Nebraska’s Rural Health Opportunities Program: 20 Years of Educating Health Professionals

1. Nebraska’s Rural Health Opportunities Program: 20 Years of Educating Health Professionals for Rural Communities NAO Conference June 24, 2010 Ann Kraft, Program Coordinator University of Nebraska Medical Center Rural Health Education Network Nebraska AHEC Program Office

2. UNMC Develops the Rural Health Education Network (RHEN) • Form partnerships among rural communities • Develop a network of volunteer faculty • Change how and where health science students are educated • Develop programs to encourage students from rural communities to consider health care careers Established in the early 1990’s to address the shortage of health professionals in rural Nebraska

3. R H E N Rural Health Opportunities Program Area Health Education Center Science Education Partnership Award Student Association for Rural Health Student Rotations Career Days Science Teacher Retreat Science Teacher Connections • Weeklong Workshops for College Students • Cultural Competency • Geriatric Careers • AgroMedicine • Behavioral Health Careers Student/Resident Education And Rotation in Community Health Regional and State Science Meets for 8th graders

4. Rural Health Opportunities Program (RHOP) • “Grow Our Own” • To recruit rural Nebraska students into the health professions • Support programs to recruit them back to rural Nebraska communities • RHOP spans 9 health professions

5. Rural Health Opportunities Program (RHOP) • 1989 - Discussions between UNMC’s College of Medicine and Chadron State representatives. Wayne State joins a year later. Chadron State College University of Nebraska Medical Center Wayne State College

6. Three Nebraska State Colleges Chadron Wayne ▼ ▼ Omaha ▼ Peru

7. Rural Health Opportunities Program (RHOP) Students who are accepted into RHOP are pre-admitted to UNMC’s academic programs when they begin their undergraduate education * Negotiations are underway to add nursing at Wayne State

8. Rural Health Opportunities Program (RHOP) Which programs? How long? How many positions?

9. Rural Health Opportunities Program (RHOP) Which programs? How long? How many positions?

10. How do students apply? • Apply on-line to RHOP at the same time they apply for admission to WSC or CSC • May apply ONLY to one program and ONLY to one college • Applications due December 1

11. Criteria used for selection • From a rural Nebraska community • Well rounded student • ACT/SAT scores • Grade point averages (especially science) • Essay • Interest in rural; connecting to rural • Experience/Knowledge of health care • Shadowing • Volunteer work

12. How many are interviewed? • About 2-3 times the number of positions available • Who interviews • Students notified before March 1 • Alternate status – must enroll at selected undergrad institution • Alternates have a high acceptance rate to UNMC because of the RHOP experiences

13. What’s the commitment? A “commitment of the heart” to return to rural Nebraska • Applicants are too young to sign a contract • We want the graduates to set up practice in a small community and make it their home. • Not leave once the “commitment” is completed

14. Early Financial Incentives 1993 • RHOP Loan Program • $400,000 from legislature • All RHOP students eligible

15. Early Financial Incentives 1998 RHOP Loan Program Discontinued • High penalties for default • Faculty discouraged use • Funds returned to State of Nebraska’s loan / loan forgiveness programs for those who practice in underserved areas

16. Financial Incentives • Tuition waiver for all programs at the undergraduate level • Eligible for waiver through the State College Board of Trustees • Many RHOP students qualify for Rural Health Advisory Commission Loan or Loan Forgiveness • Strict definitions of underserved to qualify for loan repayment regulations

17. RHOP Odds –n- Ends • RHOP Bachelor of Science in Nursing program offered at UNMC’s College of Nursing, West Nebraska Division (500 miles from Omaha) • “Rural Issues” is a distance education course from UNMC to the undergraduate students • Annual visit to UNMC

18. RHOP Pipeline

19. RHOP Graduates by Year GraduatedPracticing in Rural Nebraska Fall 2009

20. 2009 RHOP Hometowns563 RHOP students and graduates from 227 hometowns

21. 2009 RHOP Hometowns563 RHOP students and graduates from 227 hometowns • 384 are from 201 towns with populations of < 5,000 • 108 are from 16 towns with populations 5,000–10,000 • 71 are from 10 towns with populations > 10,000

22. RHOP Practice Sites

23. RHOP Practice Sites 323 practicing graduates who have completed residency 170 working in rural Nebraska 63 working in urban Nebraska 233 providers in 60 Nebraska communities (73%)

24. What we learned along the way • Market, market, market • Clarify requirements i.e. Ralston, NE • Communicate expectations • Define the advantages – early admission

25. What we learned along the way RHOP Acceptance Decision • seniors in high school vs. end of freshman year in college Benefits to State Colleges • Increased applications • Increased tuition to fund science curriculum • Stronger faculty

26. RHOP Success • Number of graduates who have completed residency: 323 • 53% in rural Nebraska • 9% in rural across the U.S. 62% currently rural! Since RHOP began, 71% of all graduates have practiced in a rural community at some point.

27. RHOP Success Drs. Kate & Jason Hesser 2006 College of Medicine RHOP graduates 3 year family practice residencies through UNMC’s Rural Training Track Program in Grand Island Joined the medical staff at Crete Medical Center (July 2009 )

28. RHOP RESULTS Niki and Aaron Salomon, live in Gothenburg She’s a pharmacist in Cozad He’s a physician assistant in North Platte

29. RHOP Success Kyle Klammer (left) 2004 State Science Meet (8th grade) 2007 Alumni Science Meet (junior in high school) 2008 freshman Chadron State College (freshman)

30. Questions? Ann Kraft Phone: (402) 559-3398 E-mail: akraft@unmc.edu www.unmc.edu/rhen