2020 ACU Virtual Conference Session Recordings

Providers serving complex and underserved populations need tools and strategies to identify patients experiencing social, institutional, and environmental factors that may drive poor outcomes and higher costs, as well as develop patient-, organizational-, systemic- and policy-level solutions to address these factors and ultimately improve population health. The Protocol for Responding to and Assessing Patients Assets, Risks and Experiences (PRAPARE) is a national effort to help health centers and other providers collect and apply the data they need to better understand their patients social determinants, transform care to meet patient and population needs, and demonstrate the value they bring to patients, communities, and payers. This session will provide an introduction to PRAPARE, how providers are implementing it, and how it has accelerated care improvements, population health, and health equity. Presenters will also summarize research findings using PRAPARE data to pinpoint common social risks, and how PRAPARE is being used to innovate risk stratification in order to enable health care organizations to better plan for and allocate care resources more efficiently and effectively.

Presenters:

• Yuriko de la Cruz, MPH, CPHQ, Social Determinants of Health Manager, National Association of Community Health Centers
• Sarah Halpin, MPH, Program Associate, Research, National Association of Community Health Centers

This update from the Bureau of Health Workforce details the “Healthy Communities, Healthy People” vision for its ongoing initiatives and details ongoing work to train the health workforce, tackle the COVID-19 pandemic, and overcome workforce challenges.

Presenter:

• Dr. Luis Padilla, MD, Associate Administrator of the Bureau of Health Workforce and Director of the National Health Service Corps

An organization’s workforce is at the core of its ability to achieve its goals, yet this area frequently does not receive focused investment in the C-suite. The duties of developing and maintaining a thriving staff are often scattered amongst the entire leadership team, with varying levels of responsibility living in the general Human Resources (HR) department. If your organization struggles with workforce recruitment and retention and lacks a cohesive workforce plan, a Chief Workforce Officer (CWO) could be the answer.

In this session, staff from NACHC and the Association of Clinicians for the Underserved (ACU) STAR2 Center will share resources from a new CWO Toolkit and answer questions about who the CWO is, what their role is at a health center, when you should incorporate them into your organization, and why this matters. Participants will focus on strategies for incorporating this role into their health centers and how this investment in their organization benefits their patients and staff.

Presenters:

• Michelle Fernandez, Senior Training Specialist, Association of Clinicians for the Underserved
• Gerrard Jolly, Director, Career Advancement Strategies, National Association of Community Health Centers
• Scott Owen, Chief Workforce Officer, Mountain Family Health Centers
• Rosa Agosto, Chief Talent & Learning Officer, Urban Health Plan
• Kathy Brieger, Chief, Workforce Development, HRHCare

In this keynote, hear the expertise of J. Nwando Olayiwola, MD, MPH, FAAFP, Chair and Professor of the Department of Family and Community Medicine at The Ohio State University, and award winning, world renowned leader in health equity advocacy. A recipient of the Harvard School of Public Health’s Public Health Innovator Award and the American Telemedicine Association’s Woman of the Year, Dr. Olayiwola is a practicing family physician and an authority on comprehensive, innovative and equitable care for underserved and marginalized communities. At this important crossroads in healthcare, Dr. Olayiwola will share what she believes is an imperative to transforming care for those made most vulnerable among us.

Presenters:

• J. Nwando Olayiwola, MD, MPH, FAAFP

This workshop will serve a brief training in the Collaborative Care Model, demonstrating what makes it a higher level of care for patients through the integration of behavioral health services into primary care and physical health settings. Education on team structure, workflows, and evidence base for the model will be presented. Presenter and participants will explore the clinical benefits of Collaborative Care (CoCM) and the evidence of improved health outcomes for patients receiving Collaborative Care. It will briefly introduce the system changes needed to implement this model (EHR, registries, provider engagement, and metrics) and demonstrate the financial benefits of the model for practices (billing codes, reimbursement for Medicare beneficiaries and other reimbursement opportunities, and future plans for increased reimbursement across the country). Interactive components will include case study examples, a look into workflows, and success stories of practices implementing the Collaborative Care Model. A question and answer session will address, concerns, or foreseen barriers regarding the Collaborative Care Model.

Presenters:

• Dr. Virna Little, PSyD, LCSW-r, SAP, CCM, Chief Clinical Officer and Co-Founder of Concert Health, Co-Founder of Zero Overdose

The dearth of physicians in underserved communities widens health disparities. The California Oregon Medical Partnership to Address Rural Disparities in Education and Health (COMPADRE), a robust collaboration between UC Davis School of Medicine, Oregon Health and Science University and 32 residency programs, aims to transform the workforce by better selecting and training physicians for practice in rural and underserved communities. This unique partnership between community health centers, academic institutions, and hospital systems will allow students to train in their future clinical practice environments throughout medical school and residency, participating in a curriculum that includes health systems science, novel competencies for practice in under-resourced communities, and wellness activities to promote meaning and joy in practice. In this interactive session, representatives from academic institutions and a community health center will describe how your organization can develop robust partnerships to create a workforce that is better prepared, more equitably distributed and more deeply connected to underserved communities.

Presenters:

• Mark Henderson, MD, Associate Dean for Admissions and Professor of Internal Medicine, UC Davis School of Medicine
• Debra Lupeika, MD, Family Medicine Program Director, Shasta Community Health Center
• Joyce Hollander-Rodriguez, MD, Associate Professor of Family Medicine, Oregon Health & Science University

Moderator:

• Nataly Diaz, Associate Director of Workforce Development, California Primary Care Association

Medical assistant and medical scribe training programs can be an effective tool to reduce clinician burnout and and increase retention across the care team. Piedmont Health developed a structured, five-week medical assistant training program consisting of two weeks of academic coursework and three weeks of clinical preceptorship. The training program increased 3-, 6- and 12-month retention rates among medical assistants to 91%, 94%, 90% compared to 75%, 75% and 50%. Piedmont Health also developed a structured, three-week medical scribe training that consists of one-week of academic coursework and two-weeks of shadowing of a senior medical scribe. In addition to documentation, the program provided training on other tasks such as orders, referrals, patient outreach and tasks related to quality improvement or research projects. This session will provide an overview of the structure, cost and return of investment (ROI) of these in-house training programs.

Presenters:

• Jan Lee Santos, MD, MHA, MA, Clinical Services Trainer, Piedmont Health

This presentation discusses lessons learned by practices who addressed disparities in care by utilizing Patient-Centered Medical Home (PCMH) criteria. A review of how disparities were identified through clinical quality reporting, research on evidence-based guidelines for statistics, best practices and addressing disparities via care management. Racial and ethnic minorities bear a disproportionate burden of the diabetes epidemic; they have higher prevalence rates, worse diabetes control, and higher rates of complications. Significant diabetes disparities exist among racial/ethnic minorities in both health outcomes and quality of care. Patients of color with diabetes have a disproportionate share of complications directly linked to blood pressure and lipid control, improved access to care and treatment for controlling blood pressure, lipids, and blood sugar could narrow the health gap for underserved populations.

Presenters:

• Amy Goodman, LCSW, CPC-A, PCMH CCE, Senior Project Manager, Primary Care Development Corporation
• Sarahjane Rath, MPH, CHES, Trainer & Curriculum Development Specialist, Primary Care Development Corporation

Increased concern regarding illicit substance use during pregnancy and parenting has not led to informed, evidence-based policy, but rather to increased surveillance, criminal and civil penalties, and forced interventions. Despite similar rates of substance use among fathers and white people, these adverse effects are overwhelmingly borne by mothers, particularly Black and Indigenous mothers. This response, focusing on punishment of parents and removal of children from their families, has done little to mitigate the harms attributed to perinatal substance use. Most of these are caused not by the substances themselves, but by systems and policies that reduce social connection, service access, and economic opportunity. Recognizing problematic substance use as an issue with biopsychosocial roots is vital to creating a response that is humane and effective. This workshop presentation will prepare participants to implement evidence-based practice, Harm Reduction, and trauma-informed, family/person centered care. Discussion topics will include pharmacology of illicit substance use in pregnancy and lactation, evidence-based strategies for screening, managing, and preventing illicit substance use, opioid overdose prevention, and syringe access as an entry point into prenatal care. Addressing implicit bias as a roadblock to effective care and overall public health will be addressed throughout.

Presenters:

• Glyceria Tsinas, QMHA, Director of Development, Academy of Perinatal Harm Reduction
• Joelle Puccio, BSN, RN, Director of Education, Academy of Perinatal Harm Reduction

Multiple research studies show that African American patients receive less information and communication from their clinicians compared to White patients. To help address these disparities and improve clinician-patient communication, an interactive, case-based, self-study course was developed to train health professionals in using evidence-based strategies to treat anxiety of these vulnerable and underserved patients. 3,980 clinicians (doctors, nurses, social workers, etc.) completed an educational module between 3/5/2019-3/5/2020, on how best to screen and treat anxiety of an African American patient living with breast cancer. Based on the information received in the course, 87% (3,469) of health professionals reported that they would implement practice changes that would benefit their patients and 92% (3,666) of the users stated that the online technical format was easy to use. This presentation will explore the impetus behind this education initiative, best practices in developing self-study courses for health professionals, and lessons learned in our efforts to train clinicians to strengthen their communication skills when discussing symptoms (e.g. anxiety) with racial and ethnic minority patients.

Learning Objectives: Describe evidence that links communication to improved patient experience. Identify questions clinicians can use to better understand their patients cultural perspectives. Discuss lessons learned using self-study communication skills training to educate clinicians.

