The Hippocrates Circle Program

Program Tool Kit- 1 - Table of Contents Introduction to The Program Mission Statement 3 The Hippocrates Circle Story 4 Goals & Objectives 5 HCP Medical Center Contacts 6Getting the Program Started 7 Developing Your Team 8 Roles & Responsibilities 8 Regional Support 10Implementation Guidelines and Timeline 11 Student Selection Process 12 Program Events Overview 13 Implementation Timeframe 14 Event Coordination: Roles & Responsibilities 15Funding & Distribution Process 17 How the Program is Funded 18 Distribution Process 18 One Card and Budget Guidelines 19 Sample Budget 20Surveys & Evaluations 21 Distribution & Evaluations 22 Student Pre/Post-Survey 23-26 Student, Physician, and Site Surveys 27-32Sample Documents 34 Event Agendas 35-39 Letter to Superintendent 40 Letter to Principal 41 Letter to Students 42 Letter to Parents 43Application Documents 44 Student Application 45 Release Agreement 46 - 2 - The Hippocrates Circle ProgramMission Statement The mission of the Hippocrates Circle Program is to provide youth from under-represented communities and diverse backgrounds with awareness that a career as a physician is possible. Through the collaborative efforts of the local school districts, Medical schools, and the physicians from the Southern CaliforniaPermanente Medical Group and Kaiser Permanente sponsorship, the Hippocrates Circle Program will strive to strengthen the self-esteem of young people and empower them to pursue their goal to become a physician. The selected individuals enrolled in the Hippocrates Circle will have several opportunities in their fellowship to interact with practicing physicians.- 3 - The Hippocrates Circle Story:How It All Began…..Hippocrates Circle is a Southern California Kaiser Permanente program designed to motivate under- represented students towards careers as physicians. This community outreach was founded in 2000 at the San Diego Medical Center by Dr. Ricardo Sistos (Family Practitioner at Kaiser’s Rancho Bernardo Medical Facility), Maria E. Torres and Laarni A. Fontillas (Sales and Account Management, Labor and Trust Funds). The program includes five interactive venues between students and physicians. The first venue is an opportunity for students and physicians to share personal experiences and discuss challenges to achieving a successful medical career. During the second event, students tour Kaiser Permanente medical facilities and experience a day in the life of a physician. The third venue is a tour of a medical school campus. Students meet medical students, as well as members of the admissions committee, to address questions about medical school. The fourth venue is the financial aid presentation which provides resources and tools for parents and students on the financial needs of attending college. The program concludes with a graduation ceremony for the students and their families, celebrating their participation in HCP and reaffirming their goal to pursue a career as a physician. Today, Kaiser Permanente’s Southern California Region has identified this program as a significant community benefit that should extend throughout all of the medical centers in the region. The Hippocrates Circle Program is active in all fourteen locations. Since the program’s inception, HCP has assisted over 4,700 students, throughout Southern California, with over 350 physicians and administrators participating in the program. Our goal is to eventually have the Hippocrates Circle Program adopted as a national program in other Kaiser Permanente regions. - 4 - Goals & Objectives of the Hippocrates Circle Program (HCP)To increase the diversity in the physician population by instilling self-esteem and providing the tools necessary for young diverse middle school students (7th and 8th graders) to achieve a higher education in medicine. Furthermore, we would like to strengthen our linkages with the community to support broader community educational efforts encouraging diverse population to pursue a higher education in medicine.  Mentor & Guide - To empower diverse middle school students to believe that they can become physicians.  Educate - To increase middle school students understanding of various roles physicians play in the health field. Facilitate Experience - To create opportunities for diverse middle school students to spend time with diverse physicians while on the job.HCP School and Student Criteria HCP Criteria for Students: Students in 7th or 8th grade that come from under-represented communities and have an interest in becoming a physician. HCP Criteria for Schools: Public middle schools which are socio-economically disadvantaged.- 5 - HCP Medical Center Contacts Medical Center Physician Champion Administrative Champion Other Key Contacts Pollyann W. Gowrie-Knox, MD Antelope Valley David E. Bronstein, MD Courtney Hines Baldwin Park Maria R. Carrasco, MD Laura Del La Torre Downey Milagro D. Ramos, MD Mario AparicioFontana Douglas K. Mack, MD Aldina WashingtonKern County Michelle S. Quiogue, MD Margie A. Gonzales Kristin N. Weirather Claire Fuller, MD Julie Fuller, MD Los Angeles Robin Schanlon, MD Gloria E. GarciaOrange County Laura M. Chaverri, MD Martha A. Bieser Mary X. Jarvis Oxnard Beverly V. Torres, MD Charlotte D. Johnson Stephanie X. Gonzalez Lisa X. Cano Mary Ann J. Wieland Panorama City Maria Castellanos, MD Christina Fam Sue B. YallerRiverside Sandra W. Paniagua, MD LaTyce N. Moyo Mary O’CampoSan Diego David C. Parra, MD Connie ZaragozaCheryl L. Browne, MD South Bay Lisa M. Montes, MD Barbara J. KennedyWest Los Angeles Madalynne Wilkes-Grundy, MD Mesia M. Polar Tracey L. Brown Patricia De La Riva, MD Rocio Galdamez Woodland Hills LaTonya White, MD Katrina BakkedahlRegional HCP: Anna Khachikyan 626-405-6536/tie line 8-335-6536 Public Affairs/Regional Community Relations: 626-405-5523/tie line 8-335-5523- 6 - Getting the Program Started- 7 - Successfully implementing and running an HCP program at your facility will require the efforts of several people. Before beginning the program it is important to receive: Medical Director approval for HCP Physician Champions  MCAAT approval to identify an HCP On-Site Program Coordinator  Signed Letter of Support from the Area Medical Director and CRC Physician Champion  Conceptual adherence to program guidelines regarding targeted student population and schoolsOnce these criteria are met and you have submitted the HCP agreement to the Regional Program Lead, developing your program should begin. In the initial stages of the program team members should expect to spend at least four hours a month on organizing and establishing the program. Developing Your TeamEach HCP Program should have a local HCP coordination team that is able to support administration of the program each year. This team works together to arrange meetings with the school superintendent and principal, schedule student events, mentor students, ensure survey submission and maintain the budget.Each HCP team should consist of: Physician Champion  Administrative Champion  Physician Mentors  Public Affairs/Sales & Marketing contact  On-site Program CoordinatorRoles and ResponsibilitiesLocal HCP Physician Champion:  Collaborate with the Regional Physician Program Lead to ensure a consistent regional Hippocrates Circle Program and contribute to regional policy development.  Share benefits of the Hippocrates Circle Program with colleagues.  Recruit committed physicians to volunteer as physician mentors.  Communicate with local leaders to establish on-going local support and resources for the Hippocrates Circle Program.  Assist with Local HCP Administrative Champion and Sales and Marketing staff to identify potential contacts in local school districts.  Assist with Local HCP Administrative Champion and Sales and Marketing staff to identify potential school partners.  Prior to the first meeting with the students, educate physician mentors on the program goals and objectives  Ensure that the appropriate resources and materials are provided for each physician.  Communicate the agenda and content of each event to physicians.- 8 - Local HCP Administrative Champion/Coordinator:  Provide support to the Local HCP Physician Champion.  Ensure physicians are prepared for the events with background information, and other appropriate resources.  Identify, select and communicate with schools in the medical center area. Logistically, it may be more manageable to select students from only one school (e.g., transportation, meeting location, etc.)  Confirm student participation from school district.  Manage program schedule and events.  Coordinate efforts with Hippocrates Circle Partners at School districts, Medical Centers, and Medical Schools.  Coordinate with schools to provide chaperones for all events.  Work with Public Affairs to coordinate Media Relations for HCP program and events.  Administer and distribute surveys to students and physicians as scheduled.Physician Mentors:  Attend the five Hippocrates Circle Events and Physician Orientation.  Provide guidance for Hippocrates Circle Students.  Serve as a role model for the students.  Provide feedback through pre/post HCP surveys to help continue to improve the HCP program.Sales and Marketing Staff / Public Affairs:  Help support local HCP Program with meeting with School Superintendent & Principal  Identify potential contacts in local school districts.  Identify potential school partners.  Submit local HCP stories to community newspapers, journals, and television networks.- 9 - Your Regional Support Team Should you have any questions with program implementation and/or administration, a regional support team has been put into place to assist you.  