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Workforce and Staffing Considerations

To achieve the goals of care coordination, it is important that rural programs have the appropriate type and level of staffing. Staffing types and levels will vary depending on the program model being implemented, the patient population being served, and the goals of the care coordination program.

Care coordination programs have interdisciplinary staff that represent healthcare, public health, and social services. Interdisciplinary teams may be most effective in providing assistance to patients with multiple chronic conditions. Types of staff may include:

  • Program managers
  • Healthcare providers
  • Care coordinators
  • Community health workers
  • Social workers
  • Counselors
  • Administrative support staff
  • Data coordinators
  • Referral coordinators
  • Reception coordinators
  • Other health professionals

Recruiting and hiring the appropriate staff to conduct care coordination activities can be a challenge for some rural communities. Similarly, training staff can be challenging since the different types of jobs involved in care coordination can be quite diverse. Because care coordination involves a collaborative approach, program staff may have both clinical and non-clinical roles. Care coordinators often need experience with home visits and need to have an understanding of the social determinants of health. In some cases they may need to assist patients with non-health related needs, such as connecting them with social services or housing resources.

The staff training required in care coordination programs may vary due to the different roles and experiences of program staff. Training of staff should include helping coordinators become familiar with community resources in order to connect patients with services. For care coordination models using HIT, it is also important to consider technical training on the HIT system and data collection. Additional information on training considerations is available in Module 2, Care Coordinator Training Topics.

Many of the models involve a level of administration that can be time-consuming and can lead to staff burnout. Depending on the program, care coordinators may be responsible for helping many patients and managing large caseloads can be challenging. Patients with chronic conditions may have complex needs which can make it even more challenging to connect them with necessary services.

Additional staffing considerations for care coordination programs include provider shortages, the closing of rural hospitals, and the presence of smaller private practices in rural areas. Small, private practices can experience challenges when trying to share data between different types of service providers. Care coordination can involve a variety of different types of specialists working together, some of which may not be physically located in the community. The majority of Health Professional Shortage Areas continue to be found in rural areas, and care coordinators will need to consider geography when coordinating care for patients.

Resources to Learn More

Integrated Care Management in Rural Communities
Document
Provides background information about new models of health care delivery created after the Affordable Care Act that integrate patient care and the implications for implementation of these programs in rural communities. The paper offers suggestions about implementation considerations related to workforce, training, payment, and funding, as well as several other relevant topics.
Organization(s): Maine Rural Health Research Center
Author(s): Griffin, E. & Coburn, A.
Date: 5/2014