TCWF’s Grantmaking
In light of the obvious need for increased diversity in the health workforce, as well as the challenges highlighted above, the Foundation’s Board of Directors in 2001 decided to make increasing diversity in the health professions one of the Foundation’s priorities. To date, the Foundation has distributed more than $11 million in grants that address the issue of diversity in the health professions. Grants are commonly given to organizations that provide pipeline programs, scholarships, mentoring programs, internships and fellowships that support and advance career opportunities for people of color in the health professions, including the allied health and public health professions. Organizations that support people of color in the health professions through strategic partnerships, leadership development, continuing education and networking activities are also eligible for funding. In addition, the Foundation funds organizations that educate policymakers about public and institutional policies that promote diversity in the health professions.
The Foundation’s work to increase diversity in the health professions is heavily influenced by two factors: 1) health workforce diversity is in the very early stages of developing as a “field”; and 2) TCWF represents one of the few sources of funding in the state directed towards this issue. These factors provide guiding principles: The Foundation must work to increase awareness of the issue, continue to “seed” the field and support promising new support and advocacy efforts, and simultaneously fund broadly in order to maintain existing programs. The Foundation’s funding goes beyond supporting diversity in medicine, nursing and dentistry — it also supports the allied health professions. Creating opportunities for people of color to join one of the many allied health professions is an important component of diversifying the health professions. Allied health professionals, including respiratory therapists, physical therapists and home health providers, play important roles in the delivery of health care, and these positions can serve as an entry point for a career ladder into other health-related jobs.
A crucial aspect of working on the issue of increasing diversity in the health professions is building the case for the importance of diversity, examining the barriers to diversity, identifying solutions to these problems, and advancing solutions among the state’s policymakers and opinion leaders. During the past three years, our Foundation has provided more than $1 million for research regarding various aspects of workforce diversity in California. Currently funded efforts include: the exploration of differences in retention rates among premedical students of various ethnic groups; the identification of exemplary nursing programs that recruit and graduate large numbers of Latino students; and the ethnic and racial diversity in the rural health workforce. Through the dissemination of products produced by these grants, the Foundation’s goal is to increase the awareness of decisionmakers about the connection between a lack of diversity in the health professions and health disparities among racial groups, and to inform the development of public policies that advance the field.
 Many advocacy organizations are involved in efforts to diversify the health workforce as well. Their work focuses on building coalitions of individuals and organizations interested in this issue, raising the awareness of policymakers regarding the issue, and identifying and publicizing policy solutions — at state, local, and institutional levels — to address the lack of health workforce diversity. The Foundation is also funding organizations that are building the advocacy capacity of individuals and groups who are usually absent from conversations regarding health workforce diversity policies, including physicians of color, low-wage workers and high school students themselves.
The Foundation has also provided more than $8 million in grants to help build the diversity of the future health care workforce. These include programs that both introduce students to health professions through internships and provide academic enrichment, tutoring and parent education. The organizations supported with these funds have provided more than 8,000 individuals with academic enrichment programs in middle and high schools; more than 1,000 students with recruitment and retention programs; scholarships for 124 individuals; and career advancement opportunities for 114 people of color already in the health professions. One cluster of grants reflects the range of organizations working to introduce young people to the health professions while improving academic preparedness. Grantees include school districts, nonprofit organizations, health care institutions and universities. Common dimensions of these middle and high school pipeline programs include academic enrichment and tutoring (especially in math and science), mentoring, academic counseling, and internship opportunities at health care facilities. Some programs, especially those geared towards students who are considered high risk, have built psychosocial support — both counseling and case management — into their services as well. Educating parents about college admissions and financial aid is an important component of many of these programs. Most efforts reflect collaborative arrangements among multiple entities — schools, hospitals and universities — that are working together in their communities to ensure that a racially and ethnically diverse group of high school graduates is prepared for entry into college or the health care field.
