Applications open for ICHS’s ARNP residency program: Preparing a future generation of primary care providers

ARNP residency program, Rebecca Calderara, Holly Park clinic
Resident Rebecca Calderara with a patient at ICHS’s Holly Park Clinic.

After completing her nurse practitioner program, Megan Wilbert wanted additional training that would help take her from the classroom to confidently caring for patients. Wilbert’s feelings are common – and driving interest in residencies as the future of nurse practitioner training.

“Your learning is a lot more accelerated than an MD and you have no residency with the exception of clinicals, which can vary,’ said Wilbert, ARNP at International Community Health Services (ICHS) clinic in Shoreline. “I’m so grateful I did it. It’s a huge transition to suddenly be responsible for patients.”

Wilbert doesn’t just work at ICHS, she was also part of the first cohort of participants in the community health clinic’s ARNP residency program, now in its fifth year. The groundbreaking program, the first to be accredited in the U.S, offers an example of the career- and knowledge-enhancing benefits a residency brings.

ICHS’s ARNP residency program prepares newly licensed and certified nurse practitioners for careers as primary care providers in a community health setting. It remains one of the most innovative and leading programs nationally after being pioneered by ICHS provider DoQuyen Huynh, ARNP, DNP. As part of her doctoral thesis, Huynh wanted to develop a training program for new family practice providers that would teach essential skills for serving patients with complex health needs and addressing systemic inequalities. Huynh was named Washington state American Association of Nurse Practitioner of the Year in 2016 for her work.

“ICHS’s unique population of immigrants and refugees made it the perfect place to develop and evolve this program,” says Huynh, who serves as the program’s director. “Each year, we’ve made changes to the curriculum to meet individual resident needs. We are viewed as a leader and many programs in the region mirror ICHS’s curriculum.”

Kelli Hiraoka, ARNP, said she immediately felt a strong connection. “I recall visiting ICHS on my interview and feeling inspired by the staff and workplace,” she said. “Each day is unpredictable, exciting and stimulating. You might be inserting a nexplanon procedure for contraception, managing an insulin-dependent diabetic, investigating why that six-month old kiddo has a persistent fever, or telling your female patient she’s finally pregnant after six months of trying. Or you could be helping a patient with heart failure who does not take his meds due to financial constraints, or an adolescent struggling with self harm and suicidal ideation.”

Participants credit Huynh’s strong leadership and the program’s high quality as selling points. Ongoing structure and support are built into the curriculum, which offers a ramp up schedule, continual education with weekly didactics and exposure to different clinical specialties. Another highlight is a mandatory community project – each cohort is responsible for developing a population-focused solution to a current health challenge. Past projects led to the creation of ICHS’s Young Adult Center, the first teen health center in Shoreline, and a video storytelling initiative advocating for funding for Medicaid and community health centers.

“I absolutely loved the residency and feel like it has prepared me well for the transition into independent practice. The ability to have dedicated preceptors, with decades of primary care experience was critical in my development as a clinician and has given me a strong footing for working in the challenging world of community health,” said Dan Gundry, ARNP, fourth cohort participant. “The entire team at the ICHS Holly Park Clinic is incredibly warm and welcoming, so I felt at home right away. I’m very thankful for the opportunity and would highly recommend it.”

ICHS also provides tools for building a sustainable career that fuels passion while avoiding burnout. Participants are taught how to manage the necessary but time-consuming behind-the-scenes work of a provider. Wilbert recalls ICHS providers candidly telling residents they needed effective time management and then coaching her cohort on efficiency and clinic flow, and how to develop better charting, diagnostics and lab management skills.

“I see other colleagues who didn’t get a residency and there tends to be a high level of burnout,’ said Maura Carroll, ARNP, DNP, a participant in ICHS’s second cohort. “It gave me a solid skill set and supported my professional goals in community health.”

ICHS’s ARNP program residents are scheduled to work together, which Wilbert credits as another plus. “I loved the cohort I worked with,” she said. “It was awesome to have two other people to bounce ideas off of and support you. Going through the experience side-by-side is extremely helpful.”