Provide leadership and oversight to the implementation teams during all phases of the program.  Provide assistance and support in removing barriers to implementation.  Ensure HCP successes, metrics, best practices and challenges are communicated and transferred throughout the region.  Communicate with Executive Sponsors and Senior Leadership to ensure appropriate resources (time, money, etc.) are allocated to the successful implementation of the program.HCP Project Manager Anna Khachikyan Regional Administration/Culturally Responsive Care Provide support to the local HCP Champions to adopt the Hippocrates Circle Program in accordance with the approved guidelines.  Set strategic direction of program  Develop project plans  Develop database for tracking students in program  Track roster of participating students on yearly basis  Monitor the progress of student selection and the event schedule at each site.  Collect surveys from HCP physicians and middle school students the local HCP Sites and report findings to Regional HCP Implementation Team.  Process Surveys  Serve as liaison with Medical Centers and Medical School  Review and process invoices along with managing budget for each site  Manage Supplies  Manage Website & Facebook  Organize annual HCP Orientation  Prepare annual report to Community Benefit.HCP Program Administrator Lakiesha Tidwell Regional Administration/Culturally Responsive Care  Marketing & Administration of program  Prepare annual regional report  Give recommendations of modification to guidelines to Regional HCP Program leads for approval. Approval is required, for any changes to occur at the local medical center. Physician Program Leads Maria Carrasco, MD Ricardo Sistos, MD- 10 - Implementation Guidelines and Timeline- 11 - Student Selection ProcessOnce your Medical Center has been approved to sponsor a HCP program and your team has been developed, the student selection process should begin as soon as possible. The following diagram should help to ensure your program gets off to a strong start.Identify local school districtIdentify targeted school(s) based on HCP HCP Criteria for Schools – Public middle schools that have a significant portion of students from criteria → under represented communities. Introduce the HCP Program and determine if the school is willing to partner. The first point of Meet with School contact should be the School District Superintendent. Then, meet with the Principal of the targeted Personnel → school. Identify potential students based on program criteria → The teachers in the school will be identifying the students:Distribution application packets to identified HCP Criteria for Students: Students ranging from 7th – 8th grade that come from under represented students → communities and have an interest in becoming a physician. The HCP On-Site Coordinator will provide the school personnel with application packets and Collect completed instructions for completing the applications. The teachers (or other identified school personnel) will application packets → distribute the application materials to the identified students. Identify potential students based on program criteria → The teachers in the school will be identifying the students:Review applications & select students based on The HCP On-Site Coordinator and local HCP Physician Champion will select student for the HCP criteria → program based on the HCP criteria for students (specified above). Identify potential students based on program criteria → The teachers in the school will be identifying the students:Identify potential students based on program criteria → The teachers in the school will be identifying the students:Mail acceptance letters & program agenda to the students & parentsRole of the On-Site HCP Coordinator – the people that may be involved in the process include the local HCP Physician Champion, local Sales & Marketing staff & LAUNCH Outreach coordinator. Role of the School Personnel – the Site HCP Coordinator will help coordinate these efforts- 12 - - 13 - Hippocrates Circle Program Events OverviewThe Hippocrates Circle Program consists of the following four events:1. Physician Presentation to Students and Parents: Physicians introduce themselves to the students and parents and share stories of becoming a physician. In addition, the students and parents are introduced to the mission and goals of the program.2. Tour of a Kaiser Permanente Medical Center: The students visit a KP Medical Center and gain insight into a day in the life of a physician. 3. Tour of a Local Medical School: The students visit a local Medical School and learn about the duties of a medical student.4. Financial Aid Planning for Parents: Parents receive information from a local College or Medical School representative on options available to finance higher education.5. Graduation Ceremony: Celebration of the students’ completion of the Hippocrates Circle Program. Students reaffirm their educational goals in front of their parents.The HCP team should began coordinating a meeting with the school Superintendent and Principal as soon as possible in order to put each of these events on the academic calendar, arrange transportation where applicable, and secure event locations. Recommended Timeline for Event PlanningEVENT SCHEDULE April May June July Aug. Sept. Oct. Nov. Dec. 1st Event: Physician Orientation 2nd Event: Tour of KP 3rd Event: Tour of Medical School 4th Event: Financial Aid Planning 5th Event: Graduation Planning PeriodEvent- 14 - Implementation Time Frame The Hippocrates Circle Program begins with the Student Selection Process. Below is a suggested time line with the various components and steps. Following the student selection process is a time line for the planning of each of the four events.Recommended Timeline for Student Selection Process Recommended Person Student Selection Process Accountable Timeline Internal External Apr Ma Jun Jul Au Sep Oct Nov Dec Identify Schools in Medical Center Area using the HCP Local HCP School & Student Criteria: Physician & Administrative “Public Middle Schools that are socio-economically Champions, Sales disadvantaged.” & MarketingIdentify Targeted School & Contact Appropriate School Local HCP School District Personnel Physician & Superintendent  Contact School District Superintendent Administrative School Principal  Select appropriate schools based on regionally Champions School Teachers established criteria  Meet with Principal of selected school to communicate the goals of HCP  Identify potential students based on regionally established criteriaConfirm the Students Participating in HCP Local HCP School Principal  Collaborate with teachers to identify students with Administrative School Teachers interest in science Champions  Distribute application documents to students  Collect applications from school  Review applications & select students  Mail acceptance letters and program agenda to students & parents- 15 - Event Coordination: Roles & ResponsibilitiesEvents Related Tasks Person Accountable Event One: Introduce themselves to the students and parents and share stories of becoming a physician. Physicians Meet with In addition, the students and parents are introduced to the mission and goals of the program. Students & Parents  Work with physicians to coordinate schedules to attend on-site visit to school  Work with physicians to ensure they are prepared with appropriate background information and resources to meet the goals of the program  Work with the school district to secure auditorium, provide transportation (if needed), and refreshments Physician Champions  Provide written materials on program goals to parents Administrative Champions  Obtain nametags and student giveaways  Distribute and collect evaluation surveysEvent Two: The students visit a KP Medical Center and gain insight into a day in the life of a physician. Medical Center Tour  Work with the school district to provide transportation to and from Medical Center  Coordinate with appropriate physician and department administrators on agenda for site visit Administrative Champions  Provide refreshments/nametags/student giveaways  Distribute and collect evaluation surveysEvent Three: The students visit a local medical school and learn about the duties of a medical student. Medical School Visit  Work with the school district to provide transportation to and from the medical school.  Work with medical school to provide lunch for students  Set agenda with medical school coordinating partner Administrative Champions  Provide student giveaways  Distribute and collect evaluation surveys- 16 - Events Related Tasks Person Accountable Event Four: The parents and students are presented with an overview of what is needed to prepare for Financial Planning college and what financial resources are available. Work with speakers to coordinate schedules to attend on-site visit  Work with speakers to ensure they are prepared with appropriate background information and resources. Administrative Champions  Work with the school district to secure auditorium, provide transportation (if needed), and refreshments  Provide written materials on financial resources  Get undergraduate application and financial aid information  Distribute and collect evaluation surveys Event Five: Celebration of the students’ completion of the Hippocrates Circle Graduation Ceremony Program.  Locate and confirm auditorium  Send invitations to students and families  Provide dinner for physicians, students, and families Administrative Champions  Coordinate video and photography  Provide decorations  Provide certifications and folders for graduation ceremony  Coordinate with technical support- 17 - Funding & Distribution Process - 18 - How the Program is Funded The Hippocrates Circle Program is regionally funded and under review each year. To be eligible for financial sponsorship, each, Hippocrates Circle Program is required to adhere to the programs guidelines regarding the targeted student population: Diverse/High-risk students in the 7th and 8th grade  Public school students  Select a different school each program yearEach site is responsible for submitting a program application and annual information on each student enrolled in the program. This information is reported by means of a student roster as well as pre and post program surveys from the students and physicians. At the end of each session this information should be submitted to the Culturally Responsive Care department. Each program budget is approved once the program application, itinerary of events with dates, and proposed budget is submitted to Culturally Responsive Care department. New programs should select one school in their local area. Funding to support thirty (30) students is given to each site in the introductory year. Student sponsorship should not exceed the number projected for each medical center. After your introductory year, you may request to have additional schools included in the program. The decision to add schools should be based on your administrative resources and Medical Center support. In the secondary year of the program, additional budget to support a maximum of forty-five (45) students may be requested from HCP Administration. If you wish to have more than the budgeted number of students, your local HCP team can manage their annual funds to accommodate the additional students. All program budgets are approved once all items below have been submitted to Regional Culturally Responsive Care.  Program Application  Itinerary of events with dates  Proposed budget - 19 - Distribution Process  Half of the program budget will be dispersed at the beginning of the program once the list of participating students and physicians are submitted along with the student and physician pre surveys. The remainder of the budget is released by the middle of the program. At the end of the entire program, each site should submit the post surveys for students and physicians. The following year’s budget is contingent on receiving the surveys. Applications, pre & post surveys should be submitted no later than 30 days after the completion of the program Program budgets are based on a calendar year (January-December) and not a school fiscal year (September-June).  Program funds do not carry over to the next calendar year and should be used and submitted for payment by the last week in November.  Each program will receive a budget template to track spending. The local HCP coordinator is responsible for maintaining this template and ensuring that the program does not go over budget. The budget template is due before and after each session to continue funding. Programs should not go over the budgeted amount allotted each year. If your program incurs an overage the remaining amount must be supplemented by your local Medical Center.- 20 - Hippocrates Circle Program (HCP) One Card and Budget Guidelines DCBI Funds RestrictionsDirect Community Benefit Investment (DCBI) Funds are only to be used for the direct benefit of the student. These funds are to be used for a community based outreach program and not for direct benefit of KP employees or physicians.One Card GuidelinesAs an HCP Coordinator, it will be your responsibility to verify purchases, credits and discrepancies on the monthly One Card Statement. The One Card Statement is due by the end of each month. The receipts must be taped to an 8 1/2 x 11 sheet of paper that is attached to the One Card Statement. Each receipt should have an explanation as to what was purchased and what the item(s) was used for. The signed statement should then be sent to Lakiesha Tidwell & copy: Anna Khachikyan for approval. The form will then be forwarded to the One Card Program Offices for processing. Be sure to record any purchases on the Hippocrates Circle Program Budget Template and keep a copy of your One Card Statement. It is very important that the One Card Statement be processed by the end of each month.Any cash purchases will be reimbursed by Expense Report. If you have any questions about which expense code to use, please contact Anna Khachikyan at [email protected], 626-405-6536 tie line 8-335-6536 * Students will state their name and affirm their commitment to be a doctor- 21 -

The Hippocrates Circle Program

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