California Correctional Health Care Services (CCHCS) is collaborating with the Community Health Center, Inc. and its Weitzman Institute to launch this groundbreaking residency training program which will take place at CCHCS clinical teaching sites. Our inaugural site will be located in Vacaville, California, within driving distance of both Sacramento and the San Francisco Bay Area. To our knowledge, this program is the first NP/PA Residency Program in the nation that will take place within a correctional setting, offering residents robust clinical training as well as rare insight and specialized expertise on California’s prison health care system and patient population.

Two NP/PA residency slots are available for the 2021–2022 CCHCS NP/PA Residency Class which runs from September 1, 2021–August 31, 2022.

Residents will be trained within CCHCS’ model of high-performance health care: Patient-Centered Model Medical Home (PCMH), team-based chronic care model, robust Quality Management and Population Health program, expert use of Telehealth technologies and the electronic health record. The residency year begins with an intensive orientation to CCHCS, including an overview of the health problems of the target population, tours of CCHCS sites (prisons/institutions and Headquarters offices), specialized safety and security procedures, meetings with health care leaders, technical training on electronic health record, and training on the responsibilities and privileges of CCHCS medical staff.

1. Precepted “Continuity Clinics”

(4 sessions/week) These are the cornerstone of the residency. In precepted clinics, the residents develop their own patient panel while having an expert CCHCS primary care provider exclusively assigned to them.

2. Specialty Rotations:

(2 sessions/week x 1/month) Planned specialty rotations include: HIV/HCV Care, Behavioral Health, Medication Assisted Treatment (MAT) for substance use disorder, Diabetes Care, Transgender Care, Palliative and Hospice Care, Urgent Care, Wound Care.

3. Mentored Clinics:

(2 sessions/week) During mentored clinics, residents work as a member of a team, and see patients at the delegation of the primary care providers, who remain available for consultations. The focus is on the practice of episodic and acute care visits.

4. Didactic Education Sessions:

(1 sessions/week) Formal learning sessions on a variety of conditions and complex clinical challenges most commonly encountered in primary care. The content of the presentations is planned to correspond to the residents’ clinical experiences.

5. Quality Improvement Training:

(1 sessions/week) Training on CCHCS’ quality improvement model, including population health management and clinical microsystems, as well as professional and leadership development.

Evaluations The CCHCS Nurse Practitioner and Physician Assistant Residency Program provides an ongoing multi-input evaluation component using qualitative and quantitative measures.

Program Presentation

The NP and PA Residency Program has the following goals:

• Increase access to quality primary care for underserved and special populations by training NPs and PAs in an robust residency program that prepares residents for full and autonomous expert care of complex populations in multiple settings.
• Provide new NPs and PAs with the depth, breadth, volume, and intensity of clinical training necessary to serve as primary care providers in the complex setting of correctional health.
• Train new NPs and PAs on a model of primary care consistent with the Institute of Medicine (IOM) principles of health care and the needs of vulnerable populations.
• Improve the clinical skills, confidence, productivity, and job satisfaction of new NPs and PAs who choose to work in underserved community settings, as well as contribute to employee satisfaction and workforce retention.
• Increase the number of NPs and PAs ready to serve in leadership roles in care for underserved populations.

The prison population is a historically underserved and high medical risk population, which in California consists of about 100,000 adults at 35 facilities across the state. Compared to the general population, the prison population has a significantly increased burden of chronic medical conditions, infectious diseases, trauma, mental illness, and substance use. There are also well-established socioeconomic, educational, and racial disparities in the correctional population. Moreover, the prison population is still part of the larger community, requiring coordination of care throughout incarceration and upon parole. It is imperative that all health care providers have an understanding of incarcerated patient populations and work together to fill in gaps in care.

QUALIFICATIONS

Nurse Practitioner applicants must be recent graduates (no more than 24 months) from an accredited Masters or DNP program, licensed (CA APRN) and credentialed or license/credential-eligible as FNP-C or AGNP-C. Physician Assistants must also be recent graduates (no more than 24 months) from an accredited PA program and board certified by the NCCPA. Applicants must also have a stated interest/commitment to practice as a primary care provider for correctional and other vulnerable populations.