It seems logical now but it was quite the novel idea back in 1974: Provide funding to bring health care education services, providers and students to rural and other medically underserved areas of the Commonwealth. The program would give people of those areas access to health care they might otherwise not have, while students would receive medical training they might otherwise not receive.

These principles have been the foundation of the Kentucky Area Health Education Centers program since its predecessor program began in 1974. As the program reaches its 40^th anniversary, KY AHEC, as it is known, continues to serve a vital role in all corners of the state.

“AHEC has impacted many lives and will continue to do so for many more years,” said former state AHEC director and now UofL Assistant Vice President for Health Affairs V. Faye Jones, M.D., Ph.D. “The need is there for AHEC. Kentucky communities know AHECs provide vital health education and clinical services.”

UofL Senior Associate Dean for State Initiatives and Outreach Kelli Dunn, M.D., was named KY AHEC director this month. She stresses the role AHEC plays in access to health training and health care delivery across the commonwealth. “In addition to training medical students” Dunn said, “our AHEC sites train a variety of other health care professionals, including nursing and nurse practitioner students as well as emergency medical technicians and others. The AHECs also provide critical educational services and outreach within our communities.”

Program began nationwide in 1971, in Kentucky in 1974

KY AHEC is part of a national AHEC program. Funded by the Kentucky Legislature, along with foundations and other sources, KY AHEC is jointly administered by the University of Louisville and the University of Kentucky.

The national AHEC program began in 1971. Kentucky did not qualify for the initial program, but in 1974, the state formed the Kentucky Area Health Education System (AHES) to support health-student rotations throughout the state.

Severe challenges to the state budget in the late 1970s forced the closure of many AHES centers, however. The uncertainty of the AHES program led UofL and UK to partner on a new federal AHEC grant application, originally awarded in 1985 to the state with funding distributed to the two universities to administer the program.

The funding has continued uninterrupted since that time, providing continuity of community education, training and care through eight AHEC regions in Kentucky. UofL oversees the four AHEC regions in the western half of the state while UK oversees the other four regions in the eastern half.

KY AHEC fulfills triple mission

KY AHEC focuses on three goals. First, its mission is to help train health professions students in underserved health care settings. Second, AHEC partners with communities statewide to provide health care and career education. Third, and perhaps most importantly, AHEC encourages medical, dental, nursing, allied health and other health professions students to practice in underserved areas in Kentucky after graduation.

Judging by the UofL School of Medicine Class of 2013, the program is working: 31 percent of class members said they plan to practice in an underserved area, and 83 percent will volunteer in free clinics for the underserved.

The program also reaches out to the future health professions workforce. In the Purchase Area AHEC alone, for example, almost 2,700 middle and high school students received hands-on health careers programming in their schools. And in the West AHEC region, Outbreak Camp is a week-long program for middle and high school students, taught by area math and science teachers to connect their students to future health careers.

Community education also is a cornerstone of KY AHEC. The Northwest AHEC region provides the GRACE Project, a training program for faith communities to become well-informed lay health workers for their congregations, as well as the Veterans Behavioral/Mental Health for Veterans/Service Members and Families Project to educate civilian health care providers on issues affecting veterans returning from Iraq and Afghanistan. The South Central AHEC provides Child Passenger Safety Technician Training, a 30-hour program from the National Highway Traffic Safety Administration to train people in the community how to travel safely with everyone properly buckled up.

The economic impact of the UofL AHEC program also shows the program’s impact: Faculty, students and residents in the four AHEC regions served by UofL provided almost $3.48 million in donated health care services last year.

Physicians, patients show program’s effect

Amelia Kiser, M.D., was a member of UofL’s medical class of 1996 who was born and raised in the Glasgow, Ky., area and credits her AHEC rotation as one reason she returned to southern Kentucky to practice. Today, she sees patients and mentors trainees and AHEC students at UofL’s Glasgow/Barren County Family Medicine Residency program

“The AHEC rotations were the best, because if you’re in the city, it’s a completely different atmosphere,” Kiser said. “You don’t approach things in the city the way you do here. I could be in an urban setting; I just choose to be in a rural setting.”

Kiser contends that practicing in an underserved area actually furthers a physician’s career. “Regardless (of where you train), you understand and can solve medical issues, but here, you are friend and counselor also,” she said. “Your job does not stop when you leave here. You run into people at Walmart, at the ball game, at church. And they will pull you aside and say, ‘Dr. Kiser, I just need to ask you one thing… .’ But, I love it, I wouldn’t practice anywhere else.”

Another UofL alumnus, R. Brent Wright, M.D., had his pick of metropolitan locations to establish his medical career. The 1998 School of Medicine graduate was his high school’s valedictorian and a top medical school student at UofL. But, instead of heading toward large hospital environments or bustling cities, he chose Glasgow.

Wright, the current Glasgow/Barren County Family Medicine Residency Director and UofL associate dean for Rural Health Innovation, came to Glasgow as part of the first class of residents there in 1998. He was recruited to stay on as an educator and fell in love with the area.

As a student, Wright’s AHEC rotation was in Munfordville, Ky. “(I was) with the quintessential, colorful, old country doctor,” Wright said. “Every day with that practice was just fun. I saw myself being in a similar community. I knew I’d return to a smaller city to practice medicine.”

Years later, the student has become the professor. Wright’s energy is focused now not only on his patients, but also on his residents and AHEC students. “You see young students come in and how they progress over three years is amazing,” he said. “It’s a great deal of pride for me, because you become so close to the residents and see how much they contribute to these patients.”

Two of those patients are Ray and Joyce Pennington. They drive more than an hour from their home in Summershade, Ky., to the Glasgow clinic. “We’ve been coming here 13 years, and it’s worth the drive to get here,” the elderly Pennington said. “We’re real thankful to have doctors who we know care about us personally. We’re older and need someone to watch out for us. These folks are like a part of our family.”

Continuing the program for all Kentuckians

Kelli Dunn and Faye Jones know that it is people such as the Penningtons that need AHEC to continue for the next 40 years – and beyond. “The funding for KY AHEC connects us with our communities,” Dunn said. “Without the funding, the program, education and activities tailored to these communities simply would not exist.”

“AHEC has served and continues to serve such a vital need,” added Jones. “The communities rely on AHEC for their community health education needs. As a university, we rely on the AHEC to provide the educational experiences for our professional students. It’s so simple and so important to continue the work and grow it.

“Our focus is on the reality that drives us every day: We are here to improve the health care status of Kentucky.”