Tuba City Regional Health Care Corporation

SPECIAL DIABETES PROGRAM FOR INDIANS

CONGRESSIONALLY DIRECTED SPENDING FOR CONSTRUCTION PROJECTS

HEALTH CENTER CLUSTER

COVID-19 RESPONSE THROUGH COMMUNITY HEALTH WORKERS CAPACITY AND PARTNERSHIPS ACROSS THE NAVAJO NATION PROJECT

HEALTH CENTER CLUSTER

TUBA CITY HEALTH CARE CORPORATION SPECIAL DIABETES PROGRAM FOR INDIANS - THE HEALTH PROMOTION DISEASE PREVENTION (HPDP) PROGRAMS' ROLE WITHIN THE TUBA CITY REGIONAL HEALTH CARE CORPORATION (TCRHCC) IS TO PROVIDE DIABETES PREVENTION BEST PRACTICES IN SCHOOL HEALTH & COMMUNITY-BASED PHYSICAL ACTIVITIES. IN ADDITION, HPDP'S ROLE IS TO INCREASE PHYSICAL ACTIVITY AND HEALTH EDUCATION AMONG COMMUNITY MEMBERS AND THEIR FAMILIES. THE HPDP’S BIANNUAL FITNESSGRAM ASSESSMENT ASSESSES THE TUBA CITY SERVICE AREA SCHOOLS. IN 2019 THE FITNESSGRAM DATA HAS IDENTIFIED APPROXIMATELY 1,660 OVERWEIGHT AND OBESE STUDENTS, AGES 6-18, IN 11 SCHOOLS IN THE WESTERN AGENCY PORTION OF THE NAVAJO RESERVATION. THE HPDP CHILDHOOD OBESITY INTERVENTION PROGRAM WILL SERVE AS A RESOURCE TO BUILD THE CAPACITY OF SCHOOLS IN IMPLEMENTING EVIDENCE-BASED PROGRAMS AND STRATEGIES TO REDUCE DIABETES RISK. THE STRATEGY IS TO INTEGRATE THE SERVICES PROVIDED BY TCRHCC WITH AFTER-SCHOOL PROGRAMS, COMMUNITY PARTICIPATION WITH REGARD TO DECISION-MAKING, FAMILY ACTIVITIES, AND THE COLLECTION OF DATA TO SUPPORT THE ACTIVITIES. TO COMPLEMENT THESE STRATEGIES, TCRHCCS' APPROACH INCLUDES ACTIVITIES TO KEEP STUDENTS ENGAGED AS WELL AS SUPPORTING ACADEMIC SUCCESS IN THE CLASSROOM. ADDITIONALLY, THE HPDP COMMUNITY-BASED PHYSICAL ACTIVITIES TARGETS OVER 20,000 PARTICIPANTS/COMMUNITY MEMBERS IN THE WESTERN NAVAJO AGENCY. THE HPDP PROGRAM PROVIDES ACTIVITIES FOR YOUTH & ADULTS. THESE COMMUNITY-BASED PROGRAMS ARE CONDUCTED SEASONALLY THROUGHOUT THE YEAR. THE ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO: FAMILY WALKING/RUNNING SERIES, COMMUNITY SPORT LEAGUES, WEIGHT MANAGEMENT PROGRAMS, HEALTH EDUCATION CLASSES, SOCIAL MARKETING, SUMMER YOUTH ACTIVITIES, HEALTHY FOOD DEMONSTRATIONS, AND FITNESS CLASSES. THE HEALTHY LIVING CENTER (HLC) DIABETES EDUCATION AND CLINICAL NUTRITION (DECN) DEPARTMENT COLLABORATES WITH HEALTH PROMOTION DISEASE PREVENTION IN GRANT ACTIVITIES AND PROGRAM OBJECTIVES. HLC/DECN IS THE CLINICAL COMPONENT FOR THE FIGHT AGAINST DIABETES. THE HEALTHY LIVING CENTER/ DIABETES EDUCATION AND CLINICAL NUTRITION INCLUDES A DIABETES EDUCATION PROGRAM RECOGNIZED BY THE AMERICAN ASSOCIATION OF DIABETES EDUCATORS, WHICH ALLOWS REIMBURSEMENT FOR THE SERVICES THEY PROVIDE AND AS A INDICATOR OF THE QUALITY OF THOSE SERVICES. THE HLC /DECN PROVIDES GROUP AND INDIVIDUAL DIABETES SELF-MANAGEMENT EDUCATION, MEDICATION MANAGEMENT, MEDICAL NUTRITION THERAPY, FOOT EXAMS, RETINOPATHY SCREENING AS WELL AS GLUCOMETER TRAINING AND SUPPORT. NUTRITION THERAPY FOR HEALTH CONCERNS OTHER THAN DIABETES, SUCH AS OBESITY, PREGNANCY, AND HYPERLIPIDEMIA ARE ALSO AVAILABLE. THE HLC IS ALSO RESPONSIBLE FOR PROVIDING NUTRITION CARE AND DIABETES EDUCATION IN THE INPATIENT SETTING. THE HLC IS RESPONSIBLE FOR MAINTAINING THE DIABETES REGISTRY AND COMPLETING THE ANNUAL DIABETES AUDIT. THE HLC WORKS CLOSELY WITH PRIMARY CARE CLINICS TO COORDINATE REFERRALS AND ENSURE ADHERENCE TO DIABETES STANDARDS OF CARE. HLC PLAYS AN INTEGRAL ROLE IN THE TREATMENT OF DIABETES AND IS FOCUSED ON PROVIDING CULTURALLY SENSITIVE CARE TO REDUCE COMPLICATIONS ASSOCIATED WITH DIABETES.

SPECIAL DIABETES PROGRAM FOR INDIANS

SPECIAL DIABETES PROGRAM FOR INDIANS - DPP

ENDING HIV/HCV/SYPHILIS EPIDEMICS AT TCRHCC - TUBA CITY REGIONAL HEALTH CARE CORPORATION (TCRHCC) IS DEDICATED TO ENHANCING SEXUAL HEALTH AND STI MANAGEMENT ACROSS ITS EXTENSIVE SERVICE AREA, PARTICULARLY FOCUSING ON HIV, HEPATITIS C (HCV), AND SYPHILIS. ESTABLISHED IN 1975 AND WITH ITS PUBLIC HEALTH DEPARTMENT FOUNDED IN 2020, TCRHCC HAS DEVELOPED A ROBUST INFRASTRUCTURE TO ADDRESS THESE CRITICAL HEALTH CONCERNS. THE STI TEAM, FORMED IN FEBRUARY 2022, PLAYS A PIVOTAL ROLE IN THIS EFFORT, MANAGING CASES OF SYPHILIS, HIV, CHLAMYDIA, AND GONORRHEA THROUGH COMPREHENSIVE CASE MANAGEMENT, EDUCATION, AND FOLLOW-UP CARE. THE CORE ACTIVITIES OF THE PUBLIC HEALTH DEPARTMENT INCLUDE COORDINATING PATIENT CARE, ENSURING TIMELY TREATMENTS, AND MANAGING CONTACT INVESTIGATIONS TO PREVENT FURTHER TRANSMISSION OF STIS. PUBLIC HEALTH TECHNICIANS (PHTS) ARE INSTRUMENTAL IN THIS PROCESS, HANDLING APPOINTMENT SCHEDULING, REMINDERS, AND CASE TRANSFERS. THEY ALSO CONDUCT CONTACT INVESTIGATIONS, NOTIFY PARTNERS, AND PROVIDE ESSENTIAL SEXUAL HEALTH EDUCATION. TO SUPPORT THESE EFFORTS, TCRHCC EMPLOYS A COMPREHENSIVE STI MASTER SPREADSHEET FOR CASE TRACKING AND OUTCOME EVALUATION, ENSURING DATA-DRIVEN DECISION-MAKING. TCRHCC’S COMMITMENT TO COLLABORATION IS EVIDENT THROUGH ITS MULTIDISCIPLINARY STI CASE REVIEWS AND PARTNERSHIPS WITH EXTERNAL HEALTH ORGANIZATIONS, INCLUDING THE ARIZONA DEPARTMENT OF HEALTH. THIS COLLABORATIVE APPROACH ENHANCES SERVICE DELIVERY AND PUBLIC HEALTH OUTCOMES. ADDITIONALLY, TCRHCC’S STATUS AS THE SOLE REGIONAL TESTING CENTER WITHIN A 75-MILE RADIUS UNDERSCORES ITS CRITICAL ROLE IN STI TESTING AND TREATMENT IN ITS REMOTE SERVICE AREA. THE ORGANIZATION’S EXTENSIVE HEALTHCARE OFFERINGS INCLUDE PRIMARY AND SPECIALIZED CARE, EMERGENCY SERVICES, AND A GROUNDBREAKING CANCER CLINIC. THIS CLINIC INTEGRATES NATIVE HEALING PRACTICES WITH WESTERN MEDICINE, PROVIDING CULTURALLY SENSITIVE CANCER CARE. TCRHCC’S FEDERALLY QUALIFIED HEALTH CENTER (FQHC) MOBILE HEALTH PROGRAM EXTENDS ESSENTIAL SERVICES TO REMOTE AREAS, ENSURING COMPREHENSIVE CARE REACHES UNDERSERVED COMMUNITIES. LOOKING AHEAD, TCRHCC AIMS TO STRENGTHEN ITS STI PREVENTION, DIAGNOSIS, AND MANAGEMENT STRATEGIES THROUGH TARGETED INTERVENTIONS AND EXPANDED OUTREACH. PLANS INCLUDE INCREASING STI TESTING RATES BY 5-10%, IMPROVING PREP COVERAGE, AND ENHANCING PARTNER SERVICES. THE ORGANIZATION WILL ALSO IMPLEMENT ROUTINE HIV TESTING FOR ALL PATIENTS AGED 13-64 YEARS AND PRIORITIZE RAPID INITIATION OF HIV TREATMENT. TO EVALUATE ITS PROGRESS, TCRHCC WILL UTILIZE A DETAILED EVALUATION PLAN THAT INCLUDES TRACKING KEY METRICS, REGULAR REPORTING, AND COMMUNITY FEEDBACK. BY ESTABLISHING A BASELINE IN 2024 AND SYSTEMATICALLY ANALYZING DATA, TCRHCC WILL ASSESS THE EFFECTIVENESS OF ITS INITIATIVES AND MAKE INFORMED ADJUSTMENTS. ENGAGING THE COMMUNITY THROUGH SURVEYS AND FOCUS GROUPS WILL ALSO PROVIDE VALUABLE INSIGHTS INTO PROGRAM IMPACT AND AREAS FOR IMPROVEMENT. SECURING NEW FUNDING IS CRUCIAL FOR SUSTAINING AND EXPANDING TCRHCC’S STI ACTIVITIES, ESPECIALLY AS CURRENT GRANT-FUNDED POSITIONS ARE SET TO EXPIRE IN 2025. THIS SUPPORT WILL ENABLE TCRHCC TO CONTINUE ITS COMPREHENSIVE APPROACH TO STI MANAGEMENT AND MAKE SIGNIFICANT STRIDES TOWARD IMPROVING HEALTH OUTCOMES AND ENDING STI-RELATED DISPARITIES IN AI/AN COMMUNITIES.

METHAMPHETAMINE AND SUICIDE PREVENTION INITIATIVE (MSPI) PROGRAM

TCRHCC NATIVE CONNECTIONS PROGRAM

DOMESTIC VIOLENCE PREVENTION INITIATIVE

SUPPORTING TRIBAL PUBLIC HEALTH CAPACITY IN CORONAVIRUS PREPAREDNESS AND RESPONSE ? 2020

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM

RADIATION EXPOSURE SCREENING AND EDUCATION PROGRAM

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

THE GRANTS TO INDIAN TRIBAL GOVERNMENTS PROGRAM (REFERRED TO AS THE TRIBAL GOVERNMENTS PROGRAM) WAS AUTHORIZED TO ASSIST TRIBAL GOVERNMENTS AND AUTHORIZED DESIGNEES OF TRIBAL GOVERNMENTS TO RESPOND TO DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, SEX TRAFFICKING, AND STALKING IN THEIR COMMUNITIES. THE TRIBAL GOVERNMENTS PROGRAM SUPPORTS PROJECTS THAT:  (1) DECREASE THE INCIDENCE OF VIOLENT CRIME AGAINST INDIAN WOMEN; (2) STRENGTHEN THE CAPACITY OF INDIAN TRIBES TO EXERCISE THEIR SOVEREIGN AUTHORITY TO RESPOND TO VIOLENT CRIMES COMMITTED AGAINST INDIAN WOMEN; AND (3) ENSURE THAT PERPETRATORS OF VIOLENT CRIMES COMMITTED AGAINST INDIAN WOMEN ARE HELD ACCOUNTABLE FOR THEIR CRIMINAL BEHAVIOR. THE GRANTEE WILL IMPLEMENT THIS PROJECT IN COLLABORATION WITH EITHER A NONPROFIT, NONGOVERNMENTAL INDIAN VICTIM SERVICES PROGRAM, SUCH AS A DOMESTIC VIOLENCE SHELTER PROGRAM OR RAPE CRISIS CENTER; A NONPROFIT, NONGOVERNMENTAL TRIBAL DOMESTIC VIOLENCE OR SEXUAL ASSAULT COALITION; AND/OR AN ADVISORY COMMITTEE THAT INCLUDES WOMEN FROM THE COMMUNITY TO BE SERVED BY THE PROPOSED PROJECT.  THE TIMING FOR PERFORMANCE OF THIS AWARD IS 36 MONTHS.

ESTABLISHMENT OF TCRHCC OFFICE OF CULTURAL AND LANGUAGE RESOURCES

TUBA CITY REGIONAL HEALTH CARE CORPORATION SEXUAL ASSAULT NURSE EXAMINE/SEXUAL ASSAULT RESPONSE TEAM

TCRHCC STI PUBLIC HEALTH RESPONSE - TCRHCC IS A NONPROFIT, TRIBAL 638 ORGANIZATION IN COCONINO COUNTY, ARIZONA, AND IS THE SOLE HEALTH CARE PROVIDER IN THIS REGION OF OVER 33,000 NAVAJO, HOPI AND SAN JUAN SOUTHERN PAIUTES. TCRHCC IS PROPOSING TO USE COOPERATIVE AGREEMENT FUNDING TO INCREASE THE REACH AND EFFICIENCY OF ITS PHN STI CASE MANAGEMENT PROGRAM THROUGH DEVELOPMENT AND IMPLEMENTATION OF A CASE MANAGEMENT AND EPIDEMIOLOGY SOFTWARE PLATFORM, COMMUNITY OUTREACH, AND A TREATMENT INCENTIVE INITIATIVE. THE AMERICAN INDIAN COMMUNITIES THAT TCRHCC SERVE ARE DISPROPORTIONATELY IMPACTED BY STIS. RATE OF STIS AMONG AMERICAN INDIANS (AI) IN ARIZONA FAR EXCEED THE GENERAL POPULATION (CHLAMYDIA RATE IS 995 PER 100,000 FOR AI VS STATE AVERAGE OF 601; AND GONORRHEA 430 FOR AI VERSUS 85 FOR WHITES). SYPHILIS RATES HAVE CLIMBED DRAMATICALLY FOR AMERICAN INDIANS IN ARIZONA OVER THE PAST 5 YEARS, UP TO 105. THIS COMPARES TO A RATE OF JUST 19 FOR WHITES IN ARIZONA. ARIZONA HAS A MUCH HIGHER RATE OF CONGENITAL SYPHILIS (137 PER 100,000 LIVE BIRTHS) THAN THE UNITED STATES (49), AND THE RATE IS DRASTICALLY HIGHER AMONG AMERICAN INDIANS IN ARIZONA (621).THE TUBA CITY SERVICE AREA HAS SEEN A 500% INCREASE IN NEW SYPHILIS CASE BETWEEN 2019-2021. SO FAR IN 2022, THERE HAS BEEN AN ADDITIONAL 80% INCREASE IN SYPHILIS CASES OVER 2021 IN THE TUBA CITY SERVICE AREA. INCREASINGLY, NEW STI CASES ARE AMONG WOMEN OF CHILDBEARING AGE (58% OF NEW SYPHILIS CASES) - A SIGNIFICANT CHANGE FROM PRIOR EPIDEMICS WHICH OFTEN AFFECTED PRIMARILY MEN WHO HAVE SEX WITH MEN. THIS SHIFT REQUIRES DIFFERENT PUBLIC HEALTH AND CLINICAL STRATEGIES—AND MORE EPIDEMIOLOGICAL DATA TO BETTER UNDERSTAND THE TRENDS AND DEVELOP EFFECTIVE INTERVENTIONS. THERE IS A CRITICAL AND URGENT NEED TO IMPROVE IDENTIFICATION AND TREATMENT OF STIS IN THIS HIGH RISK POPULATION. TCRHCC HAS THE ESTABLISHED PHN CASE MANAGEMENT PROGRAM, BUT DESPERATELY NEEDS DATA SOFTWARE TO BETTER TRACK AND RESPOND TO OUTBREAKS AND TARGET SOCIAL NETWORK RESPONSE. TCRHCC’S GOALS FOR THIS PHN STI CASE MANAGEMENT PROGRAM ARE TO: DEVELOP AND FULLY IMPLEMENT A STI CASE MANAGEMENT SOFTWARE PLATFORM BY THE END OF GRANT YEAR 1 (2023); REVIEW AND REFINE PHN STI CASE MANAGEMENT POLICIES AND PROCEDURES, CREATE AN EVALUATION PLAN, AND IMPLEMENT A PATIENT SATISFACTION COLLECTION PROCESS BY END OF GRANT YEAR 1 (2023); INCREASE THE NUMBER OF SYPHILIS TESTS CONDUCTED BY TCRHCC ANNUALLY BY 200% BY THE END OF GRANT YEAR 5 (2027); TRACK AND MEASURE BASELINE SYPHILIS TREATMENT ADHERENCE BY THE END OF GRANT YEAR 2 (2024), AND IMPROVE THAT TREATMENT ADHERENCE RATE BY THE END OF GRANT YEAR 5 (2027) THROUGH PATIENT INCENTIVES; AND REDUCE THE NUMBER OF NEW SYPHILIS CASES IN THE TUBA CITY SERVICE UNIT BY AT LEAST 25% BY THE END OF GRANT YEAR 5 (2027). THE ANTICIPATED BENEFITS OF OUR PROPOSED ACTIVITIES FOR THE AMERICAN INDIAN COMMUNITIES WE SERVE INCLUDE: GREATER AWARENESS OF STI PREVENTION; DECREASE IN STI INFECTION RATES; INCREASE IN STI EARLY DETECTION AND TREATMENT; IMPROVED QUALITY AND CONTINUITY OF CARE USING THE PHN CASE MANAGEMENT MODEL; AND INCREASED PATIENT SATISFACTION.

INJURY PREVENTION PROGRAM AT TCRHCC

THE TRIBAL SEXUAL ASSAULT SERVICES PROGRAM (TSASP), WHICH IS AUTHORIZED BY 34 U.S.C. 12511(E), IS ONE OF FIVE GRANT PROGRAMS FUNDED WITHIN THE SEXUAL ASSAULT SERVICES PROGRAM (SASP). SASP WAS CREATED BY THE VIOLENCE AGAINST WOMEN AND DEPARTMENT OF JUSTICE REAUTHORIZATION ACT OF 2005 (VAWA 2005) AND IS THE FIRST FEDERAL FUNDING STREAM DEDICATED SOLELY TO THE PROVISION OF DIRECT INTERVENTION AND RELATED ASSISTANCE FOR VICTIMS OF SEXUAL ASSAULT. OVERALL, THE PURPOSE OF SASP IS TO PROVIDE INTERVENTION, ADVOCACY, ACCOMPANIMENT (E.G., ACCOMPANYING VICTIMS TO COURT, MEDICAL FACILITIES, POLICE DEPARTMENTS), SUPPORT SERVICES, AND RELATED ASSISTANCE FOR ADULT, YOUTH, AND CHILD VICTIMS OF SEXUAL ASSAULT, NON-OFFENDING FAMILY AND HOUSEHOLD MEMBERS OF VICTIMS, AND THOSE COLLATERALLY AFFECTED BY THE SEXUAL ASSAULT. TSASP SUPPORTS PROJECTS TO CREATE, MAINTAIN, AND EXPAND SUSTAINABLE SEXUAL ASSAULT SERVICES PROVIDED BY TRIBES, TRIBAL ORGANIZATIONS, AND NONPROFIT TRIBAL ORGANIZATIONS WITHIN INDIAN COUNTRY AND ALASKA NATIVE VILLAGES. WITH THIS FUNDING, TUBA CITY REGIONAL HEALTH CARE CORPORATION (TCRHCC) OFFERS A ROBUST ARRAY OF SERVICES FOR VICTIMS OF SEXUAL ASSAULT, INCLUDING VICTIM ADVOCACY, COLLABORATION WITH LAW ENFORCEMENT, SEXUAL ASSAULT FORENSIC EXAMS, AND FOLLOW-UP HEALTHCARE SERVICES FOR BOTH ADULTS AND CHILDREN. TCRHCC HAS SIGNIFICANTLY EXPANDED ITS CAPACITY TO PROVIDE CULTURALLY SENSITIVE, TRAUMA-INFORMED CARE TO VICTIMS OF SEXUAL VIOLENCE. THROUGH TSASP, TCRHCC WILL CONTINUE TO EXPAND ITS SERVICES TO BETTER SUPPORT VICTIMS OF SEXUAL VIOLENCE AND SUCCESSFULLY CARRIED OUT A COMPREHENSIVE RANGE OF PROJECT ACTIVITIES SUCH AS :1. PROVIDE CRISIS INTERVENTION SERVICES TO AT LEAST 120 SEXUAL ASSAULT VICTIMS AND FAMILY OR HOUSEHOLD MEMBERS; 2. PROVIDE ALL CLIENTS WITH RELEVANT INFORMATION AND REFERRALS; 3. IDENTIFY AT LEAST FOUR COMMUNITY-BASED, CULTURALLY SPECIFIC SERVICES AND SUPPORT TO INCLUDE IN REFERRAL SERVICES FOR SEXUAL ASSAULT VICTIMS; 4. DEVELOP NEW MATERIALS TO INFORM THE COMMUNITY OF SEXUAL ASSAULT VICTIM SERVICES AVAILABLE; AND 5. COMPLETE A DISABILITY NEEDS ASSESSMENT AND IMPLEMENT AT LEAST TWO NEW ACCESSIBILITY FEATURES TO IMPROVE SERVICES FOR SEXUAL ASSAULT VICTIMS WITH DISABILITIES AND THOSE WHO ARE DEAF OR HARD OF HEARING. THIS AWARDWILL BE A THREE-YEAR PROJECT.

HEALTH CENTER CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY (CARES) ACT FUNDING

