June 2009

Summer is finally here and warm weather is hopefully on the way (despite all the rain!). There is no better place to be than Rhode Island when the weather turns warmer!  This edition of the Rhode Island AHEC newsletter contains updates on our RI AHEC Network programmatic initiatives and recent primary care involvement throughout the Ocean State.

Northern RI AHEC

Each summer, nriAHEC sponsors graduate and undergraduate students for internships and community-based health projects. This initiative provides sponsored students with the opportunity to investigate the communities they live in while learning a little more about the career path they are choosing. All grant-funded projects and initiatives must support and strengthen our mission in addressing known healthcare gaps while having a strong interdisciplinary and community-based focus where applicable. This year, nriAHEC will be sponsoring 5 students for Student Summer Projects; 2 of which are Brown medical students, 1 from Bryant University, 1 from Stonehill College and 1 from Rhode Island College.  Student projects vary in scope from geriatrics to research and each will develop a final report that will be presented to the public during RI National Primary Care Week in October, 2009. We are excited about this year’s candidates and look forward to working with them and providing support on their proposed projects.

nriAHEC has been working tirelessly in developing relationships with local community health centers to bring them continuing education and training in several areas. To date, we have trained over 200 Community Health Center employees from 4 locations on Cultural Competency/Cross-Cultural Communication, How to Work with an Interpreter, and a 60-hour Health Interpreter Training Course. We will be taking the summer off from training to review and evaluate our existing curriculums as well as develop some new training programs. Our classes will begin again in the fall.

Recently, nriAHEC applied for and was awarded some mini-grants to do work around tobacco-control, Lead Prevention and Rural Health. While we are waiting on some logistical information, we are looking for interested organizations in the Northern RI area to collaborate on community needs assessments and strategic planning with regard to Rural Health and/or participants to participate in Lead Prevention Workshops and tobacco control events. Interested parties should contact Sherri Carello, Program Manager, at 356-4077.

Central RI AHEC

Since the February 2009 e-newsletter, the Central RI Area Health Education Center (criAHEC) at St. Joseph Health Services of RI (SJHS) has been actively involved in a variety of programmatic initiatives targeting health professionals, health professions students, and youth.  Highlights of these efforts are as follows:

REACT RI

• In March 2009, the criAHEC, SJHS received a $39,985 grant award from Workforce Solutions of Providence/Cranston to support the 2009 REACT RI Summer Program.  Recruitment outreach to eligible youth ages 14-15 years from the Providence or Cranston community is well underway via Facebook postings, mass emails to former REACT applicants, onsite promotional sessions for community members, and blast emails from the Youth Center and other partners.  To date, more than 80 students have applied for the 40 available positions.
  Beginning with an orientation in late-June that focuses on team building skills and appropriate workplace behavior and standards, REACT RI participants will complete the six-week career exploration/work experience program, capped off by a celebration lunch in August.  Students will receive a weekly stipend of $100 and gain hands-on learning experience for 15 hours each week at partner sites including Hasbro Children’s Hospital, Miriam Hospital, Our Lady of Fatima Hospital, Rhode Island Hospital, Roger Williams Hospital, and St. Joseph Hospital for Specialty Care.  Weekly didactic sessions on health-related topics and skills including CPR/AED certification will enhance participants’ understanding of health career opportunities, personal health, nutrition, health data collection, and more.  In partnership with the School of Nursing at RI College, students also will have the opportunity to become familiar with the nursing lab and overall college campus.

Community Health Worker (CHW) Network

• The second forum of the CHW network, sponsored in part by the criAHEC, was a great success.  Approximately 75 community members representing a wide array of non-profit organizations convened on April 30, 2009 at the RI Convention Center to further promote the development of a statewide CHW network designed to meet the needs of underserved populations and communities in RI.  Buoyed by several successful forums, a strong interest remains among participants to continue work on this endeavor and a newly formed Steering Committee will begin to identify the training and technical needs of the network with more events and activities to follow in upcoming months.

2009 RI Geriatric Dentistry Mini-Residency Training Program

• In collaboration with the RI Department of Health and RI Hospital, the criAHEC, SJHS co-sponsored and convened the 2009 RI Geriatric Dentistry Mini-Residency in March at the Crowne Plaza Hotel in Warwick.  More than 160 dentists, dental hygienists, and dental assistants from private dental practice and the dental safety-net (community health center and hospital-based dental programs) participated in the event.  David R. Gifford, MD, MPH, Director, RI Department of Health, offered opening remarks and national leaders in geriatric dentistry education and/or national organizations devoted to elder oral health including the Special Care Dentistry Association and American Society of Geriatric Dentistry served as expert faculty.  Participants received up to 12 continuing education credits for completion of the sessions that focused on oral medicine/oral pathology, cognitive disorders, restorative dentistry materials and techniques, ethics and medical legal consent, health literacy, office accessibility, nursing home dental programs, and other issues specific to older adults.

Dental Home Initiative for Head Start Children in RI

• On March 25, 2009, the criAHEC, SJHS, in collaboration with the American Academy of Pediatric Dentistry (AAPD) and the federal Office of Head Start (OHS), convened more than 35 members of the oral health and Head Start/Early Head Start (HS) communities, along with state policymakers and other community partners to launch the HS Dental Home Initiative.  Through this collaboration, it is anticipated that more RI HS children will have access to a dental home – a comprehensive, continuous, coordinated, and family-centered source of oral health services.  Ultimately, with early access to a dental home, oral health outcomes will be improved among this disadvantaged group of HS children.  One of 12 states selected to participate this year, the initiative is led by Daniel Kane, DMD, Dental Director, St. Joseph Hospital, and criAHEC staff serve on the state leadership advisory team. 

Partnerships with Health Professions Training Programs

• In the April-June 2009 period, three students from the School of Dental Medicine, Tufts University are completing a five-week rotation at SJHS.  Subsequent five-week rotations for an additional eight dental students are scheduled in the July 2009-March 2010 period and hospital/departmental orientations are being coordinated by the criAHEC, in partnership with the Pediatric Dental Center.
• The criAHEC also coordinated short-term clinical rotations/observations for one student from the School of Dental Medicine, Case Western Reserve University and one student from the School of Dentistry, University of Washington.  Both students are anticipating further training upon graduation from dental school and are interested in applying to the Advanced Education in Pediatric Dentistry Residency Program at SJHS.
• In collaboration with the Community College of RI, the criAHEC coordinated externship rotations for six dental hygiene and four dental assisting students for the spring 2009 semester. 

Partnerships with Providence Schools

• Throughout May, the criAHEC has worked with several public and private schools in Providence to provide community service, job shadowing and/or health career exploration opportunities at SJHS for middle and high school students.  Participating schools include Moses Brown (Community Service Day, 8 students), Central High School (Community Outreach Day, 12 students), and Bridgham Middle School (Job Shadow Day, 13 students).

Peer Navigators – Peer Assisted Health Initiative

• The SJHS Center for Health and Human Services (CHHS) has initiated the Peer Assisted Health Initiative with support from the RI Department of Health, RI Parent Information Network, and the criAHEC.  With guidance and technical assistance from the Peer Navigator Coordinator, two bilingual Peer Navigators are providing extra support in the CHHS WIC and OB/GYN Clinics to help patients better navigate health and community systems. 

Health Fair - World Asthma Day

• On May 16, 2009, the RI Association of Certified Asthma Educators, along with an allergist and in cooperation with the criAHEC, SJHS, convened a health fair at the Metropolitan Regional Career and Technical School (often referred to as the Met School) in Providence.  The asthma educators and an allergist provided spirometry testing and asthma education/health promotion materials to nearly 45 individuals. 

Southern RI AHEC BREAKING NEWS

The Southern RI AHEC Program is undergoing an organizational transition presently, and will no longer be a not-for profit 501c 3 organization. Starting later this summer, The Southern RI AHEC Program will be hosted by the University of Rhode Island School of Nursing. The RI AHEC program Office is thrilled that the URI School of Nursing will be a partner in the Statewide RI AHEC Network, and we look forward to working together to address the issues of recruitment, retention, and continuing education of the primary health care workforce so as to improve access to care for all Rhode Islanders. Be sure to stay tuned to learn more about how the URI School of Nursing/Southern RI AHEC Program is growing!

Brown RI AHEC Program Office

The RI AHEC Program Office has been very busy with projects both inside and out of the state. Program Office staff has been working very diligently on the following initiatives:
Rhode Island Primary Care Workforce Mapping Article

An article written by Rachel Popick, MPH, Arthur Frazzano, MD, and Robert Trachtenberg, MS, entitled “Geographic Access To Care In Rhode Island Through the Use of GIS” will appear in Medicine and Health RI regarding the RI AHEC mapping project in the July 2009 Edition.

Macy Foundation Meeting

RI AHEC Associate Director Robert Trachtenberg, MS represented the National AHEC Organization at an April 2009 meeting convened by the Josiah Macy, Jr.  Foundation in Washington, DC, regarding the nation's Health Care Workforce. The meeting included individuals whose expertise is at the front lines of primary care. The Macy Foundation brought together leaders in primary care and primary care education. The invitees care for the underserved directly, as in community health venues, recruit pre-professional students  into the health professions, work to expand understanding of primary care training and practice among medical educators, and  guide training for physicians, nurse practitioners, physician assistants, and others in primary care.. The insights and recommendations that emerged from the discussions are thoughtful and compelling, and are indicated below:

• The development, disseminate information about, and operationalize the Teaching Health Center concept
• The establishment of benchmarks to measure the degree of community engagement of academic health centers
• Model this after the Carnegie Engaged University concept
• Include community engagement as one of the accreditation standards for academic health centers
• Changing the graduate medical education system to better address the healthcare workforce needs of the nation
• The establishment of a National Health Workforce Commission
• The expansion of  collaborations to increase the number of young people interested in careers in healthcare:
• The “Sister School” idea
• AHECs, CHCs, and the NHSC working closely together to achieve this goal
• The increase in publicity about primary care as the preferred specialty for those who seek to better address the nation’s healthcare needs

Health Care Reform and Title VII Reauthorization

The RI AHEC Program Office has been working very closely with Senator Jack Reed and his staff on ensuring that Title VII Reauthorization language is included in any health care reform efforts underway. As of this writing, there is a very good chance that the Title VII Reauthorization language, as initially written by Dr. Kathleen Clink, a Robert Wood Johnson Fellow working with then-Senator Clinton in 2008, will be fully accepted by the HELP Committee, including the increase in the annual AHEC federal appropriation from its current level of $33 million to $125 million.

