nc ahec investments in the future
Investments for the Future Grants leverage the potential for statewide application.

The NC AHEC Program has awarded fifteen 2018-19 Investments in the Future Grants, totaling $350,000, to seed exploratory projects and initiatives to develop future directions for the statewide NC AHEC Program.

NC AHEC has awarded these grants annually since 2015 to promote innovation in education, collaboration, and professional development and to strategically invest in exploring new collaborations and opportunities for new business.

“Investments in the Future Grants provide regional AHECs with opportunities to try new ideas and learn what works,” stated Alan Brown, MSW, associate director of the NC AHEC Program. “We welcome innovative projects that may come with higher risk—projects that the regional AHECs might not be able to support on their own without these additional funds.”

The theme for the 2018-19 grants is “Getting Ready for Medicaid Transformation,” a timely topic as North Carolina works to transform its fee-for-service Medicaid program to managed care, with an estimated start date of 2019. A law passed in 2015 directed the NC Department of Health and Human Services to develop a plan to improve quality of care while reducing costs to taxpayers. The transformation includes addressing whole-person health by integrating behavioral and physical health, addressing opiate use and substance-use disorders and unmet social needs, and strengthening care management. (For example, a child who has access to healthy foods will have better outcomes than a child who doesn’t. Instead of relying on expensive medical interventions later, helping the family access more nourishing food now is a smarter investment.) Awarded investment grant proposals focus on a variety of topics within the Medicaid transformation theme, including social determinants of health and health equity, adverse childhood experiences (ACEs), engaging rural communities and practices, and more.

Below are summaries of the fifteen Investments in the Future Grants awarded in 2018-19. Grant recipients are expected to present their results to other AHECs and share their plans for sustainability and dissemination, leveraging the potential for statewide application.

“Bridging the Queen City to Edgecombe County”

Area L AHEC, with Charlotte AHEC
Amount Funded: $19,000

Faculty from Cabarrus and Carolinas College will spend time in Edgecombe County to design a two-week rural learning experience and curriculum for their students in summer 2019. Staff from Area L and Charlotte AHECs, the Edgecombe County Health Department, and the Conetoe Family Life Center will collaborate on this endeavor.

“A Blended Learning Approach on Hierarchical Condition Categories for Coders, Practice Managers, and Physicians”

Charlotte AHEC
Amount Funded: $10,900

Charlotte AHEC aims to create a training program comprised of eLearning modules and instructor-led training to educate coders, physicians, and practice managers on the core components of the Hierarchical Condition Categories (HCC) methodology. Classroom deliveries will have the opportunity to be broadcast live to the regional AHECs to provide this education across the state, connecting rural practices to this much needed education. Correct coding under HCC directly affects reimbursements for Medicaid recipients and from private payers as they adopt this system.

“Social Determinants of Health Microlearning Project”

Charlotte AHEC
Amount Funded: $12,785

Utilizing an online, microlearning-based methodology, Charlotte AHEC will develop an engaging, highly effective and high accessible educational program on the topic of social determinants of health. The program will share essential theory and practical strategies on how to help people at risk for poor outcomes due to social determinants of health issues. This microlearning format, which runs five-to-eight minutes per module, will appeal to busy learners who may not have time for traditional programming. Potential audiences include physicians, healthcare teams, public health and social work organizations, and local government decision-makers. The modules will be based on the health factors identified in the County Health Rankings Population Health Model developed by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The model provides a systematic framework of social determinants of health factors that Charlotte AHEC will use to identify the linkages of social determinants of health to poor health outcomes and identify next steps to help learners address the needs of patients, clients, and constituents. Availability of these free modules will be advertised through collaborations with other AHECs, public health departments, county governments, and other organizations.

“Promoting Family Conversations about End-of-Life Care by Means of a Collaborative, Self-Sustaining ‘Peace of Mind’ Community Event Model”

Charlotte AHEC
Amount Funded: $7,317

The innovative, self-sustaining “Peace of Mind” Community Event Model aims to spark and facilitate family conversations about wishes for end-of-life care and completion of advance directives documents by attendees. By collaborating with Faith Community Health Ministry nurses, Cabarrus and Rowan County churches, and other partners, Charlotte AHEC will build and demonstrate the event model. The intention is to couple the innovative “Hello” end-of-life conversation game with related content designed to attract public event participation, such as a session titled, “Writing a Will is Easier (and Less Expensive) Than You Think.” Once an effective “Peace of Mind” model is created and demonstrated in Cabarrus and Rowan Counties, Charlotte AHEC plans to share it with the faith communities in other regional counties and, ultimately, make it available to partners across the state. The project is a step forward in AHEC’s transformation of healthcare education. Rather than traditional lecture-based education, it uses a serious game to attract, engage, and help learners accomplish a significant health-related behavior change. Furthermore, as North Carolina implements new payment and care targeting improving health outcomes while lowering Medicaid costs, it is important to reduce the amount of unwanted and unnecessary care. Teaching people how to talk about end-of-life with their families will lead to reduced family conflict about end-of-life choices and lead to better and timelier end-of-life conversations with care providers, ultimately resulting in better care coordination, reduced delivery of unnecessary/unwanted medical care, decreased hospital readmissions, and improved patient/family experiences.

“Launching a Blended Learning Curriculum to Disseminate the Collaborative Care Model for Managing Psychiatric Disorders in Primary Care”

Duke AHEC Program Office, with Southern Regional AHEC
Amount Funded: $25,754

In partnership with Southern Regional AHEC, the Duke AHEC Program Office will design a blended learning curriculum on collaborative care.