Preparing Students for Success
At a Central Valley school district, where the dropout rate is close to 30 percent and the ratio of students to college counselors numbers something like 800-to-1, Dr. Katherine Flores is molding students from Latino, Southeast Asian and African-American backgrounds into the next generation of Central Valley health providers. The Sunnyside Doctor’s Academy and the Junior Doctors Academy provide young people from disadvantaged backgrounds in Fresno public schools with a rigorous academic curriculum and the tools necessary to pursue health careers. Young people participate in internships at local health facilities, tour college campuses, receive supplemental tutoring, and go on study trips. Dr. Flores and her staff work with parents to ensure that students are able to make and keep their commitments to the program; for many students this requires foregoing athletic and other after-school activities. For students from rural areas outside Fresno, it requires long commutes to school each morning and home late in the evenings. Nevertheless, the program receives many more applications than there are available slots, due in no small part to the program’s well-known success. Of the 66 students who graduated from the program in 2003 and 2004, 100 percent completed high school and were accepted to four-year colleges and universities. Ten of these students were selected for early conditional acceptance to the University of California San Francisco, one of the nation’s most prestigious medical schools, upon college graduation. |
Another cluster of grants addresses the challenges of recruiting, retaining, supporting and graduating students of color in the health professions. The majority of organizations receiving support for these efforts are community colleges or four-year universities. These institutions work with students from the community college level through doctoral programs, providing various types of support necessary to retain students of color; they support their movement from one academic level to the next; and they enable them to become more academically competitive in their specific health profession. Students are provided services that include academic tutoring and advising, postbaccalaureate programs geared towards students from disadvantaged backgrounds, internship placements, opportunities to conduct research, study skills and standardized test preparation, financial support to attend professional conferences, parent education and support, and faculty mentoring. Most grantees operate programs on campuses that provide multiple types of support, based on the needs of the student population.
Researchers Assess Supportive Environments for Latino Nurses
What are the best ways for recruiting, retaining and graduating Latino nurses and which programs in the state are using these techniques? The Tomas Rivera Policy Institute in Los Angeles is looking into these questions as part of its two-year project aimed at increasing Latino participation in the nursing professions. Researchers are surveying nursing programs across California, identifying exemplary programs that are successfully recruiting and graduating Latino nurses, and conducting in-depth analyses of these programs to determine what makes them successful. Staff at the institute will disseminate the results of their research to education and training providers, state government officials and industry associations. Regional briefings will be held to ensure that stakeholders in various parts of the state learn about the research findings. |
 The provision of scholarships is an important component of our funding because the cost of attending health professions schools has become prohibitively expensive for low- and middle-income students. Several grants provide scholarships to students of color in the health professions. A number of these grantees are organizations devoted exclusively to providing scholarships; some work within just one health profession and others work in particular geographic areas. USC Keck School of Medicine, for example, received a grant from TCWF to provide full-tuition scholarships for two students of color — and has used the grant to leverage matching funds. Still others work on various health and education issues facing specific communities of color — and are using grant funds to provide scholarships to young people in these communities. A grant to The Inland Empire Scholarship Fund enabled the organization to provide scholarships to Latino students pursuing health careers; a similar grant to the California Rural Indian Health Board provides scholarships for Native American health professions students across California. Other grantees are educational institutions that receive TCWF funds to provide scholarships to enrolled students as a way of successfully recruiting a more diverse group of health professions students.
Training Minority Physicians
The Charles R. Drew University of Medicine and Science is a true cornerstone institution in the efforts to increase the diversity of the health professions. The university distinguishes itself as the only Historically Black College and University (HBCU) in California and the only allied health and medical school in the nation that is designated as both an HBCU and a Hispanic Serving Institution. The school’s history is tied to that of South Los Angeles, and the university, in conjunction with King/Drew Medical Center, works to improve the health and well-being of some of the nation’s most impoverished citizens. Drew’s physician training program is a joint effort with UCLA, in which students take their first two years of medical school classes at the UCLA David Geffen School of Medicine and then move to Drew and the King/Drew Medical Center for clinical rotations and training in years three and four. Drew University trains more than one-third of Los Angeles County’s minority physicians. |
Many institutions and health care employers are challenged to find ways to move existing employees up health career ladders. A cluster of grants provides educational and career advancement opportunities for these individuals, who may not have the needed skills to advance in their fields. Several community-based health organizations provide funding for their employees of color to go back to school or to get more advanced training. In areas where recruiting traditionally underrepresented providers is difficult, grantees use grant funding to retain interns and staff from these communities. Others provide opportunities for underemployed health care workers, usually immigrants, to move up career ladders.
