2024 legislative wins for primary care

Thanks to our legislative leaders, champion legislators Sen. Pamela Lauria and Rep. Kathleen Fogarty, and the amazing advocacy of our primary care community and supporters, this 2024 General Assembly session had some important wins for our primary care workforce!

• Enhanced Curriculum & Clinical Training: This measure provides $2.7 million to primary care practices to serve as enhanced interdisciplinary clinical training sites. It will recruit 30 advanced primary care training sites, increasing training slots by 50% for nurse practitioners, physician assistant students, and physician residents. The funds will also be used to develop a site curriculum, quarterly learning collaborative sessions, data collection, and project management. These sites are needed to train the next generation of providers, and since students often decide to work where they train, increasing training can improve access to care.

• Primary Care Scholarship Program: This measure was included as part of the Wavemaker Scholarship Program, which provides a tax credit to cover the cost of student loans. It funds a four-year scholarship program for primary care physicians, nurse practitioners, and physician’s assistants. The students would either remain in RI after medical school or return after residency training in Family Medicine, Pediatrics, or General Internal Medicine to practice primary care here for eight years. The goals are to encourage medical students to practice in these fields due to the reduction or elimination of their student debt.

• Ladders to Licensure: This measure forges collaborations between the institutions of higher learning and provider practices to support staff that want to advance from paraprofessionals to licensed clinicians. Advanced primary care requires a team-based approach, with each team member working to the top of their license. By addressing the workforce of licensed providers like registered nurses and social workers, the start of investing in this program will support primary care by reducing burnout and addressing understaffed teams.

"As a primary care nurse practitioner, I have seen the lack of access and the crisis RI is facing up close. I was proud to partner with CTC-RI to find some solutions for training and recruiting more providers," said Senator Lauria. "There is a lot of work left to do, and I will be an advocate every step of the way."

“The talk in RI was that no one could get a primary care appointment. Senator Lauria reached out to me to meet with CTC-RI. I not only learned more about the primary care shortage, but found out we had a serious lack of clinical training sites for physicians, nurse practitioners, and physician’s assistants. I said, ‘this is a 9-1-1 call for our state’ and we need to really think differently about staffing primary care,” said Rep. Kathleen Fogarty. “Speaker Shekarchi, whose father is a retired physician, concurred on these concerns, and agreed that my heart and head were in the correct place to address these issues. Working with Sen. Lauria and CTC-RI, legislation was developed and presented to both the House and Senate Finance Committees. I am pleased that we had legislative success and both H7902 and H7903 were approved, not fully funded, but still approved and became part of the 2025 budget. Now to move our plan into action!”

In addition to the above legislation, we want to thank Speaker Shekarchi for his commitment to spotlighting the needs of our industry by holding a Health Care Summit and inviting CTC-RI to participate, thank Senate President Ruggerio for his legislative package to address a wide variety of needs in health care, and the Senate for creating a new Commission to explore the potential establishment of a medical school at URI.

We hope to continue working with our legislative leaders to identify solutions that help our primary care workforce, which ultimately supports families across our state! A special thanks to our legislative champions this session, including Senator Pamela Lauria and Rep. Kathleen Fogarty, for making this progress and momentum possible.

Check out the 2024 Commonwealth Fund State Health Disparities Report for State Performance

The Commonwealth Fund 2024 State Health Disparities Report ranks Rhode Island third in the nation overall with regards to racial and ethnic healthcare access, quality of care and health outcomes, behind District of Columbia and Massachusetts. Even in top-performing states, such as Rhode Island, there is room for improvement. However, people in Rhode Island who are Hispanic experienced a lower health system performance, scoring in the 57th percentile. Rhode Island ranked first in performance for people who are Black, indicating health system performance was among the best in the nation. 

EOHHS Secretary Charest speaks to CTC-RI Board of Directors

The CTC-RI Board of Directors enjoyed a special networking and dinner meeting last month with special guest, RI Executive Office of Health and Human Services Secretary Richard Charest. Introduced by our Board President Dr. Peter Hollmann, Secretary Charest spoke on ways his office is working to advance primary care in Rhode Island. There was a very dynamic Q&A session afterward where members expressed a continued desire to work together in the coming year. We look forward to actively joining the Secretary in his vision to support delivery system transformation to improve health outcomes for all Rhode Islanders.

