MRT Innovations in Social Determinants of Health Initiative

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Q1 Please provide your contact information below.

Name


Title and Organization







lentini

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Lori Lentini, William Kaplan, Linda Romano, Margaret Deyo Allers

Senior Vice President of Human Resources and Talent Management, Access: Supports for Living; Founder and Chairman of the Board, Newburgh Armory Unity Center; Health Science Education Teacher, Newburgh Enlarged City School District; Vice President of Patient Care Services and Chief Nursing Officer, St. Luke´s Cornwall Hospital

15 Fortune Road West

Middletown

NY

10941

llentini@asfl.org

845–673–7122


Q2 Please describe your company or organizations overall goals and mission.

Project Hire is a collaborative community project that brings together the Newburgh Armory Unity Center (NAUC), The Newburgh Enlarged City School District, Newburgh Free Academy (NFA), Access: Supports for Living (Access), and St. Luke´s Cornwall Hospital, a member of the Montefiore Health System (SLCH). Each of the partners are deeply invested in improving the community by having a positive impact on the lives of their students, employees, and patients; resulting in improved health outcomes and reduced poverty. Students are educated and prepared to be qualified applicants for rewarding careers in healthcare who then provide high quality care to their patients. The missions of each individual partner intersect through their values to ensure a well–educated, fully engaged, healthy community and together support Project Hire.

The mission of the Newburgh Armory Unity Center is to provide a diversity of educational, athletic and personal development programs, in partnership with other community organizations, while promoting civic unity among people of diverse racial, ethnic, religious, and economic backgrounds and conditions. The mission of the Newburgh Enlarged City School District is to inspire students to become tomorrow´s leaders with the vision that through the work of all, we will achieve inclusive excellence.

Access: Supports for Living´s mission is to help people live the healthiest and fullest lives possible, particularly for those living with the challenges associated with developmental disabilities and behavioral health issues.

St. Luke´s Cornwall Hospital´s mission is to provide exceptional health care that improves the lives and wellbeing of individuals living in the hospital´s service area of Orange, Ulster, and Dutchess Counties.

The missions are each unique yet a common thread unities them: to help develop the resources needed in the community to support people to live healthier lives in their home community.

The goal of Project Hire is to prepare youth for higher education and a career in health care through a comprehensive program that supports and enhances educational achievement in a traditional public–school setting. The program provides a pathway and exceptional opportunity to build critical health care literacy, knowledge, and skills starting at the K–6 level which carries through High School resulting in them attaining sustainable full–time employment. Early skills include safety, critical thinking, hands–on experience, health literacy, exposure to physical and behavioral health, and health issues that impact people´s health across their lifespan. Improving the quality of community health care by integrating health science education at the youngest ages results in career ready high school graduates. These well–educated, prepared employees are able to provide exceptional health care to patients and clients. The students benefit by improving their employment prospects for careers with little actual experience. These students may otherwise find it difficult to secure good jobs in healthcare. Project Hire increases the quantity of qualified health care workers available to hospitals, nonprofits, and nursing homes. These graduates from an inner–city high school then provide health care to vulnerable populations as they work to achieve rewarding lives and outcomes for both their patients and themselves. Health literacy, education, and employment are achieved through community collaboration with the potential for exponential impact on economic and health improvements for the entire community.


Q3 Please indicate which category your organization falls under.

Community Based Organization


Q4 Innovation Executive Summary. Please describe the innovation, and how it addresses the social determinants of health. Please identify how the innovation addresses the 6 innovation criteria (i.e. ROI, scalability, feasibility, evidence–based support for innovation, relevance to the Medicaid population and speed to market).

The Project Hire innovation begins with children as young as 4 years old in the "Scholars in Scrubs" health science education program at the Newburgh Armory Unity Center. The Saturday morning class teaches hands–on activities, projects, and presentations from health care professionals to help students build an awareness of mindfulness, health, and safety; while exposing them to professionals working in the field. They build confidence in their ability and start to see the possibilities of being in these roles in the future. This component is the initial exploration into skills to become collaborators, critical thinkers, innovators, and leaders in the health care workforce. The next component is middle school volunteer opportunities and mentoring provided to students in grades 7 and 8 with interest in pursuing a career in health care. Mentoring is provided by the high school students in their classrooms by students who have interest or who have taken steps to enter the health care workforce. Middle school students volunteer at the Newburgh Armory Unity Center, serving as role models for K–6 students and working alongside high school volunteers.