Not surprisingly, many of ICHS’s ARNP residency program participants have opted to stay on at ICHS after graduation, a bonus for ICHS when it comes to recruitment.

“ICHS used to have a difficult time recruiting providers, including nurse practitioners. Since the residency, we’ve been able to fill all vacancies,” said Huynh. “We have the added confidence of knowing residents are well prepared to provide holistic care to our diverse and complex patient population.”

“I could not imagine anywhere else I would want to work. I loved the staff, support and mission at ICHS,” said Hiraoka, who now works at ICHS’s Holly Park Clinic. “There is passion and commitment to improve the lives and wellness of all, regardless of sex, background, income level and insurance status.”

As ICHS continues to invest in ensuring a future pipeline of qualified health professionals, Huynh would like to expand the program to include physician assistants, and to offer consultation and support for regional programs from other organization.

Applications for ICHS’s 2019-2020 ARNP residency program are currently being accepted until March 25, 2019. Click here to apply and for more information.

ICHS promotes healthy aging with hire of PACE medical director

International Community Health Services (ICHS) today announced Eric ‘Ric’ Troyer, MD has been hired as medical director of its proposed Programs of All-Inclusive Care for the Elderly (PACE), an innovative Medicare and Medicaid program that provides comprehensive health care and services to meet the needs of frail adults 55 and older. PACE centers aim to keep people in their homes and communities and out of a nursing home. ICHS plans to open a PACE center at Legacy House located in the International District in spring 2019. Previously, Dr. Troyer served as executive medical director of Swedish Medical Group’s continuum of care.

Dr. Troyer brings 20 years of leadership in geriatric medicine to his role at ICHS, where he will be responsible for developing ICHS capacity and programs serving the elderly, with particular emphasis on the PACE model of care. He will direct the delivery of care at the proposed ICHS PACE at Legacy House, which will open in spring 2019, assembling and leading an interdisciplinary care team, and developing and growing related community partnerships.

Studies show that PACE enrollees have better health outcomes – with fewer hospital admissions, hospital days, emergency room visits and preventable emergency room visits – at the same time Medicare and Medicaid realize significant cost savings.

“I’m pleased to welcome Ric to the ICHS team. His expertise will be invaluable as we respond to an aging baby boomer population and evidence pointing to the advantages of programs that facilitate ‘aging in place.’ Not only are there individual and systemic cost savings, but there are also emotional, social and health benefits to consider when people stay in their homes and within their communities,” said Dr. Rayburn Lewis, ICHS chief medical officer. “Ric will bring tremendous insight as we expand delivery of highly coordinated and personalized care for older, frail adults and help them live more safely, comfortably and independently.”

Dr. Troyer led a number of departments and areas of specialty during his tenure with Swedish Medical Group, including starting a transitional care program for recently hospitalized patients in 2011, and serving as the chief of family medicine at Swedish Medical Center, First Hill Campus from 2005 to 2007. He has been on staff as an active physician at Swedish Medical Center since 1998. From 2006 to 2011, Dr. Troyer served as the medical director for Evercare in Washington and Oregon, directing clinical care models for several special needs populations including those with chronic disease, those living in nursing homes, and those with Medicare and Medicaid. Over the span of his career, Dr. Troyer has contributed his leadership to a number of medical directorships and the delivery of geriatric care, alternative health care, chronic disease management and primary care to underserved populations for hospital systems and nursing facilities throughout the Puget Sound area. He was the president of the Washington State Medical Directors Association from 2009 to 2018 and currently serves as an assistant clinical professor with the University of Washington School of Medicine. Dr. Troyer obtained his MD from the Medical College of Virginia and completed his residency at Swedish Family Medicine followed by geriatric and faculty-development fellowships at Swedish and the University of Washington.

