Spring 2024 Event Recap

We learned about the work AWC and Yuma Regional Medical Center (YRMC) are doing. This includes the growth of their nursing program and a shared training facility with sim-lab. AWC shared ways to fill workforce gaps, highlighting their success in getting funding to make a dental hygiene program with Northern Arizona University (NAU). They hope to launch new programs such as occupational and physical therapy, health coaching, massage therapy, speech pathology, surgical technician, and dietitian programs. Due to few mental health inpatient services locally, they launched a behavioral health tech program to complement YRMC’s new 26-bed facility. They recognized a community need for dislocated workers in Yuma and La Paz Counties and began fast-track programs for Certified Nursing Assistants, Emergency Medical Technicians, and Phlebotomy Technicians. They asked the group to work with them to solve challenges like needing more expertise in healthcare to ensure relevant curriculum. AWC also needs tools to support students and faculty in their own mental wellness.

AZSILC shared lessons learned from their Statewide Caregiving Collaborative. The Caregiving Collaborative is a series of listening sessions, focus groups, and work groups involving family members of individuals in the long-term care system, caregivers, and individuals receiving long term services. Top barriers were identified and solutions were presented. Full details are in the slide deck. Here is a summary of themes and recommendations:

Address Transportation Issues for Recruitment and Retention

• Explore partnerships with rideshares for cost-effective solutions
• Involve AHCCCS and all providers to address transportation on a large scale 

Improve Recruitment Efforts

• Address high recruitment costs and lack of awareness
• Promote flexible schedules
  
• Work with youth and grow presence in schools
  
• Put into place incentive programs and career path options
  
• Address issues from lack of childcare.
  
  • Support policies that help caregivers with young children

Recognize and Value Caregivers to Grow Retention

• Promote personal experiences as motivation
• Better communication
  
• Support Realistic Job Previews (RJPs) and Employee Assistance Programs (EAPs)
• Explore AI tools for rewards and schedule
  
• Introduce caregiver advocate roles
  
• Utilize the AHCCCS workforce database for insights
  

 Improve Agency Onboard & Training

• Address variations in onboarding methods across agencies, delays in fingerprint clearance, mixed training approaches, and issues that rise with agency changes
• Better training through person-centered approach
• Offer fair pay for joining in training
  

How can we connect educational institutions with experts in healthcare,  including experts focused on social determinants of health (such as  housing, employment, access to food, etc.)? What about experts in engagement strategies, recovery, and independent living – including  individuals with lived experience and family members?

• Bring students into our workplaces to observe.
• Engage in school activities: COPE has done career days at middle schools and high schools. 
• JTED has lots of opportunities to expand – high school and beyond. • Establish youth council and youth and family-focused events that offer info and resources. 
• Use current drive towards mental health in schools. 
  • Some school systems have peer counseling programs. That helps develop interest in moving into that field, becoming a BH helper. 
• Regional Center for Border Health sponsors Health Occupations Students of America (HOSA) clubs throughout the Yuma Region. They have panel presentations to talk about healthcare related occupations. They bring in experts to help students learn about what requirements and schooling they need. 
• Include the right people in the room when having statewide conversations to address communal goals: 
  • City & county reps to cover regional differences 
  • FQHCs 
  • Dept of Public Safety 
  • AZHIP 
  • Housing coalitions & agencies 
  • Residents/Members/Those receiving services
• Expand general knowledge about the impact public health and SDOH have on a community.
  • Offer community fairs. 
  • Bridge the gap between public and private. 
  • Stigma affects peoples’ want to share concerns about behavioral health and substance use. 
• Ensure everyone knows of offered resources. 
  • Create and dispense an often-updated e-flyer that shows what is available in each community. 
  • Discuss resources in clinical meetings and when healthcare providers meet with individuals (such as Adult Recovery Team (ART) and Child and Family Team (CFT) meetings) ART & CFT meetings. 
  • Highlight which orgs deal with specific SDOH. 
• Who are the experts? Embrace the power of lived experiences. Share stories of those with SDOH issues such as homelessness. Encourage people and treat their candor as bravery. 
  • Crossroads used to share stories of sobriety at Yuma High schools. 
• Create coalitions. This connects people from education & healthcare fields and allows community residents to partake in the work. Find and connect with coalitions that are already doing this work. 
• Develop internship program within County health depts. 
• Healthcare providers can offer classroom presentations and join school advisory boards. 
• Develop lead agencies on SDOH. 
• Regional Center for Border Health (RCBH) has a clinical rotation program. RCBH can offer students experience in the mental health field by having them volunteer at the community food bank and various mental health (MH) agencies to gain exposure to the field. 
  • RCBH offers internships and AWC provides apprenticeships. 
• RCBH has created a pipeline from their transitional homes to employment. Their transitional housing program assists community members who are struggling with substance use. They receive life skills and employment training. They then go on to successful employment, filling workforce gaps. 
• Providers must visit local school and vocational programs to help drive engagement into the mental health field. 
• AZCH staff have visited community colleges to share with students about what we do (integrated care and behavioral health) and the resources available in the community. 
  • AHCCCS is moving in this direction as well. 
  • Focus on providing awareness as students are choosing their career path. 
• Send mental health experts into schools to gain exposure to the mental health field. 

Consider a Speakers Bureau, Human Library to ensure access to many experts who are able to partner with educational institutions as guest speakers and more.

Who would keep the Speakers Bureau/Human Library?

• Consider a position in the mayor’s office or county health departments.
• Maintaining it should be a joint effort. This should include experts from many areas.
  • Coalitions help to bring together many sectors.
• Host on a website (such as AWC’s website) to allow folks to sign up, ask questions, etc.
• Chamber of commerce 

Are there already similar programs that we could tap into or combine efforts with?

• Credible Minds offers English and Spanish program.
  • We could cross link this to other platforms.
• Work with programs like Upward Bound. It works with 1st gen students in high school or below to show career tracks/opportunities.
• HOSA clubs. 

Who should speak?

• Bridge to folks in medical training programs in college.
• Speakers who bring lived experience and can discuss stigma.
• Chambers of commerce.
• Orgs that address housing and isolation: AzHIP, Coalition to End Homelessness, local housing authorities, AZ Housing Coalition, AZ At Work, etc.
• People from groups like AA and NA
  
• AWC has a list of experts that presents and will share the list.
  
• Vetted experts in the field should be asked: professors, experts, and people with lived experience. 

How will a school or org apply for a speaker? How do we get the word out? Are there qualifications for the speakers?

• Offer CEUs and CMEs.
• Keep a list of community speakers on a website. All can request a virtual or in-person speaker.
• The bureau needs to be actively managed. There should be one point of contact for speaker and schools.
• The speakers bureau can bring resources to curriculum development.
• It is important to present information through many perspectives (i.e.: provider, community leader, person w/lived experience, etc.) to ensure well rounded info is presented.
• Speakers must be vetted to ensure they are an expert.
• Some speakers will be willing to speak for free. However, speaker compensation should be made available when needed. Travel reimbursement must be considered.
• Communications: Inform through social media, community partner outreach, flyers and community centers, libraries, coffee shops, etc.

Is there a curriculum utilized to incorporate the recovery viewpoint into school work at every level? Can curriculum be maintained at the community level and offered to schools?

• Work with the Arizona State Board of Education.
• It could help if the state required BHT certification.
• Add a college credit course to degree programs such as a Health and Resiliency Course.
• RCBH had a BHT curriculum 7 years ago, but they closed it due to low enrollment.
• AWC is opening a BHT certification program.
• Use SAMHSA and Recovery Support Specialist curriculum.
• Peer and Family Career Academy could help create programs where people receive credit.
  • Include peer counseling programs in colleges and universities.
• Look at continuing education/trainings within providers, health plans and educational institutions as many have programs about stigma and implicit bias.
• Mental health first aid is a well-established curriculum that can be used.
• Elementary schools start programs when there is a child who has an IEP in the class.
  • Offer school personnel education on the impact of Adverse Childhood Experiences (ACE’s).
• Partner with the Upward Bound program.
• Crossroads Mission in Yuma offers Celebrate Recovery.
• Yuma has a program for Military to Civilian Transition.
• There is a curriculum called Mightier that is great for schools.

What is the best way to gain support from schools?

• COPE offers a career day.
• Outreach schools and send professionals in. Enlist speakers bureau.
• Work through parent groups and the Arizona School Boards Association.
• Work with school admin. Discuss having mental health advocates talk with students. Need to increase exposure to behavioral health professions.
• Offer dual credit model for high school students.
• Contact high schools to gain their involvement; through the JTED curriculum.
• Conduct focus groups with school counselors and social workers.
• As more mental health services are provided in schools, general knowledge goes up.
• It’s not just about educating parents and youth, but also school staff and community stakeholders. Show the ripple effect.
• Go into the classroom.
• Create mentor program for youth.
  • Include youth councils in elementary schools. 

Is there already curriculum to teach humility and communication in medical education programs? How can we expand upon it?

• Teach the importance of the ratio of time talking to listening by care providers.
  • Focus on listening skills.
• National Council for Mental Wellbeing could be a help.
• There are parts of this covered in various curricula across departments.
  • Bring in new ideas and upscale for existing staff.
• Build in chances for management to get back to fieldwork so they stay in touch.
• Build course work on resilience. Include this in cultural competency educational courses.
  • Recognize cultural differences across AZ. Border areas have a different culture. We must address cultural differences and training in cultural humility.
  • Address poverty and how it impacts access to care.
  • Address issues linked to aging.
  • Include education on addiction and substance use.
  • The more we integrate the distinct parts of care, the better.
• Do case study reviews.
• Promote self-learning
• Offer continued education requiring specific new findings in best practices.
• Promote self-care to reduce burnout and promote time to learn.
• Get back to the basics of people care. Encourage leadership to have hands-on first-person experience with clients.
• More training is needed for those in the medical field who serve LGBTQIA+ folks. Medical professionals could utilize the speakers bureau for this, where they could also get CEUs/CMEs.
• Connect with people in the state who oversee medical professional compliance such as the Arizona Medical Board.
• We share member success stories. We need to learn from members when the system did not work. Professionals are more apt to listen to other professionals.
• CTE requirements- utilize people with lived experience as trainers.

How can we encourage medical professionals to continue their education with stigma? In addition to the stigma around mental illness and substance use, how can we confront stigma associated poverty, physical disabilities, aging, and beyond? How can we, as a community, provide resources to healthcare professionals (including those training to become healthcare professionals) to address implicit biases?

• All medical professionals must get CEUs or CMEs. There has been an increase in stigma trainings. Encourage integration of types of training on stigma, SDOH, etc.
• A diverse workforce throughout is one of the best ways to transform the field and combat stigma.
• Resources: OIFA can share member experiences. Community champions could speak to other professionals about their experiences.
• C3 should connect with the people who set up the medical professional CEUs- and the arm that enforces the completion of these trainings. Integrate into what is already in place.
• Inviting medical professionals to community events like NAMI Walks so they can interact with people with lived experience and hear their stories.
• Include stigma related education/training in annual required trainings for healthcare orgs.