The California Statewide AHEC Program Positioning AHEC Centers in Community Health Center Consortia: A strategy to improve access to and quality of community based training.

Learning Objectives Participants will be able to describe the California AHECs movement into community health centers and their consortia Participants will be able to describe strategies for developing AHEC centers in consortia and community health center sites Participants will be able to understand and describe why AHEC centers in clinic consortia and clinics is an effective way to develop quality preceptors, inter- disciplinary training teams and training slots for health professions students

California AHEC Program Mission Statement To improve access to and the quality of health care for underserved populations of California using academic-community partnerships for health education and workforce training

The California AHEC System

What do California AHECs Do? Conduct programs associated with one or more of CA program objectives –continuing professional education –community clinical experiences for hp students –teaching residents and students how to do community health education –career pathways programs for disadvantaged youth Serve as the health workforce arm for community health centers Serve as conveners to address emergent community needs

California Statewide AHEC Types of Organizations Community Clinic Consortia 9 Large Clinic System 2 Independent 501c3 1 Hospital 2 14

Clinic Consortia Clinic consortia coordinate policy efforts that support the health care safety net; convene partner clinics to share best practices on clinic operations; and provide technical assistance and member services, e.g., group purchasing, health information exchange, quality improvement.

Why Clinic Consortia? Due to the financial crisis and uncertainty of future funding in the state, the California AHEC has begun a process to place AHEC centers in the 13 community clinic consortia to leverage the strengths and stability of these community based organizations. Community clinic consortia and AHEC have common mission to serve the underserved-work with and develop a diverse workforce to meet community needs

North Coast AHEC Integrated within the North Coast Clinics Network, a consortium of 13 rural and frontier community health centers sites which expand across an area roughly the size of Connecticut. Each year NCCN member clinics, together, provide over 203,000 medical, dental, and mental health visits to 57,000 patients - 1/3 of the region's population. Humboldt State University and College of the Redwoods primary academic partners

North Coast AHEC Rural Consortia Based AHEC: No medical school within traveling distance Provide housing assistance for dental residents Grow your Own key to developing staffing mix Leverage Videoconferencing to provide CME Facilitate CHC HR peer support group Connect with regional consortia to leverage resources and cooperatively address challenges

San Francisco AHEC The San Francisco Community Clinic Consortium's ten partner clinics serve over 74,000 low-income, uninsured, and medically underserved people per year. The clinics are located strategically throughout San Francisco to meet the health needs of the people and communities they serve. Community Healthcorps Program

San Francisco AHEC Urban Consortia based AHEC: Many health professions schools in area Expose potential health professionals and students to community health in underserved areas Arrange clinical rotations and internships for primary care residents and nursing students in community health settings Provide continuing education activities for member clinics

AHEC Benefits to Consortia Development of the health care workforce of partner community health clinics is a priority for consortia. AHEC affiliation provides: AHEC Community Board community experience and expertise on training activities, community needs Base funding for health care workforce development activities Increased visibility and expanded access to other resources, e.g., foundations Expanded opportunities for linkages and collaborations, e.g., with academic institutions, job- readiness programs State of the art information about workforce development best practices

Benefits to Community Clinics with AHEC Partnerships Continuing education training for clinic providers, specifically targeting their identified needs and to deliver them cost-effectively Conduit for improving academic curriculum to meet the unique requirements of CHC workforce Expanded opportunities to partner with health professions schools for student, intern and residency placements Enable CHCs to overcome shortages of HPs with professionals committed to the community

Benefits continued Development of "grow our own" opportunities that encourage career advancement among current staff, especially those who come from the community, speak the language, and reflect its racial, ethnic and cultural composition Creation of a health careers pipeline for those who are interested, or may become interested in pursuing a career in community health.

Challenges to being a Consortia based AHEC Technical challenges with HIT Challenge to start residencies in rural locations Narrow Primary Care focus – difficult to meet curriculum requirements of residents Insufficient number of rural preceptors No GME or funding to compensate for preceptor's reduced productivity and significant training investments Lack of housing for students in rural areas

Challenges continued Time spent on continuing staff education, supervision of interns, and mentoring activities can reduce productivity Clinics may already be at capacity for hosting additional interns Not everyone is interested in supervising and mentoring Competing clinic priorities (implementing EHR, corporate compliance, etc.)

Partnerships and Collaborative Opportunities through Clinic Consortia Strengthen HRSA Bureau of Primary Cares investment in FQHCs through collaboration with Bureau of Health Professions programs National Association of Community Health Centers (NACHC) sponsored Community HealthCorps located in AHECs Office of Statewide Health Planning and Development (OSHPD) (CAs PCO) and California Primary Care Association (CPCA) (CAs PCA) collaboration with AHEC for the Cal-SEARCH Program and the HRSA Cooperative Agreement CPCA and AHEC offer CE/CME for CHC Professionals

Consortia based AHEC: Future Roles in Health Care Reform Increasing the diversity of health professionals Disseminate research as vital information of national importance to local practitioners (AHRQ) CHC Patient Centered Medical Homes Teaching Health Centers Primary Care Extension Model

For more information about the California AHEC Program For more information about teaching health centers and the extension model