Santa Rosa Health Centers to start nurse practitioner residency program

SANTA ROSA -- Santa Rosa Community Health Centers received a federal grant of $850,000 that will enable it to establish a residency program for nurse practitioners, which could help the federally qualified health center address an anticipated shortage of primary care providers.

[caption id="attachment_18768" align="alignright" width="314"] Santa Rosa Community Center's new Fountaingrove clinic[/caption]

The grant, received in July, is part of $71.3 million in funds from the federal Health and Human Services Department to boost national nursing workforce programs, as stipulated by the Affordable Care Act of 2010.

A total of 633 awards were distributed to various nursing programs across the country. Among the recipients -- the vast majority being universities -- were two community health center groups:  Santa Rosa Community Health Centers and one in Bangor, Maine.

Santa Rosa Community Health Centers will be able to train four nurse practitioners per year over the next three years at the Vista Family Health Center, said Francisco Trilla, medical director of the eight-location network of health centers, which serve mostly low-income patients.

"The intent here is to address what has become a shortage of primary care providers nationally," Dr. Trilla said.

The goal is to have faculty and two residents in place by January. The remaining residents would come on by December 2012.

Health officials across the country have warned of a looming primary care provider shortage, particularly after the federal health care overhaul. The law will extend health care to about 32 million Americans. In Sonoma County, roughly 45,000 new patients are expected in 2014, when many of the law's provisions take effect.

Pedro Toledo, director of government and community relations for the Redwood Community Health Coalition, said its network of health centers, which includes Santa Rosa Community Health Centers, employs a larger number of nurse practitioners because they can often more quickly attend to patients with less serious illnesses. That, in turn, allows for more patients to be treated while freeing up physicians to tend to more seriously ill patients.

"I think [nurse practitioners] definitely help to extend the ability of primary care practices," Mr. Toledo said. "We’re able to see more patients, to provide care. Not every visit needs to be done by a physician."

The Redwood Coalition has 63 full-time-equivalent nurse practitioners across its network, which includes health centers in Marin, Sonoma, Napa and Yolo counties, according to Mr. Toledo.

The looming influx of previously uninsured residents has organizations  -- particularly, federally qualified health centers -- racing to recruit and retain primary care providers. Under the Affordable Care Act, such health centers have received increased funding as they are expected to absorb a great deal of the newly eligible.

Having a residency program is particularly important, according to Dr. Trilla of Santa Rosa Community Health Centers.

"One thing that becomes evident is that residents stay in the area," he said. "This is part of the solution in making sure we have primary care providers for the future."

His health centers also are part of the Santa Rosa Family Medicine Residency program, the largest single source of family medicine physicians to Sonoma County for the past 70 years, according to Sutter Medical Center, which sponsors the program in partnership with UCSF.

Dr. Trilla said having the two residency programs at Vista Family Health Center underscores the emerging importance, and even prestige, of nonprofit health centers.

"I think the feds are looking to us, as well as local governments, to create high-quality, data-driven community organizations that can manage care," he said.

Community health centers have a ratio of physicians to nurse practitioners and physician assistants of 1.5 to 1 nationally and 2 to 1 in Sonoma County, according to a primary care workforce study released earlier this year by the Sonoma County Health and Human Services Department. The highest ratio noted in the study is 13 to 1 at Kaiser Permanente.

Considering this ratio, it makes sense why health centers would look to expand primary care capabilities through nurse practitioners, Dr. Trilla said.

"We want to help lead in the area of innovating and in expanding the workforce of primary care," he said.

He said he hoped the program would be expanded after the three-year trial.

"There are probably less than five of these nationally," he said of the new residency program. "'Unique' is probably a good word for it. Our hope is that this type of program can serve as a model, particularly in areas of the country that have severe primary care provider shortages."

That Santa Rosa Community Health Centers was just one of two health centers to obtain the grant in the recent round of funding was an honor, Dr. Trilla said.

"It is kind of an honor to have the opportunity to try and make a go of this," he said.

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