ICHS PACE programs address a growing need
The U.S. Census estimates nearly 25% of King County’s total population will be 65 years or older by 2040 — up from about 18%.  ICHS plans to further meet the area’s needs for affordable senior health services by establishing PACE programs. These include Aging in PACE (AiPACE) Washington, a new non-profit organization that partners Kin On and ICHS to open a $20 million PACE center in North Beacon Hill, slated to open in 2021.

Fight the proposed changes to “public charge”

What is public charge?
The Department of Homeland Security has proposed changes to the definition of “public charge” that would expand the criteria that apply when a person is applying for admission to the United States or seeking a green card or legal permanent residency.

Historically, those applying for permanent status must demonstrate that they will not be dependent on government programs (cash benefits like Temporary Assistance to Needy families/TANF, SSI and long-term care). The proposed regulation would expand the list of federal benefits that the government may consider as part of its process, to include:

  • Medicaid
  • Medicare Part D (low income subsidy for prescriptions)
  • Federal Housing (Section 8 housing vouchers and any Section 8 housing)
  • Supplemental Nutrition Assistance Program (formerly known as Food Stamps)

ICHS believes this proposal undermines public health and humanitarian values as it continues to attack immigrants seeking legal residence in the U.S.

Our communities must make public comments by December 10 to stop or delay the adoption of this proposal. All comments have to be reviewed by the government prior to adoption. ICHS urges patients, families and communities to stay calm and take action to:

  1. STOP FINAL ADOPTION OF THE NEW REGULATION. ICHS is working with Protecting Immigrant Families, Association of Asian Pacific Community Health Organizations and the National Association of Community Health Centers to try and stop the proposal’s final adoption by generating as many public comments as possible by the Dec. 10 deadline. You can submit as many comments as you want, but each comment must be unique.
  1. GET THE SUPPORT AND BENEFITS YOU NEED NOW. The proposed rule is not in effect and will take months to be adopted because of the public comment, review and response period that the federal government has to legally observe. Anyone currently legally qualified to participate in Medicaid, Medicare Part D, public housing and SNAP is still qualified to use them. 
  1. NOT ALL IMMIGRANTS ARE SUBJECT TO THE “PUBLIC CHARGE” TEST. Exempt are U.S. citizens; green card holders; refugees; asylees (applying for or granted asylum); people applying for green cards under the Violence Against Women Act; survivors of trafficking, domestic violence, or other serious crimes (those who have or are applying for “U” or “T” visas); and children seeking Special Immigrant Juvenile Status.

FOR MORE INFORMATION
The City of Seattle has created an overview with Frequently Asked Questions and resources.

Robert Chinn Foundation Award will bring healing arts to Shoreline

Robert Chinn Foundation Award 2018
Left to Right: Teresita Batayola, ICHS CEO, Karen Wong, Robert Chinn Foundation president, Leeching Tran, ICHS Foundation Board president, and Ron Chew, ICHS Foundation director.

On Oct. 18, Karen Wong, president of the Robert Chinn Foundation, presented a $5,000 grant to International Community Health Services Foundation that will help connect the arts with health through a vibrant community arts space at the Shoreline Clinic.

The grant will help extend the clinic’s capacity for community-curated arts exhibitions that focus on community, social issues and topics related to health care and wellness. This year, the clinic opened a historical exhibit telling ICHS’s 45-year story and highlighting its milestones. ICHS plans to extend the exhibit area to additional space.

“We’re appreciative of this generous gift from the Robert Chinn Foundation and what it allows us to create,” said Ron Chew, ICHS foundation director. “So often public spaces are sterile and even unwelcoming. Our community gallery elevates our lobby space to encourage reflection, connection and beauty.”

The Robert Chinn Foundation Grant Program was established to promote and support programs of nonprofit organizations devoted to art, culture, health and youth development.

Questions about 2019 open enrollment? ICHS is here to help

The open enrollment period to enroll, renew or change health plans through the Washington Health Benefit Exchange starts on Nov. 1 and ends on Dec. 15 for coverage to take effect on Jan. 1, 2020. Unless you qualify for Apple Health or a special enrollment period due to a qualifying event you must be enrolled to ensure there is no interruption in your health benefits and to avoid a year-long wait until the next open enrollment period in the fall of 2020.

FREE help from ICHS
ICHS provides free help for patients and for anyone seeking to enroll or renew health insurance. Plan ahead and schedule an appointment with one of our multilingual outreach and enrollment navigators, who can explain your options and assist with sign up. ICHS staff speak languages including: Amharic, Chinese (Mandarin, Cantonese, Toishanese), Eritrean, Hindi, Korean, Russian , Spanish, Punjabi, Tagalog and Vietnamese,

ICHS will offer walk-in appointments on a first-come, first-served basis on Saturdays at the ICHS International District Clinic (2nd floor) from 9 am to 3 pm. Come see us for help from a qualified navigator on the below dates:


To make an open enrollment appointment or for more information
Call ICHS at: 206-788-3700 or find enrollment information online at: https://www.wahealthplanfinder.org. You can also call or walk into any of our four full service clinics in Seattle, Shoreline and Bellevue.

ICHS press conference advocates against new definition of “public charge”

International Community Health Services (ICHS) and Children’s Alliance, a member of the Protecting Immigrant Rights – WA (PIF-WA) coalition, co-hosted a press conference on Sept. 25, at ICHS’s International District Clinic. A panel of representatives from health, legal and service organizations advocated against proposed changes to the definition of “public charge” that would deny green cards to legal immigrants if they access certain public benefits.

The draft regulation released on Sept. 22, targets a wide range of non-cash public assistance—including Medicaid, food stamps, Section 8 housing assistance and Medicare prescription drug assistance.

ICHS’s Nutrition Services Supervisor Aliya Haq joined representatives from the Seattle Office of Immigrant and Refugee Affairs, OneAmerica, King County Public Health, Northwest Harvest and the Northwest Immigrant Rights Project to emphasize the severe health and human costs should the regulation go into effect. Participants described how half a million Washingtonians could be pushed away from crucial health, nutrition and educational assistance – to far-reaching detriment.

Haq shared stories of ICHS patients who, out of fear of future reprisal, have already denied themselves or their family members benefits, describing the resulting health and human cost as “heartbreaking.”

The panel’s legal expert also shared a strong message that immigrants and their families should not dis-enroll from public benefits in response to the draft rule’s release. If the rule were to become final—which would take several months—immigrants would not be penalized for past enrollment.

The coalition is preparing for the draft’s pending publication in the federal register. Once published, members of the public will have 60 days to file comments in opposition to slow down or block the rule. ICHS and its partners will mobilize to encourage individuals to submit comments, as well as work within communities to ease fears and misperceptions, and ensure continued access to health programs and services.

The coalition emphasized in a press statement, “Above all, families who fear they may be affected by this rule should know they’re not alone, and that there’s time to fight back.”

Aliya Haq, ICHS nutrition services supervisor, contributed as a spokesperson for a panel discussion and Q&A.

ICHS health advocate Veronica Kim named 2018 Molina Community Champion

Veronica Kim, Molina community champion award, 2018
Veronica Kim, ICHS Women’s preventative health services coordinator,was honored with the Molina Community Champion Award. Pictured from left to right, Katterine Nazario, Molina community engagement specialist; Veronica Kim; and Sonia Morales, Molina senior community engagement specialist.

On Sept. 27, Molina Healthcare of Washington Inc., honored Veronica Kim, who served as women’s preventive health services coordinator at International Community Health Services (ICHS) for 25 years, with the prestigious Community Champion Award. The award recognizes Kim’s long-time contributions to level health disparities in breast, ovarian, cervical and colon cancer fatality rates among Asian Pacific Islander (API) and minority women.

As part of the award, Kim generously named ICHS the recipient of a $1,000 gift from Molina.

Kim recently retired from ICHS in August, to pass the torch to an up-and-coming generation of health workers. Her impact upon King County’s women of color, and in particular the Asian American community, has been immeasurable. Her work formed the backbone of ICHS’s Breast and Cervical Cancer Health Program (BCCHP), which connected nearly 2,600 low income people with life-saving screenings and treatment in 2017. Kim also brought the Swedish Cancer Institute’s Mobile Mammography Program to ICHS in 2007 after discovering many women were not making it to their mammogram referrals. Bringing the mobile mammogram clinic onsite to ICHS locations reduced a number of challenges for immigrant and low income women, giving help with scheduling, and reducing transportation and language barriers.

“There is no appropriate value that can be assigned to Veronica’s work within the community,” said Teresita Batayola, ICHS CEO. “When women and their families are scared and uncertain, unsure of where to turn or whom to trust, she is the breast health expert, and social and health service resource, and pillar of Seattle’s broader Asian American community.”

Kim was an early pioneer in addressing minority health within Seattle’s Chinatown-International District, starting her career as a family health worker for ICHS in 1993, when the regional health center was still a small clinic in Seattle’s Chinatown-International District. When the Centers for Disease Control and Prevention offered funding for a program to increase breast cancer screenings for API immigrant women, Veronica was tasked with enrollment – knocking on doors to make home visits, going to churches and community organizations, and patiently waiting at neighborhood venues and businesses to talk to women.

“Many health education materials did not exist in languages other than English in those early years,” said Rana Amini, ICHS health advocacy manager. “Veronica created a library of resources from scratch so the women portrayed in pamphlets reflected the age and ethnicity of her target audiences. She ensured the availability of translation, interpretation and accurate information to empower ICHS patients to make informed, life-saving decisions about their health.”

Veronica also established in-language health fairs for the Korean, Vietnamese and Chinese-speaking communities – bringing health services directly to people within their communities, at no cost. She enrolled women in health insurance and programs for those that could not afford it.

Her work also became deeply personal. When she became a cancer patient and survivor herself, she became even more aware of the challenges faced by those she had served.

“My own experience with breast cancer treatment inspired me to give the best case management possible,” said Kim. “I have been through every step so I know what our patients are thinking and feeling.”

“Veronica inspires us all to do better,” said Ron Chew, ICHS foundation director. “I know very few people who are as optimistic and compassionate as she is. She has a warm smile and kind words to offer those around her.”

Veronica has also been an annual participant and major organizer of ICHS’s fundraising team for the Susan G. Komen Puget Sound Race for the Cure. For more than 15 years, she inspired a high level of participation among ICHS staff.

“Veronica put her heart and soul into building our women’s program,” said Batayola. “She’s changed some women’s lives forever. Because of her, Susan G. Komen has funded us close to 20 years, and continued to fund ICHS’s breast health program beyond their normal five-year cycle. She is one of a kind and I hope she continues to walk with us at Race for the Cure.”

Veronica says she doesn’t plan to leave all of her commitments behind.

“I feel blessed to have had the opportunity to work with such a wonderful, dedicated and amazing group of people for the past 25 years. During my tenure at ICHS I have learned so much. ICHS will always be a special place for me,” said Kim. “I’m excited about what’s ahead and plan to spend some time traveling. I leave soon for a trip to Korea and Hawaii. But even after retirement I will continue to advocate for and work with women.”

Veronica Kim, Molina community champion award, 2018
On Oct. 22, Veronica Kim presented ICHS Foundation Director Ron Chew with a $1,000 gift as part of Molina’s 2018 Community Champion Award.

2018 National Health Center Week: Thank you ICHS heroes

NHCW 2018 at ICHS Bellevue Clinic

From Aug. 12 to 18, International Community Health Services marked National Health Center Week with celebrations that honored our health care heroes and their role making affordable health care available to people, families and communities throughout the region. ICHS looked to the past, present and future with a roundup of events.

