AHEC-PCO-PCA Relations A How-To on Managing Relationships and Utilizing Resources National AHEC Organization June 2010 Las Vegas, NV Joan Bohlke, Workforce Manager Linda Cragin, Director MassAHEC Network

Alphabet Soup: HRSA - Health Resources and Services Administration –BHPr – Bureau of Health Professions –BPHC – Bureau of Primary Health Care –BCRS – Bureau of Clinician Recruitment & Services PCO - Primary Care Office PCA - Primary Care Association AHEC - Area Health Education Center CHC - Community Health Center HCWC - Health Care Workforce Center LRP - Loan Repayment Program PC - Primary Care NHSC - National Health Service Corps

Collaboration between HRSA funded entities HRSA encourages funded entities to foster partnerships with public, private and volunteer sectors AHEC-PCO-PCA: Overlapping missions… Opportunity to positively affect state policy and resources towards providing primary care to the underserved

Three Associated Bureaus Health Professions - helps underserved communities and facilities experiencing critical shortages of health care providers recruit and retain clinicians through scholarship and educational loan repayment opportunities in exchange for service. Primary Health Care - increases the access to health care by developing, distributing and retaining a diverse, culturally competent health workforce. Clinician Recruitment and Services - funds Health Centers in communities, providing access to high quality, family oriented, comprehensive primary and preventive health care for people who are low income, uninsured, or living where health care is scarce.

So… What is a Primary Care Office? Authorization: Section 330(I) Public Health Service Act HRSA Definition Assist in the coordination of local, State, territorial, and Federal resources that contribute to improving primary care service delivery and workforce availability in the State or territory to meet the needs of underserved populations. –Work with health centers, professional organizations, public and private entities, and other community-based providers of comprehensive primary care Areas of responsibility link to the missions of 3 HRSA Bureaus

How do you find a PCO? PCO Nationwide: age/pcos.htm age/pcos.htm

PCO - Areas of Responsibility Foster collaboration across and within various levels of government, communities and nonprofit organizations Provide technical assistance to organizations and communities to expand primary care access Assess needs, barriers and share of data Workforce development for the NHSC and safety net/health center network Shortage designation updates and applications

PCO Funding Mechanisms HRSA provides support for administration and loan repayment Matching state funds for loan repayment Supporting partner organizations Requires creativity in difficult fiscal times!!

Massachusetts Primary Care Office Supporting State Entity- MA Department of Public Health –Works collaboratively with State offices of Rural Health, Oral Health and Community Health Workers –Addresses the delivery of comprehensive primary care health services, reduces health disparities, and recruits and retains health professionals in underserved areas –Analyses of provider capacity, health outcome data for the potential federal shortage designations with technical assistance to communities seeking designations and/or federal 330 funding for CHC Input on state reimbursement and licensing policies affecting primary care providers Supports 3 HRSA programs: SLP, NHSC and J-1 Visa Waivers

Massachusetts PCO Partners MassAHEC Network Mass League of CHCs/PCA MA Board of Registration in Medicine MA Boards of Health Professional Licensure MA Board of Higher Education MA Dept. of Labor and Workforce Development Boston Public Health Commission Professional Organizations (medical, psychology, nursing) Provider Associations (hospital, elder care)

And … What is a Primary Care Association? Authorization: Section 330(I) Public Health Service Act Cooperative agreement with HRSA Bureau of Primary Health Care (BPHC) Provides training and technical assistance to health centers within a state or region with the goal of advancing the HRSA and BPHC missions to increase access to a culturally competent primary care workforce for the underserved

PCA Areas of Responsibility Provide training and technical assistance to health centers and other safety-net providers Support the development of health centers in their state Enhance the operations and performance of health centers Other specific roles/responsibilities will vary state by state

So how do I find a PCA? PCAs nationwide: chc-pca-listing.cfm chc-pca-listing.cfm

PCA Funding Mechanisms HRSA State Funding (Massachusetts Health and Human Services) Creative Partnerships (Bank of America)

Mass League of Community Health Centers/PCA Analysis of state and federal health regulatory and policy issues; Training and Education for administrators, clinicians and board members; Workforce Development initiatives to increase recruitment of primary care physicians and to provide career training for employees and local residents seeking entry-level positions at health centers; Information Technology Development primarily focused on electronic medical records implementation; and Support to Expand Health Access with local health and advocacy organizations seeking to open CHCs.