Once students enter high school in Newburgh, they are eligible to enroll in the Certified Nursing Assistant Program at NFA. The program, spearheaded and taught by 2018 ACTE National Teacher of the Year Linda Romano, combines classroom instruction and clinical experience at SLCH. This allows students to complete the New York State Certified Nurse Aide (CNA) exam. Students also volunteer in the "Scholars in Scrubs" and middle school mentoring programs at the NAUC. This valuable experience provides students with the actual experience of working in a hospital setting and introduces them to a variety of options for their futures. Additionally, they can build on their skills and choose to continue onto college full time or immediately enter the workforce. Students may also choose to work part–time while they are enrolled in college.

For those students with little or no work experience, career–readiness is a challenge. Many do not have a professional résumé, have never been interviewed for a job, and lack an appropriate social media presence. To address this, Access and SLCH developed a career conference at the Newburgh Armory Unity Center specifically for Newburgh Free Academy´s students. Participants attended workshops on professional resume writing taught by a volunteer from Mount Saint Mary College´s career placement office. The students were "mock interviewed" by hiring managers from Access, SLCH, and Crystal Run Healthcare; and were taught how to build LinkedIn profiles from Public Relations professionals. The formal conference experience introduced students to health care recruiting staff in the community and provided them an opportunity to learn how to professionally prepare for an interview through the coaching provided by the hiring managers.

Students hired into full–time direct care positions at Access are eligible to participate in a newly launched apprenticeship program offered through a partnership with the Montefiore Health System and Hostos Community College. The apprenticeship program is a two– year training program that combines on–the–job training with classroom instruction. It is an accelerated career track, providing promotion opportunities. The classroom instruction component follows a Community Health Work curriculum that is approved by the New York State Department of Education. At the completion of the program, apprentices receive a certificate in Community Health Work and earn nine college credits that can be transferred to an Associate´s degree at Hostos or other local community colleges. There is no cost thanks to a Health Professional Opportunity Grant (HPOG) from the US Department of Health and Human Services (HHS) Administration for Children and Families (ACF) received by Hostos. Along with the on–the–job training, apprentices are mentored and engaged in career counseling with senior leadership and human resource professionals.

This innovation was developed when community partners who volunteer at the NAUC discussed their needs and brainstormed potential mutual solutions. In these discussions, the discovery was made that the needs dovetailed: youth needed support for educational and employment success to overcome the barriers of poverty, educational partners needed employment and higher education options for their students, and healthcare business partners needed qualified candidates for a high number of hard–to–fill positions. Furthermore, resources for the initiative were already in place and only needed to be adapted by each partner to create the collaboration.

According to the U.S. Department of Education, career and technical education (CTE) in high schools has seen a decline in participation in recent decades due to reduced funding and the push towards four–year colleges. However, evidence suggests that CTE is associated with higher wages and employment outcomes. Additionally, CTE have been found by the Community Preventive Services Task Force to improve high school graduation rates for those who are at high risk for non–completion, particularly in programs that are supplemented by job placement assistance and life skills training. Further evidence exists to support the value of apprenticeship programs. The Organization for Economic Cooperation and Development touts the role of apprenticeships in improving the transition from school to work and in ensuring low youth unemployment. Not only do students benefit, but employers stand to gain as well; improved retention of apprentices balances the cost of training and reduces resources needed for hiring.

The Harvard Family Research Project reports that after–school enrichment programs like the NAUC´s K–6 program make a difference in terms of improved test scores, including significant impact on math test scores. Studies performed specifically on at–risk populations show improved math and reading achievement. However, it was noted that such programs have higher rates of success when they combine with other activities such as athletics, arts, and life skills, all of which are offered at the NAUC. They also note certain factors that are critical in achieving the best outcomes: access to and sustained participation in the program, quality programming and staffing, and strong partnerships between the program and other community entities such as schools, families, and community–based organizations.

The New York State Department of Health reports that 45.3% of Newburgh residents are Medicaid recipients, higher than the remainder of Orange County (29.9%) and New York State (36.9%). The median household income in Newburgh is $33,469, which is down 2.56% from 2015, and the unemployment rate is 35% higher than the state average (Newburgh 6.2%, New York State 4.6%). Studies have shown correlation between vocational education and increased employment rates and earnings, pointing to these programs as a way to increase employment and reduce poverty levels. Additionally, the median age of Newburgh´s population is significantly below state average (28.4 and 38.4, respectively) indicating that increasing the number of career–ready youth could potentially reduce the percentage of the population which is unemployed and accessing Medicaid benefits.

