Needs and Opportunities for Implementing a Stronger Grow Your Own Model
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Transcript of Needs and Opportunities for Implementing a Stronger Grow Your Own Model
Needs and Opportunities for Implementing a Stronger Grow Your
Own Model
Michelle Green Clark, SORH DirectorSusan K. Stewart, Western Maryland AHEC Director
Overview
Healthcare Pipeline Today in Maryland Pieces that Exist (AHEC program) Pieces Missing - Needs Barriers Opportunity Call to Action
Review of Work Groups – Common Themes
Expand Workforce – Why we are here Expansion of opportunities to learn in rural
areas Expansion of Loan Assistance Repayment
Program (LARP) Strengthening Grow Your Own Model Telehealth Expansions Compensation for providers in rural areas
Maryland AHEC Program
Cecil
Kent
QueenAnne’s
Talbot
Dorchester
Wicomico
Somerset
Worcester
Car -oline
Garrett
Allegany Washington
Garrett
Allegany Washington
GarrettAllegany Washington Cecil
Kent
Talbot
Dorchester
Wicomico
Worcester
Car -oline
Cecil
Kent
QueenAnne’s
Talbot
DorchesterWicomico
SomersetWorcester
Caroline
Carroll
Howard
Baltimore
Balt. City
AnneArundel
St. Mary’s
Harford
Prince George’s
CharlesCal -vert
Frederick
Carroll
Howard
Baltimore
AnneArundel
St. Mary’s
Harford
Prince George’s
Charles Calvert
Montgomery
AHEC Center Locations
Maryland AHEC Program Office
University of Maryland School of Medicine Office of Policy and Planning Claudia Baquet, M.D., M.PH. Program Director
Expansion of AHEC Clinical Education Activities
Health Professions Education Pipeline
K-12 Initiatives College & Health Professions Education
Continuing Education & Training
InspireMotivateEncourageSupportAssistMentor Inform PrepareExperience
Academic Support and Enrichment
Financial Incentives
Guarantee Placement
Clinical Rotations that connect or Return Students to Communities
Retention in Shortage, isolated, or Underserved Areas
Partnerships and funding to build a sustainable pipeline also means high level collaboration between stakeholders, with legislative support.
Eastern Shore AHEC Mission
To recruit and retain health care professionals and build healthy communities
through educational opportunities and collaborative partnerships.
Jacob F. FregoExecutive Director
410-221-2600814 Chesapeake Drive. PO Box 795 Cambridge, MD 21613
ESAHEC Pipeline Programs
Elementary, middle, and high school programs in the 9 Eastern Shore counties
“The Great Hospital Adventure” puppet video show
Job shadowing; career mentoring by healthcare professionals
Hospital tours & work-based learning experiences
To improve access to and promote quality in health care through educational partnerships.
Western Maryland AHEC Mission
GARRETT ALLEGANY WASHINGTON
FREDERICK
11 Columbia StreetCumberland, MD 21502301-777-9150
Susan K. Stewart Executive Director [email protected]
STEM: Promoting Careers in Science Technology Engineering and Mathematics
Links K-12 schools with community professionals Western MD STEM Task Force to address STEM initiatives on a regional Western MD STEM Task Force to address STEM initiatives on a regional
levellevel Governor’s STEM and Economic Development Task ForceGovernor’s STEM and Economic Development Task Force
Exploring Careers in Health Occupations (ECHO)
Residential summer health careers program Trips to healthcare facilities, higher education
institutions, Baltimore, New York, DC Job shadowing, mentoringJob shadowing, mentoring College entrance advice and prepCollege entrance advice and prep
Youth Health Service Corps (YHSC)
The Youth health Service Corps’ mission is to recruit The Youth health Service Corps’ mission is to recruit diverse high school students into health care careers.diverse high school students into health care careers.
Program components Program components Training CurriculumTraining CurriculumVolunteer ServiceVolunteer ServiceReward and RecognitionReward and RecognitionService learning Projects (Wii)Service learning Projects (Wii)
WMAHEC Clinical Education Outcomes
449 health professionals who participated in Clinical Education subsequently practiced in the Western MD Region.
2 of the 11 Family Practice physicians in Garrett County (or 18%) are AHEC alumni; 90% of these physicians serve as preceptors for medical students.
WMAHEC Clin Ed Outcomes Continued
The only Primary Care internist in Garrett County is an AHEC alumnus. This internist has precepted more than 50 students since 1985, including two who subsequently returned to Western Maryland to practice.
1 of the 3 General Surgeons in Garrett county is an AHEC alumnus (or 33%).
WMAHEC Clin Ed Outcomes Continued
1 of the 5 orthopedic surgeons in Allegany County is and AHEC alumnus (or 20%).
At least 16 medical students or residents have practiced or still practice in the region.