SPECIAL DIABETES PROGRAM FOR INDIANS

PREVENTION OF ADULT CARIES STUDY (PACS) TUBA CITY CLINICAL CENTER

HEALTH CENTER INFRASTRUCTURE SUPPORT

EXPANDING SEXUAL ASSAULT NURSE EXAMINER (SANE) SERVICES AT TCRHCC

RADIATION EXPOSURE SCREENING AND EDUCATION PROGRAM - TUBA CITY REGIONAL HEALTH CARE CORPORATION (TCRHCC) SEEKS CONTINUED FUNDING FOR ITS RADIATION EXPOSURE SCREENING AND EDUCATION PROGRAM (RESEP) TO ADDRESS THE CRITICAL HEALTH NEEDS OF COMMUNITIES AFFECTED BY RADIATION EXPOSURE. TCRHCC, OPERATING UNDER THE INDIAN HEALTH SERVICE (IHS) P.L. 93-638, TITLE V SELF GOVERNANCE PROGRAM, AND A 501(C)(3) NONPROFIT, SERVES A LARGE AND DIVERSE POPULATION IN COCONINO COUNTY, ARIZONA, THROUGH ITS 73-BED HOSPITAL AND ASSOCIATED CLINICS. TCRHCC PROVIDES A WIDE RANGE OF HEALTHCARE SERVICES, INCLUDING PRIMARY CARE, DENTAL, BEHAVIORAL HEALTH, AND ANCILLARY SERVICES, AND EXTENDS ITS REACH TO REMOTE AREAS VIA ITS FEDERALLY QUALIFIED HEALTH CENTER MOBILE HEALTH PROGRAM. IN 2020, TCRHCC WAS AWARDED FUNDING TO ESTABLISH RESEP, WHICH HAS SUCCESSFULLY IMPLEMENTED RADIATION EXPOSURE SCREENING AND EDUCATION ACROSS THE WESTERN NAVAJO NATION. HOWEVER, THERE IS STILL A SIGNIFICANT LACK OF AWARENESS OF THE RESEP AND THE EFFECTS OF RADIATION THROUGHOUT THE REMOTE SERVICE AREA. CONTINUED FUNDING WILL ENABLE TCRHCC TO ENHANCE PROGRAM AWARENESS, FOCUSING ON EDUCATION ABOUT RADIATION EXPOSURE, EARLY DETECTION, AND ASSISTING WITH RADIATION EXPOSURE COMPENSATION ACT (RECA) CLAIMS. TCRHCC PROPOSES TO ENHANCE THE RESEP PROGRAM THROUGH THREE KEY OBJECTIVES: 1. REDESIGN EDUCATIONAL MATERIALS AND EXPAND OUTREACH: TCRHCC WILL REDESIGN EDUCATIONAL MATERIALS ON RADIOGENIC DISEASES AND REACH AT LEAST 200 INDIVIDUALS THROUGH TARGETED OUTREACH BY THE END OF THE PROJECT PERIOD. THE OUTREACH WILL INCLUDE COMMUNITY PRESENTATIONS, ADVERTISEMENTS, AND PARTICIPATION IN EVENTS, FACILITATED BY THE RESEP COORDINATOR. COLLABORATIONS WITH TCRHCC'S COMMUNICATIONS OFFICE WILL BOOST MEDIA VISIBILITY AND ENGAGEMENT, INCLUDING UPDATED NAVAJO-LANGUAGE RADIO ADS AND DIGITAL CONTENT. 2. CONDUCT RADIATION EXPOSURE SCREENINGS: RADIATION EXPOSURE SCREENINGS WILL BE CONDUCTED FOR AT LEAST 25 AT-RISK INDIVIDUALS WITHIN TCRHCC'S SERVICE AREA. SCREENINGS WILL COVER MEDICAL AND DEPRESSION ASSESSMENTS, OCCUPATIONAL HISTORY REVIEWS, PHYSICAL EXAMINATIONS, AND NECESSARY FOLLOW-UPS. THE TCRHCC CANCER TREATMENT CENTER, THE ONLY ONE WITHIN THE NAVAJO NATION, WILL HOST SCREENING CLINICS AND PROVIDE COMPREHENSIVE DIAGNOSTIC TESTING AND CASE MANAGEMENT. 3. ASSIST WITH RECA CLAIMS: TCRHCC WILL CONTINUE TO ASSIST ELIGIBLE COMMUNITY MEMBERS WITH RECA CLAIMS, ENSURING THEY RECEIVE THE SUPPORT NEEDED FOR COMPENSATION. THE RESEP COORDINATOR WILL LEAD THIS EFFORT, COORDINATING WITH OTHER RESEP OFFICES AND THE DEPARTMENT OF JUSTICE AS NEEDED. ONGOING CASE MANAGEMENT WILL TRACK PATIENT PROGRESS AND FACILITATE NECESSARY REFERRALS FOR FURTHER MEDICAL OR MENTAL HEALTH TREATMENT. BY SECURING CONTINUED FUNDING, TCRHCC AIMS TO SUSTAIN AND EXPAND RESEP, FURTHER ENHANCING ITS CAPACITY TO SERVE THOSE AFFECTED BY RADIATION EXPOSURE. THIS PROJECT WILL NOT ONLY PROVIDE CRITICAL HEALTH SCREENINGS AND SUPPORT BUT ALSO FOSTER COMMUNITY ENGAGEMENT AND EDUCATION, ULTIMATELY IMPROVING THE HEALTH AND WELL-BEING OF THE NAVAJO, HOPI, AND SAN JUAN SOUTHERN PAIUTE COMMUNITIES.