Presenter:

• Brittany Chambers, MPH, MCHES, Associate Director of Education, Mount Sinai, Center to Advance Palliative Care

Presenters:

• Amanda Pears Kelly, Executive Director of the Association of Clinicians for the Underserved and Chief Executive Officer of Advocates for Community Health
• Dr. Felix Nunez, Chief Medical Officer, Gold Coast Health Plan
• Dr. Gary Puckrein, President and CEO of the National Minority Quality Forum Inc. (NMQF)

Our relationships with patients, clients and teammates can be easily impacted by the judgements we make about others, often fueled by cognitive processes about which we are not aware. These assumptions and the decisions that grow from them can negatively impact health equity for individuals and communities. This presentation will explore the nature of implicit bias and the potential negative impacts on patient care and teamwork. Through experiential and reflective exercises, participants will be invited to self-reflect on bias and stereotypes. Participants will also be provided with resources and strategies to better manage implicit bias for themselves and their colleagues. This presentation will empower participants to find their voice as leaders and advocates toward the delivery of culturally responsive care.

Presenters:

• Jeffrey Ring, Ph.D., Principal, Health Management Associates

The United States is projected to face a drastic shortage of providers available to accommodate the health care needs of our growing and aging population. Over the next decade, competition for providers will be fierce and health centers will need to put their best foot forward in order to recruit and retain a strong and skilled workforce in underserved communities. In partnership with the federal Bureau of Primary Health Care, ACU created the STAR² Center (pronounced Star Center) to provide free resources, training, and technical assistance to health centers in order to improve workforce recruitment and retention efforts. During this session, STAR2 Center staff will highlight tools and resources that can be used by health centers to assess their workforce recruitment and retention needs and implement data-driven solutions. These tools include self-assessments on recruitment and retention, burnout, and compensation as well as toolkits on topics such as diversity, equity and inclusion. Join this session to learn how you can access these free resources to grow and invigorate your workforce.

Presenters:

• Suzanne Speer, Senior Director, Workforce Development, Association of Clinicians for the Underserved
• Michelle Fernandez, DSW, Senior Training Specialist, Association of Clinicians for the Underserved

The nursing workforce is increasing becoming culturally diverse and intergenerational. The interaction between cultural diversity and intergeneration factors of a nursing workforce results in unique nurse management challenges. If not properly addressed, these challenges become impediments to the effectiveness of nursing care. One way to overcome these challenges and mold them into impelling forces for the betterment of nurse workers and nursing care beneficiaries is using effective management strategies. This workshop presentation seeks to present and equip nurse leaders with effective strategies to effectively manage a culturally diverse intergenerational nursing workforce. The workshop will examine cultural diversity and intergenerational trends in nursing labor force, challenges in managing and benefits accrued from a culturally diverse intergenerational nursing workforce, and management strategies to effectively address the challenges. It is hoped that the attendees will implement the presented management strategies to mitigate the challenges posed by a multi-culture and multi-generation workforce at their workplaces to enhance the benefits such a workforce can offer.

Presenter:

•  Linda Govere, DNP, RN, CRNP, AGPCNP-BC, RN-BC, CMSRN, Assistant Professor, Nursing, Penn State College of Nursing

The Planetree Model was established over 40 years ago to address depersonalization in hospital environments. Since then, the organization Planetree International has expanded to more than 700 partner sites in 25 countries, including hospitals, community health settings, and educational institutions. The Planetree Model focuses on person-centered care, a systematized approach to healthcare delivery that centers the perspective of the patient, their loved ones, and the community.

This workshop presentation provides a look at how two community health centers – Hudson River Healthcare and Fairhaven Community Health – have implemented the Planetree Model and incorporated tenets of person-centeredness into their organizational practices.

Attendees will be able to identify the drivers of person-centered care, understand the benefits of the Planetree Model, particularly in community health settings, and receive practical suggestions for implementing the Planetree Model to support staff and patient engagement at their own organizations.

Presenters:

• Amanda Moody, MPH, CPBA, Director of Planetree, Hudson River HealthCare
• Therese Marrocco, MA, Vice President of Human Resources, Fairhaven Community Health

The social determinants of health (SDOH) are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within countries (WHO 2018). While health care is essential to health, it is a weak health determinant. Studies suggest that health behaviors…and social and economic factors are the primary drivers or health outcomes, and social and economic factors can shape health behaviors (Kaiser Family Foundation). There are many ways healthcare can address the SDOH and screening for social needs in healthcare settings is one of them. While many healthcare organizations are screening, challenges persist. A common challenge we have heard is that patients withhold vital information. This workshop will review how to use motivational interviewing (MI) for relationship building and to improve screening for social needs, including lessons learned from training over 100 clinicians in using MI to improve social needs screening. The workshop will cover basic MI skills using open-ended questions, affirming patients efforts and capability, and using reflecting listening in screening. Additionally, we will review how to use the spirit and principles of MI to improve this essential screening.

Presenters:

• Sarahjane Rath, MPH, CHES, Curriculum Developer and Trainer, Primary Care Development Corporation
• Yael Lipton, MPH, MCHES, Curriculum Developer and Trainer, Primary Care Development Corporation