Center For Health Innovation

STATE INNOVATION MODELS: ROUND TWO OF FUNDING FOR DESIGN AND TEST ASSISTANCE

BEHAVIORAL HEALTH WORKFORCE EDUCATION AND TRAINING PROGRAM

CLIMATE CHANGE HEALTH IMPACTS & COMMUNITY ACTION (CCHICA) - CLIMATE CHANGE AND DROUGHT DISPROPORTIONATELY IMPACTS RURAL AREAS AND RACIAL POPULATIONS WITHIN NEW MEXICO. HIGH EXPOSURE TO POOR AIR QUALITY, POOR WATER QUALITY AND EXTREME CLIMATE EVENTS, AS WELL AS THE DEMOGRAPHIC, SOCIAL AND BEHAVIORAL CONTEXT (E.G. HOUSING, TRANSPORTATION, INFRASTRUCTURE, SOCIO ECONOMIC STATUS, AGE, DISABILITY) MAKE POPULATIONS OF COLOR MORE VULNERABLE TO THE SHORT AND LONG TERM HEALTH EFFECTS OF DROUGHT. THIS PROJECT WILL STUDY POLICIES ENACTED AT STATE, REGIONAL AND SIX LOCAL AND TRIBAL JURISDICTIONS TO ADDRESS THE IMPACT OF DROUGHT. THE NEW MEXICO ENVIRONMENTAL AND PUBLIC HEALTH NETWORK WILL WORK WITH SIX MULTI-SECTOR COUNTY AND TRIBAL HEALTH COUNCILS TO ANALYZE HOW DROUGHT RELATED POLICIES MAY PERPETUATE STRUCTURAL RACISM. POPULATIONS OF FOCUS: SIX MULTI-SECTOR HEALTH COUNCILS WILL BE SELECTED FROM THE FOLLOWING COUNTY OR TRIBAL COMMUNITIES IDENTIFIED AS BEING AT HIGH RISK FOR HEALTH RELATED IMPACTS OF DROUGHT: THE COUNTIES OF SAN JUAN, MCKINLEY, SANDOVAL, LUNA, DONA ANA, OTERO, CIBOLA, AND SIERRA; OR TRIBAL COMMUNITIES OF NAVAJO NATION, JEMEZ, SAN FELIPE, SANTO DOMINGO, COCHITI, MESCALERO, AND LAGUNA. GOAL: TO IDENTIFY CONTENT OF DROUGHT-RELATED PUBLIC POLICY AND/OR VARIATIONS IN PRACTICES ACROSS JURISDICTIONS THAT CONTRIBUTE TO OR PERPETUATE RACIAL HEALTH INEQUITIES AND TO REVISE OR DEVELOP NEW POLICIES TO DECREASE HEALTH INEQUITIES AND REDUCE THEIR IMPACT ON STRUCTURAL RACISM. OBJECTIVES: 1. BY JANUARY 2023, 6 COUNTY AND TRIBAL HEALTH COUNCILS WILL BE SELECTED TO PARTICIPATE IN THE PROJECT AND WILL COMPLETE THE INITIAL ORIENTATION TRAINING. 2. BY JULY 2023, HEALTH COUNCILS AND MEMBERS OF THE EVALUATION AND ADVISORY TEAMS WILL COMPLETE THE INITIAL ASSESSMENT OF LOCAL POLICIES USING THE LEGAL EPIDEMIOLOGY FRAMEWORK. 3. BY SEPTEMBER 2023, HEALTH COUNCILS WILL DEVELOP A DISPARITY IMPACT STATEMENT (DIS) USING LOCAL DATA TO IDENTIFY POPULATIONS AT HIGHEST RISK FOR HEALTH DISPARITIES AND LOW HEALTH LITERACY. 4. BY SEPTEMBER 2025, HEALTH COUNCILS WILL HAVE IMPLEMENTED THEIR DIS ACTION PLANS AND COMPLETED AN ASSESSMENT OF HOW THE NEW/REVISED POLICY STRATEGIES REDUCED OR REMOVED STRUCTURAL RACISM AND IMPROVED HEALTH OUTCOMES. 5. BY SEPTEMBER 2025, HEALTH COUNCILS WILL DEMONSTRATE INCREASED CAPACITY TO ENHANCE COMMUNITIES’ ABILITY TO IMPROVE HEALTH CONDITIONS RELATED TO DROUGHT. 6. BY SEPTEMBER 2025, A FINAL REPORT DESCRIBING POLICY FINDINGS AND RECOMMENDATIONS FOR NEW OR REVISED POLICY STRATEGIES AND PRACTICES WILL BE COMPLETED AND DISSEMINATED. OUTCOMES: - NEW/REVISED POLICIES AND PRACTICES TO REDUCE HEALTH DISPARITIES DUE TO DROUGHT - INCREASED CAPACITY OF HEALTH COUNCILS AND COMMUNITY MEMBERS TO IMPLEMENT AND ASSESS THE IMPACT OF POLICY AND PRACTICES. - INCREASED CAPACITY OF COMMUNITIES TO MAKE EQUITABLE DATA-DRIVEN POLICY AND PRACTICE DECISIONS AND EFFECTIVELY ADDRESS STRUCTURAL BARRIERS CONTRIBUTING TO HEALTH DISPARITIES, ESPECIALLY AMONG RACIAL AND ETHNIC POPULATIONS. - IMPROVED HEALTH OUTCOMES FOR RACIAL AND ETHNIC MINORITY POPULATIONS OF FOCUS. - IMPROVED ACCESS TO SERVICES THAT MITIGATE FACTORS CONTRIBUTING TO STRUCTURAL RACISM.

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

THE UNIFIED PREVENTION COALITION FOR DO?A ANA COUNTY

PROTECTORES DE LA COMUNIDAD [COMMUNITY PROTECTORS] - PROJECT NAME: PROTECTORES DE LA COMUNIDAD [COMMUNITY PROTECTORS] PROJECT SUMMARY: THE PROJECT PROPOSED BY CENTER FOR HEALTH INNOVATION (CHI) ADDRESSES A CRITICAL NEED FACING 6 NEW MEXICO’S BORDER COUNTIES WHICH HAVE BEEN AFFECTED BY DISPARITIES IN MENTAL HEALTH OUTCOMES, UTILIZATION OF SERVICES AND POVERTY. OVER THE 5-YEAR GRANT PERIOD CHI AND PARTNERS WILL PROVIDE AWARENESS TRAINING USING 3 EVIDENCE-BASED CURRICULA; PEER-LED CONTINUING EDUCATION; DEVELOP AND IMPLEMENT A REGIONAL REFERRAL NETWORK AND MANAGEMENT SYSTEM; AND IMPLEMENT CULTURALLY AND LINGUISTICALLY APPROPRIATE AWARENESS CAMPAIGNS. POPULATIONS SERVED: THE PROJECT WILL FOCUS ON YOUTH AND HISPANIC/LATINX POPULATIONS WHO ARE MORE LIKELY TO FACE CULTURAL, LINGUISTIC AND STRUCTURAL BARRIERS TO RECEIVING MENTAL HEALTH TREATMENT. THE SERVICE AREA INCLUDES 6 SOUTHERN BORDER COUNTIES IN NEW MEXICO: DOÑA ANA, HIDALGO, LUNA, OTERO, GRANT AND SIERRA. THE REGION IS HOME TO A LARGE HISPANIC/LATINX POPULATION, INCLUDING OVER 70 COLONIA COMMUNITIES AND MIGRANT POPULATIONS. NEW MEXICO YOUTHS ARE TWICE AS LIKELY AS ADULTS TO ATTEMPT SUICIDE. NEW MEXICO RANKS SECOND IN THE NATION FOR SUICIDE DEATH RATES PER 100,000 POPULATION AND WITHIN NEW MEXICO GRANT, SIERRA AND HIDALGO COUNTIES RANK AMONG THE TOP 6 COUNTIES WITH THE HIGHEST SUICIDE RATES. THE REGION’S HISPANIC/LATINX POPULATION FACES UNIQUE BARRIERS TO ACCESSING MENTAL HEALTH CARE SUCH AS COMMUNICATION BARRIERS, CULTURAL VIEWS AND STEREOTYPES, BEING UNDOCUMENTED, AND COST OF MEDICAL CARE. WITHIN THE TARGET COUNTIES THE HISPANIC/ LATINO POPULATION RANGES BETWEEN 31% (SIERRA) AND 68% (DOÑA ANA AND LUNA), COMPARED TO 18.5% ACROSS THE U.S. IN SOME COUNTIES MORE THAN 50% OF THE TOTAL POPULATION SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. STRATEGIES/INTERVENTIONS/OBJECTIVES. THE PROJECT GOAL IS TO INCREASE THE CAPACITY OF REGIONAL GATEKEEPERS AND EMERGENCY PERSONNEL TO PROVIDE INTERVENTION AND REFERRALS TO INDIVIDUALS WITH MENTAL ILLNESS AND THEIR FAMILIES SO THEY RECEIVE APPROPRIATE TREATMENT. AT THE END OF THE GRANT PERIOD THE FOLLOWING STRATEGIES AND OBJECTIVES WILL BE ACHIEVED, REACHING A TOTAL ESTIMATED 175,000 INDVIDUALS: 1) 320 GATEKEEPERS RECEIVE MENTAL HEALTH FIRST AID (MHFA) TRAINING AND 80% SELF-REPORT FEELING CONFIDENT IN THEIR SKILLS TO RECOGNIZE THE SIGNS AND SYMPTOMS OF MENTAL DISORDERS; 70 FAMILY MEMBERS RECEIVE FAMILY TO FAMILY TRAINING; 70 EMERGENCY SERVICE PERSONNEL RECEIVE CRISIS INTERVENTION TEAM OR MHFA-PUBLIC SAFETY TRAINING AND DEMONSTRATE DE-ESCALATION TECHNIQUES. 2) A REGIONAL REFERRAL NETWORK AND MANAGEMENT SYSTEM IS IMPLEMENTED ALLOWING PARTICIPATING ORGANIZATIONS TO SUCCESSFULLY LINK 80% OF INDIVIDUALS WITH MENTAL ILLNESS TO DEVELOPMENTALLY, CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES. 3) 175,000 INDIVIDUALS ARE INFORMED ABOUT CULTURALLY AND LINGUISTICALLY APPROPRIATE RESOURCES AVAILABLE IN THE COMMUNITY FOR INDIVIDUALS WITH A MENTAL DISORDER AND WAYS TO AVOID STIGMA ASSOCIATED WITH MENTAL ILLNESS. 1.STATE OF MENTAL HEALTH IN NM. 2018 RETRIEVED 01/31/21 AT HTTPS://WWW.NMHEALTH.ORG/DATA/VIEW/GENERAL/2193/ 2.RETRIEVED 01/30/2021 FROM HTTPS://WWW.CDC.GOV/NCHS/PRESSROOM/SOSMAP/SUICIDE-MORTALITY/SUICIDE.HTM 3.NEW MEXICO DEPARTMENT OF HEALTH. NEW MEXICO SUBSTANCE USE EPIDEMIOLOGY PROFILE, 2020 4.U.S. CENSUS BUREAU QUICK FACTS, U.S, NEW MEXICO, NEW MEXICO COUNTIES, 2019. 5.U.S. CENSUS BUREAU QUICK FACTS, U.S, NEW MEXICO, NEW MEXICO COUNTIES, 2019.