ESAHEC Clinical Education Outcomes
330 health care professionals (includes physicians, nurses, pharmacists and social workers) who participated through AHEC as part of their training are now practicing or have practiced on the Eastern Shore.
At least one-third of the medical preceptors are former Clinical Education participants.
ESAHEC Clin Ed Outcomes Continued
According to UMES, 14 clinical education students over the past 3 years have chosen to relocate to or remain on the Shore. (33% of all students participating from UMES)
At least 9 pharmacy students served by the Center have returned to practice in the region.
“Grow Your Own” in Maryland: Public Schools
STEM Certificate Programs (CNA)
- Dual enrollment with 2 & 4 Year Colleges Health Occupations Students of America, Medical
Academy, Gear Up, Project Yes, & others Maryland Department of Education (MSDE)
– Enrichment and Summer Opportunities Maryland Rural Health Association
– Planning state’s first Med Bee– Scholarship for winners who go into health careers
“Grow Your Own” in Maryland: Community Colleges and Universities
Discipline specific collaborations with public schools
Degree collaborations with each other Cecil County Dental School Expansion Summer and other programs
– Upward Bound, Regional Science Center– Robotics camps at Garrett College and Frostburg
State University
“Grow Your Own” in Maryland:Local Hospitals
Medical Explorers, teen volunteer programs Career Ladders that encourage and pave the
way for employees to move from administrative positions into clinical positions
Scholarships for nursing education In-house training for careers not requiring
licensure
Not Another Committee on the Healthcare Workforce – But Action
New Zealand, Tony Myall MP – March 26, 2008, National Party Health Spokesman
“With its many army of bureaucrats, Labour has produced at least 43 reports on the health workforce since 2000. No one seriously believes this will all be fixed by yet another report!”
Rural Student = Rural Health Professionals
Rural Student more likely to return to rural areas to practice (Wiener, 1993)
Patterns show rural go back to rural and those from underserved areas go back to underserved areas (Bowman, 2008)
Rural training gives broader responsibility and competency skills (Hunsaker et al., 2006)
Rural Training = Rural Provider
Jeffererson Medical College – Physician Shortage Area Program (PSAP) (Rabinowitz, 1991)– 4 times as likely to practice family medicine and in
a rural area– 2.5 times more likely if had a senior rural
preceptorship (Rabinowitz, 2001)– Other predictor if not in PSAP to return to a rural
area is growing up there (Rabinowitz, 1999)
Key components to a successful Grow Your Own Model
Strong AHEC through rural areas Strong Training sites in Maryland
– Federal and State Funded– K-12 Pipeline programs (ECHO)– Clinical rotation opportunities for students– Youth Health Service Corps– Expanding– Housing and Preceptors
Commitment to Economic Development in Rural Areas Some support to rural facilities in recruiting physicians
Missing components to a successful Grow Your Own Model
FORMAL Consortium of Partners Integration of University and Community College K-
12 Programs Large Osteopathic School Private funding Support for rural students while in medical
professional school (connections back to home) Scholarships/incentives for students to return to
rural community Mandatory rotations in rural/underserved areas for
clinicians Rural Residency program
Key Components of R&R
Foundation of Workforce Programs
Task Force on HCAR Task Force on Rural
Primary Care Rural AHECs CMS EHR project
Financing and Staffing of recruitment programs
Rural attention and focus of programs
Community/local involvement
Data that retention of health providers is essential to rural quality of life
Key Components of Telemedicine
Rural Broadband Cooperative
Health Information Exchange (HIE) efforts
U of M Statewide Health Network
Telemedicine – Use and Reimbursement - Study 2006
Innovative Pilots
Little reimbursement Liability not tested Telehealth
network/consortium FEDERAL FUNDING
– FCC money left on table– USDA money left on
table
Barriers
Tough fiscal times- no new money coming in Stakeholders Need to Engage (Quantify and
Quality) Workforce is one of many rural public health
problems Existing factors that negatively impact
reimbursement and insurance High cost of medical and health professional
education
Opportunities
Focus Here Today – Continue the Work Tough Fiscal Times – Attention to most
important work SB 459 – Task Force on Rural Primary Care Medical Home Concept Telehealth – Innovation happening
Response to Workforce Issues
Addressing these issues will require the collaborative efforts of providers, community based organizations, businesses, and policy makers
Stakeholders in rural health care systems must be as vigilant in protecting and building upon the resources currently available as in addressing the challenges that remain
New England Roundtable (2008)
Other State Solutions
Alabama, New Mexico, and Oregon – Tax incentives
Washington, New Mexico – Waive licensure fee
Grow Your Own Models (AL, WV, TN, TX…) Workforce Centers – South Dakota, South
Carolina Local community solutions
Requirements to Change Workforce Policy
1. Shared perception of the problem- Public agreement, communication, frame issue,
raise priority
2. Political Support- Broad base support
3. Viable policy solution- Workable, timely, affordable, proven
(Skinner, 2008)
Time to Work!