Tuolumne Me-Wuk Indian Health Center Inc

ME WU - YA - TUOLUMNE ME WUK INDIAN HEALTH CENTER MEDICALLY ASSISTED THERAPY PROGRAMMING - DEATHS FROM OPIOID OVERDOSES HAVE INCREASED IN TUOLUMNE COUNTY SINCE 2019 - OUR LOCAL COUNTY OFFICIALS DESCRIBE OPIOID USE IN OUR COMMUNITY AS A CRISIS. OVERDOSE DEATH RATES AFFIRM THEIR CONCERN: 2017 � 5 DEATHS; 2018-56 DEATHS; 2019 � 20 DEATHS; 2020 � 19 DEATHS AND 2021 � 36 DEATHS.1 THE INCREASING USE OF FENTANYL IN THE COUNTY AND SURROUNDING COMMUNITIES ALONG WITH FENTANYL-LACED NON-OPIOID DRUGS LIKE METHAMPHETAMINE AND COCAINE WERE CITED AS CRITICAL FACTORS TO THE INCREASED DEATH RATES IN OUR AREA.2 IN 2020, TUOLUMNE COUNTY WAS RANKED FIRST IN THE STATE FOR OVERDOSES. IN THAT YEAR, THERE WERE 846.47 OPIOID PRESCRIPTIONS PER 1,000 RESIDENTS IN THE COUNTY - WHILE THE STATE AVERAGE WAS 374.87 PER 1,000 RESIDENTS. TUOLUMNE COUNTY IN 2023 - 2024 REMAINED AT THE TOP OF RANKINGS FOR THE MOST DOSAGES PRESCRIBED PER 1,000 RESIDENTS.3 . IN TUOLUMNE COUNTY, MANY OF OUR PATIENTS ARE INDIVIDUALS IDENTIFIED AS USING STIMULANTS, OPIOIDS, AND OTHER SUBSTANCES, MANY OF WHOM ARE ALSO EXPERIENCING HOMELESSNESS, FOOD INSECURITY, LACK OF ACCESS TO HEALTHCARE SERVICES, SOCIAL SUPPORT AND EXPOSURE TO CRIME, AND DUAL DIAGNOSES. IN KEEPING WITH THE GOALS OF THE TOR 2024 FUNDING OPPORTUNITY, OVER THE PAST FOUR YEARS TUOLUMNE ME-WUK INDIAN HEALTH CENTER HAS PROVIDED CULTURALLY RESPONSIVE MEDICALLY ASSISTED TREATMENT, MAT, PROGRAMMING PROMOTING HARM REDUCTION AND WELLNESS TO AMERICAN INDIANS, AND ALASKA NATIVES OF TUOLUMNE COUNTY AND MEMBERS OF THE SURROUNDING COMMUNITY AT LARGE. THESE SERVICES HAVE ALLOWED INDIVIDUALS TO ACCESS MAT WITHOUT THE HARDSHIPS OF TRAVELLING TO NEIGHBORING COUNTIES TO RECEIVE SERVICES. OUR TARGET POPULATIONS ARE AMERICAN INDIANS AND ALASKA NATIVES AND COMMUNITY MEMBERS AT LARGE. MOST OF THESE INDIVIDUALS ARE UNDERSERVED AND ALL LIVE IN A RURAL AREA. OUR MOST RECENT MAT SERVICE DELIVERY FIGURES IN 2023 REVEAL CAUCASIANS FOLLOWED BY NATIVE CLIENTS OCCUPYING MOST CASELOADS. HISPANICS ARE THE THIRD HIGHEST RACIAL/ETHNIC DEMOGRAPHIC � VERY FEW AFRICAN AMERICANS WERE SERVED. MOST OF OUR 127 PATIENTS SERVED IN 2023 HAD BOTH AN OPIOID USE DISORDER DIAGNOSIS AS WELL AS A STIMULANT USE DISORDER DIAGNOSIS. MANY ARE DUAL DIAGNOSES WITH BOTH SUBSTANCE USE AND MENTAL HEALTH DISORDERS. MOST PATIENTS SERVED ARE MEDI-CAL RECIPIENTS. TMWIHS IS REQUESTING $1,145,180 OVER (5) YEARS TO SERVE A PROJECTED PROGRAM POPULATION OF 4,730 INDIVIDUALS WITH TREATMENT SERVICES, RECOVERY SUPPORT SERVICES, PREVENTION SERVICES, AND HARM REDUCTION SERVICES. WE REALIZE WE CANNOT DO THIS ALONE. KEY TO OUR SUCCESS IS THE RECRUITMENT AND RETENTION OF CROSS SECTION OF COMMUNITY LEADERSHIP INCLUDING COUNTY BEHAVIORAL HEALTH, MEDICAL AND TREATMENT SERVICE PROVIDERS AND LAW ENFORCEMENT AND SCHOOLS.

SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT - THE TUOLUMNE ME-WUK TRIBAL CARE COORDINATION AND CHRONIC DISEASE MANAGEMENT QUALITY IMPROVEMENT PROGRAM WILL IMPROVE HEALTH OUTCOMES FOR MEMBERS OF THE TUOLUMNE BAND OF ME-WUK INDIANS AND OTHER AMERICAN INDIAN AND ALASKA NATIVE PATIENTS ELIGIBLE UNDER THE INDIAN HEALTH CARE IMPROVEMENT ACT AND IHS SERVICE AREA RULES, SERVED BY THE TUOLUMNE ME-WUK INDIAN HEALTH CENTER IN RURAL TUOLUMNE COUNTY, CALIFORNIA. THE PROJECT'S PRIMARY CLINICAL HEALTH SERVICE FOCUS AREA IS CARE COORDINATION, WITH CHRONIC DISEASE MANAGEMENT SERVING AS THE PRIMARY CLINICAL APPLICATION. THE PROJECT WILL ESTABLISH A STRUCTURED CARE COORDINATION PROGRAM FOR AI/AN PATIENTS WITH CHRONIC DISEASE, RECENT HOSPITALIZATION, MULTIPLE REFERRALS, AND IDENTIFIED CARE GAPS. SERVICES WILL INCLUDE INDIVIDUALIZED CARE PLANNING, CHRONIC DISEASE MANAGEMENT SUPPORT, REFERRAL COORDINATION, CARE TRANSITION SERVICES, HEALTH EDUCATION, OUTREACH, AND FOLLOW-UP ACTIVITIES. A COMMUNITY HEALTH REPRESENTATIVE (CHR), TRIBAL CARE COORDINATOR, AND TRIBAL REGISTERED NURSE WILL WORK TOGETHER TO IMPROVE PATIENT ENGAGEMENT, INCREASE ACCESS TO SERVICES, REDUCE BARRIERS TO CARE, AND SUPPORT CARE GAP CLOSURE. PROJECT ACTIVITIES WILL FOCUS ON IMPROVING DIABETES MANAGEMENT, BLOOD PRESSURE CONTROL, STATIN THERAPY UTILIZATION, DEPRESSION SCREENING, REFERRAL COMPLETION, AND CARE TRANSITIONS WHILE REDUCING AVOIDABLE EMERGENCY DEPARTMENT UTILIZATION AND HOSPITAL READMISSIONS. THE PROGRAM WILL UTILIZE CULTURALLY RESPONSIVE APPROACHES TO ENGAGE PATIENTS AND PROVIDE SUPPORT IN BOTH CLINICAL AND COMMUNITY SETTINGS. THE ORGANIZATION WILL IMPLEMENT THREE REQUIRED QUALITY IMPROVEMENT STRATEGIES OVER THE FOUR-YEAR PROJECT PERIOD. FIRST, THE PROJECT WILL STRENGTHEN ORGANIZATIONAL QUALITY IMPROVEMENT CAPACITY THROUGH ESTABLISHMENT OF A MULTIDISCIPLINARY QUALITY IMPROVEMENT TEAM, MONTHLY QUALITY IMPROVEMENT CIRCLE MEETINGS, STAFF TRAINING, AND IMPLEMENTATION OF PLAN-DO-STUDY-ACT (PDSA) QUALITY IMPROVEMENT CYCLES. SECOND, THE PROJECT WILL STRENGTHEN DATA COLLECTION AND REPORTING THROUGH IMPLEMENTATION OF NEXTGEN CARE COORDINATION WORKFLOWS, PATIENT REGISTRIES, SOCIAL DETERMINANTS OF HEALTH DOCUMENTATION, CARE GAP TRACKING TOOLS, QUALITY DASHBOARDS, AND AZARA REFERRAL MANAGEMENT AND REPORTING SYSTEMS. THIRD, THE PROJECT WILL IMPROVE FINANCIAL SUSTAINABILITY THROUGH DEVELOPMENT OF BILLING AND CODING INFRASTRUCTURE SUPPORTING CHRONIC CARE MANAGEMENT (CCM), TRANSITIONAL CARE MANAGEMENT (TCM), AND PRINCIPAL CARE MANAGEMENT (PCM) SERVICES. EXPECTED OUTCOMES INCLUDE IMPROVED CARE COORDINATION, INCREASED CARE PLAN COMPLETION, IMPROVED CHRONIC DISEASE OUTCOMES, INCREASED CARE GAP CLOSURE, IMPROVED REFERRAL COMPLETION RATES, REDUCED EMERGENCY DEPARTMENT UTILIZATION AND HOSPITAL READMISSIONS, IMPROVED ORGANIZATIONAL QUALITY IMPROVEMENT CAPACITY, AND DEVELOPMENT OF SUSTAINABLE SYSTEMS THAT SUPPORT LONG-TERM CARE COORDINATION AND CHRONIC DISEASE MANAGEMENT SERVICES FOR THE AI/AN POPULATION.

TUOLUMNE MEWUK INDIAN HEALTH CENTER, INC SPECIAL DIABETES PROGRAM FOR INDIANS-COMMUNITY DIRECTED PROGRAM GRANT APPLICATION

TMWIHC OVERDOSE AND POISONING PREVENTION EDUCATION INITIATIVE - THE TUOLUMNE ME-WUK INDIAN HEALTH CENTER (TMWIHC) PROPOSES THE OVERDOSE AND POISONING PREVENTION EDUCATION INITIATIVE TO REDUCE THE RISK OF UNINTENTIONAL POISONING AND OVERDOSE WITHIN THE TUOLUMNE ME-WUK TRIBAL COMMUNITY. OVER THE PAST SEVERAL DECADES, THE TRIBE HAS WORKED TO STRENGTHEN COMMUNITY WELLNESS BY BUILDING PROGRAMS THAT ADDRESS HEALTH DISPARITIES AND CREATE CULTURALLY RELEVANT PREVENTION OPPORTUNITIES. THIS PROJECT FOCUSES ON EDUCATION AS THE KEY STRATEGY TO INCREASE KNOWLEDGE AND ADOPTION OF SAFE MEDICATION PRACTICES. THROUGH THIS INITIATIVE, TMWIHC WILL CONDUCT CULTURALLY TAILORED COMMUNITY EDUCATION EVENTS, WORKSHOPS, AND TALKING CIRCLES; TRAIN COMMUNITY CHAMPIONS TO SERVE AS PEER EDUCATORS; AND IMPLEMENT AWARENESS CAMPAIGNS USING PRINTED AND VISUAL MATERIALS. THESE ACTIVITIES AIM TO REACH 80% OF TRIBAL HOUSEHOLDS OVER THE PROJECT PERIOD AND BUILD LONG-TERM COMMUNITY CAPACITY FOR OVERDOSE PREVENTION. EXPECTED OUTCOMES INCLUDE INCREASED KNOWLEDGE AND AWARENESS OF SAFE MEDICATION PRACTICES, WIDESPREAD ADOPTION OF PREVENTIVE BEHAVIORS, STRENGTHENED PEER SUPPORT NETWORKS, AND SUSTAINED COMMUNITY ENGAGEMENT. LONGER-TERM GOALS ARE REDUCED UNINTENTIONAL POISONING AND OVERDOSE INCIDENTS AND IMPROVED COMMUNITY RESILIENCE. THE PROJECT WILL BE MANAGED BY TMWIHC’S TRIBAL HEALTH OUTREACH DEPARTMENT, LEVERAGING EXPERIENCED PERSONNEL, COMMUNITY PARTNERSHIPS, AND ORGANIZATIONAL INFRASTRUCTURE TO ENSURE EFFECTIVE IMPLEMENTATION AND SUSTAINABILITY.