Application for Community-based Practice Sites Kraft Fellowship Program and/or Kraft Practitioner Program Program Year: July 2013 – June 2015 Deadline: November 15, 2012 Background The Kraft Family National Center for Leadership and Training in Community Health is seeking community health centers, or similar health care organizations serving a diverse, primarily low-income patient population, to serve as clinical practice sites for its two-year Kraft Fellowship Program and/or its two-year Kraft Practitioner Program. Selected community-based practice sites will have the opportunity to participate in one or both of these innovative programs, the goal of which is to prepare clinician-leaders who can help build the field of community health and ensure the delivery of high quality care in community-based settings that serve predominately diverse, low- and moderate-income individuals and families and underserved communities. The Massachusetts League of Community Health Centers, an important partner in the development of the Kraft Center, and community health center leaders themselves have participated in developing the selection criteria for community-based practice sites. These criteria have been designed to ensure the highest quality community-based learning experience for participants in Kraft Center programs. More details about the Kraft Fellowship Program and the Kraft Practitioner Program, and the expectations for the community-based practice sites associated with each, follow: Kraft Fellowship Program The Kraft Fellowship Program offers talented, mission-driven physicians the opportunity to practice in underserved communities while at the same time developing leadership and/or research skills, increasing their understanding of the social determinants of health through academic study, and positioning themselves for careers as academic-community providers. Community-based practice sites are a key component of the Kraft Fellowship Program, providing Fellows with hands-on clinical experience in a community 1 setting, as well as mentorship from seasoned clinicians well-versed in the specific needs of underserved groups. Specifics as to the role of community-based practice sites in the Kraft Fellowship Program include the following: Provide Kraft Fellows with appropriate clinical practice time – typically, three sessions per week that may include both continuity clinics and urgent care. [Practice sessions must accommodate Fellows’ coursework at the Harvard School of Public Health and other learning experiences offered by the Kraft Fellowship Program]. Designate a primary clinician-mentor for Kraft Fellows. The clinician-mentor will: orient the Fellow to the community-based practice site and its community; provide opportunities for the Fellow to observe and discuss how patient care visits incorporate social determinants of health and include appropriate referrals to community resources; and serve as an ongoing learning resource and sponsor for the Fellow within the site. Contribute to and provide guidance for the Kraft Fellow’s “substantive project,” which will reflect the interests of the community-based practice site and may include: participation in a community-based participatory research project; design and implementation of a quality improvement initiative; or a policy and/or program development project related to an identified need in the community served by the practice site. The priorities of the communitybased practice site will inform the project’s development. Insights and support will also be provided by the Fellow’s clinician-mentor, by Kraft Center faculty, and by Harvard School of Public Health faculty with an interest in the project’s content and/or methodology. Provide opportunities for Kraft Fellows to: participate in multidisciplinary clinical and administrative teams; have access to both the practice site’s Executive Director and Medical Director; engage in appropriate leadership development activities; and participate in practice site-sponsored community initiatives, all with a view to enhancing Fellows’ learning about community-based care and community health. Kraft Fellows will begin their clinical practice at community-based practice sites in late August/early September 2013. Fellows’ salary and benefits will be supported by the Kraft Center; patient care revenues generated by Fellows will accrue to their host community-based practice site. Kraft Fellows come from a variety of disciples, including internal medicine, primary care, family medicine, pediatrics, obstetrics/gynecology, and psychiatry. Both Fellows and selected community-based practice sites will participate in determining clinical practice placements for individual Fellows, and it is a goal that Fellows will continue to practice at their host site following completion of the program if desirable and feasible for both parties. 2 Kraft Practitioner Program The Kraft Practitioner Program is designed to attract, develop, and retain physicians and masters prepared nurses, including advanced practice nurses, for careers in community health centers and similar settings. The program responds to the stated need of community health centers for a stable, sustainable workforce of excellent clinicians to care for their patients. Community-based practice sites selected for the Kraft Practitioner Program will have the opportunity to nominate their physicians and masters-prepared nurses to participate in the program as Kraft Practitioners. The Kraft Center will reimburse community-based practice sites for 20% of Kraft Practitioners’ time, thus enabling them to take part in the training and career development activities offered by the program. Expectations for community-based practice sites selected for the Kraft Practitioner Program include the following: Nominate up to two clinicians (physicians and/or masters-prepared nurses) to participate in the Kraft Practitioner Program. Ensure the 20% protected time component of the program, as well as provide scheduling flexibility so that Kraft Practitioners can participate in Kraft Center monthly formal day-long learning sessions, as well as other learning opportunities; Work with their Kraft Practitioners to identify a community health or quality improvement project that is a priority for the community-based practice site. Provide Kraft Practitioners with an on-site mentor for that project. Meet with Kraft Center leadership at regular intervals to review their Kraft Practitioner’s progress, and provide overall support for their own Practitioners, the Kraft Practitioner Program, and the Kraft Center. Physicians and masters-prepared nurses selected for participation in the Kraft Practitioner Program will be expected to engage fully in program activities, including: Prepare for, attend, and actively participate in monthly Kraft Center learning days. Complete a community health or quality improvement project, selected in consultation with their community-base practice site’s leadership and guided by an identified on-site mentor. 