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  • Jericho Road Ministries Expanding Access to Primary Care in Buffalo’s Underserved East Side Priority Area: Special Projects Fund $200,000

    Buffalo is among the poorest large cities in the nation, with many of its residents facing a multitude of health challenges and barriers to primary care and community supports. Currently, four of the poorest ZIP codes in Buffalo’s East Side do not have adequate access to primary care, with an estimated individual-to-primary care physician ratio greatly exceeding that required to qualify as a Primary Care Health Provider Shortage Area. Jericho Road Community Health Center, a federally qualified health center (FQHC), provides primary care services to more than 12,000 patients in the Buffalo region. To fill the gaps in service caused by closures of other East Side clinics, Jericho Road completed a 10-year strategic plan that outlined the development of a new community health center on Buffalo’s East Side to provide health care and wraparound services for underserved and low-income residents. In 2017, NYSHealth awarded Jericho Road Ministries a grant to expand the FQHC and provide primary care services to additional underserved residents of Buffalo’s East Side.

  • New York Lawyers for the Public Interest Detained and Denied: Improving Health Care Access for Immigrant Detainees Priority Area: Special Projects Fund $200,000

    Each year, thousands of New York City residents are detained in U.S. Immigration and Customs Enforcement (ICE) detention jails. Although not charged with criminal violations, they are primarily held to ensure that they attend future hearings concerning their immigration status. Most of these detainees are lawful permanent residents (predominantly green card holders) and people who have lived in this country for decades, maintained employment, raised families, and had access to health care in the community through Medicaid or private insurance. But detention breaks that connection, making them reliant on the immigration detention facility, a local county jail, and ICE for health care services, some of which fail to provide adequate medical treatment. Among the many barriers to quality health care faced by immigrants in detention are a lack of information on requesting assistance, denial of health and mental health services, and a lack of discharge planning. In 2017, NYSHealth awarded New York Lawyers for the Public Interest (NYPLI) a grant to develop and launch a comprehensive program to ensure that immigrants with serious illnesses who are confined to detention facilities receive adequate health care services while in custody and access to health care upon their release.

  • Cornell University, Joan & Sanford I. Weill Medical College Addressing the Opioid Epidemic by Improving the Electronic Health Record Prescription Process Priority Area: Special Projects Fund $189,354

    The opioid epidemic continues to wreak havoc throughout New York State and across the nation. In 2014, prescription opioids were responsible for more than 2,000 overdose deaths in New York State and 19,000 throughout the United States. In 2015, these deaths reached a historic record, exceeding deaths from guns or cars, and even the toll from the HIV/AIDS epidemic at its peak in 1995. One of several critical factors causing the opioid epidemic is physician-prescribing practices. Almost all prescription opioids involved in use or overdose originate from misused or diverted prescriptions. Misused prescription opioids also contribute to the epidemic of heroin use and heroin and fentanyl fatalities. In 2017, NYSHealth awarded Weill Cornell Medicine a grant to encourage physicians at hospitals and federally qualified health centers (FQHCs) to prescribe opioids at levels consistent with Centers for Disease Control and Prevention (CDC) guidelines.

  • Health Research Inc. Reducing HIV/STDs in Western New York with Embedded Partner Services Priority Area: Special Projects Fund 250,000

    Western New York, including areas such as Buffalo, Rochester, Erie, Monroe, and Jamestown, is experiencing a noticeable increase in cases of HIV, chlamydia, gonorrhea, and syphilis. African Americans and Hispanics are the most heavily affected; in the region, 70% of people newly diagnosed with HIV and 49% newly diagnosed with syphilis are people of color. Similarly, the greatest burden of gonorrhea and chlamydia is seen among people of color in Western New York. While the overall number of newly diagnosed people living with HIV has decreased by 25% since 2010, the region surrounding Buffalo and Rochester saw increases in new HIV diagnoses between 2014 and 2015. In Erie County, a total of 120 residents were newly diagnosed with HIV in 2015, 20% higher than the 2011–2014 annual average. In 2017, NYSHealth awarded Health Research, Inc., a grant to address the increasing HIV/STD morbidity in Western New York through the New York State Department of Health (NYSDOH).

  • Medicare Rights Center, Inc. After Fully Integrated Duals Advantage (FIDA): What’s Next for New York’s Dual-Eligible Population? Priority Area: Special Projects Fund $50,000

    New York is one of 15 states originally selected to receive demonstration planning grants from the federal government to launch managed care demonstration models for people covered by both Medicare and Medicaid (known as dual eligibles). The goal of the demonstration was to provide more coordinated care at lower cost to dual eligibles, often the most vulnerable and high-cost beneficiaries. Under its duals demonstration, New York State launched the Fully Integrated Duals Advantage (FIDA) program in select downstate counties in 2015. FIDA sought to help the 124,000 New Yorkers initially estimated to be eligible for the demonstration. Unfortunately, FIDA had very low enrollment and received little support from providers. Today, only 4,600 New Yorkers are enrolled in one of 17 FIDA plans, out of an estimated 840,000 residents considered dual eligible. Although FIDA was unsuccessful, the needs of dual eligibles that motivated the program have not gone away. In 2017, NYSHealth awarded Medicare Rights Center a grant to develop a meaningful replacement program to meet the initial promise of FIDA.

  • Amida Care A Value-Based Payment Structure for an Innovator ACO Focused on HIV Population Health Priority Area: Special Projects Fund $329,949

    Ending the Epidemic 2020 is an ambitious blueprint to reduce new HIV infections, prevent disease progression, and relieve poverty in New York State. Concurrently, the State’s Medicaid program is implementing a value-based payment program that will transition away from fee-for-service payment toward a payment model based on an agreed-upon set of health outcome goals. This payment model includes the VBP Innovator Program, a new incentive program for providers to keep 100% of any savings realized from improvements in health outcomes. The VBP Innovator program offers community-based organizations (CBOs) and community health centers (CHCs) that serve HIV/AIDS populations a unique opportunity to advance Ending the Epidemic 2020 goals—allowing them to reinvest savings in innovated ways that improve the quality of care for people living with HIV/AIDS. In 2017, NYSHealth awarded Amida Care a grant to develop an innovative value-based payment structure and provide training and assistance to several New York City CHCs and CBOs partnering in a new HIV-focused VBP Innovator accountable care organization (IACO).

  • New York Immigration Coalition, Inc. Supporting Immigrant Health Care Access in the New Political Landscape Priority Area: Special Projects Fund 121,730

    Under the current administration, New Yorkers face the rollback of core health care protections in the face of potentially massive federal changes to health care financing, publicly financed health insurance, and a wide range of public benefits. Arguably no population in New York State is more vulnerable to losing ground than our immigrant communities, especially those who are undocumented. Recent events and threats have created a climate of fear and mistrust within immigrant communities, which is affecting their ability to access—and level of comfort with accessing—health insurance coverage and care. In 2017, NYSHealth awarded the New York Immigration Coalition (NYIC) a grant to support immigrant health care access during these uncertain times.

  • HCA Education and Research (dba Home Care Association of New York State) Expansion of a Community-Based Sepsis Prevention and Early Recognition Screening Tool Priority Area: Special Projects Fund $149,749

    Sepsis is an overwhelming, swift, debilitating, and deadly bodily response to infection. In New York State, approximately 50,000 patients are diagnosed with severe sepsis or septic shock each year; of those, 30% of adults and 9% of children die in the hospital from sepsis. Additionally, it is the number one diagnosis for 30‐day all-cause readmissions for New York State hospitals. Although more than 80% of sepsis cases originate outside of the hospital, no home or community sepsis screening and intervention system had existed in the United States prior to 2015. Patients in home care are at particular risk for sepsis, and the condition often goes unnoticed until it becomes life-threatening. To address this issue, the Centers for Medicare & Medicaid Services initiated in 2015 a large regional pilot of a sepsis screening tool in the Capital District and Central New York regions, which was subsequently endorsed by the Centers for Disease Control and Prevention. In 2017, NYSHealth awarded Home Care Association of New York State (HCA) a grant to expand the screening tool to all home care agencies in the State.

  • Empire Center for Public Policy, Inc. Should For-Profit Hospitals Be Allowed in New York State? Priority Area: Special Projects Fund $53,500

    New York is one of four states that prohibits for-profit hospitals owned by publicly traded companies from operating in the market. Over the past seven years, New York State lawmakers have debated changing or eliminating the prohibition on for-profit hospitals. Proponents believe that allowing for-profit hospitals to operate within the State would alleviate the chronic shortage of capital funding for hospitals and bring competition and efficiency to the market. Opponents hold that for-profit hospitals focus too much on short-term profits and weaken institutions serving the poor and other marginalized groups. In 2017, NYSHealth awarded the Empire Center for Public Policy a grant to assess whether New York State’s hospital ownership laws should be changed to allow for shareholder-owned, for-profit ownership.

  • Schuyler Center for Analysis and Advocacy Enhancing Oral Health and Developing a Blueprint for Sustainable Success Priority Area: Special Projects Fund $175,000

    Although oral health in the United States has improved overall, tooth decay remains the most common chronic childhood disease—five times more prevalent than asthma. Low-income and minority families in particular bear a high burden of dental problems, but are less likely than middle- or high-income families to have access to preventive dental services. In 2013, NYSHealth supported the Schuyler Center for Analysis and Advocacy in efforts to educate policymakers and communities in New York State about dental disease and make recommendations for policies to improve population oral health across socioeconomic status, race, and age. In 2017, NYSHealth awarded the Schuyler Center a grant to further this statewide oral health campaign.

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