Wellstar Health System Inc

HEALTHY START INITIATIVE - ADDRESS: WEST GEORGIA MEDICAL CENTER 1514 VERNON ROAD LAGRANGE, GA 30240 PROJECT DIRECTOR NAME: TBH. GRANT POINT OF CONTACT: MRS. KATHERINE TROMBLEY CONTACT PHONE NUMBERS: (470) 956-5789 EMAIL ADDRESS: KATHERINE.TROMBLEY@WELLSTAR.ORG WEBSITE ADDRESS: WWW.WELLSTAR.ORG FUNDS REQUESTED: $5,500,000 WELLSTAR HEALTH SYSTEM (WELLSTAR), ONE OF THE LARGEST NOT-FOR-PROFIT HEALTHCARE SYSTEMS IN GEORGIA AND A TOP 5 PROVIDER OF CHARITY CARE IN THE U.S., PROPOSES THE COMMUNITY-BASED ECOSYSTEM OF COLLABORATIVE MATERNAL CARE (CMC) HEALTHY START PROGRAM TO REDUCE INFANT MORTALITY AND DECREASE DISPARITIES IN INFANT MORTALITY AND POOR PERINATAL HEALTH OUTCOMES IN TROUP (RURAL AND PRIORITY CONSIDERATION), BUTTS (RURAL), AND SPALDING (MEDICALLY UNDERSERVED AREA) COUNTIES IN WEST CENTRAL GEORGIA, WITH A TARGET POPULATION OF BLACK/AFRICAN AMERICAN MOTHERS. THE CATCHMENT AREA WILL COVER THE ENTIRETY OF EACH COUNTY. MATERNAL MORTALITY HAS INCREASED NATIONWIDE, AND GEORGIA HAS THE SECOND-HIGHEST RATE OF MATERNAL MORTALITY IN THE COUNTRY (48.4 PER 100,000). STARK DISPARITIES EXIST AMONG RACE AND ETHNICITY. OVER HALF (56%) OF MATERNAL DEATHS IN GEORGIA ARE AMONG BLACK MOTHERS, THOUGH BLACK/AFRICAN AMERICANS COMPRISE ONLY 33% OF THE OVERALL POPULATION. SERVING MORE THAN ONE IN SIX GEORGIANS, WELLSTAR IS THE LARGEST SAFETY NET AND THE ONLY HEALTH SYSTEM IN THE STATE WITH A DEDICATED CENTER FOR HEALTH EQUITY COMMITTED TO IMPROVING SOCIAL DETERMINANTS OF HEALTH (SDOH) AND BUILDING SUSTAINABLE, COMMUNITY-BASED PROGRAMS TO ADDRESS THE CRISES OF MATERNAL AND INFANT MORBIDITY AND MORTALITY. ALIGNED WITH THIS MISSION, THE CMC PROGRAM WILL IMPROVE HEALTH OUTCOMES BEFORE, DURING, AND AFTER PREGNANCY AND REDUCE RACIAL DISPARITIES IN RATES OF INFANT DEATH AND ADVERSE PERINATAL OUTCOMES AMONG 700 PARTICIPANTS ANNUALLY BY PROVIDING (I) COMPREHENSIVE INDIVIDUALIZED CARE COORDINATION THROUGH AN INNOVATIVE STAFFING MODEL THAT EMBEDS HEALTH EQUITY-FOCUSED CASE MANAGERS WITHIN WELLSTAR’S W OMEN’S HEALTH SERVICE LINE; (II) COMMUNITY-BASED, TWO-GENERATION, WRAPAROUND SUPPORT SERVICES FROM A BROAD NETWORK OF PROVIDERS TO ADDRESS IDENTIFIED SDOH; AND (III) COHORT-BASED, CULTURALLY COMPETENT, AND CONVENIENT HEALTH EDUCATION AND PARENTING CLASSES. SUPPORT SERVICES INCLUDE INTENSIVE MEDICAL NAVIGATION OFFERED BY WOMEN’S HEALTH NURSE NAVIGATORS AND ACCESS TO COMMUNITY-BASED DOULAS FOR SUPPORT DURING PREGNANCY AND THROUGH THE POST-PARTUM PERIOD, ALONG WITH A HOST OF SERVICES OFFERED BY PARTNERING ORGANIZATIONS WITHIN THE SERVICE AREA TO ADDRESS FOOD INSECURITY, TRANSPORTATION, EDUCATION, EMPLOYMENT, CHILD CARE, AND HOUSING. THIS WORK WILL BE INFORMED AND STRENGTHENED BY A DIVERSE COMMUNITY CONSORTIUM, A MULTI-SECTOR GROUP OF STAKEHOLDERS AND CMC PARTICIPANTS WHO WILL IDENTIFY AND PRIORITIZE CAUSES OF DISPARITIES, FORM STRATEGIC COMMUNITY PARTNERSHIPS TO ADDRESS SDOH WITHIN THE SERVICE AREA, AND GUIDE THE IMPLEMENTATION OF CMC TO CONTINUOUSLY MONITOR PARTICIPANTS’ UNIQUE NEEDS. THE COMMUNITY CONSORTIUM WILL ALSO TRACK PROGRESS TOWARDS THE PROGRAM GOALS OF INCREASING ACCESS TO NUTRITIOUS FOOD, PRENATAL CARE, EMPLOYMENT, HEALTH AND WELLNESS OF FAMILIES, AND MENTAL HEALTH AND WELLNESS OF MOTHERS.

ZERO SUICIDE AT WELLSTAR: EXPANDING ACCESS, DELIVERING CARE, SAVING LIVES - WELLSTAR HEALTH SYSTEM (WELLSTAR) WILL IMPLEMENT ZERO SUICIDE AT WELLSTAR: EXPANDING ACCESS, DELIVERING CARE, SAVING LIVES (ZSW), SERVING A FOCUS POPULATION OF 2,870,557 GEORGIA ADULTS AGES WHO RESIDE IN BARTOW, CHEROKEE, COBB, DOUGLAS, FORSYTH, FULTON, HARRIS, PAULDING, POLK, AND TROUPE COUNTIES, COMPRISING 48% MALE, 52% FEMALE, AND A RACIALLY AND CULTURALLY DIVERSE POPULATION (SEE BELOW). SERVICES WILL BE DELIVERED ACROSS A MULTI-COUNTY GEOGRAPHIC CATCHMENT AREA IN SIX WELLSTAR HOSPITAL AND EMERGENCY DEPARTMENTS, INCLUDING SUICIDE PREVENTION ORGANIZATIONAL CHANGE, IDENTIFICATION, TREATMENT, CARE TRANSITIONS, WORKFORCE TRAINING, AND QUALITY IMPROVEMENT. WELLSTAR PROPOSES TO PROVIDE DIRECT SUICIDE-SPECIFIC SERVICES (INCLUDING BUT NOT LIMITED TO SCREENING, ASSESSMENT, TREATMENT, AND CARE TRANSITIONS) TO AT LEAST 5,000 ADULTS ACROSS THE CATCHMENT AREA. DESPITE SUCCESSES OF WELLSTAR’S IMPLEMENTATION OF THE ZERO SUICIDE MODEL ACROSS ITS HEALTH SYSTEM TO DATE, THE CATCHMENT AREA REMAINS SUBJECT TO SIGNIFICANT BEHAVIORAL HEALTH DISPARITIES, INCLUDING CARE SPECIFICALLY FOR PERSONS AT RISK FOR SUICIDE. BEHAVIORAL HEALTH, PRIMARY CARE, AND EMERGENCY CARE (I.E., AMBULATORY SERVICES, FIRST RESPONDERS, ETC.) PROVIDERS LACK A STATEWIDE SURVEILLANCE AND REFERRAL SYSTEM THAT COULD PROMOTE TIMELY, CONTINUOUS CARE IN THEIR COMMUNITIES. COMPREHENSIVE SCREENING, ASSESSMENT, CARE PLANNING AND MANAGEMENT, AND TREATMENT ARE ALL CRITICAL COMPONENTS OF EFFECTIVE AND EVIDENCE-BASED SUICIDE PREVENTION, BUT ARE OFTEN CONDUCTED (WHEN THEY ARE CONDUCTED) BY SERVICE PROVIDERS WHO WORK IN DIFFERENT HEALTH SYSTEMS WITHOUT EFFICIENT OR EFFECTIVE STRATEGIES FOR SHARING SUICIDE-SPECIFIC PATIENT INFORMATION; LEADING TO PATIENTS WHO “FALL THROUGH THE CRACKS” OF THE OVERALL HEALTHCARE SYSTEM. FURTHER, NEEDS EXIST IN THE DEVELOPMENT OF A COMPETENT AND CARING WORKFORCE WHO ARE TRAINED IN EVIDENCE-BASED SUICIDE PREVENTION STRATEGIES THAT ALIGN WITH THEIR JOB ROLES, QUALIFICATIONS, AND PERSONAL NEEDS (I.E., VICARIOUS TRAUMA, COMPASSION FATIGUE, MORAL INJURY). PURPOSE: TO REDUCE SUICIDE ATTEMPT AND SUICIDE DEATH RATES AMONG ADULT GEORGIANS AGES 18 AND OLDER BY BUILDING ON THE EXISTING WELLSTAR ZERO SUICIDE INITIATIVE’S COMMUNITY SUICIDE PREVENTION STRATEGIES, INCLUDING UPSTREAM COMMUNITY-BASED AND DOWNSTREAM TREATMENT-FOCUSED STRATEGIES, TO ENHANCE/EXPAND HEALTH SYSTEM WIDE AND COMMUNITY COLLABORATIONS, TRAINING, AND SERVICE PROVISION. GOAL 1: LEAD A SYSTEM-WIDE CULTURE CHANGE COMMITTED TO REDUCING SUICIDES THROUGH THE CONVENING OF A ZERO SUICIDE OVERSIGHT STEERING COUNCIL THAT WILL OVERSEE THE DEVELOPMENT, IMPLEMENTATION, AND QUALITY IMPROVEMENT OF THE ZERO SUICIDE PROGRAM. GOAL 2: ENHANCE/EXPAND PROVISION OF EVIDENCE-BASED SUICIDE RISK SCREENING AND ASSESSMENT ACROSS THE WELLSTAR HEALTH SYSTEM. GOAL 3: ENHANCE/EXPAND PROVISION OF TREATMENT UPON INTAKE AND RAPID FOLLOW UP AFTER DISCHARGE FROM EMERGENCY DEPARTMENTS (EDS) AND INPATIENT PSYCHIATRIC UNITS FOR FOCUS REGION ADULTS IN WHO HAVE EXPERIENCED A SUICIDAL CRISIS AND/OR ATTEMPT. GOAL 4: PROVIDE FOLLOW UP AND CARE TRANSITION/COORDINATION FOR HIGH RISK ADULTS WHO HAVE EXPERIENCED A SUICIDE CRISIS/ATTEMPT (INCLUDING THOSE WITH SMI). GOAL 5: ENHANCED/EXPAND TRAINING TO CLINICAL AND NON-CLINICAL TEAM MEMBERS SERVING AT-RISK ADULTS IN TOPICS INCLUDING ASSESSMENT OF SUICIDE RISK/PROTECTIVE FACTORS, EVIDENCE-BASED/BEST PRACTICE IMPLEMENTATION (E.G., QPR, CALM, CT-SP, CAMS, C-SSRS, RRSR, MHFA), SUICIDE RISK TREATMENT, AND FOLLOW-UP TO ENSURE CARE CONTINUITY. GOAL 6: IMPLEMENT GOALS 8 AND 9 OF THE 2012 NATIONAL SUICIDE PREVENTION STRATEGY TO REDUCE RATES OF SUICIDE ATTEMPTS AND DEATHS AMONG GEORGIA ADULTS AGES 18-64. GOAL 7: CONDUCT A COMPREHENSIVE EVALUATION AND DEVELOP/DISSEMINATE A THOROUGHLY DOCUMENTED SERVICE MODEL FOR REPLICATION/ADOPTION ACROSS THE STATE AND NATION.

