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Michigan Department of Community Health Bureau of Health Professions. Prevention Regulatory Disciplinary Workforce Excellence. Health Licensing Division . 26 Licensed Health Professions Over 400,000 Health Care Professionals
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Michigan Department of Community HealthBureau of Health Professions Prevention Regulatory Disciplinary Workforce Excellence
Health Licensing Division • 26 Licensed Health Professions • Over 400,000 Health Care Professionals • 19,713 Dentistry Licenses Granted (7,637 Dentists; 9,623 Dental Hygienists; 1,263 Dental Assistants
Health Regulatory Division • Receives Allegations of Misconduct from the public or health professionals • 3,121 Allegations of Misconduct in FY 2006 • 27,859 Allegations 1994 through 2006
Top Five in FY 2006: • Negligence/Incompetence: 1080 (35%) • Criminal Conviction: 345 (11%) • Substance Abuse: 291 (9%) • Drug Diversion: 157 (5%) • Continuing Education: 111 (4%)
Top Four Professions: • Nursing: 1,002/157,193 (.6%) • Medicine: 828/33,528 (2.5%) • Dentistry: 254/19,713 (1.3%) • Osteopathic: 239/7,001 (3.4%)
Health Investigation Division • Investigates factual allegations that represent true violations • 832 investigations authorized from 3,121 allegations in FY 2006 (27%) • 519 disciplined health professionals (from 832 investigations) in FY 2006
Top Four Disciplinary Actions in FY 2006: • Probation: 238 (46%) • Suspended License: 205 (39%) • Fine Imposed: 52 (10%) • Voluntary Surrender: 27 (5%)
Workforce Development, Research, & Evaluation Section (WDRE) • WDRE Section formed in August 2006 • WDRE staffs the Michigan Healthcare Workforce Center • MHWC major functions: • Serves as a clearinghouse for workforce data • Administers surveys to licensed health professionals • Convenes and/or participates with groups to address workforce issues • Conducts research and publishes papers on workforce related issues
(WDRE) Section (cont’d) • MDCH/MDE/MDLEG/MDHS/MHC/OCNE Serve as Advisory Body to MHWC • Professional Licensee Workforce Surveys (Phys/Dental/Nurs/Pharm/PA) • Professional Scope of Practice/Corporate Structure for Professional Practice
Healthcare Information for Professionals and Health Consumers • Two Newsletters • Six Websites • Board Support: Over 1,600 Professional Practice Inquiries from Professionals or the public responded to annually
Professional Practice Issues Currently Being Investigated • Continuous Professional Development • E-Health • Pain & Symptom Management • Sexual Boundary Violations • Patient Safety
FY 2007 Dental Survey Findings • Two-page (21-22 questions) survey available online and through mail • Collects demographic, employment, practice, and patient information • One-third of all Michigan dentists and hygienists received the survey • 697/2,777 renewing dentists (25%) and 2,062/3,433 renewing DYHGs (60%) completed the survey
FY 2007 Dental Survey Findings (cont’d) • 43% Dentists and 38% DHYGs plan to work only one to ten more years (compared to nurses and physicians at 33% and 34% respectively) • 7% of dentists plan to reduce patient care hours within three years
FY 2007 Dental Survey Findings (cont’d) • 7% of dentists plan to retire in the next three years • 80% of dentists who plan to retire or reduce patient hours cite age as a factor in their decision. • 37% of dentists are 55 years of age or older • 81% of dentists are male; 99% of DHYGs are female
FY 2007 Dental Survey Findings (cont’d) • 85% of dentists and 95% of DHYGs are white • 64% of dentists report seeing no Medicaid or MIChild children in a typical month. Only 1% of dentists report seeing an average of 250 or more of these patients each month. • 86% of dentists report that none of their patients in a typical month are covered by Medicaid. Only 1% report seeing an average of 60 or more of these patients each month.
FY 2007 Dental Survey Findings (cont’d) • 75% of dentists report seeing 20 or fewer uninsured children in a typical month. Only 1% report seeing an average of 300 or more of these patients each month. • 75% of dentists report 30 or fewer uninsured adults each month. Only 1% report seeing an average of 500 or more of these patients each month. • 82% of dentists renewing their license in Michigan attended a Michigan Dental School.
Findings of the FY 2007 Dental Surveys Reflect National Findings: • The aging healthcare workforce is likely to result in a worsening shortage of dental health care in Michigan. • Few Michigan dentist are seeing low income, uninsured or underinsured children and adults. • Ethnic minorities are underrepresented among dental health professionals. • There is a gender bias toward male dentists and female dental hygienists. • The greatest predictor of what state a dentist practices in is where s/he attended dental school.
Michigan’s Shortage of Dental Care Compared to other Midwest States*
Michigan Dental HPSA Severity Among 83 Counties • 2 Full County Geographic HPSAs (2%) • 54 Full County Population Group HPSAs (66%) • 9 Partial County Population Group HPSAs (11%) • 65 Michigan HPSA Counties (79%) • 18 Non-HPSA Counties (21%)
Dental Recruitment & Retention Challenges/Opportunities • Weakness/Challenges: • Low number of dentists serving uninsured/Medicaid population • High percentage of at risk (uninsured and Medicaid enrolled) population • Michigan = 11% and 15.1% • Ohio = 11.7% and 16.7% • Illinois = 14% and 16.3% • Indiana = 12.9% and 14.5% • Wisconsin = 9.5% and 15.9%
Dental Recruitment & Retention Challenges/Opportunities (cont’d) • Aging dental workforce • Poor Michigan economy (lure of states with better weather & better economies) • Increased demand for dentists in other Midwest states due to closure of 2 Chicago dental schools • Low Medicaid reimbursement rates • Michigan’s State Loan Repayment Program (SLRP) places relatively few dentists in southeast Michigan. • There are only 3-6 dentist applicants to SLRP each year.
Dental Recruitment & Retention Challenges/Opportunities (cont’d) • Strengths/Opportunities • Michigan’s beauty and low-cost housing • High percentage of underserved provides opportunity for new dentists • High percentage of underserved provides opportunity for federal & state loan repayment reimbursement and scholarship opportunity • Michigan has the largest State Loan Repayment Program in the nation • Michigan has a disproportionately larger share of federal (NHSC) loan repayment recipients
Dental Recruitment & Retention Challenges/Opportunities (cont’d) • Michigan SLRP and NHSC could target Detroit and other metro areas for dental placements • The SLRP and NHSC could be marketed to Michigan dental schools • Establish another Michigan dental school and increase admissions to current schools • Legislation for increased Medicaid reimbursement for practicing in a dental HPSA • Develop and national Practice in Michigan campaign that targets or includes dental professionals • Increase Medicaid reimbursement rates and reduce reimbursement processing time
Healthcare Workforce Websites Michigan Healthcare Workforce Center www.michigan.gov/mhwc Michigan Health Careers www.michigan.gov/healthcareers Michigan Center for Health Professions www.mhc.org Michigan Center for Nursing www.michigancenterfornursing.org Pain and Symptom Management www.michigan.gov/pm Patient Safety www.michigan.gov/ps
Bureau of Health Professions Steven Creamer, Manager Workforce Development, Research, and Evaluation Section 517-335-3294 creamers1@michigan.gov