Speed to market can be as little as two to three months in communities with health care CTE and healthcare employers with entry–level openings. Most will find that program components are already in place, such as K–6 enrichment resources, youth mentoring programs, vocational education classes, and employers who are actively hiring. At the same time, the need to foster relationships with community partners and develop opportunities for collaboration cannot be underestimated. It is essential to create ways for employers and students to interact, build relationships, and learn about the companies in their community. For example, classroom visits by healthcare employers provide introductions in a trusted, familiar setting for youth, and career conferences offer a chance for students and employers to interact in a way that alleviates some of the stress of job interviews. Following introductions, interviews, and other hiring activities, the students are well prepared to enter the regular recruitment process.

Project Hire addresses all components of the education category of social determinants of health. K–6 students receive enrichment education outside of a traditional classroom and hands–on health care experience that simply is not available in other settings. In addition to career preparation, literacy is one of the focal areas of the NAUC. In terms of high school completion, students at Newburgh Free Academy self–report that the program is a factor in keeping them enrolled in school and attending class on a regular basis. Students enroll in the program with the intention to carry it forward into higher education or immediate employment. The apprenticeship track allows them to do both, mitigating the risk of dropping out of college due to financial constraints or a lack of support.

The program supports economic stability as employment is the ultimate result. More than just a job, the purpose of the project is to help students build a career in a field with increasing demand for qualified workers. As their careers in healthcare progress, they will become licensed practical nurses (LPNs), registered nurses (RNs), Doctors, and health care leaders and innovators of the future who can improve both the health outcomes and the social determinants of patient health. Economic stability is addressed not only from the employee standpoint, but also from the employer´s perspective. One of the most significant problems plaguing health care providers, is a workforce that is ill prepared professionally and lacks a committed direction resulting in high staff turnover. Project Hire allows youth to be immersed in the health care field from early childhood, building a commitment and passion for the work that seamlessly translates to their careers as an adult. Employee retention is expected to ultimately improve due to preparedness, professionalism, and deep dedication to the work.

This innovative partnership creates social cohesion and improved health literacy and access centering on bringing a community together to inspire, educate and prepare qualified youth candidates to fill health care positions which are essential for the health of the community. For Access and SLCH, little additional investment was necessary; it simply required the vision and a refocusing of efforts and resources. In addition to traditional job fairs for adults and recruitment of candidates already working in the health care field, outreach was broadened to a new population: students graduating from high school. These students have the potential to be excellent health care professionals; and Project Hire provides the exposure, opportunity, training, and supports they need.

The return on investment was realized within months of the initiation; following the April 2018 career conference, Access was prepared to offer Direct Support Professional positions to 65 NFA CNA students. Of those, eight students have already applied for positions with Access. In late June 2018, SLCH, Access and the NAUC are hosting a job fair for any interested health care providers looking to fill critical vacancies. The event will be open to the entire community. An added benefit to employers is the introduction of students interested in working on a per diem basis during breaks from college or while attending college locally. Accessing this flexible staffing resource reduces organizations´ overtime costs associated with the needs to fill shift vacancies during the summer months and holidays which are prime time for staff to seek time off. Health care facilities are open 24 hours a day, every day, and overtime costs impact health care providers, costing millions of dollars annually. Hiring college students on a per diem basis improves the financial health of the organization while giving students an opportunity to gain experience and a connection with an employer that can potentially lead them to choosing full–time positions upon graduation, thereby also reducing recruitment costs.

Project Hire is scalable and adaptable to any community with high schools and health care providers with a desire to collaborate. Mercer´s US Healthcare External Labor Market Analysis estimates that the US will need to hire an additional 2.3 million health care workers by 2025. They also report that without new strategies, additional collaboration, and community innovation, hundreds of thousands of these jobs will remain unfilled. Enhanced tuition reimbursement benefits, nontraditional educational opportunities, and flexible scheduling will attract and support the demands of the 21st century workforce. As this initiative grows and is duplicated in other communities, it holds the potential to positively impact economic, educational, and health outcomes across the country.

Feasibility is measured by how well an intervention meets its objectives. Project Hire has been piloted and is successful, sustainable, and can be replicated, clearly demonstrating its feasibility. The success will be further evaluated as the Project is sustained and improvements are implemented from the experiences and results of the first year.


Q5 Was your innovation implemented? If so, please explain when, the number of people impacted, and the results.

Yes (please specify when and the estimated number of people impacted):

April 2018, 67 people impacted


Q6 Please identify the SDH Domain that your innovation addresses. (Select all that apply.)

Education,

Social and Community Context,

Health and Health Care,

Economic Stability


Q7 I give the Department of Health the right to share the information submitted in this application publicly (for example: on the DOH website). I understand that there is no monetary reward/reimbursement for my submission or for attending the summit should my innovation be selected.

I consent to have my innovation shared