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Preamble:
WHEREAS adequate medical services and the professionals required to deliver those services are critical to the safety and well-being of all Albertans; and
WHEREAS Albertans living in rural and remote areas face the largest impact from shortages of health care workers; and
WHEREAS a robust and diverse workforce of health care professionals is needed in Alberta to provide equitable access to appropriate health care services no matter where Albertans live; and
WHEREAS a cohesive provincial strategy focusing on increasing the number of health care professionals in rural Alberta is critical to ensuring stability and equity in Alberta’s health care system; and
WHEREAS health providers across most professional groups are overrepresented in urban areas compared to the proportion of Albertans living in rural areas;
Operative Clause:
THEREFORE, BE IT RESOLVED that the Rural Municipalities of Alberta advocate for the Government of Alberta to urgently prioritize a commitment to long-term sustainable funding to accelerate implementation of the Rural Health Action Plan 2024-2027 and the work of the Rural Health Professions Action Plan that focuses on increasing the total number of health care professionals in rural and remote Alberta.
Member Background:
The lack of health care professionals affects all communities in Alberta but is more acute outside of the major urban centres. Per this graph, nearly all health care professions are underrepresented in rural Alberta, leading to staff burnout, dissatisfaction, and premature retirement as well as relocation to better staffed communities.
In response to the shortage of health care professionals, community-driven attraction and retention initiatives are becoming increasingly common in rural Alberta. Leaders at the municipal, business, and community level recognize that health care services are crucial for community sustainability and where health services are not available, growth is unlikely and out-migration of taxpayers, investors, workers, and service providers is inevitable. To avoid a continuously dwindling economy, municipalities are forced to act; and this represents another case of downloading of provincial responsibility onto municipalities left with little choice but to undertake property tax-funded initiatives to try and avoid consequential health care staff shortages and resulting reduction in medical services in their community.
Despite all recruitment efforts, there were still 270 medical service disruption notices issued by Alberta Health Services in 2023 across 43 communities. This is empirical evidence that even where health facilities are established, the staff required to operate them are lacking and the facilities cannot serve Albertans. Local efforts to attract and retain service providers may address immediate community concerns, if successful, but fall short in tackling the broader challenge of addressing the overall scarcity of frontline professionals in a complex and interconnected industry.
Current demographic trends in Alberta will place additional stress on our health care system in our lifetimes unless deliberate action is taken;
References
RMA Background:
17-22F: Government Funding For Nurse Practitioners
THEREFORE, BE IT RESOLVED that the Rural Municipalities of Alberta request the Government of Alberta to establish a salary-based funding model that will fairly and equitably compensate nurse practitioners for work in rural local care facilities and rural independent clinics.
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Alberta Health
As highlighted in my mandate letter, a key government priority is to attract, train, and retain health professionals, particularly in rural and remote communities. To support this mandate, Alberta’s Health Workforce Strategy is managing immediate challenges facing the health workforce while preparing for future needs. A $16 million Rural and Remote Family Medicine Resident Physician Bursary Pilot Program is benefiting family medicine residents interested in practising in rural or remote Alberta. In return for funding, bursary recipients commit to delivering comprehensive patient care in eligible communities after completing their residency.
Additionally, Rural Capacity Investment Funds (RCIFs) have been established under recent collective agreements to support retention, recruitment, and relocation initiatives for health workers n rural areas across Alberta. These funds, totaling $17.4 million annually, enable site-specific and collaborative initiatives to increase clinical capacity and address workforce shortages.
Further the Rural Health Action Plan includes several targeted strategies, such as collaborative recruitment efforts, investment in medical education in rural settings, and multi-disciplinary team-based care models that provide comprehensive care while reducing the burden on individual providers. It also supports initiatives like peer networking, rural-specific education programs, and cultural competence training. Other innovative approaches are also being utilized, including the use of technology and mobile clinics to expand access and streamline care in rural and remote areas, while reducing administrative tasks for doctors.
To increase physician numbers, Alberta is working with medical schools to train over 100 additional physicians annually. Regional training centres in Lethbridge and Grande Prairie will enable medical students to complete most of their education in rural areas, based on evidence that rural training fosters rural practise.
Further, to attract more health care workers, creative strategies like international recruitment and targeted incentives are being used. Digital tools and virtual care also help improve access to health services in remote areas while reducing administrative tasks for doctors.
Alberta Mental Health and Addictions
Alberta’s government is committed to increasing access to mental health and addiction services in Alberta, helping to ensure all Albertans can receive the care they need when and where they need it. Ensuring mental health and addiction professionals are available to support programs and services is vital to this commitment.
Recovery Alberta is an agency responsible for the delivery of publicly funded mental health and addiction care in Alberta. Recovery Alberta has recruitment initiatives currently ongoing for both domestic and international applicants, for which Alberta Health Services provides human resources supports through a transitional shared services agreement. Recovery Alberta is focused on establishing itself as an employer of choice by offering competitive wages and benefits and meaningful career growth.
Recovery Alberta is working with partners, including the College of Physicians and Surgeons of Alberta and the Association of International Medical Graduates of Alberta, to highlight opportunities and streamline the recruitment process. Alberta Health Services also works with existing programs on behalf of Recovery Alberta, including the Rural Health Professionals Action Plan, to support community integration, setting candidates up for success in their new communities.
Recovery Alberta is removing as many barriers as possible for Internationally Educated Nurses(lENs) to join the workforce by working with nurses at each step of the process. The process to hire lENs is being expedited, reducing the time to hire from two years to six months, placing Alberta at the forefront of lEN recruitment nationwide. Recovery Alberta is committed to ensuring each lEN feels safe, supported, and valued as members of their new teams and communities, and are working closely with sites to foster these welcoming environments.
In the last round of collective bargaining, the Rural Capacity Investment Fund was established to support recruitment and retention strategies in rural and remote areas in the north, central, and southern Alberta. Approximately $17 million annually was allocated to support recruitment, retention, and relocation incentives, as well as to support team and professional development opportunities for clinical staff in these three rural zones.
Alberta’s government continues to invest in mental health and addiction supports and services across the continuum of care, including intervention, prevention, treatment, and recovery. Budget 2024 invests more than $1.55 billion to continue building the Alberta Recovery Model and to ensure Albertans living with mental illness and/or addiction have an opportunity to pursue recovery. This includes investments in services to ensure Albertans living in rural communities have access to the mental health and addiction programs and services they need.
Mental Health and Addiction provides funding to the Canadian Mental Health Association – Alberta Division for the Rural Mental Health Project (ruralmentalhealth.ca) in rural communities across Alberta. This project strengthens community capacity for better mental health in rural and remote communities through ongoing training, network collaboration, and funding. Funding is also provided to Counselling Alberta (counsellingalberta.com) to provide affordable virtual mental health counselling services across Alberta, and partners with local organizations in seven communities, including Grande Prairie, Fort McMurray, Edmonton, Red Deer, Calgary, Lethbridge, and Medicine Hat, to provide affordable virtual and in-person mental health counselling with no waitlist.
Since 2019, the Government of Alberta added over 10,000 annual additional addiction treatment spaces across the province. This includes adding new spaces, funding spaces that were previously unfunded, and upgrading existing detox spaces to medically supported detox. These spaces are in addition to the approximately 19,000 publicly funded addiction treatment spaces in Alberta, resulting in the Government of Alberta now funding approximately 29,000 addiction treatment spaces annually. This includes spaces in north, central, and southern Alberta.
Recovery Alberta’s publicly funded mental health and addiction services are available in communities across the province. Albertans living in north, central, and southern Alberta can contact Recovery Alberta’s Access Addiction and Mental Health (1-888-594-0211) for support accessing the services they need.
Recovery Alberta’s Virtual Opioid Dependency Program provides technology delivered same day medication starts, opioid treatment transition services, and ongoing opioid dependency care to Albertans living with opioid addiction. This service is available to Albertans across the province, particularly those unable to access one of Recovery Alberta’s opioid dependency program clinics, especially those in rural areas. The program helps ensure smooth transitions for patients who are moving from one care setting to another, including from hospital-based care to community-based care.
By continuing to invest in recovery-oriented mental health and addiction programs and services, Alberta’s government is working to meet the mental health and addiction recovery needs of Albertans. This helps ensure a healthy, strong Alberta for the future.
Development:
RMA sent Resolution 1-24F several ministries and agencies including Alberta Health Services, Alberta Health, Alberta Seniors, Community and Social Services, Alberta Mental Health and Addiction, and Alberta Advanced Education. To date, RMA has received a response from the Ministers of Alberta Health and Mental Health and Addiction. Resolution 1-24F calls on the Government of Alberta to support rural healthcare worker attraction and retention by prioritizing the implementation of the Rural Health Action Plan and the Rural Health Professions Action Plan. The Rural Health Action Plan includes the following workforce focus areas:
The Minister of Health’s response draws attention to their work with the resident physician bursary program and other related attraction and retention activities. RMA has previously expressed concern that some health worker grant funding may download healthcare costs onto municipalities. Many of these actions do not entail long-term sustainable funding. The Minister of Mental Health and Addiction describes several of the Government of Alberta’s rural mental health initiatives including streamlining credential recognition for internationally educated mental healthcare workers and investments in (rural) mental health services and associations. The Minister of Mental Health and Addictions’ response does not refer to the Rural Health Action plan and neither government response make any reference to the Rural Health Professions Action Plan (RhPAP) or additional supports for their work. RMA assigns this resolution a status of Intent not Met and will continue to advocate.
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