ACU 2023 Conference: Transformation: Elevating Care, Clinicians, & Communities
July 23-26, 2023
2023 ACU Conference Agenda
The following workshop sessions took place at the 2023 ACU Annual Conference, “Transformation: Elevating Care, Clinicians, & Communities,” in Washington, D.C., on July 23-26. View presentation descriptions below and find slides from each presentation (where available).
July 23: Pre-Conference Workshops
Justice, Equity, Diversity, and Inclusion: Talking with Patients About the Impact of Racism on Health
Despite its impact on physical and mental health, racism is rarely discussed with patients in a clinical setting. Lacking technical or lived experience, clinicians and others who provide direct care to patients may feel deeply uncomfortable bringing up racism, and patients might find it jarring if not incorporated into conversation delicately. This session will explore the relationship between racism and health, when and how to discuss it with patients, and steps to take when patients need support. While racism will be centered in this session, other forms of discrimination will also be discussed. Didactic training, group discussion, case studies, and role play will be used to improve your capacity to discuss and address racism and other forms of discrimination using a trauma-informed and compassionate approach. This session will be of interest to clinicians of all disciplines and others who deliver direct care and support to patients including outreach workers, community health workers, and counselors.
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Workforce: Management and Leadership Training for Retention
In today’s environment, great managers are crucial for employee retention! It is well documented that employees often leave managers, not jobs. In order to be great managers, adequate training is a must. But what types of training do they need? Join this session to learn about the critical types of training managers need to advance as leaders and retain their employees. We will discuss various technical and soft skills needed to develop well-rounded leaders at your organization. Participants will also begin developing manager training plans for their organization during this session.
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July 24-25: Workshops
Track I: Clinical Practice
Collaborative Care: Financial and Clinical Opportunities for Health Centers
Collaborative Care is an evidence based model to identify and treat patients with depression and anxiety in healthcare settings. Collaborative Care is a Medicare benefit and a Medicaid benefit in 24 states. Collaborative Care assists health centers with managing the population of patients with depression and anxiety, meeting UDS measurements and current behavioral health workforce challenges.
Presenter:
- Dr. Virna Little, PSyD, LCSW-r, SAP, CCM, Chief Clinical Officer and Co-Founder of Concert Health, Co-Founder of Zero Overdose
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Embracing Value-Based Care to Improve Outcomes, Drive Health Equity, and Strengthen Community
Join us for an engaging discussion with Dr. Scott Early, where we delve into the strategies and experiences of health centers in successfully transitioning to value-based care. We will explore best practices, share insights, and showcase the transformative impact that value-based care can have on improving patient outcomes and driving health equity within communities. Don’t miss this opportunity to gain practical knowledge and actionable steps toward building a strong foundation with value-based care in your health center.
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Family-Centered and Team-Based Care Models that Drive Health Equity Across Generations
This workshop will showcase work from the Advancing Integrated Models and the Accelerating Child Health Transformation initiatives led by the Center for Health Care Strategies and supported by the Robert Wood Johnson Foundation. Speakers will share how redesigned care delivery and staffing models that are family-centered and team-based can improve care and supports for children and families from under resourced communities. Participants will learn how a family advocate and others at Hasbro Children’s Hospital in Providence, Rhode Island, work as part of the care team to help address the complex health-related social needs (HRSN) of pediatric patients and their families, including refugee populations, in a comprehensive and two-generational way. Participants will also hear about how Community Health Workers at Johns Hopkins Pediatrics in Baltimore, Maryland, support dyadic care of mothers with postpartum depression and their infants and improve pediatric asthma outcomes through engagement of families with children. Tips, lessons learned, and a toolkit will be shared on how these models were designed, implemented, tested, and funded. Participants will have the opportunity to ask questions to the presenters.
