Health Care Homes Sustainability Roadmap 
Partnerships

Like many primary care organizations emerging from the COVID-19 pandemic, Stellis Health faced unprecedented workforce shortages. Applications for LPN and CMA positions had dwindled, and staffing levels had reached an all-time low. To keep care accessible and team-based, Stellis created the Clinical Support Team Specialist (CSTS) role—an innovative position designed to support credentialed clinical staff by taking on essential tasks that did not require licensure. While this stop-gap measure helped stabilize operations, leaders recognized the need for a more sustainable solution.

The turning point came when Stellis identified a partnership opportunity with Stepful, an online training program for medical assistants. “If we can’t hire trained staff, we’ll train them ourselves,” the team concluded. This collaboration led to the creation of an Earn as You Learn pathway, giving CSTS employees the chance to complete their Certified Clinical Medical Assistant training while continuing to earn income and remain part of the care team.

Launching the program required careful coordination. Stellis worked closely with Stepful to integrate online coursework into the CSTS workday, allowing employees to progress academically without sacrificing financial stability. By covering tuition costs and establishing transparent expectations around full-time status and post-graduation employment, Stellis ensured the program was sustainable for both staff and the clinic.

A particularly complex challenge was arranging the required 80-hour externship. These hours were unpaid, but Stellis took a flexible, person-centered approach: some participants completed all hours at once, while others spread them out to continue earning income. This adaptability reinforced Stellis’ commitment to whole-person support—for both patients and staff.

The impact of this partnership has been profound:

1. Building your own workforce creates ripple effects. Many program graduates are now pursuing RN degrees, illustrating how a partnership can expand opportunities far beyond the clinic.
2. Choosing the right partner matters. Careful selection of Stepful ensured alignment with Stellis’ needs and quality standards.
3. Blending online learning with hands-on experience works. Virtual coursework combined with in-clinic practice strengthens skills, confidence, and readiness for patient care.

For other clinics considering similar approaches, Stellis offers clear advice: dedicated training infrastructure and structured mentorship are essential. Even during staffing crises, investing in partnerships for learning pathways ensures a reliable pipeline of future care team members.

Today, Stellis Health’s Earn as You Learn approach stands as a powerful example of how strategic partnerships can strengthen both care coordination and workforce sustainability. By investing in people, meeting learners where they are, and embracing innovative collaborations, Stellis is not only addressing immediate staffing challenges—they are shaping the next generation of primary care professionals.

The HCH program thanks Stellis Health for sharing their experiences and insights.

For more than 125 years, Gillette Children's Hospital has focused its efforts on some of the toughest challenges in pediatric medicine – brain, bone and movement conditions that require specialized care. As a global leader in care and research, one of Gillette’s core missions has been to discover new treatment options for children who have disabilities.

Recently, Gillette concluded work on a five-year federal grant to support the implementation of parent advisor roles within its research process improvement team. The grant included financial reimbursement and training for parents serving in these positions.

“As a researcher, it was an amazing model,” said clinical scientist Rhonda Cady, RN, PhD. “Family Voices of Minnesota helped our clinical team learn how to work collaboratively with parent advisors and the model ended up being so impactful that we now believe it is critical to have paid parent advisors as part of our complex care program process improvement team.”  

Gillette’s success with parent advisors led to the development of the Family Engagement in Research (FER) program. FER recruits, hires, trains, and compensates patients and parents for their lived experience expertise. After some training, program participants then work with Gillette research and clinical staff as equal partners on research projects and as advisors to organizational programs.

“Our parent advisors are essential to all that we do,” Tori Bahr, MD, MedPeds Complex Care confirmed. “I think we have all learned so much over the last five years having them as a part of our clinic.

“We are currently conducting a mapping session on how complex care works and how patients come in,” Bahr added. “The goal is to determine what to do when they're ready to move on from here and how we graduate them from complex care. Parent advisors are at every single meeting.”

Bahr noted that the process began with research and clinical staff asking about the patient experience. Things have now progressed to the point where staff proactively ask how a process works behind the scenes and how staff can make it work better. 

“As a group, I feel like we can't do anything without running it by the parent advisors,” Bahr acknowledged. “Now we consider if we should make a change before first getting input from our parent advisors, knowing that their input is needed. It’s been transformative to learn that just because it works great for the provider, it doesn't necessarily mean that it's going to translate into great care.”

Bahr now considers parent advisors and their role to be woven into the fabric of the clinic’s work.

“Ultimately, I can't praise our parent advisors enough,” Bahr concluded. “They are incredible human beings.”

Rhonda Cady, RN, PhD