RHAU Conference Slides

Sponsored By:

Rural Health Association of Utah 19 Annual Conference

GETTING BACK TO THRIVING

UCRH/RHAU Executive Leadership Team

Rita Osborn

Executive Director

Kasey D. Shakespear Assistant Director

Community Partnership Development

Carrie Torgersen

Nathan Wiggins

Healthcare Workforce Development

Administrative Operations

Assistant Director

Assistant Director

UCRH/RHAU Program Managers

Alexus Erickson Program Manager

Healthcare Workforce Development

Jennifer Liebert Program Manager

Community Partnership Development

Eric Johansen

Wendy Hutcheson

Marketing and Communications

Grants and Contracts

Program Manager

Program Manager

Healthcare Workforce Development Team

Alexus Erickson Program Manager

Dane Howe

Program Coordinator

Heidi Heiner Tracy Hetherington Ginny Smith

Program Coordinator

Program Coordinator

Program Coordinator

Valerie Orlemann Nickolas Henry Bridger Lisonbee Program Coordinator

Program Coordinator

Program Coordinator

UCRH/RHAU Community Health Workers

Carrie Olvera

Lauren Gleave

Community Partnership Development Team

Jennifer Liebert Program Manager

Austin Jones

Program Coordinator

Samantha Thompson

Program Coordinator

Lauren Harris

Program Coordinator

Carisa Wood

Program Coordinator

Meet our RHAU Board

RURAL HEALTH

ASSOCIATION

OF UTAH

CONFERENCE November 9, 2023

Introductions: Rural Health Association of Utah Board

Greg Rosenvall

RHAU Board President

Kurt Loveless

RHAU Board PresidentElect RURAL HEALTH

ASSOCIATION

OF UTAH

CONFERENCE November 9, 2023

Dr. Cynthia Kimball Davis, PhD Southern Utah University

Dr. Jesse Spencer, MD Intermountain Health

Dr. David Crimin, DO Rocky Vista University COM

RURAL HEALTH

ASSOCIATION

OF UTAH

CONFERENCE November 9, 2023

Dr. Ivette Lopez, PhD, MPH Board Member Utah AHEC

Dr. Colten Bracken, MD Board Member Main Street Family Medicine

Dr. Russell Sorenson, PhD Board Member Intermountain Health

Dr. GJ Wilden, MD Board Member Gunnison Valley Hospital

Dr. Greg Olsen DDS Board Member Olsen Family Dentistry

RURAL HEALTH

ASSOCIATION

OF UTAH

CONFERENCE November 9, 2023

Greg Rosenvall RHAU President Utah Hospital Association

Kurt R. Loveless, MBA RHAU Vice President Kane County Hospital

Logan Reid, LPS, MS, MSW

Board Member Southwest Utah Behavioral Health

Dr. Melissa Hinton, DNP Board Member Advance Practice Healthcare Associates

RURAL HEALTH

ASSOCIATION

OF UTAH

CONFERENCE November 9, 2023

Dr. Matt McCullough, Ph.D. Board Member Utah Hospital Association

Robbie Gurr, PharmD Board Member Smith’s Pharmacy

Revina Talker PA-C

Board Member Monument Valley Community Health Center

Patricia Pyle, NP Board Member Green River Medical Center

RURAL HEALTH

ASSOCIATION

OF UTAH

CONFERENCE November 9, 2023

RITA OSBORN, MBA

MESSAGE FROM EXECUTIVE DIRECTOR As this fiscal year draws to a close, we want to celebrate our accomplishments with you all!

Again, this year our center has grown, both in terms of staff and programs. Let me highlight a few of these here but this report highlights so many more.

Our National AHEC Organization met for their bi-annual conference in late June 2023 in Salt Lake City, UT. This historic event showcased AHEC program offices and centers that serve most of our country. Our Southern Utah AHEC ranks in the top ten percent of all AHEC centers in terms of budget

and number of staff! This is an amazing accomplishment that has come from our incredible team and the work they do on behalf of our communities. Our team was chosen to showcase the work being done in rural Sevier county by our Community Health Workers. When the rubber meets the road, (yes, this is an analogy for the number of miles our team travels), our success comes from a secure rural healthcare workforce. Every program our center conducts harkens back to this goal. Each year, at this time of year we celebrate those alums of our pipeline programs who

choose to work in rural Utah.

Some of our new programs this next year include our new Mobile Wellness Van. This van was secured by funding from USHE and in conjunction with the SUU Nursing Department. It will provide wellness events in rural Utah. If you would like to host a visit in your community, please let us know.

This past year saw the beginning of Utah's Health Workforce Advisory Council (HWAC). This new, legislatively created council provides insight and guidance to

the legislature for initiatives that impact the healthcare workforce.

I am honored to serve on this council and encourage you to reach out if you have questions or concerns about potential legislation.

Finally, I must celebrate our team! We have grown a team who are excelling at national levels in their areas of specialty. Growing and thriving, especially with a team that works across rural Utah can be challenging, but our team is amazing! Kudos to each and every one of you.

FISCAL YEAR JULY 1, 2022 - JUNE 30, 2023

TOTAL FUNDING: $3,047,299.25

STAFF HIGHLIGHTS & LOCATIONS

Price

1

Manti

1

2

Richfield Monroe

7

Greenwich

1

Cedar City

St. George

1

5

Our staff members consistently demonstrate their commitment to improving the lives of Utah's rural and underrepresented communities. Their hard work and passion is instrumental in our organization's growth and success over the past year.

