By Jamie Cetrone | Categories: | Comments Off on 500 in 5 campaign (housing development)
This program originated from Truman Medical Center’s behavioral health program (TMCBH). TMCBH’s homeless outreach services needed access to housing units to stabilize behavioral health clients with multiple health care needs that were routinely rotating through the emergency department (ED). They renegotiated a state contract that had unused funds and secured a partnership with a supportive housing developer. A local university did a brief market analysis to help determine the number of units that could have a significant impact in the community. This led to a 5-year campaign to develop 500 units of housing in the metro area while measuring impact on healthcare and treatment.
The hospital does not allocate any direct resources. Medicaid pays for support services for most tenants served, and HUD pays for non-Medicaid reimbursed support services for those pending Medicaid and the chronically homeless. HUD dollars or Missouri Department of Mental Health monies are used to pay rental assistance, and private foundation dollars are sometimes used to fill gaps. In year one, the program has been targeting chronically homeless individuals that frequent the ED and transition-aged youth at risk of homelessness.
TMCBH partners with organizations on a project by project basis, including the Vecino Group, the Corporation for Supportive Housing, local non-profits, and multiple community landlords. When targeting transition-aged youth with mental illness, the program partnered with a local private university that had vacant dorm space to create four units of supportive housing while also enrolling the youth in college (with private foundation monies). For chronically homeless individuals, program staff secured a local landlord and master-leased 20 units with HUD and state dollars. TMCBH agreed to provide on-site staffing for 40 hours per week and keep the units filled so there are no vacancies longer than 30 days. Collaborations are specific to the population being housed.
TMCBH launched the campaign in October 2017 and have secured 25 units with an additional 45 under development. An initial report demonstrated a 68% reduction in ED visits for 22 clients in the first 6 months of housing. Research will be collected every 6 months to evaluate impact.
By Jamie Cetrone | Categories: | Comments Off on Spartanburg’s Way to Wellville
In 2015, Spartanburg was one of five communities in the nation chosen to participate in the Way to Wellville; a challenge to develop new and innovative solutions that amplify and accelerate community health. Sponsored nationally by HICCup, Spartanburg’s Way to Wellville is working to improve health outcomes through five focus areas in the City of Spartanburg: obesity prevention; kindergarten readiness; access to care for the uninsured; health for the insured; and community pride.
A Core Team of cross-sector leaders serves as the key navigator for Spartanburg’s Way to Wellville. This leadership group monitors progress, supports committees in meeting their goals, and explores and evaluates other potential partnerships and related opportunities. Way to Wellville committees create goals and develop specific projects and programs for each of the five focus areas. The hospital and participating organizations leverage resources and equally share the expenses of the Coalition. Although the Way to Wellville focuses on all residents in the City of Spartanburg, particular emphasis is placed on the vulnerable and the very young.
Hospital leadership sit on the core team and look for multiple ways to include the health system in the work. Programs working to find access for the uninsured, a small business wellness cooperative, home visitation programs for new moms…..all involve the health system in some way.
The Way to Wellville explores innovative and creative ways to address critical health issues in the City of Spartanburg. Examples include:
A major initiative to introduce nine programs that would be available to all new mothers and the 650 babies born in the city each year is underway. From home visitation to parenting classes to quality early learning, they are working on a pay-for-success model of financing and look forward to rolling out in 2019.
A prototype of a small business wellness cooperative is currently being built and a pilot will launch mid- 2018. This will allow small business owners to provide similar resources to their employees that large employers do.
By Jamie Cetrone | Categories: | Comments Off on Hurley Medical Center Food FARMacy
After reviewing other hospital programs which address social determinants of health (via America’s Essentials Hospitals and Advisory Board), Administrator of Population Health, Alisa Craig, developed a strategy that was approved by Hurley Senior Leadership. This resulted in hospital-wide screening (2-questions) for food insecurity and referral to the Food FARMacy (opened 8/1/17) if screening was positive. Hurley Medical Center’s (HMC) vision is to expand beyond the walls of the hospital to provide the best possible care to our community. By truly treating “hunger as a health issue”, Hurley is taking an important step in addressing social determinants of health within very vulnerable populations. With the rate of food insecurity being higher in Genesee County than the national average, addressing this issue proactively will have a tremendous impact on a patient’s ability to manage a chronic disease or fight illness. This is extremely important in children and older adult populations who have high rates of food insecurity. Hurley Medical Center’s Food FARMacy addresses the issue of food insecurity in their patient population by increasing access to healthy foods and providing them with additional resources to assist them long-term.
