Grace Community

HEALTH CENTER CLUSTER

HEALTH CENTER CLUSTER

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

CAPITAL DEVELOPMENT

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

HEALTH CENTER CONTROLLED NETWORKS

QUALITY IMPROVEMENT FUND - JUSTICE INVOLVED - FUNDING REQUEST: $1,000,000 SERVICE AREA – THE GRACE HEALTH SERVICE AREA INCLUDES SIX COUNTIES IN RURAL, SOUTHEASTERN KENTUCKY: BELL COUNTY, CLAY COUNTY , KNOX COUNTY, LESLIE COUNTY, LAUREL COUNTY, AND WHITLEY COUNTY. ALL THREE COUNTIES ARE MEDICAL, DENTAL, AND MENTAL HEALTH HPSAS AND FULL COUNTY MUAS.  FOR THIS PROJECT, GRACE HEALTH IS PARTNERING WITH THREE CARCERAL AUTHORITIES IN THE SERVICE AREA: CLAY COUNTY DETENTION CENTER, LESLIE COUNTY DETENTION CENTER, AND KNOX COUNTY DETENTION CENTER. ALL THREE ARE SMALL, LOCAL JAILS LOCATED IN RURAL AREAS. LACK OF TRANSPORTATION AND CARE COORDINATION AT THE TIME OF RELEASE ARE KEY BARRIERS TO ACCESS.   NEED: RURAL COUNTY JAILS IN KENTUCKY HAVE STRUGGLED TO FINANCIALLY SUPPORT OVERCROWDING DUE TO THE MASS HOUSING OF STATE INMATES IN LOCAL CUSTODY AND THE GROWING MEDICAL, DENTAL, AND BEHAVIORAL/MENTAL HEALTH NEEDS OF JUSTICE-INVOLVED INDIVIDUALS, INCLUDING SUBSTANCE AND ALCOHOL ABUSE. GRACE HEALTH WILL BE SUPPLEMENTING THE MEDICAL AND DENTAL SERVICES PARTNERING JAILS ARE REQUIRED TO PROVIDE BY PROVIDING TARGETED CASE MANAGEMENT AND CARE COORDINATION SERVICES TO INMATES AT DETENTION CENTERS THAT CURRENTLY HAVE NO TRANSITIONAL SERVICES OR SUPPORTS IN PLACE. UNDERSTAFFING AND LIMITED BUDGETS MINIMIZE THE COUNTY JAIL’S ABILITY TO PROVIDE ADEQUATE TRANSITIONAL RESOURCES TO INDIVIDUALS BEING RELEASED. HEALTH PROFESSIONAL SHORTAGES COMPOUND THE NEEDS ACROSS THE SERVICE AREA. IN ADDITION TO THE COMPLEX PHYSICAL HEALTH NEEDS OF THESE COMMUNITIES, THERE IS AN INCREASING DEMAND FOR MENTAL HEALTH SERVICES, PARTICULARLY RELATED TO SUBSTANCE USE DISORDER (SUD), OPIOID USE DISORDER (OUD), AND ALCOHOL USE DISORDER (AUD). LACK OF ACCESS TO RESOURCES AND EMPLOYMENT, COMBINED WITH POOR PHYSICAL HEALTH AND THE SOCIAL STIGMA AROUND INCARCERATION LEADS TO POOR MENTAL HEALTH STATUS AND HIGH RATES OF SUBSTANCE USE IN THE SERVICE AREA. FRAGMENTED SERVICES AND BARRIERS SUCH AS TRANSPORTATION PREVENT INDIVIDUALS FROM ENTERING CARE OR ACCESSING SERVICES EFFECTIVELY.  OBJECTIVES AND OUTCOMES TWO PRIMARY GOALS WILL DRIVE THE PROJECT TOWARD IMPROVED OUTCOMES FOR JUSTICE INVOLVED INDIVIDUALS: GOAL 1: INCREASE ACCESS TO MEDICAL, DENTAL, AND BEHAVIORAL HEALTH SERVICES BY INCREASING CARE NAVIGATION FOR 250 PERSONS ANNUALLY TRANSITIONING FROM INCARCERATION BACK INTO THE COMMUNITY AT THREE CARCERAL FACILITIES IN SOUTHEAST KENTUCKY FROM DECEMBER 1, 2024-NOVEMBER 30, 2026. GOAL 2: LEVERAGE COMMUNITY PARTNERSHIPS TO ADDRESS HEALTH RELATED SOCIAL NEEDS AND RECOVERY SUPPORT SERVICES WITH AT LEAST THREE COMMUNITY ORGANIZATIONS OVER THE TWO-YEAR PROJECT PERIOD.OBJECTIVE 1A: INCREASE CLINICAL PROVIDERS AND4 BEHAVIORAL HEALTH CARE STAFF TO MEET MENTAL HEALTH AND SUBSTANCE USE TREATMENT NEEDS. OBJECTIVE 2: INCREASE ACCESS TO MENTAL HEATH AND SUBSTANCE USE DISORDER SERVICES BY ADDING CARE COORDINATION AND NAVIGATION SERVICES FOR THE JI-R POPULATION. OBJECTIVE 3 -LEVERAGE COMMUNITY PARTNERSHIPS TO ADDRESS HEALTH RELATED SOCIAL NEEDS BY USING CASE MANAGEMENT SERVICES, OBJECTIVE 4: INFORM THE EVIDENCE BASE TO SUPPORT TRANSITION TO RE-ENTRY FOR JUSTICE INVOLVED INDIVIDUALS  HEALTH AND SUBSTANCE ABUSE TREATMENT STAFF, ORAL HEALTH STAFF AND CARE COORDINATION/ NAVIGATION STAFF, WE EXPECT TO SEE INCREASED ACCESS TO SERVICES FOR THIS FOCUS POPULATION. WE WILL LEVERAGE EXISTING RESOURCES THROUGH COMMUNITY PARTNERSHIP AND AVOID DUPLICATION OF SERVICES. SUPPORTING THESE TRANSITIONS FOR THE JUSTICE INVOLVED POPULATION IS KEY TO SUCCESSFUL RE-ENTRY. STAFF WILL BE TRAINED TO PROVIDE CULTURALLY AND LINGUISTICALLY APPROPRIATE CARE TO THE JI-R POPULATION TO HELP REDUCE STIGMA AND INCREASE PATIENT-CENTERED CARE STANDARDS FOR THIS GROUP.

ARP ECONOMIC DEVELOPMENT GRANT FOR RURAL HEALTH CARE FACILITIES

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM

HEALTH CENTER INFRASTRUCTURE SUPPORT

TELEMEDICINE GRANT

FY 2024 BEHAVIORAL HEALTH SERVICE EXPANSION - GRACE HEALTH SEEKS TO EXPAND MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES, INCLUDING MOUD IN BELL, CLAY, KNOX, LESLIE COUNTIES IN KENTUCKY. LOCATED IN THE APPALACHIAN AREA OF THE U.S., OUR RURAL SERVICE AREA IS LOCATED IN RURAL SOUTHEASTERN KENTUCKY, NEAR VIRGINIA TO THE EAST AND BORDERING TENNESSEE TO THE SOUTH. THE TOTAL POPULATION IN THE SERVICE AREA IS 182,744, WITH 53.5% OF THE WORKING-AGE POPULATION (ADULTS 20-64 YEARS) EARNING INCOMES BELOW 200% FEDERAL POVERTY LEVEL. MENTAL HEALTH DIAGNOSES FOR SERIOUS PROBLEMS INDEPENDENT FROM SUBSTANCE ABUSE ARE ALSO PROPORTIONATELY HIGHER IN APPALACHIA THAN THE REST OF THE NATION, WITH SERIOUS PSYCHOLOGICAL STRESS AND MAJOR DEPRESSIVE EPISODES ALMOST COMMON IN CENTRAL APPALACHIA. RESIDENTS FROM THE SERVICE AREA REPORT AN AVERAGE OF 4.69 POOR MENTAL HEALTH DAYS, COMPARED TO A STATE RATE OF 4.8 DAYS AND A NATIONAL BENCHMARK OF 3.1 POOR MENTAL HEALTH DAYS WITHIN THE LAST MONTH. THE LACK OF QUALIFIED PROVIDERS COMBINED WITH A CULTURAL RELUCTANCE TO SEEK MENTAL HEALTH TREATMENT RESULTS IN A HIGH MORTALITY RATE DUE TO SUICIDE AND POISONING DUE TO OVERDOSE. AS THE DATA SUGGESTS, MANY INDIVIDUALS IN NEED OF TREATMENT DO NOT RECEIVE MENTAL HEALTH INTERVENTION, WHICH MAY ACCOUNT FOR AN AGE ADJUSTED SUICIDE RATE AVERAGE OF 17.2 PER 100,000 FOR THE SERVICE AREA, IN COMPARISON TO THE NATIONAL ANNUAL SUICIDE RATE AVERAGE OF 14.0 PER 100,000. FOR THOSE KENTUCKY RESIDENTS BETWEEN 15 AND 35 YEARS OF AGE, SUICIDE IS THE SECOND LEADING CAUSE OF DEATH IN KENTUCKY. DEATH BY SUICIDE IS SECOND ONLY TO UNINTENTIONAL INJURY FOR THOSE KENTUCKY RESIDENTS BETWEEN 15 AND 34 YEARS OF AGE. THE MOST RECENTLY REPORT RESULTS OF THE KENTUCKY INCENTIVES FOR PREVENTION (KIP) SURVEY