Michigan Center For Rural Health

SHIP COVID TESTING AND MITIGATION

MEDICARE RURAL HOSPITAL FLEXIBILITY

SMALL RURAL HOSPITAL IMPROVEMENT GRANT PROGRAM

CORONAVIRUS STATE HOSPITAL IMPROVEMENT PROGRAM

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM ? MENTAL AND BEHAVIORAL HEALTH - 1.NORTHERN MI OPIOID RESPONSE AND BEHAVIORAL HEALTH CONSORTIUM (NMORBHC); INTEGRATING BEHAVIORAL HEALTH SUPPORTS INTO THE NORTHERN MI OPIOID RESPONSE CONSORTIUM 2. REQUESTED AWARD AMOUNT: $1,978,424.00 3. APPLICANT ORGANIZATION NAME: MICHIGAN CENTER FOR RURAL HEALTH 4. APPLICANT ORGANIZATION ADDRESS: 909 WILSON ROAD, EAST LANSING, MI 48823 5. APPLICANT ORGANIZATION FACILITY TYPE: STATE OFFICE OF RURAL HEALTH 6. PROJECT DIRECTOR: JOYCE FETROW, PROJECT DIRECTOR, NORTHERN MI OPIOID RESPONSE CONSORTIUM 7. PROJECT DIRECTOR: JOYCE.FETROW@AFFLIATE.MSU.EDU, 989.370.1470 8. DATA COORDINATOR: JESSICA VANWULFEN, PROJECT ASSOCIATE, NORTHERN MI OPIOID RESPONSE CONSORTIUM 9. DATA COORDINATOR: JESSICA.DAVIS@AFFLIATE.MSU.EDU; 898.858.1777 10. EIN/DUNS NUMBER EXCEPTION REQUEST IN ATTACHMENT 8? NO 11. HOW THE APPLICANT FIRST LEARNED ABOUT THE FUNDING OPPORTUNITY: HRSA PROJECT OFFICER 12. NUMBER OF CONSORTIUM MEMBERS & LIST OF CONSORTIUM MEMBERS: MYMICHIGAN HEALTH (MYMICHIGAN MEDICAL CENTER CLARE, MYMICHIGAN MEDICAL CENTER GLADWIN, MYMICHIGAN MEDICAL CENTER WEST BRANCH, MYMICHIGAN MEDICAL CENTER ALPENA), MUNSON HEALTH CARE (MUNSON CADILLAC, MUNSON GRAYLING, MUNSON GAYLORD, MUNSON CADILLAC, KALKASKA MEMORIAL HOSPITAL), NORTHERN MI OPIOID RESPONSE CONSORTIUM, MICHIGAN CENTER FOR RURAL HEALTH 13. IS THE APPLICANT ORGANIZATION A PREVIOUS OR CURRENT RCORP AWARD RECIPIENT OR CONSORTIUM MEMBER? YES, AWARD RECIPIENT FOR THE FOLLOWING: FY 18 RCORP PLANNING, FY 19 RCORP IMPLEMENTATION, FY 20 RCORP IMPLEMENTATION, FY 21 RCORP IMPLEMENTATION, AND FY 21 RCORP PSYCHOSTIMULANT SUPPORT. 14. INDICATE IF APPLICANT ORGANIZATION INTENDS TO APPLY FOR FY22 RCORP IMPLEMENTATION? YES 15. DOES THE TARGET SERVICE AREA OVERLAP WITH THE SERVICE AREAS OF THE NORTHERN BORDER REGIONAL COMMISSION, THE DELTA REGIONAL AUTHORITY, OR THE APPALACHIAN REGIONAL COMMISSION? NO. 16. RCORP-BHS TARGET SERVICE AREA (MUST BE EXCLUSIVELY RURAL, AS DEFINED BY THE RURAL HEALTH GRANTS ELIGIBILITY ANALYZE R): A. FULLY RURAL COUNTIES: ALCONA, ALPENA, CHEBOYGAN, CLARE, CRAWFORD, GLADWIN, KALKASKA, LAKE, MISSAUKEE, MONTMORENCY, OGEMAW, OSCODA, OTSEGO, PRESQUE ISLE, ROSCOMMON, AND WEXFORD (MICHIGAN) 17. BRIEF DESCRIPTION OF THE TARGET POPULATION: .9125 PERCENT OF THE TARGET POPULATION IS NATIVE AMERICAN, WITH CHEBOYGAN COUNTY HAVING THE HIGHEST PERCENTAGE AT 2.1%. THE NMORC BH INTEGRATION PROJECT WILL WORK WITH TRIBAL ORGANIZATIONS TO ENSURE THAT THE PEER RECOVERY SUPPORTS AND ADDITIONAL BEHAVIORAL HEALTH RESOURCES ARE CULTURALLY APPROPRIATE AND ARE ACCESSED BY THE NATIVE POPULATION. THE NORTHERN MICHIGAN OPIOID RESPONSE AND BEHAVIORAL HEALTH CONSORTIUM (NMORBHC) WILL UTILIZE A ROBUST STAFFING MODEL, KEY TARGETED RESOURCES, AND LEVERAGING OF EXISTING INFRASTRUCTURE TO IMPLEMENT THE CORE ACTIVITIES WITHIN THE RURAL COMMUNITIES OPIOID RESPONSE PROGRAM BEHAVIORAL HEALTH CARE SUPPORT (RCORP-BHS) OPPORTUNITY. ALL THREE GOALS ARE ADDRESSED IN A MEANINGFUL WAY. THE NMORC IS CURRENTLY A 34 -MEMBER CONSORTIUM ADDRESSING THE OPIOID EPIDEMIC IN RURAL NORTHERN MICHIGAN. MICHIGAN CENTER FOR RURAL HEALTH, LEAD APPLICANT FOR THIS PROJECT, IS AN NMORC MEMBER. FOR THIS FUNDING OPPORTUNITY, THIS EXISTING INFRASTRUCTURE WILL BE LEVERAGED, AND ADDITIONAL SUPPORTS SPECIFICALLY FOCUSED ON INCREASING ACCESS TO BEHAVIORAL HEALTH CARE WILL BE SUPPORTED. THE 16-COUNTY REGION PRIORITIZED FOR THIS PROJECT IS ENTIRELY COMPOSED OF HRSA-DESIGNATED RURAL AREAS AND CONSISTENTLY RANKED AS THE HIGHEST NEED IN THE STATE DUE TO POOR ECONOMIC FACTORS, HEALTH CONDITIONS, SOCIAL AND BEHAVIORAL BARRIERS, PRESCRIBING PATTERNS, AND HIGH PRESCRIPTION DRUG ABUSE. THE TARGET COUNTIES INCLUDE ALCONA, ALPENA, CHEBOYGAN, CLARE, CRAWFORD, GLADWIN, KALKASKA, LAKE, MISSAUKEE, MONTMORENCY, OGEMAW, OSCODA, OTSEGO, PRESQUE ISLE, ROSCOMMON, AND WEXFORD. ALL 16 COUNTIES ARE DESIGNATED TO HAVE PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREAS, AND MENTAL HEALTH PROFESSIONA

RURAL HOSPITAL FLEXIBILITY PROGRAM

STATE OFFICE OF RURAL HEALTH

RURAL PUBLIC HEALTH WORKFORCE TRAINING NETWORK PROGRAM - THE UPPER PENINSULA WORKFORCE INNOVATION NETWORK (U.P. WIN) THE MICHIGAN CENTER FOR RURAL HEALTH (MCRH) 909 WILSON RD. B-218 MICHIGAN STATE UNIVERSITY EAST LANSING, MI 48824 STATE OFFICE OF RURAL HEALTH MCRH.MSU.EDU FEDERAL FUNDS AWARD AMOUNT REQUESTED - $1,443,813 WORKFORCE TRAINING TRACKS – #1 COMMUNITY HEALTH SUPPORT & #3 COMMUNITY PARAMEDICINE JOHN BARNAS, EXECUTIVE DIRECTOR - MCRH PHONE: (517) 432-9216 EMAIL: BARNAS@MSU.EDU ELISE BUR, PROJECT DIRECTOR PHONE: (906) 227-6356 EMAIL: EBUR@NMU.EDU TARGET SERVICE AREA: THE UPPER PENINSULA OF MICHIGAN COMPRISED OF THE FOLLOWING 15 COUNTIES: ALGER, BARAGA, CHIPPEWA, DELTA, DICKINSON, GOGEBIC, HOUGHTON, IRON, KEWEENAW, LUCE, MACKINAC, MARQUETTE, MENOMINEE, ONTONAGON, AND SCHOOLCRAFT. NETWORK PARTNERS: THE MICHIGAN CENTER FOR RURAL HEALTH, NORTHERN MICHIGAN UNIVERSITY, UPPER PENINSULA MICHIGAN WORKS, UPPER PENINSULA AREA HEALTH EDUCATION CENTER, UPPER GREAT LAKES FAMILY HEALTH CENTER, UPPER PENINSULA HEALTH CARE SOLUTIONS, EVERYDAY LIFE CONSULTING, UP HEALTH SYSTEM MARQUETTE SCHOOL OF EMT, MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES – BUREAU OF EMS, TRAUMA AND PREPAREDNESS. CAPACITY TO SERVE RURAL UNDERSERVED POPULATIONS: THE OVERARCHING GOAL OF THE UPPER PENINSULA WORKFORCE INNOVATION NETWORK (U.P WIN) PROJECT IS TO INCREASE THE COMMUNITY HEALTH WORKER (CHW) AND COMMUNITY PARAMEDICINE (CP) WORKFORCE CAPACITY BY EXPANDING AND EXTENDING THE REACH OF HEALTH PROFESSIONAL WORKFORCE EDUCATION, TRAINING, EMPLOYMENT, AND RETENTION ACTIVITIES WITHIN MICHIGAN’S UPPER PENINSULA (U.P.) REGION. U.P. WIN IS A NINE-PARTNER NETWORK ADDRESSING THE HEALTHCARE WORKFORCE SHORTAGES OF CHWS AND CPS IN THE TARGET SERVICE AREAS. THE 15-COUNTY REGION PRIORITIZED FOR THIS PROJECT IS ENTIRELY COMPOSED OF HRSA-DESIGNATED RURAL AREAS AND IS ENTIRELY DESIGNATED AS PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). U.P. WIN WILL FOCUS ON THE FOLLOWING ACTIVITIES: - DEVELOP AND EXPAND A COMMUNITY PARAMEDICINE D ELIVERY MODEL IN THE U.P. THE INTENT IS TO CREATE A THRIVING EDUCATION AND TRAINING PIPELINE FOR EMT COURSES WITH THE GOAL OF SUPPLYING THE STAFF NEEDED TO GROW AND SUSTAIN THE MODEL IN THE U.P.; - LEVERAGING EMT’S TO ADDRESS AT-RISK POPULATIONS, MANAGE PATIENTS WITH CHRONIC DISEASE IN-HOME, AND DECREASE HOSPITAL RE-ADMISSIONS, WHILE AVOIDING UNNECESSARY EMERGENCY DEPARTMENT VISITS. EMT’S WILL PROVIDE VALUE-BASED HEALTH SCREENINGS, POPULATION HEALTH RELATED WORK AND SERVICE REFERRALS THROUGH THIS INNOVATIVE COMMUNITY PARAMEDICINE CARE DELIVERY MODEL; - INCREASING ACCESS TO HEALTH CARE SERVICES AS A RESULT OF INCREASING THE COMMUNITY HEALTH WORKER WORKFORCE IN THE REGION; - IDENTIFYING, EDUCATING, AND PROVIDING CROSS-TRAINING OPPORTUNITIES FOR COMMUNITY HEALTH WORKERS; - DEVELOPING AND EXPANDING A SUSTAINABLE COMMUNITY HEALTH WORKER MODEL. AS MICHIGAN’S STATE OFFICE OF RURAL HEALTH, THE MCRH PLAYS A KEY ROLE IN RURAL HEALTH CARE BY ASSISTING IN THE CREATION AND IMPLEMENTATION OF PARTNERSHIPS AMONG ORGANIZATIONS, HEALTH DEPARTMENTS, HOSPITALS, GOVERNMENT, AND ACADEMIA. THESE COLLABORATIONS AND ALLIANCES CREATE NEW OPPORTUNITIES IN THE AREAS OF NETWORK DEVELOPMENT, QUALITY OF CARE, EMERGENCY MEDICAL SERVICES, CONTINUING EDUCATION, AND RECRUITMENT AND RETENTION OF RURAL HEALTH CARE PROVIDERS. THE PROJECT DIRECTOR AND DATA COORDINATOR WILL BE CONTRACTED TO THE NORTHERN MICHIGAN UNIVERSITY CENTER FOR RURAL HEALTH BASED IN MARQUETTE, MI. FUNDING PREFERENCE: THE MICHIGAN CENTER FOR RURAL HEALTH IS REQUESTING A FUNDING PREFERENCE BASED ON QUALIFICATION 1. THE ENTIRE UPPER PENINSULA REGION IS OFFICIALLY DESIGNATED AS A PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). SEE ATTACHMENT 10 FOR MORE INFORMATION. SPECIAL CONSIDERATION: THE MICHIGAN CENTER FOR RURAL HEALTH IS REQUESTING SPECIAL CONSIDERATION BASED ON THE INCLUSION OF A SIGNED MOU FROM ALL U.P. WIN NETWORK PARTNERS INCLUDED IN ATTACHMENT 11.

FLEX RURAL VETERANS HEALTH ACCESS PROGRAM

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION - THE NORTHERN MICHIGAN OPIOID RESPONSE CONSORTIUM (NMORC) EXPANSION PROJECT WILL UTILIZE A ROBUST STAFFING MODEL AND KEY TARGETED RESOURCES TO IMPLEMENT THE CORE ACTIVITIES WITHIN THE HRSA RURAL COMMUNITIES OPIOID RESPONSE PROGRAM IMPLEMENTATION FUNDING OPPORTUNITY. ALL CORE ACTIVITIES ARE ADDRESSED AND TARGETED AT FOUR NEW COUNTIES ADJACENT TO THE CURRENT NMORC REGION: GRAND TRAVERSE, BENZIE, LEELANAU AND MANISTEE COUNTIES. THE NMORC EXPANSION PROJECT WILL ALLOW EXPANSION OF CURRENT NMORC RESOURCES TO FOUR NEW COUNTIES; GRAND TRAVERSE, BENZIE, LEELANAU AND MANISTEE AND PROVIDE A VARIETY OF NEW RESOURCES TO THESE COUNTIES WHICH ARE UNIQUE AND SPECIFIC TO THE NEEDS OF THESE THREE ADDITIONAL COUNTIES. THESE FOUR COUNTIES ARE ADJACENT TO THE CURRENT NMORC COUNTIES, ARE COVERED BY THE CURRENT NMORC MEMBER LOCAL PUBLIC HEALTH DEPARTMENTS, PRE-PAID INPATIENT HEALTH PLANS, AND COMMUNITY MENTAL HEALTH AND HAVE STARK NEEDS RELATED TO SUBSTANCE USE DISORDER, AND OPIOID USE DISORDER. IN ADDITION, THESE FOUR COUNTIES ARE IDENTIFIED BY THE CDC AS A DETERMINED TO BE EXPERIENCING OR AT-RISK OF SIGNIFICANT INCREASES IN HEPATITIS INFECTION OR AN HIV OUTBREAK DUE TO INJECTION DRUG USE . THE EXPANSION INTO THE TWO NEW COUNTIES WILL BRING IN 15 NEW MEMBERS, INCLUDING THREE NEW HOSPITALS (MUNSON MEDICAL CENTER, MUNSON HEALTHCARE MANISTEE HOSPITAL, PAUL OLIVER MEMORIAL HOSPITAL), ONE NEW FEDERALLY QUALIFIED HEALTH CENTER (TRAVERSE HEALTH CLINIC), FOUR PREVENTION COALITIONS (LEELANAU COUNTY SUBSTANCE ABUSE COALITION, GRAND TRAVERSE DRUG FREE COALITION, SUBSTANCE FREE COALITION OF NW MICHIGAN, FAMILIES AGAINST NARCOTICS – GRANT TRAVERSE), A RECOVERY HOME (PROJECT UNITY), TWO LAW ENFORCEMENT PARTNERS (BENZIE MANISTEE DRUG COURT, BENZIE COUNTY SHERIFFS DEPARTMENT), A TRIBAL PARTNER (GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS), TWO DISTRICT HEALTH DEPARTMENTS (GRAND TRAVERSE LOCAL PUBLIC HEALTH, BENZIE LEELANAU DISTRICT HEALTH DEPARTMENT) AND A COMMUNITY PARTNER (S ALVATION ARMY). A DETAILED LISTING OF CONSORTIUM MEMBERS IS PROVIDED IN ATTACHMENT 2. THE NMORC EXPANSION PROJECT IS A UNIQUE OPPORTUNITY TO LEVERAGE AN ALREADY EXISTING INFRASTRUCTURE (NMORC) INTO THREE NEW COUNTIES AND PROVIDE A VARIETY OF RESOURCES SPECIFIC TO THE NEEDS OF GRAND TRAVERSE, BENZIE, LEELANAU AND MANISTEE COUNTIES.

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

SMALL RURAL HOSPITAL IMPROVEMENT GRANT PROGRAM

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM-PSYCHOSTIMULANT SUPPORT

STATE OFFICE OF RURAL HEALTH

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM - THE PROPOSED PROJECT (ADVANCING HEALTH IN RURAL MICHIGAN) ESTABLISHES A NEW CONSORTIUM OF LOCAL, STATE, AND NATIONAL HEALTHCARE PARTNERS TO EXPAND HIGH-QUALITY RURAL POST-ACUTE RECOVERY OPTIONS VIA CRITICAL ACCESS HOSPITAL (CAH) TRANSITIONAL CARE (TC) AND INCREASE ACCESS TO MENDS® WELLNESS AND ADVANCED CARE PLANNING (ACP) EDUCATION AND RESOURCES IN THE INPATIENT, PRIMARY CARE, AND COMMUNITY SETTINGS ACROSS RURAL SOUTHWEST LOWER AND NORTH CENTRAL LOWER MICHIGAN COMMUNITIES. EFFORTS WILL ADDRESS THE LACK OF LOCALLY AVAILABLE HEALTHCARE AND ACCESSIBLE WELLNESS AND ADVANCE CARE PLANNING INFORMATION, TOOLS, AND SUPPORT. THE TARGET POPULATION FOR THE PROPOSED PROJECT IS ADULTS 18 AND OLDER, WITH A TARGET SUB-POPULATION OF MEDICARE BENEFICIARIES OF 65 YEARS OF AGE AND ABOVE. INDIVIDUALS IN THE 5-COUNTY SOUTHWEST LOWER & NORTH CENTRAL LOWER MICHIGAN SERVICE AREA (ALLEGAN, ARENAC, CASS, GLADWIN, IOSCO COUNTIES) STRUGGLE WITH PREVENTABLE POOR HEALTH BEHAVIORS AND OUTCOMES AND HIGH RATES OF CHRONIC DISEASE. GOALS: DEVELOP A STRONG MULTI-REGIONAL CONSORTIUM TO MEET THE UNIQUE NEEDS OF TARGET RURAL COMMUNITIES THROUGH NEW AND EXPANDED SERVICES; ENHANCE CARE DELIVERY, SUPPORT, AND ENABLING SERVICES ACROSS 5 COUNTIES OF RURAL MICHIGAN (SOUTHWEST LOWER MICHIGAN AND NORTH CENTRAL LOWER MICHIGAN REGIONS) BY IMPLEMENTING HOSPITAL-BASED POST-ACUTE CAH TC AT 4 CAH PARTNERS; SUPPORT THE HEALTH AND WELLNESS OF RURAL MICHIGAN COMMUNITIES THROUGH COMMUNITY-DRIVEN EDUCATION AND OUTREACH. OBJECTIVES: ENGAGE CONSORTIUM MEMBERS & RURAL COMMUNITIES TO GUIDE & SUPPORT EFFORTS; EQUIP, EDUCATE, AND SUPPORT HOSPITAL LEADERS, PROVIDERS, AND STAFF TO PROVIDE HIGH-QUALITY, POST-ACUTE TC WITHIN THE RURAL CAH SETTING; ENHANCE COLLABORATION BETWEEN RURAL HOSPITALS; LAUNCH HOSPITAL-BASED POST-ACUTE TC SERVICES WITHIN 4 CAH PARTNERS IN ORDER TO REDUCE HEALTH ACCESS AND OUTCOMES DISPARITIES AND IMPROVE THE HEALTH OUTCOMES AND QUALITY OF LIFE OF RURAL MEDICARE BENEFICIARIES (AGE 65 AND ABOVE) IN THE SERVICE AREA; ESTABLISH THE NEEDED INFRASTRUCTURE AND TOOLS TO SUCCESSFULLY IMPLEMENT EDUCATION AND OUTREACH EFFORTS; LAUNCH MENDS® (AN EVIDENCE-INFORMED MODEL) TO SUPPORT THE IMPROVEMENT OF HEALTH BEHAVIORS AND HEALTH OUTCOMES IN RURAL ADULTS (AGE 18 AND ABOVE); AND INCREASE ACCESS FOR RURAL COMMUNITY MEMBERS (ADULTS AGE 18 AND ABOVE) TO ADVANCED CARE PLANNING (ACP) TOOLS AND ONE-ON-ONE SUPPORT. OUTCOMES: INCREASE IN POST-ACUTE CAH TC ADMISSIONS, BED DAYS, AND REVENUE; FEWER DISCHARGES DIRECTLY BACK TO ACUTE CARE FROM POST-ACUTE CARE AND MORE TO HOME; SHORTER POST-ACUTE STAYS; INCREASED PATIENT & CARE TEAM SATISFACTION; INCREASE IN HEALTHCARE STAFF, PATIENTS, AND COMMUNITY MEMBERS WITH PERSONAL WELLNESS GOALS, HEALTHY BEHAVIORS, AND ADVANCED CARE PLANS. FUNDING TRACK: REGULAR FOCUS AREA: HOSPITAL-BASED TRANSITIONAL CARE & PREVENTION/WELLNESS EVIDENCE-BASED/EVIDENCE-INFORMED MODEL. THE PROPOSED PROJECT WILL UTILIZE THE EVIDENCE-INFORMED HOSPITAL-BASED TRANSITIONAL CARE WITH MENDS® MODEL. THE MICHIGAN CENTER FOR RURAL HEALTH (MCRH) HAS SERVED AS THE STATE OFFICE OF RURAL HEALTH, SERVING ALL 57 RURAL MICHIGAN COUNTIES SINCE 1991. THE MCRH HAS A LONG HISTORY IN IMPLEMENTING RURAL HEALTH PROGRAMS, INCLUDING, BUT NOT LIMITED TO THE FOLLOWING: MEDICARE RURAL HOSPITAL FLEXIBILITY GRANT PROGRAM, STATE OFFICE OF RURAL HEALTH, SMALL HOSPITAL IMPROVEMENT PROGRAM, RURAL COMMUNITIES OPIOID RESPONSE PROGRAMS (PLANNING AND IMPLEMENTATION), AND RURAL HEALTH CARE SERVICES OUTREACH PROGRAM. FUNDING PREFERENCE. THE MICHIGAN CENTER FOR RURAL HEALTH QUALIFIES FOR THE PRIMARY CARE, WELLNESS AND PREVENTION STRATEGIES FUNDING PREFERENCE (QUALIFICATION 3). THE PROPOSED PROJECT WILL FOCUS ON PRIMARY CARE, AND WELLNESS AND PREVENTION STRATEGIES. FOR SUPPORTING DOCUMENTATION, SEE ATTACHMENT 11.

RURAL COMMUNITIES OPIOID RESPONSE (PLANNING)

RURAL HOSPITAL FLEXIBILITY PROGRAM

RURAL COMMUNITIES OPIOID RESPONSE (PLANNING)