PROJECTS
BY STATE
ALABAMA
D04RH04340
Terry Watkins
East Central Mental Health-Mental Retardation, Inc.
200 Cherry Street
Troy, Alabama 36081-2044
Phone: (334) 670-5261 Fax: (334) 670-5256
Email: twatkins@knology.net
Fiscal Year 2005 2006 2007
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Obesity
East Central Mental Health-Mental Retardation,
Inc., has initiated a partnership of community agencies committed
to the development and implementation of a comprehensive, countywide
health risk prevention and outreach project. The project will focus
on preventing school-age obesity and increasing physical activity
using the Coordinated Approach to Child Health Model, a school-based
nutrition program. Goals of the project are (1) to form a supporting
network to the consortia in Alabama's Bullock and Pike counties
that reflects the growing cultural diversity; (2) to advance the
scope of the existing rural health promotion program to prevent
obesity in school-age children; (3) to implement a health prevention
and education project in the public schools that will provide school
children with the information and skills they need to avoid health-damaging
behaviors and to live healthy lifestyles; and (4) to encourage parents
and extended family participation in health risk prevention and
education programs to dissolve barriers to healthy lifestyles.
The project will target students in grades 3 through
5 in rural Pike and Bullock counties where unmet health needs and
at-risk behaviors present serious health risks and contribute to
educational and social problems. The target populations will be
multicultural, representing all racial, social, and economic backgrounds
in the two counties. Contributing to the overall ill health of community
youth is the lack of parental awareness concerning health topics
and detached parental involvement in child health issues. Implementation
of the project will provide students with the skills they need to
make healthy choices for life and will strengthen communities by
increasing collaboration among parents, teachers, and other school
partners.
Access barriers include inadequate or lack of
health insurance, lack of Medicaid providers, cultural and spiritual
barriers, lack of education and awareness, language barriers, and
difficulty getting to a health care facility due to the lack of
public transportation. In the past, this project made a significant
difference in the lives of youth in Pike County. By expanding this
program to Bullock County, more students will be given a head start
on a healthier life. Bullock County is designated as a Medically
Underserved Area for dental and primary health care professionals.
The network partners consist of eight members
of the Pike County Consortium, including East Central Mental Health-Mental
Retardation; four members of the Bullock County Consortium; and
community supporters in both counties.
D04RH06949
Margaret Morton, Ed.S., Executive Director
Sylacauga Alliance for Family Enhancement, Inc.
P.O. Box 1122
Sylacauga, Alabama 35150
Phone: (256) 245-4343
Fax: (256) 245-3675
E-Mail: mortonm@safesylacaupa.com
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keywords(s): Heart disease, Chronic Obstructive
Pulmonary Disease, Diabetes, Hypertension, Disease management, Faith-based
health advocacy
The goal of this project is to increase the quality
and years of life for individuals of the target population of under
and uninsured residents of Talladega County, Alabama with chronic
diseases of Congestive Heart Failure (CHF), Chronic Obstructive
Pulmonary Disease (COPD), Diabetes and/or Hypertension. The vehicle
by which is through a community partnership using a computer-assisted
Parish Nurse Disease Management Program (PNDMP). This PNDMP provides
a community based holistic approach and extends the impact of the
Parish Nurses with the use of Family Health Advocates (FHAs) using
laptop computers to access the management information system. The
use of FHAs will expand an existing innovative community disease
management program of parish nursing by enabling more clients to
be enrolled for a longer period of time. Utilization of a management
information system (MIS) by the community consortium providers,
a parish nurse and the family health advocates will allow for efficient
and effective exchange of information and standardization of data
collection in a community setting. Indicators of success of this
project will be a 94 percent increase in enrollment, achievement
of one or more of individual health goals, an improvement in quality
of life as indicated by results of a SF36 survey, a 30 percent increase
in pharmaceutical support (or $250,000), a 50 percent increase in
the number of social and health services provided to the target
population and a 30 percent increase in the utilization of the community
health network MIS. This project builds on existing research on
the relationship between spirituality and health, the effectiveness
of lay community health workers, and enabling technology. The further
development and expansion of a PNDMP in addition to meeting real
needs in this rural community provide a replicable model for use
in other rural communities.
D04RH06951
Antoinette Lankster, R.N., B.S.N.
Tombigbee Healthcare Authority
Bryan W. Whitfield Memorial Hospital
105 Highway 80 East
Demopolis, Alabama 36732
Phone: (334) 287-2579
Fax: (334) 287-2594
Email: mlankster@bwwmh.com
Fiscal Year 2006 2007 2008
Funding Amount $149,122 $123,292 $100,000
Keywords: Health promotion/disease prevention
(general), School-based primary health care, Faith-based primary
health care, Health education
The Rural Assistance Program for Churches and
Schools (RAPCS) will provide access to health care for disadvantaged
populations in Green, Sumter, and Marengo Counties. These counties
are ranked among the poorest in the State and the Nation. They are
rural, medically underserved, and have a large African American
population. The prevalence rates of numerous chronic health disorders
are higher in this area than other comparable areas in Alabama,
which overall has higher rates than other States. In addition to
higher rates of chronic disease, the area suffers from inaccessibility
to health care due to the unavailability of public transportation.
There also are major behavioral and social problems, such as teen
pregnancy, low birth weight, high tobacco use, and alcohol and drug
abuse problems. According to the most recent census data, the average
median household income is 36 percent of the State average. These
persons also are the ones without health insurance coverage. Those
who are covered have government-provided insurance such as Medicare
and Medicaid. Census data also show that individuals in the targeted
counties have a high school graduation average of 67 percent-below
the State average. Low education and employment perpetuate the economic
problems and often result in poor health practices and local of
knowledge about accessing and using health care resources. These
factors and others provide insurmountable barriers to health care
in this region of Alabama.
The purpose of this project is two-fold:
1) To improve access to health care by establishing outreach health
care sites throughout the counties in schools and churches where
people are isolated and lack direct access to health care, and 2)
To implement a health education campaign that would increase public
awareness of health care resources and services in the community.
These goals will be achieved by providing nursing services in local
schools and churches; making primary health care services available
in schools and churches; and increasing access to preventive health
education programs. The target population includes school students,
churchgoers, senior citizens, parents, and the working poor. The
project consortium includes local hospitals, health centers, school
systems, churches, and community-based organizations.
ALASKA
D04RH06909
Rose Heyano
President/Chief Executive Officer
Bristol Bay Area Health Corporation
P.O. Box 130
Dillingham, Alaska 99576
Phone: (907) 842-5201
Fax: (907) 842-9409
E-Mail: rclark@bbahc.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Elderly, Telehealth
The service area of this proposed project is the 34 rural communities
within the Bristol Bay Area Health Corporation (BBAHC) medical care
system in Alaska. Some 8,072 people live in the area, of whom 6,865
are all or part Native. The target population is the 555 persons
over the age of 62 that reside in the region. The most significant
barriers to care for the elderly are language and travel to advanced
medical care. Some 62 percent of elders in the service area speak
a language other than English. Of those, 9 percent do not speak
English at all, and 19 percent do not speak English well. There
are no connecting roads or bridges between any of the villages either
intraregional or to the hospital in Dillingham.
Community Health Aide/Practitioners (CHAP) provide
medical services in most of the village clinics, with a few of the
subregional clinics staffed with mid-level practitioners that also
travel to the smaller villages and provide itinerant care. Telehealth
is used increasingly to provide quality health care without the
need for the patient to travel. Dillingham has the most accessible
hospital; however there is no geriatric specialist available. More
advanced care must be sought in Anchorage or beyond. Many elders
have to move out of their villages and region as their medical needs
increase because of a lack of healthcare services, distance, and
travel expenses. This means that an elder is removed from his or
her culture, way of life, and family, causing a great deal of stress
for both the elder and family members. In the Yup'ik Eskimo and
Aleut cultures, the wisdom, knowledge, and life experiences of the
elderly are appreciated and acknowledged by the younger generation.
The overall goal of this proposed project is to
meet the healthcare needs of elders so they can remain in their
communities and stay connected to their homes and families for as
long as possible. There are five program goals: 1) To increase access
to specialized medical care for persons over the age of 62; 2) To
increase patient translation and advocacy services for persons over
the age of 62; 3) To increase provider staff knowledge of geriatrics;
4) To increase public awareness and knowledge of geriatric issues;
and 5) Increase Medicare enrollment in the target population. Strategies
to meet these goals include contracting with an itinerant physician
specializing in gerontology or internal medicine; referring elders
for assessments and treatment; providing transportation for elders
to the specialty clinic; and using telehealth capabilities to provide
services to elders in the remote villages; hiring two FTE Patient
Advocate/Translators to assist elders in accessing care; providing
staff with in-service training and community education regarding
geriatric issues; and providing education to identified patients
regarding the benefits of applying for Medicare coverage.
The realization of these goals will greatly enhance
and improve all aspects of health care for the elderly, which will
allow them to remain in their villages and to continue benefiting
the entire community. Another benefit of accomplishing these goals
is that medical providers, elders, and community members in general
will have an increased awareness and knowledge of elder health care
issues. Medical staff will be able to provide higher quality health
care services with an increased understanding of geriatric assessment
and treatment. It is anticipated that this project will be self-sustaining
at the end of the 3-year project period.
D04RH06910
Diana Turner
Executive Director
Kenaitze Indian Tribe
P.O. Box 988
Kenai, Alaska 99611
Phone: (907) 283-3633
E-Mail: dturner@kenaitze.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Colorectal cancer
This project will form a Colorectal Cancer Screening Consortium
through the Kenaitze Indian Tribe (KIT), the Ninilchik Traditional
Council, and the Alaska Native Tribal Health Consortium (ANTHC).
Cancer has been identified as the leading cause of death among Alaska
Natives, with colorectal cancer as the second leading cause of cancer
mortality. For the 5-year period from 1996-2000, Alaska Natives
were more than twice as likely to be diagnosed with colorectal cancer
as U.S. Whites. A high proportion of Alaska Native colorectal cancers
are diagnosed beyond the local stage, suggesting the need for improved
screening.
The consortium will serve more than 1,200 Native
Alaskan/Native American adults aged 50 to 80 years residing in the
rural Alaska communities of Kenai, Soldotna, Nikiski, Kasilof, Sterling,
Cooper Landing, Hope, Ninilchik, Anchor Point, and Homer. Lack of
flexible sigmoidoscopy services in our tribal health clinics and
distance from colorectal screening services in Anchorage are significant
barriers to access. Within 3 years, the consortium will increase
the percentage of Native Alaskan/Native American adults over age
50 living in the central and southern Kenai peninsula who complete
screening for colorectal cancer from the current rate of under 4
percent to a target rate of 50 percent. This goal will be accomplished
by developing a flexible sigmoidoscopy clinic at KIT health clinic;
sending one advanced nurse practitioner and one registered nurse
to ANTHC for approved training in flexible sigmoidoscopy procedures;
and conducting weekly flexible sigmoidoscopy clinics to over 500
patients in the next 3 years, with additional colonoscopy referrals
to Alaska Native Medical Center.
The consortium will monitor project progress,
identify and problem-solve barriers, develop local capacity, and
seek ways to expand outreach, networking, and public education.
ANTHC will provide intensive training in flexible sigmoidoscopy
procedures, as well as onsite follow-up and technical assistance
with both Tribes. The two Tribes will set up a referral mechanism,
as well as patient pre-screening and flow charts to be placed in
patient medical records so that individual patient progress and
follow-up can be tracked by medical care providers in each clinic.
KIT also will add the Colorectal Cancer package to its RPMS tracking
system. Both Tribes will provide patient education and preparation,
reminder calls prior to procedures, and assistance with transportation
through the low-cost area transit system or mileage reimbursements.
Each Tribe will implement public education and outreach.
The project will coordinate its efforts
with our local health and social service provider network, the Kenai
Health Services Opportunities Collaborative, State Office of Rural
Health, State Colorectal Cancer Task Force, and Alaska Tribal/rural
providers.
ARIZONA
D04RH06922
Jona Tso-Spears
Hardrock Council on Substance Abuse, Inc.
P.O. Box 26
Kykotsmovi Village, Arizona 86039
Phone: (928) 725-3501
Fax: (928) 725-3731
E-Mail: jaytsoua@yahoo.com
Fiscal Year 2006 2007 2008
Funding Amount $149,996 $125,000 $99,996
Keyword(s): Substance abuse prevention/treatment
The Hardrock Youth Wellness and Prevention Program
is a collaborative effort of the Hardrock Council on Substance Abuse,
Inc. (a local non-profit corporation), the Hardrock Chapter House
(a local governmental subdivision on the Navajo Nation), and the
University of Arizona Mel and Enid Zuckerman Arizona College of
Public Health's Project EXPORT. The purpose of the collaboration
is to strengthen their collective efforts in building a strong infrastructure
for substance abuse prevention, intervention and treatment at the
community level.
The Hardrock community lies in the heart of the
27,000 square mile boundary of the Navajo Nation and is part of
Navajo County in northeastern Arizona. Health disparities are critical
health issues for this isolated rural community, especially because
of its unique history. It is one of 11 Navajo communities that experienced
Federal relocation, land loss and livestock reduction as a result
of the 1974 Navajo-Hopi Land Settlement Act. Access to health care
is a major problem for the Hardrock community as the distance to
hospitals and clinics is over 60 miles away and the community has
severely limited and/or nonexistent medical and behavioral health
service providers.
The impact and extent of substance abuse has been
well documented in the past decade including 19 deaths in the community
in 1995. In a recent community-based survey in 2004, 84 percent
of respondents reported some association with someone, including
themselves, who is abusing alcohol or some other substance. More
than two-thirds of respondents knew of someone that was killed due
to alcohol or substance abuse since 1995.
The Hardrock Youth and Wellness Program
has two main goals: 1) To increase access and participation of youth
in substance abuse prevention education by using community-based
education programs that encompass the Dine traditional philosophy;
and 2) To increase access and participation of youth and their families
in culturally appropriate substance abuse intervention and treatment
programs. The population to be served will be children and youth
(age 4-18) and their families who reside in the Hardrock community.
The program will provide direct educational interventions through
a 6-week summer program and an additional 2-week long program during
winter and spring school breaks. It will also provide intensive
outreach, monitoring, and follow up to youth and their families
linking them with existing community-based intervention and treatment
services.
ARKANSAS
D04RH04335
Steven F. Collier
White River Rural Health Center, Inc.
P.O. Box 497
Augusta, Arkansas 72006-0497
Phone: (870) 347-2534 Fax: (870) 347-2882
Email: steven.collier@wrrhc-ar.org
Fiscal Year 2005 2006 2007
Funding Amount $162,765 $167,648 $172,677
Keyword(s): Chronic illness, Diabetes
The consortium for the Chronic Care Education
Outreach Program will expand an existing chronic illness self-management
education program to focus on the elderly in Woodruff and Prairie
counties in the Arkansas Delta region. The program will enhance
the capacity of existing community agencies to respond to the needs
of the increasing population with diabetes and other chronic illnesses.
Collaboration between community partners will result in organized
assessments, planning, and coordination of local resource agencies
to cultivate a regional comprehensive continuum of care for people
with chronic diseases. The program will use self-management interventions
to reduce health disparities and increase access to recommended
health care services for people living with diabetes and other chronic
illnesses. It also will incorporate a chronic care model used by
the Bureau of Primary Health Care and will provide services at long-term
care facilities to enhance access by the elderly population. All
activities will be coordinated with primary care services currently
provided in the area. The program will focus on increased access
to prevention, early detection, and treatment of diabetes and cardiovascular
diseases through the provision of a comprehensive self-management
education class on these chronic illnesses.
Woodruff and Prairie counties, the target counties,
have a combined population of 18,280. Seventeen percent of the population
is older than 65 years. The Arkansas Department of Health reports
that diabetes prevalence increases by age to an estimated 14.6 percent
for those older than 65 and estimates that more than 450 residents
older than 65 currently have diabetes. In addition, the rates of
diabetes, cardiovascular disease, and heart disease are higher in
the target counties than in other counties in the state. Residents
of Woodruff and Prairie counties live below 200 percent of the Federal
poverty level, and the two counties are officially designated as
Health Professional Shortage Areas and Medically Underserved Areas.
Barriers to access of health services include a 45-minute drive
to any kind of specialty care, and much of the population remains
undiagnosed for diabetes or cardiovascular disease.
The consortium for the Chronic Care Education
Outreach Program consists of White River Rural Health Center, Inc.,
the lead applicant; Woodruff County Nursing Home; Des Arc Nursing
and Rehabilitation Center; Baptist Health; and Arkansas Department
of Health Diabetes Control Center.
CALIFORNIA
D04RH05118
Margot Cybulska
Mendocino County Health Department
1120 South Dora Street
Ukiah, California 95482-6340
Phone: (707) 472-2637 Fax: (707) 472-2658
Email: cybulskm@co.mendocino.ca.us
Fiscal Year 2005 2006 2007
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Substance Abuse, Prevention Education
The Mendocino County Health Department and its
partners developed the Adolescent Drug Abuse Prevention and Treatment
Project (ADAPT) in response to the need for substance abuse prevention
and treatment services for rural youth in northern California. ADAPT
will team a substance abuse therapist with an intervention specialist
to increase youth resiliency-while reducing the incidence and harmful
effects of substance abuse-through prevention, intervention, and
treatment. The three primary components of the program are substance
abuse treatment; prevention education and opportunities for personal
growth and development through service learning, project-based modules,
and outdoor adventure; and family strengthening services. Program
goals are to reduce high-risk behavior for alcohol and other drug
use among youth; to increase refusal skills and knowledge of harmful
effects of substance abuse among youth; and to increase prevention
knowledge and awareness among parents. Services will be provided
at schools, community-based organizations, and county Alcohol and
Other Drug Programs (AODP) offices.
Widespread production, use, and abuse of alcohol
and other drugs as well as economic impoverishment exist in Mendocino
County, which is designated as a Medically Underserved Population.
Summary results for the California Healthy Kids Survey show a high
level of youth experimentation and involvement with alcohol and
other drugs. However, substance abuse treatment services for youth
are extremely limited throughout the county, especially in the targeted
communities of Willits (population 13,500) and Potter Valley (population
1,900). In Potter Valley, substance abuse treatment is not available
in any form; the AODP office in Willits offers limited treatment
to youth in alternative school or criminal justice settings, but
no treatment to youth in mainstream settings. In addition, residents
in both Potter Valley and Willits must travel 25 miles to Ukiah
for specialized services, and transportation is very limited. ADAPT
will provide services to youth age 13 through 18.
In addition to the lead applicant, the Mendocino
County Health Department's Division of Alcohol and Other Drug Programs,
ADAPT consortium partners include Howard Memorial Hospital, Nuestra
Alianza, Potter Valley Community Center, Potter Valley Community
Health Center, Potter Valley Community Unified School District,
Sherwood Valley Rancheria, Willits Action Group, and Willits Unified
School District.
D04RH06923
Meade Hallock
Tulare Local Healthcare District
869 N. Cherry Street
Tulare, California 93274
Phone: (559) 685-3424
Fax: (559) 685-3835
E-Mail: mhallock@tdhs.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Mobile clinic, Telehealth technology,
Primary care services, Specialist consultation
Tulare Local Healthcare District (Tulare District
Hospital, TDH) is the lead agency of a consortium composed of. Tulare
Community Health Clinic (a Federally Qualified Health Center), public
health nurses from Tulare County Office of Education's Migrant Education
Program, Tulare County Asthma Coalition, Alta Vista School District,
Pixley Union School District, and Love In the Name of Christ (a
501(C)(3) non-profit community based organization).
These partners formed this consortium to address
the lack of basic healthcare available in the rural, impoverished
areas of Alta Vista and Pixley in Tulare County, which is located
in the Central Valley of California. The purpose of the Mobile Clinic/Telehealth
Outreach Project is to provide primary health care services and
specialist consults, including dental services, to underserved residents
in rural Tulare County. TDH will visit each site once a week, on
a set schedule, bringing health care directly to the community in
a Mobile Health Clinic. Telehealth Monitors placed at each school
site will provide live access to the nurse practitioner on the Mobile
Clinic, Monday through Friday.
The low income population of these areas is designated a Medically
Underserved Population, as well as a Medically Underserved Community.
In addition, the target areas are designated as primary care Health
Professional Shortage Areas. (Alta Vista is in an unincorporated
region east of Porterville, MSSA 231/232.)
The focus of the Mobile Clinic/Telehealth project
will be primary care, women's health (with an emphasis on OB care),
pediatrics, asthma, diabetes, and hypertension. Specialist consults
and dental care will be provided at Tulare Community Health Clinic.
Public health nurses from Tulare County Office of Education's Migrant
Education Program will work closely with the Mobile Health Clinic
to provide these communities with access to health care.
Tulare County has the highest rate of diabetes
in the State, and the second highest rate of teenage pregnancy.
Central Valley has the highest rate of childhood asthma in California.
The target population is Hispanic agricultural workers and their
families. The Census Bureau reports that Tulare County has the fifth
highest percentage of poverty and the third-highest percentage of
people with less than a high school diploma in the nation. Statewide,
census statistics reveal that Tulare County has the highest percentage
of poverty, unemployment, and lack of education in California. Nearly
two-thirds of the population under age 18 in Tulare County live
below 200 percent of poverty-the highest rate in the State. Tulare
County is the leading agricultural producer in the Nation, yet the
Hispanic agricultural workers who harvest these crops live in extreme
poverty and suffer from poor housing conditions, malnutrition, and
lack of medical care. School officials in the areas targeted by
this grant confirm that over 80 percent of students are Hispanic,
and 93-100 percent of students at each school qualify for the Federal
Free or Reduced Lunch Program.
The Mobile Clinic/Telehealth project will provide
primary and preventative medical care for these impoverished communities
by taking services directly to the community. By placing permanent
telehealth monitors at each site, individuals without transportation
can walk to the school sites and receive medical treatment and consultation
Monday through Friday. Tulare Community Health Clinic will provide
specialist consultations and dental care by referral. Love INC is
already well established in all targeted areas, delivering food
and basic necessities to the communities through a network of local
churches.
D04RH06932
Dawn Sampson
Avalon Medical Development Corporation
Catalina Island Medical Center
100 Falls Canyon Road
P.O. Box 1563
Avalon, California 90704
Phone: (310) 510-0520
Fax: (310) 510-2381
Email: amdcsw@catalinaisp.com
Fiscal Year 2006 2007 2008
Funding Amount $149,120 $124,238 $94,942
Keyword(s): Satellite clinic, Bilingual specialty
services, Telemedicine technology, Substance abuse treatment
Located on Santa Catalina Island, 26 miles off the coast of Long
Beach, California, Catalina Island Medical Center (CIMC) provides
24-hour emergency room services, acute care, skilled nursing care,
rehabilitation services, and primary care services to residents
and visitors of Santa Catalina Island. There are 3,127 year-round
residents of the City of Avalon, the island's only incorporated
city. Forty six percent of the island population is Hispanic. Its
physical beauty and rustic charm make Catalina an attractive tourist
destination, drawing 1,000,000 annual visitors to the island.
While the picturesque Avalon may appear
to be an idyllic small town, the City struggles with many of the
same problems as much larger cities, and has added barriers to accessing
services due to the island's physical isolation from the mainland.
Catalina Island is designated a Health Professional Shortage Area.
Like most rural facilities, CIMC requires local financial support
to keep the doors open. The current needs to be addressed with this
project are as follows:
- The rugged West End of Catalina Island has
never had local primary medical care services available to its
493 year-round residents, 1,648 summer residents, and hundreds
of boaters and divers. To reach CIMC, located in the main city
of Avalon for primary care, residents of the West End must travel
the 23 mile, 1.25-hour trip over mountainous terrain and partially
paved roads. To reach a mainland facility they must travel at
least 1 hour by boat, then find ground transportation. The only
transportation service between the West End and Avalon costs $46
per round trip, and only one trip per day is available. Ownership
of private vehicles is limited by high barge costs to the island,
high cost of required liability insurance, and high gasoline costs
(currently $4.71 per gallon).
- There is a lack of specialty services on all
parts of the island. In the main city of Avalon, CIMC's medical
providers refer patients in need of specialty care to the mainland,
but compliance with these referrals is poor due to financial,
logistic, and frequently language barriers, particularly for the
low-income population. Especially needy are those patients who
require psychiatric services and diabetic patients requiring ophthalmology
services.
- Drug and alcohol dependencies are a large
problem in our community, but there are no local chemical-dependency
treatment programs.
A consortium consisting
of Catalina Island Medical Center, Loma Linda University Medical
Center, and the USC Catalina Island Hyperbaric Chamber, with the
help of the Santa Catalina Island Company and Two Harbors Enterprises,
will utilize creative outreach models to bring primary care services
through a satellite clinic to the remote island community of Two
Harbors. The consortium will also bring bilingual specialty services
to the island city of Avalon using telemedicine technology. Services
will especially benefit the medically fragile and low-income island
residents. In addition, a program feasibility study on development
of a chemical dependency treatment program will help the island's
sole community health care provider/ Critical Access Hospital to
tailor strategic program planning to the unique needs of the island
population while striving to develop a positive operating margin
to guarantee continuing operations.
D04RH06931
Janie Elson
Lindsay Unified School District
475 E. Honolulu
Lindsay, California 93247
Phone: (559) 562-5974
E-Mail: jcelson@lindsay.kl2.ca.us
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Health insurance enrollment, Primary
care, Dental care, Case management
The Rural Health Services Outreach Grant for Tulare County's Children's
Health Initiative specifically focuses on increasing medical and
dental access in two, majority-Latino, low-income, rural farm communities
of Lindsay and Woodlake within the central California county of
Tulare. Lindsay and Woodlake school district Healthy Start and Family
Resource Centers and the Children's Health Initiative coalition
through First 5 Tulare County are partnering with the Children's
Hospital Los Angeles' e-Dental Health program to provide a comprehensive
continuum of health care service for uninsured children.
The Tulare County Children's Health Initiative
(CHI) is focused on increasing dental and medical health access
for children ages 0-18 through outreach and enrollment into publicly
funded programs and by offering a new gap insurance product, Healthy
Kids, for children ineligible for state Medicaid (known as Medi-Cal)
or the State Children's Health Insurance Program (S-CHIP, known
as Healthy Families in California). Healthy Kids is a new, local
public/private partnership program with comprehensive medical, dental,
and mental health benefits mirroring the state Healthy Families
program. It is scheduled to launch in January 2006. Healthy Kids
will be for children in families with incomes up to 300 percent
of the Federal Poverty Level, regardless of immigration status,
and is modeled afer similar successful programs in other California
counties.
The project begins with health insurance enrollment
at local sites for children in Lindsay and Woodlake into current
public programs Medi-Cal and Healthy Families, if eligible, or Healthy
Kids-all in one application and one appointment for all children.
An e-Dental Health network at school sites that connects the rural
communities of Woodlake and Lindsay with a newly created e-Health
Center at Children's Hospital Los Angeles will utilize telecommunications
technology to provide dental consultation and treatment or treatment
referral. Participation in the e-Dental program requires some sort
of insurance coverage. It is estimated that 30 percent of the two
towns' children are ineligible for public programs. These children
will qualify for the new Healthy Kids program. Referral appointments
from the school e-Dental site to local dentists will be tracked
by local case managers, along with quarterly follow-up with families
of children enrolled into Healthy Kids in order to provide health
care utilization assistance.
Project funds will provide a.5 FTE Certifed
Application Assistor/case manager each in Woodlake and Lindsay and
Healthy Kids insurance premium costs for 55 children ages 6-18,
which will allow services identifed by the e-Dental and other health
providers to be accessed. First 5 Tulare County will subsidize Healthy
Kids premium costs for children ages 0-5.
DELAWARE
D04RH04341
Brian Olson
La Red Health Center
505-A West Market Street
Georgetown, Delaware 19947-2321
Phone: (302) 855-1233 Fax: (302) 855-1020
Email: bolson@laredhealthcenter.org
Fiscal Year 2005 2006 2007
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Prenatal Services
La Red Health Center (LRHC) will expand an existing
program to offer prenatal and labor/delivery services to underserved
and vulnerable pregnant women in Sussex County, Delaware. LRHC will
develop a formal promotoras program, utilizing an indigenous case
management model developed to facilitate access to medical care
in underserved communities. The goals of this project are (1) to
improve perinatal health outcomes and reduce disparities as a result
of expanded access to care and education for low-income, at-risk
women and (2) to develop a comprehensive countywide promotoras program
to provide outreach, community health education, case management,
and other services to encourage early entry to prenatal care, concordance
with medical advice, and subsequent medical care for infants and
children.
The program will serve rural Sussex County, which is the largest
county in Delaware in terms of land mass and has a population of
156,638. The entire county is federally designated as a Medically
Underserved Area, a low-income Health Professional Shortage Area
(HPSA), and a dental HPSA. The lack of access to prenatal care for
both uninsured and Medicaid-enrolled women has created a crisis
in the county. No private obstetricians in western Sussex County
accept patients with Medicaid into their practice, other obstetricians
in the county limit the number of patients with Medicaid they will
treat, and uninsured patients cannot pay the required fees for prenatal
care. Most uninsured women served by an existing LRHC program did
not seek early prenatal care. This trend, combined with limited
provider availability, compounds the problem of early access to
care. Thus, there is a tremendous need for LRHC's prenatal services.
To address the demand for prenatal services, LRHC
will partner with two private obstetricians, two hospitals, and
other state and community agencies and programs to build a countywide
network. Existing capacity for the prenatal program will be doubled
and complemented by an aggressive campaign of community education
urging early entry to care.
FLORIDA
D04RH06933
Mark Lee Szurek, Ph.D.
Rural Health Network of Monroe Co., FL, Inc.
P.O. Box 4966
Key West, Florida 33041
Email: mszurek@rhnmc.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Primary care, Mental health services,
Substance abuse treatment, Dental care
The Rural Health Network of Monroe County, FL,
Inc. (RHNMC) was created in 1993 in response to the enactment of
Florida Statute 381.0406. This Act mandates the formation of health
networks throughout the State in certified rural areas for the purpose
of providing "... a continuum of quality health care services
for rural residents through (local) cooperative efforts...".
In May 2000, through support received from a HRSA Office of Rural
Health Policy Outreach grant, RHNMC secured funding to initiate
a primary care program, through the use of a single medical mobile
van. Since that time, this organization has expanded its services
to include yet another mobile medical van, two "fxed site clinics,
and a dental clinic, thereby extending services in the Florida Keys
over a 120-mile linear island chain.
This project is designed to build upon previous
accomplishments established by this network organization through
its local partners, and through funding granted by HRSA to create
a meaningful, sustainable and lasting provision of comprehensive
primary care. In responding to the Florida Statute-mandate to ensure
a continuum of care, RHNMC has entered into local communities with
an intent of not duplicating services, creating service access where
those service may be lacking, and more importantly, to work within
and without a network framework to improve health care services
where possible. RHNMC seeks to partner with a local for-profit hospital
network member and with the largest substance abuse and mental health
facility in this county to offer outpatient primary care, outpatient
mental health and substance abuse services, and access to dental
care for uninsured residents of the Lower Florida Keys-10 hours
a day, 7 days a week.
For almost 30 years, the Guidance Clinic
of the Middle Keys (GC 1K) has provided mental health and substance
abuse services for the people of Monroe County. As a recent (ORHP)
outreach grantee (May 2003 - April 2006), GCMK has partnered with
RHNMC in the limited provision of its services to the homeless.
The Lower FL Keys Health (Hospital) Center (LFKHC; a founding RHNMC
member) has voiced its desire to merge the resources of RHNMC, GCMK,
and itself to create a seamless and comprehensive health care program
targeted to the uninsured and homeless. This project is the first
merger of its kind in county history, bringing together a for-profit
hospital/primary care service, not-for-profit mental health and
substance abuse care and not-for-profit primary and dental care.
GEORGIA
D04RH02552
Kristie Dunson
Tanner Medical Foundation
99 Doctor's Drive
Carrollton, Georgia 30117
Phone: (770) 836-9282 Fax: (770) 838-8110
Email: kdunson@tanner.org
Fiscal Year 2004 2005 2006
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Diabetes, Hypertension, Pulmonary
disease, Asthma
The West Georgia Chronic Disease Initiative (WGCDI)
is a community-based treatment, management, and prevention program
targeting citizens in Carroll, Haralson, and Heard counties in rural
West Georgia. WGCDI was formed initially in 2001 as a broad partnership
with more than 70 local participants and was prompted in part by
the results of two community health assessments, which indicated
a prevalence of risk factors associated with diabetes and hypertension.
Currently, the Initiative has now formed a rural health consortium
to guide the program's continued growth and development. The consortium
proposes to expand existing protocol for patients with diabetes
and hypertension, and add programs targeting asthma and chronic
obstructive pulmonary disease (COPD). Increases in county's general
population and the "aging" of the area's population have
led to an increased need for these services.
The expanded West Georgia Chronic Disease Initiative
will serve individuals who currently suffer from diabetes, hypertension,
asthma or COPD, or who are at risk for these diseases. The program
will place a special emphasis on low-income, uninsured, and underserved
individuals, including the community's growing minority populations.
Specific target populations include 72 percent Caucasian, 25 percent
African American, 2 percent Hispanic, and less than 1 percent Asian.
Members of the West Georgia Chronic Disease Initiative
Consortium include the Tanner Medical Foundation (Applicant/lead
agency), Carroll, Haralson and Heard County Health Departments,
Haralson, Heard, Carrollton City and Bremen City Schools Systems,
the Center for Allergy and Asthma of West Georgia, Dr. Sandra Stone
of the State University of West Georgia, the American Lung Association
of Georgia, and the Tallatoona Economic Opportunity Authority.
D04RH04347
Patricia Townley
Floyd County Board of Health
315 West 10th Street
Rome, Georgia 30165-2638
Phone: (706) 802-5444 Fax: (706) 802-5445
Email: patownley@gdph.state.ga.us
Fiscal Year 2005 2006 2007
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Oral Health Care
The new Floyd County Dental Clinic will operate
as a regional clinic, serving residents of a five-county area in
rural northwest Georgia. The goal of the clinic is to increase access
to oral health care for residents in the region. The regional dental
clinic will offer a full range of pediatric and adult dental services,
including outpatient dental care for young children with serious
dental needs. The clinic will accept adult and pediatric emergencies
and will have an oral surgery program as well. Opening the clinic
will provide many residents in the region access to high-quality
dental services that are currently unavailable to them. The need
for dental services among low-income families in the target area
is tremendous. Only four dentists accept Medicaid, and acceptance
is sporadic. Low-income families with dental insurance cannot find
a provider who will take them as patients. A mobile dental clinic
provides limited services to only a fraction of the residents in
need of dental care, and clients in need of follow-up care have
no local options.
The five counties are located in the foothills
of the Appalachian Mountains. The total population of the five-county
area is 260,591. According to 2000 Census data, 88 percent of the
population is white, 8 percent is African American, and 4 percent
is Hispanic. The Hispanic population in the area has grown significantly
in the past 10 years, because of employment opportunities. However,
their jobs are often minimum wage with no health insurance benefits.
Access to oral health care is problematic for
many residents in the target area, especially for those with low
income or who lack insurance. The five county health departments
have no public health dental facilities and only one mobile dental
van. Four counties in the target area are designated as Medically
Underserved Areas or Medically Underserved Populations. One of the
counties is designated as a Dental Health Professional Shortage
Area.
Consortium members include Floyd County Health
Department, Coosa Valley Technical College, Floyd College Health
Sciences Division, Floyd Medical Center, Northwest Health District,
and Rome/Floyd County Commission on Children and Youth.
D04RH04348
Mary Ann Kotras
East Central Georgia Regional Teen Wellness Coalition
Lincoln County Commission
P.O. Box 68
Thomson, Georgia 30824-0068
Phone: (706) 595-3112 Fax: (706) 595-3113
Email: mkotras@comcast.net
Fiscal Year 2005 2006 2007
Funding Amount $198,810 $198,092 $198,896
Keyword(s): Health Education
Experts agree that decisions youth make regarding
lifestyle and personal behavior in adolescence have tremendous future
consequences. These consequences include, but are not limited to,
lifelong substance abuse (e.g., tobacco, alcohol, other drugs);
teen parenthood and subsequent low educational attainment and low
socioeconomic status; and/or eventual chronic disease (e.g., cardiovascular
disease, stroke, diabetes, cancer). The proposed East Central Georgia
Regional Teen Wellness Initiative will increase awareness and access
to health promotion services by providing ongoing leadership training
regarding healthy lifestyles for local youth; encouraging these
youth to take a leadership role in planning, implementing, and monitoring
local health promotion/education projects; and supporting these
you as they plan and coordinate an ongoing local health lifestyles
education outreach campaign for youth in the proposed service area.
The rural underserved service area includes eight
counties: Glascock, Jenkins, Lincoln, McDuffie, Screven, Taliaferro,
Warren, and Wilkes. The proposed population is 7,452 youth (age
10 to 18). The region displays demographic characteristics similar
to many poor rural areas, including high percentage of minority
residents, isolation, poverty, negative health indicators, lack
of educational attainment, and a struggling rural economy. According
to the 2000 census, the region is home to 75,184 individuals: 59
percent white, 40 percent African American, and 1 percent other.
More than one out of every four children (age 0 to 17 years) in
the region is currently living below the poverty level. Much of
this poverty is a result of adolescent childbearing. Nearly one-fifth
(18.4 percent) of the total births to region residents were to unwed
teen females, and more than one out of every two (56.0 percent were
to unwed mothers (regardless of age). More than one out of every
three female-headed households with children under age 18 in the
region are currently living below the poverty level.
An estimated 6,920 county residents are in need
of alcohol treatment services, and 2,977 are in need of drug treatment.
State mental health officials estimate that only 20 percent of those
who need treatment services will actually demand or want the assistance.
Many of these adults are raising young children and making their
children victims of the downward negative spiral of intergenerational
addiction and its consequences.
In 2002, 60 percent of all deaths in the region
were due to heart disease, stroke, diabetes, and cancer. Death and
disability from these diseases are related to a number of modifiable
risk factors, including high blood pressure, high blood cholesterol,
diabetes, having a sedentary lifestyle, being overweight, and smoking.
The East Central Georgia Regional Teen Wellness
Coalition comprises eight county community collaboratives-Glascock
Action Partners, Jenkins County Family Enrichment Commission, Lincoln
County Family Connection, McDuffie County Partners for Success,
Screven County Community Collaborative, Taliaferro County Family
Connection, Warren County Family Connection, and Wilkes County Community
Partnership (all of which have included and supported school health
programs in their strategic plans-as well as Medical College of
Georgia, University of Georgia (College of Family and Consumer Science),
and the East Central Public Health District.
D04RH04349
Brenda Lee
Turner County Board of Education
213 North Cleveland Street
Ashburn, GA 31714-0609
Phone: (229) 567-9066 Fax: (229) 567-2877
Email: blee@turner.k12.ga.us
Fiscal Year 2005 2006 2007
Funding Amount $169,004 $160,198 $161,620
Keyword(s): Dental clinic
services, preventative dental care
The goals of the South
Georgia Regional Dental Outreach Initiative are to increase the
number of individuals who receive preventive dental screening, the
number of individuals who have access to dental clinic services,
and residents' awareness of the importance of dental hygiene and
preventive dental care. To accomplish these goals, the initiative
will provide (1) dental services for at least 1,500 individuals;
(2) dental health preventive education for more than 15,000 individuals
annually though onsite services provided in school systems, pre-kindergarten
programs, Head Start, daycare centers, nursing homes, health department
clinics, employee screenings at local businesses, and community
health fairs and other community sites; and (3) an area dental services
referral network for individuals with no other dental care options.
The service area is a five-county
underserved area in rural southern Georgia with a population of
67,463 individuals. Demographic characteristics of the region include
a high percentage of minority residents, isolation, poverty, negative
health indicators, lack of educational attainment, and a struggling
rural economy. The racial/ethnic composition is 67 percent white,
32 percent African American, and 1 percent other. Employment prospects
for local residents are limited due to lack of funding. Attempts
at supporting health and dental health promotion have been inadequate.
There is a shortage of dentists in the area, and at-risk residents
without private dental insurance must go without preventive dental
care and have to ignore dental problems because of inadequate financial
resources. All five counties in the region are Medically Underserved
Areas, and three are designated as Dental Health Professional Shortage
Areas.
The South Georgia Regional
Dental Outreach Initiative comprises the Turner County Board of
Education, the lead applicant; Public Health District 8-1; area
volunteer dentists; and five community collaboratives-Fitzgerald-Ben
Hill Policy Council for Children and Families, Irwin County Family
Connection, Turner County Connection, Wilcox County Family Connection,
and Worth County Family Connection.
D04RH06912
Greg Rossidivito
Hospital Authority of Washington County, Inc.
Washington County Regional Medical Center
610 Sparta Road
P.O. Box 636
Sandersville, Georgia 31082
Phone: (478) 240-2391
Fax: (478) 240-2390
E-Mail: grossidivito@hotmail.com
Fiscal Year 2006 2007 2008
Funding Amount $149,969 $124,342 $99,968
Keyword(s): Physical activity/fitness, Obesity/overweight
From 1991 to 1998, Georgia reported the greatest
rate of increase in prevalence of adult obesity (101.8 percent)
in the United States. A recent study by the University of Georgia
and the Georgia Prevention Institute at the Medical College of Georgia
found that Georgia children are more likely to be overweight than
previously thought, with approximately 37 percent considered too
heavy. With increased numbers of chronic illnesses, health crises,
and general poor health, the implications of this large number of
overweight and obese children (and adults) impact all health care
systems. Washington County, like many rural areas, has a significant
number of overweight and obese children and youth who generally
do not seek medical services to address the causes, resultant medical
problems, or possible remedies. Most commonly, they are uninsured,
poor, poorly educated, often isolated, and lack family support in
addressing overweight/obesity.
Children are usually at the mercy of parents/caregivers
in the matter of food selection, purchase, and preparation. Poor
nutrition is compounded by lack of access to a comprehensive fitness
program or facility because of limited or non-existent transportation.
Rural children are particularly at risk as a result of multiple
barriers, many of which are remediable.
The Washington County Community Wellness Consortium,
a collaborative of agencies and health providers, has developed
a small, multidisciplinary weight loss and fitness model program,
the cornerstone of which is martial art taekwondo. This model program
began July 18, 2005, with a small grant from Georgia Southern University's
Intellectual Capital Partnership Program (ICAPP). This program is
already showing positive results in participants. Approximately
50 percent of the children are obese or overweight. Parents and
children are enrolled. For the proposed project, additional children
will be recruited from schools, health providers, the recreation
department, and churches for an after-school and summer program.
Transportation, not currently provided, will be provided for students.
Use of a martial arts program is a comprehensive
approach to exercise and yields a wide array of benefits, such as
increased self-esteem, a positive body image, goal setting, and
reduced aggression. Children who participate in this proposed project
will be assessed using several standard instruments. A physical
exam by a pediatrician will be required. Individual fitness/wellness
plans will be developed. Parents/primary caregivers and other adults
will be recruited and encouraged to participate as well. The program
will include 75 obese/overweight children, 25 parents/primary caregivers,
and 50 non-overweight peers and/or adults. To avoid stereotyping
obese children, enrollment will be open. All program participants
will receive regular nutrition education and food preparation demonstrations
provided by the Washington County Extension Service. Children will
be required to attend 21 classes in an 8-week cycle (or three classes
per week), leading to earning a series of belts. At specific intervals,
children's physical and psychosocial progress will be assessed.
Interval successes and instructor feedback will motivate children
and families to continue their individual plans.
D04RH06911
Janice Massey
Evans County Health Department
P.O. Box 366
4 North Newton Street
Claxton, Georgia 30417
Phone: (912) 739-2088
E-Mail: jamassey@gdph.state.ga.us
Fiscal Year 2006 2007 2008
Funding Amount $148,994 $124,908 $100,000
Keyword(s): Perinatal health
Evans County Health Department, along with its network partners,
seeks to implement Best Babies, a perinatal health program to improve
health outcomes for women, infants and children in Candler, Evans,
Tattnall, and Wayne Counties in southeast Georgia. Best Babies will
offer a comprehensive, integrated approach to perinatal care for
women in these counties who are at high risk for adverse birth outcomes
including maternal or infant mortality, low birth weight, very low
birth weight, or other medical or developmental problems. The coordinated
system of care will include identification of women who are at high-risk
for poor birth outcomes, intensive case management, and home visits
by registered nurses.
Network partners include the lead agency, Wayne
Memorial Hospital, Evans Memorial Hospital, Candler County Health
Department, Tattnall County Health Department and Wayne County Health
Department. Two nurses will be hired to provide services to program
participants under the direction of a project director.
The four targeted counties have high rates of
poverty, ranging from 27 percent of the population of Evans County
to 16.7 percent in Wayne County. The statewide rate of Georgians
living in poverty is 12.3 percent. The population of the target
area is 66 percent Caucasian, 28 percent Black, and 6 percent Hispanic.
Evans, Candler, and Tattnall counties have seen tremendous growth
in their Hispanic populations over the past 10 years.
Infant mortality rates (IMR) and neonatal mortality
rates (NMR) are higher than those for Georgia and substantially
higher than Healthy People 2010 objectives. IMR and NMR rates for
Blacks are significantly higher than for Caucasians or Hispanics.
Two of the counties, Candler and Tattnall, do not have birthing
hospitals, and women must travel long distances to hospitals in
Wayne and Evans counties for delivery. All four targeted counties
are Federally designated Medically Underserved Areas. Best Babies
is modeled after the highly successful Perinatal Health Partners
Program, which provides perinatal services to residents of 10 counties
in southeast Georgia.
D04RH06913
Lynne D. Feldman, M.D., M.P.H.
Irwin County Board of Health
Georgia Department of Human Resources
407 W. Fourth Street
Ocilla, Georgia 31774
Phone: (229) 333-5290
E-Mail: ldfeldman@gdph.state.ga.us
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Diabetes
Diabetes is one of the nation's most common chronic diseases and
was the eighth leading cause of death in Georgia in 2001. Unfortunately,
the 2000-2001 prevalence of diabetes in two rural southern Georgia
counties-Ben Hill (13.2 percent) and Irwin (14.7 percent)-is more
than twice that of Georgia (6.9 percent) and the United States (6.2
percent). According to a 2002 publication by the Georgia Hospital
Association Research and Education Foundation, Ben Hill and Irwin
Counties fall in the top 50 percent of counties in Georgia with
the highest hospital admissions for uncontrolled diabetes. Considering
this prevalence data, related health indicators-such as high rates
of obesity and little physical activity, high poverty levels, and
the racial makeup of the populations-it is clear that diabetes is
a serious health issue for Ben Hill and Irwin Counties. Since these
counties are medically underserved areas additional resources are
critical to combat this chronic illness.
The Irwin County Board of Health, as the lead
partner, proposes to work with the Ben Hill County Board of Health,
Dorminy Medical Center, the Ben Hill County School System, Irwin
County Hospital, the Irwin County School System, the South Central
Primary Care Center, Irwin County Family Practice Associates (Dr.
Howard McMahan), and the South Health District to address diabetes
in these two counties. The target population will include individuals
who have been diagnosed with type 2 diabetes, with an emphasis on
those who do not have insurance and/or who live in poverty; middle
school children who need to develop healthy lifestyle behaviors
that will lower their risk of becoming diabetic; and the general
public. Given the poor health status of many people in these counties,
it will be important to provide education and prevention messages
to the public at large in order to reduce the incidence of diabetes.
The goals of the project will be to reduce the
number of hospitalizations resulting from diabetes or diabetic complications
in Irwin and Ben Hill counties by 10 percent, to increase healthy
lifestyle behaviors among middle school children, and to reduce
the incidence of type 2 diabetes in these two counties through awareness
of prevention strategies.
Grant funds will be used to hire a Nurse
with a background in diabetes education as the Project Coordinator
and a Secretary. The project also will contract with Dorminy Medical
Center for 50 percent of a Registered Dietician. Services will include
expanded educational classes for diabetics, including individual
and group nutritional counseling, and community education programs
for the public that will be offered to churches, senior citizen
centers, the tech school, and others. The middle school component
will focus on decreasing obesity, increasing physical activity,
educating the students/parents about healthy lifestyles, and evaluating
the school-based nutrition programs. During the first year, staff
will be oriented, educational classes planned, local physicians
educated about the project, community education approaches planned,
and contact initiated with key school personnel. Program implementation
will begin the last quarter of the first year. In the second year,
a joint community health fair focused on chronic disease/diabetes
will be held for the general public and a 10K Steps-A-Day program
initiated in both communities.
IDAHO
D04RH04399
Ann M. Sandven
Terry Reilly Health Services
211 16th Avenue, North
P.O. Box 9
Nampa, Idaho 83653-0009
Phone: (208) 467-4431 Fax: (208) 467-7684
Email: asandven@trhs.org
Fiscal Year 2005 2006 2007
Funding Amount $198,795 $178,071.09 $181,591.09
Keyword(s): Pediatric Obesity
Healthy Families Active Youth is a health promotion
and fitness project that will target elementary school children
and their parents in two towns in rural southwest Idaho to prevent
and treat pediatric obesity. The goal of the project is to promote
healthy weight and activity levels in rural children. Objectives
include increasing the knowledge of healthy foods, increasing servings
of fruit and vegetables, increasing the percentage of children who
get at least 30 minutes of physical activity 5 days a week, stabilizing
or decreasing the weight of overweight children participating in
a weight management program, and promoting appropriate identification
and treatment of childhood overweight by health care professionals.
The target population is low-income elementary
school children and their families in two towns in rural Canyon
and Owyhee counties. Nearly one in five residents in Canyon County
is Hispanic, compared to one in four Owyhee County residents. Poverty
rates for most of the target area are higher than state averages.
The project will serve 1,400 children, at least 100 parents, and
25 health care professionals. Approximately 52 percent of participants
will be Hispanics, 46 percent non-Hispanic whites, and 2 percent
other ethnicities. The two counties are home to an estimated 25,319
migrant and seasonal farmworkers. An estimated 50 percent or more
of migrant workers lack health insurance, compared to an estimated
18 percent of all persons in Idaho. Barriers to access of health
services include poverty and lack of insurance. Language, cultural,
and education barriers exacerbate health problems for which Hispanics,
who make up the majority of migrant and seasonal farmworkers in
the state, are at added risk. An estimated 28,000 people in the
two counties lack insurance, with many more struggling with inadequate
coverage. Both counties are designated as Health Professional Shortage
Areas, and Owyhee County and the southern part of Canyon County
are also designated as Medically Underserved Areas.
Healthy Families Active Youth partners include
Terry Reilly Health Services as the lead agency, Southwest District
Health Department, Treasure Valley Family YMCA, Homedale School
District, and Caldwell School District. All partners have participated
in a broad-based community coalition of more than 15 organizations
that began in October 2003 to address childhood overweight.
D04RH06958
Barbara Mohoney
Gritman Medical Center/Adult Day Health Program
700 S. Main
Moscow, Idaho 83843
Phone: (208) 883-6483
Fax: (208) 883-6489
E-Mail: barbara.mahoney@gritman.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Primary care, Social services, Elderly,
Health promotion/disease prevention (general)
The consortium for this project includes Gritman
Medical Center/Adult Day Health, Pullman Regional Hospital, Whitman
Hospital and Medical Center, the Council on Aging & Human Services/COAST
Transportation, and Region II Area Agency on Aging.
The primary goal of Project ACCESS (Accommodation, Collaboration
for Community Education about Services for Seniors) is to increase
access to medical care and social services for seniors in the rural
areas of Eastern Washington in Whitman County and North Central
Idaho in Latah County. The strategies proposed to increase access
will enable seniors to live independently and increase the capacity
of these rural communities to sustain conditions necessary for early
intervention if a senior becomes at risk for problems that may impede
her or his ability to living a physically and emotionally healthy
life.
First, ACCESS will define and expand the senior
community health services network in the rural areas. We will initiate
the nationally recognized Gatekeeper program, which is a proactive
network of community members trained to identify changes in behavior,
routines, and other early warning signs that a senior may be at
risk for a health/mental health related crisis. Given the independent
nature of rural elders in Whitman and Latah Counties, at-risk seniors
would remain invisible to service delivery systems without such
a community-based program. Gatekeepers are trained to recognize
changes and to contact a local agency on aging to engage the appropriate
service delivery system. Grant funds will also initiate care giver
support groups in rural communities so that those who care for rural
seniors have local access to support, respite care, information,
and referrals.
Second, the grant will increase access to primary
health care and related social services through an expanded volunteer
corps of drivers from rural communities. Volunteer drivers will
be recruited and trained by a transportation volunteer coordinator
housed at the Council on Aging & Human Services/COAST in Whitman
County. In addition, COAST Transportation will also work collaboratively
with Latah County to identify and train volunteer drivers to respond
to requests in Latah County.
Third, ACCESS will increase access to wellness
and disease prevention information and referrals by developing and
purchasing materials accessible to all community members and health
and human service providers through medical offices, libraries,
hospitals, and agencies on aging. Community education programs will
also be presented, duplicated, and made available through similar
venues. Local information and referrals will also be made accessible
through the Washington and Idaho 2-1-1 telephone systems.
ILLINOIS
D04RH02551
Michael Lewis
Warren Achievement Center, Inc.
1220 East 2nd Avenue
Monmouth, Illinois 61462
Phone: (309) 734-3131 Fax: (309) 734-7114
Email: susan_blackman@warrenachievement.com
Fiscal Year 2004 2005 2006
Funding Amount $165,836 $157,055 $144,210
Keyword(s): Developmental screenings, Healthy
lifestyle education
Preschool-age children in a three county rural
area of western Illinois are missing vital developmental services
because parents and health care providers are not aware of their
value and availability. Additional children are denied services
because their identified needs do not conform to highly regulated
eligibility criteria. Still other children fall in age ranges that
force them out of one program before they are eligible for another.
Early diagnosis and treatment of children at risk for developmental
disorders prevents problems at school and offers huge economic benefits
to both the child and the community. Project All Aboard will identify
these children through public awareness campaigns, developmental
screenings, and provider networking to provide intervention and
other needed developmental services to ensure every child has an
opportunity to reach their potential.
Project All Aboard targets any preschool child
not eligible for other state or locally-funded services in Henderson,
Knox, and Warren counties, Illinois. The consortium, which includes
the Warren Achievement Center, the Knox County Health Department,
the Henderson County Health Department, the Knox-Warren Counties
Special Education District, the West Central Illinois Special Education
Cooperative, and the Henderson County Rural Health Center, aims
to reduce the average age children are first screened for developmental
delays from 20 months to 14 months, increase referrals of at-risk
children receiving services by 100 percent, and to ensure services
to 10 children in the first year of the program, 20 children in
the second year, and to 30 children in the third year of the program,
who are in need of early intervention services but don't qualify
under current guidelines.
D04RH06963
Linda Weiss
Executive Director
Coles County Mental Health Association, Inc.
1300 Charleston Avenue
Mattoon, Illinois 61938
Phone: (217) 234-6405
Fax: (217) 258-6136
Email: lweiss@ccmhc.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Perinatal depression
The Project for Perinatal and Postpartum Depression
Detection (P2D2) is a collaborative effort of the partner organizations
of the Regional Behavioral Health Network (RBHN) and local health
departments in a three-county region of rural east central Illinois.
All three counties are designated health professional shortage areas
for both primary care and mental health. Coles County Mental Heath
Center, the Human Resources' Center of Edgar and Clark Counties,
and Sarah Bush Lincoln Health Center, which comprise the organizations
of RBHN, are joining forces with local health departments in Clark,
Coles, and Edgar Counties to address the need for screening, assessment,
and referral of women with symptoms of perinatal depression.
This project will increase community awareness
about perinatal depression, improve access to mental health screenings
for childbearing women, and provide assessments and linkages to
appropriate treatment for women with symptoms of depression. Through
collaboration with the local health departments and the WIC/Family
Case Management programs, RBHN will initiate an integrated screening
and assessment process directed at reaching women at the greatest
risk of depression. Project partners will 1) provide community education
about the symptoms of postpartum depression and how women can receive
help; 2) improve the efficacy of the cross-disciplinary linkages
between the mental health and primary care providers serving postpartum
women; and 3) increase the number of postpartum women using behavioral
health services.
Screening services will reach an estimated
1,250 women (350 in Year One, 400 in Year Two, and 500 in Year Three).
Education and outreach activities will reach an estimated 500 persons
each year. A key objective of the project is to strengthen the cross-disciplinary
linkages between mental health and primary care services. The Women's
Mental Health Program of the University of Illinois at Chicago will
provide training for project personnel and workshops for primary
and mental health care providers on the issues of perinatal depression
and options for treatment. A consultant will facilitate a process
mapping of P2D2's screening and assessment procedures to develop
a common understanding of the process and work toward developing
a uniform protocol that integrates the region's resources for primary
care and behavioral health treatment options available to women
with perinatal depression. Partnering organizations will jointly
host a regional conference to explore and improve the delivery of
these treatment options in the targeted service area.
INDIANA
D04RH06943
Heidi Miller
Dunn Center
630 East Main Street
Richmond, Indiana 47375
Phone: (765) 983-8053
Fax: (765) 983-8686
E-Mail: hmiller@familyhealth-chc.org
Fiscal Year 2006 2007 2008
Funding Amount $149,999 $124,999 $100,000
Keyword(s): Mental Health
The Dunn Center, a community mental health center, is collaborating
with Family Health Services, Inc. (a local community health center)
and Affiliated Service Providers of Indiana, Inc., (a network of
behavior health providers) to improve the health and wellness of
people living in the rural communities of Fayette, Franklin, and
Rush counties in Indiana, especially the low income and elderly.
These goals will be accomplished by decreasing barriers to care,
providing prevention and early intervention education, increasing
treatment effectiveness, and expanding the program to include an
eight-county region.
These proud, rural communities show the signs
of suffering from the fallout of lack of jobs, lack of health insurance
or having inadequate insurance, drug and alcohol addiction, and
the long term ramifications of chronic illness. Fayette County is
partially designated as medically underserved area. Rush County
is a health professional shortage area for residents at 200 percent
or below the poverty level. All of Franklin County is a health professional
shortage area, a medically underserved, and a mental health shortage
area.
These challengers are inter-related. The Primary
Care Plus + program will be managed and governed by an Advisory
Committee composed of specialists with expertise in the integration
of mental health services into primary care. Dunn Center, a nonprofit
mental health agency, will provide managerial and fiduciary oversight
of the program. It also will oversee most aspects of the project's
mental health treatment component, including diagnostics, short-term
crises management, individual counseling, group psychological education,
and group counseling. Patients needing intensive treatment will
be referred to the Dunn Center or another appropriate service provider,
such as psychiatrists for pharmacological consultations. Dunn Center
will also provide transportation and translators.
The program will be housed at Family Health Services'
two health centers that serve Fayette, Franklin, and Rush counties.
Family Health Services will provide the project director, clinical
office space in each county, management of integration to primary
care, coordination of services, support staff, child care, and translators
as needed. The program will address the racial, cultural, and socioeconomic
needs of each patient individually. Affiliated Service Providers
of Indiana, Inc., (ASPIN) will provide evaluation and technical
assistance related to education and dissemination of outcomes. It
also will oversee the replication of this model in Years 2 and 3
of the project in nearby counties.
D04RH06942
Sharon Goodman
Gibson General Hospital
Rural Health Care Services Outreach Grant Program Gibson General
Hospital
1808 Sherman Drive
Princeton, Indiana 47670
Phone: (812) 385-9220
Fax (812) 385-9415
E-Mail: sgoodman@gibsongeneral.com
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $124,476 $99,783
Keyword(s): Diabetes
Lifestyles Diabetes Project will provide diabetes education and
treatment services to the citizens of Indiana's Gibson and Pike
Counties. The project is designed to achieve diabetes awareness
and prevention for citizens in the two counties and to provide education
and support on self-management for many who have already developed
the condition. The project brings together a consortium of local
organizations-Gibson General Hospital, the Gibson County Health
Department, the Pike County Health Department, Tulip Tree Family
Health Clinic, the Gibson County Council on Aging, the North Gibson
School Corporation, and Brink's Family Practice-along with the Indiana
State Department of Health Diabetes Prevention and Control Program
Lifestyles Diabetes Project addresses a significant
health need. According to the Centers for Disease Control and Prevention
and the Indiana State Department of Health, diabetes is the sixth
leading cause of death in the United States, the State of Indiana,
and Gibson County. In the United States, the number of adults with
diagnosed diabetes has increased 61 percent since 1991 and is expected
to more than double by 2050. According to the 2003 Indiana Behavioral
Risk Factor Surveillance Systems, 7.8 percent of adults age 18 and
older in Indiana have been diagnosed with diabetes.
Poor lifestyle choices and lack of awareness are
root causes of the increased prevalence of diabetes and its resulting
complications. Much of the burden related to diabetes, once developed,
can be prevented or delayed with early detection, improved delivery
of care, and better education on diabetes self-management. Moreover,
better than managing diabetes is preventing its onset in the first
place. Convenient access to knowledge, resources, and support-in
a familiar setting-makes prevention and self-care more likely. The
Lifestyles Diabetes Project aims to provide the people of Gibson
and Pike Counties with this access to knowledge, resources, and
support.
The Lifestyles Diabetes Project has two
primary goals. First, it aims to reduce long- and short-term diabetes-related
complications for as many residents as possible who have already
developed diabetes. To reach this goal, the project will provide
diabetes self-management education following recognized national
standards at the project's clinic and at key outreach locations.
Second, we aim to promote awareness and prevention of diabetes to
as many citizens as possible in the two-county area. To achieve
this goal, the project will conduct awareness, assessment, and education
sessions at senior citizens' centers, schools, churches, and health
fairs. It also will conduct a diabetes awareness and prevention
marketing campaign. Success of the project will result in healthier
communities in Gibson and Pike Counties, more effective use of existing
healthcare resources, and a reduction in community health care costs.
IOWA
D04RH02572
Dawn Stephens
Crisis Intervention Services
500 High Avenue
Oskaloosa, Iowa 52577
Phone: (641) 673-0336, ext. 11 Fax: (641) 673-0336
Email: crisisintervention@mahaska.org
Fiscal Year 2004 2005 2006
Funding Amount $195,076 $187,061 $151,486
Keyword(s): Domestic violence, Sexual abuse, Provider
education
Health professionals frequently treat survivors
of domestic abuse and sexual assault, but physicians often treat
injuries only symptomatically. As a result, important opportunities
for intervention are missed, and survivors continue to suffer adverse
health consequences of physical and emotional abuse. Of the estimated
6.9 million intimate partner rapes and physical assaults committed
annually, 2.6 million will result in an injury to the survivor,
and more than 695,400 will result in medical treatment. In addition
to the climbing medical expenses resulting from domestic abuse,
estimated between $3 billion and $5 billion annually, businesses
are forfeiting nearly an additional $100 million annually in lost
wages, sick leave, and non-productivity. Survivors of domestic abuse
are more likely to experience numerous chronic health problems including
depression, post-traumatic stress disorder, chronic pain syndrome,
gynecological problems, irritable bowel syndrome, eating disorders,
and complications during pregnancy than others.
To address these and other unmet health care needs
of survivors of domestic abuse and sexual assault in Mahaska and
Keokuk counties, Crisis Intervention Services formed a consortium
of local health agencies including the Keokuk County Health Center,
Keokuk County Public Health, and the Mahaska Health Partnership
(Community Health, Mahaska Hospital, and New Directions). Through
a coordinated community response, with leadership and guidance from
the Domestic Abuse/Sexual Assault Taskforce, the consortium seeks
to provide intensive education for medical and mental health care
providers of domestic abuse and sexual assault victimization issues,
develop and implement effective screening protocols for medical
and mental health providers, develop and implement a Sexual Assault
Nurse Examiner (SANE) program, provide extensive education for teenagers
and their parents, and develop and implement an extensive public
awareness campaign on sexual assault prevention.
The target population is 90 percent Caucasian,
4 percent Hispanic, and a smaller mix of American Indians, African
Americans, and Asians and Pacific Islanders.
D04RH02573
Judith McDonough
Northwest Iowa Mental Health Center
201 East 11th Street
Spencer, Iowa 51301
Phone: (712) 262-2922 Fax: (712) 262-2741
Email: judim@seasonscenter.org
Fiscal Year 2004 2005 2006
Funding Amount $195,644 $199,937 $199,992
Keyword(s): Mental health, Substance abuse, Education
Experts believe that 1.8 percent of the U.S. general
population live with severe mental disorders. According to the Substance
Abuse and Mental Health Services Administration of the U.S. Department
of Health and Human Services, the rate of severe mental disorders
among those entering jail is 6.4 percent for male detainees and
12.2 percent for female detainees. Of these, 72 percent also suffer
with alcohol or drug abuse disorders. In 1999, there were 11.4 million
admissions to jail, meaning that an estimated 802,000 detainees
had severe mental disorders, and 577,440 of those also met the criteria
for alcohol or drug abuse. Minorities are disproportionately represented
in our criminal justice system, and also experience a higher rate
of co-occurring disorders, with Hispanics being the fastest growing
group in jail populations, (approximately 8 percent Hispanic versus
more 90 percent Caucasian/Non-Hispanic). A great number of people
living with co-occurring mental health and substance abuse disorders
in the target area of the northwest Iowa counties of Buena Vista,
Osceola, Dickinson, Lyon, Emmet, O'Brien, Clay, and Palo Alto face
inappropriate incarceration and re-incarceration because they are
not diverted from the judicial system into the mental health and
substance abuse treatment systems, and cannot be effectively and
immediately connected with services following their jail stay to
reintroduce them into the community successfully.
The Integrated Service Pathways Network-which
includes Northwest Iowa Mental Health Center; Seasons Center for
Community Mental Health; Northwest Iowa Alcohol and Drug Treatment;
and the sheriff departments and health departments of Emmet, Dickinson,
Lyon, and Osceola counties-seeks to address these surprising statistics
by diverting people with co-occurring disorders from the traditional
criminal justice system/jail by implementing officer training and
education of magistrates and other judicial officers, providing
in-jail mental health and substance abuse assessment and treatment
to detainees, utilizing translation and telehealth technologies
as appropriate, and initiating non-traditional case management services
to offenders with co-occurring disorders to ease the transition
into the community's support system and break the cycle of arrest,
jail, release, and re-arrest.
D04RH06945
Jana Enfield, Project Director
Marshalltown Medical and Surgical Center
104 South 1st Street
Marshalltown, Iowa 50158
Phone: (641) 752-1730
Email Address: capsjana@thewebunwired.com
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Prenatal care
Marshall County, population 39,311, is located
in rural Central Iowa. The county's population has remained stable
over the past 50 years; however, the demographics of the population
have shifted dramatically in the past 10 years. This demographic
shift has resulted in a 480 percent increase in the minority population,
which includes a 1,106 percent increase in the Hispanic Community
in the past 10 years.
Along with these demographic changes, local officials
have witnessed an increase in the number of people living in poverty
and an upsurge in the number of uninsured or under-insured residents.
For economic reasons, Marshall County is designated as a Health
Professional Shortage Area. Further, the county has been designated
a Medically Underserved Community, and the immigrant population
has been designated as a Medically Underserved Population due to
language and cultural barriers in accessing health care services.
The Building Healthy Families project is a culmination
of 5 years of research, data collection, review, and program planning.
The project draws on the staff, expertise, and available funding
of all consortium members, and develops a coordinated service delivery
system that avoids duplication of effort.
The Building Healthy Families project is designed
to meet the unique cultural, social, and linguistic needs of pregnant
Hispanic women living in Marshall County. The project's goal is
to improve prenatal health outcomes via identification and assessment,
provision of family support and health education services, and incentives
to increase participation in health care and educational opportunities
in the community. It will promote rural health care services by
expanding our current postnatal home visitation model to include
a new and enhanced prenatal service component. This project will
address the severe lack of services available to our target group
due to cultural and language barriers.
D04RH06946
John Boyd Sinclair
Wayne Community School District
102 N. Dekalb
Corydon, Iowa 50060
Phone: (641) 872-1220
Fax: (641) 872-2091
E-Mail: sinclair@aea15.k12.ia.us
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Mental health services
The proposed Wayne County Multi-Generational Behavioral
Health Project will serve one of the State's most poor, isolated,
and distressed areas. This community also is home to the State's
largest number of elderly residents over the age of 85. Located
in southern Iowa along the Iowa-Missouri border, Wayne County suffers
troublesome economic, education, and environmental problems that
have for years damaged the mental and behavioral health of its children
and youth, families, schools, and communities. These four strata
of life will be integrated into this project.
The Project aims to increase access to behavioral
health care for children, youth, and isolated elderly members by
providing outreach and education resources, and promoting greater
community involvement in an integrated network of services. It represents
a new transition from mental health to a broader, more pervasive
behavioral health condition that has emerged as the county's most
telling unmet need. The target population consists of 1,500 Mercer
County children and elderly persons.
The project has four goals.
Goal 1 focuses on school-based identification,
problem-solving, and documentation of students with behavioral
health problems. It employs a Behavioral/Learning Area Support
Team (BLAST) model from the Rathbun Area Mental Health Center
in Centerville, Iowa and the UCLA Center for Mental Health in
Schools.
Goal 2 involves linking school-based children and their
families to intensive behavioral health services; faculty and
staff consultations, counseling, and referrals. AgriWellness,
Inc., has joined the Consortium to train and serve project families
through Family Support Specialists. A case manager from Rathbun
will be employed to counsel and refer children in cooperation
with faculty and staff, two in-kind managers, and three Specialists.
Goal 3 focuses on providing behavioral health services
to at-risk children and their families through community-based
mentoring development together with professional training.
Goal 4 involves Sowing the Seeds of Hope (SSoH) training
for specialists and staff, and developing a new behavioral health/emergency
health care outreach network for rural, isolated elderly persons.
The Consortium has developed from its roots in
1999: It includes Wayne County School District, the Seymour School
District, Wayne County Public Health; Wayne County Home Care Aide
Agency, Regional Department of Human Services/Wayne County; Area
Education Agency 15, Rathbun Area Mental Health Center; Wayne County
Hospital, and the local Extension Service. Also represented in the
consortium is the Ministerial Alliance of Mercer County, the Wayne
County Response under the auspices of Wayne County Hospital, and
six other groups. Consortium and community support organizations
assume specific, dynamic roles.
KANSAS
D04RH06947
Sally Tesluk, Executive Director
PrairieStar Health Center
200 West 2nd Avenue
Hutchinson, Kansas 67501
Phone: (620) 663-8484
E-Mail: tesluks@prairiestarhealth.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Dental
PrairieStar Health Center, a non-profit rural
health clinic located in Hutchinson, Kansas, is working with three
health care organizations in Kansas' Reno and Harvey Counties to
establish the South Central Dental Project. PrairieStar's partners
for this effort are Health Ministries Clinic, a non-profit medical
clinic in Newton, Kansas (Harvey County); the Reno County Health
Department in Hutchinson; and the Harvey County Health Department
in Newton.
The South Central Dental Project will establish
a dental team that is shared by PrairieStar Health Center and Health
Ministries Clinic. The cost of services will be offset by using
a sliding fee schedule of discounts based upon the patient's income.
This project will especially focus efforts to increase access for
pregnant women and children, since these populations are especially
vulnerable. Additionally, it will be a model of care that integrates
dental services with existing medical services provided by the partner
organizations. This integration will include a Performance Improvement
Committee that has medical representatives from both non-profit
clinics as well as dental staff. This Committee will initially determine
performance measures that bridge between dental and medical services,
and will meet regularly to measure progress and/or need for improvement
in meeting those measures. The Project's primary goal is to provide
access to dental care to at least 80 percent of all low-income children
and pregnant women without private insurance that receive medical
care at a partner organization facility. Currently, these individuals
in the two-county area lack access to dental services. Needs assessments
conducted in 2004 in both Harvey and Reno Counties show that access
to dental care is the greatest unmet health care need in the two-county
area. Low-income participants in a Harvey County focus group indicated
that this unmet need is so great that it negatively impacts their
overall quality of life.
South Central Dental Project staff will include
a dentist, two dental assistants, 1.8 FTE dental hygienist, a program
manager, and administrative support staff. In addition, funding
from the Rural Health Outreach Grant will be used to place case
managers at both Health Ministries Clinic and Prairie Star Health
Center to assist patients with registration, transportation, and
other services that will improve their overall dental experience.
The case managers will also contact patients the day before their
scheduled appointment to remind them of the date and time to reduce
no-show rates.
This project will not only address a tremendous
unmet need for dental care for the low-income people in the area,
but will also pilot a dental program model integrated with medical
care now provided by the participating clinics.
KENTUCKY
D04RH02558
Susan Starling
Foothills Community Action Partnership
128 Kentucky Avenue
Irvine, Kentucky 40336
Phone: (606) 723-2115 Fax: (606) 723-9726
Email: jisfort@lourdes-pad.org
Fiscal Year 2004 2005 2006
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Health promotion/disease prevention
(general)
The seven rural counties that make up the proposed
target area for this project (Lee, Owsley, Jackson, Powell, Wolfe,
Estill, and Breathitt) are among the poorest counties in Kentucky.
Besides being economically disadvantaged, these counties have limited
access to health care services. Only two of the seven counties have
local hospitals, and the other five counties have, at best, access
to limited service clinics that are managed from outside the local
area. Within KRHN's service area, five counties are designated as
Medically Underserved Areas. The high illiteracy rate in these counties
negatively impacts the potential for these populations to gain access
to health care services. The socioeconomic stress on the underinsured
and uninsured is further exacerbated by the lack of access to local
health care services.
KRHN is in phase 1 of a twofold mission to improve
access to preventive care services for the underinsured and uninsured
in the target area. The proposed services and activities for phase
1 include mammography, prostate and prostate-specific antigen (PSA)
screenings, development of a hepatitis screening service, transportation
services, educational programs to recruit students interested in
the medical field, continuing educational programs for participating
health care providers, and public awareness programs in Lee County.
Phase 2 consists of KRHN's long-term plan to implement the proposed
services and activities in the other 6 counties, while further developing
the network system to sustain this and other future collaborative
projects. The long-term plan focuses on community development that
places an emphasis on the education of children and students throughout
the region and continuing education for health care providers.
The Kentucky River Health Network consists of
Marcum and Wallace Memorial Hospital (a Critical Access Hospital),
the Kentucky River District Public Health Department, Lee County
Constant Care (a long-term nursing and assisted-living facility),
the Lee County Emergency Medical Services, the Lee County Fiscal
Court, and the Lee County Area Technology Center (a vocational technology
high school). The target population is more than 98 percent Caucasian
and nearly 2 percent African American. While there is a growing
number of Hispanics in the region, they are expected to represent
less than 1 percent of the total population served by this project.
D04RH02559
Loretta Maldaner
Murray State University
Purchase AHEC
225 Wells Hall
Murray, Kentucky 42071
Phone: (270) 762-4123 Fax: (270) 762-4125
Email: loretta.maldaner@murraystate.edu
Fiscal Year 2004 2005 2006
Funding Amount $187,150 $187,150 $190,781
Keyword(s): Dental health, Preventive care
The Surgeon General's Report on Oral Health (2000)
describes oral disease in America as a "silent epidemic."
Healthy People 2000 reports 18 percent of 2- to 4-year-olds have
visible decay, and the numbers are rising. More than half of elementary
school children have dental decay, and by the time they graduate
from high school, it has increased to 84 percent. 99 percent of
the population ranging from high school graduation to mid life (age
45) has tooth decay. Children can avoid cavities entirely if provided
with early and proper dental care, but not all children receive
appropriate oral health care. In children age 5 to 17, 80 percent
of cavities are found in a particular subgroup. Specifically, this
subgroup is within 25 percent of the lower end of the socioeconomic
scale. The problem lies with the success of preventive measures
not extending to those at the lower end of the socioeconomic scale.
Previous studies conducted indicate that poor children have about
five times more unfilled, decayed teeth than children above 300
percent of the poverty line.
The West Kentucky Dental Health Project (WKDHP)
is a collaborative community-driven project that aims to build an
infrastructure in 12 counties in rural western Kentucky to address
early childhood caries and dental caries. The project will target
children and families (80 percent Caucasian, 10 percent African
American, and 10 percent Hispanic) of the Women, Infants, and Children
(WIC) program, Head Start, and first and second graders through
educational programming, preventive projects, and activities to
increase access to treatment. Similar to goals contained within
the Healthy People 2010 Report, WKDHP's goals are to reduce the
proportion of children and adolescents who have dental caries experience
in their primary or permanent teeth or untreated dental decay, increase
the proportion of children and adolescents under age 19 at or below
200 percent of the Federal poverty level who use the oral health
care system each year, and who receive any preventive dental service
during the past year, increase access by purchasing restorative
services from community dentists for those children without insurance
or adequate resources, and to increase the proportion of children
who have received dental sealants on their molar teeth.
The WKDHP organizations include the Purchase and
Pennyrile District Health Department, the Graves County Migrant
Program, the Office of Family Resource and Youth Services Center,
Murray Head Start, the West Kentucky Technical College (WKTC) Dental
Hygiene/Dental Assisting Program, the Purchase Area Development
District (PADD), and the Purchase Area Health Education Center (AHEC).
D04RH06929
Nicole Lavy
Chief Executive Officer
Kentucky United Methodist Home
2050 Lexington Road
Versailles, Kentucky 40383
Phone: (859) 873-4481
E-Mail: nicole@kyumh.org
Fiscal Year 2006 2007 2008
Funding Amount $149,974 $124,987 $99,986
Keyword(s): Health promotion/disease prevention
(tobacco, overweight/obesity, alcohol abuse)
The Kentucky United Methodist Home and its partners-the
Kentucky Cabinet for Health and Family Services, and the Madison
County Health Department-joined forces to provide health care and
human services for low-income children, youth, and families in two
rural counties of central Kentucky (Anderson and Madison) through
the Connections Rural Health Initiative.
Rural residents in Kentucky and the nation face
a number of health disparities-among them, higher rates of the top
three leading actual causes of death in the United States (tobacco,
overweight, and alcohol)-and barriers to health care, especially
access issues that make it difficult for citizens to obtain the
care they need. While access/barrier issues abound, Connections
is designed to address two in particular: the lack of transportation
and the lack of insurance. We chose these two issues because they
significantly reduce our families' ability to access the care they
need and because the Connections program design helps work around
them. Project activities include the following:
- We will provide in-home case management and
other services when possible, and we will help families arrange
for transportation to other providers and services as necessary;
- We will make the evaluation of each family's
eligibility for third-party payment and support programs (Medicaid,
KCHIP, K-TAP) a fundamental priority of our case management services,
and we will help enroll individuals and families as appropriate.
- The Connections Rural Health Initiative
will address identified health care needs, facilitate and encourage
healthy behaviors, and help overcome barriers and disparities
that interfere with families' ability to foster their own and
their children's health.
We have identified four major goals:
- Seventy-five percent of families served will
be able to access services independently upon discharge from the
Connections program;
- Participation in Connections will result in
a reduction in the number of smokers, and especially youth smokers,
as compared to baseline measures;
- Eighty percent of the children in the families
we serve will have a dental exam and will follow through with
treatment in the year after Connections services are provided;
- Partnerships/collaborations begun through the
Connections program will be self-sustaining; that is, they will
continue beyond the grant period.
We have designed Connections to focus on areas
where we believe we can have the greatest impact. By targeting low-income
families, we serve those in greatest need. By targeting youth with
our psycho-educational programs covering content areas we know significantly
impact health (tobacco, diet/nutrition/exercise, substance abuse/mental
health, and oral health/dental care), we maximize our opportunity
to break the cycle of unhealthy behaviors and produce long-term
results.
Within the three-year period of this grant,
we believe we will improve the lives of the families served, strengthen
current referral networks and partnerships, create new collaborations,
and enhance the health of the rural communities we serve.
D04RH06930
Jan Chamness
Public Health Director
Montgomery County Kentucky Health Department
117 Civic Center
Mt. Sterling, Kentucky 40353
Phone: (859) 498-3808
E-Mail: janm.chamness@ky.gov
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Dental care, Minority health
This project plans to establish an outreach program
developed by the Western Appalachian Kentucky Health Care Access
Consortium. The consortium's mission is to improve access to primary
care and dental care among low-income, uninsured, and underinsured
residents, with a special emphasis on providing outreach services
for the unmet needs of an expanding Latino population. Over the
next 3 years, the consortium plans to provide 2,244 primary care
visits and 315 dental care visits, as well as outreach, transportation,
and other services.
The consortium service area is a contiguous, six-county
region of more than 1,400 square miles on the western edge of Appalachian
Kentucky. All six of these counties are designated as medically
underserved populations/medically underserved areas, and all but
one are federally designated Appalachian counties. All counties
are rural.
The consortium is an expansion of the successful
Montgomery County Migrant Coalition, a 25-plus member organization
established in 2001 with funding from the U.S. Department of Agriculture.
All consortium members are active participants. The consortium is
comprised of four health care agency partners: 1) Montgomery County
Health Department, 2) Mary Chiles Hospital, 3) the Family Care Clinic
(a rural health clinic), and 4) the Vollmer Dental Office. The consortium
also includes two non-health care partners, Montgomery County Cooperative
Extension Service and the Montgomery County Industrial Authority,
which, with the four other traditional agencies, create an innovative
partnership that is well-equipped to fulfill the consortium's mission.
The six goals of the consortium are to: 1) Expand
the existing services of the collaborating organizations; 2) Advocate
on behalf of the target population for improved access to existing
health care resources; 3) Provide a link between providers and Latino
patients; 4) Provide an interpretive link between existing and prospective
employers and Latino workers to ensure a healthy Latino workforce;
5) Increase the community's understanding of Latino culture; and
6) Develop a long-term sustainability plan for the consortium.
Through this project, the consortium will expand
its capacity to offer primary care and dental services, and to develop
an extensive outreach program. The consortium will use a promotora
model of community health workers to reduce and eliminate barriers
to care that Latinos often face, including the inability to communicate
because of language barriers, lack of transportation, inability
to navigate the local health care system, occupational barriers,
and lack of cultural competency among local service providers.
We believe the creative strategies planned
to enhance service delivery can be a model for other rural communities
to follow, especially where Latino populations are relative new,
such as Appalachia and States beyond the U.S.A-Mexico border. The
University Kentucky College of Public Health will assist with process
and outcome evaluations, and with the dissemination of findings.
LOUISIANA
D04RH4333
Mary W. Murimi
Louisiana Tech University
P.O. Box 3168
Ruston, Louisiana 71272
Phone: (318) 257-2607 Fax: (318) 257-4014
Email: murimi@ans.latech.edu
Fiscal Year 2005 2006 2007
Funding Amount $197,385 $178,963 $191,285
Keyword(s): Obesity, Chronic Diseases, Health
Education
The purpose of the Dubach Health Outreach Project
is to provide access to a multidisciplinary community-based intervention
to combat obesity and related chronic diseases. The project will
focus on primary care and prevention strategies along with wellness
strategies that deal with obesity and related risk factors and diseases
such as coronary heart disease. A consortium of preventive health
service providers and agencies will maximize resources to increase
the number of individuals and families receiving preventive care
for obesity and related disorders, and foster positive behavior.
The project will target at-risk and obese preteens
and teens by implementing a health education, nutrition, and physical
education program in targeted schools with a focus on primary prevention
and education. The project also will target adults, who will receive
secondary and tertiary prevention services such as screening, testing,
health education, nutritional assessment, and counseling.
The project will serve the town of Dubach and
surrounding rural communities in northern Lincoln Parish, Louisiana,
where more than 25 percent of the population lives in poverty. The
target populations are rural, low-income Caucasian and African American
preteens to adults who are at risk of obesity and its complications
and who have high levels of "health illiteracy." The leading
causes of death in the targeted population are heart disease, diabetes,
and stroke, all of which are aggravated by obesity.
All areas to be served are rural communities in
which many residents have low access to primary care and preventive
medicine. High consumption of dietary fat and calories and low frequency
of exercise contribute to obesity in the target population. Cultural,
educational, and socioeconomic barriers to access include lack of
exercise facilities, lack of education, and a high poverty rate.
All areas and people to receive services are in a Health Professional
Shortage Area and are Medically Underserved Populations. Lincoln
Parish is designated as a Medically Underserved Area.
In addition to Louisiana Tech University, the
lead applicant, consortium members include Lincoln General Hospital,
Town of Dubach, Dubach High School, Dubach Revitalization Coalition,
Dubach Restoration and Beautification Organization (DRABO), and
Lincoln Council on Aging.
D04RH04336
Sharon Murff
City of Grambling/Grambling Family Medical Clinic
2045 Martin Luther King Jr. Avenue
P.O. Box 108
Grambling, Louisiana 71245
Phone: (318) 247-6120 Fax: (318) 247-0940
Email: murffsttt@aol.com
Fiscal Year 2005 2006 2007
Funding Amount $195,140 $184,890 $184,890
Keyword(s): Obesity, Diabetes
Healthy Communities of Louisiana-The Obesity Project
is a health education and screening project targeting obesity and
related diseases such as diabetes, coronary heart disease, and stroke
in at-risk African American adolescents and adults. At the core
of the problem is the lack of seamless coordination among key agencies
providing preventive and medical services along with a high rate
of health illiteracy among the target population, rural African
Americans. The project will establish a network of preventive health
service providers and agencies to increase the number of individuals
receiving preventive care and screenings and foster positive behavior.
The two-pronged intervention approach will target at-risk school-age
individuals as well as at-risk adults who are obese and African
American. The goal of the project is to serve the target population
at risk for chronic diseases because of obesity through preventive
services, aggressive health screening, and education, along with
a seamless continuum of care and referral networks. One novel approach
the project will use is to target families at family reunions to
provide health education and interventions such as screenings.
Rural Bienville and Lincoln parishes in north
central Louisiana-the target area-are home to some of the most poverty-stricken
areas in the state and in the Nation. More than 20 percent of the
total population in the state is below the poverty line, and more
than 40 percent of the children in north central Louisiana under
age 20 live in poverty. Among female-headed households with children
under age 5, the poverty rate is a staggering 80 percent. In 2000,
Bienville had a population of 15,563 (44 percent African American),
and Lincoln Parish had a population of 42,173 (40 percent African
American). Obesity-related diabetes and heart disease in African
Americans are at epidemic proportions in the two parishes, and effective
strategies are needed to reduce the burden of diabetes and other
obesity-related diseases.
Geographically, Bienville and Lincoln parishes
are relatively accessible to major highways, and access barriers
to needed services are not so much physical distance but rather
cultural and socioeconomic. In addition to poverty and lack of education,
barriers include disparate medical care for African Americans, cultural
mores that place a greater emphasis on preventive care for females
than males, and the rural African American emphasis on family. Other
barriers include a high consumption of dietary fat and calories,
a sedentary lifestyle, and psycho-spiritual attitudes such as forgoing
medical treatment in the belief that God will "fix it."
Consortium members include the City of Grambling/Grambling
Family Medical Clinic; Office of Public Health, Bienville Parish
Health Department; Shreveport Black Nurses Association; Partners
in Wellness Prevention Project; Bienville Parish School System-Arcadia
School Complex; Bienville Health and Wellness Center; and Methodist
Ministerial Alliance/St. Duty CME Church.
D04RH06916
Rev. Craig A. Mathews
ByNet Executive Director
P.O. Box 278
Franklin, Louisiana 70538
Phone: (337) 828-5638, ext 104
E-Mail: cmathews@bynet-la.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Medication assistance, Telehealth,
Chronic Disease
The CEI: Project Outreach will expand upon the Bayou Teche Community
Health Network's Information and Help Center, Medication Assistance
Program, Telehealth Project, and Chronic Disease Management/Prevention
Outreach Programs. Expected results of the project include:
- Increased enrollment in local, State and national
programs (i.e., LaChip/Medicaid/Medicare Savings/Care for the
Caregiver);
- Continued decrease in non-emergency ER use;
- Increase in outreach partners comprising Community
Health Teams;
- Increase in number of comprehensive screenings
(i.e. diabetes/blood pressure and service eligibility);
- Establishment of single points of entry for
patient mapping;
- Leverage of State funds ($50,000) and Federal
funds ($150,000);
- Increase in number of residents with an identified
medical home;
- Increase in number of churches providing transportation
to medical care;
- Consortium access to state-wide meetings and
seminars through coordination of teleconferencing equipment; and
- Accumulation of additional data on the target
population through Service Point customization and expansion.
ByNet's St. Mary Parish
(County) Chamber of Health Coalition, which is comprised of over
70 representatives of health care, social service, consumer, faith-based
and governmental entities, identified five key areas of need to
improve healthcare in St. Mary and surrounding Parishes. Focus groups
and committee research led the coalition to identify education,
consumer-finance, transportation, access to medication, and primary
and specialty care as key barriers to health care access for residents.
In addition, the Health Access Barriers in the State (HABITS) Survey
was conducted for the three target counties. The University of Louisiana
at Lafayette's Health Informatics Center conducted the surveys used
as baseline data for network program evaluation. Emergency room
usage, lack of health insurance, transportation, and inability to
afford needed medications were identified as key concerns for all
three target areas. In 2001, the network's consortium of members
began to implement programs and services to address identified needs.
In the aftermath of the September 2005 Hurricane Katrina devastation
experienced in the southern coastal region of the United States,
the previously identified needs have significantly enhanced to an
insurmountable level. St. Mary, Iberia and Terrebone Parishes have
now become home to thousands of survived families requiring these
services.
The target population for the project is the underinsured
and uninsured residents of St. Mary, Iberia, and Terrebonne Parishes
in south central Louisiana along the Gulf Coast. This population
has recently experienced an enormous influx due to Hurricane Katrina
survivors who have migrated into local communities. Those organizations
comprising the consortium are the founding members of the Bayou
Teche Community Health Network (ByNet). The State's first vertical
rural health network members include two state hospitals, two St.
Mary Parish rural hospitals, one St. Mary Parish Federally Qualified
Health Center, one Iberia Parish Federally Qualified Health Center,
one tribal clinic, one Louisiana Regional Office of Public Health,
one social service agency, and a representative of the St. Mary
Chamber of Health Coalition.
D04RH06918
Lisa Dixon
Chief Executive Officer
Franklin Parish Hospital Service District No. 1
2106 Loop Road
Winnsboro, Louisiana 71295
Phone: (318) 435-9411
E-Mail: ldixon@fmc-cares.com
Fiscal Year 2006 2007 2008
Funding Amount $149,722 $121,778 $93,883
Keyword(s): Mental health
There is a lack of behavioral health care services
in Louisiana's Franklin and Tensas parishes, both of which are located
in the rural, impoverished region of the Mississippi River Delta.
There are two key services to be developed under the project-case
management and psychological evaluation and treatment services.
These services will be provided to individuals at three rural health
clinics, long-term care facilities, and home-bound patients. The
target population will be primarily African American adults.
The overarching goal of this project is
to establish a primary care-based behavioral health program. The
eight related goals that support this are:
- To identify and enroll individuals in the behavioral
health care management program;
- To ensure individuals receive assessment and
treatment services at one of three rural health clinics that are
primary care sites in the two-parish service area;
- To expand the behavioral health program to
include patients residing in area long-term care facilities;
- To expand the program upon implementation to
include patients who are home-bound and actively enrolled as a
home health patient;
- To reduce the incidence of serious mental illness,
depression, schizophrenia, and generalized anxiety disorders;
- To reduce the proportion of homeless adults
who have serious mental illness;
- To ensure program sustainability; and
- To conduct a program evaluation.
D04RH06917
Donna Newchurch
Executive Director
Louisiana Rural Health Association
167 Highway 402
P.O. Box 387
Napoleonville, Louisiana 70390
Phone: (985) 369-3813
E-Mail: newchurch@lrha.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Infrastructure development, Elderly
(education), Medication assistance, Quality improvement
The rural composition of Louisiana's delta region is a photograph
of health care professional shortage areas, extremely low preventive
health compliance rates, high poverty rates, vast geographic boundaries,
and above-average geriatric populations.
Through a 2004 ORHP Network Development Planning
Grant, the Louisiana Rural Health Association, the Louisiana Health
Care Review, Assumption Community Hospital, and Assumption Rural
Health Clinic developed a network dedicated to increasing adult
immunizations and adult vaccinations. Network partners worked together
to form the Planning Equals Access for Louisiana (PEAL) Initiative.
With active participation in community forums
by community members and natural growth, the initial four network
partners expanded to include the Centers for Medicare & Medicaid
Services and the Louisiana Department of Insurance Senor Health
Insurance and Information Program. It was through this process that
PEAL grew from an informal network to an emerging coalition. PEAL
members successfully developed a strategic plan with the overarching
goal of implementing the comprehensive, mobile strategic plan developed
by collaborating partners and existing rural health coalitions.
The end results were major quality improvements, transformational
changes, and increased access to care in 30 rural Louisiana parishes.
The goals for this project are as follows: 1)
To engage partners in making transformational changes that will
enhance efficiency, increase access to care, improve service coordination,
and improve quality of care; 2) To educate Medicare beneficiaries
about their rights and benefits, increase the number of allied health
care professionals providing preventive services, expanding the
payer network via innovative approaches, and improve the use, distribution,
and payment of prescription drugs among Louisiana's rural elderly;
and 3) To identify strategies for sustaining PEAL after ORHP funding
ceases.
D04RH06919
Jinger Greer
Richland Parish Hospital
407 Cincinnati Street
Delhi, LA 71232
Phone: (318) 878-5171
E-Mail: delhihospital@yahoo.com
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $124,760 $99,130
Keyword(s): Cardiovascular disease
Richland Parish Hospital (RPH) is a critical access
hospital with a 501(c)(3) nonprofit designation. It is located in
Delhi, Louisiana, Richland Parish, in the northeast corner of the
State, and is the main provider of health care services in the parish.
The Richland Parish Hospital-Delhi (RPH-Delhi) Community Wellness
and Prevention Program is a model program designed to provide health
assessments, health promotion, and health education in settings
such as the school, worksite, health care facility, and community.
Richland Parish is a designated health professional
shortage area and a medically underserved population. There are
significant access barriers to health care as reflected in the income
and poverty demographics, health status indicators, and health disparities.
The primary needs to be addressed through
this project are as follows:
- To increase the quality, availability, and
effectiveness of community-based programs designed to prevent
cardiovascular disease, improve health, and improve quality of
life;
- To expand the availability of health education
resources to underserved, vulnerable, and special-needs populations
to reduce cardiovascular disease;
- To decrease the risk factors and the resulting
high incidence rate of cardiovascular disease and correlating
chronic diseases;
- To strengthen the health care infrastructure
and service delivery systems in Richland Parish as they relate
to the management and treatment of cardiovascular disease and
correlating chronic diseases.
The network has developed the following goals:
- Develop a model comprehensive community cardiovascular
disease program in Richland Parish that can be replicated in 10
other parishes;
- Increase community awareness of cardiovascular
disease and associated risk factors, with a focus on Syndrome
X, tobacco use, and personal stress management;
- Decrease the incidence of cardiovascular disease
and the incident of associated risk factors through a behavioral
modification focus that targets dietary habits, physical activity,
tobacco use, and personal stress levels; and
- Enhance the management and treatment of cardiovascular
disease and related risk factors by focusing on early detection,
education, behavior modification, and pharmacotherapy.
MAINE
D04RH04331
Leah Binder
Healthy Community Coalition
20 Church Street
Wilton, Maine 04294-3803
Phone: (207) 645-3136 Fax: (207) 645-4138
Email: lbinder@fchn.org
Fiscal Year 2005 2006 2007
Amount Funded $200,000 $200,000 $200,000
Keyword(s): Obesity, Clinical Interventions
The Healthy Living Initiative of the Healthy Community
Coalition will focus on community and primary care strategies to
address obesity, a major risk factor for a number of diseases, as
well as behavioral factors that contribute to the obesity epidemic.
The initiative will integrate and expand clinical and community-based
strategies for promoting proper nutrition and increasing physical
activity to reduce the prevalence of overweight and obesity in rural
Franklin County, Maine, and several neighboring towns. The initiative
will expand the range of clinical interventions available locally
for obese and overweight adults and adolescents and will educate
health care providers in diagnosing overweight and obesity. A marketing
campaign to promote physical activity and good nutrition will educate
the community at large.
The target population comprises residents of Franklin
County and eight neighboring towns. Greater Franklin suffers from
an escalating rate of obesity and overweight among its 40,000 residents.
In 2000, 60 percent of adults and 15 percent of children were clinically
obese or overweight. The region is at higher risk for obesity and
overweight than other areas of the state because risk factors associated
with obesity, such as the lack of health insurance and lower education
levels, are significantly higher in the county than the rest of
Maine. The project will address the unmet needs of the entire population
in the area with a focus on the lowest income residents, those at
or below 250 percent of the Federal poverty level, who are most
likely to need services and least likely to be able to afford access
to them. The project also will focus on Franco-American residents
who tend to have a lower socioeconomic status as well as poor nutrition
and low physical activity.
Barriers to accessing services include the lack
of fitness facilities in the area; low-income residents cannot afford
the few that are available. After-school activities also are limited.
Public transportation is unavailable. Rural residents are geographically
far-flung, and geographic distances make travel difficult and time-consuming
and require considerable time to accomplish routine tasks. The excessive
dependence on vehicles leads to a sedentary lifestyle pivoting around
vehicle usage. Seventeen communities in the Healthy Community Coalition
service area are designated as either a community or population
primary or dental care shortage area, and 18 communities are Health
Professional Shortage Areas.
Consortium members include the Healthy Community
Coalition, the lead applicant; HealthReach Community Health Centers;
the University of Maine at Farmington; and Franklin Community Health
Network.
D04RH02555
Kay Henderson
Northeast Health
6 Glen Cove Road
Rockport, Maine 04856
Phone: (207) 596-8392 Fax: (207) 596-5316
Email: khenderson@nehealth.org
Fiscal Year 2004 2005 2006
Funding Amount $199,913 $199,913 $199,913
Keyword(s): Mental health, Substance abuse
Almost 21 percent of U.S. children age 9 to 17
(15 million persons) have a mental or addictive disorder that causes
some impairment. However, studies show that pediatricians do not
identify 80 percent of children living with behavioral and emotional
problems, and in any given year, it is estimated that less than
one in five of these youth receive treatment. The Maine Medical
Association recently passed a resolution identifying the lack of
mental health care for children as the biggest health issue for
the state, an action well supported by Maine's health statistics.
Northeast Health in cooperation with three partner
organizations, Mid-Coast Mental Health Center, the Penobscot Bay
YMCA, and the Maine Department of Behavioral and Developmental Services
joined forces to form the Mid-Coast Mental Health Integration Initiative
in an effort to increase access to adolescent mental health and
substance abuse services in Knox, Lincoln, and Waldo counties, Maine.
The goals of the Mid-Coast Mental Health Integration
Initiative are to improve access to child and adolescent mental
health services, reduce the stigma associated with mental health,
reduce the number of crisis interventions, improve coordination
and cooperation among local health providers, and disseminate an
innovative model. Nearly 97 percent of Maine's population is Caucasian.
The ethnic mix of this program is similar, targeting 95 percent
Caucasian, 2 percent Hispanic, 1 percent Asian, and a mix of African
Americans and Native Americans totaling less than 1 percent of the
target population. Children between the ages of 0 to 12 make up
40 percent of the target population, while adolescents age 13 to
17, at nearly 50 percent, represent the largest group to be served.
D04RH06920
Dawn Cook
Chief Executive Officer
Rural Maine Healthy Aging Program
Health Access Network, Inc.
51 Main Street
Lincoln, Maine 04457
Phone: (207) 794-6700
E-Mail: dcook@hanfqhc.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $75,000
Keyword(s): Aging/Elderly
Health Access Network (HAN) is a 330-funded community
health center that provides primary care services to residents of
19 rural communities in Penobscot County-one of Maine's most remote,
rural locations in the isolated northern region of the State. The
target population for this project is the near elderly (ages 55-64)
and the older population (age 65 and above). HAN targeted the elderly
population for special attention in its original Section 330 New
Access Point grant application submitted in December 2002. Since
that time, HAN has worked diligently to meet the needs of its service
area's older residents, as well as the near elderly, with nearly
one-third of its present patient population falling within the ages
of 55-65 and older. One of HAN's main goals is to develop a comprehensive
medical and social service resource for the area's aging population.
For this project, HAN's partners include Penobscot
Valley Hospital (PVH) and Millinocket Regional Hospital (MRH), both
of which are critical access hospitals; the University of New England;
and the University of Maine Center on Aging. An additional 16 local,
regional, and statewide organizations and individuals support this
project.
According to recent reports, Maine's elderly population
continues to increase. Maine's population 65 and older is now at
15 percent, compared to 12 percent for the nation. Maine's aged
population ranks third in the country, trailing behind only Florida
(17 percent) and West Virginia (16 percent). Its median age (40.6),
which has increased by 2 years since 2000, is now the highest in
the country. While Maine's population is projected to grow only
slightly-less than 9 percent by 2017-the age distribution will change
dramatically. Forecasters predict that the number of children will
shrink 3 percent; the working-age adult population will grow only
5 percent; and the elderly will jump 38 percent.
The State's near-elderly and elderly population faces significant
barriers in access to quality health care and support services,
including lack of transportation, limited financial resources, lack
of insurance coverage for many services (even for those on Medicare),
and an insidious cultural bias against the elderly, promulgated
by a youth-obsessed society. Additionally, as a number of needs
assessments, discussions, and meetings determined, there is often
a "disconnect" between providers of health care and social
services, leading to acute fragmentation of care within the health
care and social service system. These access issues, coupled with
the fragmentation of services, result in poor health outcomes, lack
of attention to preventive care, and reduced quality of life for
the area's vulnerable elderly population.
The project's primary goals are: 1) To improve
access to high quality, locally coordinated, multi-specialty and
integrated health care; 2) To expand preventive services, emphasizing
specific concerns for older adults, such as substance abuse, tobacco
use, injury prevention, obesity, physical activity, mental health,
and immunizations; and 3) To expand mental health awareness and
services. Project activities include expanded case management with
a geriatric focus; vigorous community outreach and education; improved
preventive care and screenings; and the promotion of higher education
in rural geriatrics.
MARYLAND
D04RH05061
Rebecca Shockley
Worcester County Health Department
P.O. Box 249
Snow Hill, Maryland 21863-0149
Phone: (410) 632-1100 Fax: (410) 632-0906
Email: rebeccas@dhmh.state.md.us
Fiscal Year 2005 2006 2007
Funding Amount $199,521 $199,521 $199,521
Keyword(s): Service Accessibility, In-home Care,
Behavioral Health
The Worcester Adult Centralized Care, Evaluation,
and Support Services (ACCESS) Collaborative will expand services
that promote independent, unrestricted living for Worcester County's
aging population. Goals include the provision of leadership and
direction to the Worcester ACCESS project, increased accessibility
to services for older county residents, and increased utilization
of available services. New and expanded services will address the
need for in-home care services and accessible behavioral health
services for older county residents. Worcester ACCESS will increase
the accessibility of in-home personal care, chore, and home improvement
services using the Asset-Based Community Development approach, which
emphasizes the involvement of community assets in addressing community
needs. A behavioral health team, comprising a behavioral clinical
specialist and a psychiatrist, will work closely with other health
care professionals to ensure that the mental health needs of older
adults are met. The project will increase utilization of services
and healthy behaviors in the target population through community
outreach and education activities. Services will be coordinated
through a single point of entry and overseen by the collaborative.
Worcester County, Maryland, is a rural, relatively
poor community with complex issues affecting the health and safety
of older adults. The current long-term care infrastructure cannot
support the population of older residents in need of personal care
assistance. The population of residents over age 65 is increasing
rapidly, and chronic and disabling conditions make it difficult
for older adults in the county to remain independent. The target
population-adults age 60 and older-comprises 26 percent of the total
county population of 46,543 in 2000. Between 1990 and 2000, the
number of adults age 65 and older increased 55.8 percent. The influx
of retired persons into the county, Maryland's only Atlantic seacoast
county, has created an additional challenge for service providers.
Future growth in the aging population is expected to continue as
a result of the retiring population coming into the county as well
as the aging of the baby boomer population already living in the
county. Access barriers include inadequate long-term care services
and the lack of personal care providers, resulting in only 50 percent
of total needed care being met. Worcester County is designated as
a Health Professional Shortage Area for primary care, dentists,
and mental health.
In addition to the Worcester County Health Department,
consortium members include the Worcester County Department of Social
Services and the Worcester County Commission on Aging.
D04RH06944
Jacob F. Frego
Executive Director
Eastern Shore Area Health Education Center
814 Chesapeake Drive
P.O. Box 795
Cambridge, Maryland 21613
Phone: (410) 221-2600
Fax: (410) 221-2605
E-Mail: jfrego@esahec.org
Website: www.esahec.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Dental
In 2005, the Eastern Shore Oral Health Action Network (ESOHAN) was
developed as a result of an Office of Rural Health Policy Network
Development Planning Grant. The primary goal of the ESOHAN is to
address disparities in access to, and use of, oral health care services
for children and low-income families. Through this network planning
process, a service delivery consortium was created to address oral
health access issues, particularly in Dorchester County, Maryland.
The members of the Eastern Shore Children's Regional Oral Health
Consortium (CROC) include the Eastern Shore Area Health Education
Center (AHEC); the University of Maryland Dental School; two federally
qualified community health centers, Choptank Community Health System,
Inc. and Three Lower Counties, Inc.; and a local hospital, Shore
Health System, Inc. Funds from the outreach grant will be used to
improve the availability of and access to preventive, restorative,
and rehabilitative oral health care for low-income children on the
Eastern Shore.
On the Eastern Shore, dental disease and lack
of access to dental care is one of the most pressing health care
issues. Considerable oral health disparities remain in this area,
especially among the low-income and pediatric populations. Children
living on the Eastern Shore exhibit more dental disease than any
other area of the State. All six counties in the CROC service area
have been designated Dental Health Professional Shortage Areas.
Historically, local dentists have not participated in the Medicaid
program because of the low reimbursement rates and the complexity
of processing claims, creating additional access barriers to dental
care for low-income patients. There are no dentists in Dorchester
County that accept medical assistance. Children with special health
care needs and those with extensive dental disease requiring sedation
have to travel at least 75 miles to Baltimore to access dental care.
CROC's work plan focuses on low-income children
who are uninsured or enrolled in medical assistance. The target
population for Cambridge Dental Center includes the 3,900 children
residing in Dorchester County who are eligible for medical assistance.
The target population for the hospital-based pediatric dental program
includes low-income children in the six counties on the mid and
lower Eastern Shore. There are approximately 26,800 children in
who are eligible for medical assistance MA in these six counties.
There are three components to the CROC Program:
1) the development of a comprehensive dental center in Dorchester
County; 2) the development of a regional hospital-based pediatric
dental program for the six mid and lower Shore counties; and 3)
the development of community-based clinical and educational training
opportunities for dental hygiene students on the Eastern Shore.
MICHIGAN
D04RH04338
Nancy Spencer
Alcona Citizens for Health, Inc.
Alcona Health Centers
177 North Barlow Road
Lincoln, Michigan 48742
Phone: (989) 736-3020 Fax: (989) 736-8380
Email: nspencer@ncc-mi.net
Fiscal Year 2005 2006 2007
Funding Amount $196,543 $183,124 $190,139
Keyword(s): Behavioral Health, Psychiatric Services
Integrated Behavioral Health Care of Northeast
Michigan is an expansion and enhancement project that will build
on an existing clinic-based behavioral health service program. Currently,
the Alcona Health Centers and Thunder Bay Community Health Services
have implemented the Strosahl integrated behavioral health model
at six clinics in five northeast, lower peninsula Michigan counties
with two behavioral health consultants and one clinical psychologist
covering all six clinics, and there is a need for more behavioral
health consultants. The project will provide new psychiatric services
at four clinics and will add two new behavioral health consultants
and neurological health services to address the needs of the substantial
elderly population. In the integrated behavioral health care model,
psychologists, psychiatrists, and behavioral health consultants
will be integrated members of the primary care system at Alcona
Health Centers and Thunder Bay Community Health Services. The expansion
of services is holistic, cost-efficient, and very much needed. Eventually,
telepsychiatry will be added to improve access to care.
The target area served by the consortium comprises
four counties-Iosco, Alcona, Montmorency, and Presque Isle-in the
lower peninsula of Michigan. The general population in the service
area is 63,000, and the target population is the more than 12,000
rural adults and children in the area estimated to be in need of
mental health services, including psychiatric, counseling, and referral
services. These individuals face multiple obstacles to services,
including low income, lack of education, cultural barriers, rural
isolation, stigma, lack of facilities and resources, funding disparities,
and age discrimination. The target population is very rural and
has less access to adequate health care due to income, education,
and transportation issues. There are 0.25 psychiatrists as well
as one psychologist and two behavioral health consultants in the
four-county service area. The main providers of behavioral health
are primary care physicians. The primary reason patients are generally
unable to access behavioral health services is the lack of qualified
behavioral health specialists in primary health care settings. The
target area is designated as a Health Professional Shortage Area
and a Medically Underserved Area.
The primary members of the consortium include
Alcona Health Centers, Thunder Bay Community Health Services, Alpena
General Hospital, and Northern Collaborative Care.
D04RH02574
Laurie Neldberg-Weesen
Marquette General Health System
420 West Magnetic Street
Marquette, Michigan 49855
Phone: (906) 225-3251 Fax: (906) 225-3180
Email: lweesen@mgh.org
Fiscal Year 2004 2005 2006
Funding Amount $199,910 $197,882 $199,314
Keyword(s): Geriatric care, Mental health
Alzheimer disease is the eighth leading cause
of mortality among elderly persons in the United States, accounting
for more than 100,000 deaths annually. The cost of irreversible
dementia is presently estimated at $100 billion per year, making
the illness our Nation's third most costly medical condition behind
heart disease and cancer. At present, most dementia disorders are
costly, progressive, and without a cure. The effects are devastating
to the caregivers and family as well as the affected individual.
It is projected that by 2050, more than 13 million Americans will
have Alzheimer disease.
The 6 counties in Michigan's Upper Peninsula targeted
for this project are Baraga, Gogebic, Houghton, Keweenaw, Marquette,
and Ontonagon counties. This geographical area has an Alzheimer
disease rate nearly double that of the state of Michigan. It is
conservatively estimated that 5,593 residents (4 percent of the
population) suffer from a dementia disorder. Some dementia disorders
can be treated; others are irreversible but can benefit from coordinated
medical and social management. Unfortunately, many people with memory
disorders remain undiagnosed and under-managed. The project recognizes
five issues that result in less than optimal care management for
people suffering from memory loss: delayed entry into medical services,
variation in care coordination and clinical practice, family member
difficulty in recognition and intervention (particularly those geographically
distant), caregiver risk for health and psycho/social problems,
and the compliance variation in care provided within the home setting.
The applicant, Marquette General Health System,
has joined with its network partners, Grand View Health System,
Keweenaw Memorial Medical Center, and the Portage Health System
to develop Softening the Sunset Journey, a community-based collaborative
which seeks to maximize local coordinated care resources toward
the improvement of community awareness, early identification, access
to care, and caregiver screening for older adult memory loss. Targeted
populations include older adults experiencing memory loss and their
family members and caregivers. The majority of people experiencing
memory loss will be age 65 and older (95 percent), with the remainder
of the target population age 18 to 64 (5 percent).
D04RH04339
Kathy E. Balcer
Sanilac Medical Services, Inc.
119 East Sanilac Road, Suite 1
Sandusky, Michigan 48471-1184
Phone: (810) 648-3092 Fax: (810) 648-2513
Email: balcerdan.kay@echoicemi.com
Fiscal Year 2005 2006 2007
Funding Amount $200,000 $200,000 $200,000
Keyword(s): EMS Providers, Capacity Building
The Huron-Sanilac Emergency Medical Services (EMS)
Volunteer Recruitment and Retention Project will aggressively seek
to reverse the declining number of active EMS providers in this
rural area of Minnesota. The project goal is to increase EMS volunteers
for Huron and Sanilac counties from 246 to 300 licensed volunteers,
with an increase in advanced certifications of 5 percent. This will
enable Huron and Sanilac counties to replace outgoing EMS volunteers
and build their volunteer rosters. A two-pronged approach includes
capacity building and outreach. Project strategies include increasing
access to EMS training, reducing barriers to EMS training and service,
increasing awareness of the value and importance of EMS, and increasing
incentives for EMS volunteers.
The primary target audience is residents living
in Huron and Sanilac counties located in the "Thumb" of
the mitten-shaped state of Michigan. The Thumb is a sparsely populated
area with a disproportionately high number of residents age 65 and
older. Health care providers are challenged with meeting the needs
of large populations of senior citizens and low-income residents.
Both counties are low-income Health Professional Shortage Areas.
Because of the overwhelming need for EMS in rural areas, all residents
in Huron and Sanilac counties are beneficiaries of the program.
In Huron County, 14.6 percent (5,135) of residents live in townships
that are designated as Medically Underserved Communities. In Sanilac
County, 44.6 percent (19,865) residents live in such designated
areas. Four of the six local hospitals are Critical Access Hospitals,
and 10 EMS services meet guidelines for a Critical Access Ambulance
Model.
In addition to Sanilac Medical Services, Inc.,
the lead applicant, consortium members include the Huron County
Medical Control Authority, Sanilac Intermediate School District,
and Huron Intermediate School District.
D04RH06935
Laura Frisch, F.N.P.
Helen Newberry Joy Hospital
502 W. Harrie Street
Newberry, Michigan 49868-1209
Phone: (906) 477-6066
E-Mail: frischla@portup.com
Fiscal Year 2006 2007 2008
Funding Amount $149,988 $124,999 $100,000
Keyword(s): Obesity/overweight
The problem is clear: Michigan has the third highest obesity rank
in the United States, with 62 percent of adults being overweight
or obese. Our children are following in our footsteps. Eleven percent
are considered overweight, and 13 percent are at risk for overweight.
These youth are likely to become overweight adults with all the
serious health conditions, psychological issues, and health care
costs that arise with excess weight and energy imbalance.
Two critical access hospitals have joined with
their regional referral center to reduce the proportion of children
and adolescents who are overweight or obese. The project targets
families in three counties in Michigan's Upper Peninsula-Luce Mackinac,
and Marquette. These counties are home to 83,601 people. State statistics
suggest there are 5,598 youth ages 5-19 in the service area who
are overweight or obese.
This project takes a practical, scientific approach
to what is often an emotional issue. We recognize three specific
needs:
- Families lack knowledge and basic skills for
translating scientific information on nutrition and exercise into
everyday practice, which results in less than optimal growth and
development for youth.
- Youth who have a high potential for developing
metabolic syndrome often experience delayed entry into appropriate
services.
- Rural communities lack the critical mass and
specialty expertise to provide evidence-based programming for
youth weight loss.
Local autonomy will be combined with cooperative
regional efforts and evidence-based models for prevention, early
identification and treatment. Site coordinators will be placed in
each community to implement project activities and coordinate with
local stakeholders. Consortium partners will cooperate to develop
and deliver coordinated awareness and education curricula, to offer
local screenings for metabolic syndrome, and to deliver a video-conferenced
treatment program that will demonstrate a reduction in body mass
index and improved lab values related to chronic diseases. Local
staff will provide patient follow-up and communication streams among
health care providers. An evaluation team, headed by a nationally
recognized researcher at Northern Michigan University will conduct
evaluation for process and outcome measures.
The applicant is Helen Newberry Joy Hospital and
Healthcare Center, a critical access hospital with an attached long-term
care facility, a rural health clinic, and three outreach health
clinics. The consortium partners are Mackinac Straits Hospital,
a critical access hospital, and Marquette General Health System,
a 364-bed regional referral center. Staff will be dedicated to this
project within each partner organization, strengthening each partner's
role while cooperating on all activities. An advisory group of project
staff, community stakeholders, and representatives from the target
group will oversee this project.
D04RH06934
Ann Marie Hepfer
Tuscola County Health Department
1309 Cleaver Road, Suite B
Caro, Michigan 48723
Phone: (989) 673-8114, ext. 115
Fax: (989) 673-6191
E-Mail: ahepfer@tchd.us
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Obesity/overweight
The Thumb Area Nutrition and Physical Activity
Campaign is a result of a community health assessment conducted
by the Thumb Rural Health Network. Results indicated that the overarching
issue related to death rates from heart disease, diabetes, and other
chronic disease is obesity. Despite numerous health education programs
that address nutrition and physical activity, 66.5 percent of adult
residents and 40 percent of youth are overweight or obese. The proposed
project is the result of 15 months of research and planning by the
task force.
The Tuscola County Health Department will provide
project management and partner with three Michigan State University
Extension Services, health departments in Huron and Sanilac Counties,
and rural hospitals to implement the project. The Task Force has
four long term goals: 1) To increase the proportion of adults who
are at a healthy body mass index (BMI) from 33.8 percent to 38.8
percent by 2015; 2) To reduce the proportion of adults who are obese
from 28.8 percent to 26.8 percent by 2015; 3) To reduce the proportion
of children and adolescents that are overweight or obese from 40
percent to 30 percent by 2015; and 4) To increase the proportion
of children and adolescents ages 6 to 19 years whose intake of meals
and snacks at school contributes to good overall dietary quality.
The Thumb Steps Up Task Force has developed
a community-wide campaign that goes beyond health education. The
campaign is based on State models and Centers for Disease Control
and Prevention-recommended programs. Interventions include community
outreach and health promotion. Project activities include a social
marketing campaign; community presentations; community activity
programs; promoting local and State recognition programs for "Promoting
Activity Communities" and "Healthy Eating"; and providing
technical assistance to grocers, restaurants, human service providers,
governmental bodies, schools, and worksites. The Task Force has
emphasized the need to address childhood obesity and reach youth
who have a greater propensity for change than adults. Research shows
that, to impact youth, the adults and environment that they live
in must also be changed. Therefore, children, their families, and
the communities where they live will be the priority population
targeted for interventions. Major outcomes include:
- Outcomes 1 & 2: 60 percent of focus group participants
will indicate social marketing messages are credible and have
the ability to influence behavior.
- Outcome 3: 90 percent of food outlets/suppliers
that participate in an assessment increase their score.
- Outcome 4: Pre- and Post-Health Risk Appraisal
Reports indicated a significant improvement in health indicators
related to obesity.
- Outcome 5: Nine communities will receive awards
from the Michigan Promoting Active Communities Program by 2009.
- Outcome 6: Nine schools complete assessments
and have a Health Improvement Plan.
- Outcome 7: The percentage of youth exhibiting
healthy eating behaviors will increase significantly.
- Outcome 8: The percentage of youth exhibiting
physical activity behaviors will increase significantly.
MINNESOTA
D04RH04364
Anne C. Rodgers
Cass County Health, Human and Veterans Services
400 Michigan Avenue, West
P.O. Box 40
Walker, Minnesota 56484-0040
Phone: (218) 547-1340, ext. 210 Fax: (218) 547-7232
Email: a.rogers@co.cass.mn.us
Fiscal Year 2005 2006 2007
Funding Amount $180,019 $194,670 $200,000
Keyword(s): Women's Health
The overall goal of the program is to foster increased
capacity and resources to assure rural health delivery of quality
programming for women's health, including family planning and risk
reduction services in three counties in north central Minnesota.
The four program goals include improving access to family services,
reducing unintended pregnancy, improving the quality of women's
health care services, and improving communication between providers
through consortium involvement and improved technology capabilities.
A primary point of access for women during reproductive
age is for contraceptive care, and the project seeks to improve
acceptance of and access to this service and to make this service
more comprehensive for all women. Women will receive contraceptive
care and assessment/referral for issues relating to their health.
The project will use a community clinic model of service delivery
and will work with family planning and general practitioners to
build capacity to serve women in a holistic manner.
Unintended pregnancy is a high-priority public
health problem in Cass, Todd, and Wadena counties, the low-income,
primarily rural area the project will serve. The target population
is women of reproductive age, with an emphasis on low-income or
uninsured/underinsured women. The majority of the population in
all three counties is white. The American Indian population (10.8
percent in Cass County, 0.5 percent in Todd County, and 0.6 percent
in Wadena County) receives most services from the Indian Health
Service, but the project will serve part of that population in outlying
clinics. Todd County has a growing Hispanic community (8 percent),
which the project will include as part of the target population.
Many residents in all three counties live in isolation,
miles away from medical services, and must travel 75 to 80 miles
to receive subsidized family planning services. Many of the most
at-risk women have unreliable transportation, making access to care
difficult. Other barriers to access include cost and the lack of
insurance. A large percentage of the population is uninsured. Thirty
percent of the population delay or fail to seek medical care because
of cost or lack of insurance. All three counties are designated
Health Professional Shortage Areas for primary care and Medically
Underserved Areas. The project population is a Medically Underserved
Population.
Consortium members include Cass County Health,
Human, and Veterans Services; Todd County Public Health; Wadena
County Public Health; CentraCare Clinic; Dakota Clinic-Walker; Dakota
Clinic-Menahga; Pine River Family Clinic; Wadena Medical Center;
and Ottertail Wadena Community Action Council.
D04RH04363
Brenda Anderson
Northwestern Mental Health Center
603 Bruce Street
Crookston, Minnesota 56716
Phone: (218) 281-3940 Fax: (218) 281-6261
Email: banderson@nwmhc.org
Fiscal Year 2005 2006 2007
Funding Amount $180,835 $185,993 $191,300
Keyword(s): Mental Health Services
The Mahnomen County Mental Health Consortium will
focus on at-risk children and adolescents and their families, while
expanding access of the general population to short-term outpatient
services to ensure earlier intervention for individuals and families.
The consortium will provide professional home-based mental health
therapy services to children and adolescents and their families,
with special emphasis on children and adolescents involved in the
criminal justice system. It also will provide school-based mental
health services to improve both social and academic performance,
reduce school dropouts, and decrease out-of-home placements. Functional
family therapy and family group decision-making will be adapted
to address the special cultural needs of Native American children
and families. Outpatient services will be initiated to ensure access
to all populations to improved crisis management and to better integrate
mental health with primary health services, particularly relevant
to the Native American population. The project will establish an
interagency process for coordinating early identification, screening,
assessment, and intervention. Goals of the project are (1) to develop
an interagency network of health, mental health, and human service
agencies to implement early identification, screening, referral,
and intervention to address the needs of at-risk families, children,
and adults in need of mental health care; and (2) to improve access
to mental health resources for county residents.
The target population is at-risk children and
adolescents and their families in need of multiple services in Mahnomen
County, a small rural county in northwestern Minnesota located entirely
within the boundaries of the White Earth Indian reservation. The
county has a diverse population of 5,215 people, including a significant
number of Native Americans (28.6 percent of the population). With
30.9 percent of the population living in poverty, the area is among
the poorest in the state and has the lowest per capita income in
Minnesota. Unemployment is 8.1 percent. If estimates of the unemployed
were expanded to include unemployed people who are no longer actively
seeking work, the percentage of unemployed people in the county
would approach 50 percent.
County residents experience mental health problems
that are among the most serious of any county in the state. The
challenges of poverty, cultural diversity, a failing rural economy,
and natural disasters-all barriers to accessing services-also contribute
to the need for mental health services. Mahnomen County is designated
as a primary medical care Health Professional Shortage Area and
a Medically Underserved Area.
Consortium members include Northwestern Mental
Health Center, the lead applicant; Mahnomen County Human Services;
Mahnomen Health Center; Independent School District No. 432; and
White Earth Reservation Health Services.
D04RH06962
Lawrence Massa
Chief Executive Officer
Rice Memorial Hospital
301 Becker Avenue SW
Willmar, Minnesota 56201
Phone: (320) 231-4227
E-Mail: lorry@rice.willmar.mn.us
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Dental
The Surgeon General's 2002 Report on Oral Health
recognizes oral health as a significant health care concern that
especially burdens the poor, children, minorities, and the elderly.
Minnesota is facing major problems in dental care delivery stemming
from current dental workforce shortages and rising health care costs-challenges
that are exacerbated in rural communities.
The goal of the Rice Regional Dental Clinic is
to increase access to dental care for uninsured and underserved
residents in the 12-county service area of west central and southwest
Minnesota. Strategies to support this goal include: 1) providing
dental care for uninsured and underserved residents in the service
area; 2) promoting careers in dentistry among people living in the
area through education and public service; 3) engaging area dentists
and dental hygienists in public service; 4) increasing the number
of dentists and dental hygienists choosing to practice in the service
area; 5) providing opportunities for inter-professional education;
and 6) strengthening the dental clinic infrastructure.
The dental clinic's target population is underserved
residents in the 12-county service area, including public program
patients and others who lack dental insurance or the means to access
care. Eight of the twelve counties are federally designated Dental
Health Professional Shortage Areas. In addition to being home to
a large number of American Indians, the 12-county service area includes
a significant number of ethnic minorities, including Somali, Latino,
and Sudanese populations.
The Rice Regional Dental Clinic will be constructed
on the campus of Rice Memorial Hospital in Willmar, Minnesota. The
clinic will feature a unique dental education model. Once it is
fully operational, an estimated six dental and dental hygiene students
will rotate through the clinic and provide patient care on a year-round
basis, supervised by the clinic's staff, which includes a full-time
University of Minnesota School of Dentistry faculty member, two
dental assistants, and a dental hygienist. An estimated 8,100 patient
visits will be conducted annually once the dental clinic is fully
operational.
Rice Memorial Hospital is the largest city-owned
hospital in Minnesota and has a history of commitment to outreach.
The project consortium also includes the University of Minnesota
School of Dentistry, which will help staff the Dental Clinic with
dental students; Southern Minnesota Area Health Education Center,
which will support the dental students and provide links to K-12
and community resources; and Kandiyohi County Public Health and
Countryside Public Health, two public health agencies currently
serving the target population in the 12-county service area, who
will provide the critical link to the target population.
MISSISSIPPI
D04RH04330
Coney L. Johnson
Claiborne County Family Health Center
P.O. Box 741
Port Gibson, Mississippi 39150-0741
Phone: (601) 437-3052 Fax: (601) 437-3051
Email: cljohnson55@bellsouth.net
Fiscal Year 2005 2006 2007
Funding Amount $196,236 $185,750 $178,123
Keyword(s): Primary Health Care, Prevention Services,
Health Education
The Claiborne County Rural Health Care Services
Outreach project, established by the Claiborne County Family Health
Center (CCFHC) and consortium partners, will operate three school-based
health clinics to provide primary health care, prevention services,
and health education on topics such as diet, nutrition, exercise,
high-risk behavior prevention, and tobacco use prevention to students
in grades K-12 students in the Claiborne County Public School District.
The project also will provide immunization tracking as well as reproductive,
dental, and mental health services. Age-specific programs will educate
students on becoming responsible for their own health and practicing
preventive health. Programs will include personal hygiene, health
as part of one's lifestyle, obesity/weight management classes, reproductive
health/abstinence education, building positive self-esteem, and
assessment for at-risk behavior or at-risk psychosocial environment
factors. The school program will operate on a year-round basis approximately
40 hours a week. CCFHC and the county hospital will offer backup
services when the school clinics are closed or when additional health
care services are needed.
The service area, Claiborne County, is located
in the mid-Mississippi Delta region-the poorest region of the United
States. The target population is students in the Claiborne County
Public School District. Currently, there is limited access to health
care in the schools. The majority (approximately 99.8 percent) of
the students in the Claiborne County School District are African
American, 72 percent of whom are estimated to be at or below the
200 percent Federal poverty level. Of the state's 82 counties, Claiborne
ranks 26th in the percentage of births to teens; almost 21 percent
of all the babies born in the county are born to teenagers. Barriers
to health care in the county mirror the socioeconomic and health
care problems of the Delta region, ranging from lack of indoor toilets
to illiteracy. The Delta region has one of the highest illiteracy
rates in the Nation, with only 54 percent of the adult population
completing high school. In addition to depressed economic conditions
and low educational attainment, other barriers include the absence
of public transportation and lack of other transportation and phone
service.
