Saint James Health Inc

HEALTH CENTER PROGRAM

HEALTH CENTER PROGRAM

FY 2021 ENDING THE HIV EPIDEMIC - PRIMARY CARE HIV PREVENTION - SAINT JAMES HEALTH, INC., (SJH) GRANT NUMBER H80CS29015, PROPOSES TO USE FY 2022 ENDING THE HIV EPIDEMIC (EHE) PRIMARY CARE HIV PREVENTION (PCHP) FUNDING TO DECREASE RISK OF HIV TRANSMISSION AMONG PERSONS WITH HIV AND AT RISK FOR HIV DISEASE CONSISTENT WITH FEDERAL EHE GOALS THROUGH EXPANDED HIV TESTING, TO INCREASE ACCESS TO AND PRESCRIPTION OF PREEXPOSURE PROPHYLAXIS (PREP), AND TO INCREASE LINKAGE OF NEWLY-DIAGNOSED PLWH TO HIV MEDICAL CARE. NEED. SJH CLINICS ARE LOCATED IN THE CITY OF NEWARK, NJ WHICH IS THE EPICENTER OF NEW JERSEY’S HIV EPIDEMIC – HOME TO 15% OF NEW JERSEY’S PEOPLE LIVING WITH HIV (PLWH) DISEASE BUT ONLY 3% OF THE STATE’S POPULATION. SJH SERVES PATIENTS IN THE GREATER NEWARK SERVICE AREA INCLUDING MUNICIPALITIES AND ZIP CODE AREAS IN TWO OF THE 48 FEDERAL EHE JURISDICTIONS – ESSEX COUNTY (INCLUDING NEWARK) AND ADJACENT HUDSON COUNTY. SJH CURRENTLY CONDUCTS TESTING FOR INDIVIDUALS AT RISK FOR SEXUALLY TRANSMITTED INFECTIONS (STIS) WHICH ARE THE SAME RISK FACTORS FOR HIV DISEASE. SJH ALSO CONDUCTS HIV TESTING. PERSONS TESTING HIV POSITIVE ARE REFERRED TO THE CITY OF NEWARK CHC (MARY ELIZA MAHONEY HEALTH CENTER) FOR HIV MEDICAL CARE PROVIDED BY AN INFECTIOUS DISEASE SPECIALIST. FEDERAL CDC FUNDING SUPPORTS HIV TESTING IN THE SERVICE AREA BUT NEW HIV DIAGNOSES HAVE DECLINED FROM 2017-2020 ACCORDING DATA ON AHEAD.HIV.GOV. PROPOSAL. WITH EHE PCHP FUNDING, SJH WILL IMPLEMENT A STATUS NEUTRAL APPROACH TO PATIENTS AT RISK FOR HIV VIA SEXUAL ACTIVITY AND INJECTION DRUG USE. GOAL 1: SJH WILL INCREASE HIV TESTING OF SJH PATIENTS (DOUBLE THE NUMBER OF PATIENTS TESTED IN 2020) THROUGH COORDINATION WITH STI TESTING AND WILL IMPLEMENT RAPID HIV TESTING ONSITE TO PROVIDE HIV TEST RESULTS WITHIN 20 MINUTES (CONFIRMATORY HIV POSITIVE WITHIN ONE HOUR). SJH WILL SEEK TO IMPLEMENT “OPT OUT” HIV TESTING FOR PATIENTS IN COLLABORATION WITH THE EHE ESSEX COUNTY INITIATIVE. SJH WILL ALSO PROVIDE OUTREACH SERVICES FOR HIV TESTING AND FOLLOW UP. GOAL 2: SJH WILL INCREASE PRESCRIPTION OF PREP FOR INDIVIDUALS TESTING HIV NEGATIVE THROUGH EDUCATION AND DIRECT ASSISTANCE. (1) SJH WILL PROVIDE PREP EDUCATION TO BOTH INDIVIDUALS TESTING HIV NEGATIVE AND THOSE TESTING HIV POSITIVE FOR THEIR HIV NEGATIVE PARTNERS. THIS WILL INCREASE DEMAND FOR PREP. (2) SJH WILL INCREASE PRESCRIPTION OF PREP TO ALL INTERESTED INDIVIDUALS IDENTIFIED IN (1). (3) SJH WILL FOLLOW UP WITH PREP PATIENTS ACCORDING TO CDC CLINICAL PRACTICE GUIDELINES FOR PREP RELEASED DECEMBER 8, 2021. GOAL 3: FOR INDIVIDUALS TESTING HIV POSITIVE, SJH WILL PROVIDE HIV MEDICAL CARE ON SITE WITH MEDICAID, CHC AND OTHER FUNDING. SJH HAS APPLIED FOR FY 2022 ESSEX COUNTY EHE FUNDING FOR RAPID ANTIRETROVIRAL (ART) TREATMENT SCHEDULED TO START MARCH 2022. IT IS EXPECTED THAT MORE HIV DIAGNOSES WILL COME FROM THE WEST WARD LOCATION BASED ON CURRENT ZIP CODE HIV DATA FROM AIDSVU.ORG AND SJH TESTING DATA - BUT ALL OF NEWARK IS IMPACTED. IN 2019, OVER 2% OF NEWARK RESIDENTS HAVE HIV THROUGHOUT ALL ZIP CODES, COMPARED WITH 0.8% OF ESSEX COUNTY RESIDENTS LIVING OUTSIDE OF NEWARK AND 0.4% OF NEW JERSEY RESIDENTS. THE PCHP INITIATIVE WILL BE SUPPORTED AT THE TWO SJH SITES BY TWO MEDICAL TEAMS (TOTAL 0.4 FTE INFECTIOUS DISEASE SPECIALISTS, 0.4 MEDICAL ASSISTANTS), 0.2 FTE LICENSED CLINICAL SOCIAL WORKER (BEHAVIORAL HEALTH), 1.0 FTE PATIENT EDUCATION/PREP NAVIGATORS, AND FINANCIAL AND HUMAN RESOURCES SUPPORT. DIRECT COSTS WILL INCLUDE PURCHASE OF HIV RAPID TESTS, PATIENT EDUCATION MATERIALS, LAB COSTS FOR UNINSURED INDIVIDUALS, COST OF PROGRAMMING ELECTRONIC MEDICAL RECORDS AND PRACTICE MANAGEMENT SYSTEM TO CAPTURE HIV TESTING AND PREP DATA AND PROVIDE NECESSARY EHE TRIANNUAL REPORTS. SJH WILL COORDINATE PCHP WITH THE EHE ESSEX COUNTY INITIATIVE AT THE NEWARK DEPARTMENT OF HEALTH AND COMMUNITY WELLNESS/RYAN WHITE UNIT.

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

FY 2024 BEHAVIORAL HEALTH SERVICE EXPANSION - SAINT JAMES HEALTH (SJH) PROPOSES TO USE BEHAVIORAL HEALTH SERVICE EXPANSION (BHSE) FUNDING TO PROVIDE EXPANDED SCREENING, DIAGNOSIS AND TREATMENT OF MENTAL HEALTH (MH) ISSUES, SUBSTANCE USE DISORDER (SUD) ISSUES, AND OPIOID USE DISORDER THROUGH APPROPRIATE MEDICATIONS (MOUD) EXPERIENCED BY UNSERVED AND UNDERSERVED RESIDENTS IN OUR GREATER NEWARK NJ SERVICE AREA. SJH HAS ALREADY MADE SIGNIFICANT PROGRESS INTEGRATING ON-SITE BEHAVIORAL HEALTH (BH) INTO MEDICAL CARE AND REMOVING BARRIERS. BHSE WILL FILL IN REMAINING GAPS TO SERVE 400 UNDUPLICATED PATIENTS (335 MH AND 118 SUD) BY THE END OF 2025. NEEDS. IN THE SJH SERVICE AREA, ESSEX COUNTY (INCLUDING NEWARK) HAS THE HIGHEST PREVALENCE OF UNDIAGNOSED AND UNTREATED MH ISSUES, SUD AND OPIOID USE IN NEW JERSEY (NJ). RATES ARE DOCUMENTED IN BH NEEDS ASSESSMENTS OF NJ DEPARTMENTS OF HUMAN SERVICES (2022) AND HEALTH (2022) AND NEWARK EMA FOR PEOPLE LIVING WITH HIV (2023). NEEDS ARE HIGHEST AMONG LOWEST INCOME RESIDENTS, DUE TO STIGMA, DENIAL, LACK OF HEALTH INSURANCE AND LANGUAGE/CULTURAL BARRIERS. THE BH SYSTEM IS FRAGMENTED AMONG AGENCIES: HOSPITALS, EMERGENCY DEPARTMENTS, SPECIALTY CARE, CERTIFIED COMMUNITY BEHAVIOR HEALTH CENTERS (CCBHCS), HEALTH CENTERS AND COMMUNITY AGENCIES. FRAGMENTATION IS WORSENED BY NJ STATE FACILITY LICENSING REQUIREMENTS FOR TWO SEPARATE LICENSES FOR AMBULATORY CARE AND MENTAL HEALTH FROM TWO STATE DEPARTMENTS BEFORE A HEALTH CENTER CAN TREAT BOTH MEDICAL AND BEHAVIORAL NEEDS IN A SINGLE LOCATION. THE HIGH COST OF BILINGUAL LICENSED PROFESSIONALS – PSYCHIATRIST TO PRESCRIBE MEDICATIONS AND LICENSED CLINICAL SOCIAL WORKER (LCSW) TO TREAT BOTH MH AND SUD – RESULTS IN SPANISH-SPEAKING POPULATIONS NOT BEING TREATED. POPULATIONS. SJH BHSE WILL SERVE LOW INCOME RESIDENTS-PRIMARILY ADULTS AND THEIR FAMILIES, MOST OF WHOM ARE RACIAL/ETHNIC MINORITY – BLACK/AFRICAN AMERICAN AND HISPANIC/LATINO – WITH MANY BEST SERVED BY A LANGUAGE OTHER THAN ENGLISH (SPANISH). PROPOSED SERVICES. WIT H BHSE FUNDS SJH WILL PROVIDE AN INTEGRATED CARE SYSTEM FOR PATIENTS AND SERVICE AREA RESIDENTS THROUGH A CONVENIENT, CULTURALLY APPROPRIATE SINGLE ENTRY POINT. BHSE FUNDED SERVICES WILL BE PROVIDED AT OUR THREE CLINIC LOCATIONS IN NEWARK’S EAST, WEST AND SOUTH WARDS. THE EAST WARD SITE IS ALREADY LICENSED FOR MH; MH LICENSING IS BEING FINALIZED FOR THE WEST AND SOUTH SITES. SJH WILL IMMEDIATELY HIRE A CERTIFIED PSYCHIATRIC NURSE PRACTITIONER (PSYCH NP) AND THREE LCSWS WITH BILINGUAL CAPABILITY TO DIAGNOSE AND TREAT MH AND SUD. THEY WILL ROTATE AT THE THREE SITES. THE PSYCH NP AND SJH MEDICAL DIRECTOR WILL PRESCRIBE NEEDED MEDICATIONS TO TREAT OUD. BHSE WILL FUND BOTH TRAINING FOR SJH STAFF ON BH PROTOCOLS/PRACTICES, AND PEER SUPPORT SPECIALISTS FOR TREATMENT COMPLIANCE. SJH REFERRAL SYSTEMS ARE IN PLACE FOR NEEDED BH CARE AND COORDINATION. IN 2022 SJH BEGAN COLLABORATING WITH NEW JERSEY’S LARGEST HEALTH CARE SYSTEM – ROBERT WOOD JOHNSON/BARNABAS (RWJB) – TO CREATE A MEDICAL AND BH CARE CONTINUUM BETWEEN RWJB HOSPITALS, EMERGENCY DEPARTMENTS, SPECIALTY CARE, AND THE SJH HEALTH CENTER– TO ENSURE APPROPRIATE CARE AND CONTINUITY. REFERRAL AGREEMENTS ARE ALREADY IN PLACE AND WILL BE EXPANDED TO INCLUDE BH SERVICES. THE EPIC EMR IS USED THROUGHOUT THE RWJB SYSTEM AND AT SJH WHICH MEANS ONE SINGLE PATIENT CHART FOR BH – FURTHER REMOVING PATIENT CARE BARRIERS AND IMPROVING CARE COORDINATION. THE RWJB/TRINITAS RENOWNED BH SPECIALTY CARE PRACTICE IN ELIZABETH NJ ADJACENT TO NEWARK WILL RECEIVE REFERRALS OF APPROPRIATE PATIENTS AS WILL INTEGRITY HOUSE, A CCBHC IN NEWARK. SJH CASE MANAGERS AND ENTER INTO EPIC SOCIAL DETERMINANTS OF HEALTH (SDOH) FOR EACH PATIENT, WHICH ARE USED FOR REFERRALS TO NEEDED COMMUNITY SERVICES. INDIVIDUAL HEALTH RELATED SOCIAL NEEDS (HRSNS) WILL BE ADDED. BHSE SERVICES AND OUTCOMES WILL BE MONITORED BY AN UPDATED QUALITY MANAGEMENT PLAN AND MONTHLY PERFORMANCE REVIEW. RESULTS WILL BE SHARED WITH RWJB PARTNERS FOR SYSTEM-WIDE IMPROVEMENT.

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

HEALTH CENTER INFRASTRUCTURE SUPPORT

FY 2023 EARLY CHILDHOOD DEVELOPMENT

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

FY 2023 EXPANDING COVID-19 VACCINATION

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

FY 2023 BRIDGE ACCESS PROGRAM