Photo Album

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Nebraskas 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
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UNMC Develops the Rural Health Education Network
(RHEN)
Established in the early 1990s to address the
shortage of health professionals in rural Nebraska

• 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

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Rural Health Opportunities Program
Area Health Education Center
Student Association for Rural Health
Science Education Partnership Award
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
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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

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Rural Health Opportunities Program (RHOP)

• 1989 - Discussions between UNMCs College of
  Medicine and Chadron State representatives.
  Wayne State joins a year later.
• Chadron State College
• University of Nebraska Medical Center
• Wayne State College

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Three Nebraska State Colleges
Chadron
Wayne
?
?
?
Peru
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Rural Health Opportunities Program (RHOP)

• Students who are accepted into RHOP are
  pre-admitted to UNMCs academic programs when
  they begin their undergraduate education

Medicine Pharmacy Dentistry Dental Hygiene Clinical Laboratory Science Physician Assistant Physical Therapy Radiography Nursing (at Chadron only)

Negotiations are underway to add nursing at Wayne
State
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Rural Health Opportunities Program (RHOP)

• Which programs? How long? How many positions?

Length of Education Length of Education of Positions of Positions
Program Degree College UNMC CSC WSC
Medicine MD 4 years 4 years 5 5
Pharmacy PharmD 3 years 4 years 3 3
Dentistry DDS 4 years 4 years 3 3
Dental Hygiene BSDH 2 years 2 years 1 2
Clinical Laboratory Science BSCLS 3 years 1 year 4 3
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Rural Health Opportunities Program (RHOP)
Which programs? How long? How many positions?
Length of Education Length of Education of Positions of Positions
Program Degree College UNMC CSC WSC
Physician Assistant MPA 4 years 28 months 4 4
Physical Therapy DPT 4 years 3 years 3 2
Radiography BSRST 3 years 1 year 2 1
Nursing BSN 1 ½ years 2 ½ years 6 n/a
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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

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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

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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

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Whats 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

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Early Financial Incentives

• 1993
• RHOP Loan Program
• 400,000 from legislature
• All RHOP students eligible

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Early Financial Incentives

• 1998 RHOP Loan Program Discontinued
• High penalties for default
• Faculty discouraged use
• Funds returned to State of Nebraskas loan / loan
  forgiveness programs for those who practice in
  underserved areas

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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

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RHOP Odds n- Ends

• RHOP Bachelor of Science in Nursing program
  offered at UNMCs 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

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RHOP Pipeline
Med Pharm Dental Dent al Hygiene Nurse Phys Asst Phys Thpy Clinic Lab Science Rad Total
CSC 15 7 9 3 6 7 12 2 4 68
WSC 19 7 10 4 --- --- --- 3 --- 43
UNMC 33 18 16 3 6 5 11 2 2 96
Grads 81 56 42 25 7 51 44 36 14 356
TOTAL 151 88 77 35 19 63 67 43 20 563
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RHOP Graduates by Year GraduatedPracticing in
Rural Nebraska
PRACTICING RHOP Graduates Total Rural Nebr Urban Nebr Rural Out of State Urban Out of State Grad Rural Nebr Grad Rural (NE and OS) Grads Staying in Nebraska
Medicine 67 36 14 5 12 54 61 75
Dentistry 41 23 4 5 9 56 68 66
Dental Hygiene 25 10 6 3 6 40 52 64
Pharmacy 53 22 17 -0- 14 42 42 74
Nursing 7 5 2 -0- -0- 71 71 100
Physician Assistant 49 34 4 5 6 69 80 78
Clinical Lab Science 29 16 2 4 7 55 69 62
Physical Therapy 41 21 9 7 4 51 68 73
Radiography 11 3 5 -0- 3 27 27 73
323 170 63 29 61
Percentage Totals Percentage Totals 53 20 9 19 53 62 73
Fall 2009
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2009 RHOP Hometowns563 RHOP students and
graduates from 227 hometowns
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2009 RHOP Hometowns563 RHOP students and
graduates from 227 hometowns

• 384 are from 201 towns with populations of lt
  5,000
• 108 are from 16 towns with populations
  5,00010,000
• 71 are from 10 towns with populations gt 10,000

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RHOP Practice Sites
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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)
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What we learned along the way

• Market, market, market
• Clarify requirements i.e. Ralston, NE
• Communicate expectations
• Define the advantages early admission

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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

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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.

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RHOP Success
Drs. Kate Jason Hesser 2006 College of
Medicine RHOP graduates 3 year family practice
residencies through UNMCs Rural Training Track
Program in Grand Island Joined the medical staff
at Crete Medical Center (July 2009 )
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RHOP RESULTS
Niki and Aaron Salomon, live in Gothenburg Shes
a pharmacist in Cozad Hes a physician assistant
in North Platte
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RHOP Success
Kyle Klammer (left) 2004 State Science Meet (8th
grade)
2008 freshman Chadron State College (freshman)
2007 Alumni Science Meet (junior in high school)
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Questions?
Ann Kraft Phone [phone] E-mail
akraft_at_unmc.edu www.unmc.edu/rhen