Health professions education and training (HP-ET) programs can take a variety of forms to serve a variety of professional pathways. This episode of of the STAR² Center Talks Workforce Success podcast series features Robyn Weiss, Director of Workforce Development at the Northwest Regional Primary Care Association (NWRPCA) speaking to that variety and sharing how the Region X PCA supports health centers in Alaska, Idaho, Oregon, and Washington as they develop and grow their HP-ET programs. She also highlights the Education Health Center Initiative (EHCI) and other resources health centers can tap into throughout their HP-ET journeys.

Transcript by Rev.com

Helen Rhea Vernier: Welcome to the first episode of the sixth season of the STAR² Center Talks Workforce Success Podcast series. I’m your host for this episode, Helen Rhea Vernier, associate director of Workforce Development at the STAR² Center at the Association of Clinicians for the Underserved.

This season, we’re focusing on health professions pathways as a tool for recruitment and retention. Today I’m talking to Robyn Weiss, director of Workforce Development at the Northwest Regional Primary Care Association or NWRPCA based in Seattle, Washington. Thank you so much for being here.

Robyn Weiss: It is my pleasure. Thank you for asking me.

Helen Rhea Vernier: Of course. To get us started, could you introduce yourself and tell us a little bit about your organization?

Robyn Weiss: Absolutely. To introduce myself, I’m a clinician by background, and I’ve been in medical education. I’ve taught at the University of Texas for many years in physical therapy. But what I found is I really just have a passion for our workforce in general, not just clinicians, but everyone that goes into the space of healthcare. There’s a place for everyone in healthcare is what I find.

The Northwest Regional Primary Care Association just fits that bill. We absolutely are there to support the entire process of community health and migrant healthcare. We’ve been established as a regional since 1983. We focus on community and migrant healthcare in four states, Washington, Oregon, Alaska, and Idaho. And really what we’re doing is we are there to ensure equal access regardless of financial or insurance status in primary care, preventive medicine, oral care, and behavioral health, as well as tribal.

We do all of those and more. We also have the Education Health Center Initiative. We have the CHW, which is Community Health Worker initiative, and we have an Innovation Lab. So we’re quite busy and always got something up our sleeve.

Helen Rhea Vernier: Awesome. I love all the work that you all do at NWRPCA and I’m excited to learn more about how you support health professions education and training. With that in mind, how does NWRPCA support health centers in Region 10 that are trying to get started with HP-ET programs?

Robyn Weiss: Yeah, absolutely. A lot of what we do is all about equitable outcomes. One of the things that give that rise within our health centers is to make sure that we have a strong and diverse workforce. That’s a big part of what the HP-ET program is all about. HP-ET stands for health professions education and training. So what we are doing is trying to support our health centers in having that strong and diverse workforce. That comes down to tackling some really big issues around recruitment, retention, making sure we have the right person in the job to be able to serve the population that comes through our doors in our community health centers and our migrant health centers.

One of the first things that we do when one of our health centers is really either looking to start a program or they have a program that just needs some tweaking, is to really do a needs assessment, really look for those gaps and just kind of analyze the data of where the needs are.

Just as a quick example, OB services, so patients delivering babies and newborn wellness and maternal wellness is such a big topic, and to really make sure that we don’t have a desert, meaning that we have an area of our region that just doesn’t have adequate services where mom and family have to travel more than an hour to get to adequate services. We need to discover that, and then we need to figure out how we can recruit, retain, and support services for the areas that are needed, sort of those deserts or those gaps in services. Same for oral health, which is our dental services. Same for behavioral health as well as primary and preventive care.

The first thing we do is really find out where those needs are and then figure out how we can find a champion in the area to really fill the gap and start or booster a struggling HP-ET program. One of the ways in which we do it, which I’m sure we’ll talk about in just a sec, is just really working on career ladders, pathways. Those are all access points to training in place or growing your own. It’s harder to get someone to come to those areas compared to trying to tap into the wonderful people that are already in those areas. That’s one of the pieces that we look at.

Helen Rhea Vernier: That makes sense, and it sounds like you all are doing really thorough, robust work from that assessment piece to then working with health centers on implementation, so that’s awesome. What are some of the biggest challenges you’ve seen health centers face in developing HP-ET programs, and what are some of the greatest successes on the flip side that you’ve seen health centers have?

