It's tough to find workers for Idaho's health clinics right now, but an apprenticeship program is hoping to address these woes.

Nearly three years of the pandemic have led to turnover and burnout in the medical field, and workers are hard to find with unemployment numbers so low.

To deal with the crunch, the Idaho Community Health Centers Association is collaborating with North Idaho College and the Idaho Department of Labor on a statewide apprenticeship program where students can earn while they learn.

Robin Donovan is the program manager of workforce development for the association.

"We know that there's a huge shortage for medical assistants and dental assistants, and those are a little bit more entry-level positions coming into a clinic," said Donovan. "It doesn't require a degree. And so we looked at ways to bring these apprenticeship programs across the state."

Donovan said the goal was to create a program that wouldn't be a burden for their organization or clinics to manage.

Since January, one student has graduated from the dental assistant program and six more expected to graduate this month.

The dental assistant apprenticeship can take as little as four and a half months and the medical assistant apprenticeship is eight and a half months.

Students not on North Idaho College's campus in Coeur d'Alene work with clinical preceptors, or experienced clinicians in their community.

Marty Matney - manager of health, occupations and careers for the North Idaho College workforce training center - said the pandemic has shown the school how it can be successful at a distance.

"We're very successful in our medical assistant apprenticeship because we've benefited form COVID, if you can believe that," said Matney, "in that we have learned how to take a program that is largely hands on and put it online."

Donovan noted that the apprenticeship program also can create career ladders for people, and says that program helps local communities.

"They're 80% more likely to stay in that clinic in that community and continue working," said Donovan. "So it's a great retention tool for the employer to offer those types of trainings."

Matney said higher education is adapting post-COVID.

"Higher ed is playing a role right now by being flexible and responding to the needs of the community," said Matney.

Support for this reporting was provided by Lumina Foundation.

Telehealth has been key to health care in the wake of the COVID-19 pandemic, but some of the flexibilities for this type of care for Medicare patients could expire soon.

A new report from the Bipartisan Policy Center details how Congress can improve telehealth.

Without action from Congress, telehealth provisions for Medicare expire at the end of 2024.

Maya Sandalow, senior policy analyst with the Bipartisan Policy Center, said telehealth is especially important for rural states like Idaho.

"We know that patients have to travel way farther than folks in urban areas to access care," said Sandalow. "Hospitals are shutting down and struggling to stay afloat. And so telehealth is really an important part of this puzzle when it comes to helping people living in rural areas to access care."

Sandalow said Congress looks likely to give a two-year extension to telehealth provisions, but she also noted that members should consider ways to ensure people can access this care.

The report recommends three policies for Congress to consider if it extends telehealth provisions.

First, she said policymakers need to consider the cost - by mandating a study from the Centers for Medicare and Medicaid Services - because there is some disagreement about whether it costs more than in-person care.

Sandalow said CMS should also set up a way to track telehealth companies.

"These companies are really important for expanding access to care," said Sandalow, "but there are some quality concerns associated with some of these companies."

Lastly, Sandalow said Congress should make some of the policies around telehealth permanent, such as doing away with location restrictions.

She said telemedicine is going to continue to be important to the health care landscape going forward.

"Research finds that it can be really high quality, equally good as compared to in person care," said Sandalow. "And we're living in a behavioral health crisis and any measures to expand access to care are really important."




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North Carolina must increase its crisis response capacity for long-term success, according to a new report by the mental-health policy group Inseparable. The report analyzes 988 crisis lifeline responses in every state and proposes improvements.

One key area it says requires attention in North Carolina is the need for more crisis-response mobile units and beds. Kelly Crosbie, director of the Division of Mental Health, Developmental Disabilities and Substance Use Services at the North Carolina Department of Health and Human Services, acknowledged this challenge and said funding from the General Assembly is addressing the need.

"So, now we have 19 'urgent cares' opening across the state," she said. "In the community crisis center space, we've added about 64 new beds for adults and 44 new beds for children."

The report shows an 81% call capacity rate, with a recommended goal of 90%. Crosbie said current numbers are higher, with call capacity at 98% and calls being answered in about 14 seconds. North Carolina's 988 line receives around 8,000 calls monthly.

In order to sustain this progress for the long term, Crosbie said, the 988 system will need sustainable funding.

"We really need insurers to recognize this as an appropriate level of care and to cover it. So they all cover 'urgent cares' now, right? Folks who go to an urgent care, and you have Aetna or Blue Cross, they're going to cover it," she said. "You go to a mental-health 'urgent care'; that should be covered as well."

Angela Kimball, chief advocacy officer for the group Inseparable, said the report calls on state legislatures to focus on creating sustainable funding sources and accountability measures for their crisis response systems.

"By having these accountability pieces," she said, "this allows legislators to oversee the system over the long haul, and to set up the structures for continuous learning, continuous system improvement."

She said data collection, annual reporting and coordination between the 988 and 911 systems are ways states can make them more accountable.

New York doctors are advising people how to stay healthy in the summer heat.

Temperatures across the state will reach the high 80s and mid-90s in the coming days. Some climatologists estimate 2024 will overtake 2023 as the hottest year on record, and New York's average temperature has risen 3 degrees since the 1970s.

Dr. Steven Foulis, a physician at
UBMD Primary Care, said people need to always stay hydrated.

"When you sweat, you lose a good deal of salts and other solutes through the sweat," he said, "so being able to replete those with whether it be a sports drink or really, any drink that has electrolytes in it will be an important thing to replete what your body is losing during warm days."

Foulis said people need to wear sunscreen when they're outdoors, since some aren't aware of the risks direct sun exposure poses. However, he added, this shouldn't stop anyone from getting away from their screens to enjoy the outdoors. New York Gov. Kathy Hochul's "Get Offline, Get Outside" campaign champions this by making all state park pools free this summer.

Not staying hydrated can lead to heat stroke or heat exhaustion, in turn leading to an emergency room visit. A Centers for Disease Control and Prevention study finds heat-related ER visits rose in 2023.

Dr. Donna O'Shea, chief medical officer for population health at UnitedHealthcare, said virtual care can help you decide whether a situation is serious enough to seek emergency care.

"You can decide, with a knowledgeable caregiver, 'Do I need more?' Most of the time, if it's related to hydration and heat stroke, if you're able to keep fluids down, virtual care can help determine how much, how long to wait before you go to the emergency room," she said. "Same thing even for sunburns or for bike safety."

She added that using virtual care can be a less time-consuming and less expensive option than going directly to a hospital. While telehealth can cost around $50, an in-person emergency room visit can cost around $2,700.