Year in Review 2018

the future looks BRIGHT because of you

2018 YEAR IN REVIEW

HOPE

located inside these pages

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Where hope grows, miraclesj blossom. j j

- Elna Rae

We see miracles happen every day because of you.

We see them in the bigger things, but more often we see them in the everyday actions of our employees and patients. Because of your support, hope springs up everywhere—from the school nurses striving to make sure every child’s needs are met, to students building a deeper connection to patients, to doulas inspiring another generation, and more.

Every year, we count our blessings and having you on our side fills us with hope.

From there, miracles happen. 2018 has been a big year, thanks to you, and you’re on a roll to make 2019 even better. Build momentum by sharing these stories with those around you. We look forward to the many miracles you will make possible in the year to come.

You Build Trusting Relationships Where They’re Needed Most

Jessica had a hard time trusting doctors, which did not make it easy when it came time to have her first baby. You alleviated her fear by making it possible for her to bond with a medical student during her pregnancy.

“Hunter was so encouraging and uplifting,” says Jessica of her experience in the delivery room. “I’m not going to lie—it was really hard, but he has such a good bedside manner. He just brings such a warm, loving presence.”

Hunter Smith, UNC School of Medicine Asheville Campus 3rd year student, is thinking of going into pediatrics. He wanted to see first-hand the journey a woman goes through during pregnancy and learn what he can do as a provider to care for the whole family. So he signed up for a rotation through the Centering Pregnancy program, which is a group model of prenatal care. That’s where he met Jessica and things changed for both of them. He assisted her with vitals, provided information, and made her comfortable. But he did more than that—he gained her trust.

Being able to provide that experience left its mark on Hunter as well. Medical school involves quite a bit of time studying and being in the classroom, which is why Hunter was excited for the curriculum at MAHEC.

“He listened to me, and he treated me like a normal human being,” says Jessica. “I was able to get really close and to trust him. I even trusted him enough to actually deliver my baby, Scarlett.”

Because of you, MAHEC trains students, residents, and fellows to not only provide comprehensive medicine, but to do so with the greatest compassion and care. In a time when she was at her most vulnerable, it was exactly what Jessica needed to feel safe and secure.

“While medical school can be very difficult, connecting with patients and building deep relationships reminds me why I am working to become a doctor,” says Hunter.

The program includes time spent practicing in real clinics with real patients. Just as he was able to help Jessica find trust, she helped him remember the importance of truly connecting with patients and the difference it makes. In fact, Jessica has offered him the position of Scarlett’s pediatrician when he graduates.

“I know my daughter will be in really good hands,” says Jessica.

“He will always be a major part of our lives.”

All definitions from Miriam Webster Dictionary - www.merriam-webster.com

trust \'trĆ?st\

noun

assured reliance on the character, ability, strength, or truth of someone or something

movement \'mĂźv-mĆ?nt\

noun

a series of organized activities working toward an objective

The role of a peer support specialist (2nd from right) is becoming more integrated with medical care and provides patients with compassion, understanding, and shared experiences.

You’re Helping Push Along a Movement

by Taking Away Feelings of Shame and Replacing Them with Hope

Seeing audience members in tears can be concerning, but in the case of the first ever North Carolina statewide Peer Support Conference this past October, those tears represented feelings of validation. Over 180 people attended the conference, and, because of you, many finally felt like they were getting the advocacy they’ve needed for so long.

“We had audience members that were literally crying and saying, ‘I wish this was there when I needed help and was just starting my recovery journey. I was motivated but didn’t have the resources or tools, and I was too ashamed to ask for help.’

That was pretty powerful,” says Scott Melton, MDiv, continuing education planner at MAHEC. With a push to integrate peer support into medical care, it’s starting to become better understood for the benefits it provides. Scott says when patients speak only with health professionals who do not have any lived experiences they can relate to, it can cause feelings of unworthiness and guilt in patients. But peer support specialists help inspire hope by having shared similar situations.

“There’s total understanding of where that person is, with no shame or blame,” says Scott. “Research has shown that, with peer support specialists, there are better outcomes with people adhering to doctor’s recommendations, a lower no-show rate for follow-up doctor’s appointments, and patients feel like they’re getting better services with someone who understands them.”

The conference, provided by MAHEC and Sunrise Community for Recovery and Wellness, was a way to bring attention to peer support and how it’s changing the way healthcare is provided, as well as what still needs to be done. One of the people leading the way is Cherene Caraco, founder and CEO of Promise Resource Network. She opened one of the first peer support agencies run by peers in North Carolina and spoke at the conference, where she continued to push the movement forward.