Robyn Weiss: Yeah, I think one of the biggest challenges is the one size fits all approach. That is such a challenge because when you are looking at the four states that we have, but you can take this philosophy from anywhere in the country, but that one size fits all is really tough for us because within our region of Alaska, Idaho, Washington, and Oregon, we have got urban centers in downtown Seattle really working homeless populations, refugee populations.

But then we’ve got our rural, which is a totally different set of circumstances, but we have frontier and we have tribal. So if you are trying to build a program that is really going to hit the Seattle area and the richness that we have in recruitment versus a very small isolated pocket of Alaska, one size fits all doesn’t work.

A prime example of that is just Alaska and the challenges. In Alaska, we have some wonderful health centers that face such a difficult staffing. In the winter, they might be a health center that can run off of just four people within their health center, but in the summer when fishing industry is hot, they have an influx of folks that are traditionally seen as migrants that come in and have a range of health needs, and they’re bringing their families with them.

It’s everything from oral, behavior, primary care, but it’s also pediatrics. So it’s just this influx on this little tiny health center, and wow, do they rise to the challenge, but they need us to help them with their training and education programs to be able to recruit heavily and retain the staff to be able to service. That one size fits all is really, really tough given the circumstances that all of our health centers in all of our areas are so different in scope of need.

Now, what is working? That’s where I love to really push in the promotion for HP-ET programs. I would say it’s the training in place, growing our own, and the apprenticeship programs. When we take that model and figure out who wants to work in healthcare, whether we’re talking clinical or non-clinical, it doesn’t matter, in giving them the opportunity to see and create that vision and mission, that’s the winning combination, not only for recruitment, but also for retention and for satisfaction of being on the job.

When we’re able to train a healthcare worker in the location that they will be servicing patients, that’s the magic, that’s the secret sauce because you are able to build that mission at the same time that you’re building the training program. Apprenticeship means that folks are coming in, they’re training on the job, they’re working at the same time that they’re learning, and they’re working with the population that they will continue to work in. And they fall in love with it.

So it’s really building the mission at the same time that you’re building a health team. That’s what gets us excited because we see time and again, that’s the recipe for success. It’s getting us our strong and diverse workforce because we’re pulling from the community that also is a patient, and it’s giving those skills within the community health center and the migrant health center that will continue to build career ladders as that person works over time within our center. Our apprenticeship programs are really designed not just to give a skill and then have them go on to somewhere else. It’s to give a skill and work on a career within the health center that they trained in.

Helen Rhea Vernier: That’s beautiful, and I love the way you describe this coming together of these different pieces and tying in our mission as health centers individually and as an entire movement into how we have this opportunity to train new clinicians as well as health center staff who are non-clinical. Thank you so much for sharing.

You kind of have touched on this a little in other answers, but I’d love to know more about how you’ve seen HP-ET programs affect staff recruitment and retention at health centers in your region.

Robyn Weiss: Yeah, absolutely. We kind of dive into it in a couple different aspects. I’ll talk about them briefly, each one of them. We have a pathways program, which is really bringing community into our health centers, but we also have a career ladder. The career ladders is essentially a part of the program to make sure that we are bringing everybody up to the level that they need to work at. If you’ve mastered one skill, it’s time to move up into the next skill, and it’s really giving satisfaction to the job as well.

Either way, we’re growing our own. It’s a neat concept that the health centers have really latched onto. Let’s talk a little bit about pathways. Pathways is really bringing folks from the community or from an educational establishment or an academic institution into our health centers to learn the mission, to learn the values, to understand our very unique patient population.

It can start in junior high and high school. So a lot of our community health centers have outreach programs in our region. A great example of that is actually NEW Health University up in Colville, Washington, kind of a remote area up in Eastern Washington. There’s not a whole lot around. There are some academic institutions a little bit below in Spokane, but they’re kind of isolated up there and they realize that problem right off the bat.

What they did is they built their own internal university, and then they go and recruit all the way down into the junior high level. Do you want to be a doctor? Do you want to be a nurse? Do you like working with vision? Do you like working with patients in behavioral health? They introduce junior high kids to all of these different areas of medical need or medical necessity that they’re going to have in their community health center.