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Inclusive Strategies for Implementing Behavioral Health Crisis Services
With the rise in mental health and substance use (behavioral health) conditions necessitating immediate access to specialized care, many communities are embarking on efforts to provide access to behavioral health crisis care outside of a traditional hospital emergency department and in coordination with law enforcement and other emergency response services. However, there are several challenges when building a crisis care system, including funding and sustainability, access to qualified providers, collaboration and care coordination, and implementation of standardized care. Despite these challenges, many communities across the U.S. are paving the way toward better access to the right care for those experiencing a behavioral health crisis. This session and poster will provide recommendations and considerations to address the common challenges of implementing behavioral health crisis services.
Presenters:
- Dr. Jenene Washington, MD,MBA, FAAP, PCMH-CCE, PMP, CEO, Renaye James Healthcare Advisors
- Pam Llewellyn, LCSW-C, MBA, Senior Behavioral Health Consultant, Renaye James Healthcare Advisors
Putting the “Eye” in Teams: Fostering a Team-Based Approach in Primary Care to Prevent and Mitigate Vision Loss and Blindness
Vision loss has been shown to cause substantial social and economic tolls, emotional suffering, social isolation, loss of productivity, and diminished quality of life. Upwards of 70% of adults with visual impairments or blindness are unemployed, and 1 in 4 children has a vision problem that may affect their ability to learn in school, meet developmental milestones, learn, and play sports. Despite the importance of vision and eye health on one’s quality of life, many historically marginalized populations continue to face barriers to accessing the eye and vision care as only 20-25% of health centers have integrated comprehensive vision services. This interactive session will train primary care teams to identify, screen, and refer early and consistently to prevent significant vision loss. Attendees will be introduced to complex patient cases and be given a quality improvement (QI) template to design and implement their own QI project.
Presenters:
- Julie Grutzmacher, MSW, MPH, Director of Patient Advocacy and Population Health Initiatives, Prevent Blindness
- Debi Sarma, OD, Director of Eye Care Service, Codman Square Health Center
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Suicide Safer Care at All Stages of Life: Pediatric & Geriatric Suicide Prevention
Suicide is increasingly posing a dual crisis for both pediatric and geriatric populations: suicide is the second leading cause of death in youth aged 10-14, and suicide rates among people aged 65 or older, particularly men, are the highest of any group in the country. Nearly half of individuals who later die by suicide visit their primary care provider (PCP) in the month before their death, however, giving providers at health centers a crucial opportunity to intervene. This session will help providers, their teams, and medical leadership better understand unique considerations in Suicide Safer Care for these populations by providing an overview of pediatric and geriatric suicide and why providers can play an important role in prevention. It will also detail effective suicide screening and prevention practices for both populations, from risk assessments to clinical pathways and evidence-based interventions.
Presenter:
- Dr. Virna Little, PSyD, LCSW-r, SAP, CCM, Chief Clinical Officer and Co-Founder of Concert Health, Co-Founder of Zero Overdose
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Track II: Community Engagement and Advocacy
Coming to America: How Medical Homes Can Help Refugee and Asylee Populations Thrive
One of the cornerstones of the FQHC ecosystem is the ability to provide a medical home to the community members that seek comprehensive community-based care. The medical home is critical to the assimilation of groups that are coming from countries experiencing political destabilization, religious persecution, climate change, or other life-altering event. CCI’s decade old Refugee Health Program, not only provides crucial services to the refugee and asylee populations, but coordinates the wraparound care, access to needed social services, and becomes the collectivist hub that most populations are used to in their former countries. In today’s session, you will hear from CCI’s Refugee Health programmatic leadership, a refugee health provider, and from an employee that went through the program and has thrived.
Presenter:
- Jessica Wilson, Chief Strategy Officer, CCI Health Services
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Educating and Empowering Advocates to Speak about the National Health Service Corps
The NHSC was designed to bring primary care clinicians to the country’s most underserved communities. Unfortunately, the future of the National Health Service Corps (NHSC), Health Centers and other vital programs for the underserved is at risk. We need your voice to build our power to protect and expand these vital programs. In this session, discover how to become an ACU advocate. Attendees will also learn about the NHSC’s field strength, equity and diversity within the NHSC, the program’s funding history, current issues, and recommendations for Congress to address health workforce shortages.
Presenter:
- Jordan Marshall, MPH, Deputy Director of Policy & Advocacy, Association of Clinicians for the Underserved
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Involving Communities in Addressing the Maternal Health Crisis: Making an IMPACT
There is an ongoing maternal health crisis in the United States that is disproportionately impacting communities of color. Led by a partnership of Morehouse School of Medicine, University of Colorado (School of Medicine and School of Public Health), a robust network of community-based organizations, and a Regional Advisory Board, (RAB); located at an epicenter of the US’s Black maternal health crisis, our coalition meaningfully engaged with one another to address the inequities in maternal morbidity and mortality through the creation of Project IMPACT (IMproving Preconception Action and Choices for Tomorrow). With the community, a culturally tailored preconception counseling intervention and implementation strategy was developed for Black, southern, low-income women and men of reproductive age to be implemented in community-based organizations. Phase I of this project included: a community needs and assets assessment; a two-site pilot study in Georgia; and a follow-up qualitative implementation assessment with community members and implementers. An analysis of all parts of Phase I has informed Phase II (which is ongoing) to scale the implementation of this intervention to 10 community-based organizations across four southern states.
Presenters:
- Madison Haiman, MSW, Research Assistant, Center for Maternal Health Equity at Morehouse School of Medicine
- Natalie Hernandez, PhD, MPH, Associate Professor, Morehouse School of Medicine
- Latrice Rollins, PhD, MSW, Assistant Professor, Morehouse School of Medicine
- Erin Harris, BA, Research Assistant, Center for Maternal Health Equity – Morehouse School of Medicine
Supporting Primary Care CHW Programs in a Post-COVID Funding Environment
During the pandemic, Community Health Workers (CHWs) played an important role in the support of vulnerable and historically marginalized communities. President Biden officially recognized CHW efforts, and millions of dollars in grant funding supported CHW programs across the US. This funding expanded the CHW workforce to meet the pandemic-fueled need for medical and social service resources. Now, the COVID grant funding that built the CHW workforce is waning. Although some resources have become available, there isn’t funding to sustain the workforce at its present level. Unfortunately, the acute – and persistent – need for CHW services remains high. A CHW’s trusted relationship with their community often increases the communication and engagement with a community member’s primary care team and treatment plan. In this session, we will discuss the value of working with CHWs beyond the limited scope of grant funding. We will talk about their unique skill sets and how integrating CHWs into your care teams can give valuable insight into the life your clients live outside the clinic walls. With the prospect of a looming “financial cliff,” we will explore creative ways to build, support, and sustain the CHW workforce in your agency.
Presenter:
- Kelly Volkmann, MPH, Project Director, Northwest Regional Primary Care Association
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Voices for Care, Voices for Change: CHC Storytelling for Advocacy, Outreach, & More
Quantitative data informs nearly every aspect of medicine, but qualitative stories often shape popular understanding of care and services. Effective storytelling can allow patients, providers, and organizations alike to make health center services real to a broader public, not only improving awareness and outreach but also advocating to advance health equity. This presentation will introduce strategies for patient/provider and institutional storytelling to help health centers and advocates better tell their stories to the communities they strive to serve and the legislators they hope to inform.
