North East Medical Services

HEALTH CENTER CLUSTER

HEALTH CENTER CLUSTER

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

TEACHING HEALTH CENTER (THC) GRADUATE MEDICAL EDUCATION (GME) PAYMENT PROGRAM

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

ARRA - CAPITAL IMPROVEMENT PROGRAM

HEALTH CENTER INFRASTRUCTURE SUPPORT

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM

TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION PROGRAM - PROJECT TITLE: NEMS TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION PROGRAM APPLICANT NAME: NORTH EAST MEDICAL SERVICES MAIN CLINIC ADDRESS: 1520 STOCKTON ST, SAN FRANCISCO, CA 94133 ADMINISTRATIVE ADDRESS: 2171 JUNIPERO SERRA BLVD, DALY CITY, CA 94014 PROJECT DIRECTOR NAME: DIANA KAWASAKI-YEE CONTACT PHONE NUMBERS: VOICE: 415-391-9686; FAX: 415-433-4726 EMAIL ADDRESS: DIANA.KAWASAKI-YEE@NEMS.ORG WEBSITE ADDRESS: WWW.NEMS.ORG FUNDING AMOUNT REQUESTED: $800,000 FUNDING PREFERENCE: PRIORITY 1: HPSA AND PRIORITY 2: MUC TRAINING PROGRAM NAME: NEMS INTERNAL MEDICINE RESIDENCY PROGRAM RESIDENCY PROGRAM DISCIPLINE: INTERNAL MEDICINE TYPE OF APPLICATION: NEW ELIGIBLE ENTITY TYPE: FQHC; NEMS WILL OPERATE THE RESIDENCY PROGRAM ALONE YEAR PROGRAM TO BEGIN TRAINING RESIDENTS: 2023 NORTH EAST MEDICAL SERVICES (NEMS) IS A PRIVATE, NON-PROFIT COMMUNITY HEALTH CENTER SERVING MEDICALLY UNDERSERVED AREAS AND POPULATIONS IN THE SAN FRANCISCO BAY AREA, CALIFORNIA. NEMS IS REQUESTING $800,000 TO SUPPORT NEMS INTERNAL MEDICINE RESIDENCY PROGRAM THROUGH THE HRSA/BHW TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION (THCGME) PROGRAM. FUNDING WILL BE USED TO TRAIN FIVE (5) RESIDENTS PER YEAR THROUGHOUT THE THREE-YEAR PROGRAM, FOR A TOTAL OF 15 (5-5-5) RESIDENT FTES. THE TOTAL RESIDENT FTE POSITIONS TO BE FUNDED UNDER THIS PROGRAM FOR ACADEMIC YEAR 2023-2024 IS 5 (5-0-0). NEMS PROVIDES HIGH QUALITY, PRIMARY AND PREVENTIVE HEALTH CARE SERVICES, INCLUDING MEDICAL, DENTAL, MENTAL HEALTH, LABORATORY, PHARMACY, ALTERNATIVE MEDICINE, SOCIAL SERVICES, AND SPECIALTY CARE. WE ARE A HRSA/BPHC HEALTH CENTER PROGRAM GRANTEE WITH OVER 50 YEARS OF EXPERIENCE SERVING A PREDOMINANTLY ASIAN POPULATION. IN 2021, NEMS CARED FOR OVER 67,000 PATIENTS THROUGH APPROXIMATELY 374,000 VISITS. AMONG THOSE SERVED, 89% WERE ASIAN, 92% WERE COVERED BY MEDI-CAL (MEDICAID OR DUALLY ELIGIBLE MEDICARE/MEDICAID), AND 80% WERE BETTER SERVED IN A LANGUAGE OTHER THAN ENGLISH. NEMS RECEIVED ACGME SPON SORING INSTITUTION ACCREDITATION IN JANUARY 2022 AND ACGME PROGRAM ACCREDITATION IN SEPTEMBER 2022. THE NEMS INTERNAL MEDICINE RESIDENCY PROGRAM IS BASED OUT OF THREE NEMS CLINICS/SERVICE DELIVERY SITES IN DESIGNATED MUAS AND/OR PCSAS IN SAN FRANCISCO – 1520 STOCKTON STREET CLINIC IN CHINATOWN (MUA #00351), 2574 SAN BRUNO AVENUE CLINIC IN PORTOLA/BAYVIEW (MUA #00353; MSSA ID 162F), AND 1443 OCEAN AVENUE CLINIC IN EXCELSIOR (MSSA ID 162D). OUR TARGET POPULATION INCLUDES ALL ASIANS AND THOSE WHO ARE UNINSURED OR COVERED BY MEDICAID, MEDICARE, OR PUBLIC INSURANCES. THE PRIMARY TEACHING SITE, STOCKTON CLINIC, HAS A DISPROPORTIONATELY HIGH NUMBER OF SENIORS AGES 65 AND OVER (28%) COMPARED TO COMPARABLE HEALTH CENTERS ACROSS CALIFORNIA. IT IS ALSO ONE OF THE MOST ECONOMICALLY DISADVANTAGED NEIGHBORHOODS IN THE CITY, WITH 39% OF RESIDENTS IN ZIP CODE TABULATION AREA (ZCTA) 94108 AND 33% OF RESIDENTS IN ZCTA 94133 LIVING BELOW 200% FPL. DURING TRAINING AT NEMS, RESIDENTS WILL GAIN A DEEPER UNDERSTANDING OF THE SOCIOECONOMIC, LANGUAGE, AND ACCESS BARRIERS THAT CONTRIBUTE TO THE HEALTH DISPARITIES EXPERIENCED IN THESE COMMUNITIES. TO COMPLEMENT THE COMMUNITY HEALTH EXPERIENCE AT NEMS AND NEMS PACE (PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY), ROTATIONS AT SETON MEDICAL CENTER, OUR HOSPITAL PARTNER IN DALY CITY, AND BICYCLE HEALTH, AN ADDICTION MEDICINE PROVIDER BASED IN REDWOOD CITY, WILL ALLOW RESIDENTS TO EXPERIENCE AN OPTIMAL BALANCE OF INPATIENT AND AMBULATORY MEDICINE IN COMPLIANCE WITH ACGME REQUIREMENTS. GIVEN THE DISTINCTIVE NEEDS AND CHALLENGES IN THE COMMUNITY, IT IS ESPECIALLY IMPORTANT FOR NEMS TO RECRUIT, TRAIN, AND RETAIN PRIMARY CARE PROVIDERS THAT ARE ATTUNED TO THE COMMUNITY’S UNIQUE NEEDS AND HEALTH DISPARITIES.

ARRA - INCREASE SERVICES TO HEALTH CENTERS

FY 2023 EXPANDING COVID-19 VACCINATION

FY 2024 BEHAVIORAL HEALTH SERVICE EXPANSION - NORTH EAST MEDICAL SERVICES (NEMS, HEALTH CENTER PROGRAM GRANT NUMBER H80CS00221) IS A PRIVATE, NON-PROFIT COMMUNITY HEALTH CENTER SERVING MEDICALLY UNDERSERVED AREAS AND POPULATIONS IN THE SAN FRANCISCO BAY AREA, CALIFORNIA. NEMS IS REQUESTING $600,000 IN YEAR 1 AND $500,000 IN YEAR 2 TO SUPPORT NEMS BEHAVIORAL HEALTH SERVICE EXPANSION 2024 THROUGH THE FISCAL YEAR 2024 BEHAVIORAL HEALTH SERVICE EXPANSION (BHSE) FUNDING OPPORTUNITY. WITH OVER 50 YEARS OF EXPERIENCE SERVING THE COMMUNITY, NEMS PROVIDES HIGH-QUALITY PRIMARY AND PREVENTIVE HEALTH CARE SERVICES, INCLUDING MEDICAL, DENTAL, BEHAVIORAL HEALTH, LABORATORY, RADIOLOGY, PHARMACY, COMPLEMENTARY/INTEGRATIVE MEDICINE, SOCIAL SERVICES, AND SPECIALTY CARE. IN 2023, NEMS CARED FOR OVER 72,000 PATIENTS THROUGH MORE THAN 450,000 VISITS. AMONG THOSE SERVED, 83.7% ARE ASIAN, 75.8% ARE COVERED BY MEDI-CAL (MEDICAID OR DUALLY ELIGIBLE MEDICARE/MEDICAID), 84.2% HAD INCOMES AT 200% AND BELOW THE FEDERAL POVERTY LEVEL (AMONG THOSE ASSESSED), AND 75% ARE BETTER SERVED IN A LANGUAGE OTHER THAN ENGLISH. IN 2023, NEMS SERVED 318 PATIENTS DIAGNOSED WITH ALCOHOL-RELATED DISORDERS; 223 PATIENTS WITH OTHER SUBSTANCE-RELATED DISORDERS (EXCLUDING TOBACCO); 2,528 PATIENTS WITH DEPRESSION AND OTHER MOOD DISORDERS; AND 2,641 PATIENTS WITH ANXIETY DISORDERS, INCLUDING POST-TRAUMATIC STRESS DISORDER (PTSD). OVER THE PAST DECADE, NEMS HAS MADE GREAT STRIDES IN DEVELOPING AN INTEGRATED BEHAVIORAL HEALTH PROGRAM, GROWING OUR LINGUISTICALLY COMPETENT DIRECT SERVICES TEAM FROM JUST UNDER 2.0 FTE IN 2013 TO ROUGHLY 15.45 FTE IN 2023 (INCLUDING ABOUT 4.0 FTE BEHAVIORAL HEALTH LINKAGE WORKERS). MUCH OF THE GROWTH IS THANKS TO HRSA’S MANY BEHAVIORAL HEALTH (BH) AND SUBSTANCE USE DISORDER (SUD) FUNDING OPPORTUNITIES SINCE 2017. HOWEVER, OUR BH AND SUD OFFERINGS HAVE NOT KEPT PACE WITH THE SIGNIFICANT GROWTH/DIVERSIFICATION OF AND STRUGGLES FACED BY OUR PATIENT POPULATION: THE NUMBER OF ADULT PATIENTS AGE 18 AND OLDER HAS INCREASED BY 20.7% FROM 2013 TO 2023; NEMS HAS EXPANDED INTO MORE DIVERSE AND CHALLENGING AREAS, INCLUDING