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Needs and Opportunities for Implementing a Stronger Grow Your Own Model. Michelle Green Clark, SORH Director Susan K. Stewart, Western Maryland AHEC Director. Overview. Healthcare Pipeline Today in Maryland Pieces that Exist (AHEC program) Pieces Missing - Needs Barriers Opportunity

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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 Director

Susan K. Stewart, Western Maryland AHEC Director


Overview
Overview Your Own Model

  • Healthcare Pipeline Today in Maryland

  • Pieces that Exist (AHEC program)

  • Pieces Missing - Needs

  • Barriers

  • Opportunity

  • Call to Action


Review of work groups common themes
Review of Work Groups – Common Themes Your Own Model

  • 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


Allegany Your Own Model

Washington

Cecil

Garrett

Kent

Queen

Anne’s

Car

-

oline

Talbot

Dorchester

Wicomico

Worcester

Somerset

Maryland AHEC Program

Allegany

Allegany

Washington

Washington

Carroll

Carroll

Cecil

Cecil

Harford

Garrett

Garrett

Harford

Frederick

Baltimore

Baltimore

Balt.

Howard

Kent

Kent

Howard

City

Montgomery

Anne

Anne

Queen

Arundel

Arundel

Anne’s

Car

-

oline

Caroline

Talbot

Prince

Prince

Talbot

George’s

George’s

Cal

-

Charles

Charles

Maryland AHEC Program Office

University of Maryland

School of Medicine

Office of Policy

and Planning

Claudia Baquet, M.D., M.PH.

Program Director

vert

Calvert

Dorchester

Dorchester

Wicomico

Wicomico

St. Mary’s

St. Mary’s

Worcester

Worcester

Somerset

AHECCenter Locations

Expansion of AHEC Clinical Education Activities


Health Professions Education Pipeline Your Own Model

K-12 Initiatives

College & Health

Professions Education

Continuing Education

& Training

Inspire

Motivate

Encourage

Support

Assist

Mentor

Inform

Prepare

Experience

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 Your Own Model

Torecruit and retain health care professionals and build healthy communities through educational opportunities and collaborative partnerships.

Cecil

Kent

Queen

Caroline

Talbot

Dorchester

Wicomico

Worcester

Somerset

Jacob F. Frego

Executive Director

410-221-2600

814 Chesapeake Drive.   

PO Box 795   Cambridge, MD 21613


Esahec pipeline programs
ESAHEC Pipeline Programs Your Own Model

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

To improve Your Own Modelaccess to and promote quality in health care through educational partnerships.

Western Maryland AHECMission

WASHINGTON

ALLEGANY

GARRETT

FREDERICK

11 Columbia Street

Cumberland, MD 21502

301-777-9150

Susan K. Stewart

Executive Director

[email protected]


Stem promoting careers in science technology engineering and mathematics
STEM: Your Own ModelPromotingCareers 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 level

  • Governor’s STEM and Economic Development Task Force


Exploring careers in health occupations echo
Exploring Careers in Health Occupations (ECHO) Your Own Model

  • Residential summer health careers program

  • Trips to healthcare facilities, higher education institutions, Baltimore, New York, DC

  • Job shadowing, mentoring

  • College entrance advice and prep


Youth health service corps yhsc
Youth Health Service Corps (YHSC) Your Own Model

  • The Youth health Service Corps’ mission is to recruit diverse high school students into health care careers.

  • Program components

    • Training Curriculum

    • Volunteer Service

    • Reward and Recognition

    • Service learning Projects (Wii)


Wmahec clinical education outcomes
WMAHEC Your Own ModelClinical 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
WMAHEC Your Own ModelClin 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 continued1
WMAHEC Your Own ModelClin 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
ESAHEC Your Own ModelClinical 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
ESAHEC Your Own ModelClin 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
“Grow Your Own” in Maryland: Your Own ModelPublic 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
“Grow Your Own” in Maryland: Your Own ModelCommunity 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
“Grow Your Own” in Maryland: Your Own ModelLocal 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
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 = Rural Health Professionals Action

  • 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
Rural Training = Rural Provider Action

  • 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 Action

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

Key components to a successful Grow Your Own Model


Missing components to a successful grow your own model

FORMAL Consortium of Partners Action

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

Missing components to a successful Grow Your Own Model


Key components of r r

Foundation of Workforce Programs Action

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 R&R


Key components of telemedicine

Rural Broadband Cooperative Action

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

Key Components of Telemedicine


Barriers
Barriers Action

  • 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
Opportunities Action

  • 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
Response to Workforce Issues Action

  • 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
Other State Solutions Action

  • 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
Requirements to Change Workforce Policy Action

  • Shared perception of the problem

    • Public agreement, communication, frame issue, raise priority

  • Political Support

    • Broad base support

  • Viable policy solution

    • Workable, timely, affordable, proven

(Skinner, 2008)



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