And then they foster that all the way up through high school and eventually have a university within their system where kids can actually start learning in high school. They’ll go half day to high school and half day to the community health center, and they’ll start working to be a medical assistant apprentice. They’ll start working in the front office. They’ll start working in the IT department, in the HR department.

Clinical, non-clinical, it doesn’t matter. And what’s really neat about that is they’re giving opportunities to the entire community this way, and parents are seeing this. They’ve actually had kids that are recruited into their NEW Health University, and then they’ve had parents that will join in for the same type of training. So they are building their needs for a stable workforce right there from their community pipeline. It’s absolutely fantastic. That’s called a pathways program.

But to go a little farther into it, let’s talk a little bit about career ladders. Now, career ladders in a community health center, because it is just a tight-knit group, it means that when you are recruited in and you’ve got that training to be in the front office, but you really are seeing how neat going into the oral health side, you want to be a dental hygienist, or you see how great it is what an MA does, a medical assistant does, career ladders, let’s get you trained and start working and start experiencing those areas so that you can move up your level of education and move into a new area.

But this goes for the non-medical side too. So it’s front office or maybe you came in as a medical assistant, but you really love the area of IT or HR. It’s moving into the areas, learning on the job, and working to create skills for that next move up.

We have MAs, front office to MA to RN to COO, chief operations officer. The sky’s the limit. When you get into a community health center and you understand the mission and you understand the importance of working with patients in your community, it’s really where do you want to go? Where do you see it leading to? And how the community health center can not only help the patients, but help the staff in whatever training they want to do.

It’s a pretty neat system that we not only are supporting the patients in the community, but we’re supporting our own, our own internal workforce to keep that retention, keep that satisfaction, keep raising up to the levels where they want to go. So it’s a great system.

Helen Rhea Vernier: Yeah, that all sounds so awesome. I know often here at the STAR² Center we refer, like you’re saying, to the Health Center mission and talk about how of course we’re here to serve the community, but like you’re saying, to turn that mission inward and make sure that we are serving our staff as well. And this seems like such a great way to live that mission and support the community that is your staff and clinicians. Of course, they are part of the community that you’re serving. And so I love this model. It’s so great.

Robyn Weiss: Oh, you know what’s really neat too, and time and time I’ve seen this as I talk with folks across the country that are also doing HPET programs, is we may have somebody leave our community, it happens, spouses get a job somewhere else or whatever the case may be, but oftentimes we will have somebody that works in the community health center, understands the mission, and has such a connection with that, that they will go seek out employment wherever they end up at a community health center.

We are all sharing in the same system, which is expansive. You can find a community health center anywhere. As I mentioned earlier, they are in urban centers. It’s a big part of our urban centers are community health centers. They’re in tribal, they’re in rural, and they’re in frontier. So wherever you go, you already have family. You’re part of a mission, you’re part of a vision, you’re part of a program to help that commitment to equitable outcomes. So I love that story as well.

Helen Rhea Vernier: Yeah, I absolutely love that. There’s the saying in the health center movement, you’ve seen one health center, you’ve seen one health center, but at the same time, you’re so right that it’s such a privilege that we get to be part of this larger movement and community. Like you’re saying, yeah, if you have to leave your health center for whatever reason, you can still go and just plug into another place that again has maybe a different specific mission, vision, values, et cetera, serves a different population or whatever, but has this base, this foundation in-

Robyn Weiss: The core values.

Helen Rhea Vernier: Yeah, their core values are in social justice, health equity, access. And that is just so inspiring to me. It’s one of my favorite things about the health center movement is again, this piece of they’re all different and also we’re all connected via these core pieces.

Robyn Weiss: Absolutely, yes.

Helen Rhea Vernier: I love that idea. And then to your point about NEW Health University, I know when I was in middle school, I knew a little bit about the health center in my town, but I didn’t have this understanding that NEW Health is offering to, like you said, kids as young as middle school of the variety of positions that one could hold within the healthcare sphere or at a health center specifically. And so I love that they’re starting folks so young in that.

Robyn Weiss: There really is a place for everyone in a community health center. The job opportunities are just so broad. There’s also place once you’re inside of the community health center for movement. So it’s not a dead end job by any means. It just takes that exploration to learn what it is that you want to accomplish and then set your sights and go.

Helen Rhea Vernier: Yes, totally. I love that. I’m so inspired by this conversation. I love talking about this stuff.