SAN FRANCISCO’S TENDERLOIN DISTRICT WHERE DRUG USE AND HOMELESSNESS IS RAMPANT; AND THE BROADER COMMUNITY CONTINUES TO RECOVER AND COPE WITH THE COVID-19 PANDEMIC, WHICH HAS GREATLY EXACERBATED THE UNDERLYING HATE AND VIOLENCE AGAINST THE ASIAN COMMUNITY. MOREOVER, BH AND SUD SERVICES CONTINUE TO BE UNDERDIAGNOSED AND UNDERUTILIZED AMONG THE ASIAN COMMUNITY DUE TO PREVAILING CULTURAL BELIEFS, STIGMA, LOSS OF FACE, DENIAL, AND LINGUISTIC OR SOCIOECONOMIC BARRIERS. MEDICAL PROVIDERS ARE OFTEN UNFAMILIAR WITH SUD SERVICE RESOURCES AVAILABLE IN THE COMMUNITY; AND MAY LACK PROPER KNOWLEDGE, TECHNIQUES, DECISION SUPPORT AND PATIENT AGREEMENT TO INITIATE SUD SERVICES AND/OR MEDICATIONS FOR OPIOID USE DISORDER (MOUD). SPECIALTY MENTAL HEALTH AND SUBSTANCE ABUSE CARE SERVICES MUST BE ACCESSED AT THE COUNTY LEVEL, WHICH CAN BE ESPECIALLY CHALLENGING FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY TO NAVIGATE AND SEEK OUT. FUNDING FROM THE BHSE OPPORTUNITY WILL SUPPORT THE HIRING OF 2.0 FTE NEW BH THERAPISTS AND 1.0 FTE NEW BEHAVIORAL HEALTH LINKAGE WORKER TO SUPPORT OUR HIGH NEED CLINICS IN SAN FRANCISCO AND SAN MATEO COUNTIES; AN EXISTING NEMS PRIMARY CARE PROVIDER AT OUR TENDERLOIN CLINIC TO ACT AS A PHYSICIAN CHAMPION FOR SUD/MOUD SERVICES; CONSULTATION AND DECISION SUPPORT FROM TWO PART-TIME CONTRACTED PSYCHIATRISTS; EHR APPLICATION AND DATA ANALYST SUPPORT; AND SPECIALIZED MOTIVATIONAL INTERVIEWING/MOTIVATIONAL ENHANCEMENT THERAPY TRAININGS FOR BH AND PRIMARY CARE PROVIDERS TO SUPPORT BH/SUD/MOUD PATIENTS. FUNDS WILL ALSO SUPPORT RESOURCES FOR CONTINGENCY MANAGEMENT , TO ENCOURAGE POSITIVE BEHAVIORAL CHANGES AMONG SUD/MOUD PATIENTS. NEMS AIMS TO MEET THE FOLLOWING GRANT OBJECTIVES BY THE END OF 2025 (PATIENT COUNTS MAY BE DUPLICATED): 400 PATIENTS FOR NEW MENTAL HEALTH SERVICES, 24 NEW SUD SERVICES PATIENTS, AND 24 NEW PATIENTS RECEIVING TREATMENT WITH MOUD.

TEACHING HEALTH CENTER PLANNING AND DEVELOPMENT PROGRAM

CAPITAL DEVELOPMENT

AFFORDABLE CARE ACT PATIENT CENTERED MEDICAL HOME FACILITY IMPROVEMENTS GRANT PROGRAM

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

FY 2023 BRIDGE ACCESS PROGRAM

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM