workforce & leadership: trends & opportunities merle cunningham, md, mph, geiger gibson...
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Workforce & Leadership: Trends & Opportunities
Merle Cunningham, MD, MPH, Geiger Gibson Program in Community Health Policy & Leadership
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Session Objectives
To become familiar with evolving national trends related to CHC workforce development and changing models of practice
To understand evolving trends in CHC leadership development
To become familiar with opportunities for collaboration on workforce development and leadership development
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Conceptual Framework for Continuum
CATEGORY WORKFORCE LEADERSHIP
Clinical PCPs – MD, DO, NP, PA, CNMNursing- RNs, LPNs, MAsOther medical providersOral health providers Behavioral health providersCHWs, Case managers
CMO, Site Med DirectorDental DirectorNursing DirectorOther clinical directorsOther clinical supervisors
Administrative
Front deskFiscal & billing staffHIT staffEnabling services staffOther management & support
CEO, COO, CFO, CIOSite DirectorsSupervisors
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Workforce & Models of Practice
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8,776
20,329 23,1737,595
17,58220,042
4,292
9,890
11,273
0
25,000
50,000
Nurses Physicians NPs/PAs/CNMs*
Health Center Workforce Goals: Based on ACCESS for All American Patient Projections
20,663
47,80154,488
*Nurse Practitioners, Physician Assistants, Certified Nurse Midwives.Source: Access Transformed: Building A Primary Care Workforce for the 21st Century. NACHC, Robert Graham Center, and GWU SPHHS. August 2008.
Ful
l-T
ime
Equ
ival
ent S
taff
Current Median Provider Ratios
Today Range in 2015
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Long history of “Grow your own…” Since earliest years of OEO NHCs – late 1960s AHEC pipeline partnerships for decadesCurrent AT Still-NACHC Dental School AT Still-NACHC School Osteopathic Medicine
Arizona 1st class of 96 graduates June 3rd
Teaching Health Centers (medical & dental residencies)-THC funding 6 of 11 to CHCs, partners in 4 of 5
Future Evolving Comprehensive Workforce Continuum
Strategy
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Percent of Health Centers Participating in Health Professions Training Programs, 2007
42.1%50.3%
28.1%
54.3%49.4%
0%
10%
20%
30%
40%
50%
60%
ResidencyPrograms
MedicalSchool
Programs
SEARCH*Programs
AHEC**Programs
Other
Percent Participating
*Student/Resident Experiences and Rotations in Community Health** Area Health Education CenterNote: 35% response rate. Survey responders make up a nationally representative sample of all federally-funded health centers.Source: NACHC 2007 Survey of Health Profession Training Programs in Community Health Center
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NACHC Strategies - Clinical Clinical Staff
Advanced – MD, DO, NP, PA, CNM, DDS, DH, BH NHSC utilization (increase from 30%) J-1s/H-1Bs, Vets, Retirees Replicate AT Still University model (community campuses) More GME – Teaching Health Center models More Dental Residency – AEGD (Advanced Educ General
Dentistry) NP & PA academic partnerships Behavioral health academic partnerships
Entry level – RN/LPN, MA, DA, CHW, Enabling staff, Other Community college partnerships Western Governors University (WGU) – “Growing From Within” Americorps – Professional Corps model (MA, DA and CHWs)
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NACHC Strategies - Administrative Administrative Staff
Advanced (Senior level positions) Leadership Development Institutes (LDI) Core Competencies – modular curriculum
components “Emerging Leader” track & networking
Entry & Mid Level – (Ops, HR, HIT, front desk, communications, fiscal, communications, etc.) Web-based modules for onsite entry level
trainings More conference content for mid-level staff
development
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Evolving Models of Practice Health Care Team approaches-
Fundamental to early health centers Basic component of “Care Model” used in HDCs
Practice “transformation” – fundamental to PCMH “Working at the top of your license” Integration behavioral health Integration of oral health
Care Management (CMS Demos) “Old wine, new bottles” Reducing Care Fragmentation: Toolkit for Coordinating
Care Note: NH + VT highlights from Readiness Survey
Adoption, MU, PCMH, Registries/Clin Warehouses, Telemed
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Leadership Development
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NACHC Strategies Leadership Development Institutes (LDI) – to follow Core Competencies for CHC management
Identified with curriculum/ courses wrt accreditation Components can be shared via Distance Learning “mix
and match” for many different audiences and programs among PCAs and others as part of a national learning community
Emerging Leaders Geiger Gibson – Annual awards at P&I through CEO
nomination & selection by panel of GG Distinguished Visitors
NACHC – New networking sessions at P&I, CHI; planning new “track” at future conferences
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Hub & Spoke Model Hub: NACHC & Geiger Gibson Program Spokes: multiple regional programs (PCAs w/
academic partners) Mass League – Suffolk University Greater Midwest PCAs – Univ Kansas Northwest Regional PCA – Univ Washington Blue Shield Foundation of CA – UCSF Center for
Health Professions North Carolina PCA – East Carolina University Geiger Gibson Program, GW School of Public
Health & Health Services
Leadership Development Institutes
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GW-NACHC Partnership Programs
“Hub” Program: Capstone in Health Policy and Leadership (3 cycles per year in Oct, Feb & June)Directors: Merle Cunningham & Becky Beauregard
Senior Advisor: Sara Rosenbaum
“Spoke” Program:Graduate Certificate in CHC Management (2 cohorts per year, starting in Fall and Spring Semesters)Director: Merle Cunningham
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“Hub” Program: Capstone in Health Policy & Leadership
Program Goal To increase the number of trained CHC leaders to meet
the increasing current and future demand Learning Objectives
To gain familiarity with the federal health policymaking process and how policy influences legislation and subsequent programs
To interact with policymakers, congressional staff & Federal health program leaders
To become familiar with policy-related health services research involving health centers
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GW Capstone Curriculum
Pre-Capstone Webinars (Dates scheduled in 4 week period preceding each Cycle): Four one-hour live webinars with assigned readings and online exercises
Onsite Program in DC (3 days): presentations by health policy researchers and policymakers; dialogues with Congressional staff; and informal meetings with NACHC senior leadership, HRSA staff and other Federal agency officials.
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Capstone Specifics
PCA Selection Process Interested PCAs may have positions in each cycle
of 20 students Student selection is locally determined Target audience is mid-level and senior staff
interested in executive leadership careers in CHCs Cost
$1000 per student, not including travel, lodging and most meals
Timeframe 3 cycles per year in October, February and June
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“Spoke” Program: Graduate Certificate in CHC Management
Designed for Working Professionals Training current and future CHC professionals for
management and executive leadership positions Offered over 3 semesters, 3 courses each
semester, 2 credits per course = 18 academic credits overall
Combines accredited academic training with practical skills that CHC managers need
Guidance and oversight provided by a GG Leadership Advisory Group of Charter members from CHCs and PCAs with students in the initial cohort
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Certificate Curriculum First Semester Courses
Intro to Health Management Health Services Finance Community Health Center Policy
Second Semester Courses Quality & Performance Improvement Health Services Information Applications Health Services Marketing and Planning
Third Semester Courses Health Law for Managers Human Resources Management and
Organizational Behavior Health Services Advocacy and Communication
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Online and On Campus
Executive Distance Learning Format Individual online sessions Biweekly interactive webinars and video
conferences Two group sessions: Launch with CHI, End in DC on
campus
The GW Experience A team project addressing a current local CHC
initiative Biweekly policy updates from NACHC A culminating Capstone with team presentations in
DC
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Program Details
Admission Requirements:Completion of a bachelor’s degreeThree years of related experience in community healthAn introductory accounting courseGRE scores within past 5 years (waived if have any graduate degree)Transfer to Master’s Degree: Apply all 18 credits toward MHSA or MPH at GW SPHHS; credits may be transferred to another educational institution with similar accreditationTuition: $12,000 for 18 credits (savings of more than
$9000); eligible for Federal financial aid; AmeriCorps education awards recognized
Applications: due by July 1st for Fall Semester 2011
For more information, visit: www.gwumc.edu/chc
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Regional Opportunities Workforce & Practice Transformation
Medical Home Pilot (VT) – potential TA sharing Care Management Project (NH) State scope of practice & licensing (NH & VT) Sharing “Community Health Team” models
Bi-State Leadership Development Program 2011-2012
Certificate Program & Seminar Series in Community Health Leadership Oct 2011 – Apr 2012
Leadership Advocacy Quality Improvement Workforce Development Budgeting Strategic Leadership
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Recap Highlights 1. Reviewed evolving national trends in CHC
workforce development and changing models of practice
2. Reviewed evolving leadership development activities for CHC mid-level and senior managers
3. Identified some opportunities for regional collaboration related to workforce issues, practice transformation and emerging leadership
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Take Home Messages 1. Embrace all creative variations of “grow your own”
strategies for workforce development, recognizing that short term cost are really long term investments
2. Continue aggressive work towards practice transformation, integration of services, team care coordination across all levels of care and use of regional information systems to improve population health
3. Continue to evolve a learning community with regional and national partners to share best practices and to coordinate or consolidate systems where appropriate.