RI MomsPRN Quality Improvement Initiative

CTC-RI, together with the Rhode Island Department of Health (RIDOH) and the Executive Office of Health and Human Services (EOHHS), invited our fourth cohort of RI MomsPRN practices to participate in a perinatal quality improvement initiative after a successful statewide call for applications. Unlike prior cohorts, practices will identify their own quality improvement project related to perinatal behavioral health focusing on advancing respectful, culturally responsive, and linguistically appropriate care. The ten-month quality improvement initiative includes eight ECHO learning sessions. Participating practices include:

• Care New England Medical Group Family Care Center
• Lifespan Obstetrics & Genecology
• Tri-County Community Action Agency
• VICTA

At the kickoff meeting where teams were introduced and brought up to speed on program logistics and next steps, Dr. Zobeida Diaz, attending Psychiatrist and Interim Division Director of The Center for Women’s Behavioral Health and Day Hospital, shared various screening tools that she uses to help screen for specific conditions that may present during the perinatal period, along with cultural considerations when screening for mental health conditions, and barriers to treatment. The ECHO Learning program offered to these practices will also be made available to the larger learning community. Be on the lookout for registration and more details later this month!

Thank you to RIDOH and EOHHS for continued support and funding for this opportunity.

Monthly CBO Spotlight: Parent Support Network of Rhode Island

Our primary care transformation efforts often include the support and partnership of community-based organizations (CBOs) statewide. CTC-RI is spotlighting a different CBO each month to recognize and appreciate their work in our communities. This month, we're spotlighting the Parent Support Network of Rhode Island, dedicated to behavioral health.

What ways does your organization uniquely support Rhode Islanders?       

Parent Support Network (PSN) is a statewide family and peer controlled non-profit organization in Rhode Island operating since 1993 dedicated to the behavioral health population. We work in partnership with state government, families, youth, individuals and communities to reduce disparities and address social determinants of health by providing community health and peer recovery services and assistance with accessing healthcare, food, housing, treatment for trauma, education, employment, and a healthy environment. We have a statewide team of over 50 culturally and linguistically diverse, dual-certified community health worker - peer recovery specialists who are available to meet the direct needs of children, youth, adults and their family members.   

How can a partnership with primary care providers strengthen your work?

PSN is ready and prepared to expand in our work to build a partnership with primary care providers across the state as we know that the individuals we serve will benefit. This will be an opportunity for PSN to strengthen our referral network of primary care providers and the accessibility of healthcare treatment for the individuals, children, youth and families that we serve.  

What's something you'd like the primary care community to understand about your organization?

Primary care providers are providing healthcare services daily and we recognized that primary care providers could benefit from making a referral for patients to receive home- and community-based health education, care coordination and direct family and peer support services with children who are involved with early intervention, early childcare, special education, behavioral health treatment, child welfare and the justice system. We work closely with RI Family Court, and we are the Prevent Child Abuse America - Rhode Island Chapter.  

Want to get in touch?

Contact the PSN warm line at 401-467-6855 or visit www.psnri.org for assistance.

Save the date for PCP-specialist forum this fall!

Plan to join us on September 13 (7:30-9:00am) for a powerful discussion on improving collaboration and communication between primary care and specialty groups across systems of care in RI, including:

• The successful e-consults and e-referrals program covered by most payers

• Efforts to improve PCP-specialist alignment that increase high-value visits and reduced costs



• Progress on a statewide, EHR-agnostic, e-consult solution

June Breakfast of Champions: Adapting Practices to be More Friendly to Neurodiverse Patients

At our June Breakfast of Champions meeting, Susanne Campbell, RN, MS, PCMH CCE, moderated a session on Adapting Practices to be More Friendly to neurodiverse patients. Ariana DeAngelis, M. Ed., from the Autism Project spoke about approaching neurodiverse patients across the age-span. Francisco Cordero, Sc.M., from the University of Texas at Austin, discussed national and state models to support the diagnosis of autism spectrum disorder in the medical home model. In addition, our 49 attendees heard from Emily Feinberg, ScD, CPNP, from the Hassenfeld Institute, and Amelia Monteiro, MD, from New Bedford Community Health, about advancing Autism assessment and diagnosis in primary care. These presenters described their work in training community health workers to implement structured behavioral observation as a second-level screening process for autism spectrum disorder.

Optimizing a Behavioral Health Approach to Children’s Sleep in Pediatrics ECHO® Program

CTC-RI is excited to launch an ECHO® program, Optimizing a Behavioral Health Approach to Children’s Sleep in Pediatrics, to increase practice learning on healthy sleep across the age span in pediatrics. Funded by Blue Cross & Blue Shield of Rhode Island, this ECHO® program is supporting practices in a 12-month series of didactic training and case-based learning. 

Practices will learn how to provide developmentally targeted guidance to families on healthy sleep using behavioral health principles. Dr. Julie Boergers, Co-Director of the Pediatric Sleep Disorders Clinic at Hasbro Children’s Hospital, is the content expert for this series. Five practices will also be completing a quality improvement project alongside the learning series, with Practice Facilitator Dr. Liz Cantor. Congratulations to the participating practices:

• Anchor Medical Pediatrics
• Atlantic Pediatrics
• Blackstone Valley Pediatrics
• Partners in Pediatrics
• P.R.I.M.A. Inc
• Waterman Pediatrics

Project Kickoff: RI Cardiovascular Disease Learning Collaborative

This month, practices met to kick off the RI Cardiovascular Disease (CVD) Learning Collaborative, funded by RIDOH and CDC. The practices learned about the national and state prevalence of CVD and discussed important social determinants of health related to CVD. We were introduced to RIDOH community partners, including the WISEWOMAN program from Cindy Ariza, MPA, RIDOH, and the Community Health Network from Erica Hanson, RIDOH. The participating practices will continue to meet and learn about CVD in this learning collaborative, in addition to completing a quality improvement project. Congratulations to the participating practices, Clinica Esperanza / Hope Clinic and RI Free Clinic.

CTC-RI selects practices and launches Diabetes / Chronic Kidney Disease Learning Collaborative

CTC-RI is excited to kick off the project, Implementing Primary Care and Pharmacy Strategies to Improve Care for Patients with Diabetes, to help primary care practices improve the screening and treatment of diabetes, and detect diabetes-related eye and kidney disease earlier in patients. The project is a partnership with University of RI College of Pharmacy and RI Department of Health (RIDOH), with funding provided by UnitedHealthcare and RIDOH. This two-year learning collaborative includes collaboratives and quality improvement projects to improve screening rates and management for patients with diabetes, retinopathy and nephropathy. Our participating practices met this June to kick off the project, with Kelley Sanzen, PharmD, and Stephen Kogut, PhD, MBA. Congratulations to the participating practices:

• Clinica Esperanza / Hope Clinic
• Coastal Medical – Hillside Family Medicine
• Medical Associates of Rhode Island
• Rhode Island Primary Care Physicians Corporation
• Rhode Island Free Clinic

Clinical Strategy Committee: June and July 2024

Our June Clinical Strategy Committee meeting will bring together state partners, community members, and clinical teams to discuss healthcare updates in RI. Partners from Bailit Health will review the Rhode Island AHEAD Model Application, discuss RI’s progress, and next steps. CTC-RI's Dr. Liz Cantor will present on a proposed alternative process to NCQA Behavioral Health Distinction, requested by OHIC, called “RISE-PC” (Reaching Integration and Supporting Excellence in Primary Care). In addition, Pano Yeracaris, CTC-RI Chief Clinical Strategist, will discuss a proposed integrated behavioral health per-member-per-month (PMPM) rate for adults and pediatrics.

In July, we will hear updates from the MassHealth teams on their implementation of a primary care capitation plan, as well as an overview of the New York Department of Health about their Medicaid healthcare waiver with a focus on addressing Health-Related Social Needs.