TCRHCC DEMENTIA PROGRAM

SPECIAL DIABETES PROGRAM

TRIBAL SEXUAL ASSAULT SERVICES PROGRAM AT TCRHCC

INJURY PREVENTION PROGRAM

TCRHCC TIPCAP PROJECT - TCRHCC SERVES A LARGE, RURAL POPULATION OF NAVAJO, HOPI, AND SAN JUAN SOUTHERN PAIUTE PEOPLE ACROSS MORE THAN 7,000 SQUARE MILES IN COCONINO AND NAVAJO COUNTIES, ARIZONA. AS A P.L. 93-638, TITLE V SELF-GOVERNANCE TRIBAL HEALTH ORGANIZATION, TCRHCC OPERATES A 73-BED HOSPITAL, SPECIALTY CLINICS, AND A FEDERALLY QUALIFIED HEALTH CENTER MOBILE HEALTH PROGRAM THAT REACHES SOME OF THE MOST REMOTE COMMUNITIES IN THE SOUTHWEST. THE PROPOSED PROJECT SEEKS FUNDING THROUGH PART 1 OF THE TIPCAP PROGRAM AND WILL EXPAND TCRHCC’S INJURY PREVENTION PROGRAM (IPP) TO ADDRESS FOUR LEADING CAUSES OF PREVENTABLE INJURY AND DEATH WITHIN ITS SERVICE AREA: MOTOR VEHICLE CRASHES (MVCS), INJURIES ASSOCIATED WITH ALCOHOL AND SUBSTANCE MISUSE, ELDER FALLS, AND SUICIDE. LOCAL AND STATE DATA CONFIRM THAT THESE INJURIES ACCOUNT FOR A DISPROPORTIONATE SHARE OF EMERGENCY DEPARTMENT VISITS, HOSPITALIZATIONS, AND FATALITIES AMONG AMERICAN INDIAN/ALASKA NATIVE POPULATIONS IN NORTHERN ARIZONA. TCRHCC’S FIVE-YEAR GOAL IS TO ACHIEVE A CONSISTENT FIVE PERCENT ANNUAL REDUCTION IN INJURIES AND FATALITIES RELATED TO MVCS AN INJURIES ASSOCIATED WITH ALCOHOL AND SUBSTANCE MISUSE. ADDITIONAL GOALS INCLUDE ACHIEVING FIVE PERCENT INCREASE IN OUTREACH AND EDUCATION RELATED TO ELDER FALLS AND SUICIDE PREVENTION. THE PROGRAM WILL PRIORITIZE MOTOR VEHICLE CRASH PREVENTION AND SUBSTANCE MISUSE IN YEARS 1 AND 2, FOLLOWED BY EXPANSION OF COMMUNITY EDUCATION IN ELDER FALLS AND SUICIDE PREVENTION. THE IPP WILL IMPLEMENT EVIDENCE-BASED AND EVIDENCE-INFORMED STRATEGIES ENDORSED BY THE CDC AND INDIAN HEALTH SERVICE IHS. THESE INCLUDE THE CHILD PASSENGER SAFETY PROGRAM, CDC OVERDOSE DATA TO ACTION FRAMEWORK, MATTER OF BALANCE, MENTAL HEALTH FIRST AID (MHFA) INTERVENTIONS WILL INCLUDE CAR SEAT CLINICS AND SAFETY CHECKPOINTS, NARCAN AND FENTANYL TEST STRIP DISTRIBUTION, HOME SAFETY ASSESSMENTS FOR ELDERS, AND CULTURALLY TAILORED SUICIDE PREVENTION EDUCATION. A FULL-TIME INJURY PREVENTION COORDINATOR (IPC), SUPERVISED BY THE ENVIRONMENTAL HEALTH OFFICER, WILL LEAD THE IMPLEMENTATION, DATA ANALYSIS, AND EVALUATION OF ALL PROGRAM ACTIVITIES. THE IPC WILL COORDINATE WITH MULTIDISCIPLINARY INTERNAL AND EXTERNAL PARTNERS TO ENSURE ALIGNMENT, IMPROVE EFFICIENCY, AND MAXIMIZE IMPACT. EVALUATION WILL BE GUIDED BY A MIXED-METHODS FRAMEWORK INTEGRATING QUANTITATIVE INJURY SURVEILLANCE AND QUALITATIVE COMMUNITY FEEDBACK. DATA WILL BE COLLECTED QUARTERLY THROUGH TCRHCC’S INJURY DATA SURVEILLANCE SYSTEM (IDSS) AND THE ELECTRONIC HEALTH RECORD (EHR) TO MONITOR TRENDS, MEASURE PERFORMANCE, AND INFORM QUALITY IMPROVEMENT. TCRHCC’S PROPOSED PART I INJURY PREVENTION PROGRAM WILL COMBINE CULTURAL RELEVANCE, COMMUNITY LEADERSHIP, AND DATA-DRIVEN PUBLIC HEALTH PRACTICES TO ADVANCE SAFETY, WELLNESS, AND SELF-DETERMINATION ACROSS THE TUBA CITY SERVICE AREA. EXPECTED OUTCOMES INCLUDE INCREASED SEATBELT AND CAR SEAT USE, REDUCED ALCOHOL-IMPAIRED DRIVING, FEWER OVERDOSE-RELATED HOSPITALIZATIONS AND DEATHS, IMPROVED ELDER SAFETY AND MOBILITY, EXPANDED COMMUNITY TRAINING IN SUICIDE PREVENTION AND CRISIS RESPONSE, AND STRENGTHENED LOCAL CAPACITY TO SUSTAIN INJURY PREVENTION EFFORTS BEYOND THE GRANT PERIOD.

