NEED/RATIONALE:
Workforce Shortages: Wyoming County, a federally designated geographic Health Professional Shortage Area and geographic/population group Medically Underserved Area, is facing growing health workforce concerns. Focus groups conducted by the Western New York Rural Area Health Education Center (R-AHEC) with local hospital, long term care and home health care agency leaders identified critical shortages in dental medicine, mental health, nursing and medical technology in addition to ongoing needs for medicine and pharmacy.
Pipeline Programs Work: Dr. Thomas E. Norris, Associate Dean, University of Washington School of Medicine and Dr. Thomas C. Rosenthal, Chair, Department of Family Medicine, University at Buffalo (UB) have both reviewed the long term effects of community based pipeline strategies and concluded that they are the most likely of all strategies to result in a stable, community appropriate, panel of health professionals. (Norris, J Rural Health, 2000;16:208; Rosenthal J Rural Health, 2000;16:213) Eastern Pennsylvania, Alabama, Minnesota and Washington have all published results confirming that upwards of 65% of high school students identified, tracked and assisted through the formative training years will return to serve their communities of origin. The retention of these providers exceeds the retention rate of any other program.
A pipeline project can assist Wyoming County students to reach their full potential in health careers, keep them near families, and provide good jobs. Mr. and Mrs. John Johnson, the late daughter and son-in-law of Mr. Thiel, demonstrated their belief and success in pipeline programs. Their support of the Rotary Club initiative in Perry, New York attracted Drs. Reagan and Logan to the area where 20 years later they still provide community centered health care.
Wyoming County’s academic and provider communities are uniquely positioned to benefit from the relationship between the University at Buffalo and the R-AHEC and a comprehensive health workforce development strategy (pre career pipeline initiatives, clinical placements and practice site development) targeting critical short-term and long-term local recruitment, education, training, and retention needs.
WHAT WILL BE DONE?
Overall Strategy: To effectively and efficiently address these issues, a comprehensive and multi-faceted workforce development plan will be implemented. The University at Buffalo will provide real community experiences for its trainees, a structured educational environment through its partnership with the R-AHEC, and opportunities to develop relationships with community providers that will enhance care through a facilitated referral network. Once successfully developed and implemented, this strategy will stand as a model project to attract additional local, regional, and national funding sources to expand the Wyoming County Health Careers Initiative and support its replication elsewhere in New York.
Since 1999, the R-AHEC has accepted a performance mandate from the University at Buffalo (as its sponsoring academic institution and as the New York State AHEC System Statewide Office), to serve as the region’s designated liaison among the UB’s health professions schools and local rural provider communities they seek to serve. Acknowledging the existing association and the organization’s proven programming and partnering capabilities, the University at Buffalo will subcontract with the R-AHEC to operationalize "The Wyoming County Health Careers Initiative: A Community/Academic Partnership."
Project Initiatives—Pipeline Timetable
? Model health careers awareness program available to all six school districts and three Board of Cooperative Educational Services (BOCES) systems in Wyoming County
? Speakers bureaus (classroom, parent and faculty presentations)
? Distance learning telecasts
? Small group Career Exploration Labs on site at schools or a central location
? Annual Health Careers Fair on site at a school or central location
? Annual Medical Academy for Science and Health Camps for 7th and 8th graders
? Quarterly remote site experiences for high school students in UB Medical Science and Technology Program (MedSTEP)
? Grade appropriate curriculum and support materials for use by school faculty
? Quarterly Wyoming Health Careers Initiative Newsletter
Ongoing
Quarterly
Fall 02/Spring 03
Spring 03
Summer 2003
Fall 02/Spring 03
Fall 02/Spring 03
Ongoing
? Personalized case support and career counseling for students identified with health career aptitude, ability, and interest Ongoing
? Local coordination of Thiel Foundation Health Careers Scholarship Program
? Applicant recruitment and screening
? Tracking and case management to support students’ maximum achievement
? Coordination of a paid summer Work Study Initiative
? Service Based Learning Opportunity for interested students of all ages
Fall 02/Spring 03
Ongoing
Summer 03
Fall 02/Ongoing
Project Initiatives—Development/Training/Retention
? Wyoming County Externship Opportunities for UB health professions students Summer 03
? Community-based clinical placements
? Interdisciplinary pre career training/post graduate residencies
? Practice site development with local hospital and providers Immediate
Spring 03
Immediate
? Continuing education programs, based on needs assessments, for health professionals
? Quarterly multi-disciplinary continuing education programs
? Skills Enhancement Sessions for entry level workers in identified need areas
Ongoing
Fall 02
? Annual Community Health Assessment activity/related Public Outreach Series Fall 02/Spring 02
WHO WILL BE INVOLVED?
The University at Buffalo, on behalf of its health professions schools (medicine, nursing, health related professions, dental medicine, pharmacy and social work), will partner with the R-AHEC to enhance existing academic and community resources and foster new collaborations. The proposed initiative is unique; there are no other area providers delivering similar services. Through this alliance programs to increase the health care professional workforce, proven effective in other AHEC states, will be implemented in Wyoming County and serve as a model for development in all of western New York.