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM - WELLSTAR HEALTH SYSTEM (WELLSTAR), ONE OF THE LARGEST NOT-FOR-PROFIT HEALTHCARE SYSTEMS IN GEORGIA AND A TOP 5 PROVIDER OF CHARITY CARE IN THE U.S., PROPOSES THE RURAL HEALTHCARE ACCESS PARTNERSHIP PROGRAM (RHAP) TO ADDRESS THE PROFOUND DISPARITIES IN MATERNAL AND INFANT HEALTH OUTCOMES AFFECTING HISTORICALLY UNDERSERVED AND RURAL POPULATIONS IN EAST GEORGIA. THE PROGRAM WILL SERVE AT LEAST 300 PARTICIPANTS ANNUALLY (150 MOTHERS AND THEIR NEWBORNS) ACROSS A NINE-COUNTY SERVICE AREA INCLUDING JEFFERSON, BURKE, EMANUEL, WASHINGTON, GLASCOCK, WARREN, MCDUFFIE, JENKINS, AND JOHNSON COUNTIES, WHICH ARE FEDERALLY DESIGNATED AS RURAL, MEDICALLY UNDERSERVED (MUA/MUP), AND WITHIN A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). AT LEAST 50% OF PARTICIPANTS WILL COME FROM THE TARGET POPULATION OF BLACK MOTHERS AND THEIR NEWBORNS WHO EXPERIENCE DISPROPORTIONATELY HIGH RATES OF MATERNAL MORTALITY, PRETERM BIRTHS, LOW BIRTHWEIGHT, AND OTHER ADVERSE PERINATAL OUTCOMES DUE TO SYSTEMIC INEQUITIES AND SOCIAL DETERMINANTS OF HEALTH (SDOH). RHAP’S OVERARCHING GOALS ARE TO REDUCE MATERNAL AND INFANT MORBIDITY AND MORTALITY, IMPROVE ACCESS TO PERINATAL CARE, AND POSITIVELY IMPACT MATERNAL HEALTH OUTCOMES RELATED TO SOCIAL DETERMINANTS OF HEALTH (SDOH). SPECIFIC OBJECTIVES INCLUDE: (I) EXPANDING ACCESS TO LOCAL CERTIFIED NURSE MIDWIFERY SERVICES AT THE JEFFERSON COUNTY PRENATAL CENTER TWO DAYS PER WEEK TO PROVIDE CRITICAL PERINATAL CARE; (II) IMPLEMENTING OBSTETRICAL CARE VIA TELEHEALTH AND ONGOING VIRTUAL EDUCATION TO OVERCOME TRANSPORTATION AND CHILDCARE CHALLENGES; (III) OFFERING ACCESS TO DOULA SERVICES TO PROVIDE CULTURALLY COMPETENT, PERSONALIZED SUPPORT THROUGHOUT PREGNANCY, LABOR, AND 12 MONTHS POSTPARTUM; AND (IV) PROVIDING CARE COORDINATION SERVICES TO ADDRESS UPSTREAM BARRIERS SUCH AS FOOD INSECURITY, HOUSING, AND INSURANCE ENROLLMENT. THESE OBJECTIVES ALIGN WITH EVIDENCE-BASED AND EVIDENCE-INFORMED MODELS INCLUDING HEALTH EDUCATION AND CHILDBIRTH CLASSES, DOULA SERVICES, TELEHEALTH, AND CARE COORDINATION. THE EXPECTED OUTCOMES OF RHAP INCLUDE A MEASURABLE REDUCTION IN PRETERM BIRTH AND LOW BIRTHWEIGHT RATES, IMPROVED MATERNAL AND INFANT HEALTH OUTCOMES, INCREASED ACCESS TO AND UTILIZATION OF PERINATAL SERVICES EARLIER IN PREGNANCY AND POSTPARTUM, AND STRENGTHENED COMMUNITY COLLABORATIONS TO ADDRESS RURAL AND RACIAL HEALTH DISPARITIES. RHAP WILL BUILD AND MAINTAIN ONGOING COMMUNITY PARTNERSHIPS TO DRIVE SUSTAINABLE IMPROVEMENTS IN THE HEALTHCARE INFRASTRUCTURE OF THE SERVICE AREA, ENSURING CONTINUED ACCESS TO MATERNAL HEALTH SERVICES BEYOND THE FUNDING PERIOD. WELLSTAR BRINGS EXTENSIVE EXPERIENCE IN SERVING RURAL AND UNDERSERVED POPULATIONS, INCLUDING THE RECENT IMPLEMENTATION OF A HEALTHY START PROGRAM IN WEST GEORGIA. WELLSTAR’S CENTER FOR HEALTH EQUITY HAS A DEMONSTRATED HISTORY OF FORMING AND MAINTAINING COLLABORATIVE PARTNERSHIPS TO ADDRESS SDOH AND IMPROVE HEALTH OUTCOMES. RHAP WILL LEVERAGE THIS EXPERTISE TO ESTABLISH A RURAL COMMUNITY CONSORTIUM (RCC) COMPRISED OF HEALTHCARE PROVIDERS, PUBLIC HEALTH DEPARTMENTS, ACADEMIC INSTITUTIONS, AND COMMUNITY-BASED ORGANIZATIONS, ENSURING SHARED DECISION-MAKING AND ROBUST COMMUNITY ENGAGEMENT. THIS RHAP PROGRAM QUALIFIES FOR THE SPECIAL TRACK OF MATERNAL HEALTH AND HEALTH PROFESSIONAL SHORTAGE AND MEDICALLY UNDERSERVED PREFERENCE AS IT WILL DIRECTLY BENEFIT RURAL UNDERSERVED POPULATIONS THAT EXPERIENCE SIGNIFICANT HEALTH DISPARITIES. SUPPORTING DOCUMENTATION IS PROVIDED IN ATTACHMENT 11.