A visit from Sharon Turner, U.S. Health Resources and Services Administration’s Region X administrator, recognized ICHS’s achievements as one of the nation’s highest performing health centers. Her visit was part of an announcement of $125 million in awards to 1,352 community health centers nationally and $3.8 million to health centers in Washington state.

HRSA announcement at International Distric clinic during 2018 NHCW

Washington state senators Maria Cantwell and Patty Murray issued statements in support of the federal grants.

“Community health centers play a critical role in making sure patients and families across Washington state, and across the country, have access to quality health care — which is why we need to make sure these centers have the resources they need,” said Senator Murray. “I’m glad we were able to reach a bipartisan agreement earlier this year to help community health centers support and enhance the great work they already do to make sure patients and families in all corners of our country have quality care within reach regardless of income, and I hope we can continue to build on that progress.”

“Community health centers provide essential health care for many of Washington’s most vulnerable patients and communities,” said Senator Cantwell. “Many children and families throughout our state rely on community health centers for primary care, dental care, mental health and addiction services, and other important health needs. I’m proud to support our community health centers, and I’m glad we have secured more resources to foster innovation and deliver high-value care to families throughout Washington state.”

 

The installation of a historical exhibit in ICHS’s Shoreline Clinic gave a nod to the past and ICHS’s 45 years of history.

ICHS: Our Story historical exhibit at Shoreline Clinic, 2018ICHS: Our Story historical exhibit at the Shoreline Clinic, 2018

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Community members were invited to join the celebration with fun games and activities, and voter registration at our clinics in Bellevue, Holly Park and the International District.

2018 NHCW at the international district clinicSigning up a voter, NHCW 2018

Thank you to the many staff, community members, partners and friends who made this year’s National Health Center Week a success!

Click here and here to see more photos and highlights.

ICHS recognized among nation’s highest performing health centers

International Community Health Services (ICHS) today announced it is among 1,352 community health centers nationally that have been selected for $125 million in federal awards from the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services. In issuing the grants, HRSA further recognized organizations exceeding national quality benchmarks as National Quality Leaders and those with the best overall clinical performance as Health Center Quality Leaders. ICHS was awarded both distinctions.

“ICHS’s consistently high quality care and outstanding clinical performance have earned a place of honor among Washington’s health centers. We have been named a Health Center Quality Leader every year since 2014, and a National Quality Leader in 2014, 2015, 2017 and 2018,” said Teresita Batayola, ICHS CEO. “These awards are based on overall patient health data as a result of our care. We are proud of this record of achievement. ICHS is an example of the exceptional value our nation’s system of community health centers routinely deliver, providing comprehensive care at significantly lower cost to millions of Americans.”

HRSA’s Quality Improvement grant awards promote continued improvements in expanding access to comprehensive care, improving care quality and outcomes, increasing comprehensive care delivery in a cost-effective way, addressing health disparities, advancing the use of health information technology, and delivering patient-centered care. ICHS’s exceptional results and standards in seven out of eight of these categories led to a grant award of $249,174.

“Being a quality leader means that ICHS patients are more likely to achieve desired health outcomes,” said Dr. Asqual Getaneh, ICHS medical director. “This points to the success our clinics are achieving across the life span from healthy pregnancies, well child care, and management of chronic conditions like diabetes. This grant will further ICHS’s efforts to widen access to high quality, affordable care among underserved communities and bring better health to greater numbers of the state’s residents.”

The award was announced at ICHS’s International District Clinic by Sharon Turner, U.S. Health Resources and Services Administration’s Region X administrator, during National Health Center Week, the annual celebration that highlights the critical role community health centers play in providing high-quality, affordable, primary health care.

“I commend ICHS for being recognized as a National Quality Leader,” said Turner. “It’s a pleasure to be here and to celebrate HRSA’s partnership with ICHS and community health centers across the nation in providing high-quality, affordable primary care.”

For a list of 2018 Quality Improvement Award recipients, visit: https://bphc.hrsa.gov/programopportunities/fundingopportunities/qualityimprovement/index.html.