RI AHEC Summer Medical Student Projects

This summer, as in past years, the RI AHEC Program Office will support and mentor a number of medical students working with underserved populations. The list of projects below demonstrates the breadth and depth of projects that will help Rhode Islanders access better health care and improve health outcomes:

• Sunil Hebbar (MD12) will investigate the presence of lead exposure from housing among refugee children Rhode Island to develop more effective resettlement policies and tailor educational health interventions so as to mitigate the effects of lead poisoning.
• Aleema Patel (MD12) will offer “The Clinical Application of Mindfulness Based Stress Reduction as an Accessible form of Preventative Medicine and Treatment in the Underserved” at the RI Free Clinic.
• Natasha Hunter (MD12) will work on the creation of a national resource for medical educators and inviting collaboration among institutions. The two primary goals for the summer are to develop a list of existing courses and their leaders and key administrators and to write a preliminary set of questions to be administered to these educators later in the year as a formal survey, with the ultimate hope of establishing a national technical assistance center at Brown University and the RI AHEC Program.
• Working in partnership with the RI Public Health Institute, Gloria Faboyede from URI and Colleen Phillips from JWU will conduct a health interview survey, Neighborhood Health √Check, involving randomly-selected blocks in the Southside Providence—an area characterized by underserved low-income, racial and ethnic populations. The purpose is to develop tools and produce data that community based organizations can use to inform program planning, strategic planning, grant applications and policy advocacy in underserved areas. 
• Lauren Goddard (MD11) will be working with the Program Office and the Center Directors to develop a public policy and advocacy strategy as well as develop resource materials for use when visiting with legislators and policy makers, both locally and nationally.

5 Brief AHEC Facts

Did you know that:

1. The Statewide RI AHEC Network provided over 14,000 educational contact hours to over 1,500 RI health professionals?
2. The RI AHEC Network has successfully mapped the RI primary care landscape and is utilizing the data to help identify gaps in service and identify where there may be potential access to health care services issues?
3. The annual appropriation for the national AHEC program was increased from $28 million in FY08 to $33.4 million in FY09? Those dollars go to support the 52 medical and 2 nursing schools that have AHEC Programs, as well as the 220 regionally based Centers.
4. Of the 48 states that have AHEC Programs, 37 of those states receive state funds to support the efforts of the AHEC infrastructure? The Rhode Island AHEC, to date, does not receive any state funding. By the way, the oldest AHEC Program-Arkansas-has been in operation since 1973, and the newest-North Dakota-has been in operation since 2008.
5. In 2008, via the AHEC network throughout the country, over 44,000 health professions students received training at 17,000 community-based sites, and nearly 8,000 of the community-based training sites were located in underserved areas, including over 3,500 in designated Health Professions Shortage Areas (HPSAs) and over 1,000 at Community Health Centers?

RI AHEC Blog Is here! The RI AHEC Program Office has created a Blog dedicated to all things RI AHEC: The blog is up and running and can be found here: http://blogs.brown.edu/biomed/ahec/

The 54 AHEC Programs and their 220 AHEC Centers across the country are vital to training primary care providers for under-served populations. These Centers represent more than 30 years experience in federal, state, and local partnerships that provide training in local under-served and rural communities. Roughly 45,000 health providers were placed in under-served and rural communities in 2007-2008; 20,000 of which were primary care providers, and 4,000 were advance practice nurses. AHECs provide a unique focus on diversity of the primary care workforce and promoting training in underserved areas of the country. Please click on the link below to get an overview of the breadth and depth of the National AHEC Program; you will be impressed with how far-reaching and effective the national network is!

http://www.nationalahec.org/home/index.asp
RI AHEC Network Contact Information

RI AHEC Program Office Brown University
The Warren Alpert Medical School
97 Waterman Street
Providence, RI 02912
401-863-2621
http://med.brown.edu/ahec/

Central RI AHEC
c/o Saint Joseph’s Hospital
21 Peace Street
Providence RI 02907
401 456-4082

Northern RI AHEC
One Cumberland Plaza, 2nd FL
Woonsocket, RI 02895
Fax: (401) 356-4269
www.northernriahec.org

Southern RI AHEC
http://www.southernriahec.org

RI AHEC (Area Health Education Center) is a statewide network dedicated to enhancing access to quality health care— particularly primary and preventive care— by improving the supply and distribution of healthcare professionals through community/academic educational partnerships.  The RI AHEC program is housed at the Warren Alpert Medical School of Brown University, with regional AHEC programs in the medically underserved communities of Woonsocket, Providence, and Newport.