Mass League/PCA - Partners Commonwealth of Massachusetts UMass Medical School Boston Public Health Commission Blue Cross Blue Shield of Massachusetts Foundation Community Care Alliance Community Partners Health Access Network Critical MASS for eliminating health disparities MA Department of Public Health MassAHEC Network MA Division of Health Care Finance and Policy Office of Medicaid (MassHealth) MA Executive Office of Health and Human Services Massachusetts eHealth Collaborative Massachusetts Health Data Consortium Massachusetts Health Council Massachusetts Coalition of School-Based Health Centers Health care and pharmacy insurers, etc.

And what about that AHEC? INFRASTRUCTURE DEVELOPMENT AWARD & POINT OF SERVICE MAINTENANCE AND ENHANCEMENT AWARD designates an underserved area or population to be served; fosters networking and collaboration among communities and between academic health centers and community-based centers; serves communities with a demonstrated need of health professionals in partnership with academic medical centers; addresses the health care workforce needs of the communities served in coordination with the public workforce investment system; and has a community-based governing or advisory board that reflects the diversity of the communities involved.

So… In Massachusetts… HRSA All Grantees meeting in DC -AHEC director met PCO director: -“We should collaborate.” -Shared interests, shared needs, common goals

MassAHEC – PCO Relationship Project funding from UMass Medical School MassAHEC employee works at PCO UMMS: salary and fringe DPH: space and equipment Dual identity, joint reporting Joint management/strategic planning meetings MassAHEC on State Rural Health Council; DPH on MassAHEC Advisory Board

MassAHEC - PCO Outcomes New data collection systems with boards of registration/licensure in medicine, nursing, pharmacy, dentistry Analysis of LRP, J-1 Visa Waiver, NHSC programs with feedback to state offices of Oral Health and Rural Health Improved application processes Surveys of past program participants Website including friendly URL Marketing - material development, train-the-trainer; community outreach thru AHEC centers

MassAHEC – PCA Relationships PCA on MassAHEC Advisory Board and CHCs on AHEC Center Boards MassAHEC on PCA special projects committees MassAHEC staff on various committees Strong UMass Medical partnership

MassAHEC - PCA Outcomes Staff training and development Medical Assistant Training Grant SEARCH PCA lead, MassAHEC training sites Internships and Clinical Rotations Presentation to college pre-med advisors Exploring new opportunities: Teaching Health Centers Patient Centered Medical Home Commonwealth Fund demonstration State demonstration

MassAHEC - PCO - PCA Outcomes Report: Recruitment and Retention of Primary Care Physicians at Community Health Centers: A Survey of Massachusetts Physicians (2010) Presentation to Medical Directors on recruitment and retention stragegies Boston Mayors Task Force on Primary Care Shortage Designation Materials/Promotion Health Care Workforce Advisory Council comprehensive health workforce legislation

Opportunity Gained: State and Local Impact Relationships foster outreach to more areas of the state

Keys to forming a partnership Identify potential partners Identification of aligned missions →Review of related HRSA grant work plans Recognize common goals Extending the invitation Follow up and communication

Keys to sustaining the partnership: Review common goals Identify strengths and weaknesses Share success Share needs and plans Recognize individual identity (lots of logos!) Continued communication

Discussion: What is next in Massachusetts? What is happening in your state?

Helpful Websites MassAHEC Network: MA Primary Care Office/PCO: Mass League of CHC/PCA: HRSA: BHPr: BPHC: BCRS: MA Health Care Workforce Center: