Teaching Health Centers: A Possible Model for Nursing Education.

Teaching health centers were created as part of the Patient Protection and Affordable Care Act (Part C of title VII of the Public Health Service Act [42 U.S.C. 293k et. seq.], as amended by section 5303). The purpose of this legislation was to enhance the primary care workforce through funding graduate medical education in federally qualified health centers, community mental health centers, rural health clinics, tribal clinics, and Title X clinics (Affordable Care Act, 2010). In 2011, 63 resident positions in 11 teaching health centers were funded with increases through 2015 when 690 residents were funded in 59 sites (Brown & Klink, 2015; U.S. Department of Health & Human Services, 2016a, 2016b). Even though the legislation was reauthorized, no grant competition is planned for fiscal years 2016 or 2017. Due to funding limitations, an alternative model involving a formal partnership with a community health center (CHC) and an academic medical center (AMC) has been proposed. This model, known as Community Health Center and Academic Medical Partnership (CHAMP), involves a formal partnership, provides for concurrent training of several primary care specialties (e.g., family medicine, pediatrics, geriatrics), and creates the potential to create a CHAMP Medicaid Accountable Care Organization through the seamless provision of subspecialty care (Rieselbach, Crouse, Neuhausen, Nasca, & Frohna, 2013). Given the fact that there are fewer than 100 academic health centers in the United States and more than 1,300 CHCs, this gap creates possibilities for clinical education within schools of nursing. The current lack of funding for teaching health centers provides an opportunity for schools of nursing to create innovative academic practice partnerships with organizations that provide care for previously underserved populations. CHCs have 19 programmatic requirements related to need, service, management and finance, and governance. Those requirements concerning need and service are aligned with the baccalaureate and master’s Essentials in a way that allows for innovative clinical teaching models to emerge. The Table provides a synopsis of the CHC requirements along with the parallel Essentials (Essentials of Baccalaureate Education for Professional Nursing Practice [American Association of Colleges of Nursing, 2008]; Essentials of Master’s Education in Nursing [American Association of Colleges of Nursing, 2011]). CHCs provide a wealth of opportunity for nursing education. Students gain exposure to concepts like social justice in a tangible manner. Additional advantages of CHCs as nursing education sites include: