaHubsiteforProjectECHO,whichconnectsmultidisciplinaryteamsofexpertslocatedattheHubwithlearnersataSpokesite(s),mostofteninruralandtribalcommunities.Byprovidingevidenced-basedtreatmentofopioidusedisorders(OUD),inacase-basedlearningformatthecapacity,confidence,andcomfortofruralprimarycareteammembershasimproved.Allmembersofthehealthcareteamtoinclude,butnotlimitedto:medicationassistedtreatment(MAT)prescribingproviders,prescribingprovidersinterestedinbecomingMATproviders,nurses,behavioralhealthproviders,andpharmacists,areinvitedtoparticipate.ThirtyProjectECHOclinicswereheldDec.2017-April,2019,fundedbySAMHSA,StateTargetedResponsetotheOpioidCrisisgrant.ECHOsessionswillcontinueinOctober2019,supportedbytheSAMHSA,StateOpioidResponsegrant,whichwillexpandtheskills,capacityandnetworkoftheruralworkforceavailabletoservethosewithOUD/SUD.Moreinformationisavailableathttps://ruralhealth.und.edu/projects/project-echo.Results/Outcome:“It’sbeenimmenselyhelpfuljusttoattendECHOandhavetheresources.Weknowwhowecancallandaskquestions,andweknowwehavethatbackup”“WearejustintheprocessofdevelopmentofrelationshipswithcommunityphysiciansinprovidingMATatourfacility.Thisadditionalinformationregardingbestpracticeandidentifyingchallengeswillbeverybeneficialinestablishingeffectivecoordinationofcarebetweenprovidersandourresidentialandoutpatienttreatmentservices.”

C. AreaHealthEducationCenter(AHEC)TheCenterforRuralHealth,servesastheprogramofficefortheNDAHEC.TheAHECisfocusedoncreatingjobsinhealthcareandprovidingeducationandtrainingfortheexistinghealthcareworkforce.TheAHECiscurrentlyworkingwithHeartview(aconsortiummember)toconducteducationalworkshops,infourruralcommunities,relatedtoSUD/OUDwhichincludescommunityeducationandawarenessandtrainingforhealthcareprofessionalstoinclude,butnotlimitedto:physicians,nurses,homehealth,ambulanceservice,sheriff’soffice,socialworkers,andteachers.WeanticipatetheAHECwillcontinuetoworkincollaborationwiththeECHOprojecttosupportadditionalworkshopsinruralareasinordertobuildknowledgeandskillsofruralproviderteamsrelatedtoSOU/OUD.

D. StateOpioidResponse(SOR)GrantTheNorthDakotaDepartmentofHumanServices’BehavioralHealthDivisionawardscommunitieswithgrantdollarstopreventopioidoverdose-relateddeaths,increaseevidence-basedtreatmentandrecoveryservicestosupportindividualswithanOUD,andincreasethecapacityofrecoverysupportservicesinthestateforindividualswithanOUD.Communitiesareabletousegrantdollarstoincreasetheavailabilityofmedicationassistedtreatment(MAT)intheircommunities.TheDepartmentofCorrectionsandRehabilitationhasalsodevelopedanMATprogramforindividualswithOUDs.Moreinformationisavailableathttps://www.behavioralhealth.nd.gov/addiction/opioids.

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E. ONERx

ONERx(OpioidandNaloxoneEducation)isaninnovativeapproachtoscreenandeducatepatientswhoreceiveprescribedopioidmedicationsatparticipatingcommunitypharmaciesinthestateofNorthDakota.Addressingopioidusepriortomisuseisacornerstonetohelpcommunities.Inaddition,throughpatientscreening,pharmacistscancompleteathoroughassessmenttodetermineifapatientismorelikelytoexperienceanaccidentaloverdose,eveniftakingthemedicationasprescribed.Underthismodel,pharmacistsarepartofthelargerpreventionandreferralnetworkforindividualsatriskofOUD/SUD.Additionally,whiletheseprovidersarenotbeingtrainedtoprescribeMATservices,pharmacistsareabletoprescribeandprovideNaloxoneandNaloxoneeducationtoindividualstheydeematriskofanopioidoverdose.Moreinformationisavailableathttps://www.nodakpharmacy.com/onerx/.

3.PlanforIdentifyingandObtainingEligibilityforSitestoPlaceNationalHealthServiceCorps(NHSC)Clinicians

TheNorthDakotaPrimaryCareOffice(PCO)hasamission

“toimproveprimarycareservicedeliveryandworkforceavailability.TheseactivitiesareaccomplishedbyfacilitatingthecoordinationofactivitieswithintheStatethatrelatetothedeliveryofprimarycareservicesandtherecruitmentandretentionofcriticalhealthcareproviders.TheNorthDakotaDepartmentofHealthsubcontractswiththeUniversityofNorthDakotaCenterforRuralHealthtoprovideservicesforworkforcedevelopmentandshortagedesignationactivities”(https://www.ndhealth.gov/pco/).

StacyKusler,workforcespecialistfortheCRH,ispartoftheNorthDakotaPCOteam.Inthisrole,shemanagestheJ-1visawaiverprogramandservesasthepointofcontactfortechnicalassistancefortheNHSCprogram.HerworkwiththeNHSCprogramincludesinformingandsupportingpotentialNHSCsiteswiththeirapplications,aswellasinformingthemofthevariouswaysinwhichtheNHSCprogramcanhelpthemrecruitandretainhealthcareworkforceintheircommunities.Additionally,thenewfundingopportunitiesthroughNHSCinthepastyearhavebeencommunicatedtoallpotentialsitesaroundthestate.StacyworkscloselywithTerriLangandSonjaBauman,whoarepartofthePCOteamperformingshortagedesignations.Together,theysupportcommunitiesthatneedassistanceinunderstandingtheirHPSAscoresorthatrequestanychangestotheirscoresbasedonproviderdata.TheCRHalsocontinuestohostawebsitewithvaluableinformationabouttheNorthDakotaNHSCprogram.Thisinformationisavailableathttps://ruralhealth.und.edu/projects/primary-care-office/nhsc.

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APPENDIXA

SlideDeckPreparedforConsortiumMembers

Identifies:WorkforceShortages

OUD/SUDOverdoesRatesExistingProgramsLegislativeUpdates

PresentedatConsortiumMeetingsLastUpdatedMarch2019

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