We have staff members living in various counties throughout rural Utah including, Washington, Iron, Piute, Sevier, Sanpete, and Carbon.

We are proud to have a team that goes above and beyond to ensure the success of our programs and initiatives. Their expertise, professionalism, and compassionate approach

Program Coordinators and witnessing staff members assume new roles, we saw our team flourish in their respective areas of expertise. Their collective efforts allowed us to expand our reach and create meaningful opportunities for those in need. We cannot overstate our gratitude for the dedicated individuals who are part of our organization, providing invaluable knowledge and experience.

Their continued commitment to our mission is a driving force behind our achievements.

Pathway Programs

96.1% of UHs students were accepted into medical school this application cycle

96.1% is more than double the national average of 41%

22%

higher acceptance rate into medical school than students not in our

program

SNOW COLLEGE SERVE WITH PUROSE EVENT In collaboration with Snow College's Softball Team, and the Healthy Badger's Coalition, the Utah Health Scholars program proudly hosted a campus and community-wide service event aimed at making a positive impact, in honor of the late Snow College student, Paige Rydalch. Students from these exceptional programs and clubs dedicated their efforts to develop a service project that focused on assisting patients in pediatric and NICU departments, with a particular emphasis on rural communities. Each activity planned for the event involved creating items to be donated to these deserving causes.

The Serve with Purpose event embodied the spirit of community engagement and the power of collective action. Our goal was to foster compassion,

empathy, and a sense of purpose among participants while making a tangible difference in the lives of those in need.

We are grateful for the collaboration and dedication of Snow College's Softball Team, the

UTAH HEALTH SCHOLARS ALUMNI SPOTLIGHT “In Utah Health Scholars, I particularly enjoyed volunteering at the foot clinic in a homeless shelter in St. George. Here I was able to practice medical skills like obtaining blood pressures and performing foot exams, all while interacting with the people living there. I admire the physicians that donate their time and their example influenced the kind of provider I have tried to become in the community in which I live now.”

-Eric Hammer, PA Raised in both rural and suburban Utah, Eric Hammer was drawn to serve in Gunnison by his wife’s rural roots. Through Utah Area Health Education Center (AHEC), Eric has participated in Rural Health Scholars in college, a graduate rotation in PA school, and is currently active in recruiting healthcare providers to rural places through 3RNet. In addition, he volunteers his time each semester to teach a course at the Snow College Rural Health Scholars program, allowing him to motivate college students to pursue rural practice as a PA. While in college, he participated in several cultural immersion trips to Montezuma Creek, Utah and Shiprock, Arizona.

Assisting in medical ways in these rural, underserved areas furthered his passion for his career as a PA Eric graduated with a bachelor’s degree in biology from Southern Utah

UTAH HEALTH SCHOLARS ALUMNI SPOTLIGHT

Eight years ago, the Potter brothers were in the spotlight for excelling in Southern Utah University's pre-med program. Today, all four are practicing medicine in Utah, making a positive impact on their patients' lives.

James Potter, D.O., serves as an anesthesiologist and pain management specialist at Uintah Basin Healthcare in Roosevelt and Vernal. Derek Potter, P.A.C., practices dermatology and family medicine at the same facility. David Potter, O.D., is an optometrist at Eyeglass World in Draper near Salt Lake City. Scott Potter, M.D., is currently a Pathology Resident at the University of Utah School of Medicine.

Hailing from rural Price, Utah, they credit their success to their tight-knit community, excellent teachers, physician role models, and parental emphasis on education. They began their journey at the College of Eastern Utah (now Utah State University Eastern) before enrolling at SUU.

Each brother sought guidance from the Rural Health Scholars (now Utah Health Scholars) program, which provided invaluable mentorship. The Potter brothers are grateful to be back in Utah, close to their roots and the institutions that shaped their careers.

The Potters exemplify how healthcare professionals can impact their communities positively. Their success reflects their passion, dedication, and service-oriented leadership. Bringing these qualities back home is the icing on the cake for this remarkable group of brothers.

UHS CULTURAL IMMERSION TRIPS Within the past year, forces with Warriors & Quiet Utah

Spider Rock

Health Scholars, Waters, an organization that in

overlook, and

collaboration with guides veterans and their various

engaged in

partners, had loved ones to find peace,

conversations

the opportunity to meaning, and purpose participate in

with knowledge

healthcare through fly fishing and other cultural immersion

holders and

trips nature-based activities. The to destinations including

silversmiths,

students had the privilege of the Dominican Republic,

gaining deeper

working alongside disabled Montana, and the Hopi

insights into

veterans, engaging in

the rich cultural

Indian tribe in Chinle, heartfelt conversations, and Arizona.

heritage and

These eye-opening forging lifelong friendships experiences

healing practices

provided while experiencing the pre-health students with

of the Navajo

power of empathy and hands-on opportunities healing in

and Hopi

nature.

communities.

to tackle global health The cultural immersion trip issues

Southern Utah University student assists in performing wellness screenings on a Dominican woman and her children.

and provide care to to the Navajo Nation and underserved

These

committed to making a

communities, Hopi Health Care Center in while also

transformative

difference in the lives of

fostering cultural Arizona aimed to learn more competency

experiences

individuals and communities

within the about Diné (Navajo) and medical field.Hopi

empowered Utah

in need.

culture and healthcare.

Health Scholars to embody

Students interacted with

the spirit of service and

One such trip took students Diné traditional healers,

empathy, shaping them into

to the Dominican Republic, explored the beauty of

future healthcare providers

where they embarked on

mobile medical clinics, known as Barrio Clinics, making a positive impact on the lives of over 400 Dominican and Haitian patients. Working alongside exceptional healthcare professionals, the students witnessed a wide spectrum of medical cases, gaining invaluable hands-on experience and expanding their understanding of diverse healthcare needs.

