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  • Trustees of the University of Pennsylvania From Crisis to Solutions: Cost Analysis and Interventions for Aging Homeless Adults Priority Area: Special Projects Fund $123,599

    Homelessness has steadily increased in New York State, with the large majority of the State’s homeless population residing in New York City. People who experience homelessness often have a complex array of illnesses or other serious disabilities, which leads to high use of hospital-based care and health care costs. As the homeless adult population ages, there will be corresponding increases in health care needs and costs. Studies have found that homeless people age prematurely and have very high rates of geriatric health issues at younger ages compared with people who are not homeless. To mitigate this potential crisis, the University of Pennsylvania School of Policy & Practice (Penn SP2) will conduct multistate, data-driven research and analysis on the health care utilization, needs, and costs of people who are homeless and ages 55 and older. In 2017, NYSHealth awarded a grant to Penn SP2 to support New York State’s participation in this national effort.

  • University of Rochester Project ECHO – Expanding and Achieving Financial Sustainability of ECHO PSYCH in New York State Priority Area: Special Projects Fund $50,000

    Project ECHO®, which originated at the University of New Mexico, is an innovative model of health care education and delivery that can significantly improve the treatment of chronic and complex diseases for rural and underserved populations. Unlike the typical telemedicine service model, the Project ECHO model uses Web-based videoconferencing to create virtual grand rounds, which dramatically increase access to specialty treatment in rural and underserved areas by providing front-line physicians with the knowledge and support they need to manage patients with complex conditions. It does this by engaging primary care physicians at rural sites in a continuous learning system and virtually partnering them with an interdisciplinary team of specialist mentors (e.g., psychiatry, nursing, social work, psychology, pharmacy) at an academic medical center. In 2014, NYSHealth awarded a grant to University of Rochester Medical Center (URMC) to launch ECHO GEMH, the first Project ECHO clinic in New York State. ECHO GEMH equipped primary care providers in rural counties across New York State with the skills to provide geriatric mental health services in underserved communities. In 2017, NYSHealth awarded a grant to URMC to support the continuation and expansion of Project ECHO.

  • New York University School of Medicine Enhancing Rural Health Surveillance by Using Geospatial Analysis to Identify Local Disease Hot Spots Priority Area: Special Projects Fund $300,000

    Without the necessary resources to perform sophisticated health surveillance, Sullivan County Public Health Services is limited in its ability to target and prioritize initiatives to help improve health outcomes for the county’s residents, of whom more than 80% live in rural regions. Accurately capturing and estimating health surveillance data to pinpoint the health needs of residents is often too costly or labor intensive for most rural health departments. To address this issue, New York University School of Medicine’s (NYU) Health Geographics Research Initiative has developed a method for using data to create highly detailed and localized maps of disease burden. In 2016, NYSHealth awarded a grant to NYU to work with Sullivan County Public Health Services on developing and validating its method to enhance rural health surveillance.

  • JustLeadershipUSA, Inc., (fiscal sponsor to Katal Center for Health, Equity, and Justice, Inc.) Replicating the Law Enforcement Assisted Diversion (LEAD) Model in Staten Island Priority Area: Special Projects Fund $199,318

    LEAD is an evidence-based, harm reduction-oriented program designed to reduce low-level arrests and recidivism and promote better health outcomes. Instead of making an arrest for certain criminal offenses (such as low-level drug charges), police officers, prosecutors, and defense attorneys work together to divert individuals directly to a case manager, who then facilitates access to a comprehensive network of services for drug addiction, alcoholism, mental illness, and other health-related issues. These individuals receive intensive case management and targeted social services, with greater coordination among systems of care. In 2014, the city of Albany, with NYSHealth support, launched its own LEAD program, making it the first jurisdiction on the East Coast and only the third in the nation with this program. In 2016, NYSHealth awarded a grant to JustLeadershipUSA, a fiscal sponsor to Katal Center for Health, Equity, and Justice (Katal), to help replicate LEAD on Staten Island, which has been struggling with its own devastating opioid epidemic.

  • American Cancer Society Statewide Convening on Electronic (E-Cigarette) and Other Alternative Nicotine Delivery Systems Priority Area: Special Projects Fund $50,000

    Electronic Nicotine Delivery Systems (ENDS), otherwise known as e-cigarettes and vapes, are a relatively new and controversial phenomenon in New York State, nationally, and internationally. E-cigarettes are a growing concern for many in the public health field because of their rapid uptake and popularity—especially among youth—and a lack of research on their impact on health, particularly in regards to e-cigarettes as a gateway for future cigarette use in teens. The perception that e-cigarettes are less harmful than smoking, the absence of enforcement regulations on indoor use, and the popularity of vape shops as a destination for socializing are also contributing to the problem. With research on the dangers of ENDS emerging and new policy directives underway, now is a good time for stakeholders within New York State to take stock of these developments and lay out next steps. In 2016, NYSHealth awarded a grant to the American Cancer Society (ACS) to convene a group of expert stakeholders to discuss and recommend statewide strategies to address ENDS use in New York State.

  • Adaptive Design Association, Inc. Integrating Adaptive Design Services into Managed Care Priority Area: Special Projects Fund $25,000

    Standardized equipment for children with disabilities serves many purposes, but cannot meet all the requirements of children with nonstandard body types and learning needs. Adaptive Design Association (ADA) builds custom adaptations to wheelchairs, hearing aids, and modified computers—using a collaborative design process with members of the child’s care team—that allow children with disabilities to be more independent at home, in school, and in the community, as well as improve their physical and emotional health. Currently, the majority of adaptations and educational services provided are covered by grants from private and community foundations, which is not sustainable. As New York State moves towards a new reimbursement system under Medicaid Redesign and the Delivery System Reform Incentive Payment (DSRIP) program, ADA received funding from the New York Community Trust to hire a managed care consultant to explore reimbursement possibilities for its services. In 2016, NYSHealth awarded ADA a grant to supplement the consultant’s work to ensure financial sustainability of ADA services.

  • Fund for the City of New York, Inc. Collaborative Connections to Care Fund for Mental Health Priority Area: Special Projects Fund $300,000

    At least one in five New Yorkers will experience a mental health disorder in any given year. Front-line staff at community-based organizations (CBOs) report that many clients often appear depressed or anxious, which they suspect may interfere with clients’ ability to succeed in programs. However, with limited mental health training, staff at these organizations are unprepared to deal with clients’ emotional and/or behavioral problems. In response to this issue, New York City has released a plan to guide an overhaul of the City’s mental health services. A key component of the initiative is Connections To Care (C2C), a public-private partnership that aims to build mental illness prevention and treatment capacity of CBOs that work in the areas of workforce development, education, and early childhood services. In 2016, NYSHealth awarded Fund for the City of New York a grant, in partnership with the Altman Foundation, to support CBOs in building their capacity to help low-income New Yorkers receive mental health care.

  • Montefiore Medical Center Using a Continuum-based Framework to Implement Behavioral Health Integration in Primary Care Settings in New York State Priority Area: Special Projects Fund $215,670

    The need to integrate high-quality treatment and management of depression, anxiety, and other common behavioral health conditions into primary care has been well documented. Furthermore, most patients prefer receiving behavioral health treatment from providers with whom they already have an established relationship, such as their primary care providers. However, integrating behavioral health into primary care practices remains a challenge because of the varying structures and sizes of these practices across the State. Through a review of best-practice integration models and substantial input from various experts and stakeholders, Montefiore Medical Center (Montefiore) developed a framework that delineates a series of steps that practices can take to integrate behavioral health services and track progress based on a practice’s available resources, size, and structure. In 2016, NYSHealth awarded a grant to Montefiore, with co-funding from United Hospital Fund, to provide a practical implementation approach to integrating behavioral health services in primary care practices.

  • Community Healthcare Network, Inc. Enhancing the Use, Role, and Retention of Nurse Practitioners in New York State Priority Area: Special Projects Fund $177,169

    Primary care physician shortage is a major issue and is predicted to worsen, but there are cost-effective solutions that do not sacrifice quality of care to mitigate this problem. For instance, nurse practitioner (NP) visits cost less than physician visits, and the outcomes of NP-provided care are equivalent to those of a physician. However, NPs face barriers in practicing to the full extent of their scope of practice, which in turn may lead to their high turnover rate at medical facilities, especially in federally qualified health centers (FQHCs) that provide care for the medically underserved. To address this issue, Community Healthcare Network (CHN) developed the New York State Community Health Workforce Initiative (CHWI) model, which helps NPs perform to their fullest scope of practice. In 2016, NYSHealth awarded CHN a grant to help health care organizations across the State use its model to improve the work environment for and maximize the use of NPs in primary care and behavioral health settings.

  • The American Congress of Obstetricians and Gynecologists Women, Pregnancy, and the Opioid Epidemic in Upstate New York: A Health Care Provider Educational Approach Priority Area: Special Projects Fund $224,681

    Opioid use—which includes heroin and prescription drug use—is rising at a fast rate in New York State, including among pregnant women. Opiate use during pregnancy can also affect newborns, resulting in neonatal abstinence syndrome, a drug withdrawal syndrome in newborns that is also growing in incidence. Given this trend, pregnancy may be an effective time for obstetricians and gynecologists to initiate treatment, decrease high-risk behavior, and optimize maternal and infant health. However, clinicians often lack familiarity with key guidelines related to opioid use and safety, knowledge about opioid addiction, and the necessary skills to address the unique needs of these patients. In 2016, NYSHealth awarded American Congress of Obstetricians and Gynecologists (ACOG) a grant to improve knowledge and awareness of opioid use and safety in pregnant women among obstetricians and gynecologists.

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