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

FY 2023 EXPANDING COVID-19 VACCINATION

RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT PROGRAM

HEALTH CENTER CLUSTER PLANNING GRANTS

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

FY 2023 BRIDGE ACCESS PROGRAM

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION - PROJECT TITLE: TUBA CITY LONG TERM CARE FACILITY CONSTRUCTION APPLICANT NAME: TUBA CITY REGIONAL HEALTH CARE CORPORATION, INC. ADDRESS: 167 N. MAIN ST., P.O. BOX 600, TUBA CITY, AZ 86045-0600 PROJECT DIRECTOR: LYNETTE BONAR, RN, MBA, BSN PHONE NUMBER: 928-283-2797 E-MAIL: LYNETTE.BONAR@TCHEALTH.ORG WEBSITE: WWW.TCHEALTH.ORG NOFO: HRSA-22-134 CONGRESSIONALLY DIRECTED SPENDING: CONSTRUCTION PROJECTS FUNDING REQUESTED: $8,000,000 TUBA CITY REGIONAL HEALTH CARE CORPORATION (TCRHCC) IS AN INDIAN HEALTH SERVICE (IHS) P.L. 93-638, TITLE V SELF GOVERNANCE TRIBAL ORGANIZATION AND A 501(C)(3) NONPROFIT IN COCONINO COUNTY, ARIZONA. TCRHCC BEGAN OPERATION WITH 638 FUNDING IN 2002, CONTINUES TO GROW AS A REGIONAL COMMUNITY-BASED HEALTH CARE SYSTEM, AND ACHIEVED PATIENT-CENTERED MEDICAL HOME (PCMH) RECOGNITION IN 2020. TCRHCC PROVIDES COMPREHENSIVE PRIMARY CARE, DENTAL, BEHAVIORAL HEALTH, AND ANCILLARY SERVICES THROUGH ITS 73-BED HOSPITAL AND CLINICS IN TUBA CITY, AZ TO OVER 33,000 NAVAJO, HOPI AND SAN JUAN SOUTHERN PAIUTES. TCRHCC ALSO SERVES AS A REGIONAL REFERRAL MEDICAL CENTER FOR OVER 75,000 RESIDENTS ACROSS THE NAVAJO NATION AND HOUSES THE ONLY ONCOLOGY CENTER ON THE NAVAJO NATION. TCRHCC HAS BEEN INVITED TO APPLY FOR CDS FUNDING FOR CONSTRUCTION PROJECTS, TO SUPPORT CONSTRUCTION OF A LONG TERM CARE FACILITY ON TCRHCC’S EXISTING CAMPUS IN TUBA CITY: 167 N. MAIN STREET, TUBA CITY, AZ 86045. THE VISION OF THE TUBA CITY LONG TERM CARE (TCLTC) FACILITY IS “TO PROVIDE A SKILLED NURSING FACILITY THAT PROVIDES ALL 3 LEVELS OF CARE AND THAT MEET CULTURAL CARE NEEDS FOR THE COMMUNITY, PROVIDES HIGHER LEVEL AND QUALITY OF CARE, AND BRINGS NAVAJO ELDERS HOME.” THERE HAS BEEN A CRITICAL NEED FOR LONG TERM CARE IN THIS REMOTE REGION FOR DECADES. HUNDREDS OF ELDERS FROM THE WESTERN NAVAJO SERVICE AREA ARE IN LONG TERM CARE FACILITIES FAR FROM HOME, OVER HALF OF THEM IN PHOENIX (OVER 220 MILES AWAY FROM THEIR HOME COMMUNIT Y). THE TCLTC WILL PROVIDE SAFE AND CULTURALLY RESPONSIVE HOUSING FOR OUR NAVAJO ELDERS WHO NEED ADVANCED CARE, PRESERVING THEIR PERSONAL DIGNITY AND QUALITY OF LIFE BY PROVIDING CULTURALLY SPECIFIC SERVICES BY NAVAJO-SPEAKING STAFF. CDS FUNDING WILL BE UTILIZED FOR CONSTRUCTION EXPENSES OF THIS NEW FACILITY TO BE BUILT ON THE TCRHCC MEDICAL CAMPUS: A 3-STORY, APPROXIMATELY 75,200 SQUARE FEET NEW BUILDING WITH CONNECTOR CORRIDORS TO THE EXISTING HOSPITAL. THE TCLTC WILL INCLUDE 90 BEDS FOR LONG TERM CARE RESIDENTS, ACTIVITY ROOMS, COMMERCIAL KITCHEN, RESIDENT DINING AREA AND OFFICES. THE NEW FACILITY WILL ALSO HOUSE A NEW ONCOLOGY SUITE, PHYSICAL THERAPY AND RELATED SUPPORT SPACES. TCRHCC IS NEARLY DONE WITH THE PLANNING AND DESIGN PHASE OF THE PROJECT, HAS OBTAINED REQUIRED PERMITS, AND COMPLETED FEDERAL ENVIRONMENTAL AND HISTORIC PRESERVATION REQUIREMENTS. THIS APPLICATION REQUESTS $8,000,000 TO SUPPORT TOTAL CONSTRUCTION, WITH THE REMAINING CONSTRUCTION COSTS COMING FROM OTHER FUNDING SOURCES INCLUDING THE NAVAJO NATION, TCRHCC, AND A USDA LOAN. CONSTRUCTION IS ANTICIPATED TO BEGIN DECEMBER 2022 AND BE COMPLETED BY DECEMBER 2024.

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM