By Jamie Cetrone | Categories: | Comments Off on Worcester ACTs
The HOPE Coalition (Healthy Options for Prevention and Education), funded by UMass Memorial Medical Center, is launching a new initiative, Worcester Addresses Childhood Trauma (Worcester ACTs) for children who have witnessed violence. This program is a response to research conducted by the coalition’s director Laurie Ross, PhD in partnership with the Worcester Youth Violence Prevention Initiative (WYVPI).
For over a decade, the Worcester Police Department (WPD) has actively worked to reduce gang-related violence, and progress has been made in lowering the occurrence of violent incidents involving city youth. But young men of color — particularly Latinos — are still highly involved in serious incidents. In 2012, as the research partner with the Safe and Successful Youth Initiative (SSYI), a state program, Dr. Ross read case histories of young men who are a proven risk for gun or knife violence. Thirty percent had their first violent experience (as a victim or witness) before age 12, and 30 percent were parents, creating the potential for an ongoing cycle of violence. Analysis of WPD data encompassing 24,000 men (younger than 27) and 98,000 incidents showed that if they had been a victim or witness to violence before age 12, they were 49 percent more likely to have a violent incident later and participate in three more recorded incidents than those not involved with police at an early age.
Even more surprising was that if they had been a witness only, they were more likely to experience violence later in life than those who were victims only. While most social services support victims, Worcester ACTs will introduce timely trauma-informed family support for children under 10 and their families who have witnessed an incident. Within 72 hours of a call to the police, a culturally competent Community Health Worker (CHW) will help the family with emergent and longer term needs.
Worcester ACTs includes the below partners, who work together to address an identified gap in the connection of young children who have witnessed violence to needed social and mental health services:
Center for Health Impact
Central Massachusetts Area Health Education Center, Inc.
Clark University
Community Healthlink
Fairlawn Foundation Fund at Greater
Worcester Community Foundation
Straight Ahead Ministries
UMASS Medical School Child Trauma Training Center
Worcester Division of Public Health
Worcester Police Department
YWCA of Central Massachusetts
All 400 WPD officers have already received training on how trauma affects a child’s brain development and hiring of CHWs is underway. The program launches in January, 2018.
By Jamie Cetrone | Categories: | Comments Off on Youth Mental Health Model
UMass Memorial Medical Center provides funding to support the coordinator role of the Healthy Options for Prevention and Education (HOPE) Coalition, a youth-adult partnership created to reduce youth violence and substance use, and promote adolescent mental health. HOPE addresses public health concerns affecting at-risk youth, including tobacco and alcohol use, violence, and access to mental health. Several programs initiated through this effort include; HOPE Peer Leaders, a program that works closely with the City of Worcester Health & Planning departments to change local policies that regulate outdoor signage of tobacco products; HOPE Mental Health model, provides on-site mental health services at youth-serving organizations; and Youth Worker Training Institute, a thirteen-week program that trains Youth Workers on protective factors in order to work better with adolescents.
HOPE peer leaders co-chair the Youth Substance Abuse Prevention Task Force with the Worcester Division of Public Health (WDPH). In fiscal year 2016, peer leaders focused on changing the city’s tobacco purchase policy and, by working with the WDPH, successfully raised the minimum age for tobacco purchases in the city to 21.
In 2016, the program served approximately 631 youth through one-on-one counseling, therapeutic groups and crisis intervention delivered by You, Inc. Since its launch, the model has served over 5,000 youth who otherwise would not have had access to mental health support.
By Jamie Cetrone | Categories: | Comments Off on Veggie Mobile
The Regional Environmental Council (REC) developed the Grant Square Community Garden in 2010 with support from UMass Memorial Medical Center and the City of Worcester. It has 30 raised beds maintained by the REC YouthGROW program and neighborhood residents. The youth tended garden generates between 500-800 pounds of produce for the neighborhood and 15 stops in food-insecure areas across the city through REC’s “Veggie Mobile” mobile farmers market, including three stops in Bell Hill. Medical Center funding doubles the value of food stamps for purchase at the Veggie Mobile.
UMass Memorial Medical Center partners with the Worcester Regional Environmental Council (REC) to bring fresh produce to low-income/food-insecure neighborhoods through the Veggie Mobile program. Funding provided by UMass Memorial Medical Center to the Worcester Regional Environmental Council doubled SNAP purchases on the Veggie Mobile. REC’s Food Justice Program works to increase access to nutritious, healthy, and locally grown food in Worcester’s food-insecure neighborhoods, including Bell Hill where the UMass Memorial campus is located. REC programs encompass a community garden, three school gardens, a YouthGROW urban farm, and the Veggie Mobile which makes 15 weekly stops in all five of the Neighborhood Revitalization Strategy Areas identified in the city.
Since 2012, SNAP and EBT purchases on the Veggie Mobile have increased from 30% of sales, to 90% currently. Total purchases have increased by 300 percent.
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 Pathways to Nursing
Pathways to Nursing was initiated by the Chief Community Relations Officer and the Kansas City Public School Assistant Superintendent of Innovation & Special Projects. The initial goal was to pair Certified Nursing Assistant (CNA) students with nurse mentors, leading to a program where CNAs shadow their mentor and attend education sessions at the hospital on a weekly basis. Upon satisfactory completion of the program and their clinical requirements, the students are issued a letter of intent to hire. Students come from the Manual Career Technical Center, a part of Kansas City Public Schools located in the urban core and underserved zip codes.