3 Develop career goals and a professional development plan that includes selfdirected and peer learning components. Upon completion of the Kraft Practitioner Program, Kraft Practitioners will be expected to remain committed to their community-based practice site, developing into leadership roles as appropriate, serving as mentors and role models for new clinicians beginning their careers in community-based settings, and helping to build the capacity of the practice site to attract and retain the next generation of clinicians. Eligibility and criteria for selecting community-based practice sites Key criteria for community-based practice sites participating in the Kraft Fellowship Program and/or the Kraft Practitioner Program are outlined below. Applicants to both programs will be required to submit socioeconomic data on their patient populations, as well as evidence that they are able to meet all applicable selection criteria. Key criteria for all community-based practice sites: Serve a diverse, primarily low-income patient population Engage actively in assessing and responding to community needs Demonstrated prior experience with and participation in quality improvement initiatives Key criteria for Kraft Fellowship Program community-based practice sites: Demonstrated capacity and commitment to supporting Kraft Fellows at a level comparable to the supports provided to current clinicians, in terms of: available practice sessions; space; clinical and administrative support; and participation in multidisciplinary team care. Have a need and/or place within the site’s practice for a clinician from one or more of the disciplines (including internal medicine, primary care, family medicine, pediatrics, obstetrics/gynecology, and psychiatry) represented by the current cohort of Kraft Fellows. (Please note that the selection process for Kraft Fellows and thus for community-based practice sites seeks to ensure diversity and appropriate balance among these disciplines). Provide Kraft Fellows with an identified primary clinical mentor. Model shared leadership with the Chief Medical Officer or Medical Director participating in goal-setting, strategy development, and decision-making for the practice site. Be a patient-centered health home or have a commitment to practicing using team-based care. Due to the need to coordinate Kraft Fellows’ clinical practice schedules with course offerings at the Harvard School of Public Health, the 2013 cohort of Kraft Fellowship 4 Program community-based practice sites will be selected primarily from sites in the Greater Boston area for this year of the Fellowship. Key criteria for Kraft Practitioner Program community-based practice sites: Demonstrated commitment to attracting, developing, and retaining excellent clinicians. Capacity to support a Practitioner, including: arrangements for 20% protected time; assignment of one or more project mentors; and scheduling flexibility to participate in monthly day-long structured learning sessions. Capacity to identify one or more potential community health and/or quality improvement projects in collaboration with the Kraft Practitioner Commitment on the part of practice site leadership to participating in relevant Kraft Center activities. Kraft Practitioner Program community-based practice sites will be selected from sites throughout Massachusetts for this year of the program. Selection of Kraft Practitioners: Community-based practice sites selected for the Kraft Practitioner Program will be required to nominate up to two clinicians (physicians and masters-prepared nurses) to participate in the program. Each nominated clinician must be within the first five years of their community-based practice career and must submit a statement of interest accompanied by a letter of recommendation from the practice site. The Kraft Center will review the applications and select a cohort of approximately sixteen Practitioners for the current program year. The selection process will seek to ensure that the cohort of Kraft Practitioners includes diversity and appropriate balance in terms of professions (physicians and nurses), discipline (internal medicine, primary care, family medicine, pediatrics, obstetrics/gynecology, and psychiatry), and practice site characteristics, including populations served and the nature and types of community programs available at the site. The selection process may include candidate interviews, as well as conversations with leaders at the nominating practice site. More information on the Kraft Practitioner selection process will be made available to participating community-based practice sites. KRAFT CENTER FOR COMMUNITY HEALTH COMMUNITY-BASED PRACTICE SITE APPLICATION FORM Once completed, please email this application form by Thursday, November 15th to: Tara Murphy, Administrative Director, Kraft Center for Community Health at tmurphy15@partners.org 5 Name of organization Address Contact person Email: Phone: Executive Director (name and years in position) Medical Director/CMO (name and years in position) Applying for: o Kraft Fellowship Program o Kraft Practitioner Program o Both All applicants must complete the following sections: Description of patient population Number of patients Number of visits Unique number of patients below 200% of federal poverty level Racial and ethnic composition (please provide %) Please describe briefly (in no more than 75 words per item) the practice site’s experience in the following areas: Clinical teaching Clinical research Quality improvement projects Community programs 6 Progress toward becoming a patient-centered health home Applicants to the Kraft Fellowship Program must complete the following: Please describe briefly (in no more than 75 words per item) the practice site’s anticipated arrangements to support a Fellow: Practice sessions and appropriate practice space Clinical and administrative support Participation in a multidisciplinary care team Potential clinical mentor(s) Please identify Potential mentor(s) for scholarship project Please describe the organizational leadership model and roles of Chief Executive Officer/Executive Director and Chief Medical Officer/Medical Director Applicants to the Kraft Practitioner Program must complete the following: Please describe briefly (in no more than 75 words) the practice site’s experience with recruitment and retention. Please describe briefly (in no more than 75 words per item) the practice site’s anticipated arrangements to support a Kraft Practitioner: Arrangements for protected time One or more community health and/or quality improvement projects Potential project mentor(s). Please identify and describe. Please describe the ways in which the organizational leadership at the practice site will engage with the Kraft Practitioner Program – e.g. hosting a learning session, sharing expertise and leadership development experiences 7 with Kraft Practitioners, and developing career paths and further professional development opportunities for Kraft Practitioner Program graduates. Given that we plan to use technology to facilitate Kraft Practitioner learning, please indicate the extent to which your practice site have the technical capacity to support virtual learning -- e.g. availability of space and a computer with Web access for use by the Kraft Practitioner; access to video conferencing; etc. (These are not requirements). We are interested in selecting a cohort of Kraft Practitioners that represent diversity across professions, disciplines, and practice experience. If you are selected as a community-based practice site, we are interested in your current thinking about the characteristics of your potential nominees in the following areas. (We are not expecting identification of particular individuals at this point): Profession (physician or nurse) Discipline (internal medicine, primary care, family medicine, pediatrics, OB/GYN, and psychiatry) Priority for your practice site – recruiting a new clinician or retaining relatively new clinicians (1-5 years in practice) 8