Robyn Weiss: Yeah. I think our region, which is Region 10, the Northwest Regional Primary Care Association does a great job of, we have conferences, we have webinars, we have all kinds of different programming to really push out to our community health centers that they’re not alone. That information of what Alaska’s doing is filtered down into Washington. What Idaho’s doing is connected to what Oregon’s doing. And then we have the national scope, so we can always bring in other training as needed to give that support.

When you’re in a community health center, no matter if you are big and you have 25 locations, or you’re small and you have a staff of four and you’re on an island, it doesn’t matter. We’re part of a bigger program, and whatever you need, that HP-ET programming is going to be there to support.

Helen Rhea Vernier: Yeah. Awesome. I just have one more question for you. What recommendations, tools, or resources do you have or would you recommend for a health center that’s just starting to plan or to build their own HP-ET program?

Robyn Weiss: Sure. Absolutely. The first thing is really to, again, kind of do that gap analysis. Try to figure out what your needs are. If you have a great physician, but you don’t have enough MAs, medical assistants, to help run that office, you’re not going to see as many patients. Maybe that’s your holdup. Or maybe it’s really hard to recruit a physician to your area, and that’s where you need to grow your own. The Grow Your Own Program can be at almost any level.

The first is to find out really what your needs are. Find a champion within your organization. Maybe it’s on your board, maybe it is your physician or your HR. Find that champion that truly wants to help you walk that walk, talk that talk, and build an HP-ET program, a health education professional training program, of your own.

And then there’s all kinds of resources out there. Just to give you a couple of examples, there is a website that can give you all kinds of information on building a residency program. What’s neat about this, this is for recruitment of physicians, bringing dentists and doctors to your community to train.

What we found it is more likely that where you train is where you’re going to stay because you’re going to put down roots. You’re going to fall in love with your community. So having these doctors and dentists and psychiatrists come to your community to train is a really great way to do that Grow Your Own Program.

It’s THCGME.org. THCGME stands for Teaching Health Center Graduate Medical Education dot org. That really has a lot of resources on how to build a residency program within your health center.

Another one is one that actually NWRPCA sponsors, and that’s educationhealthcenter.org. The education health center program that we run has a guide. It’s HRSA sponsored. HRSA is the Health Resource and Services Administration. And it is an actual guide on how to build an HP-ET program.

Now, it kind of has a focus on residency, but you literally can use it to start any HP-ET program, any Grow Your Own Program. It talks about everything from how to get your organization started, how to do finance, legal considerations. It’s got everything in there. So tap into our website here at Northwest Regional or the educationhealthcenter.org, and you can get that free guide from HRSA.

The other thing that I would highly recommend is looking at your specific state. By doing that, you’d want to go to your primary care association. So wealth of resources right there on any HP-ET program that your state specific is promoting. California, my goodness, you go onto their website, they have just tons of resources, Michigan, tons of resources, New York, Arizona, Florida. The primary care associations have really done a great job, again, being backed by HRSA of putting together programs for training and building your own HP-ET program within your health center.

The HP-ET initiative itself is really there to help the health centers recruit, develop, and retain workforce. That kind of says it all. Things to tap into, that TCHGME.org, the educationhealthcenter.org, as well as any of your PCAs in your state, you’re going to find a wealth of information. By the way, they don’t mind sharing with each other. So you could be in Michigan and tap into California for resources and vice versa. We’re all in it together.

Helen Rhea Vernier: Beautiful. Thank you so much. We love giving those tangible resources to folks as they’re getting started on these programs. And I think those are some really great places to start. So thank you so much for sharing those. Is there anything else you’d like to add before we finish up?

Robyn Weiss: I think that you all at the STAR² Center have done just an awesome job of building that network, your resources are incredible, and just kind of pushing out a product that we all can use. So you’re a great resource as well.

Helen Rhea Vernier: Thank you so much. We love that. Well, Robyn, thank you so much for joining us today and sharing your wisdom. And listeners, thank you for tuning in. We hope today’s conversation provided you with ideas, suggestions, and insights into ways you can approach health professions pathways programming for recruitment and retention.
Be sure to check out all of our free workforce tools and resources, which can be found at chcworkforce.org, and check out all NWRPCA has to offer at nwrpca.org. Thank you again, and we’ll see you next time.