BEHAVIORAL HEALTH WORKFORCE EDUCATION AND TRAINING PROGRAM FOR PARAPROFESSIONALS - PROJECT ABSTRACT • PROJECT TITLE: BEHAVIORAL HEALTH WORKFORCE EDUCATION & TRAINING (BHWET) • APPLICANT ORGANIZATION NAME : CENTER FOR HEALTH INNOVATION- PUBLIC HEALTH INSTITUTE (CHI-PHI) • ADDRESS: 11587 US 180 E, SILVER CITY, NM 88061 • PROJECT DIRECTOR NAME: GENA TRUJILLO • CONTACT PHONE NUMBERS: (575) 649-8714 • EMAIL ADDRESS: ETRUJILLO@CHI-PHI.ORG • WEBSITE ADDRESS: WWW.CHI-PHI.ORG • GRANT FUNDS REQUESTED IN THE APPLICATION: $350,000 PER YEAR FOR 4 YEARS (PROGRAM ADMINISTRATION = $170,000 AND TIER 1 PRE-SERVICE SUPPORT = $180,000) TOTAL FEDERAL FUNDING REQUEST = $1,400,000.00 • FUNDING PREFERENCE AND PRIORITY. CHI REQUESTS FUNDING PRIORITY 1 AND FUNDING PREFERENCE QUALIFICATION 3 (NEW PROGRAM). SEE ATTACHMENT 8 FOR JUSTIFICATION. PROJECT OVERVIEW: BEHAVIORAL HEALTH WORKFORCE EDUCATION & TRAINING (BHWET), INITIATIVE USES DISTANCE EDUCATION TECHNOLOGY AND BUILDS UPON EXISTING NETWORKS TO ENHANCE EVIDENCE-BASED PRACTICES AND CARE FOR UNDER-RESOURCED AND HIGH NEED AREAS OF SOUTHERN NEW MEXICO. BHWET CREATES AND EXPANDS THE INTEGRATION OF BEHAVIORAL AND PRIMARY HEALTH CARE IN NEW MEXICO WHERE BEHAVIORAL HEALTH SERVICES ARE LIMITED AND OFTEN DISCONNECTED FROM PRIMARY HEALTH CARE. WHEREAS FEDERALLY QUALIFIED HEALTH CENTERS AND HOSPITAL SETTINGS TYPICALLY HAVE SOME LEVEL OF PRIMARY AND BEHAVIORAL HEALTH CARE INTEGRATION, SMALL PRIVATE PRACTICES OR CLINICS AND OTHER SETTINGS OFTEN INTEGRATE CARE THROUGH FORMAL AND INFORMAL LINKAGES WITH OTHER COMMUNITY SERVICE PROVIDERS. BHWET WILL PROVIDE TRAINING, TECHNICAL ASSISTANCE AND EXPERTISE ACROSS LOCATIONS AND BY VARIOUS MEANS WITHIN THE SERVICE AREA TO HELP ORGANIZATIONS ENHANCE AND IMPROVE INTEGRATED AND INTERPROFESSIONAL CARE USING EVIDENCE-BASED MODELS, APPROACHES AND TECHNOLOGY. PROJECT GOALS AND OBJECTIVES: BEHAVIORAL HEALTH PROFESSIONALS WORKING WITH PERSONS IN UNDER-RESOURCED