The R-AHEC is prepared to assume a principal role in providing the proposed deliverables and for securing any additional resources needed to fulfill its contractual obligations. R-AHEC personnel include Kenneth Oakley, PhD, CEO, Jane Munro, Associate Director, Sandra Brewer, Administrative Assistant/Data Specialist and a career/case management specialist to be hired.
The University at Buffalo is responsible for overall subcontract oversight and accountability to the Community Foundation of Greater Buffalo/Thiel Foundation. In-kind support will be provided by New York State AHEC System Deputy Director, Mary Sienkiewicz, MBA, who will coordinate communication with the University at Buffalo, R-AHEC and the Community Foundation of Greater Buffalo. New York State AHEC System personnel include Statewide Office Medical Director, John Brewer, MD, and Nursing Director, Carol Brewer, PhD, RN, who will coordinate faculty development initiatives among the UB health professions schools.
INTENDED IMPACTS/OUTCOMES:
Talented Wyoming County students will experience educational initiatives tailored to their needs, abilities and potential. The long-term goal is an increase in students who train in the health professions and who return to Wyoming County as practitioners. Health careers awareness programs will involve over 840 elementary and secondary school students, parents and educators. A total of 75 health professions students will be placed with 33 preceptors at 28 community-based practice sites. All of UB’s health professions schools will develop pre career training or post graduate residencies. Twelve undergraduate and health professions students will be involved in the UB Health Careers Scholarship Program. Continuing education and skills enhancement sessions will reach 92 individuals.
EVALUATION:
Documentation of outreach will be measured by numbers of programs and participants. Students will be tracked through pipeline programs, clinical placements and post graduate employment. Qualitative measures will include evaluation of program participants, pre-and post-assessment of students regarding intention to pursue health careers and quality of instructional experience.
PUBLICITY:
"The Wyoming County Health Careers Initiative: A Community/Academic Partnership" project and role of the Community Foundation of Greater Buffalo/Thiel Foundation will be publicized through UPDATE—New York State AHEC System newsletter, reports to the federal Health Resources and Services Administration and New
York State Department of Health, releases to the local media and communications with community partners.
See Excel Document for budget (Thielprodraft.xls)
DRAFT—Budget Narrative—DRAFT
"The Wyoming County Health Careers Initiative:
A Community/Academic Partnership"
PERSONNEL
Program leadership (.1 FTE) The R-AHEC Chief Executive Officer will be responsible for overall strategic planning, development and leadership of the proposed initiative.
Program implementation (.3 FTE) The R-AHEC Associate Director and program coordinators will be responsible for implementing the career labs and fairs, MASH camps, MedSTEPs, externships and other proposed educational activities.
Program support (.4 FTE) The R-AHEC Administrative Assistant will be responsible for clerical and administrative support associated with the proposed initiative.
Career/case management (1.0 FTE) The individual in this position will have an education/counseling background and will work directly with all participating students as a mentor/case manager to assist them with personal and health professions career choices, career planning, summer employment and work study opportunities and tracking as they enter and progress throughout the health career pipeline. This key position will be focused on interacting with students to select realistic career goals and prepare academically and experientially for those career goals as they proceed from middle school through high school through college and health professions schools.
Faculty development (.2 FTE) University at Buffalo, New York State AHEC System Statewide Office Medical Director and Nursing Director will coordinate communications with and interdisciplinary residencies of the six health professions schools (Medicine, Nursing, Health Related Professions, Pharmacy, Dental Medicine and Social Work).
TRAINEE SUPPORT/STUDENT TRAVEL
Career labs, career fairs and MASH camps: Travel costs associated with student travel to off-site program activities in which they are introduced to hands-on activities and career opportunities.
MedSTEP: Costs of bus transportation for four trips between local high schools and the University at Buffalo for high school students participating in the MedSTEP for hands-on experience in health career exploration.
Externships: Stipend and travel/mileage reimbursement for the sponsorship of four medical students participating in six week summer externship experiences with Wyoming County-based preceptors.
Pre career training/Post graduate residencies: Through a request for proposal process, each of the University at Buffalo’s six health professions schools (Medicine, Nursing, Health Related Professions, Dental Medicine, Pharmacy and Social Work) will design a Wyoming County experience for its students at the pre-career training or post-graduate residency level. These interdisciplinary training opportunities will place students directly with community practitioners and with other health professions students.
Scholarships: Awards to University at Buffalo students training for health careers.
PROGRAM COSTS
Career labs and career fairs: Programs implemented on-site at local schools and/or hosted at central locations to introduce students to health careers.
MASH camps: Two day programs with hands-on learning opportunities at a local hospital for 7th and 8th grade students.
MedSTEP: Local programs and recognition events for students to complement University at Buffalo field trip experiences.
Newsletter/scholarship coordination/tracking: Tracking of participating students through the career pipeline and quarterly communication with students and community/academic partnerships about health careers and scholarship programs.
Work study initiative: Local summer work opportunities for four health career pipeline students.
Continuing education/skill enhancement: Quarterly, multi-disciplinary continuing education programs for health professionals and recurring skill enhancement sessions for entry level workers in specific need areas.
Community assessment: Annual community health assessment activity and a related public outreach education services.
Staff travel: Costs associated with R-AHEC travel for aforementioned program activities.
INDIRECT COSTS: R-AHEC (12 percent) and University at Buffalo (6 percent) institutional indirect costs associated with the respective institutions’ administration of the proposed initiative.