FROM 2021, CONDUCTED BY THE STATE’S REGIONAL PREVENTION CENTERS, SHOW THAT THE INCREASE IN THE RATES OF SUICIDE ATTEMPT IN THE PAST YEAR FOR 10TH-GRADERS WHO HAVE VAPED IN THE PAST 30 DAYS IS STRIKING, AT 23.9% COMPARED TO ALL 10TH-GRADERS AT 8.1%. THE DA TA ARE EVEN MORE ALARMING FOR STUDENTS WHO USED CANNABIS (28.6%) AND THOSE WHO REPORTED USING BOTH (30.6%). IN ADDITION, RESEARCH SHOWS THAT CHILDREN WHOSE PARENTS HAVE A SUBSTANCE USE DISORDER ARE EIGHT TIMES MORE LIKELY TO DEVELOP AN SUD AS A RESULT OF THE MODELING OF DRUG USE, INCREASED ACCESS TO DRUGS, AND NEGLECT/ABUSE THAT SO OFTEN OCCURS IN FAMILIES IMPACTED BY SUD. SUBSTANCE USE IS ALSO A FACTOR IN WELL-BEING OF ADOLESCENTS IN THE PROPOSED AREA. THE SERVICE AREA HAS A HIGH RATE OF BINGE DRINKING AT 19% COMPARED TO 14% ACROSS THE STATE OF KENTUCKY. THE KENTUCKY OFFICE OF DRUG CONTROL POLICY SHOWS THAT 2,250 PEOPLE DIED FROM A DRUG OVERDOSE IN 2021, A NEARLY 15% INCREASE FROM 2020. IN THE FIRST YEAR OF THE PANDEMIC, THE UNITED STATES EXPERIENCED THE HIGHEST-EVER COMBINED RATES OF DEATHS DUE TO ALCOHOL, DRUGS, AND SUICIDE. ACCORDING TO A REPORT RELEASED BY TRUST FOR AMERICA'S HEALTH AND WELL BEING TRUST, KENTUCKY'S RATE WAS SECOND IN THE NATION. KENTUCKY'S COMBINED DEATHS OF DESPAIR INCREASED BY 36% BETWEEN 2019 AND 2020, SECOND ONLY TO WEST VIRGINIA, WHICH HAD A 37% INCREASE. IN 2020, THE LATEST PAIN IN THE NATION: THE EPIDEMICS OF ALCOHOL, DRUG, AND SUICIDE DEATHS REPORT SHOWS KENTUCKY HAD 3,680 COMBINED DEATHS FROM ALCOHOL, DRUG, AND SUICIDE, AN AGE-ADJUSTED RATE OF 82.8 DEATHS PER 100,000 PEOPLE. OF THOSE, 738 WERE ALCOHOL-INDUCED (37%), 2,187 WERE DRUG-INDUCED (47%), AND 801 WERE BY SUICIDE (7%). GRACE HEALTH WILL UTILIZE BEHAVIORAL HEALTH EXPANSION FUNDS TO PURCHASE A MOBILE UNIT AND TO ADD 7.7 FTE NEEDED BEHAVIORAL HEALTH PROVIDERS AND SUPPORT STAFF TO INCREASE ACCESS TO 520 MENTAL HEALTH PATIENTS, 50 NEW SUD PATIENTS AN 45 NEW MOUD PATIENTS BY DECEMBER 31, 2025.

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

FISCAL YEAR 2025 EXPANDED HOURS. - GRACE HEALTH, H80CS09959, WILL USE $500,000 EACH YEAR FOR TWO YEARS OF EXPANDED HOURS FUNDING TO FURTHER EASE PATIENTS’ AND UNDERSERVED COMMUNITY MEMBERS' ABILITY TO ACCESS ESSENTIAL HEALTH CENTER SERVICES DURING NEW OPERATING HOURS INCLUDING EVENINGS AND WEEKENDS, WHEN ACCESS TO PRIMARY CARE MAY OTHERWISE BE LIMITED OR NONEXISTENT IN THEIR COMMUNITY. NEW OPERATING HOURS WILL SUPPORT PATIENTS TO RECEIVE CARE IN A PRIMARY CARE SETTING, REDUCING VISITS TO EMERGENCY DEPARTMENTS. THIS WILL REDUCE HEALTH CARE COSTS AND PRESERVE EMERGENCY DEPARTMENT CAPACITY FOR PATIENTS WITH ACUTE NEEDS. HOURS WILL BE EXPANDED FOR AT THREE SITES TOTALING 14 ADDITIONAL HOURS FOR MEDICAL, PHARMACY AND ENABLING SERVICES. PATIENT NEEDS RELATED TO ACCESSING CARE BEFORE OR AFTER WORK, AFTER SCHOOL, AND ON WEEKENDS WILL INCREASE OPPORTUNITIES TO ADDRESS PREVENTIVE CARE, MEDICATION MANAGEMENT, AND ADDRESSING BARRIERS TO ACCESS SUCH AS COST OF CARE, TRANSLATION AND TRANSPORTATION. THE THREE SITES WHERE HOURS WILL BE EXPANDED INCLUDE: GRACE HEALTH MEDICAL CAMPUS (KNOX COUNTY) WILL INCREASE FROM 67-70 HOURS PER WEEK; GRACE HEALTH HYDEN WILL INCREASE FROM 48 TO 54 HOURS PER WEEK AND, GRACE HEALTH MANCHESTER WILL INCREASE FROM 45 TO 50 HOURS PER WEEK. ALL THREE SITES WILL OFFER THE FULL SCOPE OF PRIMARY CARE INCLUDING PREVENTIVE SCREENINGS, DIAGNOSTIC X-RAY AND DIAGNOSTIC LABS, PATIENT EDUCATION, EXAMS, GYNECOLOGICAL CARE, PEDIATRIC CARE, ACUTE CARE, AND APPOINTMENTS FOR FOLLOW-UP VISITS AS NEEDED. PHARMACY SERVICES WILL BE OFFERED AT MANCHESTER AND THE MEDICAL CAMPUS THROUGH THE ON-SITE PHARMACY AND INCLUDE PRESCRIPTION FILLING / REFILLING, PATIENT EDUCATION, ASSISTANCE WITH COST AND DELIVERY SERVICES TO HYDEN. ENABLING SERVICES WILL INCLUDE ELIGIBILITY ASSISTANCE AS ALL PATIENT SUPPORT STAFF ARE TRAINED TO ASSESS FINANCIAL ELIGIBILITY FOR SLIDING FEE DISCOUNT, TRANSLATION SERVICES AVAILABLE THROUGH THE LANGUAGE LINE AND ASSISTANCE WITH TRANSPORTATION THROUGH ESTABLISHED COLLABORATIVE AGREEMENTS WITH RTEC AND KCEOC, THROUGH COLLABORATION WITH HORIZON HEALTH FOR PERSONS WITH SUBSTANCE USE DISORDER OR THROUGH THE USE OF GRACE HEALTH'S PATIENT ASSISTANCE FUND. THE EXPECTED IMPACT OF THIS PROJECT INCLUDES INCREASED ACCESS TO CARE FOR 750 NEW PATIENTS AND 580 EXISTING PATIENTS, IMPROVED HEALTH OUTCOMES, REDUCED EMERGENCY DEPARTMENT UTILIZATION FOR NON-URGENT VISITS, AND REDUCTION IN BARRIERS TO CARE SUCH AS TRANSPORTATION AND AFFORDABILITY. GRACE HEALTH WILL SUSTAIN SERVICES AND EXPANDED HOURS BEYOND THE PROJECT PERIOD THROUGH EFFICIENT BILLING AND COLLECTIONS, STAFF RETENTION, INCREASED UTILIZATION BY EXISTING PATIENTS, INCREASING REFERRALS FROM COMMUNITY PARTNERS, AND INCREASING NEW PATIENTS.

RURAL HIT NETWORK PROGRAM

FY 2023 EARLY CHILDHOOD DEVELOPMENT

FY 2023 EXPANDING COVID-19 VACCINATION

ARRA - CAPITAL IMPROVEMENT PROGRAM

SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT

ARRA - INCREASE SERVICES TO HEALTH CENTERS

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

TELEMEDICINE GRANT

FY 2023 BRIDGE ACCESS PROGRAM

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM

CAPITAL DEVELOPMENT