University Hospitals Health System Inc

REGIONAL PEDIATRIC PANDEMIC NETWORK

CHILDREN'S HOSPITALS GRADUATE MEDICAL EDUCATION PAYMENT PROGRAM

REGIONAL PEDIATRIC PREVENTION NETWORK - THE RPPN IS A NATIONAL NETWORK OF CHILDREN’S HOSPITALS FOCUSED ON STRENGTHENING PEDIATRIC DISASTER PREPAREDNESS LOCALLY AND REGIONALLY. IN 2021 HRSA FOUNDED THE RPPN AND, TOGETHER, IT ESTABLISHED A COMMUNITY OF HUNDREDS OF EXPERTS WITH A PRIMARY OBJECTIVE TO IMPROVE THE NATION’S CAPABILITY TO CARE FOR ALL CHILDREN IMPACTED BY DISASTERS IN EVERY COMMUNITY. THE NEW PPN EXPANDS ON THIS FOUNDATIONAL WORK BY FOCUSING ON SPECIFIC IDENTIFIED NEEDS TO: 1) GROW PEDIATRIC DISASTER PREPAREDNESS PROGRAMS ANCHORED AT CHILDREN’S HOSPITALS; 2) STRENGTHEN PEDIATRIC CARE CAPABILITY THROUGHOUT LOCAL-REGIONAL HEALTHCARE SYSTEMS AND DISASTER WORKFORCE; 3) FOSTER BETTER COMMUNITY COLLABORATIONS AND PARTNERSHIPS TO AID DISASTER RESILIENCE; 4) EVOLVE A SUSTAINABLE, MULTIDISCIPLINARY PROFESSIONAL DISCIPLINE IN PEDIATRIC DISASTER MEDICINE OPERATING AT THE HIGHEST LEVEL OF RESEARCH-INFORMED CARE; AND, THEREBY, 5) ENHANCE OUTCOMES IN TARGET AT-RISK POPULATIONS (CHILDREN WITH SPECIAL HEALTH CARE OR BEHAVIORAL HEALTH NEEDS; THOSE WHO LIVE IN RURAL, REMOTE, OR TRIBAL COMMUNITIES; AND POOR COMMUNITIES WITH LIMITED RESOURCES), INCLUDING VIA EXPANDED TELEHEALTH PROGRAMS AND PEDIATRIC READINESS PROGRAMS. THE PPN’S METHODOLOGY IS FUNDAMENTALLY DEFINED BY OUR STRUCTURE AS A NETWORK OF CHILDREN’S HOSPITALS COLLABORATING NATIONALLY AND ENGAGING LOCALLY. THE 5 CENTERS AND AFFILIATE CHILDREN’S HOSPITALS EMBODY PEDIATRIC PREPAREDNESS AND DISASTER CARE EXCELLENCE THAT CAN LEAD THEIR COMMUNITIES AND REGIONS TO ACHIEVE THE PPN GOALS. EACH CENTER ALSO CONTRIBUTES TO THE NATIONAL COLLABORATIVE EFFORTS ON TOPIC-SPECIFIC WORKGROUPS DEFINING BEST PRACTICE, ESTABLISHING QUALITY IMPROVEMENT INITIATIVES, PRODUCING EDUCATIONAL MATERIAL AND SUPPORT MATERIAL (GUIDELINES, TOOLKITS, TECHNICAL ASSISTANCE), AND SUPPORTING NATIONAL DATA COLLECTION AND ANALYSIS. PPN PARTNERSHIPS AND COLLABORATIONS ARE ALSO CRITICAL TO OUR STRATEGIC PLANS FOR SUCCESS. THESE INCLUDE PARTNERSHIPS WITH PEDIATRIC READINESS AND OTHER DISASTER PREPAREDNESS PROGRAMS, COMMUNITY ORGANIZATIONS (IE CHILDCARE CENTERS, SCHOOLS, MEDICAL HOMES), YOUTH AND FAMILY ADVISORS, EMS AGENCIES, HEALTHCARE COALITIONS, AND A VAST COLLECTION OF SUBJECT MATTER EXPERTISE IN KEY TOPICS (IE TELEMEDICINE, TRAUMA, INFECTIOUS DISEASE, MENTAL HEALTH, ETC.). THE SCALE OF THE NETWORK OF HOSPITALS AND PARTNERS PROVIDES THE STRUCTURE AND PROCESSES NEEDED TO ACHIEVE PPN GOALS AND OBJECTIVES. AMBITIOUS SHORT-, MEDIUM-, AND LONG-TERM OBJECTIVES ARE DEFINED WITH NUMEROUS SPECIFIC METRICS TO MEASURE THE PROGRAM’S SUCCESS. EXAMPLES OF THE MOST ASPIRATIONAL LONG-TERM MEASURES TO GAUGE OUR SUCCESS (WITH ASSOCIATED HIGH-LEVEL PERFORMANCE INDICATORS) INCLUDE: 1. DECREASES IN PEDIATRIC DISASTER-RELATED MORBIDITY AND MORTALITY AS MEASURED EXTERNALLY BY CDC, FEMA, OR NOAA EVENT-SPECIFIC REPORTING 2. IMPROVED PERCEPTIONS OF PREPAREDNESS EXPRESSED BY YOUTH AND FAMILIES IN POST-EVENT OR DRILL SURVEYS 3. DEVELOPMENT OF PEDIATRIC DISASTER WORKFORCE PROFESSIONALS, EVALUATED BY THE NUMBER OF PEDIATRIC PRACTITIONERS NATIONALLY OBTAINING BOARD CERTIFICATION IN DISASTER MEDICINE AND/OR ASSUMING EMERGENCY MANAGEMENT LEADERSHIP ROLES AT HEALTHCARE INFRASTRUCTURES 4. EXPANDED DELIVERY OF RESEARCH INFORMED DISASTER RELATED CARE, MEASURED BY INCREASING PDPACH SURVEY SCORES OF OUR CHILDREN’S HOSPITALS 5. IMPROVED ACCESS TO HIGH-QUALITY EMERGENCY HEALTHCARE FOR EVERY CHILD, IN EVERY SITUATION, MEASURED BY PEDIATRIC EMERGENCY AND DISASTER READINESS SCORES FOR EVERY HOSPITAL 6. EXPAND TELEHEALTH PROGRAMS AT EACH CENTER, MEASURED BY THE TOTAL NUMBER OF RURAL, REMOTE OR TRIBAL COMMUNITIES (FACILITIES) SERVED BY EACH CENTER.