Claiborne County is a designated Health Professional
Shortage Area as well as a Medically Underserved Area/Medically
Underserved Population. The county has only three physicians with
a physician-to-patient ratio of 1:4,469.
In addition to CCFHC, the lead applicant, consortium
members include the Claiborne County Public School District, Claiborne
County Hospital, and West Central Public Health District 5 of the
Mississippi State Department of Health.
MISSOURI
D04RH04329
Kathleen Anne Howard
District III Area Agency on Aging
106 West Young Street
Warrensburg, Missouri 64093-1124
Phone: (660) 747-3107
Email: khoward@careconnectionservices.org
Fiscal Year 2005 2006 2007
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Primary Health Care, Health Education,
Social Support Services
The goal of the Lafayette County 4 Health Project,
a rural health education and outreach project, is to improve access
to primary care health and social support services in the county
through an integrated network of local providers. The project will
incorporate community education and outreach approaches to connect
vulnerable, low-income populations to an integrated network of local
health and social support services. In the first year, the project
will use community education and health promotion activities to
address disease prevention issues and mental health topics with
a special emphasis on domestic violence and child abuse. The project,
which includes outreach to the seasonal migrant community, will
strengthen and expand a referral process among local providers by
developing a technology-aided management information system to expedite
patient scheduling, intake, and follow-up.
The target population is medically underserved
and uninsured residents of Lafayette County, Missouri. There is
little ethnic diversity in the population, which is 96.6 white,
2.6 percent African American, 1.2 percent Latino, 0.5 percent Asian/Pacific
Islander, and 0.9 Native American. The target population includes
nearly 500 seasonal migrant workers and their families. Of the county
population of 32,960, 25.5 percent of the residents have incomes
at or below 200 percent of the Federal poverty level. In addition
to poverty, barriers to accessing services include distance, transportation
difficulties, lack of insurance, and lack of providers. There are
19,466 uninsured individuals in the county, and the entire population
is classified as underserved because of the dearth of medical providers.
The physician-to-population ratio is 3,619:1. Lafayette County is
a designated Health Professional Shortage Area.
Consortium members include the District III Area
Agency on Aging, Lafayette County Health Department, Lafayette Regional
Health Center, and Rodgers-Lafayette Health Center.
D04RH04328
Cheryl Snapp
Princeton R-V School District
1008 East Coleman Street
Princeton, Missouri 64673-1210
Phone: (660) 748-3211 Fax: (660) 748-3212
Email: snapp@tigertown.k12.mo.us
Fiscal Year 2005 2006 2007
Funding Amount $192,941 $192,292 $199,910
Keyword(s): Behavioral Health Care
The Mercer County Behavioral Health Outreach Project
seeks to increase access of children and isolated rural farm families
to behavioral health care by providing outreach and education resources
and promoting greater community involvement in an integrated network
of services. The four goals are as follows: Goal 1 focuses on school-based
identification, problem-solving, and documentation of students with
behavioral health problems. Goal 2 involves linkages of school-based
children and their families to intensive behavioral health services,
faculty and staff consultation, counseling, and referrals. Goal
3 focuses on services to behavioral at-risk children and their families
through countywide asset-building activities. Goal 4 involves the
training of specialists and staff and development of a new rural
behavioral health/emergency disaster health care outreach network
of project partners.
The service area is rural Mercer County, which
is a farming area located in north central Missouri along the Iowa-Missouri
border. It is one of the state's most poor, isolated, and distressed
areas. The target population is 921 Mercer County students and 124
farm families in the context of family, school, and community. The
county is 98.7 percent Caucasian. In 2002, there were 3,669 residents
with a median age of 42.4. Depression is a major health issue, and
the county has the state's highest suicide rate. The county does
not have a mental health facility, and behavioral health problems
afflict both school-age children and adults, especially those living
in isolated farm families or alone.
Access barriers include rural isolation, unstable
family environments, poverty, and lack of transportation. Mercer
County is a designated Health Professional Shortage Area as well
as a Medically Underserved Community and Medically Underserved Population.
In addition to Princeton R-V School District,
the lead applicant, consortium members include Cainsville R-I School
District; Newtown-Harris R-III School District; North Mercer R-III
School District; Spickard R-II School District; North Central Missouri
Mental Health Center; Harrison County Community Hospital; Mercer
County Health Department; Northeast Family Health Clinic; Mercer
County Office, Missouri Department of Social Services; and National
Alliance of the Mentally Ill of Missouri.
MONTANA
D04RH04398
Janice Prinkki
Butte Silver Bow Primary Health Care Clinic, Inc.
(AKA Butte Community Health Center)
445 Centennial Avenue
Butte, Montana 59701-2870
Phone: (406) 496-6003 Fax: (406) 723-3059
Email: janicep@buttechc.com
Fiscal Year 2005 2006 2007
Funding Amount $191,318 $165,475 $155,267
Keyword(s): Child Sexual Abuse, Education/Prevention
The Butte Consortium for Sexual Abuse Prevention
was formed to address child sexual abuse in Butte and southwest
Montana, where the incidence of sexual abuse is unusually high.
Primary goals of the project are education/prevention, evaluation,
and follow-up. The consortium will employ three strategies: (1)
prevention education for preschool and young children (grades K-3)
using the Talking About Touching personal safety curriculum; (2)
evaluations for suspected victims of child sexual abuse at the Child
Evaluation Center; and (3) professional therapeutic support services
for the victims and their families as well as for children at risk
for sexual abuse. Few children in Butte receive education from their
families about how to stop or prevent someone from sexually abusing
them, and almost no services are available to assist children or
their families once sexual abuse occurs. This project seeks to remedy
the lack of services and meet the ever-spiraling needs associated
with child sexual abuse and its aftermath.
About 1,300 cases of child abuse or neglect are
reported in the area each year. There are 220 registered sexual
and violent offenders in Butte, a large number for a community of
33,000. In the past 4 years, more than 370 children were evaluated
for child sexual abuse, but research suggests this number is low
and represents only about one-fourth of the number of incidents
that actually occurred. Butte is a very poor community, where the
prevalence of alcohol and drug abuse and violence contributes to
the growing problem of child sexual abuse. Ninety percent of the
alleged child abuse and neglect cases in Butte involve drugs or
alcohol use.
The target population is children at risk for
sexual abuse or who have been sexually abused within Butte and the
surrounding area. Additional unmet needs in the community-isolated
geography, large numbers of low-income residents, depressed economy,
and a culture of violence and addictive behaviors-all contribute
to the high rate of child sexual abuse. Butte is located in Silver
Bow County, a rural area located in the northern Rocky Mountains.
Of its population of 33,300, 95.4 percent are Caucasian, 2.7 percent
Hispanic/Latino, 2.0 percent Native American, 0.2 percent African
American, and 1.1 percent other. Currently, 40 percent of Butte's
(Silver Bow County) population lives at or below 200 percent of
the Federal poverty level, and 53 percent of the total public school
student population qualifies for free or reduced lunches.
Barriers to services for prevention of child sexual
abuse include lack of education and awareness, insufficient financial
resources, addictions, and lack of therapy and support services
for children and families. Butte-Silver Bow County is a designated
Health Professional Shortage Area (HPSA). It is a low-income HPSA
and qualifies as a mental health and dental HPSA. It also is a Medically
Underserved Area/Population.
Community partners in the consortium include the
Butte Silver Bow Primary Health Care Clinic, Inc., the lead applicant;
St. James Healthcare; Butte Silver-Bow Law Enforcement Detectives;
Butte Silver-Bow County Attorneys Office; Butte Office of Department
of Family Services; and Dr. Ken Graham, a private pediatrician.
D04RH03722
Teri L. Sanddal
Associate Director Research/Injury Prevention
Critical Illness and Trauma Foundation, Inc.
300 North Willson Avenue, #3002
Bozeman, Montana 59715
Phone: (406) 585-2659 Fax: (406) 585-2741
Email: tsanddal@citmt.org
Fiscal Year 2004 2005 2006
Funding Amount $199,974 $199,974 $199,974
Keyword(s): Provider training, Continuing medical
education (CME)
One of the most pressing needs for rural emergency
medical services (EMS) systems is ongoing medical oversight. This
is true regardless of whether the emergency medical response is
provided by a volunteer, government, fire department, hospital-based,
or other organization. Rural physicians are required to provide
this oversight, often without training or understanding of the task.
They are frequently constrained by their ability to travel to medical
oversight training offered within or outside their geopolitical
jurisdiction. The lack of medical oversight within rural EMS systems
impacts patient care, utilization of health resources, and the preparation
for large-scale disaster responses.
The Critical Illness and Trauma Foundation, the
Burns Telecommunications Center at Montana State University, the
Billings Area Indian Health Service, the National Association of
Emergency Medical Service Physicians, the National Association of
State Emergency Medical Service Directors, and other collaborators
seek to modify the delivery format of a training program titled:
Guide for Preparing Medical Directors, currently distributed by
the National Highway Traffic Safety Administration. The goal of
the project is to develop the Guide for Preparing Medical Directors
into an electronically delivered, mentor-supported, self-study program
to train medical oversight physicians in rural, frontier, and wilderness
locations. By making these materials available online, it is anticipated
that medical oversight training will become more widely available
resulting in benefits to the emergency medical services and disaster
response systems in rural areas. The demographic and ethnographic
characteristics of the target population will mirror the rural and
frontier populations that the EMS agencies serve. Targeting the
states of Alaska, Kansas, and Montana, 40 percent of the secondary
and tertiary population served will be Alaskan Natives or American
Indians. The remaining ethnic mix will be predominately Caucasian
with a substantial mix of Hispanic/Latino individuals.
D04RH06925
Gary Scott Mitchell
Wheatland Memorial Hospital & Nursing Home
530 3rd Street, N.W.
Harlowton, Montana 59036-0307
Phone: (406) 632-4351
E-Mail: sgmitche@svh-mt.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Chronic disease, Diabetes
The Chronic Care Outreach Program (CCOP) was created
through the collaborative efforts of Wheatland Memorial Hospital
and several urban partners-St. Vincent Healthcare (tertiary hospital
and Level II trauma center, internists, and diabetes center); Northwest
Research and Education Institute (continuing medical education,
community education, the Mansfield Health Education Center and Library,
and Partners in Health Telemedicine Network); and the South Central
Montana Community Mental Health Center (regional mental health services).
All of the urban partners are located in Billings Montana.
The Chronic Care Outreach Program will plan self-management
interventions and programs to reduce health disparities and increase
access to nationally recommended health care services for residents
living with diabetes and other chronic illnesses. All residents
of the area living with chronic illnesses will be targeted for this
program to reduce poor health outcomes and increase healthy years
of life in which they can continue to live on their own. Local health
care systems and community resources will be used to streamline
activities to prevent duplication of services and bring additional
assistance to the population of this area that are living with diabetes
and other chronic illnesses.
The service area proposed includes the Wheatland
Memorial Hospital (WMH) service area, the lead organization in the
consortium. WMH is located in Harlowton Montana, a ranching community
in central Montana with approximately 1.6 people per square mile.
The population of the service area is estimated to be 4,000 people,
with WMH serving residents of Wheatland, Golden Valley, Judith Basin
and portions of Sweet Grass and Meagher Counties. The nearest tertiary
care facility is 92 miles south of Harlowton in Billings Montana,
the largest urban center in Montana. The next closest tertiary care
service is located in Great Falls Montana, 130 miles north. Lewistown,
Montana, is located 60 miles from Harlowton to the east, which is
a secondary care facility.
D04RH06927
Katherine Ann McIvor Wilson
Executive Director
Cooperative Health Center, Inc.
1930 Ninth Avenue
Helena, Montana 59601
Phone: (406) 457-8956
Fax: (406) 457-8990
E-mail: kwilson@co.lewis-clark.mt.us
Web site: www.co.lewis-clark.mt.us/index.php?id=59
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Mental health, Substance abuse
Low-income Lewis & Clark County residents
have high rates of mental illness, yet access to affordable mental
health care services is almost non-existent. A 2003 survey of 200
Cooperative Health Center (CHC) patients indicated that 23 percent
had been diagnosed with depression, 35 percent had had generalized
anxiety, 46 percent experienced somatic complaints, and 14 percent
had been diagnosed with an alcohol or drug problem. The three-agency
consortium formed for this project will provide access to mental
health and substance abuse services, regardless of patients' ability
to pay.
The CHC will collaborate with two other federally
supported mental health/substance abuse service providers in the
county, Golden Triangle Community Mental Health Center and Boyd
Andrew Community Services. Golden Triangle will provide mental health
services to CHC patients with severe mental health problems that
are not within the scope of CHC's ability to treat. Boyd Andrew,
which provides chemical dependency treatment services, will provide
in-service trainings for CHC care providers and hold four appointment
slots per month for CHC patients seeking treatment for substance
use disorders.
Mental health and substance abuse (MH/SA) services
provided will include screening, assessment, diagnosis, case management,
cognitive-behavioral therapy, brief problem-solving therapy, solution-focused
therapy, mastery of panic and anxiety, brief alcohol intervention,
and psychotherapy, when judged appropriate. MH/SA services will
be delivered during patients' primary care visits and during one-on-one
visits with MH/SA providers, who will include a CHC mental, health
specialist and a Golden Triangle case manager, both working at the
CHC clinic site. Primary care providers will introduce the mental
health specialist to the patient in the exam room when the provider
determines the patient needs mental health or substance abuse care.
This approach will integrate mental health and primary care services,
reducing stigma and increasing the number of patients served. All
CHC patients will be screened for MH/SA issues 5 afternoons a week
at the start of the project, expanding to 5 full days as the project
progresses.
The CHC will assess the effectiveness of treatment
for depression by using Key Depression Care Measures from the Depression
Collaborative. Effectiveness of treatment for anxiety will be assessed
with the appropriate sections of Prime MD, a widely used mental
health diagnostic/assessment questionnaire. The CHC will track MH/SA
patients with an expanded registry modeled on the Depression Collaborative
registry. The case manager will use the registry to follow patients'
progress and manage their treatments, medications, and connections
with necessary community services.
The CHC targets Lewis & Clark County residents
living below 200 percent of poverty. Of county residents of all
ages, 28.6 percent lived below 200 percent% of poverty in 2000,
and 44 percent of those were uninsured. CHC will focus first on
delivering MH/SA services to its current patient population, which
consisted of 6,082 unduplicated patients in FY 2005. Six percent
of the patient population is homeless.
D04RH06926
Kenneth Smoker
Fort Peck Assiniboine Sioux Tribes
P.O. Box 1027
Poplar, Montana 59255
Phone: (406) 768-3469
Email: krsmoker@yahoo.com
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $124,936 $100,000
Keyword(s): Mental health, Substance abuse, Telemedicine
The Rural Access: Mental Health Care Project will
increase behavioral and mental health care services to low-income
American Indian children and youth living on the Fort Peck Indian
Reservation in rural northeastern Montana. The Fort Peck Indian
Reservation is one of the poorest areas in the United States, with
a poverty index three times higher than the State of Montana. This
project was developed by the superintendents of the reservation
based school districts, the Tribal Health Department, the Tribal
Family Violence Resource Center, Indian Health Service and the Department
of Psychiatry, Harvard Medical School in Boston, Massachusetts.
The schools district computer communications systems will be upgraded
to the compatibility of Massachusetts General Hospital and Harvard
Medical School to initiate telemedicine psychiatric counseling services
with post-doctoral students at Harvard Medical School. The project
also establishes a Harvard Medical School Psychiatric Internship
Program that will station a post-doctoral fellow on the Fort Peck
Indian Reservation for 6 months per year. The project consortium
estimates that psychiatric care services will be increased by 420
new patient visits in both Year 2 and Year 3.
NEBRASKA
D04RH06948
Jolene Lordemann
Good Neighbor Community Health Center
2282 East 32nd Avenue
Columbus, Nebraska 60681
Phone: (402) 563-9224
Fax: (402) 563-0554
Email: jlordemann@ecdhd.com
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Mental health
Significant discrepancies exist in the availability
of behavioral health resources for persons living in rural areas.
For example, in 1999, 87 percent of the Mental Health Professional
Shortage Areas in the United States were in non-metropolitan counties
(Bird, Dempsey, and Hartley, 2001). In rural Nebraska, there are
federally designated Mental Health Professional Shortage Areas in
88 of Nebraska's 93 counties. Of the State's 146 board certified
and licensed psychiatrists, 326 licensed practicing psychologists
and 1,890 licensed mental health practitioners-a significantly disproportionate
number (26 percent)-serve 850,000 rural residents (47 percent of
the State's population) residing over a 70,000 square mile area.
Meanwhile, 74 percent of behavioral health professionals provide
services to the 53 percent of the population residing in metropolitan
areas. An estimated 20 percent of children and adolescents ages
9 to 17 also have identifiable mental illnesses each year (Schaffer,
Fisher, Dulcan et al., 1996), with even less access to specialty
services and preventive care then available for adults.
A consortium consisting of the Good Neighbor
Community Health Center (GNCHC), Boys and Girls Homes of Nebraska
(BGHN), the East Central District Health Department (ECDHD) -all
from rural Columbus, Nebraska-and the Behavioral Health Clinics
training program of the University of Nebraska Medical Center (UNMC)
have joined forces to address these issues. Using an approach that
integrates behavioral health into primary care practice, the consortium
will add behavioral health faculty and trainees from the training
program at UNMC to its existing array of services at the Good Neighbor
CHC and to the diagnostic and treatment services of the Boys and
Girls Homes programs. The overall goals of the project are:
- To reduce discrepancies in the availability
of outpatient behavioral health care to the rural medically underserved
population of east central Nebraska through the provision of expanded
services and increased numbers of behavioral health providers
- To reduce the number of inappropriate out-of-home
placements for children and adolescents through the provision
of integrated behavioral health team evaluations for juvenile
justice and child protective service agencies in East Central
Nebraska; and
- To evaluate the effectiveness of an integrated
behavioral health program in the primary care Good Neighbor Community
Health Center and replicate the program in at least one additional
site in Nebraska by the end of the 3-year grant cycle.
Funding from the project will go towards: 1) increasing
current GNCHC psychiatric availability, 2) providing child-adolescent
psychology service provision, and 3) recruitment, training, placement,
and retention of behavioral health professionals (social workers,
counselors, psychologists, psychiatric nurses, and other behavioral
health professionals) in rural primary care settings. Funding will
also be used to address the specific needs of the underserved population
of Hispanic individuals and families through support for a Spanish-speaking
interpreter and a van driver who will assist rural patients with
transportation needs to get to their BH appointments.
The Behavioral Health Clinics training program
at UNMC has a history of integrating behavioral health into primary
care practices and has HRSA training funds (Allied Health and Graduate
Psychology Education grants) that will provide further support for
this rural behavioral health effort.
D04RH06950
Shirleen Smith
West Central District Health Department
111 North Dewey
North Platte, Nebraska 69101
Phone: (308) 696-1201
E-Mail: shirleensmith@allltel.net
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $90,000 $26,625
Keyword(s): Dental services
West Central District Health Department (WCDHD) has recognized a
need for access to dental care among residents of its service area
who either rely on Medicaid or who self-pay for dental care. A survey
of residents in the eight counties served by WCDHD confirmed that
Medicaid and self-pay residents forego dental care at much higher
rates than their privately insured counterparts. Part of the reason
for this is that only one dentist in North Platte accepts new Medicaid
patients. For the most part, Medicaid patients must travel outside
the service area to get dental care. As a result, WCDHD and other
organizations in North Platte have formed a very limited dental
clinic for youth up to age 18 whose families meet the income requirements
for Medicaid. The experience with that clinic has convinced WCDHD
and its partners that a permanent clinic that serves both adults
and youth is needed.
Therefore, WCDHD and its partners are establishing
a permanent dental clinic in North Platte, Nebraska, to serve Medicaid
recipients and low-income self-paying residents. During the first
year of operation, the clinic will be open on a half-time basis
and will be staffed by a halftime dentist, a full-time dental assistant
who will also act as an office manager, and a half-time receptionist
that will be staffed by volunteers through the Retired Senior Volunteer
Program. During the first year, the clinic expects to serve 1,000
patient visits. Services during the first year will not include
more elaborate restorative procedures such as dentures and bridges.
During the second year, the clinic will again be open on a half-time
basis, but the staff will be expanded to include a half-time dental
hygienist. Dental services will also be expanded to include dentures
and bridges. During the second year, the clinic expects to serve
1,800 patient visits. In the third year, the clinic will be open
on a full-time basis and expects to serve 3,900 patient visits.
Quarterly evaluation meetings with consortium
members and dental staff to assess financial and patient flow will
be held for the duration of the grant period. WCDHD and its partners
intend for the clinic to be self-sustaining by the end of the grant
period.
NEVADA
D04RH06921
Sylvia Elexpuru
Project Director
BrightPath Adult Day Services, Inc.
P.O. Box 279
Elko, Nevada 89803
Phone: (775) 778-0547
E-Mail: selex@frontiernet.net
Fiscal Year 2006 2007 2008
Funding Amount $149,994 $124,994 $99,998
Keyword(s): Telemedicine
The goal of the Rural Dementia Telemedicine Initiative (RDTI) project
is to establish a long-term, sustainable method of service delivery
to Alzheimer's (dementia) patients, caregivers, and health care
professionals involved in the delivery of diagnosis, disease management,
and treatment in rural and underserved communities of Nevada and
other western states through the Center for Cognitive Aging's (CCA)
Alzheimer Disease Diagnostic and Treatment Center (ADDTC) via telemedicine.
Through the capabilities that telemedicine offers the RDTI program
can bring urban medical specialists face-to-face with patients in
geographically remote areas of Nevada and other western states.
Individuals identified by community screening sessions or through
physicians' offices will also be afforded follow-up care and ongoing
medication management. In addition to medical care, the telemedicine
project will be used to train health care professionals, health
care providers and caregivers; and to provide a venue by which support
groups can meet. The project is also aimed at reducing the economic
burden associated with long-term care costs for patients, families,
and employers through early identification and intervention of Alzheimer's
disease and other dementias.
Approximately 381 patients and their families
will benefit by using the RDTI program over the next 3 years. This
project primarily serves the elderly, 65 year of age and over, including
American Indian and Hispanic populations, which are spread over
95,763 square miles in the rural and frontier areas of Nevada alone.
The RDTI project, which can tap into existing telemedicine facilities
and networks, substantially reduces expenses for equipment and has
the potential to become a model for other rural and frontier areas
of the country.
D04RH06803
Dr. Michael McFarlane
Vice President for Academic Affairs
Great Basin College
1500 College Parkway
Elko, Nevada 89801
Phone: (775) 753-2187
E-Mail: mikem@gwmail.gbcnv.edu
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Human service training
Founded in 1967, Great Basin College (GBC) is the oldest, public
community college within the Nevada System of Higher Education (NSHE).
Located in the rural high desert of northeastern and central Nevada,
GBC's service area covers over 45,000 square miles and includes
the counties of Elko, Eureka, Humboldt, Lander, and White Pine.
The area has 78,000 residents and has been classified as "frontier"
with an average of less than two people per square mile. Overall,
GBC's service area encompasses only 3.9 percent of the total population
of Nevada.
GBC is developing and implementing a Human Services
Certificate Program and a Human Services Associate of Applied Science
Degree Program, that will train and educate individuals for jobs
that support the delivery of a broad range of health-related services
currently lacking in GBC's expansive, rural service area. The human
service profession promotes improved service delivery systems by
filling positions that address the quality of direct services as
well as the accessibility, accountability, and coordination among
professionals and agencies of these services. Examples of service
delivery settings include mental health agencies; agencies serving
the elderly; family, child, and youth service agencies; correctional
agencies; and agencies/programs concerned with alcoholism, drug
abuse and violence.
The development of the Human Services Program
will be accomplished by the project consortium members, which include:
Great Basin College, Nevada Department of Health and Human Services,
the Nevada State Office of Rural Health, Indian Health Service-Southern
Band Health Center, BrightPath Adult Enrichment Center, and Partners
Allied for Community Excellence (P.A.C.E. Coalition).
The project will seek to accomplish the following
goals:
- To develop and implement
a Human Services program that offers a Certificate and an Associate
of Applied Science degree;
- Work with service providers
to develop 20 practicum/clinical sites for hands-on student learning;
and
- Enroll at least 20 students
in the Human Services Program.
NEW HAMPSHIRE
D04RH04332
Judith P. Harris
Home Healthcare, Hospice and Community Services, Inc.
312 Marlboro Street
Keene, New Hampshire 03431-4163
Phone: (603) 352-2253 or (800) 541-4145 Fax: (603) 358-3904
Email: jharriss@hcsservices.org
Fiscal Year 2005 2006 2007
Funding Amount $182,000 $183,031 $189,643
Keyword(s): Chronic Disease Management, Diabetes,
Congestive Heart Failure, Telehealth
The focus of the Rural Outreach for Improvement
of Chronic Disease Management Project is implementation of a chronic
disease management program for individuals with diabetes and congestive
heart failure in rural southwestern New Hampshire. Specific goals
for the project are significantly reduced hospitalizations, reduced
emergent care, better access to care and services, and improved
patient quality of life and satisfaction. Implementation of telehealth
technology is an essential element in the program. A primary care
physician, cardiologist, or clinic or home care nurse will identify
patients at risk for heart failure or diabetes. A feature of the
project is incorporation and development of clinical pathways for
patients with heart failure or diabetes in relation to acceptable
blood pressure, weight, and other markers, so that primary care
interventions can occur in a more timely way and "crises"
can be avoided. The project will implement wellness and prevention
strategies by introducing patients to self-help materials and educational
resources upon discharge from an acute hospitalization, clinic visit,
or home health care admission.
The service area is rural and isolated with no
divided highways. The general population in the area is 97.3 percent
white. The chance of experiencing chronic illness increases significantly
with age, and the poor and less educated have an increased likelihood
of chronic illness. The target population is people older than age
65. A significant proportion of the target population also is at
high risk because of poverty, isolation, mental health issues, disabilities,
and transportation barriers. Residents older than age 65 represent
13.7 percent of the service area population, and the accelerating
older population is a major concern with regard to increasing levels
of chronic illness. Income and education levels vary widely across
the area, and poverty-often accompanied by lack of education-is
a pervasive barrier to accessing health for many in the region,
exacerbating problems with insurance, the ability to pay for medications,
and transportation. Fifty-six percent of the state's elderly do
not have prescription drug coverage. Problems related to transportation
include long distances and travel times to health care resources,
lack of coordinated public transportation, and long winters with
heavy snow, which make travel difficult for visiting nurses and
other home care providers as well as for patients. Two towns (Acworth
and Charlestown in Sullivan County) in the service area are designated
as Medically Underserved Populations.
The Consortium for Chronic Disease Management
includes VNA at HCS, a subsidiary of Home Healthcare, Hospice and
Community Services, Inc., the lead applicant; the Cheshire Medical
Center; and Dartmouth-Hitchcock Keene (a multispecialty physician
practice).
D04RH06788
Richard D. Silverberg
The Caring Community Network of the Twin Rivers
841 Central Street,
Franklin, New Hampshire 03235
Phone: (603) 934-0177, ext. 107
E-Mail: rsilverberg@ccntr.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Chronic disease, Telehealth
The Caring Community Network of the Twin Rivers (CCNTR) is a recognized
nonprofit organization in the State of New Hampshire formed in 1996.
CCNTR has been working as a collective to create a coordinated,
accessible system of care across the region. This project will enhance
existing mechanisms and expand the capacity of the network to provide
effective, coordinated, and accessible services throughout the region
that improve health outcomes of uninsured clients with chronic illness
and provide appropriate services such as emergency room care.
Individuals in the Twin Rivers face higher rates
of many health risk indicators than the rest of the state. There
are disparities among chronic disease factors, and socio-economic
indicators. In addition, residents face significant barriers to
access service and prevention programs including: geographic or
social isolation, lack of transportation, lack of awareness of services,
uncertainty of how to access service, lack of insurance, not enough
insurance, and fear of stigmatization or reprisal. These barriers
reduce use and inhibit the continuity of care, decreasing the overall
effectiveness of the service delivery system.
There are three target groups who will benefit
from the activities in this proposal: (1) low-income and uninsured
adults, (2) low-income, uninsured and underinsured elderly, and
(3) individuals with chronic illness such as diabetes and CVD/hypertension.
These populations overlap and are inter-related. The proposed project
develops roles that will support several models that have been proven
effective in this and other areas, will replicate those models for
new populations, and will expand the reach of mechanisms that work
well in other parts of the country for use here. These staff positions
include:
- 175 days of contracted outreach care coordination
each year will be arranged with existing network staff to work
with residents that need to be connected to primary care and other
supports;
- One FTE disease manager who will work with
primary care providers, nutritionists, and other health care professionals
to provide health education, counseling, and coordinated care
planning to people living with chronic disease;
- .25 FTE project manager to integrate care coordination
and disease management with the system of uncompensated care,
and overall project management.
- A CCNTR staff evaluator will be contracted.
A small amount of consulting time will be used to develop modifications
to telehealth tools.
The proposed project will
positively impact service delivery in the region. It will: (1) identify
best practices in disease management, planned care visits, and coordination
currently used by medical providers to implement them region-wide,
(2) incorporate the use of electronic tools, developed with an outside
source of revenue, to use a shared client data base for health education,
coordination, referral, and chronic disease registry (3) enhance
client access to the above services and to other services available
in the region, and (4) increase the level of disease and care management
available, resulting in improved patient health outcomes.
D04RH06908
Michael Kasson
Northern Human Services
87 Washington Street
Conway, New Hampshire 03818
Phone: (603) 447-3347
Fax: (603) 447-8893
E-Mail: mkasson@northernhs.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Mental health, Telehealth
The Northern Tele-psychiatry Initiative will provide
access to child psychiatry through telemedicine in northern New
Hampshire. The Northern Tele-psychiatry Initiative will improve
the mental health of children and teens, reduce the number of admissions
to child psychiatric in-patient units, and help prevent the inappropriate
prescribing of psychotropic medications by primary care practitioners
to children and adolescents.
The project plans on establishing videoconferencing
systems in Wolfeboro and Berlin in Year 1, increasing the number
of systems to Conway and Colebrook in Year 2 and installing the
final system in Littleton in Year 3. The Northern Tele-psychiatry
Initiative will be examining options for changes to the New Hampshire
Medicaid State plan and third party payers for telemedicine. The
Northern Tele-psychiatry Initiative will also promote the use of
child tele-psychiatry through education of community leaders and
family members. Finally, the Northern Tele-psychiatry Initiative
will evaluate the project on an ongoing basis to ensure the satisfaction
of the child tele-psychiatry treatments.
The Northern Tele-psychiatry Initiative covers
a medically underserved area. Currently, there are no child psychiatrists
in northern New Hampshire, geographically 43 percent of the rural
northernmost portion of the State. The target population, which
is 98 percent Caucasian, is 24,927 children, age 0 to 17, who are
residents of northern Grafton, Carroll, and Coos Counties-a region
that covers 4,447 square miles. Due to the loss of traditional industries
in northern New Hampshire, the primary jobs are low-paying (an average
of less than $23,000) in the tourism, food service, and retail industries.
Access barriers to services include long distances outside of northern
New Hampshire to private child psychiatrists or child psychiatric
in-patient units; year-long waits for evaluation by private child
psychiatrists; lost income to caregivers resulting from the geographic
isolation and the lack of local child psychiatrist.
The Northern Tele-psychiatry Initiative
consortium members are Northern Human Services, the lead applicant;
the New Hampshire Department of Health and Human Services, Bureau
of Behavioral Health; NAMI New Hampshire, and the Behavioral Health
Network.
NEW MEXICO
D04RH04337
Deborah Harris-Usner
Las Cumbres Learning Services, Inc.