Hospital resources used for the program include staff time and budget for supplies such as food, etc. Transportation is provided by Kansas City Public School District.
The anticipated outcomes of the program are: employment, advanced knowledge of career options, and development of a talent pipeline.
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 Aqui Para Ti
Aqui Para Ti (APT) was created in 2002 to support Latino adolescents who are often raised in a different culture than that of their parents. APT became a certified Health Care Home in2010, and a certified Behavioral Health Home in 2016.
The program serves to consult and educate teens and families about topics such as health, relationships with family and friends, concerns with weight/height, mental health, abuse of drugs and/or alcohol, family planning, and sexual health. The program provides complete physical exams, pregnancy tests, treatment of common diseases, pregnancy care testing, and treatment for sexually transmitted infections (STIs).
This program works closely with the staff of the Family Medicine department and the Whittier Clinic where the program is located. The program is funded by the Eliminating Health Disparities Initiative of the Minnesota Department of Health. Aqui Para Ti is also closely affiliated with the Between Us Initiative, another Latino teen focused program that helps build communication between teens and their parents.
Aqui Para Ti currently has 300+ active patients with 70 new patients added each year.
By Jamie Cetrone | Categories: | Comments Off on Bridge to Employment
The goal of this pilot program, a partnership between JEVS Human Services and Einstein Healthcare Network, is to place youth on a path leading to career opportunities, financial stability, and personal fulfillment in the health care field.
Participants of Bridge to Employment were identified by school guidance counselors at Kensington Health Sciences Academy and YouthBuild as individuals who, although facing adversity in their life and home situation, show strong potential for overcoming challenges and making the most of all the opportunities being offered through the program.
Upon completing JEVS’s two-month comprehensive educational and skills training phase, then a month-long, hands-on externship experience at Einstein, these eager young adults are placed into entry-level positions as patient services representatives throughout Einstein’s network of medical facilities. The program prepared them to be well-rounded and effectively serve as the first-point-of-contact for patients upon entering the facility by covering related soft skills, customer service know-how, and topics of instruction including insurance, medical terminology, ethics/HIPAA regulations, medical office database, office essentials, and more.
By Jamie Cetrone | Categories: | Comments Off on Next Step
The Next Step program was launched in July 2016 with the goals of reducing the rate of violent re-injury and re-hospitalization for youth and young adult victims of violent assault injuries, supporting positive development and holistic healing for victims and families affected by violence, and interrupting the cycle of recurrent violence.
The Next Step program is a hospital-based violence intervention program. It is available to individuals ages 12 – 28 who are admitted to HCMC with a violent injury. The program starts as an in-hospital crisis intervention with staff youth workers who are available to provide immediate and ongoing support, advocacy, and connection during the full hospital stay. The youth workers enable and empower participants to envision a different future and to help them create a goal plan towards that new vision. Next Step youth workers continue to provide support after discharge and facilitate connections with other community resources to support participants as they work towards their goals. Funding for the programs comes from the city of Minneapolis and the Minnesota Department of Public Safety – Office of Justice Programs. The hospital staffs Next Step. There are currently three youth workers who are the heart of the program.
The Next Step program staff have worked collaboratively with other hospital departments to re-view, re-think, and re-write protocols for admitting and transferring victims of violent injuries so that the processes are trauma-informed and trauma-sensitive. The resulting protocols take into account the needs of patients, their families, staff, visitors, providers, and the community. Next Step staff also regularly work with myriad community-based providers to meet the diverse needs of program participants. Additionally, via partnership with the City of Minneapolis Health Department, the program is part of a broader collective impact network of jurisdictional partners and stakeholders focused on preventing youth violence across the city.
During the first year of Next Step 98 individuals participated in the program. On average, 38 participants were actively receiving services at any given time. Only 3 (3%) of the program participants had returned to HCMC with a violent injury. (National average for re-injury after a violent attack is ~40 %.) Nearly 60% of participants developed a goal plan and received support from staff toward at least one goal. (Goals might relate to safety, housing, school, employment, basic needs, positive social activities, etc.) Of those who developed a goal plan, 70% completed at least one goal.
By Jamie Cetrone | Categories: | Comments Off on The Food Shelf @ HCMC
The Food Shelf @ HCMC was started to address hunger and food insecurity among patients and families, with a long-term vision of creating a hunger-free hospital where all patients have the healthy food they need for their well-being.
The program serves patients and families who receive care at the primary care and specialty care clinics located within the hospital and/or at one of the hospital’s community clinics. Volunteers help package inventory and fill sturdy bags with healthful groceries. The bags are then delivered to the each participating clinic and are available for staff to give to patients/families in need.
The Food Shelf @ HCMC staff work closely with clinic staff in different departments to make sure they provide options that meet patients’ nutritional needs related to specific health conditions. The staff work with a variety of community partners to make sure they are able to provide both non-perishable foods for those with limited access to food storage as well as fresh produce and other foods to those with adequate food storage options. A major partner is Feeding America’s Second Harvest Heartland, which distributes food to food shelves throughout the state. Food is packaged in sturdy, handled bags which can be managed on public transportation, and are filled with items tailored to specific patient populations.
The Food Shelf @ HCMC serves nearly 30,000 households composed of approximately 90,000 individuals each year. More than half of the individuals served are children.