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

EMPOWERING WOMEN AND PROVIDERS FOR IMPROVED CARE OF URINARY INCONTINENCE : EMPOWER STUDY - EMPOWERING PATIENTS AND PROVIDERS TO IMPROVE CARE FOR URINARY INCONTINENCE: EMPOWER STUDY URINARY INCONTINENCE (UI) AFFECTS OVER 50% OF WOMEN. NON-SURGICAL TREATMENT, INCLUDING BEHAVIORAL INTERVENTIONS OR PHARMACOTHERAPY, IS USUALLY EFFECTIVE, BUT RECOGNITION AND EVIDENCE-BASED CARE FOR THIS CONDITION REMAINS SUBOPTIMAL. FRONTLINE TREATMENT IN PRIMARY CARE, WITH SYSTEM SUPPORT AND SPECIALTY BACKUP, HAS GREAT POTENTIAL, BUT A VARIETY OF PATIENT-, PROVIDER-, AND SYSTEM-LEVEL BARRIERS RESULT IN UNDER-DIAGNOSIS AND SUBOPTIMAL MANAGEMENT. THEREFORE, USING ESTABLISHED PATIENT-CENTERED OUTCOMES RESEARCH EVIDENCE FOR NONSURGICAL TREATMENTS FOR URINARY INCONTINENCE IN WOMEN, WE PROPOSE AN INTEGRATED, MULTILEVEL (PATIENT, PROVIDE, AND SYSTEM) APPROACH THAT ADDRESSES KEY BARRIERS TO DIAGNOSING AND MANAGING UI IN THE PRIMARY CARE SETTING. IMPLEMENTATION STRATEGIES INCLUDE LARGE-SCALE SCREENING, EMPOWERING PATIENTS TO DISCUSS UI WITH THEIR PROVIDERS, PROVIDER EDUCATION AND TRAINING, PRACTICE FACILITATION THROUGH NURSE NAVIGATION, AND A NOVEL MOBILE PLATFORM “CHATBOT” TO ENGAGE PATIENTS IN SELF-MANAGEMENT OF THEIR UI. A SYSTEM-BASED STRATEGY FOR STREAMLINED REFERRAL AND TREATMENT WILL ALSO BE IMPLEMENTED. THE IMPLEMENTATION PLAN IS FULLY ALIGNED WITH AHRQ'S EVIDENCENOW FRAMEWORK: PRACTICE FACILITATION, EXPERT CONSULTATION, SHARED LEARNING COLLABORATIVE, DATA FEEDBACK AND BENCHMARKING, AND HEALTH-INFORMATION TECHNOLOGY SUPPORT. OVER THE COURSE OF 3 YEARS, WE AIM TO 1) IMPLEMENT THE “EMPOWERMENT FOR IMPROVING UI” PROGRAM ACROSS A LARGE NETWORK OF PRIMARY CARE PRACTICES. THE PROGRAM WILL INVOLVE SYSTEMATIC SCREENING AND IDENTIFICATION OF UI, PATIENT EMPOWERMENT, PROVIDER TRAINING AND EMPOWERMENT, NURSE NAVIGATION, AND SIMPLE AND PRACTICAL EVIDENCE-BASED TECHNOLOGY. WE HYPOTHESIZE THAT THE PROGRAM WILL BE IMPLEMENTED WITH FIDELITY TO ALL PLANNED ELEMENTS AND WITH LOCAL TAILORING IN ALL RECRUITED PRACTICES. 2) CREATE AN EVIDENCE-BASED PATIENT-CENTERED CARE PATHWAY THAT MINIMIZES BURDEN ON PRIMARY CARE WHILE OPTIMIZING HEALTH-INFORMATION SYSTEMS, INCLUDING AN EMBEDDED ELECTRONIC SCREENING TOOL, THAT LEAD TO SUSTAINABLE IMPROVEMENT IN QUALITY OF CARE. 3) ASSESS THE IMPACT OF THE EMPOWERING FOR IMPROVING UI INTERVENTION ON OUTCOMES IMPORTANT TO PATIENTS AND ON PROVIDER KNOWLEDGE AND CONFIDENCE, PRACTICE WORKFLOW AND SATISFACTION AMONG PRACTICE PROVIDERS AND STAFF. THROUGH A SYSTEMIC INTERVENTION THAT IS MULTILEVEL, PATIENT-ORIENTED AND SUPPORTIVE OF PRIMARY CARE PRACTICE, AND A RIGOROUS MIXED METHODS ANALYSIS, THE PROPOSED RESEARCH HAS GREAT POTENTIAL TO IMPROVE PRACTICE AND PATIENT OUTCOMES AND TO GENERATE TRANSPORTABLE NEW KNOWLEDGE TO IMPROVE CARE FOR WOMEN WITH URINARY INCONTINENCE.

RYAN WHITE TITLE IV WOMEN, INFANTS, CHILDREN, YOUTH AND AFFECTED FAMILY MEMBERS AIDS HEALTHCARE

ADDICTION MEDICINE FELLOWSHIP

CENTER TO IMPROVE CLINICAL DIAGNOSIS - ABSTRACT: DIAGNOSTIC ERRORS ARE COMMON AND FREQUENTLY EXTREMELY SERIOUS. UNFORTUNATELY, STRATEGIES TO IDENTIFY DIAGNOSTIC STANDARDS AND BEST DIAGNOSTIC PRACTICES FOR A VARIETY OF PROBLEMS ARE SCARCE. THE FOCUS OF THE CENTER TO IMPROVE CLINICAL DIAGNOSIS WILL BE TO TACKLE DIAGNOSTIC PROBLEMS USING A DATA AND CONSENSUS DRIVEN APPROACH. THE GOALS OF THE CENTER ARE TO (A) ASSEMBLE A DIVERSE, MULTIDISCIPLINARY TEAM TO PROVIDE FORMAL INPUT ABOUT STANDARDS AND BEST PRACTICES; (B) TO IMPLEMENT A 4-STEP STRATEGY TO DEVELOP RECOMMENDED DIAGNOSTIC PRACTICES; AND (C) TO SUSTAIN THE CENTER BY CREATING A SET OF POLICIES, METHODS, A FUTURE AGENDA, AND PARTNERSHIPS WITHIN AND OUTSIDE OUR ORGANIZATION. OUR CENTER WILL BE FULLY INTEGRATED INTO A LARGER HEALTH SERVICES RESEARCH CENTER WITHIN UNIVERSITY HOSPITALS HEALTH SYSTEM. OUR GENERAL 4-STEP PROCESS TO DEVELOP RECOMMENDED PRACTICES INCLUDES (1) IDENTIFYING PROBLEMS WHICH ARE COMMON, ASSOCIATED WITH HIGH RATES OF DIAGNOSTIC ERROR, AND FOR WHICH GUIDANCE IS LACKING AND IDENTIFY CURRENT DIAGNOSTIC PRACTICE (OR PRACTICES IN RESPONSE TO DIAGNOSTIC INTERVENTIONS) (2) IDENTIFY OUTCOMES OF DIAGNOSTIC PRACTICES; (3) IN COLLABORATION WITH A PANEL OF DIAGNOSTICIANS, REVIEW DATA ABOUT PRACTICE AND OUTCOMES AND FORMULATE RECOMMENDATIONS; (4) IMPLEMENT RECOMMENDATIONS AND MONITOR THEIR IMPACT. WE HAVE CHOSEN THREE PROBLEMS AS DEMONSTRATION PROJECTS BASED ON HOW COMMON AND SERIOUS THEY ARE AND THE EXPERTISE AND EXPERIENCE OF OUR RESEARCH TEAM: (1) THE BEST APPROACH TO IDENTIFYING AND EVALUATING UNINTENTIONAL WEIGHT LOSS IN ADULTS; (2) THE BEST APPROACH TO SCREENING FOR HYPERTENSION IN AFRICAN AMERICAN ADOLESCENTS USING HOME-BP DEVICES; (3) IMPROVED DIAGNOSIS OF SEPSIS IN CHILDREN IN COMMUNITY EMERGENCY DEPARTMENT (ED) SETTINGS, AND ADULTS IN COMMUNITY (ED) AND INPATIENT SETTINGS THROUGH IMPLEMENTATION AND MOST IMPORTANTLY, REFINEMENT OF ELECTRONIC SEPSIS TRIGGER TOOLS. WE BELIEVE OUR SYSTEMATIC APPROACH TO DEVELOPING STANDARDS AND BEST PRACTICES FOR THESE AND FUTURE PROBLEMS WILL PROVIDE A SYSTEM FOR BADLY NEEDED DIAGNOSTIC GUIDANCE THAT IS USEFUL FOR PATIENTS, CLINICIANS, AND HEALTH SYSTEMS.

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION

EMERGENCY DEPARTMENT ALTERNATIVES TO OPIOIDS (ED-ALTO) AT UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER (UHCMC) - SUMMARY: OHIO IS RANKED AS THE SIXTH HIGHEST STATE FOR OPIOID OVERDOSE DEATHS IN 2021 WITH A RATE OF 41.1 PER 100,000 PERSONS. LOCATED IN NORTHEAST OHIO, UH CLEVELAND MEDICAL CENTER (UHCMC) EMERGENCY DEPARTMENT (ED) SERVES A BROAD CATCHMENT AREA INCLUDING URBAN, SUBURBAN, AND RURAL COUNTIES, AND IS A PRIMARY SOURCE OF CARE FOR THE PREDOMINANTLY MINORITY AND SOCIOECONOMICALLY DISADVANTAGED LOCAL POPULATION. IN A 2022 REVIEW OF 66,086 ED VISITS IN OUR ELECTRONIC HEALTH RECORD (EHR), 15,546 ED VISITS WERE FOR PATIENTS PRESENTING WITH PAIN AND DISCHARGED HOME. OF THESE VISITS, OVER 25% RECEIVED AN OPIOID MEDICATION IN THE ED, REPRESENTING AN OPPORTUNITY TO REDUCE THAT PERCENTAGE. THE OVERALL GOAL OF THIS PROPOSAL IS TO DECREASE OPIOID USAGE IN THE ED BY (1) INCREASING ED PROVIDER KNOWLEDGE AND (2) IMPLEMENTING ALTO THERAPIES IN THE ED FOR PATIENTS PRESENTING WITH PAIN. WE WILL CARRY OUT THIS OBJECTIVE THROUGH A LONGITUDINAL ALTO IMPLEMENTATION PROJECT WITH INITIAL INTERVENTION IN THE ED AND SUSTAINED FOLLOW-UP IN THE OUTPATIENT UH CONNOR WHOLE HEALTH (UHCWH) CLINICS. SPECIFIC OBJECTIVES: (1) UNDERSTAND CURRENT UHCMC ED PAIN COMPLAINTS, APPROACHES, AND POTENTIAL BARRIERS TO IMPLEMENTATION OF ALTO; (2) TRAIN ED PROVIDERS ON MEDICATIONS FOR OPIOID USE DISORDER (MOUD) AND ALTO INTERVENTIONS; (3) IMPLEMENT ACUPUNCTURE AND MUSIC-ASSISTED RELAXATION IMAGERY (MARI) ALTO APPROACHES IN THE UHCMC ED.; (4) DISSEMINATE BEST PRACTICES THROUGH THREE PLANNED PUBLICATIONS IN PEER REVIEWED JOURNALS AND NUMEROUS PRESENTATIONS AT NATIONAL/INTERNATIONAL CONFERENCES OF EMERGENCY MEDICINE AND INTEGRATIVE MEDICINE. PLAN TO MEET OBJECTIVES: KEY PERSONNEL INCLUDE A (1) PROGRAM DIRECTOR WITH TRAINING AND EXPERTISE IN SYSTEM-LEVEL PROJECT AND PROGRAM MANAGEMENT, (2) EMERGENCY MEDICINE PHYSICIAN (CO-PI) WITH EXPERTISE IN IMPLEMENTATION SCIENCE OF INTERVENTIONS IN THE ED, (3) INTEGRATIVE MEDICINE RESEARCHER (CO-PI) WITH NIH-FUNDED EXPERTISE OF DEPLOYING NON-PHARMACOLOGIC INTERVENTIONS IN THE ED AND ACUTE CARE AND ASSESSING OUTCOMES, AND (4) EMERGENCY MEDICINE PHYSICIAN (CO-I) WITH EXPERTISE IN ADDICTION MEDICINE. TO ASSESS AND IMPROVE DEVELOPMENT AND UPTAKE OF THESE ALTO APPROACHES, THE TEAM WILL CONDUCT A ~10 ITEM SURVEY OF ED PROVIDERS TO UNDERSTAND THEIR KNOWLEDGE, PERSPECTIVES, AND POTENTIAL BIASES REGARDING PAIN MANAGEMENT AND ALTO TECHNIQUES, INCLUDING BARRIERS TO ALTO IMPLEMENTATION IN THE ED. THE TEAM WILL CONDUCT A PRE-SURVEY (INITIAL 3-MONTH START-UP PERIOD) AND WILL RE-ASSESS PROVIDERS’ PERSPECTIVES HALFWAY THROUGH (YEAR 2) AND AT THE END (YEAR 3) (OBJ 1). THE OVERARCHING GOAL OF THIS PROPOSAL IS TO USE THE COMBINATION OF ED PROVIDER TRAINING ON MOUD AND ALTO TECHNIQUES (OBJ 2) TO INCREASE REFERRALS FOR ALTO INTERVENTIONS, SPECIFICALLY EVIDENCE-BASED ACUPUNCTURE AND MARI IN THE ED (OBJ 3), IN ORDER TO DECREASE THE CURRENT RATE OF OPIOIDS USED IN THE ED TO TREAT ACUTE AND CHRONIC PAIN. AS A NOVEL INNOVATION, ED PROVIDERS WILL BE ABLE TO REFER PATIENTS TO ONE OF THE FIVE UH UHCWH OUTPATIENT CLINICS TO RECEIVE ALTO INTERVENTIONS THAT ARE COVERED BY MEDICARE, OHIO MEDICAID, OR BY PATIENTS’ PRIVATE INSURANCE. RATIONALE: THERE IS A NEED NATIONWIDE FOR EMERGENCY MEDICINE PROFESSIONALS TO USE MOUD AND ALTO INTERVENTIONS TO SAFELY MANAGE ACUTE/CHRONIC PAIN. THE DEPT OF EMERGENCY MEDICINE AND UHCWH SUCCESSFULLY COLLABORATED ON A FEASIBILITY PILOT OF BRINGING ACUPUNCTURE TO THE UHCMC IN A NIH-FUNDED TRIAL. HOWEVER, THE STUDY TEAM CONTENDS THAT: (1) REDUCTION OF ED OPIOID USE BY ED PROVIDERS AND (2) INCREASED USE OF ALTO INTERVENTIONS TO REDUCE PAIN IN THE ED WOULD PROVIDE A UNIQUE TWO-PRONGED APPROACH TO BEGIN TO COMBAT THE OPIOID EPIDEMIC. WITH WIDESPREAD DISSEMINATION OF RESULTS (OBJ 4), THIS PROJECT WOULD PROVIDE ROBUST EVIDENCE FOR A SCALABLE INTERVENTION WITH THE POTENTIAL TO READILY EXPAND TO OTHER EDS.

ADDICTION MEDICINE FELLOWSHIP - THE NE OHIO CENTER FOR ADDICTION RESEARCH, PREVENTION, AND EDUCATION (“CARPE”) COLLABORATIVE WILL UTILIZE FUNDING PROVIDED THROUGH THE ADDICTION MEDICINE FELLOWSHIP (AMF) PROGRAM [HRSA 25-069] TO SUSTAIN AND EXPAND THE ACGME-ACCREDITED ADDICTION PSYCHIATRY FELLOWSHIP (APF) AT UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER (UHCMC) AND ADDICTION MEDICINE FELLOWSHIP (AMF) AT PARTNER INSTITUTION METROHEALTH. THIS INNOVATIVE, CITY-WIDE COLLABORATIVE MODEL ALSO INCLUDES FACULTY FROM CLEVELAND CLINIC FOUNDATION (CCF) AND THE CLEVELAND VA MEDICAL CENTER. HRSA FUNDING OF FELLOW STIPENDS WILL BE USED TO RECRUIT AND RETAIN 24 ADDICTION FELLOWS OVER THE GRANT PERIOD. THE PROGRAM WILL SUSTAIN RELATIONSHIPS WITH 36 ROTATION SITES IN THE REGION, ADD A RURAL ROTATION SITE IN ASHTABULA COUNTY AND A LOW-BARRIER BUPRENORPHINE CLINIC, REFINE AND STRENGTHEN THE DIDACTIC CURRICULUM, AND CONTINUE TO RAISE THE PROFILE OF THIS HIGH-NEED SPECIALTY. OHIO AND CUYAHOGA COUNTY CONTINUE TO GRAPPLE WITH SUBSTANCE USE DISORDERS (SUD) AND POVERTY. AS THE SECOND MOST POPULOUS COUNTY IN OHIO, CUYAHOGA COUNTY RECORDED 2,944 OPIOID OVERDOSE DEATHS FROM 2016 TO 2020—54 PER 100,000 RESIDENTS, NEARLY TWICE THE NATIONAL RATE OF 28. ADDITIONALLY, APPROXIMATELY 1,413 YOUTH (1.6% OF THOSE AGED 12–17) AND 62,116 ADULTS (6.3% OF THOSE AGED 18 AND OLDER) IN THE COUNTY EXPERIENCED UNTREATED ALCOHOL USE DISORDER IN THE PAST YEAR. WHILE OVERALL OVERDOSE FATALITIES DECLINED IN 2023–2024, OVERDOSE DEATHS CONTINUE TO INCREASE AMONG SOME SUBGROUPS. THESE TROUBLING TRENDS UNDERSCORE THE CRITICAL NEED FOR A WELL-TRAINED SUD CARE WORKFORCE (SEE BIBLIOGRAPHY FOR DATA CITED). THE CARPE COLLABORATIVE WILL ADDRESS EACH OF THE OBJECTIVES OF THE FUNDING OPPORTUNITY: (1) INCREASE THE NUMBER OF ADDICTION MEDICINE AND ADDICTION PSYCHIATRY SUB-SPECIALISTS TRAINED TO PRACTICE IN MEDICALLY UNDERSERVED COMMUNITY-BASED SETTINGS; (2) INCREASE FELLOWS’ KNOWLEDGE AND ABILITY TO ASSIST THEIR PATIENTS WITH REFERRALS TO NAVIGATE THE LEGAL AND SOCIAL SYSTEMS RELATED TO PATIENTS’ CLINICAL NEEDS OR CARE; AND (3) INCREASE AWARENESS OF ADDICTION MEDICINE AS A SUB-SPECIALTY AND REDUCE PROVIDER STIGMA. THE COLLABORATIVE WILL BE LED BY SYBIL MARSH, MD AN EXPERIENCED CLINICIAN AND EDUCATOR AT UHCMC BOARD-CERTIFIED IN ADDICTION MEDICINE. THE LEADERSHIP TEAM WILL INCLUDE THREE ADDITIONAL KEY PERSONNEL -- TWO PROGRAM TRAINING DIRECTORS (ONE FOR APFS AND ONE FOR AMFS) AND A PROGRAM MANAGER. THE CARPE COLLABORATIVE IS APPLYING FOR FUNDING PRIORITY 1: TEAM BASED CARE AND FOR FUNDING PREFERENCE UNDER QUALIFICATION 1: HIGH MUC PLACEMENT RATE.

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION - UNIVERSITY HOSPITALS (UH) PORTAGE HOSPITAL (FORMERLY ROBINSON MEMORIAL HOSPITAL) HAS BEEN CARING FOR PORTAGE COUNTY AND THE SURROUNDING COMMUNITIES FOR OVER 100 YEARS, ACHIEVING CLINICAL EXCELLENCE IN SEVERAL SERVICES GREATLY NEEDED BY OUR COMMUNITY. UH PORTAGE IS A 302 LICENSED-BED PROGRESSIVE HOSPITAL. AS THE ONLY HOSPITAL IN THE COUNTY, UH PORTAGE MEDICAL CENTER OFFERS AN ARRAY OF INPATIENT AND OUTPATIENT MEDICAL AND SURGICAL SPECIALTIES. UH PORTAGE MEDICAL CENTER OPERATES A LEVEL III TRAUMA EMERGENCY DEPARTMENT, TWO URGENT CARE FACILITIES, AND COMPREHENSIVE IMAGING FACILITIES, ALONG WITH A NETWORK OF PHYSICIAN PRACTICES AND OUTPATIENT CENTERS AND MEDICAL FACILITIES THROUGHOUT THE COUNTY. UH PORTAGE’S MEDICAL STAFF CONSISTS OF NEARLY 400 PHYSICIANS IN OVER 40 MEDICAL SPECIALTIES. WOMEN’S HEALTH CARE OVER THE LIFE CYCLE IS AN ESSENTIAL COMPONENT OF UH PORTAGE’S SERVICES. IN ADDITION TO MANAGING THEIR OWN CARE, WOMEN ALSO PROVIDE THE BACKBONE FOR THEIR FAMILIES’ CARE. WE MUST DO ALL THAT WE CAN TO HELP SUPPORT WOMEN THROUGHOUT THE LIFE COURSE. THERE ARE SIGNIFICANT OPPORTUNITIES FOR ENHANCING WOMEN’S HEALTH CARE. ONE OF THESE IS IN THE AREA OF BREAST CANCER TREATMENT, AS A GREAT DEAL OF NEW CASES ARE DIAGNOSED ANNUALLY AT UH PORTAGE. ENHANCEMENTS TO BREAST HEALTH SERVICES AT UH PORTAGE WILL INCREASE PATIENT ACCESS WITH VASTLY IMPROVED COORDINATION OF CARE AMONG PROFESSIONALS WHO WILL BE ABLE TO WORK COLLABORATIVELY. SPECIALTY BREAST HEALTH EQUIPMENT AND SOME MODEST FACILITY UPDATES WILL MAKE A PATIENT-FOCUSED BREAST HEALTH CENTER AT UH PORTAGE A REALITY. THE EQUIPMENT OUTLINED IN THIS REQUEST WILL ALLOW UH PORTAGE MEDICAL CENTER TO BETTER SERVE WOMEN NEEDING SCREENING MAMMOGRAMS, AND FURTHER DIAGNOSIS OR TREATMENT IF NEEDED. THE SELECTED EQUIPMENT BUILDS ON OUR CURRENT OFFERINGS OF SCREENING MAMMOGRAPHY, DIAGNOSTIC MAMMOGRAPHY, TUMOR BIOPSIES AND BREAST SURGERY. ADDING THIS EQUIPMENT TO OUR EXISTING ARRAY OF SERVICES WILL BRING THE MOST TE CHNOLOGICALLY ADVANCED SCANS TO THE PEOPLE OF PORTAGE COUNTY. ADDITIONALLY, IT WILL ALLOW US TO SERVE MORE WOMEN IN NEED OF THESE SERVICES WITH A SIGNIFICANT INCREASE IN CAPACITY FOR MAMMOGRAPHY. WHEN AN ABNORMALITY IS DETECTED IN A SCREENING MAMMOGRAM, THERE ARE SEVERAL STEPS AND POSSIBLE PROCEDURES THAT FOLLOW TO DETERMINE IF THE ABNORMALITY IS CANCEROUS. THE REQUESTED EQUIPMENT WILL ALLOW UH PORTAGE PATIENTS TO RECEIVE THESE SUBSEQUENT SERVICES IN A WELL-COORDINATED FASHION, WITH A REDUCED WAIT TIME. THIS GETS WOMEN INTO NEEDED TREATMENT FASTER IF NEEDED, AND IF NO CANCER IS DETECTED, THEN PROVIDES MORE TIMELY RELIEF FOR THE PATIENT. UH PORTAGE HAS DEDICATED CAREGIVERS WHO SEE THE PHYSICAL AND EMOTIONAL TOLL BREAST CANCER EXACTS FROM PATIENTS EVERY DAY. THEIR VISION IS TO ENHANCE AND EXPAND SERVICES BY CREATING A COMPREHENSIVE BREAST HEALTH CENTER THAT PROVIDES A MORE COMFORTABLE, WELL-COORDINATED, AND HIGHEST QUALITY EXPERIENCE FOR PATIENTS. THE PHYSICIANS, STAFF, ADMINISTRATION AND PATIENTS OF UH PORTAGE MEDICAL CENTER THANK YOU FOR YOUR SUPPORT FOR THIS IMPORTANT PROGRAM TO FIND, DIAGNOSE AND TREAT BREAST CANCER. THIS COMPREHENSIVE APPROACH TO BREATH HEALTH AND THE TREATMENT OF BREAST CANCER WILL GREATLY BENEFIT THE WOMEN (AND MEN) OF PORTAGE COUNTY AND THE SURROUNDING AREA.

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION - APPLICANT: UNIVERSITY HOSPITALS HEALTH SYSTEM PROJECT LOCATION: UNIVERSITY HOSPITALS PARMA MEDICAL CENTER, 7007 POWERS BOULEVARD, PARMA, OH 44129 PROJECT CONTACT: MARY BETH TALERICO, DIRECTOR, OPERATIONS AND CLINICAL SERVICES, 440-743-4580, MARYBETH.TALERICO@UHHOSPITALS.ORG APPLICANT WEBSITE: HTTPS://WWW.UHHOSPITALS.ORG/ UNIVERSITY HOSPITALS RESPECTFULLY REQUESTS $855,000 OF HRSA FUNDS TOWARDS ESTABLISHING A COMPREHENSIVE BREAST HEALTH CENTER AT UNIVERSITY HOSPITALS PARMA MEDICAL CENTER, A 278-BED FULL SERVICE HOSPITAL THAT HAS SERVED LOCAL RESIDENTS FOR MORE THAN 60 YEARS. DEMAND FOR THESE SERVICES IS HIGH AND INCREASING: BREAST OFFICE VISITS AT UH PARMA DOUBLED FROM 2020 TO 2021 TO 971 VISITS AND THE HOSPITAL ALSO INCREASED THE NUMBER OF BREAST SURGERIES, BIOPSIES AND ULTRASOUNDS. CURRENTLY, BREAST CANCER SERVICES ARE LOCATED IN VARIOUS PLACES ON THE CAMPUS, REQUIRING PATIENTS TO NAVIGATE THE RANGE OF TREATMENTS, COORDINATE WITH A NUMBER OF HEALTH CARE PROFESSIONALS AND VISIT SEVERAL LOCATION POINTS. THE RENOVATED SPACE WILL INCLUDE DIAGNOSTIC TESTING, EXAM ROOMS, AND ADDITIONAL PROVIDER OFFICES. THE HOSPITAL WILL RELOCATE, MODIFY AND UPDATE TWO MAMMOGRAPHY UNITS AND ONE ULTRASOUND MACHINE TO THE SURGEON’S OFFICE. THESE CHANGES WILL RESULT IN MORE EFFICIENT AND ADDITIONAL SERVICES THAT WILL ALLOW FOR STREAMLINED, ACCESSIBLE DIAGNOSIS TO TREATMENT OF BREAST CANCER AND STANDARDIZED HIGH-QUALITY BREAST CARE. THIS FUNDING WILL PURCHASE MOVEABLE-ONLY EQUIPMENT NEEDED FOR THE COMPREHENSIVE BREAST HEALTH CENTER. EQUIPMENT INCLUDES FIVE CRITICAL UNITS FOR BREAST HEALTH AND BREAST CANCER OPERATIONS – A MAMMOGRAM, AN ULTRASOUND, A TRIDENT BREAST TISSUE IMAGING UNIT, A SENTIMAG UNIT, AND A NEOPROBE UNIT. THE FINAL THREE ITEMS WILL BE FOR THE OPERATING ROOM.

RYAN WHITE HIV/AIDS PROGRAM PART C EIS COVID-19 RESPONSE

TELEMEDICINE PREPARATION FOR OLDER ADULTS WITH TYPE 2 DIABETES - DURING THE COVID-19 PANDEMIC, MANY PRIMARY CARE APPOINTMENTS WERE CONVERTED TO TELEMEDICINE. TELEMEDICINE APPOINTMENTS MAY BE ESPECIALLY BENEFICIAL FOR PATIENTS WHO ARE AT HIGH RISK FOR COVID MORTALITY, SUCH AS OLDER ADULTS, AFRICAN AMERICANS, AND PATIENTS WITH TYPE 2 DIABETES. NUMEROUS STUDIES HAVE FOUND TELEMEDICINE CAN BE AN EFFECTIVE VENUE FOR DIABETES CARE. UNFORTUNATELY, SUCH INTERVENTIONS OFTEN ASSUME THAT PATIENTS ALREADY HAVE INTERNET-CAPABLE DEVICES, RELIABLE INTERNET SERVICE, AND BASIC DIGITAL SKILLS. MANY PATIENTS, ESPECIALLY OLDER PATIENTS AND AFRICAN AMERICANS, LACK THE DIGITAL SKILLS NEEDED FOR TELEMEDICINE. UNFORTUNATELY, THE NET RESULT IS THAT THOSE AT HIGHEST RISK FOR CHRONIC DISEASES AND THEIR COMPLICATIONS ARE OFTEN LEAST ABLE TO TAKE ADVANTAGE OF TELEMEDICINE. WE PROPOSE A DIGITAL SKILLS TRAINING INTERVENTION COMPRISING ESSENTIAL BASIC SKILLS TO PARTICIPATE IN A TELEMEDICINE APPOINTMENT FOR OLDER (AGE 50-70 YEARS) MOSTLY AFRICAN AMERICAN PRIMARY CARE PATIENTS WITH TYPE 2 DIABETES WHO ALREADY OWN AN INTERNET-CAPABLE DEVICE BUT HAVE NEVER HAD A TELEMEDICINE APPOINTMENT. THE INTERVENTION'S GOAL IS TO PREPARE PATIENTS TO HAVE A SUCCESSFUL TELEMEDICINE APPOINTMENT. PATIENTS WILL FIRST BE ASSESSED FOR SKILLS AND THEN RECEIVE CUSTOMIZED DIGITAL SKILLS TRAINING THROUGH A COMMUNITY-BASED ORGANIZATION. PARTICIPANTS WILL ALSO BE SCHEDULED TO HAVE A VIRTUAL DIABETES MANAGEMENT APPOINTMENT WITHIN 6 MONTHS. FOR SPECIFIC AIM # 1, WE WILL MEASURE WHETHER OR NOT PATIENTS REFERRED TO THE TELEMEDICINE TRAINING INTERVENTION COMPLETE A TELEMEDICINE APPOINTMENT WITHIN 6 MONTHS. IN SPECIFIC AIM # 2, WE WILL INTERVIEW PATIENTS AND ANALYZE INTERVIEW TRANSCRIPTS TO ASSESS THEIR EXPERIENCE WITH TELEMEDICINE. PATIENTS WHO SUCCESSFULLY COMPLETED A TELEMEDICINE APPOINTMENT WILL BE ASKED ABOUT THEIR SATISFACTION WITH BOTH THE TELEMEDICINE TRAINING INTERVENTION AND THEIR TELEMEDICINE APPOINTMENT. PATIENTS WHO ENROLLED IN THE TELEMEDICINE TRAINING INTERVENTION BUT EITHER DID NOT COMPLETE A TELEMEDICINE APPOINTMENT AND/OR DID NOT COMPLETE TELEMEDICINE TRAINING WILL BE ASKED ABOUT THEIR BARRIERS AND HOW THE TELEMEDICINE TRAINING INTERVENTION COULD BETTER MEET THEIR NEEDS.

TELEMEDICINE GRANT

THE AFFORDABLE CONNECTIVITY OUTREACH GRANT PROGRAM PROVIDES ELIGIBLE GOVERNMENTAL AND NON-GOVERNMENTAL ENTITIES WITH THE FUNDING AND RESOURCES NEEDED TO INCREASE AWARENESS OF AND PARTICIPATION IN THE AFFORDABLE CONNECTIVITY PROGRAM AMONG THOSE ELIGIBLE HOUSEHOLDS MOST IN NEED OF AFFORDABLE CONNECTIVITY.

RYAN WHITE HIV/AIDS PROGRAM PART D WICY COVID-19 RESPONSE

DLT OPIOID GRANTS