“Identifying and Mitigating Adverse Childhood Experiences: Building Resiliency in School-Age Children”

Eastern AHEC
Amount Funded: $35,000

Adverse Childhood Experiences (ACEs) are common and have wide-reaching health and mental health consequences. There is extensive evidence linking ACEs with alcohol and drug abuse, suicide, teen pregnancy, sexually transmitted diseases, depression, and other health-related problems. Eastern AHEC will develop a multi-pronged approach to help local school systems address this very important problem.

“Social Determinants: An Upstream Approach to Health Equity”

Greensboro AHEC
Amount Funded: $25,000

Greensboro AHEC has formed regional partnerships with local health systems and community partners, including Greensboro United Way, Guilford County Health Department, Greensboro Housing Coalition, Cone Health Foundation, Cone Health Office of Inclusion and Health Equity, and Cone Health Healthy Communities, to provide healthcare professionals with an educational event on addressing social determinants of health and health equity. The goal of the event is to inspire, educate, and connect healthcare providers of services in social determinants of health and health equity work within Greensboro AHEC’s eight-county region to overcome social determinants outlined in the NC Medicaid reform proposal, such as housing, food insecurity, transportation, and toxic stress. The interprofessional educational event will begin with a theater performance involving social determinants of health and health equity provided by a professional theater company whose mission is to foster dialogue and implement solutions that result in a palpable change in communities. A keynote speaker will address his or her specific works on an effective change related to social determinants of health, and four breakout sessions will provide the interprofessional group of participants opportunities to explore social determinants of health and health equity relevant to their practice settings.

“Building a Culture of Resiliency: Trauma Informed Care Focused on Adverse Childhood Experiences and Social Determinants of Health”

Mountain AHEC, with Area L AHEC, Charlotte AHEC, and Duke AHEC Program
Amount Funded: $44,700

MAHEC will target rural areas across North Carolina by creating three “Building a Culture of Resiliency” online courses on ACEs and social determinants of health, followed by live, four-hour sessions on building skills in workforce resiliency, ACEs, resiliency for target populations, and community resiliency. Following the live sessions, MAHEC will lead an AHEC Trauma Informed ECHO to assist rural areas in developing trauma informed care specialties.

“Opioid Prevention Educational Tool for Children”

Mountain AHEC, with Area L AHEC
Amount Funded: $37,000

MAHEC will present an original drama piece titled “It’s Just a Pill” to multiple elementary and middle schools and other venues in the fall of 2018, combined with a Q&A with local leaders, presentation of a follow-up toolkit for teachers, and the opportunity for parents to create a prevention/intervention strategy for their children. The two-hour program will reach more than 4,000 children, teachers, and parents in up to nine mostly rural counties.

“Basic Life Support in Obstetrics for Rural Emergency Department Providers, Nurses, and Emergency Responders”

Mountain AHEC
Amount Funded: $20,250

In rural western North Carolina, some women have to travel over mountain roads for over two hours to deliver their babies in Asheville, creating risk for both mother and baby. This program will provide basic life support in obstetrics training to emergency department providers, nurses, and emergency responders in rural areas so they gain knowledge and confidence to provide emergent/emergency obstetric care in their communities.

“Complete Health Improvement Program in Rural Areas of North Carolina”

Mountain AHEC, with Northwest AHEC
Amount Funded: $15,794

The Complete Health Improvement Program (CHIP) is an evidence-based educational intervention with behavioral and skill development content that has demonstrated significant results in the management of chronic diseases. Through this project, the CHIP will be teleconferenced from MAHEC in partnership with healthcare providers in rural areas of North Carolina. While all individuals will benefit from the program, MAHEC will target remote, rural areas, including the Morganton area (in Northwest AHEC’s region) and Murphy, the westernmost area of the MAHEC region.

“Northwest AHEC Social Determinants of Health Pilot Collaborative Learning”

Northwest AHEC, with Greensboro AHEC
Amount Funded: $40,000

Northwest AHEC will facilitate and support educational offerings to social service agencies in the region defined by the Piedmont Triad Council of Governments.

“Breaking the Cycle of Trauma: Creating Healthy Environments for Our Communities”

South East AHEC
Amount Funded: $12,500

South East AHEC will develop an ACEs summit for mental health clinicians and other healthcare providers as well as teachers and school administrators in the South East AHEC region. Additionally, following the summit, SEAHEC will assist in the coordination and development of a resiliency taskforce, a group comprised of school administrators, health and other service providers, and community members to collectively work together within communities to align resources and strategies to address the needs of those who live with toxic stress.

“Preparing Southeastern North Carolina for Medicaid Managed Care”

South East AHEC
Amount Funded: $10,000

To help prepare southeastern North Carolina for Medicaid managed care, SEAHEC’s practice support and continuing education teams will host a forum in the fall of 2018, bringing state and local leaders together to discuss the latest details and implications for stakeholders. One or two smaller discussions on relevant and timely subjects will be included. Topics will include social determinants of health and the state’s work to develop a standardized screening tool, the opioid epidemic and the Cape Fear region’s successful community-level intervention, and Hierarchical Condition Categories coding and risk adjustment and their impact on value-based payments.

“Implementing Acceptance and Commitment Therapy to Improve Diabetic Patient Outcomes in Primary Care Settings”

Southern Regional AHEC, with Duke AHEC Program
Amount Funded: $350,000

This program will train non-mental health providers to implement acceptance and commitment therapy in primary care settings to improve diabetic patient treatment adherence. The program represents integrated care at its best and should demonstrate improved outcomes for individual patients and for Southern Regional AHEC’s population of diabetic patients.