“I’m not the one who created peer support,” says Cherene.

“There were pioneers way before me, but I think it’s important to know from whence you came. I feel a level of responsibility to hold this space for the movement at this point and to do it really, really well so that people coming in the future can understand all of the effort that it took. When I got that standing ovation, it was affirmation of all the work that it took to get to this point, but it was also recognition that we need to keep pushing forward.”

For Cherene, being a peer support specialist is not simply a job—it’s a movement. Her feelings about how they needed to be truly recognized and valued in their organizations resonated with attendees. Having moved to NC in 2005 to create change in the behavioral healthcare system, she felt that this conference was another step forward for her with many more to go. But seeing everyone together, sharing dialogue and ideas, reminded her that what she’s been working towards matters.

“We’ve been working really hard in our local communities, but to see all these people come together in one space—it was a culmination of 14 years of hard work.”

You provided the 30,000 FOOT VIEW Through Public Health Experiences Outside of the Classroom for better health Marie Gannon, LCAS, LPC, knows the individual stories of so many women with prenatal substance use disorders through her work in Project CARA. Her passion is helping these women through recovery, linking them with important resources and services, and finding new and better ways to provide that care. But sometimes the hardest thing for health professionals to do is see beyond their patients. Thanks to you, Project CARA was able to do just that with the help of MAHEC’s public health interns.

“People trained in public health have a different lens than those of us who are actually providing the healthcare,” says Marie, behavioral director of Project CARA at MAHEC. “We’re so in it that we get bogged down in the individual stories and details while they’re able to have more of that 30,000 foot view. They can look at the problem across all the different sectors and see how those pieces fit together.”

Chelsea Swanson was one of the students who was instrumental in providing that view. She worked with Project CARA this past summer for her master of public health (MPH) practicum for UNC Gillings School of Global Public Health. Chelsea developed a training protocol for rural healthcare providers, making it easier for them to screen perinatal women for adverse childhood experiences (ACEs), which are stressful or traumatic events related to the development of health problems.

“Everybody has preconceived notions about healthcare and health problems, but you really have no idea what’s going on with a particular program or disease until you’re in the trenches trying to figure it out,” says Chelsea.

That is exactly what MAHEC’s summer internship allowed her to do. Chelsea says that, although she originally considered going into counseling, the program shifted her career path. Public health gives her the opportunity to intervene with mental health issues farther up the line and help prevent them from happening in the first place.

Marie believes that the ACEs screening tool and the evidence-based research behind it will give providers a way to look at all the social determinants of health rather than only substance use.

“It’s a gentler way to open the door,” says Marie. “You can say to the patient, ‘I know bad stuff happens, you don’t have to tell me what those bad things are, and I know that it has a long-term consequence for you.

I want to help you address that.’”

Chelsea also helped evaluate a perinatal substance use group started at Blue Ridge Health Community Services in Polk County. She helped build a collaboration so that they could sign on as an official Project CARA spoke site with MAHEC providing technical assistance as the hub. This allows the organization to grow their own program while also saving women from having to travel to Asheville for care.

These types of experiences outside the classroom setting make a real difference, not only for patients and providers, but for the students themselves.

“It was the most phenomenal experience I’ve ever had,” says Chelsea.

“They are able to take students out into different parts of the western region and give us all these amazing experiences with great people.

They really enlighten you to things you didn’t know existed. I’m really grateful for that experience because it gave me the chance to get out there and see all these different opportunities that I didn’t know were out there.”

experience

\ik-'spir-Ä“-Ć?n(t)s\

noun

practical knowledge, skill, or practice derived from direct observation of or participation in events or in a particular activity

Public health interns Chelsea Swanson (left) and Keller Dixon (right)

doula \'dĂź-lĆ?\

noun

a person trained to provide advice, information, emotional support, and physical comfort to a mother before, during, and just after childbirth

SistasCaring4Sistas Community-Based Doulas with the Mothering Asheville Board

THE COMMUNITY SPOKE

and you listened

SistasCaring4Sistas are Changing the Way Clinical Care is Provided Through a Labor of Love Labor can be a fast-paced, frightening experience for women as they face intense pain while doctors and nurses come and go from the room.

With your support, women are now finding comfort with trained doulas who are there throughout their pregnancy and right into the delivery room with them. Doulas offer consistency, let the women know what to expect, provide evidence-based information, advocate for them, and— most importantly—give physical and emotional support.

It just so happened that at about the same time infant mortality rates came out in 2016, a local community member mentioned that she could teach the skills for anyone interested in becoming a doula. It was perfect timing.

“We were already contemplating what we could do to save our babies,” says Nikita Smart, community-based doula.

Today, with a grant from Blue Cross Blue Shield of NC Foundation and collaboration with several other community organizations, MAHEC employs five doulas in the SistasCaring4Sistas program that supports women who could not otherwise afford a doula.

“Because all of us who are doulas are also parents, we saw how important the need was,” says Cindy McMillan, community-based doula.

“I know a lot of us thought, ‘Why didn’t we have these when we were delivering?’ Childbirth is a vulnerable space. Having somebody in there that understands and is in your corner 100% is important.”

The doulas are all trained childbirth educators and breastfeeding peer counselors. Nikita says that 90% of their clients leave the hospital breastfeeding. However, the success and support does not stop there.

“For some of us, the finish line isn’t delivery,” says Nikita.

Many follow their clients into postpartum, answering questions about developmental milestones and breastfeeding, and even attending birthday parties as they continue the relationships they created with families during one of the most important times in a mother’s life.

Nikita says that the doulas are all hoping to continue training to become postpartum doulas as well. But for as much support and care as the doulas provide for their clients, they’re receiving so much more in return.

It’s a labor of love.

“We work really hard at what we do, but we also love what we do,” says Cindy. “The different ways that the moms handle childbirth is never the same. We work with a wide range of women from teen moms to moms with substance use disorders. Each one has their own strengths, and it’s unbelievable the strength they have when they’re in that room delivering. They all touch me in a different way. There’s not one that I don’t remember.”

And the women and the families that they’ve helped remember them as well. Nikita says they get recognized around the area as the “doulas that delivered my baby.” And word is spreading. Young girls look up to them and are asking questions about how to become a doula.

For as much positive change as they’ve been able to create in their community, they’re doing just as much in the system as well.

“This was community led,” says Maggie Adams, MAHEC’s project manager for Mothering Asheville. “This was the community telling us this is what we need, and then MAHEC coming in to support that. We’re listening and we’re creating relationships, and it’s changing the way that clinical care is provided here.”

Who We Are Mission Statement MAHEC’s mission is to train the next generation of healthcare professionals for Western North Carolina through quality healthcare, innovative education, and best practice models that can be replicated nationally.

Values Statement We value:

Excellence Innovation Compassion Collaboration We represent these values through: Quality Education, Innovative Ideas, Compassionate Care, Community Partnerships, and Professional Standards

BOARD OF DIRECTORS

Foundational Principles CIVILITY We treat all people with respect and kindness, all the time.

INCLUSIVITY We value the contribution of people different than ourselves and the merits of an organization that reflects differences in our teams and our community.

EMPOWERMENT We value engagement, commitment, and ownership of MAHEC’s mission, work, and budget.

At-Large Members Robert Blouin, PharmD Melissa Himelein, PhD Mr. Clifton Metcalf Mr. Kenneth Partin Joseph Pino, MD Representing Mission Health System Board Janice Brumit David Franklin, MD William Hathaway, MD Jill Hoggard Green, PhD Mr. Paul McDowell Ronald Paulus, MD Representing Pardee Hospital Board Mr. Jay Kirby Representing Western Carolina Medical Society Board Henry McDade, MD Al Mina, MD Brian Moore, MD Representing Western North Carolina Health Network Board Mr. Casey Cooper Alan Stiles, MD CEO | Jeffery E. Heck, MD

WHAT YOU MADE

$1,355,660 Charity Care

Construction started on UNC Health Sciences at MAHEC academic health center for WNC on Biltmore Campus, dedicated to improving rural health

242

Project CARA Patients

support provided for perinatal women with substance use disorders

459

Centering Pregnancy Patients

679

newly enrolled

Total Number of MAHEC Employees full and part-time

67

Positions Added

146

Employees Hired

59

Research Projects

with 39 faculty and 46 learners

126,193 Total Patient Visits

978

Continuing Professional Development Programs

New MAHEC Dental Health Center at Columbus in Polk County to open in spring 2019

POSSIBLE IN 2018 New Simulation Center opened at the Biltmore Campus

510

Medical and Dental Graduates to date

Renovations to MAHEC OB/GYN Specialists lobby, waiting areas, and additional exam rooms

2,381 Babies Delivered

www.mahec.net

The MAHEC Philanthropy Department connects the generosity of the community with opportunities to improve healthcare in WNC.

For questions, information, or campus tours, please contact our Philanthropy Department:

Lizzie McKenna Cozart (828) 771-4203 lizzie.cozart@mahec.net