Presenters:
- Rick Brown, MA, Associate Director of Communications & Membership, Association of Clinicians for the Underserved
- Jenn Dix, Communications and Membership Coordinator, Association of Clinicians for the Underserved
- Julie Grutzmacher, MSW, MPH, Director of Patient Advocacy and Population Health Initiatives, Prevent Blindness
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Track III: Development and Training Programs
Advancing Health Centers through Trauma Informed Care: The TACHC Model
Patients seen in health centers typically have complex social, emotional, and medical needs which can be met with the foundational use of ‘universal trauma precautions’ in order to provide an environment that engenders holistic patient-centered care and promotes healing. Although the recognition of responses to trauma on human behavior began well before what became known as the Adverse Childhood Experiences Study or ‘ACEs Study,’ this landmark research from the late 1990’s, ignited the movement towards what is known as trauma informed care (TIC). Based on SAMHSA’s principles, TIC is a strength-based framework that recognizes the pervasiveness and impact of trauma and adversity, and emphasizes the importance of interactions based on safety, choice, collaboration, empowerment, and trustworthiness, amid cultural sensitivity.
Conceptually, TIC is about realizing that trauma is real and pervasive, recognizing the signs and symptoms of trauma, responding to individuals who have experienced trauma in a way that promotes healing, and resisting re-traumatization through changes to policies, practices, and procedures. On a practical level, TIC is a full-system transformation towards an environment of understanding, healing, and resilience. As health centers with all of our multiple competing priorities, TIC can be incorporated through intentional trainings, deepening understanding, and ‘hands-on’ TIC practices that result in improving outcomes.
In 2019, the Texas Association of Community Health Centers (TACHC) began collaborating with Texas health centers to implement the Trauma Informed Care (TIC) Program, as an intervention framework aimed at creating lasting and upstream changes for patients, staff, and communities to identify and mitigate the effects of trauma in patients made vulnerable due to circumstances and systems, while also providing support to health center staff. Through a train-the-trainer model, health center staff are taught through an original evidence-based, comprehensive, and multifaceted approach to fully integrate SAMHSA principles associated with TIC into all aspects of the health center experience: for all patients, by all staff. Fundamental to this practice are the TIC pillars, which include: Safety, Trust, Choice, Collaboration, Empowerment, Peer Support, and Historical, Cultural and Gender factors.
At its core, the TACHC TIC Program is an organization-wide quality improvement transformation that is strategically aligned to advance the most pressing, pertinent health initiatives and address the current workforce crisis. The curriculum and training bolsters health center staff’s understanding of the connection between TIC and non-medical drivers of health, workforce retention and burnout-reduction, while embedding values of justice, equity, diversity, and inclusion and aligning the move towards holistic approaches in value- based care. To demonstrate improvement, TACHC partnered with the University of Texas– Houston, School of Public Health in order to measure the ways in which the TIC approach can impact both patient and health center outcomes in the short, intermediate, and long-term. Therefore, data collection began at the program’s inception, and after four (4) cohorts, with 40% of Texas health centers’ participation and transformation, over 3,235 Texas health center staff have been trained in TIC. Furthermore, well over 407,525 patients have been impacted by changes made at their local health center.
Now that TACHC is approximately 4 years into this process, data is pointing to improvements for Texas health center staff and their patients. Specifically, TACHC TIC Program data demonstrates statistically significant shifts in culture change through measurable indicators to include health center staff knowledge, as well as workforce retention, and patient health outcomes. This presentation and discussion will enable participants to learn about TACHC’s Trauma Informed Care Program and the findings to date, with an emphasis on how other health centers and primary care associations can take bold next steps for better outcomes and well-being of staff and community.
Presenter:
- Roxana Cruz, MD, FACP, Director of Medical & Clinical Affairs, Texas Association of Community Health Centers
- Aniela Brown, MSW, Trauma-Informed Care Coordinator, Texas Association of Community Health Centers
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Leadership Development: A Framework for HPET Preceptor Success
Engaged, passionate, and knowledgeable preceptors are the foundation for a successful Health Professions Education & Training program. By applying principles of successful leadership development to faculty development strategies, CHCs can ensure a robust and engaged HPET faculty, dedicated to the success of their HPET learners. In this session, we will explore the key elements of successful HPET preceptors and successful leadership development programs and how these two strategies combined can supercharge HPET programs.
Presenters:
- Kelly Rondou, Senior Consultant, Wipfli LLP
- Steve Hopkins, Director, Wipfli LLP
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Minimizing Health Disparities by Building Capacity Among the Healthcare Workforce
As one of the eight offices of minority health within the U.S. Department of Health and Human Services, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) is committed to helping minority populations achieve health equity. To do so, CMS OMH recognizes the importance of establishing partnerships and connecting with stakeholders to help disseminate CMS data, resources, and initiatives, which can help support the health care workforce that is working directly with these populations. During this workshop, we’ll highlight initiatives to support the health workforce, beginning by highlighting CMS’s efforts to better understand gaps in care through data and how we use that data to improve our programs, before showing how it helped us develop CMS’s Framework for Health Equity. We’ll close by focusing specifically on the Framework’s third priority to build capacity of health care organizations and the workforce to reduce health and health care disparities and show how we’re doing so through programs such as our Health Equity Technical Assistance Program, Minority Research Grant Program, and signature health literacy program, Coverage to Care, including resources for the audience to use in their own practice.
Presenter:
- Dr. LaShawn McIver, MD, MPH, Director, The Centers for Medicare & Medicaid Services Office of Minority Health
Supporting a Thriving Healthcare Workforce through State Funding
The COVID-19 pandemic has placed incredible strain on health care workers resulting in unprecedented rates of workforce loss. To continue supporting health centers’ current and projected patient population, health centers must leverage policies that help retain current staff and broaden the opportunities to train and recruit new staff. While over half of states provide direct funding to support health centers with improving access to care, outreach and enrollment initiatives, capital expansion, and more, state funding is a largely untapped resource for supporting workforce initiatives. In this educational session, attendees will learn how 2 state primary care associations – the California Primary Care Association and the Ohio Association of Community Health Centers – and 1 health center – HealthLinc, secured state funding to support the training of health care professionals across a number of disciplines including medical, dental, and behavioral health.
Presenters:
- Beth Wrobel, CEO, HealthLinc
- Marie Grady, Workforce Development Program Manager, Ohio Association of Community Health Centers
- Nataly Diaz, Director of Health Center Operations, California Primary Care Association
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Track IV: Recruitment and Retention
Creating Job Announcements That Shine Among the Competition
Join the STAR2 Center team to learn how to craft job announcements as part of a recruitment strategy that appeals to a wide range of qualified candidates. Many key elements make up a successful recruitment effort, and a well-written job announcement is one of the most important. This session will address the importance of developing impactful language that captures attention and details the mission-driven heart of health centers. The STAR2 Center team will use examples and promising practices to give you concrete tools to build tailored job postings and develop a recruitment strategy that reaches out to diverse, qualified, and motivated job seekers.
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Creating Trauma-Informed Systems for Healthcare Workforce Retention
The COVID-19 pandemic posed many challenges in the care of the historically marginalized. Specifically, the rates of morbidity and mortality related to the pandemic were higher amongst these communities, and while these communities have often faced healthcare workforce shortages, the pandemic exacerbated this issue. Additionally, our healthcare workforce has been faced with increased workload, patient complexity, and higher rates of morbidity and mortality of patients which has impacted their health and wellness. As our systems work to put the pieces together after the pandemic and come out stronger, the creation of trauma-informed systems is crucial not only to patient care, but for healthcare workforce wellness and retention. The trauma-informed framework works to define trauma as well as understand the way individuals, organizations, and systems interact to prevent new trauma and retraumatization. While this framework has been often directed only towards trauma-informed patient care, evidence supports the value of creating trauma-informed systems to create work environments that support individual staff members, promote wellness, and retention.
Presenters:
- Sarah Vaillancourt, WHNP-BC, Women’s Health Nurse Practitioner, Community Medical Centers
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Data-Informed Decision-Making to Build a Workforce that Reflects Communities Served
Community Health Centers are rooted in a community-representative model. This is evident in the majority consumer boards that are a required hallmark of these transformative organizations. Having a workforce that is representative of the patients served is not a HRSA requirement, but is recognized as a contributor to the advancement of health equity. The limited availability of data comparing the race and ethnicity of the health center workforce to the available workforce within the state and to its patient population has made it difficult for health centers to assess themselves in this aspect of their goal to achieve a community representative workforce. In this session, attendees will learn about a recently developed workforce data collection tool and diversity index that allows health centers to make data informed decisions to build a workforce that reflects the communities they serve. You will hear from two health centers that piloted the tool and learn more about how they are using the data to advance health equity through an aspiring representative workforce. Don’t miss this opportunity to learn more about how you can secure the data to inform your health center’s efforts to reflect your communities in your workforce.
Presenter:
- Gerrard Jolly, MA, CDP, Director, Career Advancement Strategies, National Association of Community Health Centers
- Edward Salsberg, MPA, FAAN, Lead Research Scientist, The George Washington University
- Rashad Collins, CEO, Neighborcare Health
- Don Holloman, MEd, CHCEF, CEO, Cabarrus Rowan Community Health Centers, Inc.
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The Great Retention: Inclusive Practices that Keep Talent at Your Organization
The U.S. Bureau of Labor Statistics found that workers are quitting at the highest rate in decades reaching a twenty year high in 2022. According to a study published by the Pew Research Center, the third most common reason for this mass exodus, or “The Great Resignation” was employees feeling disrespected at work. For people who identify with a minoritized group, inclusion and respect go hand in hand. This session will provide the formula for employee retention through JEDI principles. Participants will learn ways to prioritize DEI and improve the employee experience, evaluate their current workplace culture, and lay the groundwork for intentional onboarding plans.
Presenter:
- Victoria Walters, JEDI Training Specialist, Association of Clinicians for the Underserved
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Inclusive Healthcare Teams: Psychological Safety, Inclusion, and Anti-Racism
This workshop provides participants with awareness, knowledge and skills to serve as agents of change in their organizations toward the provision of culturally responsive care and the elimination of health inequities. Together we will explore health justice and team-based care through a lens of the oppressive history of our nation and the impacts on health and mental health for the targets of that oppression. More specifically, we will explore the power and importance of creating a health system of psychological inclusion, healthy navigation of implicit bias, and the dismantling of racism, sexism, heterosexism and other such dynamics in the workplace.
Presenter:
- Jeffrey Ring, PhD, Health Psychologist
Medical Scribe to Provider Pathway at a Rural FQHC
Piedmont Health Services (PHS) is a federal qualified health center operating 10 community health centers and 2 senior care centers providing primary care and other services to a majority underinsured and uninsured population in central North Carolina. In 2018, PHS started an in-house medical scribe program to decrease documentation burden amongst providers and provide a paid gap year opportunity for MD, DO, PA school applicants creating a scribe to provider pathway. For the past 4 years, we trained and integrated 32 medical scribes in which 12 are still employed and 20 transitioned out. 13/20 (65%) are attending health professional school (7 MD, 3 DO and 3 PA). 6/12 (50%) of those employed have been accepted into MD (5) and DO (1) schools. 10/13 (77%) of those in school have expressed an interest in coming back to PHS. During the past year, we hosted 4 former scribes as visiting clinical rotation students. Two are graduating and applied for available provider positions thus closing the loop from scribe to provider. 12/13 (92%) indicated that they never would have thought of career in community health had it not been for their scribe experience. Qualitative survey results indicate medical scribes having an effect in decreasing documentation burden, improving physician job satisfaction and quality of life thereby preventing physician burnout.
Presenters:
- Jan Lee Santos, MD MHA MA, Director of Research and Professional Development, Piedmont Health Services
- Gaohly Anjolie Kue, Medical Scribe, Piedmont Health Services
July 26: Hill Day
Advocacy Visits on Capitol Hill
This day will be reserved for advocacy visits to Capitol Hill to speak with members of Congress and their staff to support the National Health Service Corps and other vital health extender programs.