In August 2017, Hurley began screening for food insecurity (within their electronic medical record – EPIC) and providing referrals to the newly opened Food FARMacy. Upon discharge from inpatient units or outpatient primary care clinics, a patient who gets this referral can get nutritious food for themselves and their household members, twice per month, for three months. The food provided is tailored based on their health needs, chronic conditions, and allergies. The patients have the opportunity to meet with a Registered Dietitian while at the FARMacy, and are given community resources for longterm support. Assistance is provided to make sure the patients are appropriately enrolled in benefits such as SNAP, WIC, and Double Up Food Bucks.
By addressing their food insecurity, patients will be able to better manage their chronic conditions, not have to make as many financial “trade-offs” (like having to choose to pay for medicine vs. food), and may have improvements in health status. Hurley provides the physical space for the Food FARMacy, which is co-located within the Adult Diabetes Center. Funding for a part-time dietitian and food comes from a Community Foundation grant. Program staff work closely with the IT department (EPIC) to establish the screening/referral/reporting process.
Collaboration is key, both internally and externally. The EPIC (EMR) team is crucial in this project, and staff has engaged all levels of nursing, nursing management, nursing education, residents, and the GME dept. Externally, staff work very closely with the Food Bank of Eastern Michigan to get most of the food. They also supplement via local gardens (MSU-E Edible Flint) and growers. Volunteers come from the hospital’s foundation volunteer services, students from the MSU School of Human Medicine’s Leadership in Medicine for the Underserved, and AmeriCorps team members via Pediatric Public Health Initiative. Funding is provided from the hospital, hospital foundation, and the Community Foundation of Greater Flint.
Funding through the Community Foundation of Greater Flint;
To date, close to 800 people have received food from the Food FARMacy, with new patients being referred daily. The need is great, and they have already seen a 35-53% Food Insecurity rate in primary clinic settings. In addition, the program has helped several patients get appropriately enrolled in nutrition assistance programs. Program staff hope to have more specific data, related to health outcomes, to share by July 2018.
By Jamie Cetrone | Categories: | Comments Off on Fresh Foodies
A significant proportion of Harris Health System’s primary care patient population is obese (BMI > 30); and nearly one third of patients with a diabetes diagnosis are considered to have poor control of their blood glucose levels (A1c >9). This data highlighted the need for more comprehensive, patient-centered education and support and led to the development of the Fresh Foodies program. The goal of the program is to help patients with diabetes and obesity manage their health with nutrition through grocery store tours and food vouchers. These tours reinforce the lessons from group nutrition classes and individual appointments that participants have with a registered dietitian.
Patients have to attend two appointments with a registered dietitian or one appointment with the dietitian (RD), and one nutrition class. Once completed, the RD sends the patient list to the health educator who then invites the patient to participate in the tour. The health educator works with grocery store management to schedule the tour and order the $30 gift cards. Health educators and community health workers provide reminder calls, grocery store tours, and follow-up phone calls. The tour guide focuses on the perimeter of store and selected inner aisles (i.e. bread, beans, and frozen food aisles). Upon completion of the grocery store tour, the patient is provided with a $30 grocery store gift card to practice planning and purchasing healthy foods for family meals on a budget.
Funding for the program was provided by the Harris County Hospital District Foundation. Harris Health Nutrition Services and Harris Health Community Outreach Services work collaboratively to provide nutrition education to patients in individual and group settings and lead patients on the tour. The grocery store tour takes place at an a H-E-B Grocery Store located near the participating community health centers.
In five months, 67 patients were provided with semi-personal (one staff per two patients) guided grocery store tours and 40 of the 67 participated in the two-week follow-up phone call. Patients have reported learning how to purchase more food for less money, select fresh produce, read labels, shop for fresh and not processed food. Patients also report learning that fresh vegetables and fruits are better than canned food. All patients believe the grocery store tour enhanced what was taught during the nutrition class and during their appointment with the dietitian, and all patients report that they would recommend the tour to friends and family.
By Jamie Cetrone | Categories: | Comments Off on Caught in the Crossfire
In 1993, Sherman Spears, a paraplegic former gunshot victim working at local CBO Youth ALIVE!, began visiting young gunshot wound (GSW) victims at the Oakland hospital where he had been treated. This became Caught in the Crossfire, the first hospital-based violence intervention program – now a national model.
