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  • 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.

  • Foundation for Quality Care, Inc. Mouth Care Without a Battle: Improving Oral Health Care for Older Adults in Nursing Homes Priority Area: Special Projects Fund $255,568

    Poor oral health—which is linked to pneumonia and can lead to hospitalization, intensive care, or death—is a rising issue for elderly people living in nursing homes. In particular, nursing home residents with dementia experience limited quality and frequency of oral health care because nursing home staff often feel that they are not adequately prepared to manage difficult behaviors that typically arise during care of these patients. Mouth Care Without a Battle (MCWB) is an evidence-based approach to daily mouth care (e.g., tooth brushing, flossing, care of the gums, and denture care) for people with cognitive and physical impairments. Combining best practices in dementia care and oral hygiene, the pilot program has shown improvements in health and overall quality of life for this population. In 2017, NYSHealth awarded Foundation for Quality Care (FQC) a grant to scale up MCWB so as to improve oral health care for nursing home patients with dementia.

  • Asian American Federation of New York Planning Grant: Addressing Asian American Mental Health Needs in New York City Priority Area: Special Projects Fund $75,000

    Mental illness is among the leading contributors of disease burden for New Yorkers, and the burden may be even more pronounced among Asian-American communities. In New York City, Asian Americans are the only racial group for which suicide is one of the top 10 leading causes of death. However, Asian Americans are less likely to seek and receive mental health care because of cultural stigma, insurance limits, and a dearth of culturally and linguistically competent service providers. Given the current trends, there is a need to develop strategies to reduce stigma and other barriers to mental health services, increase awareness of the mental health needs of pan-Asian residents in New York City, and foster greater collaboration between formal service systems and community resources to reach these residents. In 2017, NYSHealth awarded Asian American Federation of New York (AAF) a planning grant to identify and raise awareness of mental health issues affecting the New York City pan-Asian community and barriers associated with seeking and receiving care.

  • Be More America Breaking Bias in Health Care Priority Area: Special Projects Fund $150,000

    Unconscious biases are ingrained habits of thought that lead to errors in how people perceive, reason, and make decisions when interacting with others from different social, racial, and ethnic backgrounds. In the health care setting, unconscious bias can affect a provider’s line of questioning and lead to misdiagnosis; it can also affect body language and other subtle cues that cause patients to lose trust, withhold information, or fail to follow medical advice. To address the impact of unconscious bias on health care, Be More America created a series of in-person training workshops designed to reduce physician bias in medical decision-making. Based on the success of the in-person workshops, it then developed a prototype online training program. In 2017, NYSHealth awarded a grant to Be More America to scale up this work by deploying the online training program at New York City-based hospitals.

  • 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.

  • 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 the 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.

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