COMMUNITIES ACROSS NEW MEXICO TO DELIVER EVIDENCE-BASED BEHAVIORAL HEALTH SERVICES. PROGRAM OBJECTIVES INCLUDE: • 30 PARTICIPANTS WHO SEEK A BEHAVIORAL HEALTH CERTIFICATION WILL COMPLETE THE BHWET PROGRAM REQUIREMENTS AND RECEIVE CERTIFICATION WITHIN 6 MONTHS OF COMPLETING THE PROGRAM. • ANNUALLY, APPROXIMATELY 30 PARTICIPANTS, FIELD SUPERVISORS, AND COMMUNITY PARTNERS WILL RECEIVE TRAINING AND TECHNICAL ASSISTANCE ON EVIDENCE-BASED INTERPROFESSIONAL AND INTEGRATED CARE PRACTICES AND TECHNOLOGY INTEGRATION TO IMPROVE OR ENHANCE CLIENT CARE. • 5 EXPERIENTIAL SITES WILL RECEIVE INTENSIVE TRAINING AND TECHNICAL ASSISTANCE RESULTING IN IMPROVED INTEGRATED PRACTICES APPROPRIATE FOR BOTH THE TRAINING SITE AND PARAPROFESSIONALS SERVED BY THIS GRANT. • 90% OF BHWET PARTICIPANTS WILL SHOW AN INCREASE IN COMPETENCIES, INCLUDING COMPETENCIES IN INTEGRATED CARE PRACTICES AND TECHNOLOGY.. • THE NUMBER OF FIELD PLACEMENT SITES WILL INCREASE BY 2 ADDITIONAL SITES IN YEARS 2-4. • THE BHWET ADVISORY BOARD WILL INCREASE BY 1 NEW MEMBER ANNUALLY. HOW THE PROJECT WILL BE ACCOMPLISHED: OVER THE 4-YEAR GRANT PERIOD, THE BHWET PROGRAM WILL FOCUS ON 8 BEHAVIORAL HEALTH CERTIFICATIONS: PEER SUPPORT WORKER (CPSW); YOUTH PEER SUPPORT WORKER (YPSW); COMPREHENSIVE COMMUNITY SUPPORT SERVICES (CCSS); COMMUNITY HEALTH WORKER/REPRESENTATIVE (CHW); CERTIFIED PREVENTION SPECIALIST (CPS); LICENSED SUBSTANCE ABUSE ASSOCIATE (LSAA); LICENSED ALCOHOL & DRUG ABUSE COUNSELOR (LADAC); REGISTERED BEHAVIOR TECHNICIAN (RBT). CHI WILL WORK WITH THE BHWET ADVISORY BOARD PARTNERS TO IMPROVE CONNECTIONS AND STREAMLINE PROCESSES AMONG PARAPROFESSIONAL CERTIFICATION STAKEHOLDERS, DIFFERENT AUTHORIZED TRAINING PROVIDERS, STATE AGENCIES AND CERTIFICATION BOARDS, EMPLOYERS AND EXPERIENTIAL LEARNING SITES. SERVING AS AN INTERMEDIARY AMONG THESE PLAYERS, MORE CERTIFIED PARAPROFESSIONALS WILL BE ABLE TO SERVE HIGH NEED AREAS AND POPULATIONS PROVIDING EVIDENCE-BASED CARE.

UNIFIED PREVENTION COALITOIN OF DONA ANA COUNTY, NM

RURAL COMMUNITIES OPIOID RESPONSE (PLANNING)

RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT PROGRAM

RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT PROGRAM

RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT PROGRAM

ADVANCING & IMPROVING MEASUREMENT AND VALUE IN PRIMARY CARE (THE AIM-PC STARFIELD SUMMIT) - PROJECT ABSTRACT: OUR CURRENT HEALTH CARE SYSTEM IS OVERPRICED AND UNDERPERFORMING IN PART DUE TO FAILURE TO NURTURE HIGH- PERFORMING PRIMARY CARE. RELATED TO THIS, THE US LACKS CONSENSUS ON A PARSIMONIOUS SET OF MEASURES CAPABLE OF FOCUSING PRIMARY CARE ON ITS HIGH-VALUE FUNCTIONS. TO ADDRESS THESE CHALLENGES AND AHRQ’S PRIORITIES OF IMPROVING HEALTH CARE AFFORDABILITY, EFFICIENCY AND COST TRANSPARENCY, THE VIRGINIA CENTER FOR HEALTH INNOVATION, IN PARTNERSHIP WITH THE CENTER FOR PROFESSIONALISM AND VALUE IN HEALTH CARE AND THE UNIVERSITY OF MICHIGAN VBID CENTER, IS REQUESTING A ONE-YEAR AHRQ CONFERENCE GRANT TO SUPPORT THE CONVENING, DEVELOPMENT OF WORK PRODUCTS, AND DISSEMINATION AND IMPLEMENTATION OF RESULTS FOR THE AIM-PC STARFIELD SUMMIT, ENTITLED “ADVANCING & IMPROVING MEASUREMENT AND VALUE IN PRIMARY CARE.” INITIATED IN 2016, THE STARFIELD SUMMITS ARE “ENVISIONED AS AN ONGOING SERIES OF MEETINGS… AMONG A DIVERSE GROUP OF LEADERS IN PRIMARY CARE RESEARCH AND POLICY, INTENDED TO GALVANIZE ITS PARTICIPANTS, GENERATE IMPORTANT DISCUSSION FOR PUBLIC CONSUMPTION, AND ENABLE RESEARCH AND POLICY AGENDA-SETTING IN SUPPORT OF PRIMARY CARE FUNCTION.” AHRQ WAS A SUPPORTER OF THE 3RD STARFIELD SUMMIT THAT HELPED PRODUCE THE PATIENT CENTERED PRIMARY CARE MEASURE WHICH IS NOW ENDORSED BY CMS AS A QCDR MIPS MEASURE AND WHICH IS GOING THROUGH NQF ENDORSEMENT. WE PROPOSE A 5TH STARFIELD SUMMIT TO ADDRESS THE CHALLENGE OF MEASUREMENT IN PRIMARY CARE. NESTED WITHIN THE BROADER CONVERSATION ABOUT “MEASURES THAT MATTER FOR PRIMARY CARE”1-3 WILL BE A FOCUSED CONVERSATION ON HOW TO SPECIFICALLY INCREASE ITS VALUE THROUGH MEASUREMENT AND REDUCTION OF LOW VALUE CARE (LVC) BY PRIMARY CARE PROVIDERS. THERE ARE NOW HUNDREDS OF TESTS AND PROCEDURES CONSIDERED UNNECESSARY, IDENTIFIED BY THE CHOOSING WISELY CAMPAIGN, THE US PREVENTIVE SERVICES TASK FORCE, INTERNATIONAL ENTITIES, AND EVEN COMMERCIAL SOFTWARE. DESPERATELY NEEDED IS CONSENSUS ON WHICH LVC MEASURES MATTER MOST – TO PAYORS, ACADEMICS, CLINICIANS, POLICYMAKERS, AND PATIENTS, ESPECIALLY THOSE IN PRIORITY POPULATIONS. OUR SUMMIT AND ITS SUMMARY WRITINGS WILL FRAME PRIMARY CARE LVC IN THE CONTEXT OF OVERALL PAYMENT REFORM, REVIEW AND IDENTIFY THE RANGE OF LVC RECOMMENDATIONS, DEVELOP CRITERIA FOR EVALUATING LVC MEASURES, ESTABLISH FEASIBILITY FOR LVC MEASURE IMPLEMENTATION, ACHIEVE CONSENSUS ON A CONCISE SET OF LVC INDICATORS SPECIFIC TO PRIMARY CARE; AND DISSEMINATE THE SELECTED MEASURE SET FOR WIDESCALE IMPLEMENTATION. WE WILL ACHIEVE THIS AIM THROUGH THE VIRTUAL ASSEMBLY OF LEADING LVC AND PRIMARY CARE MEASURES ADVISORS AND EXECUTING TWO RATING AND RANKING SURVEYS TO YIELD DESIRED DELIVERABLES.