The program serves youth and adult survivors of intentional injury (gunshot, stab wound, and physical assault) with immediate response upon hospital treatment in the golden moment when the patient is open to long-term support. Continuing post-discharge for 6-12 months, trained intervention specialists from the peer community of the patients will provide case management, mentoring, linkage to mental health and services, safety assessment/retaliation prevention, and other services in the field/community in order to prevent retaliation and reinjury and to promote physical, social, and emotional healing from trauma.
This program coordinates with hospital Administration, Social Services, and Trauma to access patient records, coordinate hospital access to visit patients, and to communicate about follow-up care. Community partners include Youth ALIVE!, Eden Medical Center, Children’s Hospital Oakland, Alameda County Emergency Medical Services, and the City of Oakland.
Program measures include positive outcomes such as attachment to mental health services, education/employment and housing, and reduction in negative outcomes such as arrests and injury recidivism. Without intervention, nationally, up to 44% of patients recidivate within 5 years. In the program, it is less than 3%.
By Jamie Cetrone | Categories: | Comments Off on Rx for Change
The Rx for Change program was created with funding and support from Regional One Health’s Foundation, and a partnership with the Office of the Mayor of the City of Memphis. The purpose of Rx for Change is to “intervene and offer support and guidance to victims of violence” by connecting clients with community resource partners which may 1) reduce retaliation levels, 2) allow clients to achieve personal goals, and 3) reduce recidivism rates.
The program serves clients ages 14-24 who are victims of intentional violence and residing in Shelby County, Tennessee. The program is funded and staffed by the hospital, but involves a number of internal and external partners that help assist clients with navigating on-going care, as well as completing personal goals outlined by the client once they are discharged. Partners include: Blue Cross/Blue Shield, Regional One Health Foundation, the City of Memphis Mayor’s Office, GRASSY, 901 BLOC, Workforce Investment Network, HopeWorks, and Hospitality Hub.
Clients are reviewed at the end of a six-month period of time to assess progress. At that time the client is marked graduated, or not. Through-out the process clients are marked active, deferred, inactive or referred. These categories allow us to monitor progress toward success. To-date, approximately 200 clients have been on-boarded. Repeat Intentional Injury rates are low, and this past fiscal year three clients were successfully graduated.
By Jamie Cetrone | Categories: | Comments Off on Lincoln-West School of Science & Health
MetroHealth leadership wanted to develop a program that would help local high school students realize a more promising future. In September 2016, the Lincoln-West School of Science & Health opened within MetroHealth Medical Center. With deep immersion in the MetroHealth community, including exposure to a wide variety of careers in the health system and health care industry at large, the goals of the school are to mentor students and prepare them for post-secondary and career opportunities.
Students come from throughout the Cleveland Metropolitan School District, and the program is managed by a MetroHealth employee. In addition to core classes, students have a health industry-specific curriculum that includes community health, empathy, exercise, leadership, medical simulations, and ethics. Freshmen are on-boarded through monthly field trip experiences and sophomores are matched with mentors in areas of interest. Juniors participate in a scholar-employee shadow program and seniors are hired as unpaid interns in various departments throughout MetroHealth.
Per their specific interests, students are matched with hospital employees who are mentors, so they can see firsthand what a career in their interest area entails. Students can be matched with doctors, flight nurses, accountants, food service workers, development staff, strategy teams, any of the hundreds of jobs in a health system.
There has not been a graduating class yet because this is only the second year of the school. It is anticipated that with the smaller class sizes, devoted teachers, and hospital employees who volunteer as mentors and tutors, students will receive the support and encouragement they need to flourish.
By Jamie Cetrone | Categories: | Comments Off on West 25th Street Community Transformation
MetroHealth’s mission is a healthier community. In addition to good health care, for individuals and families to become healthier they need affordable and safe housing, access to fresh nourishing food, and employment. MetroHealth is taking steps to revitalize the neighborhood surrounding the hospital campus. As MetroHealth embarks on a multi-million-dollar campus transformation that includes a new hospital, it is focusing on the growth of residential, commercial, and retail development in the area. The five-year goal is to revitalize the neighborhood to attract new residents and commerce by improving public transportation, offering a mix of moderate and market rate housing, and stimulating job growth so current residents can move on up, not out.
The largest concentration of Hispanics in Ohio is in the neighborhoods surrounding MetroHealth Medical Center, and median incomes are close to the federal poverty level for most families. MetroHealth, a primary anchor in the community, is the largest employer on the west side of Cleveland. To accelerate revitalization, MetroHealth is creating the CCH Development Corporation, a nonprofit 501(c)(3), which will secure funding from private and public sources. It will acquire land and other assets, construct residential and commercial buildings, own and manage real estate, and have the authority to form legal partnerships with private and public entities.
Many hospital departments, such as Arts in Medicine, Aamoth Family Wellness Center, and specific specialties will provide programs and care to enhance lives and ensure better health. MetroHealth also is working with private, governmental, and nonprofit partners to promote economic and community development.
The economic and community development activities will contribute to population health. There will be “placemaking” enhancements to improve the quality of life of residents and those who come to work, visit, shop, and play in the West 25th Street neighborhood.
By Jamie Cetrone | Categories: | Comments Off on Healthy Youth Transitions
Memorial Healthcare System in Hollywood Florida started the Healthy Youth Transitions (HYT) Program 7 years ago as a result of an investigation of the child welfare system which identified gaps in services when youth unsuccessfully transitioned to adulthood with little support, skills or preparation. HYT helps youth and young adults age 15 to 22 who are aging out of foster care make the transition to independent living.
The program structure is provided by Memorial Life Coaches, who develop rapport and engage youth in an open, honest professional relationship in order to assist them with successful transition to an acceptable, responsible, productive adulthood. Typically, the youth distrust the very systems they have relied on as they have been disappointed frequently by foster care agency staff turnover, lack of services, frequent group home relocations (several youth served have been in over 20 homes in the 10-12 years they have been in foster care) and being separated with the siblings. By building a safe and nurturing relationship, HYT youth being to realize that the Memorial staff are here to help them grow, mature and develop into the adults they desire to become but did not have the role models or consistent caring adults in their lives. The Life Coach aims to help each participant gain skills and self-sufficiency to navigate the logistics of daily living, health management, social relationships, education, employment and money management, and other aspects of young adulthood.
All of Memorial Healthcare System’s Community programs and initiatives are rooted in collaborative partnerships that work to strengthen families and communities. HYT involves internal collaboration, with partnership from the primary care, specialty services, and behavioral health departments. External community partners include local universities, food banks, legal service providers, and the sheriff’s office.
Current outcome measures of the program found that 96% of the females have had no new pregnancies, 98% of all youth have had no new law violations, 98% demonstrated proficiency in employability and/or job retention skills, 86% made progress in school, were promoted, graduated, or obtained a GED, and 89% have obtained stable housing.
By Jamie Cetrone | Categories: | Comments Off on Road to Better Health
The Road to Better Health Coalition (RTBH) was formed in 2008 following a community health assessment that identified serious needs in the areas of teen pregnancy, access to care, obesity and other health-related issues. It also confirmed that the community faced significant health disparities related to race, income and education. Leaders took action and formed RTBH, a coalition of over 70 partners and stakeholders, to identify health priorities for Spartanburg County and improve health outcomes through data-driven decision-making. The current priority areas are access to care, adult oral health, behavioral health, birth outcomes, health equity, obesity prevention and tobacco cessation.
The RTBH Coalition is guided by an Advisory Board that includes key leaders from 18 organizations. The Advisory Board provides leadership and strategic input on the operations and activities of RTBH and serves as the collective decision-making body. RTBH taskforces have been formed to establish goals and monitor progress across each of the priority areas. The hospital and participating organizations leverage partnerships and resources and equally share the expenses of the coalition. Although the RTBH focuses on all residents of Spartanburg County, particular emphasis is placed on disparate populations.
The RTBH Coalition strives to connect and mobilize partners who are working to improve local health outcomes. The hospital along with representatives from academia, non-profits, government, philanthropy, and the business community offer their skills, expertise, and resources to the coalition and are committed to bringing about positive change as engaged members of RTBH taskforces and initiatives.
RTBH stakeholders come together every three years to review and prioritize the critical health issues identified in the Spartanburg Community Indicators Public Health Report. They also convene annually to assess progress toward collective goals. The following initiatives serve as select examples of successful efforts to address community health concerns and reduce healthcare costs.
AccessHealth Spartanburg (AHS) connects uninsured residents to a network of donated care, a medical home, and other services including behavioral health care. The success of AHS has contributed to the decrease in charity costs at Spartanburg Medical Center from $116 million (2008) to $64 million (2016). For every $1.00 invested in AHS, there is $12.62 returned in benefits.
Collaborative efforts among local institutions and multiple community partners have led to a remarkable reduction in teen birth rates. The overall teen birth rate for 15-19 year olds in Spartanburg County decreased by 50% from 2010 – 2016. The most substantial decline occurred among African American females; decreasing by 68% from 2010 to 2016.
Spartanburg County’s County Health Ranking improved from 21st in 2010, to 18th in 2014, to 14th in 2017.
