In a discussion that covered a broad range of topics from mental health, homelessness, the prison system, kindergarten readiness, and workforce diversity, the Oregon Health Policy Board appeared to wholly agree on one issue: a commitment to an interdisciplinary, team-based approach to health care.
“We need to break down silos and bring divisions together,” said Leslie Clement, chief of policy at the Oregon Health Authority. Indeed, the state agency plans to utilize this approach in tackling its first priority area of transformation – the development of a statewide behavioral health system strategy and implementation plan.
Often, the school systems, police departments and correction facilities become the de facto mental health providers yet don’t have the appropriate training, said Carlos Crespo, who runs the School of Community Health at Portland State University.
It’s difficult to turn around a broken mental health system in a short timeline, acknowledged Dr. Robert Dannenhoffer, CEO of the Umpqua Health Alliance. But, rather than establish an arbitrary timeline, coordinated care organizations need to step back and engage the community in dialogue to determine what the mental health system should look like. “Mental health is the most siloed among poor people. We need to change that.”
The coordinated care organizations can also play a role in determining kindergarten readiness through the early learning hubs, according to Dr. Helen Bellanca, the maternal child family program manager with Health Share. Such hubs focus on early literacy, early math skills, and approaches to learning such as the ability to follow directions.
But, the CCOs already have insufficient resources to perform their existing obligations, much less the potential of dealing with early learning hubs, said Dr. Joe Robertson, president of Oregon Health & Science University. In response, Bellanca said that coordinating existing community resources would lead to further costs, but improve the quality of care, and save money.
In a preliminary report about the diversity of Oregon’s work force, it’s likely that the work force is less racially and ethnically diverse than the state as a whole. The information, gathered from seven licensing boards remains incomplete because 13 percent of the workforce records are missing race and ethnicity data.
From what’s known, however, primary care providers are more linguistically diverse than the healthcare work force.
For example, in counties with a high Hispanic population, the workforce is more likely to be Hispanic than the state as a whole. However, a significant gap remains since those same counties also tend to have fewer Hispanic health professionals than counties with a smaller Hispanic population. There are fewer African American and Hispanic primary care providers than the percentage of African Americans and Hispanics in Oregon’s population, respectively.
More specifically, the data revealed that among the 11,886 licensed medical doctors, osteopaths, and physician assistants in Oregon, 8,266 were white, representing 69.5 percent. Comparatively, 333 identified themselves as Hispanics (2.8 percent) and only 95 as African American (0.8 percent).
Among dentists, there was a similar trend – 1,914 identified as white, 69 as Hispanic, and 12 as African American. Of the 2,655 dental professionals, that breaks down to 72.1 percent white, 2.6 percent Hispanic, and 0.5 percent African American.
The nursing workforce had the largest preponderance of ethnically diverse professionals – 33,079 white (67.9 percent), 1,946 Hispanic (4.0 percent), and 713 African American (1.5 percent) – and thus, the most promising. For instance, 25.3 percent of Hispanic health professionals currently work as certified nursing assistants. Felisa Hagins, board member and political director for the Service Employees International Union, suggested adopting strategies such as training Hispanic certified nursing assistants towards becoming registered nurses and nurse practitioners, might contribute to solving both county workforce deficits and providers’ language proficiency levels.
The demographics report confirms the need for improvement in recruiting and retaining a diversity of health professionals that better reflect and can thus, better respond to Oregon’s population, according to the board.
Jennifer can be reached at [email protected].