P.O. Box 1362
Espanola, NM 87532-1362
Phone: (505) 753-4123 Fax: (505) 753-6947
Email: deborah.harris@lascumbres-nm.org
Fiscal Year 2005 2006 2007
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Early childhood mental health services
The Northern New Mexico Rural Infant Mental Health
Consortium project will provide access to mental health services
for high-risk families with young children, from birth to age 5.
The project will serve the residents of Rio Arriba County, a largely
rural and mountainous region between Santa Fe and the Colorado state
line. The project will use a three-pronged approach: (1) provide
comprehensive, expanded infant mental health services at three sites;
(2) provide training, consultation, and capacity-building to health
care and early childhood development programs; and (3) increase
access to, and utilization of, infant mental health services by
developing bilingual outreach materials, home visits, and child
assessments and by strengthening collaborative referral networks.
The project will utilize a successful, evidence-based model that
combines home-based, center-based, and community-based services
in counseling, case management, parenting skill development, client
advocacy, and early intervention.
The target population is families with young children
in Rio Arriba County, which has high rates of poverty, lack of health
insurance, alcohol and drug abuse, and other health problems. The
county has an extremely high risk of and high prevalence of infant
mental health problems-problems that are directly related to the
area's high rates of substance abuse, teen pregnancy, domestic violence,
poverty, and child abuse and neglect. Nearly one-quarter of the
county's families live below the poverty level, and 35 to 40 percent
of the county's residents lack health insurance. Approximately 73
percent of the county's 41,190 residents are Hispanic, and 14 percent
are Native American.
Barriers to access to health services include
the high rate of poverty, geographic isolation and lack of transportation,
lack of health insurance, and inadequate health care resources.
The county qualifies as a Medically Underserved Area and includes
13 divisions designated as Health Professional Shortage Areas.
Core members of the Northern New Mexico Rural
Infant Mental Health Consortium have come together to address the
need for expanded infant mental health services in Rio Arriba County.
These partners include Las Cumbres Learning Services, Las Clinicas
del Norte, La Clinica del Pueblo, the Rural Psychiatry Program at
the University of New Mexico Health Sciences Center, and El Centro
de los Niños.
D04RH04334
Silvia Madrid
Border Area Mental Health Services, Inc.
P.O. Box 1349
Silver City, New Mexico 88062-1349
Phone: (505) 388-4497 Fax: (505) 534-1150
Email: smadrid@bamhs.com
Fiscal Year 2005 2006 2007
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Substance Abuse, Mental Health Disorders
The main goals of the project are (1) to increase
access to appropriate levels of care for mental health and/or substance
abuse services; (2) to increase capacity to provide services to
individuals with substance abuse and/or mental health disorders;
and (3) to improve access to and management of psychotropic medications.
Activities include developing protocols with key referral sources,
developing protocols among treatment providers so that individuals
can access appropriate levels of care in an efficient and smooth
manner, providing technology for distance training and consultation,
addressing the shortage of professionals through partnerships with
universities and policy changes at the state level, and improving
access to psychotropic medications through training and information
using best practices. In addition, the project proposes an innovative,
comprehensive approach to substance abuse outpatient treatment that
incorporates gender-specific and trauma-based approaches, as well
as research-based therapeutic practices and supportive services.
The service area includes Grant, Hidalgo, Catron,
and Luna counties in southwestern New Mexico. A high percentage
of residents in the region live in poverty, ranging from 18.7 percent
in Grant County to 32.9 percent in Luna County, compared to 18.4
percent for New Mexico and 12.4 percent for the United States. The
percentage of the population below two times the Federal poverty
level and not on Medicaid is estimated at 27.9 percent. The project
will target children, adolescents, and adults who have mental health
or substance abuse disorders as well as their family members. The
demographics of the mental health target population are representative
of the region where the ethnic breakdown is 51 percent Hispanic/Mexican
and 49 percent white. The enhanced outpatient substance abuse treatment
will target three subpopulations: (1) adults involved with the court
system, (2) substance-abusing adult women with children, and (3)
adults with substance abuse or co-occurring disorders. In the target
region, there is a severe lack of services for persons with substance
abuse and/or mental health disorders. The four counties face tremendous
challenges in providing behavioral health services due to barriers
such as a shortage of providers and practitioners (especially those
who are bilingual), weak linkages with referral sources, a lack
of integrated services for co-occurring substance abuse and mental
health disorders, the lack of insurance coverage for substance abuse
disorders, and culture or language. The target area for the project
is a designated Medically Underserved Area and a Health Professional
Shortage Area for mental health professionals.
Consortium members include Border Area Mental
Health Services, Inc., the lead applicant; Fort Bayard Medical Center-Yucca
Lodge; Gila Regional Medical Center; Hidalgo Medical Services; Presbyterian
Medical Center; and Ben Archer Health Center.
D04RH02560
Carol Miller
Frontier Education Center, Inc.
HCR 65, Box 126
Ojo Sarco, New Mexico 87521
Phone: (505) 820-6732 Fax: (505) 820-6783
Email: carol@frontierus.org
Fiscal Year 2004 2005 2006
Funding Amount $198,651 $200,000 $200,000
Keyword(s): Mental health, Substance abuse
Project R&R offers a solution to the critical
need for mental health and substance abuse services in a high-risk,
multi-cultural frontier community. The target area consists of the
communities in the Penasco Independent School District, and includes
all of southern Taos County, the entire Picuris Pueblo reservation,
and the southeastern section of Rio Arriba County in north central
New Mexico. The target community of 3817 people is spread across
an area of 900 square miles. However, there are no incorporated
villages or towns within this area and only minimal health services
of any type. The actual medical service area, which includes the
closest towns of Espanola in Rio Arriba County and Taos in Taos
County, each with a hospital, extends the health care service area
to 1600 square mile. The racial and ethnic mix of populations to
be served reflects the community: 73 percent Hispanic, 14 percent
Native American, and 13 percent Caucasian. The two foci of Project
R&R are to address mental health and substance abuse and to
build resiliency among the youth.
Picuris Pueblo, a federally recognized Indian
tribe, and the small traditional Hispanic agricultural villages
that make up the target community have long and proud histories.
Still existing among the elders is a tremendous amount of knowledge.
Their wisdom is not only about the natural world-the wild plants
and herbs (remedios) that sustained the communities before any health
care was available locally-but also about the very concept of neighborliness
and community. Through recent discussions with the coordinator of
the Rural Psychiatry Outreach Program at the University of New Mexico,
Project R&R discovered that any "diagnosis" of its
communities would have to include mention of Historical Trauma.
Historical Trauma is a clinical diagnosis of an ongoing psychiatric
disorder related to loss of land, relocation, economic disarray,
and dislocation, which presents with symptomology and negative behaviors
including alcoholism, substance abuse, and difficult, often violent,
interpersonal relationships. Although the economic and health status
data paint a picture of a very troubled community, that is only
a part of the picture.
The network partners of the project include the
Frontier Education Center, HCH Rural Health of Penasco, the Health
Centers of Northern New Mexico - Penasco Clinic, the Taos Public
Health Office of the New Mexico Department of Health, the Penasco
Independent School District, Picuris Pueblo, and the Health Science
Center of the University of New Mexico.
D04RH02557
Tomas Martinez
Mora/Colfax Head Start
P.O. Box 180
Holman, New Mexico 87723
Phone: (505) 387-3139 Fax: (505) 387-6656
Email: T2mart@hotmail.com
Fiscal Year 2004 2005 2006
Funding Amount $192,003 $181,365 $184,594
Keyword(s): Pre/peri/post-natal care, Preventive
health
Mora and San Miguel counties are located in rural
Northeastern New Mexico. For most of its history, Northern New Mexico
has enjoyed a tradition of close-knit, extended families living
in convenient proximity for generations. This allowed young people
to benefit from the instruction and support of their elders and
neighbors. Through poverty and general displacement and isolation,
the modern economic structure has extended into local culture in
a way that has left people cut off from customary support systems
without providing an alternative. One of the results of this shift
has been that young; first-time mothers can no longer count on learning
how to be parents and care for their children through the traditional
extended family process of learning, nor are social service agency's
available to rural homebound first-time specific parents. Currently,
the children of the largely rural San Miguel and Mora counties are
at higher risk for illness, abuse, and even mortality than those
in other areas of New Mexico and, in fact, the United States.
The Mora & San Miguel Primeros Pasos/First
Steps Program proposes to serve up to 60 first-time parents and
their children through the implementation of the research-based
Healthy Families America Program. The target population is 88 percent
Hispanic, 8 percent Caucasian, and a 4-percent mix of African American
and Native American descent. The program will be staffed by family
assessment workers and three promotoras who will provide intensive
home visiting services for the first 3 years of the baby's life.
The goals of the Mora & San Miguel Primeros
Pasos/First Steps Program are to promote healthier pregnancies with
reduced rates of low birth weight and infant mortality, lower the
incidence of child abuse and neglect, and to promote healthy child
development through an emphasis on early intervention in developmental
delays, immunizations and other preventive health care.
D04RH06939
Barbara Hau
Program Director
Taos Health Systems
Holy Cross Hospital
P.O. Box DD
Taos, New Mexico 87571
Phone: (505) 758-8818
E-Mail: bhau@taosnet.com
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $98,702
Keyword(s): Diabetes
The word Taos means 'red willow' in the Tewa language.
Two features dominate this sparsely populated region-the high desert
mesa, split in two by the 650-foot-deep chasm of the Rio Grande;
and the Sangre de Cristo range, which tops out at 13,161-foot Wheeler
Peak, New Mexico's highest mountain. The County is situated where
the western flank of the Sangre de Cristo range meets the semiarid
high desert of the upper Rio Grande Valley. It is comprised of several
small villages scattered throughout the mountainous region, the
Taos Pueblo, and the Picuris Pueblo, both inhabited for over 1,000
years. The County is spread out over 2,203.17 square miles, with
a density of 13.6 persons per square mile.
In this beautiful and rugged landscape, 9.5 percent
of the adult population has a diagnoses of diabetes compared to
8.9 percent statewide. Approximately 17 percent of people aged 40
and over in New Mexico have diabetes. Hispanics comprise 58 percent
of the population in Taos County. One in four Hispanics are uninsured.
In addition to being more prevalent, diabetes in Hispanics tends
to be more severe than non-Hispanic whites. Among Hispanics, diabetes
occurs at a younger age, more often requires insulin to be controlled,
results in more limb amputations, contributes to eye disease, is
responsible for six times higher incidence of kidney failure, and
results in a death rate two to four times the rate for non-Hispanic
whites.
While Native Americans comprise a smaller percent
of the population (7 percent) they too are two to three times more
likely to be at risk for diabetes and less likely to have private
health insurance than either Whites or Hispanics. A combined 65
percent of the Taos County population (58 percent Hispanic and 7
percent Native American) is comprised of at risk populations for
diabetes. In a Taos County Needs Assessment process, 144 low income
County residents were interviewed in 2001 and over half the families
in this interview process did without needed medical care in order
to make ends meet, or gave priority to their children's care.
This 3-year outreach proposal is focused on designing
a Single Point of Entry and Lay Promotora Program to deliver Prescription
Assistance to a target population defied as residents of Taos County
18 years and older with a diagnosis of type 1, type 2, or gestational
diabetes who are up to 185 percent of the poverty level.
Holy Cross Hospital is a not-for-profit, 49-bed
acute care hospital. Its mission is to provide preventive, curative,
and supportive health care services, maintaining high quality standards
and using innovative, educational, and cost effective approaches
for all members of the culturally diverse Taos community and surrounding
areas. Collaborative Action for Taos County Health (CATCH), a consortium,
will implement a Prescription Assistance Program to assist residents
in accessing no cost/low cost prescription medications. A comprehensive
Single Point of Entry and a Lay Promotora Program will help to coordinate
appropriate healthcare including prescription assistance, encourage
self-management of diabetes through counseling and support, thereby
strengthening the ability of residents to reduce the risk and/or
severity of diabetes.
NEW YORK
D04RH02591
Shirley Caezza
Chenango Memorial Hospital
179 North Broad Street
Norwich, New York 13815
Phone: (607) 337-4033 Fax: (607) 337-4284
Email: shirley_caezza@uhs.org
Fiscal Year 2004 2005 2006
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Primary care, Health promotion/disease
prevention (general)
Students in the Norwich School District have been
identified with unmet health needs including immunizations, physical
exams, acute episodic care for ear infections, upper respiratory
illness, pharyngitis, strep infections, dermatitis, injuries including
sprains and fractures, and the lack of regular primary health care
which would typically result in healthier children. Conditions including
lack of dental care, asthma, diabetes, obesity, and mental health
issues have been identified as well. When school nurses in the Norwich
School District were asked to describe the problems experienced
by school-age children, such as cultural, social, geographical,
and financial barriers; they cited lack of insurance or being underinsured,
high copayments, and the inability of the parent to leave work to
access medical care, as relevant conditions. In addition, many students
do not have an established "medical home" with regular
health care or primary care providers, so their care lacks continuity.
Families have low literacy rates, which affects their capacity to
use information they receive from school, such as eligibility for
certain benefits or good health practices. Navigating the Medicaid
system has proven problematic for local families. They often do
not understand that they must renew their eligibility periodically
and are confused as to how to receive the benefits to which they
are entitled.
The target population to be served by the project
is 97 percent Caucasian, 2 percent African American, and less than
1 percent of Hispanic, Native American, and Asian school-age students
age 4 to 18. Most students live in Norwich, with some coming from
the towns of North Norwich, McDonough, East Pharsalia, Plymouth,
South Plymouth, or Oxford. The area served is large in geography
and short on major highways and public transportation. The lack
of public transportation creates incredible barriers to accessing
any type of service. Chenango County has suffered severe economic
changes due to business closures. Many of the jobs that remain are
low paying, with no health or dental insurance.
Along with the other members of the consortium
(the Chenango County Catholic Charities, the Chenango Health Network,
and the Norwich School District), the Chenango Memorial Hospital
plans to improve the health status of its school-age populations
by enrolling 90 percent of the target population into school-based
health centers by the end of the school year; increasing access
to primary care, mental health, and dental care services for students;
and increasing enrollment in Medicaid, Child Health Plus, and Family
Health Plus.
D04RH04491
Manish Shah
Livingston County Department of Health
2 Livingston County Campus
Mount Morris, New York 14510-1122
Phone: (585) 243-7270 Fax: (585) 243-7287
Email: Manish_Shah@urmc.rochester.edu
Fiscal Year 2005 2006 2007
Funding Amount $190,762 $195,520 $199,977
Keyword(s): EMS Provider Education, Older Adults,
Case Management
In this injury and illness prevention project,
the Livingston County Department of Health and its partners seek
to maximize the health and quality of life of rural, community-dwelling
older adults and will implement a system based on emergency medical
services (EMS) to screen, identify, educate, and refer rural-dwelling
individuals at risk for preventable conditions. The project also
will ensure patient access to long-term health care and social services
using case managers and primary care physicians. Another feature
of the project is the education of EMS providers regarding the appropriate
care of older adults. During emergency responses, EMS personnel
will screen older adults for risk of falling, medication errors,
and depression; educate patients and their families during emergency
responses about risks; and refer at-risk patients to a case management
program. The project will expand an existing case management program
to provide at-risk patients with follow-up care and will evaluate
the impact of the EMS-based program by assessing critical process
and outcome measures.
The target population adults age 60 and older
in rural areas of Livingston County, New York. The percentage of
older adults in the county is rapidly increasing, resulting in increased
demands for community-based and in-home services. The county's population
is expected to grow by 4.8 percent between 2000 and 2015, but the
population age 60 and older is expected to increase by 31.5 percent
and the population age 85 and older by 36 percent. Older adults
have a high disease burden, high risk for disability, limited financial
resources, and difficulty accessing care. Patients who suffer from
falls, depression, and medication errors are at risk for disability,
mortality, and institutionalization. These conditions benefit from
screening, but access to health care is often limited for the most
vulnerable patients. There is a need to prevent diseases, injuries,
and disability among older persons to maximize their quality of
life and to prevent morbidity, institutionalization, and mortality.
No universal access system currently exists for caregivers or recipients
of services to identify and access the various services. Older adults
and their caregivers typically do not know what services are available
or what services they need. This project will affect all service
providers and provide older adults with increased ease of access
to services. The county is designated as a Medically Underserved
Population.
Members of the consortium include the Livingston
County Department of Health, the lead applicant, Livingston County
Office for Aging, Genesee Valley Health Partnership, Department
of Emergency Medicine at the University of Rochester Medical Center,
and Tri-County Family Medicine.
D04RH06961
Susannah Evans LeVon
Assistant Director of Nutrition Services
Champlain Valley Physicians Hospital Medical Center
75 Beekman Street
Plattsburgh, New York 12901
Phone: (518) 562-7550
E-Mail: slevon@cvph.org
Fiscal Year 2006 2007 2008
Funding Amount $149,806 $124,308 $98,673
Keyword(s): Diabetes, Telehealth
A consortium has been established between Champlain
Valley Physicians Hospital Medical Center, a Regional Referral Health
Care Center, Clinton County Health Department, a community health
care leader, and the Joint Council of Economic Opportunity of Clinton
and Franklin Counties (JCEO), a social service agency that conducts
community outreach programs. The project is designed to finance
the development, implementation, and evaluation of the North Country
Diabetes Project. This endeavor has been designed based on best
practice standards including the American Diabetes Association (ADA)
Guidelines for quality diabetes self-management training.
The North Country Diabetes Project will target
Clinton, Essex and Franklin County residents over the age of 45
who have diabetes or are at risk for developing diabetes. Innovative
outreach activities will involve health professionals, as well as
community workers, who provide relevant services to this population.
This region is medically underserved with shortages of primary care
providers. It is also socioeconomically disadvantaged. The median
household income is significantly below State and national levels.
Education levels are low adversely affecting health behavior and
outcomes. This is reflected in the area's level of obesity, smoking,
high blood pressure, and lack of regular exercise causing significant
rates of diabetes and complications from diabetes. This region reports
a higher than State average of hospital admissions resulting in
major health care costs and complications due to diabetes, which
diminish quality of life.
Diabetes is reaching epidemic proportions in the
United States. Diabetes cannot be cured. But it can be managed through
life style modifications and appropriate health care. Without this
intervention, patients suffer from serious complications-blindness,
limb amputations, advanced renal disease and heart disease.
The North Country Diabetes Project will build
ongoing community collaboration among core health care providers
to increase access to diabetes care through the development of a
physician referral network and establish an American Diabetes Association-recognized
diabetes self management training program. The project will execute
a unique community health approach including screenings, risk awareness,
and education sessions, creatively using a registered dietitian
at the Health Department, home health care registered nurses, JCEO
case managers, and community outreach workers. JCEO volunteers will
provide transportation to medical appointments for homebound seniors.
Public service announcements will increase community awareness as
will telehealth capability of 13 local libraries with Internet access
to reliable diabetes education resources and postings for local
services. Key community agencies such as the Office of Aging, The
Senior Citizens' Council, and the United Way will publicize the
project's services.
This project will reduce the impact that diabetes
has on the tri-county region by increasing community awareness,
improving health outcomes (i.e. decreased blood glucose levels,
reduced complications and reduced hospital admissions) and increasing
patient quality of life.
D04RH06957
Jane Hamilton, R.N.
School-Based Health Center Program Clinical Coordinator
The Mary Imogene Bassett Hospital
One Atwell Road
Cooperstown, New York 13326-1394
Phone: (607) 746-9332
E-Mail: jane.hamilton@bassett.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): School-based services, Dental, Mental
health
Bassett Healthcare and six school districts have
formed a Consortium that seeks to expand and enhance their School-Based
Health Centers (SBHC) to include dental and mental health care programs
and community outreach services. Bassett Healthcare and the school
districts of Delhi, Edmeston, Laurens, Morris, Sherbure-Earlville,
and South Kortright are located in Chenango, Delaware, and Otsego
counties-all of which have been designated as Mental Health Professional
Shortage Areas. Delaware County has been designated a Dental Health
Professional Shortage Area.
The Consortium has specifically targeted school-age
children (5-18 years of age) for services. The seven goals of the
project are to: 1) increase the number of children receiving dental
health care, 2) reduce the number of untreated caries in children,
3) control the number and severity of new caries developing in children,
4) reduce serious emotional disturbances (SEDs) in children and
adolescents, 5) increase the number of children seen in primary
care who receive mental health screening and assessments, 6) increase
the number of students enrolled in Medicaid and New York State's
Child Health Plus Insurance Program, and 7) increase wellness and
the access to preventive health care for students and their families
without health insurance.
Input from community advisory boards and residents
in the three counties determined that a number of barriers preclude
the area from receiving adequate dental and mental health care for
school-age children. These barriers include: lack of insurance,
inability of parents to enroll in public insurance programs, limited
numbers of dentists and mental health providers, limited fluoridated
water, rural poverty, rugged geography and terrain, inclement weather,
and lack of public transportation.
This project will use dental hygienists, a mental
health social worker, community outreach staff, portable equipment
for dental exams, and PDAs for data storage and case management.
Staff will be hired to work in six existing School-Based Health
Centers. The Consortium anticipates caring for approximately 2,800
clients.
The applicant organization for the Consortium
is Bassett Healthcare, a not-for-profit rural health network of
primary and specialty care providers dedicated to patient care,
teaching and research. Bassett Healthcare staff will oversee grants
administration (including day-to-day operations and fiscal and billing
issues), and conduct the evaluation for the project. Members of
the Consortium will provide office space, assist in marketing and
planning, collect information, and support analysis.
NORTH CAROLINA
D04RH06941
Phil Donahue
Executive Director
Albemarle Hospital Foundation, Inc.
1144 N. Road Street
Elizabeth City, North Carolina 27909
Phone: (252) 384-4072
Fax: (252) 384-4677
E-Mail: pdonahue@albemarlehosp.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Chronic disease, Minority health,
HIV/AIDS, Mental health, Substance abuse
The Albemarle Hospital Foundation, Inc., and its
four consortium members are focusing on providing expanded services
to medically indigent, uninsured and underserved adult populations
of a six county catchment area of northeastern North Carolina: Camden,
Chowan, Currituck, Gates, Pasquotank and Perquimans. The project
is designed to deliver inter-related healthcare activities to curb
the multiple illness patterns and the high incidences of secondary
conditions among the most disadvantaged by poverty, lack of education,
minority status, unemployment, and uninsured or underserved.
Since the Healthy Carolinians 2002 Report, further
evidence of the health trends affecting this region have been updated
in the 2004 North Carolina Rural Profile by the Rural Economic Development
Center and from the State's Center for Health Statistics and the
North Carolina State Office of Rural Health. They continue to show
that the area is plagued with chronic cardiovascular disease, cancer,
respiratory disorders, a growing problem with Type 2 diabetes and
obesity. The service area is now seeing HIV/AIDS cases growing exponentially
among African Americans and Hispanics ages 20 to 49.
In an effort to expand the adult services of care
and support to the medically indigent, uninsured and underserved,
the consortium will use grant funds to concentrate on the following
activities:
- Reducing, through more cost effective means,
rapidly growing infectious disease incidents by providing local
access to an infectious disease physician;
- Providing more comprehensive intake coordination,
psychosocial and HIV/AIDS counseling, and assist in case management
of the expanding patient base;
- Improving drug access to overcome deficiencies
of AIDS Drug Assistance Program;
- Overcoming cultural barriers to health care
in the growing Hispanic community; and
- Becoming a rural State model for regional community
health care partnerships.
By merging divergent service
delivery systems and philosophies into a common vision and organization
under the community care clinic model, the project hopes to expand
services to the medically indigent, who traditionally experience
barriers in accessing health care and may not be receiving primary
care, much less care for chronic illness and/or chronic illness
as a secondary condition of AIDS.
The primary consortium member are the Albemarle
Hospital Foundation, Inc., initially organized by Albemarle Hospital
to provide community based health care to the medically indigent;
the Albemarle Regional Health Services manages the region's core
public health functions; Jeff Jones Consortium, a nonprofit organization
dedicated to serving persons infected with HIV/AIDS; Northeastern
Community Development Corporation (NCDC), a nonprofit organization
offering a community Hispanic resource center and assistance in
the areas of housing, housing counseling, small business development,
child care, and skills training; and the Albemarle Mental Health
Center providing a mix of outpatient mental health and substance
abuse services.
NORTH DAKOTA
D04RH04326
Joyce R. Rice
Cavalier County Job Development Authority
901 3rd Street, Suite 5
Langdon, North Dakota 58249-2457
Phone: (701) 256-3475 Fax: (701) 256-3536
Email: jccjda@utma.com
Fiscal Year 2005 2006 2007
Funding Amount $199,781 $143,399 $122,047
Keyword(s): Wellness Programs
The Wellness Interventions Lasting a Lifetime
(WILL) project-designed to encourage wellness and healthy lifestyles-will
provide education on disease management and prevention to North
Dakota residents of Cavalier County, the northwest section of Pembina
County, and the northern portion of Ramsey County. The WILL project
will be implemented with classes and lectures, screenings, and fitness
and nutrition programs to manage chronic disease and their modifiable
risk factors. The WILL Network's goals are to implement the WILL
project, to increase awareness of chronic disease conditions, to
promote wellness and lifestyle change programs, to increase awareness
of activity-related injury prevention and wellness programs, to
increase awareness of overall occupational wellness, and to promote
self-managed wellness programs. The WILL Network will deliver educational
programs on a local, regional, and statewide basis through Internet
technology; hold classes, lectures, general fitness and nutrition
programs, and screening tests; distribute brochures; take wellness
to the next level of activity in the community; and combine all
community health-related resources. The project will promote wellness
programs to residents of every age, gender, and activity level.
Education and promotion will focus on overall wellness, and fitness
and nutrition programs, with an end goal of self-managed wellness
programs.
Residents of the service area are primarily Caucasians,
with 0.99 percent Native Americans living in the area. In rural
areas, long distance between health care facilities presents a large
barrier to seeking and receiving health care. As the population
continues to age, the lack of public transportation compounds this
problem. In addition, the mindset and attitudes of rural residents
can be a barrier to needed health care services in this area. They
generally are stoic, hard-working individuals, often too proud to
ask for necessary health care assistance. Depression, due to a declining
farm economy, as well as aging and other stress-related issues are
examples of health care needs in the service area that would benefit
from the promotion of wellness education. Cavalier County is a designated
Health Professional Shortage Area.
The network partners are the Cavalier County Job
Development Authority, Cavalier County Memorial Hospital, and Cavalier
County Health District. Existing and supportive community (ad hoc)
members are North Dakota State University Extension Service-Cavalier
County Office, Cavalier County Social Services, Walhalla Economic
Development, Parish Nurse-Faith Based Organization, Cavalier County
Senior Meals and Services, and the City of Langdon.
D04RH06915
Emmett White Temple, Jr.
Standing Rock Sioux Tribe
Standing Rock Reservation
P.O. Box D
Fort Yates, North Dakota
Phone: (701) 854-7206
E-mail: thlthdir@westriv.com
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Mental health
The focus of the Standing Rock Reservation's Mental
Health First Aid program is to empower non-mental health professionals,
including first responders, health providers, and community members
to recognize signs, make use of basic skills, and assist with accessing
mental health resources in the frontier and reservations areas of
North and South Dakota. As mental health resources are scarce in
rural, frontier, and tribal areas, implementing a program at the
grassroots level and training health professionals, paraprofessionals,
and interested volunteers to better understand mental health issues
and provide a supportive environment is an innovative way to address
mental health problems.
Suicide in the northern plains region is at epidemic
proportions requiring an immediate and innovative mental health
response. Through the development of the Mental Health First Aid
program, a training and curriculum will be developed consisting
of a 12-hour course developed at the Centre for Mental Health Research
at The Australian National University, to improve mental health
knowledge, skills, and attitudes.
The Mental Health First Aid program uses five
basic skill steps to address issues related to suicide: 1) Assessing
the risk of suicide; 2) Listening non judgmentally; 3) Giving reassurance
and information; 4) Encouraging the person to get appropriate professional
help; and 5) Encouraging self-help strategies.
There are three phases to this program. First,
the developmental phase includes training for trainers, adapting
the Australian curriculum for use on the reservation, and piloting
the training on the Standing Rock Reservation and West River Health
Service area. These trainings for Standing Rock personnel will be
held in the local districts and conducted by the Community Health
Representatives in each district. The West River trainers will conduct
the training in local communities requiring less travel by the majority
of participants and trainers. In year 2, the implementation phase,
the training of providers would begin emphasizing training for the
medical and emergency personnel in each of the eight districts within
the Standing Rock Reservation and throughout the West River Health
Service area. All trainings will be conducted by the original trainers
from the first year of the project. In Year 3, the expansion phase,
the project will expand the previous training to include other sectors
of the community such as, business, education, faith/religion, and
government/public. Additionally, curricula will be developed for
training new trainers and more trainers trained. Dissemination of
the program into other Tribal communities would be completed during
this phase.
D04RH06914
Carlotta Ehlis
Southwestern District Health Unit
2869 3rd Avenue W
Dickinson, North Dakota 58601
Phone: (701) 483-0171
E-Mail: cehlis@state.nd.us
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Cancer
The health care needs of the area were identified
through a community health assessment initiated by the Healthy 8
Communities Network. This group is a multidisciplinary team of 55
members representing over 35 community groups from the eight southwestern
counties of North Dakota. Results in 1997 and a repeated survey
in 2002 indicated Areas of Opportunity for Health Action, with cancer
identified as a significant health priority. The Cancer and Substance
Abuse Task Force was formed in 1998 creating the Pathways to Healthy
Lives program, which became a reality through funding by a Rural
Health Care Services Grant from 2000-2003. The results of the 2002
assessment revealed the positive impact of the program and identified
the need for program expansion to include comprehensive screenings
and education for breast, prostate, lung, colorectal and skin cancer.
Pathways to Healthy Lives provides public education
focusing on making healthy dietary choices, being physically active,
protecting oneself from sunlight and chemical exposure, and preventing
initiation or cessation of tobacco products usage. Free breast,
prostate, colorectal, and skin cancer screenings to be held in local
communities within the eight counties. Collaboration between community
leaders, providers, clinics, hospitals, and Pathways to Healthy
Lives makes it possible to offer services in local communities where
people live, thus increasing accessibility and reducing the amount
of distance people must travel.
The consortium for Pathways to Healthy Lives consists
of members from Southwestern District Health Unit, Community Action
Partnership, and St. Joseph's Hospital and Health Center. These
three agencies have partnered together since the inception of the
Pathways to Healthy Lives program and to provide advisement and
support.
The goals of the Pathways to Healthy Lives program
are to: 1) increase awareness of healthy lifestyles, 2) increase
the availability of comprehensive screening events, 3) increase
the number of cancers identified in the in situ or localized stage
by 5 percent over the 1997 numbers documented in the North Dakota
Cancer Registry, 4) increase the number of participants in educational
programs related to smoking, smoking cessation, and exposure to
secondhand tobacco smoke in an effort to reduce the incidence of
lung cancer.
The southwest eight counties have significant
physical isolation from specialty health care providers. Harsh climatic
conditions have a major impact on the ability of residents to seek
medical services. Pathways to Healthy Lives serves the 38,365 residents
of Adams, Billings, Bowman, Dunn, Golden Valley, Hettinger, Slope,
and Stark counties in the 10,000 square mile area of southwestern
North Dakota. An American Indian population resides in the northern
part of Dunn County. Five and a half of the counties served are
designated full Health Professional Shortage Area, and six-and-a-half
are Medically Underserved Areas. In 1999, North Dakota had a per
capita person income of $17,769. The national average is $21,587.
Some 11.9 percent of North Dakota residents overall were below poverty
level in 1999; however, 17.5 percent of Dunn, 16.9 percent of Slope,
and 15.3 percent of Golden Valley county residents were below poverty
levels. Also, 12.5 percent of adults in the service area lack health
insurance coverage.
