The Family Medicine Residency of Idaho (FMRI) has received numerous grant awards to augment resident education and improve patient services for at-risk populations. Grant funds make it possible to expand curriculum to include special programs to enhance the resident experience and to better prepare him/her for practice in rural communities.
Federally Qualified Health Center (FQHC)
In 2007, FMRI clinics were designated as Federally Qualified Health Center Look-Alikes (community-based health care providers that meet the requirements of the HRSA Health Center Program, but do not receive Health Center Program funding). In 2013, FMRI applied for a New Access Point (NAP) grant with three clinic locations and was awarded to become part of the Federally Qualified Health Center (FQHC) system. FQHCs are community-based health care providers that receive funds from the HRSA Health Center Program to provide primary care services in underserved areas. They must meet a stringent set of requirements, including providing care on a sliding fee scale based on ability to pay and operating under a governing board that includes patients as board members. This designation allows enhanced reimbursement for our Medicaid and Medicare patients allowing us to continue to offer this valuable and necessary service to this vulnerable population of patients.
Access Increases in Mental Health and Substance Abuse Services (AIMS)
In 2017, FMRI was awarded supplemental funding to support the expansion of access to mental health services, and substance abuse services focusing on the treatment, prevention, and awareness of opioid abuse. Health centers will enhance these services by increasing personnel. Included in the this award is one time funding to leverage health information technology (IT) and provide training to support the expansion of mental health services, and substance abuse services focusing on the treatment, prevention, and awareness of opioid abuse, and their integration into primary care.
Teaching Health Center (THC) Graduate Medical Education (GME) Payment Program
In 2011, FMRI was awarded designation as a Teaching Health Center (THC) by the federal government. This made our program one of the first of 11 in the nation to receive this designation. THCs are community-based primary care training programs committed to preparing health professionals to serve the health needs of the community. By moving primary care training into the community, THCs are on the leading edge of innovative educational programming dedicated to ensuring a relevant and sufficient supply of health workforce professionals. Though THCs often collaborate with other health and education organizations to ensure quality training for their students, they maintain the lead role in setting the educational mission and framework for their training programs. A THC is an entity that combines a Federally Qualified Health Center (FQHC) with a primary care residency, in our case a family medicine residency. The funding for this is still up in the air based on what happens in Congress with the politics of health care reform and the Congressional appropriations of funding. Regardless, it is a phenomenal feat for our program to become a cutting edge, first of its kind, new wave THC that starts to address a new model of health care education and patient care based on the power of teams at the community level.
Primary Care Residency Expansion (PCRE) Grant
In 2010, FMRI was awarded two primary care expansion grants to increase the class size in the Caldwell RTT to a 3-3-3 program and the Magic Valley to a 2-2-2 program. The hospital systems at West Valley Medical Center and St. Luke’s Magic Valley Regional Medical Center are supportive and have committed to sustain the program after the five year grant period and offset additional expenses. The purpose of the Primary Care Residency Expansion (PCRE) Program is to increase the number of residents trained in general pediatrics, general internal medicine and family medicine by supporting new expanded resident positions in three-year primary care residency programs.
Ryan White- Early Intervention Services with Respect to HIV Disease
FMRI has been a Ryan White Grantee since 1998. Ryan White Funds are used to provide comprehensive HIV care to those living in Southern Idaho. Our model of care is patient-centered, comprehensive primary care provided by HIV specialists. Commitment to this care model has led to the development HIV Primary Care Fellowship. The WC is seamlessly integrated with FMRI, allowing for the provision of comprehensive health care services that the residency offers as a Federally Qualified Health Center (FQHC) and Teaching Health Center (THC). Our program utilizes Part C funds to support comprehensive Early Intervention Services including: HIV testing; counseling and referral; medical evaluation and clinical care, including appropriate CD4 cell count and HIV viral load monitoring, anti-retroviral therapy, prophylaxis and treatment of opportunistic infections, and screening and diagnosis of malignancies. Other primary care services include oral health care, outpatient mental health care and substance abuse care, nutritional services, and specialty care through formal referral mechanisms. Additional program services provided include medical case management and outreach services.
Organized Approaches to Increase Colorectal Cancer (CRC) Screening
In 2016, FMRI received funding to advance our colorectal screening policy and procedures from a provider driven process to a patient-centered, organizationally adopted workflow that addresses patients’ screening statuses at each stage of the visit by each member of the patient’s care team. FMRI established formal screening procedures and the nursing team and providers adopted the preventive guidelines as outlined by the US Preventive Services Task Force. As a FQHC, we have annual federal reporting that is required for Colorectal Cancer (CRC) screening through our UDS reports. This grant will also allow us to continue building outreach efforts as well as patient and provider education processes, ensuring that the foundation set in this first year supports patient-centered colorectal cancer screening among Idaho’s most vulnerable populations. We aim to use the 2017-2018 CRC funds to develop registries to track patients and reach out to them proactively to increase overall screening of our population.
Refugee and Entrance Assistance
FMRI holds the state contract for screening all newly arrived refugees into Health District 4. When a refugee resettles in District 4 FMRI is alerted and is responsible for initiating the screening within 30 days. Screening for both medical and mental health issues is included. The contract also allows for the provision of immunizations up to 12 months post arrival.