Rhode Island will at last get its own set of Area Health Education Centers
under a federal program aimed at reaching underserved minority and uninsured
populations. The hope is that the centers may one day become self-sustainable
small businesses.
The initial three-year grant for $2.6 million will first result in the creation of a program office to be housed at grant recipient Brown University. Three area health centers based in “underserved areas” will follow shortly – a site in Providence within the Rhode Island Health Center Association will open this fall, followed by centers at Thundermist in Woonsocket (October 2005) and New Visions in Newport (October 2006). Dr. Arthur Frazzano, the associate dean for clinical faculty at Brown Medical School, will serve as director of the new program.
“This is going to result in improving the supply, distribution, diversity and quality of health care providers in Rhode Island,” Frazzano said.
Area Health Education Centers were created in 1972 and are funded by the Health Resources and Services Administration, an agency within the U.S. Department of Health and Human Services. The goal of these academic-community partnerships is to increase access to care in medically underserved areas – from poor inner cities to remote rural counties.
The local centers will serve three functions: to create training programs for medical, nursing and pharmacy students; to recruit more poor and minority high school students into the health professions; and to offer continuing education programs to improve disease prevention and primary care.
Frazzano said the idea is that although the centers will initially depend on grants for their operating expenses, they will eventually become self-sustaining small businesses over the long term. He said area health centers have been run very successfully in Massachusetts for the last 20 years and in Connecticut for about the last eight. And though individual centers don’t open their books, Frazzano said he has heard a number of success stories from other programs. In particular, he mentioned a North Carolina center where doctors and students are paid by towns to fly into remote stretches in the state’s western regions to deliver services.
The initial grant is renewable for up to a dozen years, hopefully enough time for the centers to become self-sustainable. Only five states are without an area health center, which Frazzano attributed to the grant program. Frazzano said the grant application process has moved forward in “fits and starts” over the last four years, with a concerted effort in just the past couple as the state’s minority and non-English speaking populations have grown.
Among a variety of other agencies, there have already been talks with the nursing programs at Salve Regina University, Rhode Island College, the Community College of Rhode Island and the University of Rhode Island (along with URI’s College of Pharmacy) about their participation. Frazzano added that he’s willing to talk with any organization about how they can get involved.
The first phase of the grant will bring $500,000 into the state and Frazzano said the hope is that the state government will kick in at least another $50,000, hopefully through a state Senate grant. Brown has already agreed to contribute another $193,000.
Each year, the amount of the federal grant doled out will increase as more centers come online, paying for expenses like rent, supplies on hand, and things like a computer and travel stipends. The federal agency has recommended that Brown receive an additional $2.1 million over two years to support the anticipated growth. Frazzano hopes that the state will see the 10 percent request as reasonable, noting that Rhode Island is likely to make back its money in the first year thanks to the taxes generated by an anticipated 8 to 10 jobs that will be created.
A “doctoring program” is already planned to run out of the Brown program office beginning next fall. First- and second-year medical students at Brown will be paired with mentors and will be required to spend a certain amount of their time caring for patients in those underserved areas.
Frazzano said students often go to volunteer at clinics, but without an attending physician overseeing their work, are not allowed to treat patients. The grant may help ensuring that the school provides at least one student and doctor a night at a particular clinic.
Frazzano said the centers won’t necessarily be doctor-oriented, instead focusing
on providing whatever resources a particular community needs. He said one of
the best examples might be the need for interpreters – while programs are offered
at some area hospitals and clinics, he said too often doctors resort to pulling
members of the housekeeping staff into their office to serve as an interpreter
to patients.
“In Rhode Island, there are serious social and economic obstacles to health
care,” Frazzano said. “But Rhode Island is small and we’re pulling together.
Brown Medical School has a role to play in eliminating health disparities. Part
of our mission is to turn out socially responsible doctors, which is why we
pursued this program.”