OHIO
D04RH06793
Joseph Liszak
Executive Director
Community Health Services
410 Birchard Avenue
Fremont, Ohio 43420
Phone: (419) 334-8943
E-mail: jliszak@fremontchs.com
Fiscal Year 2006 2007 2008
Funding Amount $150,00 $125,000 $100,000
Keyword(s): Dental, Women's health, Prenatal care,
Diabetes
A consortium of three parties-the Community Health
Services (CHS), Mercy Hospital of Willard, and Huron County Health
Department-are working together to provide basic primary care and
dental services to a target population of adults and children with
incomes under 200 percent of the federal poverty level who live
in the area of Willard, Huron County, Ohio, as well as the southeast
corner of Seneca County and the northeast corer of Crawford County.
This rural health outreach grant will enable community health services
to expand the operation of the Willard clinic from 5 hours per week
to 12 hours per week, to provide expanded prenatal services to the
target population, and to provide basic dental services to adults
and children.
Within the city of Willard, 16.5 percent of the
population has an income less than 100 percent of the federal poverty
level. This contrasts with 8.5 percent of Huron County residents
and 10.6 percent of Ohio residents whose incomes are less than the
poverty level. There is no safety net clinic in the area where uninsured
patients may access care on a sliding fee basis other than the CHS
Willard clinic, Mercy Hospital's OB/GYN clinic, a twice monthly
well-child clinic offered by the Health Department, and the Mercy
emergency room. In the Willard area, there are three dentists. Only
one is listed on the Huron County Department of Job and Family Services
list of dentists who accept new Medicaid patients. Most people in
Huron County who need dental care and lack dental insurance and
the means to pay simply go without care or must drive 60 minutes
to the nearest safety net, the CHS main office in Fremont, Ohio.
Community Health Services plans to close the primary
care and dental service gap by expanding services from 5 hours per
week at its Willard clinic to 12 hours per week, potentially open
on some Saturdays, and engage in a referral arrangements with two
Willard dentists who will accept uninsured patients on a modest
voucher payment system. This expansion of the Willard clinic will
allow the clinic to provide 1700 medical encounters per year, in
contrast to the present 700 annual encounters. It will open up sufficient
appointment slots to provide pap smears to 90 female adult patients
as needed. The additional hours also will ensure that each of the
72 diabetics currently being treated at the clinic can be seen minimally
on a quarterly basis and on a monthly basis at the point that their
sugar is uncontrolled, and to aggressively treat pre-diabetes. Women
in need of prenatal care will be seen at the Mercy Hospital, OB/GYN
clinic. Persons in need of dental care will be referred to local
dentists. These dentists will provide basic preventive and restorative
services to adults and children referred to them through Mercy Hospital,
who will assist with the payment of care for at least 85 children
and adults each year. The Huron County Health Department will refer
children to the dental services through its twice monthly well-child
clinic in Willard, and will refer adults who come to its adult clinics.
D04RH06936
Timothy McKnight
Chief Executive Officer
Twin City Hospital
819 N. First Street
Dennison, Ohio 44621.
Phone: (740) 922-2800
E-mail: mjentes@twincityhospital.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Overweight/obesity
The Goal of the Twin City Hospital (TCH) Healthy
Community/Happy Children Outreach Program (HC/HCOP) is to provide
an innovative, multi-agency means to reduce the number of overweight
and obese men, women, and children of all ages in the Village of
Dennison, Tuscarawas County, and the surrounding counties of Carroll,
Harrison, and Guernsey. The program will allow a consortium of community
agencies to pool precious resources to enhance educational opportunities,
outreach, facilities and services through a collaborative countywide
effort. Program services will be offered to all populations regardless
of their abilities to pay or ethnic backgrounds.
Twin City Hospital Healthy Community/Happy Children
Outreach Program (HC/HCOP) information will be disseminated through
various promotional efforts such as: mailings, speaker's bureau
activity, newspaper articles, radio public service announcements,
church bulletins, grocery bag inserts, school handouts, and brochures
and fliers placed in area libraries, physician's offices, schools,
and Head Start Centers. The project also plans to make information
available via the Twin City Hospital's web page at www.twincityhospital.org.
The development of the Twin City Hospital HC/HCOP
will address the following health and wellness needs in the community:
1) Lack of affordable diet and exercise training; 2) Need for a
central location where people can access health and wellness information
that is appropriate for all age levels; 3) Need to provide treatment
for obesity among all age groups; 4) Need for enhanced diabetes
treatment and education; 5) Need for fitness programs for all ages;
6) Need for child care to allow busy parents the time to participate
in HC/HCOP services; and 7) Need to provide local access to these
services due to a lack of affordable public transportation in Tuscarawas
County.
The Twin City Hospital HC/HCOP will provide the
following age-appropriate services to meet the community needs listed
above: 1) Provide nutrition and exercise programs for all population
groups through a series of two "Fit" programs: Fit for
Life for adults and Fit for Fun for children and teens; 2) Provide
special health interventions for adults and children who either
have diabetes or are at risk for diabetes; and 3) Provide nutrition
and exercise information online on the Hospital's website in order
to improve access to health and wellness information. While the
administrative function of the program will be housed at Twin City
Hospital, services will be offered at various locations throughout
the community in order to reach all segments of the targeted population.
According to the 2000 Census, 90,914 populate Tuscarawas County.
To address transportation needs, Twin City Hospital
will use school buildings in towns throughout the service area so
that people can access program services without having to drive
a long distance.
D04RH06937
Melinda Lutz
Zanesville-Muskingum County Health Department
205 North 7th Street
Zanesville, Ohio 43701
Phone: (740) 454-9741
E-Mail: mlutz@zmchd.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Prescription medication assistance
The RxCUE program is a community-based prescription
medication assistance program. This program for southeastern Appalachia
Ohio involves a coalition of four core members, and six additional
community agencies and stakeholders. The program will assist any
resident with a prescription medication need who is not able to
fill the prescription on his/her own. These individuals include
uninsured, low-income/fixed income, and those residents experiencing
hardships that would legitimately preclude them from fill physician-prescribed
medications.
The three core consortium members are the
Zanesville Muskingum County Health Department, Eastside Community
Ministry, and Genesis Healthcare. Contributing members include Muskingum
County Center for Seniors, Muskingum TB and Respiratory Clinic,
Alfred Carr, Mental Health and Recovery Services Board, Six County,
Inc., and Muskingum County Job and Family Services. These agencies
and various affected individuals from the community worked for nearly
3 years to complete a needs analysis, identify target populations,
develop budget start-up costs, and develop goals, objectives, and
activities. RxCUE will use a three-tier system for assisting clients:
- Tier I will link individuals with free pharmaceutical-sponsored
programs.
- Tier II will fill prescriptions from the State
pharmacy repository. The State of Ohio passed House Bill 221 provides
for the development of a State Pharmacy repository for collection
and redistribution of surplus medications from individuals and
agencies.
- Tier III will use the stopgap approach to filling
medications through outright purchase. The purchase of medications
will be done through a cooperative agreement with consortium members
that use volunteer pharmacists to fill prescriptions at hospital
costs. Grant money will fund the purchase of medications in this
tier only. The result is an average savings of 50 percent over
purchases from a private pharmacy.
This program will target approximately 1,250 unduplicated
clients each year, including senior citizens, low-income individuals
and families, and those with financial hardships (who do not have
prescription medication insurance coverage or cannot meet deductible/co-payment
requirements). Based on local statistics, the greatest needs of
this target population include medication for diabetes, hypertension,
pulmonary, cancer, and respiratory conditions.
OKLAHOMA
D04RH06794
Lori Timmons
Chief Executive Officer
119 W. Main Street
Hulbert, Oklahoma 74441
Phone: (918) 772-3471
Fax: (918) 772-3102
E-Mail: lori.timmons@neochc.org
Web Site: neochc.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Alzheimer's disease; Caregivers
In operation since April 23, 2002, Northeastern
Oklahoma Community Health Centers was established in response to
the overwhelming need for accessible health care in rural northeastern
Oklahoma. The mission of the health center is to provide high-quality
preventive and primary health care to eastern Oklahoma. Since its
inception, the health center has experienced rapid growth and works
within a constructive, collaborative environment to expand the range
of services offered. The health center operates five sites, employs
eight full-time providers, and offers the full range of preventive
and primary care services.
The target population of the health center is
the uninsured and underinsured residents of Cherokee County, Oklahoma;
however, health center patients come from across the multi-county
region of northeastern Oklahoma-some driving as long as 2 hours
to reach the health center. Needs to be addressed include providing
information and education to individuals who are caregivers to those
suffering from Alzheimer's disease. Topics of education include
available medications and treatments, legal and financial concerns,
and caregivers' high risk for stress-related illness and coping
mechanisms that can be used to reduce stress-induced health risks.
Services to be provided include a needs assessment, through which
community-specific needs will be identified, resources available,
and an action plan that will map a path toward meeting those needs.
In addition, the importance of "Maintaining Your Brain"
will be a focal point for education aimed at delaying the onset,
and reducing the severity of, Alzheimer's disease.
The target population is the service area
of Northeastern Oklahoma Community Health Centers, namely Cherokee
County, and its four surrounding counties. The goals of this project
are:
- To improve the ability of area organizations
to better meet the mental and physical needs of caregivers;
- To improve the ability of caregiving families
to use health care and support services in their communities;
- To support the mental and physical health caregivers;
- To educate area residents about maintaining
brain health and decreasing the impact of Alzheimer's;
- To use advanced communication tools, including
the Internet, to achieve goals more efficiently; and
- To develop a plan for sustainability.
OREGON
D04RH06924
Margery Dogotch
La Clínica de Cariño Family Health Center
849 Pacific Avenue
Hood River, Oregon 97031
Phone: (541) 308-8340
Fax: (541) 386-1078
Email: mdogotch@lcdcfh.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Diabetes, Overweight/Obesity,
Mental health
La Clínica del Cariño,
a community and migrant health center in Hood River, Oregon-in partnership
with The Next Door, Inc., a community social service agency, and
Providence Hood River Memorial Hospital-is supporting a community
project entitled Steps to Wellness/Pasos a Salud. This project is
intended to improve the emotional and physical well-being of our
rural community residents by providing individual and group support
and education to people suffering from diabetes and/or obesity.
We will particularly emphasize services for low-income and medically
underserved English-speaking and Spanish-speaking residents of the
rural four county target area.
Recent evidence of the
reciprocal and reinforcing relationships between chronic diseases
such as obesity and diabetes on depression is startling. Not only
can diabetes and obesity (and their sequelae) lead to depression,
but depression also can make people more likely to be obese and
diabetic. Given the known stigma associated with mental health treatment,
which are amplified in a rural community, approaching mental health
issues from another common denominator can be an effective way to
elucidate the extent of the problem and possible solutions.
Steps to Wellness/Pasos
a Salud has the following four goals: 1) To address mental health
issues that impact patient self-management of diabetes and/or obesity;
2) To improve patients' ability to manage their diabetes and/or
obesity; 3) To improve recognition of the importance of physical
activity to the mental and physical health of people with diabetes
and/or obesity; and 4) To increase community awareness of diabetes,
obesity, and the concurrent emotional issues.
To accomplish these goals,
a comprehensive training strategy will be implemented, using the
expertise and resources of consortium members, to ensure that project
staff members, including co-directors and community health promoters,
are well versed in mental health, diabetes, and obesity issues.
Services to the community will be provided in a four-pronged approach:
1) Education and support groups for 60 participants; 2) Lay counseling
for 10 dialysis patients; 3) Case management services for 35 patients;
and 4) Community outreach to 5,000 people through general outreach
and 500 people in more intensive, one-on-one contact. In addition,
the consortium will meet to choose and provide an intervention for
obese children, the first of its kind in our community.
Steps to Wellness will
target low-income, uninsured, or underinsured residents in the rural
communities of Hood River, Wasco, Klickitat, and Skamania counties,
with special attention to Hispanics. The project will direct program
activities toward people who struggle with weight management and/or
diabetes, or who have a family member with weight management issues
or diabetes. The project will also identify and focus upon those,
among this population, whose mental distress (depression, anxiety,
or stress) is interfering with their disease self-management. Addressing
both mental health and obesity/diabetes simultaneously promises
to lead to more effective influence on health habits and health
outcomes in our community's vulnerable populations.
D04RH06902
Kim Procknow
Director of Research & Development
Three Rivers Community Hospital
2600 Siskiyou Boulevard, Suite 100
Medford, Oregon 97504
Phone: (541) 789-5298
E-mail: kimanddave@charter.net
Fiscal Year 2006 2007 2008
Funding Amount $149,982 $124,836 $99,980
Keyword(s): Cardiovascular
disease, Stroke, Elderly
Josephine County, much
of which is designated as a medically underserved area, is situated
in the southwest corner of Oregon. It encompasses a geographical
area spanning 1,641 square miles, and supports a population base
of 77,123 persons. The over age 65 population in this area is anticipated
to increase to 31 percent by 2020-about 20-30 years sooner than
is projected for the nation as a whole. In Josephine County, where
currently an astounding 20 percent of all residents are aged 65
or older, residents are besieged by health disparities. Of particular
concern is the fact that people in Josephine County are 1.5 times
more likely to die from cardiovascular disease than their cohorts
throughout Oregon.
The high incidence of cardiovascular
disease and stroke, coupled with the growing over age 65 population
in Josephine County supports the critical need for this proposed
rural outreach project entitled Heart Health: A Rural Prevention
and Treatment Program. Three Rivers Community Hospital, Josephine
County Public Health Department and AMR of Josephine County, in
collaboration with other regional providers and consumers, have
developed a rural outreach project with the following four goals:
1) To improve the capacity of Josephine County stakeholders to identify
and intervene in men and women's cardiovascular disease specific
risk factors; 2) To reduce risk-adjusted rates of cardiovascular
disease related morbidity and mortality by increasing the use of
evidence-based practices in the prevention and treatment of Josephine
County men and women; 3) To improve the capacity of Josephine County
men and women at high-risk of cardiovascular disease to manage their
health and receive seamless care across the continuum of heart related
care; and 4) To improve the capacity for rapid transport and treatment
of Josephine County ST segment elevation myocardial infarction (STEMI)
patients.
These goals emerged from
a community wide planning process and are responsive to the needs
of this rural area to reduce risks and improve outcomes for rural
elderly men and women who are at high-risk for cardiovascular disease
and stroke. The strategies that will be employed and evaluated to
achieve these goals include: gender sensitive education programs
and materials for providers and consumers; community screenings
to identify and intervene with persons at high-risk of cardiovascular
disease and stroke; workflow redesign and monitoring geared to increase
best practice use and improve rapid transport and treatment; and
a health promotion program utilizing case management/self-management
to support lifestyle change and behavior modification, resulting
in reduced risks and lowered heart related morbidity and mortality
rates for Josephine County men and women. This project, and its
sustained operation, will significantly expand and enhance treatment
and prevention of cardiovascular disease and stroke; a community
response to the critical needs of elderly men and women in rural
Josephine County.
D04RH06903
John Gardin II
ADAPT, Inc.
P.O. Box 1121
Roseburg, Oregon 97540
Phone: (541) 672-2691
Email: drjohn@adapt-or.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Substance abuse,
Mental health, Migrant health
Douglas County is situated
in southwest Oregon. It encompasses an area that spans 5,134 square
miles and supports a population base of 100,400 persons. A huge
expanse of Douglas County, totaling 2,459 square miles, supports
a population density of fewer than seven persons per square mile,
thus meeting Federal criteria for designation as a frontier area.
Douglas County currently holds Federal designations as a health
professional shortage area, a mental health professional shortage
area, medically underserved area, and as containing a medically
underserved population comprised of low-income residents and migrant
and seasonal farm workers.
Douglas County's people
suffer from a number of social ills, including elevated TANF rates,
elevated food stamp recipient rates, and poor high school completion
rates. Documented health disparities include malignant neoplasms,
cardiovascular disease, chronic obstructive pulmonary disease, diabetes,
hypertension, and infant mortality. The Oregon Primary Care Association
(January 2002) estimates that the county's current safety net system
of care is meeting the needs for only 6 percent of Douglas County's
low-income and medically uninsured residents. Fully 14,345 such
individuals lack access to a continuous source of primary care.
Addictive disorders are
evident within the population at elevated rates beginning with 12-year-old
children. Studies conducted by the Center for Oregon Health Plan
Policy and Research confirm that one-quarter of all Medicaid recipients
are receiving prescriptions for Vicodin. While elements of addictive
disorders are seen in virtually every primary care practice in Douglas
County, it is the consensus of the medical community that few resources
exist to help either patients or their attending primary care providers.
To this end, the Rural Health Care Services Outreach project will
establish a program of integrated primary and behavioral health
using elements of successful, HRSA-sponsored Health Disparities
Collaborative models. In specific, behavioral health nurses placed
in primary care settings will provide addiction assessment, intervention,
and self-care management planning for 175 patients in Year 1, and
250 patients in each Year 2 and year 3. Intended outcomes include
improvements in Global Adaptive Functioning for program participants
and reduction in use rates for inappropriate primary care office
visits.
The project has established rigorous statistical
measures, and will feature the innovative use of the PDSA model
for continuing to refine the program along a continuum of quality
improvement. The project is sponsored by ADAPT, Inc., Healthcare
for Women, Douglas County Independent Practice Association, Douglas
County Health and Social Services, and Douglas County Family Development
Center.
PENNSYLVANIA
D04RH06797
David L. Hoff
Manager of Grants & Development
Wayne Memorial Hospital Contact
601 Park Street,
Honesdale, Pennsylvania 18431
Phone: (570) 251-6533
E-Mail: hoff@wmh.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Medication assistance
This project is built on the premise that a significant
aspect of patient safety that can be improved is in the realm of
medication, including prescription, transcription, validation, documentation,
ordering, dispensing, administering, and usage of drugs and other
pharmaceuticals. Wayne Memorial Hospital, a 98-bed community hospital
in rural Pennsylvania, and its consortium of primary care practices
throughout Wayne and Pike Counties, Pennsylvania. The consortium
also represents portions of Lackawanna County, Pennsylvania, and
Sullivan County, New York. The project will implement an integrated
medication safety program called the IMAPS Project, or Improving
Medication and Patient Safety.
Through the use of comprehensive information systems
and automation the medication processes of ordering, transcribing,
dispensing, and administering medication for patients served throughout
the Wayne Memorial Health System and the community will be improved
substantially. The project will involve sharing this vital medication
information between the hospital and the physicians employed in
physician practices within the community, both health system entities
and private practices. The mechanism for accessing this information
will be the Internet through a secured web portal. The project will
include enhanced automation and information systems in the following
Hospital areas: inpatient units, operating rooms, and emergency
services.
The primary goal of the project is improvement
in patient safety. A concurrent goal is a reduction in the need
for additional services caused by medication errors and the resultant
drain on both the patient's resources and the medical resources
of this medically underserved community. The objective to accomplish
these goals is reduction of medication errors. Success of the project
will be measured through quarterly reports identifying the number
of medication errors by unit of service within the Hospital. This
information will be compared to baseline (historical data) before
the new system was implemented. The type of data to be collected
and maintained will include: (1) the number of medications administered,
both in grand totals and by department and by individual provider
(nurse and/or doctor); (2) the number of medication errors and the
type of errors (ordering, transcribing, dispensing, or administration
errors). Specifically, the project goal will be a 50 percent reduction
in medication errors over historical events.
The number of Hospital inpatients that will
be affected by this project will be 4,000-4,500 per year. The number
of emergency room encounters with potential for interaction with
this project is 19,000-20,000 per year. The number of provider orders
impacted by this system will be 435-450 per day, or 158,000 to 164,000
per year.
SOUTH CAROLINA
D04RH06789
Cheryl Dye
Oconee Memorial Hospital, Inc.
298 Memorial Drive
Seneca, South Carolina 29672
Phone: (864) 888-8411
Fax: (864) 886-9773
Email: tcheryl@clemson.edu
Fiscal Year 2006 2007 2008
Funding Amount $149,767 $124,190 $99,615
Keyword(s): Chronic disease, Home health services,
Self-management
Adults over the age of 65 years residing in Oconee
County, South Carolina, have higher rates of many chronic diseases
and risk behaviors than their State and national counterparts. This
county ranks second in the State for the percentage of the population
over 65 years of age at 15.6 percent. Of this population, 12.9 percent
live in poverty, compared to the national average of 6.4 percent.
Lack of resources makes self-management of chronic disease very
challenging, often leading to the need for home health services
(HHS). However, even during the episode of care offered by the two
nonprofit HHS agencies in Oconee County, patients exceed the State
and national average in HHS patient hospital and emergent care.
After discharge from HHS, avoidable incidences of emergent and hospital
care arise because of the difficulty the older adult faces in transitioning
from home health services to chronic disease self-management.
In the rural, older population of Oconee County,
much of this emergent and hospital care is related to congestive
heart failure, diabetes, and cardiovascular disease. Frequently,
such care could have been avoided if the disease had been more effectively
managed through better adherence to the home health care plan and
prompt recognition of "red flag" signs and symptoms. Adherence
can be improved by building patients' self-management skills and
helping them navigate the complex network of health and social services.
This project's model is designed to improve chronic disease management
among rural, HHS patients through trained community volunteers called
"Health Coaches." These coaches will help patients transition
from home health services to self-care and family care by offering
home-based education, monitoring, support, and referrals, thus reducing
the risk for emergent and hospital care.
The role of the Health Coach merges community
volunteer with "patient navigator" and includes: 1) Building
patient chronic disease self-management skills; 2) Coordinating
health care services and provider referrals; 3) Collaborating with
community organizations to obtain services and make referrals; 4)
Helping with medication management; 5) Arranging and reminding clients
about appointment schedules and treatment regimens; 6) Making transportation
arrangements for health needs; 7) Facilitating communication between
client, family, caregivers, and service providers; 8) Providing
and facilitating social support; 9) Implementing nutrition and physical
activity educational programs; 10) Facilitating participation in
immunization clinics; and 11) Facilitating enrollment in clinical
trials.
The project will implement best practices
such as those tested in the South Carolina Rural Geriatric Initiative
Project (SC GRIP). Health Coaches will be trained using the SC GRIP
curriculum for geriatric technicians and will be trained to use
the State's medical management materials, and its information and
referral database. The also will be trained to implement Clemson
University Extension nutrition and physical activity curricula.
The project will build on these successful programs, integrate them
with home health services, and organize strategies with the Chronic
Care Model framework to coordinate care as the patient transitions
along the continuum from acute care to self-care.
SOUTH DAKOTA
D04RH04324
Sandy Arseneault
Custer School District 16-1
527 Montgomery Street
Custer, South Dakota 57730-1124
Phone: (605) 673-4540 Fax: (605) 673-4710
Email: sarseneault@csd.k12.sd.us
Fiscal Year 2005 2006 2007
Funding Amount $199,900 $199,446 $199,512
Keyword(s): Drug Prevention Services, Equine-assisted
Learning
The goal of the Southern Hills Leadership and
Resiliency Initiative (SHLRI) is to reduce use of alcohol, tobacco,
and other drugs by students in five communities in the southern
Black Hills of South Dakota. The initiative will provide alcohol,
tobacco, and other drug prevention and early intervention services
in grades 5 through 12 in five rural schools. There is an alarmingly
high rate of alcohol, tobacco, and other drug use among the youth
of in this service area, which is higher than national rates. SHLRI
will use a research-based alcohol, tobacco, and other drug prevention
program to address the problem through prevention and early intervention
of alcohol, tobacco, and other drug addiction. The project will
include a prevention curriculum for 5th through 9th grades; parent
education; awareness activities for youth; early intervention programming
for students in the 9th through 12th grades; incorporation of an
alcohol, tobacco, and other drug prevention curriculum into health
and physical education classes; and collaboration with mental health
providers. Equine-assisted learning (experiential activities involving
horses) will be an integral component of the early intervention
program.
The target area includes the communities of Custer,
Edgemont, Hill City, Hot Springs, and Oelrichs in the southern Black
Hills in the southwest corner of South Dakota. South Dakota has
a low rate of economic growth and a per capita income among the
lowest in the United States. The closest city with 24-hour primary
health and mental health services is Rapid City, which is 30 to
80 miles away. In addition, unpredictable weather from October to
April and inadequate roads limit accessibility to services. Area
schools have experienced continued budget cuts. South Dakota is
a rural state with a rugged individualism or frontier mentality,
which can be a hindrance to citizens in need of assistance. Parents
and community members lack understanding of the significance of
early adolescent use of alcohol, tobacco, and other drugs. Cultural
barriers exist between Caucasian and Native American Lakota people
residing in the area. Barriers to access include poverty, isolation,
and cultural differences. The service area is designated as a Medically
Underserved Area and Medically Underserved Population.
In addition to the Custer School District, members
of the consortium include Lifeways, Inc., a nonprofit alcohol and
drug prevention agency; Walking In Grace, a faith-based nonprofit
counseling center; Native American prevention specialists; and an
evaluator from Black Hills State University.
D04RH04325
Ann Bush
Easter Seals South Dakota
1351 North Harrison Avenue
Pierre, South Dakota 57501-2373
Phone: (605) 224-5879 Fax: (605) 224-1033
Email: abush@sd.easterseals.com
Fiscal Year 2005 2006 2007
Funding Amount $199,386 $190,518 $192,084
Keyword(s): Durable Medical Equipment
The Recycle for Life Program-operated by Easter
Seals South Dakota and its partners-has helped thousands of rural
South Dakotans with disabilities gain access to durable medical
equipment since it began in 1999, but the need for durable medical
equipment continues to be an issue. Goals of the program are to
strengthen 12 existing volunteer networks and create 8 new volunteer
networks to aid in the solicitation, storage, transportation, refurbishing,
and redistribution of previously owned equipment; to provide good-quality
refurbished medical equipment to an average of 200 individuals per
month by enhancing a refurbishing and redistribution system for
used durable medical equipment; to educate agencies and organizations
that purchase durable medical equipment for clients about medical
equipment options; to sustain and expand a statewide equipment loan,
donation, and refurbished equipment redistribution program; to increase
a current caseload of 1,500 individuals to 2,400 individuals; and
to conduct a statewide campaign for donation of durable medical
equipment by individuals and agencies across the state.
Service delivery for medical equipment in South
Dakota is a challenge, especially for people with disabilities in
rural communities who live far from basic services. Many rural families
have either inadequate or no health insurance, leaving them with
limited or no access to medical equipment. For individuals with
disabilities, access to costly medical equipment is difficult or
impossible, and many insurers and health care providers do not cover
the cost of assistive devices. More than 97 percent of South Dakota
is considered frontier, rural, or reservation; 83 percent of the
counties in South Dakota are federally designated Health Professional
Shortage Areas, and more than 90 percent are Medically Underserved
Areas. Twelve counties in South Dakota are among counties with the
highest poverty rates in the United States. According to the 2000
Census, 13.6 percent of state residents have disabilities or chronic
illness. In addition, 8.4 percent of South Dakotans are without
access to primary care providers, 8.1 percent of the total population
was uninsured in 2004, and more than 50 percent of the uninsured
live below 200 percent of the federally established poverty level.
Easter Seals South Dakota (ESSD) has experienced an influx in the
number of requests for medical equipment as state government and
other agencies continue to downsize their programs.
Network partners include Easter Seals South Dakota,
the lead applicant; the South Dakota Office of Adult Services and
Aging; and Northland Rehab Supply.
D04RH06952
Donna Keeler
Executive Director
South Dakota Urban Indian Health, Inc.
1714 Abbey Road
Pierre, South Dakota 57501
Phone: (605) 224-8841
Fax: (605) 224-6852
E-Mail: donnak@sduih.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $124,999 $99,997
Keyword(s): Overweight/obesity; Diabetes
South Dakota Urban Indian Health, Inc., is a non-profit,
Federally Qualified Health Center. Through the Keya (Lakota for
Turtle) Program - Long Life for Good Health, the Keya Program Consortium
seeks to reduce overweight and obesity to prevent diabetes and to
improve the health status of those with diagnosed diabetes. The
target population is rural Lakota American Indians living off reservations.
When relocating to urban (non-reservation) areas, American Indians
lose access to free health care provided by Indian Health Service
and/or Tribal programs on the reservations. South Dakota Urban Indian
Health has been providing health services continuously since early
1978. These clients are served at South Dakota Urban Indian Health
clinics in Aberdeen and Pierre.
In addition to South Dakota Urban Indian Health, three other separately
owned health care organizations have been working together for planning
and implementing Keya Program activities. The other three consortium
partners are non-profit health care organizations located in eastern
South Dakota. They include: Avera McKennan Hospital & University
Health Center, Avera St. Luke's Health Services, and the Avera Corporate
Office. Additionally, 78 rural South Dakota Urban Indian Health
clients participated in a needs assessment survey to help plan for
the Keya Program.
The Keya Program will expand existing diabetes
prevention and education services by fostering the development of
new collaborative efforts for delivery of health care among rural
American Indians in residing in Pierre, Fort Pierre, and Aberdeen,
South Dakota. These towns have large American Indian populations:
Pierre (9 percent); Fort Pierre (5 percent); and Aberdeen (3 percent).
Keya program goals to be met by April 2009 include the following:
- Rural South Dakota Urban Indian Health clients
will witness a 12 percent average improvement in five targeted
risk factors (glucose levels, waist circumference, blood pressure,
high density lipoprotein, and triglycerides); and
- A framework for Keya Program sustainability
for working with rural South Dakota Urban Indian Health clients
will be developed. This will be accomplished through a variety
of health promotion and education activities targeting exercise
and diet, and through continued input from targeted clients.
This project aims to increase the quality and
years of a healthy life and to eliminate health disparities among
an estimated 873 rural South Dakota Urban Indian Health clients
at risk of diabetes development or who have diagnosed diabetes.
Several unmet health needs are noted: 1) Sioux American Indians
are generally younger, less likely to graduate from high school,
have lower incomes, and are poorer in comparison to other South
Dakotans, American Indians and all persons in the United States;
2) South Dakota American Indians have the greatest infant mortality
rate of any race or ethnic group in the United States; and 3) the
South Dakota median age of death due to all causes is 80 years for
whites, compared with 57 years for American Indians. The proposed
project has planned rural health care outreach services that address
social and belief differences of the target population. Linguistic
barriers are not present since the target population speaks English.
TENNESSEE
D04RH06938
Charlene Allen
Chief Operating Officer
Ridgeview Psychiatric Hospital and Center, Inc.
240 West Tyrone Road
Oak Ridge, Tennessee 37830
E-Mail: callen@ridgevw.com
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Substance abuse, Mental health
Each month, Anderson County, Tennessee, identifies
50 new cases of drug-endangered children (DEC) and/or drug-exposed
infants (DEI). Drug-endangered children are those children whose
parental drug use is endangering their lives. In Anderson County,
30 percent of the methamphetamine lab arrests include children in
the home. And this explosion of methamphetamine production occurs
in a community already ravaged by extremely high rates of oxycotin
and other drug addiction. Drug-exposed infants are newborn babies
whose mothers' drug use during pregnancy had a harmful impact on
that baby. These DEC/DEI are placed in custodial care of the natural
parents, a relative, or a foster parent, dependent of the individual
circumstances. The custodial parent lacks the knowledge and resources
to adequately address the medical, social, emotional, and behavioral
development of these at-risk children. By intervening with the family
at a critical time, we intend to prevent future problems for the
DEC/DEI and their family.
Our goals are to: 1) Ensure the DEC/DEI has a
stable, short-term environment (up to 6 months) that addresses the
child's physical, emotional, and social well-being; 2) Ensure the
parents have the skills and resources to provide positive parenting
in a drug free home environment and; 3) Assess and implement a drug
treatment plan for the abusing parent. The target number to serve
is 72 DEC/DEI families over the 3-year grant period.
Working with our county's Department of Children's
Services, Ridgeview Psychiatric Hospital and Center, Inc., will
partner with Methodist Medical Center, our region's primary medical
health provider, and Anderson County Health Council to deliver integrated
medical and mental health services to the 24 DEC/DEI and their families
per year immediately upon identification. The DECSS treatment team
consists of a registered nurse and a social worker who will conduct
assessments and implement treatment plans through a home visitation
model. The DECSS treatment intends to work with each DEC/DEI and
family for approximately 6 months to stabilize each family unit
and facilitate the family's participation with a long-term provider.
Our underlying strategy is to intervene when the family is most
vulnerable, yet open to learning. We also aim to provide immediate
support for critical concerns, and ensure the parents acquire the
child advocacy skills so as to prevent future medical, social, and
behavioral concerns.
The Drug Endangered Child
Outreach Network, which will oversee this project, is committed
to expanding the consortium to include additional community stakeholders.
The DECSS is being developed as a pilot prevention project designed
to address a problem that is reaching epidemic proportions in rural
America.
TEXAS
D04RH02913
Susan Rushing
The Burke Center
4101 South Medford Drive
Lufkin, Texas 75901
Phone: (936) 639-1141 Fax: (936) 639-1149
Email: susanr@burke-center.org
Fiscal Year 2004 2005 2006
Funding Amount $198,725 $198,725 $198,725
Keyword(s): Domestic violence, Mental health
Interpersonal violence within the family is a
national concern, with estimates of at least 2 million to 4 million
women each year being physically abused across the country. The
physical, emotional, and economic impact of this abuse is enormous
for women victims and their children. The Texas Council on Family
Violence (TCFV) conducted a telephone survey in 2002 regarding domestic
violence. They found that 74 percent of all Texans experienced or
know someone who has experienced some form of domestic violence.
Of the 59 percent that had personal experience, 26 percent had been
physically abused, and 31 percent report having been either physically
abused, sexually abused, or threatened by their partner at some
point in their lifetime. East Texas exemplifies these problems,
as there is a high incidence of family violence and widespread poverty,
which increases the risk of mental and physical health problems
for women and children in this area. East Texas has a significant
medically unserved and underserved population and faces a severe
shortage of mental health services. All nine counties in the service
area are designated as mental health professional shortage areas,
and 7 of the 9 counties are designated with a full medically underserved
area status.
CareLink, a collaborative initiative consisting
of the Burke Center, a regional community mental health center,
the Women's Shelter of East Texas (WSET), and East Texas Community
Health Services, a federally qualified health center, was formed
to improve access to comprehensive health screening and treatment
for victims of interpersonal violence in a nine county area of east
Texas. The initiative will blend systematic screening and assessment
for unmet health and mental health needs, health education, professional
consultation and training, and the direct delivery of mental health
and primary care to the target population of mostly women and children
served through the WSET. The ethnic background of the target population
is 65 percent Caucasian, 22 percent African American, 12 percent
Hispanic, and 1 percent Native American.
D04RH06796
Wanda Kennel
Executive Director
East Texas Border Health
401 N. Grove
Marshall, Texas 75670
Phone: (903) 938-1146
E-Mail: wkennel@etex.net
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $125,000 $100,000
Keyword(s): Health promotion/disease prevention
(general); Chronic disease; Mental health, Substance abuse
East Texas Border Health is a 501(c)(3) primary
care clinic in rural Harrison County, Texas. For this project, East
Texas Border Health has joined forces with Sabine Valley Center,
East Texas Council on Alcohol and Drug Abuse, Wiley College, and
United Churches Care to deliver integrated primary and mental health
care to isolated, chronically ill population groups in Harrison
and Marion counties. The target population for this project consists
primarily of low-income adults and children with unmet health care
needs, especially those with both chronic conditions (diabetes,
hypertension, respiratory illnesses) and mental illness.
The goals of this project are threefold: 1) To
enhance access to care for 3,000 primarily low income individuals
with chronic physical and mental illness over the three year grant
period; 2) To provide community-based health education designed
to address the deleterious effects of chronic illness and increase
capacity for self-care by 1,500 patients over 3 years; and 3) To
leverage the increased access to health care and health education
to improve treatment compliance and reduce related hospitalizations
of participants by 30 percent in 3 years.
Harrison and Marion counties are home to 73,381
residents. The counties' poverty level (17 percent) exceeds the
national average by 36 percent. Smaller communities like Marshall
and Jefferson have especially high rates, 22.8 percent and 32.9
percent, respectively. Nearly one in five residents is uninsured,
and East Texas Border Health is the counties' only provider of health
care without regard to ability to pay. Harrison and Marion counties
are designated as Health Professional Shortage and Medically Underserved
Areas. Inadequate health care resources and persistent isolation
have contributed to an overall mortality rate that surpasses Texas';
including especially high rates of death from cerebrovascular diseases,
chronic lower respiratory diseases, and diseases of the heart. Additionally,
over 10,000 adults and children in the counties have a serious mental
illness, and isolation and resource scarcity cause many to go untreated.
The resulting paranoia, confusion, and general distrust impede self-care
and primary care compliance, with dangerous effect for those who
also have chronic physical health conditions.
The consortium proposes to address existing health
care disparities and access issues by introducing three critical
resources. (1) A full time Registered Nurse (RN) will travel throughout
the counties holding outreach clinics at church facilities located
near highly isolated communities. These visits will be coordinated
by United Churches Care. Participating churches will identify congregants
and others with unmet physical or mental health care needs, assist
in making appointments with prospective patients, and provide transportation
if needed. East Texas Council on Alcohol and Drug Abuse will support
outreach and will connect patients with substance abuse problems
to available resources. East Texas Border Health will provide continuity
care for patients with chronic illness. (2) The RN will complete
a brief mental health assessment with each patient and will arrange
for Sabine Valley Center, the state designated Mental Health and
Mental Retardation Authority for Harrison and Marion counties, to
care and treat eligible individuals identified as having mental
health or substance abuse needs. (3) On the days that the RN is
seeing patients at the church, Project OutREACH from nearby Wiley
College will conduct health education classes in the waiting areas
on relevant physical and mental health topics.
D04RH06940
Brenda Harris
Matagorda Episcopal Health Outreach Program
101 Avenue F North
Bay City, Texas 77414
Phone: (979) 245-2008
E-Mail: bharris@mehop.org
Fiscal Year 2006 2007 2008
Funding Amount $147,108 $123,470 $98,935
Keyword(s): Dental care, Diabetes, Chronic Disease,
Telehealth
The members of the Matagorda-Wharton Health Access
Consortium are the Matagorda Episcopal Health Outreach Program (MEHOP),
the Stark Diabetes Center at the University of Texas Medical Branch,
and Victa Edwards, D.D.S., an independent contractor who provides
dental services out of MEHOP facilities. The service area is Matagorda
County, Texas, and the city of Wharton in Wharton County. Both of
these counties are rural and designated as medically underserved
areas. The target population is approximately 12,000 low-income,
uninsured residents of the service area.
The project has four goals: 1) To improve oral
hygiene among low-income residents in Matagorda and Wharton Counties,
and to expand a Tooth Fairy program in Wharton County; 2) To improve
understanding and treatment of diabetes and other chronic conditions,
and the ability of patients to self-manage care through the expansion
of interactive telehealth services for consumers and their families
and continuing education for providers; 3) To improve continuity
of care and reduce financial barriers to care through comprehensive
case management services for clients seeking medical, dental, or
social services; and 4) To advance public policy regarding dental
care, patient education, and case management services for low-income
and uninsured rural residents in Texas by sharing outcomes of program
activities with selected State and professional agencies and with
health professions educators.
MEHOP is a grassroots program established to meet
an identified need for health care services for poor residents of
all ages. It is the only provider of health and dental services
to the uninsured, low-income, heavily Hispanic (32 percent) population
of the service area. The clinic's clients have little access to
secondary and tertiary medical services, and no access to dental
services besides the dentist who contracts to provide care at the
MEHOP site. There also is a shortage of health education programs
for both patients and providers. Case management services to identify
and help remove barriers to care are available on a limited basis
but cannot keep up with the demand.
Grant funds will be used to like MEHOP as a practice
site for dental students at a nearby junior college, bringing a
currently unavailable service to the area. It also would fund an
expansion of the Tooth Fairy oral health education program for kindergarten
and first grade students in a local school district. Oral health
education programs would be available to older students and to the
community via videoconferencing technology developed as a result
of MEHOP's partnership with Stark Diabetes Center. The technology
will bring diabetes self-management classes from the Stark Center
to MEHOP patients and extend twice-monthly diabetes lectures to
local practitioners. Access to other services for diabetic patients
and other medical and dental patients with unmet needs will be enhanced
by expanding case management services.
D04RH06790
Kathy Ball
Chief Executive Officer
Lavaca Medical Center
1400 North Texana
Hallettsville, Texas 77964
Phone: (361) 798-3671, ext. 235
Email: kball@goliad.net
Fiscal Year 2006 2007 2008
Funding Amount $149,981 $122,314 $99,111
Keyword(s): Elderly
The Texas Independence Program (TIP) is designed
to reduce the need for long-term institutional placement and increase
options in the community for the 1,842 frail elderly and disabled
residents of Texas' Colorado, Lavaca, and Jackson Counties. TIP
will blend primary medical care with preventive and supportive services
through enhanced case management provided by project staff. Enhanced
case management includes financial and programmatic integration
of primary medical care with case management and home and community-based
services, thereby addressing the key risk factors associated with
institutionalization. TIP's voluntary enrollees will be served by
a panel of six physicians and mid-level practitioners, all of whom
are members of the TIP consortium.
TIP aims to increase the cost-efficiency of Medicaid
long-term care funds by using enhanced case management to eliminate
fragmented service delivery, promote self-care and informal caregiver
support, and reduce inappropriate emergency room use, multiple hospitalizations,
and nursing home placements caused by preventable medical complications.
The project service area is located between San
Antonio, Houston, and Corpus Christi, where the population density
(19.5 persons per square mile) is one-quarter that of the rest of
Texas and the United States (both 79.6 persons/square mile). In
addition to health insurance participation rates and income and
education levels significantly lower than Texas and the United States,
the region exhibits an increasingly elderly population distribution.
Fully 19 percent of the population is 65 years or older (Texas =
9.9 percent, United States = 12.4 percent).
TIP is governed by a 12-member board composed
of community hospital leaders, registered nurses with utilization
review and home health expertise, rural Health Clinic physicians
and mid-levels, and elderly consumers. TIP is based on nationally
recognized care models, including PACE (Program of All-inclusive
Care for the Elderly) and SOURCE (Service Options Using Resources
in Community Environments).
The TIP consortium has an evaluation plan
with process, outcome and impact measures designed to determine
the extent to which project activities result in cost efficiencies,
and improved health outcomes for the elderly and disabled. The consortium
will position TIP for sustainability by negotiating a home and community-based
services waiver under the authority of Section 1915(c) of the Social
Security Act with the state of Texas for enhanced case management,
and by replicating TIP in other Texas counties.
VERMONT
D04RH06800
Nancy Lanoue, ME.Ed.
Southern Vermont Area Health Education Center
365 River Street
Springfield, Vermont 05156
Phone: (802) 885-2126
E-Mail: nlanoue@vermontel.net
Fiscal Year 2006 2007 2008
Funding Amount $149,717 $124,947 $99,959
Keyword(s): Obesity
The Precision Valley Physical Activity and Nutrition
Consortium will increase youth and family access to physical activities
and increase opportunities for healthy food choices in Springfield
and Windsor, Vermont. This will be accomplished through an interdisciplinary
consortium that has put together a services network called the "30+5"
Nutrition and Physical Activity Intervention. "30+5" is
short for a recommendation to children and families to get at least
30 minutes of exercise and eat 5 fruits and vegetables daily. The
target population is youth 10-13 and their parents.
The intervention combines school nursing and primary
care expertise and judgment in clinical assessment with varied community
resources for referral. These practitioners will have more levels
of service available. The intervention will consist of a brief message
and an "action pack" full of information about how, when,
and where to find exercise and better nutrition opportunities including
family access to low-cost fruits and vegetables, nutrition classes,
and structured recreation programs. For youth, active and fun informal
sports programs will be increased through volunteer leaders and
scholarships for memberships and fees. A second level of intervention
consists of the "30+5" clinical dietitian consultant who
will counsel youth and families with an emphasis on wellness and
prevention using a community outreach model. All staff of the project
as well as consortium members will be working together to increase
education in the middle schools and the community about the importance
of physical activity and nutrition.
Both rural farm communities share a past
of machine tool manufacturing which is now only a shadow of what
it was a decade ago. Consequently, unemployment is the second highest
in the State. The rate of poverty among single-mother families is
between 60-70 percent. Median family income is $6,000-$7,000 below
the state median. Surveys including the 2003 Youth Risk Behavior
Survey in Vermont show that, in Springfield, 15 percent of students
are at risk of overweight and 13 percent are already overweight
in grades 8-12. In Windsor, 17 percent of students in grades 8-12
are at risk of being overweight, and another 17 percent are already
overweight. This target group was chosen because the consortium
believes that youth represent the most sustainable, long-term potential
for obesity-prevention efforts.
VIRGINIA
D04RH05297
Robert G. Goldsmith
People Incorporated of Southwest Virginia
1173 West Main Street
Abingdon, VA 24210
Phone: (276) 623-9000 Fax: (276) 628-2931
Email: rgoldsmith@peopleinc.net
Fiscal Year 2005 2006 2007
Funding Amount $200,000 $200,000 $200,000
Keyword(s): Physician Education
People Incorporated of Southwest Virginia and
its rural health outreach partners will serve low-income families
in Buchanan, Dickenson, Russell, and Washington counties, located
in rural southwest Virginia. Goals of the program are to improve
the overall health of low-income families in the four rural counties,
increase physician knowledge of community-based resources to support
low-income patients' self-efficacy, and provide community-based
experience to medical residents. The project will include home visits
by medical residents and human service providers, health education,
early intervention for children with special needs, and use of strengths-based
practices to assist families in developing self-sufficiency. The
consortium also will host an information exchange forum for human
service providers and physicians in the four counties. The project
will link physicians, medical residents, local health districts,
and human service providers.
The target population consists of 180 low-income
families served through the agency's Comprehensive Health Investment
Program (CHIP) and families with Medicaid-eligible children from
birth to age 6. The population in rural southwest Virginia is primarily
white (more than 96 percent) from Appalachian or Melungeon heritage.
For the estimated 19,679 low-income individuals residing in the
area, chronic illness is a way of life. Southwest Virginians age
35 to 54 die from diseases such as chronic liver disease, diabetes,
and heart disease at nearly twice the rate of residents from other
parts of the state, and they are 67 percent more likely to commit
suicide. Significant barriers to service include socioeconomic conditions
such as poverty and lack of health insurance, high unemployment,
and low education, coupled with geographic isolation and lack of
transportation. The service area includes officially designated
Health Professional Shortage Areas or Medically Underserved Communities
or Populations. All counties to be served through the project are
designated Medically Underserved Areas.
Consortium members include People Incorporated
of Southwest Virginia, the lead applicant; Mt. Rogers Health District;
CHIP of Virginia; and two private physicians.
D04RH06802
Debbie Lipes
Chief Executive Officer
Bath County Community Hospital
P.O. Drawer Z
Hot Springs, Virginia 24445
Phone: (540) 839-7059
E-Mail: bcchdl@bcchospital.org
Fiscal Year 2006 2007 2008
Funding Amount $147,318 $114,436 $99,954
Keyword(s): Health promotion/disease prevention
(general)
The Rural Health Outreach Consortium, a consortium
of health and human service agencies in Bath County, Virginia, has
formed to sponsor a community wellness program for county residents.
Bath County is a rural, sparsely populated county of 5,073 people
nestled in the Allegheny Mountains on the western border of central
Virginia. By providing free access to health screenings, the community-based
and employer-based HealthConnection Screening reaches out to those
whose access to health care has been limited by geographic isolation,
costs of health services, and fear or difficulty in seeing a physician.
A Bath County Community Hospital (BCCH) health care team of four-a
nurse practitioner, a registered nurse, a medication assistance
coordinator, and a program coordinator-will visit employer sites
and community centers where neighbors, fire and rescue volunteers,
and community leaders gather to learn their "health numbers."
These numbers are blood pressure, blood sugar, cholesterol, height,
weight, and body mass index. Patients will be advised of appropriate
follow-up to primary care providers and can come back to the next
HealthConnection Screening to check their progress. All tests will
be provided by the Bath County Community Hospital at no charge to
the participants.
For ongoing wellness care, residents will be encouraged
to enroll in HealthConnection Prevention, a preventive health care
package offering exams, appropriate ancillary services, such as
mammograms, and tracking of health care indicators for follow-up
and recall care. Patients will have the opportunity to change risky
behaviors and develop healthy habits at each visit with the nurse
practitioner or participating physician. Chronic care management,
medication assistance, and transportation help are all part of the
package.
These services are especially targeted to people
for whom the cost of a medical exam is a barrier, primarily those
who are uninsured (15-20 percent of the population) or underinsured,
and whose incomes fall below 300 percent of the poverty level. Free
or minimum fees will apply to those under 200 percent of poverty
(26 percent of population), and discounts up to 300 percent. All
exams and tests will be reasonably priced for out-of-pocket payment.
Free or reduced price medicines are available to eligible persons
upon enrollment with the medication assistance coordinator. Other
medication assistance may be available to those over the 200 percent
income level.
It is anticipated that 10 percent of the
Bath County population of 5,073 will be helped during the first
through third years of the project. Recording and tracking the health
indicators to remind and encourage residents to receive preventive
health care is a goal of the applicant, Bath County Community Hospital
(BCCH). By joining efforts with a consortium of community partners
(called the Rural Health Outreach Consortium)-such as the Bath County
Administration, the Bath County Health Department, the Bath County
Department of Social Services, members of the Bath County Fire and
Rescue Squads, Bath County Health Care Providers, the Allegheny
Highlands Free Clinic, and the Valley Program for Aging, Bath County
Community Hospital-the project hopes to see improved health behaviors
in county residents.
WASHINGTON
D04RH06795
Terri Trisler, R.D., C.D., M.S.
Yakima Valley Farm Workers Clinic
P.O. Box 190
Toppenish, Washington 98948
Phone: (509) 248-8602
E-Mail: territ@yvfwc.org
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $124,893 $100,000
Keyword(s): Diabetes, Obesity/overweight, Migrant
health
The goals of the Salud en Sus Manos (Health in Your Hands) project
are to reduce disparities in diabetes, obesity, and other nutrition-related
medical conditions; improve access to diabetes, obesity, and other
nutrition-related health services; and improve the quality of diabetes,
obesity, and other nutrition-related health services for Hispanic
and rural residents in the Yakima Valley in Washington. The strategies
of the project are to educate outpatient users, participants, and
community members on diabetes, obesity, and other nutrition-related
medical conditions; build community capacity by recruiting and training
diabetes self-management education staff and lay leaders; implement
a chronic care model for diabetes, obesity, and other nutrition-related
diagnoses and enhance the electronic registry for outpatient users
with these conditions.
Yakima Valley Farm Workers Clinic (YVFWC) users
with diabetes, obesity, and other nutrition-related medical conditions
in a pilot project showed the following poor health status: 70.4
percent had HbAlc >7, 46.5 percent had total cholesterol >200,
51.5 percent had total triglycerides >150, 39.4 percent had HDL
<40 (male), 67.7 percent had HDL <50 (female), 60.9 percent
had LDL >100, and 84.6 percent had BMI >25.
The activities of the Salud en Sus Manos
Project are as follows:
- YVFWC will provide medical nutrition education
and nutrition self-management education, for outpatient users
with diabetes, obesity, and other nutrition-related diagnoses.
- YVFWC and the Yakima Valley Memorial Hospital
(YVMH) will recruit, train, and mentor Lay Leaders who will provide
Tomando Control de su Salud (Taking Control of Your Health)/Chronic
Disease Self Management Program (CDSMP) workshops for community
participants.
- YVMH and Radio KDNA will provide weekly diabetes,
obesity, and other nutrition and self-management education radio
shows for community members, while Prosser Memorial Hospital will
provide diabetes self-management education for community members.
- YVFWC will assign Dr. Katherine Smalley to
provide medical nutrition education services.
- YVFWC will hire a Coordinator to provide coordination
of Tomando/CDSMP self-management education and contract with YVMH
to attend the Tomando/CDSMP master trainer training.
- YVMH will provide diabetes and obesity self-management
education via weekly radio shows, and Prosser Memorial Hospital
will contract a Diabetes Educator to develop and implement diabetes
self-management education.
- YVFWC will participate in the Washington State
Diabetes Collaborative.
- YVFWC will manage the Chronic Disease Electronic
Management System.
The Salud en Sus Manos consortium will target
Hispanic, low-income, and other underserved users with diabetes,
obesity, and other nutrition-related medical conditions in the rural
communities of Toppenish, Grandview, and Prosser, Washington. Compared
to the population in Yakima County, YVFWC users with nutrition-related
diagnoses are more likely to be Hispanic, older, poor, publicly
insured, uninsured, and speak Spanish.
WISCONSIN
D04RH04322
Judith Durkee
Alzheimer's Disease and Related Disorders Association, Inc.
203 Schiek Plaza
Rhinelander, Wisconsin 54501-3364
Phone: (715) 362-7779 Fax: (715) 362-1879
Email: judith.durkee@alz.org
Fiscal Year 2005 2006 2007
Funding Amount $191,577 $189,964 $192,758
Keyword(s): Dementia Services
This partnership project seeks to improve dementia
services and availability in northern Wisconsin. Alzheimer's disease
affects approximately 10 percent of the population age 65 and older
as well as a small number of persons between the ages of 35 and
65. Because the incidence of Alzheimer's disease appears to double
every 5 years after age 65, it is believed to affect nearly half
of all persons older than age 85. Population projections through
the next 30 years indicate that the number of Wisconsin residents
with Alzheimer's disease will increase significantly. This project
seeks to formulate a proactive rather than reactive approach to
the identified number one health concern in Wisconsin-Alzheimer's
disease-and will focus on three major areas of activity: dementia
care network development, rural educational outreach, and diagnostic
efficacy and clinic support and development. Project efforts will
link with local community health centers, rural health clinics,
Indian Health Service sites, local public health departments, and
primary medical care professionals. Impact of the project will increase
the capacity of primary care physicians and their staff, as well
as patient and care partner wellness and the prevention of care
partner stress-related diseases processes. The project will not
only build service capacity but will also affect service quality
and availability.
The estimated total population of persons age
65 and older living in the service area is 62,345: 1,021 African
Americans, 2,798 Hispanic, 1,144 Asian, and 11,688 Native American.
The estimated population of persons with Alzheimer's disease in
the proposed service area is 9,438, and the number is expected to
grow to 10,042 during 2010 and to 12,361 by 2020. The target population
is older adults, especially those with Alzheimer's disease.
This project will serve 16 counties in the rural
and underserved areas of northern Wisconsin. Thirteen of the counties
in the service area are Medically Underserved Communities. The project
service area includes seven sovereign tribal nations. The area poses
serious challenges and threats for persons affected by Alzheimer's
disease. Population centers are few and far between, and homes are
scattered throughout the area.
While the service area is attractive to vacationers,
the environment poses risks to travel, social, and service isolation,
and a risk of wandering and death for persons with Alzheimer's disease.
In addition, a higher percentage of persons age 65 and older live
alone in this area than in the state as a whole. Accessibility to
medical and support services is hampered by stigma, geography, and
availability. The counties served by this project are characterized
by relatively low population densities, smaller average household
sizes, and the clustering of resources outside this largely rural
service area, all of which create significant challenges and barriers.
Barriers to services include long, harsh winters with impassable
road conditions; variable road systems, which make travel difficult;
the potential for patients with Alzheimer's becoming lost in the
national forest or a deserted farm field; and lack of affordable
transportation. Other barriers include low literacy and cultural
differences experienced especially by Native Americans seeking treatment.
Consortium partners include the Alzheimer's Association
of Greater Wisconsin, the lead applicant; Wisconsin Alzheimer's
Institute; Northern Area Agency on Aging; and Northern Wisconsin
Area Health Education Center.
D04RH04323
Linda Lowery
Ho-Chunk Nation
N6520 Guy Road
Black River Falls, Wisconsin 54615-5405
Phone: (715) 284-9851 Fax: (715) 284-9592
Fiscal Year 2005 2006 2007
Funding Amount $189,902 $184,220 $188,762
Keyword(s): Diabetes, Obesity
An estimated 15 percent of children age 6 to 19
in the United States are overweight. The Ho-Chunk Nation data are
even more alarming-59.5 percent of children age 5 to 14 and 48.1
percent of children age 15 to 19 are overweight or at risk for overweight.
The ultimate goal of the Ho-Chunk Nation Youth
Fitness Project (HYFP) is to prevent, or at least delay, the onset
of type 2 diabetes among people of Ho-Chunk Nation, an already high-risk
ethnic group. This project will bring together resources and personnel
from an already successful Pediatric Fitness Clinic in a collaborative
effort to modify the overweight risk factor through improved eating
and activity habits. HYFP will expand the prior program to include
the following components: (1) offer 90 minutes of fitness, nutrition,
and wellness classes, twice a week, to all Ho-Chunk youth age 6
to 18, regardless of weight, for 16 weeks; (2) require parents of
the youth participants to attend weekly nutrition and fitness classes;
(3) have parents and youth meet weekly with a guidance counselor
who will promote positive self-esteem and overall well-being; (4)
offer the program to the Tomah/Wyeville area, which has not received
these services; and (5) implement the new program in Black River
Falls. The HYFP goal is to develop strategies for preventing and
reducing childhood overweight through fitness, nutrition, and counseling
that can be replicated in other communities and tribal organizations.
Parental involvement will be encouraged because parent support is
necessary in the success of the child's weight loss.
The target population is 400 Ho-Chunk youth age
6 to 18 and their parents who reside in the Tomah and Black River
Falls areas. The jurisdictional lands of the Ho-Chunk Nation, a
federally recognized Indian Tribe, cover a 16-county area in central
Wisconsin. The majority of the Ho-Chunk lands are located in rural
areas that lack access to specialized health care services with
the nearest being 50 miles.
The service area faces several other barriers
to health care. Ho-Chunk tribal members do not always feel comfortable
seeking non-tribal health services, especially with the stigma that
often goes with obesity. Until the establishment of HYFP, there
was no program addressing childhood overweight being offered within
the Black River Falls area and currently there is not a program
in Tomah. Treatment for obesity is not covered by most insurance
plans, and many families lack financial resources to travel to special
program service sites. Monroe and Jackson counties, where project
services will be provided, are Medically Underserved Populations
and Medically Underserved Areas. In addition, Ho-Chunk Health Care
Center serves a Medically Underserved Community.
Consortium partners include the Ho-Chunk
Division of Health, Ho-Chunk Education Department, Ho-Chunk Social
Services, and Tomah and Black River School Districts.
D04RH06792
Martin Schaller
Northeastern Wisconsin Area Health Education Center, Inc.,
804 Jay Street, Suite 201A
Manitowoc, Wisconsin 54220
Phone: (920) 652-0238
Fax: (920) 652-0617
E-Mail: martys@newahec.org
Fiscal Year 2006 2007 2008
Funding Amount $149,886 $124,944 $99,994
Keyword(s): Health promotion/disease prevention
(general)
This project will enhance the efforts of Healthiest
Manitowoc County 2010 (HMC2010) through the implementation of four
initiatives. HMC2010 is a broad-based, community-driven coalition
formed in 2004 to address the most critical health needs of Manitowoc
County. HMC2010 addresses six health priorities through seven Community
Health Improvement Committees (CHICs) and a Steering Committee.
The six health priorities of HMC2010 are as follows: physical activity
and nutrition; tobacco use; teen pregnancy and risky sexual behavior;
injury prevention; oral health; and alcohol and other substance
abuse. The First Initiative, Know Your Numbers, will build upon
current HMC2010 activities and will provide outreach and a comprehensive
health risk assessment to underserved adults, with follow-up counseling
and referral to community resources.
This is an overarching project that touches many
health care issues. For example, the rate of Manitowoc County adults
at healthy weight is currently 34 percent, compared to 42 percent
of Wisconsin residents. The Second Initiative, High School Peer
Health Education, will train high school students at three high
schools to creatively deliver key messages both to their peers and
to junior high school students that will inform and foster healthy
lifestyle choices regarding tobacco use, alcohol and drugs, risky
sexual behavior, and physical activity & nutrition.
Manitowoc County's (MC) teen pregnancy rate increased
33 percent between 1995 and 2002, compared to a 27 percent decrease
statewide; MC's rate for underage drinking arrests is 128 per 10,000
kids, compared to the state rate of 90 per 10,000; MC high school
student smoking rate is 29 percent compared to 24 percent statewide;
binge drinking among MC high school students is 30 percent compared
to 28 percent statewide; the percentage of MC high school students
achieving Healthy People 2010 nutrition (daily vegetable consumption)
and exercise (vigorous physical activity) targets is 23 percent
and 70 percent, respectively. The Third Initiative, Manitowoc County
Network for Child Passenger Safety, will enhance the county-wide
network for child passenger safety by ensuring there are an adequate
number of certified child passenger safety technicians at both hospitals
in the county to provide education to each family of newborns delivered
at their hospital, and provide outreach and education to the community
regarding child passenger seat safety. Need addressed: In the past
3 years, over 95 percent of child passenger safety seats presented
for car seat checks in Manitowoc County were installed incorrectly.
The Fourth Initiative, Healthy Teeth Healthy Kids, will provide
comprehensive preventive and restorative dental services to 1,305
Medicaid and uninsured children in elementary and middle schools
in the schools with the highest rate of poverty in the county.
Only 18 percent of Medicaid recipients in Manitowoc
County received dental care in the past year, compared with 23 percent
of Medicaid recipients statewide and 73 percent of the total Manitowoc
County population. Only one Manitowoc County dentist accepts pediatric
Medicaid patients.
D04RH06791
Lynn Ann Dehmlow
Wood County Health Department
184 North 2nd Street
Wisconsin Rapids, Wisconsin 54494
Phone: (715) 421-8911
E-Mail: ldehmlow@co.wood.wi.us
Fiscal Year 2006 2007 2008
Funding Amount $150,000 $200,000 $200,000
Keyword(s): Minority health, Occupational health
Currently, services available to the Hispanic
population are limited and fragmented across the four-county region.
Reliable data on this population are poor due to fears that the
Hispanic population has about accessing services and providing information
due to their immigration status. The overarching goal of this proposal
is to reduce health disparities in the Latino/Hispanic population
in a four county area by increasing access to health care, providing
health information and education, increasing direct health care
services, improving occupational health and safety and developing
community capacity and infrastructure to deliver culturally competent
health care services.
The Alliance for Hispanic Outreach and Regional
Awareness (AHORA) is a coalition formed by Wisconsin's Wood County
Health Department in September 2003 to assemble providers for discussion
about regional strengths and weaknesses in meeting the needs of
the rapidly growing Hispanic community in central Wisconsin. AHORA
includes representatives from the counties of Clark, Lincoln, Marathon,
Portage, and Wood. It has grown to include membership from 42 medical
and service providers, non-profit organizations, faith-based groups,
Latino service providers, and community volunteers both Hispanic
and non-Hispanic.
The model that will be used to provide health
and safety outreach for this proposed project is founded on the
community health outreach model. The project is designed to address
the health disparities and access issues in the Hispanic community
in four counties in the north central heartland of Wisconsin. The
counties are Wood, Marathon, Clark, and Lincoln counties. The community
health outreach services focus on four primary and interrelated
services including:
- Providing health information and referral using
a community health outreach worker approach that includes a toll-free
telephone help line and health navigators to assist Hispanic/Latino
individuals to access and benefit from community resources to
meet their needs;
- Provide health information to Hispanic families
and children through a home visitation model, with bilingual staff
that will use a curriculum to provide health information, but
will also address individuals' needs for information and support;
- Train bilingual health educators to provide
services to women infants and children in the Hispanic community
using a train the trainer model developed by the Wisconsin WIC
program; and
- Provide occupational health and safety information
to Hispanic workers and employers with a variety of educational
interventions including health fairs at employer locations, with
families, with children in schools, at churches, in the Spanish
newspaper, in the AHORA newsletter, and at Hispanic events like
the area soccer league.
This activity also impacts the Healthy People
2010 goal addressing socioeconomic factors that influence health.
It is believed that the development of the
partnerships created through this grant opportunity will provide
regional and cross systems coordination to better assess needs and
identify priorities for future systems and service development.
In addition, the sense of purpose created by unifying our goals
and creating a common vision and shared outcomes will drive the
development of quality services for the Hispanic population in north
central Wisconsin for years to come.
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