 Another strategy pursued by TCWF is recognizing and encouraging leaders working on increased diversity in the health professions. To recognize individuals who have, over the course of their careers, made significant strides towards diversifying California’s health workforce, the Foundation has developed its annual Champions of Health Professions Diversity Award. Three champions are selected each year through a confidential nomination and selection process, and each is presented with a $25,000 award at a dinner held in conjunction with the Foundation’s annual conference on increasing diversity in the health professions. The champions come from a wide variety of fields — honorees have been former state employees, advocates, professors, college counselors and hospital nurses. They have dedicated their professional lives to helping students and changing systems to ensure that people of color can succeed in the health professions. While some are well-known in the field, others are unsung heroes, quietly continuing their work without recognition by anyone other than the students they help. The award honors their efforts and raises their profile across the state.
Helping Immigrants Re-Enter Health Professions
The Welcome Back Centers, located in several cities across the state, work with health professionals who have been trained in other countries. In California, these individuals often work in low-wage jobs outside the health field, since training and certification from other countries can be difficult to transfer. Welcome Back provides case management, test preparation, licensing and registration assistance, and job placement services to clients who were trained in Central and South America, Africa, Asia and the Middle East. Health-related English classes are an important component of the program as well, as they help students to learn the medical terminology that they will need for careers in nursing, dentistry, medicine or the allied health professions in the state. By providing this training, the Welcome Back Centers, which work in conjunction with community colleges in the communities they serve, tap into the health care skills and expertise already held in immigrant communities and diversify the health professions by bringing existing providers into the state’s health care community. |
In addition to recognizing these individuals, TCWF provides these awards as a vehicle for highlighting the importance of increasing health workforce diversity. The Foundation develops and implements a strategic communications plan for the award, with the goal of raising the visibility of the issue among policymakers and opinion leaders. Thus far, nine champions have been recognized by the Foundation, and numerous media outlets have provided coverage of the award and the issue of health workforce diversity. Notably, feature stories in La Opinión and Hoy, two major Southern California, Spanish-language daily newspapers with statewide readerships, have attracted the attention of community leaders. In 2005, a panel discussion at Town Hall Los Angeles, a civic forum that has long been respected as a venue for policy discussions, featured TCWF grantees and other local leaders offering their perspectives on the issue of increasing diversity in the health professions.
Bringing Advocates Together
Although TCWF annually convenes organizations and institutions working in the health professions, a statewide gathering in a state as large as California doesn’t provide enough opportunity for an examination of workforce diversity issues and challenges at a citywide or regional level. At the 2004 conference, representatives from several Bay Area organizations connected and determined that a regional gathering would prove useful to them in their work. The Greenlining Institute, a well-known advocacy organization, recently received a three-year grant to build a coalition of organizations and individuals in the local area that is working to diversify the health professions. Members of the newly formed group come from a number of different fields that include community colleges and four-year institutions, pipeline programs, mentoring programs, researchers and ethnic-based advocacy groups. Collectively, the group aims to develop policy recommendations that would lead to more effective diversification of the health workforce and to use the established networks of Greenlining and other members to convey those recommendations to opinion leaders in the state. |
Because the “field” of diversity in the health professions is just beginning to coalesce, organizations that do the work to prepare and train students of color in the health professions often work in isolation, disconnected from others doing similar work. The Foundation annually brings together more than 70 organizations, including grantees, other practitioners and funders, across the state. The conference offers participants an opportunity to meet one another, to learn firsthand about efforts in other parts of California, to share promising strategies and to brainstorm about common programmatic challenges. Conference attendees discuss needed systemwide changes and identify policy priorities that advocacy groups can use in crafting their work over the course of the year. The conference also serves as a vehicle for organizations from different fields to come together around common issues. At the 2005 conference, community clinic and safety net advocates, who struggle with recruiting providers of color, heard from community college administrators about the importance of a fully funded community college system in training allied health professionals. The conference highlighted the potential for these organizations to become allies — and work towards improving access to higher education — and to become a vehicle for training health providers of color. As a result, new allegiances were born.
- continue -
|