Primary care community should support the AHEAD Model

The Task Force on Primary Care Workforce Development heard a presentation this month on the AHEAD Model from Elena Nicolella of the Rhode Island Health Center Association. The presentation focused on the benefits the AHEAD Model would afford to primary care. If accepted to Cohort 3, Rhode Island could realize $12 million in funding for a two-year planning period. The multi-year implementation phase will include enhanced prospective per-member-per-month payments for Medicare beneficiaries. Primary care providers are encouraged to submit letters of support to the Governor and OHIC Commissioner in favor of the AHEAD Model application, which is due August 12. View a Click here for a sample letter of support and learn more about the AHEAD Model.

CTC-RI announces agenda for 2024 Annual Conference

CTC-RI’s 2024 Annual Conference on October 31 at the Crowne Plaza offers enriching learning opportunities across key tracks: health equity, priorities in population health, best practices in Behavioral Health, and improving child/family health. We are thrilled to share our dynamic draft agenda for the day! Get ready for insightful sessions such as “Value-Based Payment for Primary Care in Medicaid: Learnings from MassHealth's Primary Care Sub-Capitation Program,” “Behavioral Apps for PCPs: Assessing Evidence and Evaluating Options,” and “Taking a Positive Sexual Health History.” Our lineup features a stellar group of presenters brimming with expertise including the RI Department of Health, Brown Medicine, MassHealth, Thundermist, and Boston Medical Center, and others. Don't miss out on this exceptional opportunity to connect with colleagues, learn from experts, and discover ways to advance primary care and health equity. Secure your spot now! Exhibitors interested in participating can reach out to Michelle Mooney at mmooney@ctc-ri.org for more information.

Quarterly DULCE Learning Collaborative Meeting

This month, CTC-RI hosted our quarterly DULCE Learning Collaborative with 25 participants, focused on the progress made from participating practices (Blackstone Valley Community Health Center, Tri-County, Care New England Family Care Center, Coastal Toll Gate, and Hasbro). The family specialists from each organization shared how they engage with new families and warm handoffs at six months by working with resources such as family visiting. New practices (Cohort 2) shared practice/family success stories. Practices discussed progress made on developing sustainability plans including community health worker billing and networking opportunities across the state. Thank you to the funders supporting this pilot program: Congressional Direct Spend, UnitedHealthcare, RIDOH, EOHHS and Tufts Health Plan/Point32Health.

Upcoming CTC-RI Committee Meetings and Workgroups

• June 21, 07:30-09:00AM – Clinical Strategy Committee
• June 28, 07:30-08:45AM – Board of Directors
• July 03, 07:30-08:30AM – PCP/Specialist Monthly Oversight
• July 10, 08:00-09:00AM – Primary Care Workforce Taskforce
• July 19, 07:30-09:00AM – Clinical Strategy Committee
• July 26, 07:30-08:45AM – Board of Directors

Upcoming Learning Collaboratives and Professional Development

• June 20, 07:30-08:30AM – ECHO: Increasing Access to Care for Children and Adolescents with Restrictive Eating Disorders by Optimizing Integrated Behavioral Health Care
• June 21, 12:00-01:00PM – Integrated Behavioral Health Meet and Eat
• June 25, 07:30-08:30AM – Transition of Care Learning Collaborative
• June 26, 07:30-09:00AM – Asthma Final Learning Collaborative
• June 27, 07:30-08:30AM – Pediatric Sleep ECHO series
• July 11, 07:30-08:30AM – Improving Child Health in RI
• July 16, 08:00-09:00AM – Best Practices in Team-Based Care
• July 18, 07:30-08:30AM – ECHO: Increasing Access to Care for Children and Adolescents with Restrictive Eating Disorders by Optimizing Integrated Behavioral Health Care
• July 19, 12:00-01:00PM – Integrated Behavioral Health Meet and Eat
• July 25, 07:30-08:30AM – Pediatric Sleep ECHO Series
• July 30, 07:30-09:00AM – Pharmacy QI Learning Collaborative: CGM & ABPM