Climbing the Career Ladder in New York City’s Community Health Centers

2015 Winter Newsletter, Initiative Updates

New York City’s Federally Qualified Health Centers provide crucial primary care services to under-served communities.  They are safety net providers, mandated to accept patients regardless of ability of pay.  Healthcare reform is pushing these centers to advance a “triple aim,” that is, to provide higher quality care, to offer a better patient experience, and to contain costs.  In that effort, centers are focused on achieving or maintaining status as a level 3 Patient Centered Medical Home (PCMH).   The PCMH model emphasizes patient-centered access, team-based care, population health management, care management and support, care coordination, and performance measurement and quality improvement, and comes with higher reimbursement rates.

In order to achieve and maintain their PCMH status, community health centers need staff with the right skills.  NYACH worked with partner the Community Health Care Association of New York State (CHCANYS) and the City University of New York (CUNY) to hold focus groups with community health centers.  This feedback was used to enhance existing medical assistant curricula with additional material on industry context, the PCMH model, integrated team-work, enhanced communication skills, patient-informed decision-making, scheduling, electronic medical records, and CPT and ICD coding, as well as to incorporate an externship component into training.  Mike Gera, the Electronic Health Records instructor at the Borough of Manhattan Community College (BMCC) spoke about the evolving demands on medical assistants.

“Historically, medical assistants didn’t extensively utilize electronic health records, but things have changed.  Today’s medical assistant spends so much time with the patient, and frequently it is the alert medical assistant who catches a discrepancy, such as a misspelled patient name, a wrong insurance number, or an outdated address.” – Mike Gera, Instructor of Electronic Health Records, BMCC

The resulting industry-informed Medical Assistant Training, piloted at BMCC, Lehman College, and Queensborough Community College, was designed as an opportunity for community health centers to promote staff from within.  Annie Wiseman, from the Institute for Family Health, a key employer partner in the initiative, describes their motivation for promoting existing staff.

“Our mission is to provide high quality care to underserved patients.  If we can promote someone from within they are already part of the culture of the organization and part of the communities they serve.  There is a level of cultural competence there that we want to preserve.  Many of our staff members develop strong relationships with patients over many years; to continue to see that familiar face over time is key.” – Annie Wiseman, Institute for Family Health

Five community health centers partnered with the program, identifying patient service representatives and front desk staff for medical assistant training and promotion.  1199SEIU Training and Employment Funds identified additional entry-level healthcare workers, such as home health aides, to participate in the program.  Unemployed individuals and those working in other sectors were trained as well, creating a student population mix of both incumbent workers and job-seekers.

From the first cohort of training, 58% of graduates have received jobs or promotions as medical assistants so far, with a 9% average wage gain.  100% of graduates working as medical assistants reported increased job satisfaction, and 83% felt the training had prepared them “very well” for the job, with the remaining 17% answering that the training prepared them “well.”

Some of the students who had not yet obtained positions as medical assistants also felt that they were advancing towards their goals.  For example, one student who previously worked scattered odd jobs obtained a full-time position with benefits as a patient care representative.  He commented that the steady paycheck meant a lot in his life, and he was just waiting for a medical assistant position to open up at his center in order to take his newfound career in healthcare to the next level.