Flyfishing in Montana with the Warriors and Quiet Waters Foundation

UTAH TECH HEALTH CAREERS EXPO UHS at Utah Tech is happy to share with you the resounding success of the 2023 Health Careers Expo, held at Utah Tech University in May. This event was an extraordinary experience that allowed high school and undergraduate students to immerse themselves in a world of healing hands and explore the limitless possibilities within the healthcare industry.

The expo served as a platform for individuals to delve into the realm of health careers, and it proved to be an opportunity for discovery and inspiration for all who attended.

The Health Careers Expo offered hands-on experiences that allowed participants to get up close and personal with various aspects of the healthcare field. Whether it was practicing vital sign measurements, learning proper techniques for administering injections, or engaging in simulated medical scenarios, attendees were able to roll up their sleeves and truly

get their hands dirty.

These interactive experiences not only enhanced their understanding of healthcare practices but also sparked a deeper passion for their potential future careers.

The success of this event would not have been possible without the dedication and hard work of numerous individuals. We extend

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AHEC UPDATES Southern Utah AHEC is proud to report another successful year in 2022-2023.

We continued to work hard to improve the health of our rural communities, and we made significant progress in a number of areas.

One of our highlights of the year was our participation in the National AHEC Organization (NAO) Conference, which was held in Salt Lake City in June 2023.

Three of our staff members, Carrie Torgersen, Lauren Gleave, and Carrie Olvera, presented on the topic of "Improving Health Outcomes By Bridging Resources and Social Drivers With Community Health Workers." Their presentation was well-attended and very successful.

We also continued to provide a variety of other programs and services to our communities in 2023. These included:

• Facilitating clinical rotations for health professions students • Sponsoring the Utah Health Scholars program • Producing and distributing the Utah Directory of Health Training Programs • Providing high school students with opportunities to explore health careers • Hosting 3R Net, a national job board for rural health care positions We are grateful for the support of our partners and stakeholders, and we look

AHEC SCHOLARS STUDENT SPOTLIGHT "My journey as a Doctor of Nurse Practice-Family Nurse Practitioner (DNP-FNP) student at the University of Utah and a future healthcare provider started as an immigrant from a rural town of Siliguri, India to the United States of America. Like every immigrant, this was a dream come true. After moving to the U.S., I continued my passion for healthcare at Southern Utah University. Through the SUU Rural Health Scholar program, I received various support and guidance to be accepted into the health-related graduate program. SUU Rural Health Scholars is an excellent program directly supporting undergraduate SUU students in getting accepted into different health-related graduate schools.

As a DNP-FNP student at the University of Utah, I am also a Utah AHEC (Area Health Education Center) scholar. It is an excellent program for healthcare professional students who are interested in meeting the health needs of Utah’s underserved rural and urban populations. Being in this excellent curriculum has enabled me to understand the complex U.S. healthcare system and various social determinants that affect an individual's health. Utah AHEC achieves its goals of serving professional healthcare students, including myself, by conducting the annual primary care summit (my favorite), several book discussions focused on social determinants of health every semester, a minimum of 80 hours of clinical at the rural and underserved population, access to grants for any research that affects the underserved population in Utah and many other extracurricular activities related to healthcare needs of the underserved population.

I am extremely fortunate that Rita Osborn, Executive Director of Southern Utah AHEC, accepted to mentor me. She has been very gracious in helping me find all the resources I need to be a healthcare provider. I am confident that through the current Utah AHEC program, I will gain enough resources to

Clinical Training Programs

RURAL ROTATION SUCCESS STORY I had the privilege of completing a rotation at the esteemed Kazan Memorial Clinic in Escalante, Utah, where I had the opportunity to collaborate with Jenny Evans, my preceptor, pharmacy technicians, and other healthcare professionals within the clinic. Working alongside Jenny, an experienced pharmacist in a rural community, provided invaluable insights into the intricacies of pharmacy practice in such settings. The clinic staff demonstrated exceptional kindness and hospitality, creating a welcoming environment for both patients and fellow healthcare providers. Witnessing the seamless teamwork displayed by the healthcare professionals in delivering optimal patient care was truly inspiring, exemplifying the importance of interprofessional collaboration.

During my rotation, I was privileged to participate in a community presentation highlighting the significance of medication adherence and the pharmacy's role in supporting patients in this aspect. Engaging with the residents of this town allowed me to forge connections and develop a deeper understanding of their healthcare needs. The Kazan Memorial Clinic has established itself as a hub of healthcare excellence, with dedicated professionals who go above and beyond to provide the highest quality of care. Escalante, with its breathtaking landscapes, proved to be an ideal backdrop for my rotation experience. The panoramic views visible from the clinic and the opportunity to explore the town's surrounding trails added to the overall richness of my stay. I am immensely grateful for the invaluable experience and the lasting relationships I formed with the exceptional healthcare workers who made my six-week tenure truly remarkable.

UTAH PSYCHOLOGY INTERNSHIP CONSORTIUM We are pleased to announce the upcoming graduation of 7 talented individuals from our renowned Utah Psychology Internship Consortium, scheduled for July. This significant achievement signifies their successful completion of our rigorous program and their preparedness to embark on their professional journey as psychologists. Notably, we are delighted to share that 5 of these graduates have decided to remain in Utah, a testament to the appeal and opportunities available in our state for aspiring psychologists.

As an organization committed to continuous growth and development, we are excited to witness the expansion of our program. The addition of a new host site further strengthens our ability to provide exceptional training opportunities to aspiring psychologists. This expansion not only bolsters our consortium's capacity but also enables us to accommodate the increasing number of interns seeking to join our program, further elevating the quality and impact of our training initiatives.

Looking ahead, we eagerly welcome a new cohort of 7 interns who have been successfully matched for the upcoming cohort beginning in August. This diverse group of individuals brings a wealth of knowledge, experiences, and perspectives, fostering an enriched learning environment and facilitating collaborative growth. With their unique contributions, we are confident that our consortium will continue to thrive and produce skilled psychologists who can make significant contributions to the field, advancing mental well-being across Utah.

The ongoing success and growth of the Utah Psychology Internship Consortium are a testament to the dedication and expertise of our staff, the commitment of our interns, and the invaluable support of our esteemed partners. Together, we cultivate a supportive community that empowers aspiring psychologists to excel, ensuring they are equipped to address the complex challenges of mental health and contribute to the

3RNet plays a valuable role in connecting skilled medical professionals with practices in need of their services. The commitment of 3RNet to supporting healthcare professionals in finding the right job is truly remarkable. Their platform serves as a valuable resource, providing crucial information and guidance to assist healthcare professionals in making informed career decisions. We are proud to collaborate with 3RNet and be part of their mission to facilitate successful matches. We are confident that this placement will have a positive impact, as the resident joins their new practice and begins contributing to the healthcare needs of their community. This achievement underscores the significance of connecting talented professionals with healthcare practices, ultimately improving access to quality care in various settings.

Community Programs

Current Grant Projects Rural Communities Opioid Response Program Psychostimulant Support Grant

HRSA - $391,914 over 4 Years

Rural Communities Opioid Response Program Behavioral Healthcare Support Grant HRSA - $500.000 over 3 years.

E-Cigarette Marijuana and Other Drug Prevention Grant (SUU and Utah Tech) Southwest Utah Public Health Department – $180,195.36 over 3 years (Each Campus) Higher Education Prevention Grant University of Utah - $225,000 over 27 months Health Care Workforce Program Grant Cambia Health Foundation - $50,000 over 18 months Reshaping Diabetes ECHO Grant National AHEC Organization - $60,000 over 18 months Utah Primary Care Grant Program UDHHS - $20,000 over 1 year Montana AHEC NEPQR Subaward HRSA - $216,384 over 4 years

HIGHER EDUCATION COALITIONS It was an exciting year for our Higher Education Prevention Coalitions. We saw great growth and excitement with our existing coalitions at Southern Utah University and Utah Tech, with huge strides being made in our campus efforts. The Healthy T-Birds Coalition was nominated for the SUU Health & Wellness Club of the Year award, and the Healthy Trailblazers Coalition was nominated for the Utah Tech Club of the Year award for the second year in a row. These nominations are a testament to the efforts of our student leaders to work hard, cultivate meaningful relationships across campus, and facilitate positive outcomes for the campus communities.

With the Healthy T-Birds and Health Trailblazers Coalitions running smoothly this year, we were also able to add another coalition to the mix.

As with the existing coalitions, the Healthy Badgers Coalition will utilize the campus club model to serve both the Ephraim and Richfield campuses of Snow College. We are excited to see what can be accomplished at Snow College, as there is already great support and enthusiasm in place behind the coalition. By working closely with community and campus partners, we envision great success in our efforts to bring a greater emphasis on health, wellness, and substance abuse prevention to our local campuses.

In February, representatives from each of the coalitions were able to attend the annual Community Anti-Drug Coalitions of America (CADCA) conference in Washington D.C., which provided us with a wonderful opportunity for further training and understanding of current issues, trends, and solutions. We were glad that our student leaders were able to attend this conference and interact with peers and experts in the field and gain first-hand appreciation for the efforts being made around the country in prevention.

There is so much positive momentum happening behind our coalitions, and we couldn’t be more thankful to our campus community board members on each of our campuses that make what we do possible.

PREVENTION

Where does RHAU Go From Here?

Spring 2024

• Approve final new board members to reach a full board • Review of Board Bylaws

Potential Projects Under Consideration

• Growth of our Project ECHO and other educational opportunities • Including a focus on more Continuing Ed. Credits • More In-Person Educational Events • RHAU Student Internship Program • Consulting Services • Quality Improvement • Data Consulting • Marketing Consulting • Grant Writing/Management • Needs Assessments with members to determine other potential Services *These are just potential projects, nothing has been approved by the board for to proceed

CALL ME ANY TIME!!!

Kasey DeLynn Shakespear

(435) 879-4364 (435) 690-9521 Kaseyshakespear@suu.edu

CONTACT US SUU

UTAH TECH

351 University

225 S. 700 E.

150 College

451 E 400 N

Blvd. Cedar

St. George, UT

Ave Ephriam,

Price, UT

City, UT,

84770 Hazy

UT

84501

84720 SC 304

321 (435) 879-

84627

(435) 463-

(435) 865-8573

4364

(435) 283-7218

4528

SNOW COLLEGE USU EASTERN

"AS SOMEONE WHO LIVES IN RURAL UTAH, I HAVE A UNIQUE UNDERSTANDING ABOUT THE SOCIAL DETERMINANTS OF HEALTH AND HEALTH DISPARITIES FOR THOSE IN RURAL AREAS. MORE THAN EVER, WE NEED HEALTH CARE PROFESSIONALS IN THESE AREAS TO HELP PEOPLE WHO ARE STRUGGLING AND DESPERATELY NEED ACCESS TO BETTER HEALTH CARE." 3

7

- SPENCER COX, UTAH STATE GOVERNOR

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A Message from our Breakfast Sponsor

3RNET.ORG Utah 3RNET Coordinator Carrie Torgersen 435-638-7449 torgersen@suu.edu

Innovation in Rural Healthcare JoAnne Zitting, MBA-HM Chief Operating Officer

RURAL HEALTH

ASSOCIATION

OF UTAH CONFERENCE

November 9, 2023

Innovation in Rural Healthcare Presenter JoAnne Zitting, COO 435-900-1104 ext.45 joanne.zitting@creekvalleyhc.com

Why Grass Roots?

Grass roots have withstood the turbulence and the conditions in which they were planted So have you.

You know your people, you know their turbulence, you have withstood the conditions in which you were planted.

The Biosphere 2 Project, conducted by philanthropist and billionaire Ed Bass, revealed a profound insight about the importance of stress in nature.

JoAnne Zitting, MBA-HM

Professional Figure-It-Out-er

Creek Valley Health Clinic Timeline 10 Dec

Community members come together with a vision of bringing primary care to Colorado City

9 Apr

Organization successfully submits the 175 page NAP Grant Application – scored 103 / 100

11 Sep

HRSA awards grant. CVHC begins enrollment with CMS, Dep of Health, and CLIA

2018

Staffing Supplies Equipment Insurance Contracting Technology Compliance Outreach

120 Days

16 Dec

Grand Opening!

Location & Distance from Health Services (in Utah) ~800 residents

Note: Arizona residents insured by Medicaid (AHCCCS) have historically been able to access only emergency care in Utah. ~10,000 Total Population

This has led to high volumes of non-urgent and non-emergent usage of the ER at DRMC

No Healthcare Services in over 10 years

~2,900 residents

Colorado City~3,200 residents ~2,800 residentsCentennial Park ~450 residents

Location & Distance from Health Services (Arizona) 2 of our original Physicians practiced in Page when we opened

Nearest healthcare services for AHCCCS patients are in Page Arizona.

Colorado City Needs Assessment Geography –

Culture –

Nearest health facility: Utah residents: 24 miles Arizona residents: 112 miles (excluding ER)

No taxis, shuttles, busses, or UBER in service area.

History of complete isolation Fear of outside intervention Severe individual and community trauma (Jeffs) Unfinished housing and malnutrition Large plural families (Avg Household Size: 8.86) Population under age of eighteen: 56% (UT – 30%)

Income, Education, Insurance* –

Disease Prevalence* –

Median household income $37,557 (UT - $68,358) Median per capita income $4,238 (UT - $21,839) Unemployment 18% (UT – 3.6%) Female Unemployment 24% (UT – 3.6%) High school education or higher 40% (UT – 92%) Bachelors or higher 4% (UT – 32.5%) Uninsured ~20% (UT – 11%) Medicaid ~55% (UT - ~10%)

Colorado City is significantly worse (>10%) than state averages in the following areas: Diabetes Suicide Hypertension Binge Drinking Obesity Depression Cancer Screening Cigarette Usage Asthma

Transportation –

Data extracted from ACS estimates and the 2017 CDC Behavioral Risk Factor Surveillance Survey

Rural Living: Rural Americans are more likely to die from the top 5 causes of death – heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke.

Department of Health, Survey, 2019, Higher Rural Causes of Death Linked to Tobacco Use

Rural Challenges (It’s okay to cringe at this slide…)

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Limited access to healthcare facilities.

Insufficient access to quality education and limited school options.

Fewer employment opportunities and lower average income.

Limited public transportation options.

Limited access to high-speed internet and digital services.

Greater distance to grocery stores and essential services.

Limited access to cultural and recreational amenities.

Challenges in accessing fresh and affordable produce.

Difficulty in attracting and retaining healthcare professionals.

Limited access to mental health services.

Longer emergency response times.

Insufficient infrastructure maintenance and road conditions.

Reduced availability of affordable housing.

Higher utility costs, especially for heating and cooling.

Limited access to public transportation.

Limited or no access to public utilities like water and sewer systems.

Isolation and limited social interactions.

Greater vulnerability to natural disasters.

Limited job diversity and career advancement opportunities.

Reduced access to childcare facilities.

Limited access to financial services, such as banks and ATMs. Increased travel time for daily activities.

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Challenges in attracting new businesses and industries.

Reduced access to public safety resources.

Limited availability of cultural and recreational activities.

Limited opportunities for higher education.

Less government funding and support for rural areas.

Challenges in finding qualified and experienced teachers.

Decreased property values and limited home equity.

Limited access to legal services.

Reduced access to public transportation.

Limited access to addiction and rehabilitation services.

Limited public transportation options.

Decreased access to support for individuals with disabilities.

Limited opportunities for volunteer and community involvement.

Limited access to diverse dining and entertainment options.

Increased reliance on personal vehicles.

Limited access to public libraries and educational resources.

Challenges in attracting and retaining young professionals.

Reduced access to specialized healthcare, like pediatric or geriatric care.

Rural Challenges at Creek Valley Health Clinic ●

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Reimbursement Complexities in Border Towns: Creek Valley grapples with intricate reimbursement challenges, affecting the sustainability of vital services.

Historical Trauma's Economic Toll: A history of trauma has left the community economically devastated, generating substantial hurdles to economic recovery.

Educational Attainment Disparities: Educational attainment in the area stands staggeringly low, requiring comprehensive efforts to enhance access and opportunities.

Workforce Expertise Scarcity: A shortage of qualified workforce presents a formidable obstacle to providing comprehensive healthcare services.

Chronic Disease Management Struggles: The region confronts subpar chronic disease diagnosis rates and management, necessitating improved healthcare infrastructure.

Limited Access to Cancer Screenings: The dearth of accessible cancer screenings demands strategic intervention to promote early detection and prevention.

Low Health Literacy Levels: Health literacy within the community is strikingly low, emphasizing the need for robust educational initiatives.

Primary Care Resistance: Resistance toward primary care services, including immunizations, requires targeted engagement strategies to foster community well-being.

Poverty Amid Large Family Sizes: Poverty, exacerbated by exceptionally large family sizes, underscores the significance of economic empowerment efforts.

Religious Extremism Impact: The community has faced challenges both pre- and post-Warren Jeffs, with the influence of religious extremism necessitating careful attention and support.

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Startup Capital Shortages: A scarcity of startup funds hampers the establishment and growth of essential community initiatives.

Community Division: An underlying sense of community division warrants endeavors to foster cohesion and shared purpose.

Behavioral Healthcare Resistance: Resistance toward behavioral healthcare underscores the need for culturally sensitive mental health services.

Government Agency Mistrust: Widespread mistrust of government agencies calls for transparent and community-centered approaches to collaboration.

Geographic Isolation: The community's geographic isolation, separated by the grand canyon from Arizona, presents unique challenges in healthcare access and service delivery.

Lack of Public Transportation Options: The absence of public transportation options compounds the geographic challenges, impacting healthcare access.

Cultural Sensitivity Imperative: Cultural sensitivity is paramount to effectively addressing healthcare disparities and nurturing community well-being.

Antiquated Prejudice Toward Outsiders: Lingering prejudice against outsiders and those who appear different necessitates community-wide diversity and inclusion initiatives.

Regulatory Complexities: Navigating governmental regulations is intricate and requires expertise and diligence.

Telemedicine Infrastructure Development: Establishing a robust telemedicine infrastructure is pivotal for enhancing healthcare accessibility and service quality.

Flipping the Script

Combat each challenge by looking around at the resources that are available to you.

“In scarcity, there is abundance. By needing less, we suddenly have more.” – Barbara Kingsolver

Rural Strengths 1.

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Peace and tranquility with less noise and pollution.

Beautiful natural landscapes and open spaces.

Strong sense of community and close-knit relationships.

Lower cost of living and affordable housing options.

Reduced traffic congestion and shorter commute times.

Lower crime rates and enhanced safety.

Cleaner air and water quality.

Access to fresh, locally grown produce.

Opportunities for gardening and farming.

Abundant wildlife and outdoor recreational activities.

Greater self-sufficiency and sustainability.

Less crowded public spaces and amenities.

Lower stress levels and improved mental well-being.

Opportunities for rural businesses and entrepreneurship.

Close connection to nature and wildlife.

Opportunities for hunting, fishing, and outdoor sports.

Stronger community support systems.

More affordable and larger housing options.

Lower population density and less congestion.

Access to outdoor and nature-based education.

Opportunities for a healthier lifestyle.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

39.

40.

Enhanced sense of safety and security.

Greater access to gardening and self-sufficiency.

Opportunities for raising animals and livestock.

Slower pace of life and reduced stress.

Opportunities for stargazing and night-sky viewing.

Stronger connection to local traditions and culture.

Opportunity for participating in local governance.

Access to open land for building and expansion.

Opportunities for sustainable and renewable energy.

Stronger connection to local arts and crafts.

Opportunity for quieter and more peaceful living.

Lower property taxes and costs.

Access to larger outdoor yards and space.

Opportunities for volunteering and community involvement.

Lower population density and reduced crowding.

Opportunity for hunting and wildlife conservation.

Access to wilderness and protected natural areas.

Opportunities for horseback riding and equestrian sports.

Stronger connection to local food production and farmers' markets.

NEVADA

We Are Here 45 Mins

How We Converted Border Town Disadvantages to Advantages 1.Strategic Collaboration with St. George: We capitalize on our strategic partnerships with St. George, fostering synergistic relationships for mutual benefit.

2.Attracting Expertise with Competitive Wages: Leveraging the Utah workforce, we offer competitive wages to attract and retain top-tier healthcare professionals.

3.Optimizing Arizona’s Creek Valley’s Billing Process: We meticulously navigate our reimbursement process to ensure the best possible rates, in both Utah and Arizona.

5.Cross-Association Collaboration:

We harness the advantages of affiliation with professional networks in both states, including the two state health departments.

6.Innovative Deficit Coverage: We effectively utilize the Arizona Qualifying Charitable Organization tax credit to address operational deficits and maintain

financial stability.

7.Utah's Collaborative Spirit: Utah has been exceptionally supportive, offering state grants, resources, and partnerships to fortify our operations and enhance our services.

From the most meager of circumstances often emerge the most abundant and ingenious solutions.

Ask yourself, “What do we have?” Build from there. ●

Mammogram Bus Project

●

8 Different Schools to Provide Health Education and Service Access To

●

Creek Valley Condors

●

Partnerships to Complete Annual Health Fairs

●

Mountain Ranges for Running, Hiking, Biking Clubs

●

Active Facebook Social Media Following

●

Post Office – EDDM Flyer Distribution

●

University Partnerships – In Kind Staffing

●

Empty, Run Down Old Clinic

●

Incredible Construction Based Workforce (local BID Received for a

●

A community with incredible work ethic and commitment

●

4 Medical Providers Born and Raised in Short Creek

●

Chronic Disease Focus Days

●

Intermountain Healthcare’s Infrastructure and Support

●

Arizona QCO Program

●

Incredible Food Bank

●

Police station conference room

●

Internal Grant Writers! Strategically Write Grants to Support

●

Run Down Old Birthing Clinic Converted to Patient Communication

7,300 sg/ft Expansion Came in at 1/2 of Other Bid Amounts)

Existing Projects

Center

●

100% of Labor/Supplies Donated by Community to Remodel CVHC

●

Adolescent Champion Model

●

Enabled New Community Health Resources and Organizations

●

SNACC Program

S.N.A.C.C. Program Strengthening Nutrition and Activity in our Connected Community

• Health Coaching – ASU Doctorate Intern Students, In Kind Staffing • Recipe Book and Resource – Distribution • Cooking Demonstrations & Classes – Partner with USU Create Better Health • Food Rx Bag – Cooking class utilizes food bank foods with attached recipes

• Produce Subscription Cards – Produce vouchers redeemable at local grocery store - $5 Kids Cash, $20 and $50 • Healthy Recreation and Youth Sports – Sponsorship of healthy community activities

• Donated Sports Equipment and Jump Ropes to the Local Schools – Dicks Sporting Goods Grant • Youth Sports Camps - Hosted in Partnership with SCORE International • Chronic Disease Focus Days – Diabetes and Hypertension

Chronic Disease Focus Days Quarterly Focus Days Implemented in Quarter 3 of 2021

Patient Navigator – Schedules DM and HTN patients quarterly

Follow ups scheduled according to treatment plan to ensure patient is not lost to care.

Provider Visit, Integrated Behaviorist, Self Monitoring Blood Pressure Device Offered, Occupational Therapist, Case Management Intro/Touch Base

Arizona State University Behavioral Health Doctoral Students - Follow up with Patients 3-6 times to Discuss Care Goals, Mental Health Status, Medication Concerns, etc.

Cookbooks, Produce Cards, Nutrition Education and other Resources Given Out and Discussed

Patients are Provided with Eligibility Assistance

Innovation at Work

Innovation = Outcomes 2020 to 2023

Diabetes HgbA1c > 9

Controlled Hypertension

2020 2023 48% 17% 2020 2023 30% 62%

Cervical Cancer Screening

Colorectal Cancer Screening

2020 2023 14% 51% 2020 2023 11% 39%

Short Creek Today

Final Remarks:

“Innovation is seeing what everybody has seen, and thinking what no one has thought” – Dr. Albert Szent-Györgyi

THANK YOU for the great work you do across Utah.

A Message from our Lunch Sponsor

Intermountain – Round Valley Valley Behavioral Health Solstice Health & Wellness

Intermountain – St. George Booth Wellness Center

2023-2024 Cohort

2020-2021 Cohort

2022-2023 Cohort

2019-2020 Cohort

2021-2022 Cohort

Legislative updates & Listening Session David Gessel, JD, MA None

Executive Vice President Utah Hospital Association

RURAL HEALTH

ASSOCIATION

OF UTAH CONFERENCE

December 1, 2022

Utah Political And Legislative Update for 2024

Politics is still “weird” in Washington!  Most polarized politics since the late 1960’s and early 1970’s  Both Republican and Democratic parties continue their on going internal civil wars

 U.S. Senate barely held by Democrats  U.S. House barely held by Republicans

 Speaker selection tells us everything  President Biden much more liberal than anticipated

2024 Presidential Election Taking Over Washington  This means little will be likely get done in the next year  America continues to be a very divided nation politically  Does anyone want a 2024 rematch of Biden vs. Trump?  Third straight Presidential election where majority of Americans are not happy with their choices

One Year Out From 2024 Election  Trump is currently ahead by 4-10% in five of the six swing states that will decide the election – Arizona, Georgia, Wisconsin, Michigan, Pennsylvania and Nevada

 Biden weighed down by his age, gaffes and economic policies  Still could go either way  Trump is a political phenomenon that will be studied for decades – no President like him ever before

 Things won’t be normal for at least 5 more years

U.S. Senate likely to go Republican  Democrats currently hold a 51-49 lead in the U.S. Senate  Democrats have many more Senators up for election  4 current Democratic Senators are very vulnerable to losing  4 more could lose  No Republican losses expected

U.S. House Could Go Either Way  Republicans hold a 222-213 lead in the U.S. House  Hard to get anything done there with such a close margin  Could go either way but will likely stay close in numbers  Celeste Maloy likely to win Chris Stewart seat

2024 Utah Election: “VERY” Status Quo Governor Cox has been good for rural Utah and is likely to be re-elected by a large margin

 Utah Senate likely to stay the same with 23 Republicans along with 6 Democrats with maybe 1 or 2 changes either way. Senate leadership likely to stay the same

 Utah House will remain heavily controlled by Republicans.

Republicans have 61 seats to 14 for Democrats. There could be 3-5 races that could switch parties. Republican caucus continues to lose a number of seasoned leaders and becomes even more conservative.

 New House Speaker likley Mike Schultz

Utah Has Great Economy?  Utah positioned well for continued good economy  We have some of the lowest unemployment in the country  State Budget should be fine for the coming year unless strong recession hits.

 New Utah – more in migration, more minorities, more elderly, less childen being born. Long term cultural and economic impacts

Major 2024 Legislative Issues  Always education -- teacher raises  Affordable housing – cost of housing is unprecedented in Utah right now

 Water use and conservation  Saving The Great Salt Lake

 Transportation  Growth

Utah Medicaid Status  Medicaid Expansion is fine for at least the next couple of years due to sales tax funding source

 Good chance of status quo Medicaid hospital and other Medicaid funding in 2022 with small inflation increase

 Medicaid budget could have challenges due to reduced federal match rate

and reduction of phantom Medicaid enrollees as well as potential economic slowdown

 New Prism computer system still causing problems for both providers and patients

Other Major Health Issues in 2024 State Legislative Session  Mental Health funding and reform  Healthcare Workforce funding and future  Abortion? Still in courts  Cost, access and quality issues

Good Citizens Make a Difference Still smart to engage even in this politically challenging time Seek to be known as an expert in your area by your political leaders – get to know them personally

Strive for civil discourse – first seek to understand, then to be understood. Help find common ground Find ways to support your political leaders – money, time, endorsements, etc.

Teach younger generation how important and fragile our system of government is

Questions?

Population heath and data How are they connected?

Data’s role Population health and data are strongly connected. Data plays a crucial role in understanding, improving, and managing the health of communities.

In 2020 the PCRH Medicare Rural Hospital Flexibility Program (Flex) team implemented a program to help critical access hospitals (CAHs) be able to pull data in a timely and reliable manner.

Department of Human Services Primary Care and Rural Health (PCRH)

The DHHS Office of Primary Care and Rural Health has partnered with REDiHealth to assist Critical Access Hospitals in providing technical assistance and recommendations to resolve issues with isolated data.

Partners in this effort

Electronic health records (EHR): What is the problem? ●

●

●

Timely consumable data Billing the right way for the care you provide Getting paid for the care you deliver

Managing the needs of the patient of a clinic and hospital, as efficiently as possible, is a key skill in today's health care delivery. ●

●

●

Best clinical outcomes demonstrated to payers Efficiency with staff and resources Care is not confined to the issue that the patient came into the clinic for

The why

Patient volume is coming

OMB explain RHC Social drivers of health (vol will make that worse)

How can you respond?

How is this sustainable?

Data and the Outpatient Clinic Sarah Woolsey, MD, MPH Medical Director Association for Utah Community Health RHAU Breakout 3C November 9, 2023

AUCH

• •

•

•

Utah’s designated Primary Care Association (PCA) Provide over 15,000 hours of training/assistance to members and affiliate members yearly Support UTECH, including member Population Health Platform Partner with all public/private agencies to ensure best outcomes for Utah underserved patients

Self- Assessment

What kind of data sources do you have at your clinic site?

Electronic Health Record Registries?

Populations of Focus?

No-shows? Cycle Times?

Financial?

Practice Management System?

How do you get your referral consultation notes?

Self- Assessment

What kind of “outside” data sources do you have?

Hospital EHR Access?

Payer Lists?

Portal for a payer or ACO? USIIS Immunization Registry?

CHIE? ADT Feeds? (Admission, Discharge, Transfer) Controlled Substance Database?

What have I missed?

So you got it, how do you use it?

Quality Team Financial Team Care Management Team/Coordinator Point of Care Review of Data Huddle Other?

Best Care Pays

Good outcomes are win/win Asks us to know our patients and know their needs Develop ways to best care for them Potential financial benefit when you can demonstrate your ability

Data will assist to make that case (in and outside wall data)

Next Steps

Reach out for assistance/consider a consult Develop a team to look at goals and priorities

Look for opportunities to make your case for your quality/efficiency Reinvest into your systems and add data support as you can Reach out to the team at the State Office of Rural Health, AUCH, Comagine or RHAU for resources; Sara Hallvik SHallvik@comagine.org Know and continue to know your data Remember this is doable

Resources

Federal Office of Management and Budget: data standardization

Kem C. Gardner population projections

Current Behavioral Health & Wellness Efforts

The mission of Get Healthy Utah is to foster a culture of health through engaging multi-sector stakeholders, building partnerships, providing r e s o u r c e s , a n d c o n n e c t i n g e ff o r t s t h a t s u p p o r t healthy eating, active living, and mental wellbeing.

Organization Staff

Board of Directors

Wayne Niederhauser State Homeless

Devynne Andrews Communications Coordinator

Coordinator

We Need to Support Healthy Adults: Behaviors Teens: 12%

8%

7%

2%

Meet fruit recommendations

Meet vegetable recommendations

Meet fruit recommendations

Meet vegetable recommendations

55%

26%

Meet physical activity recommendations

Meet physical activity recommendations

SOURCE: https://ibis.health.utah.gov/ibisph-view/indicator/complete_profile/OvrwtObe.html

SOURCE: https://www.cdc.gov/mmwr/volumes/71/wr/mm7101a1.htm#T1_downl

SOURCE: https://www.cdc.gov/mmwr/volumes/70/wr/mm7003a1.htm SOURCE:https://ibis.health.utah.gov/ibisph-view/indicator/complete_profile/PhysActAdol.htmll

Chronic Disease is Expensive Projected total cost of chronic disease 2016-2030 in Utah:

SOURCE: https://www.fightchronicdisease.org/states/utahl

Prevention Matters Over 80% of chronic disease and premature death could be prevented by healthy eating, regular exercise, and not smoking.

An estimated 40% of all cancers can be prevented.

Every dollar invested in evidence-based prevention yields $5.60 in savings SOURCE: https://www.sciencedaily.com/releases/2009/08/090810161906.htm#:~:text=Summary%3A,according%20to%20a%20new%20report.

Healthy Choice the Default Choice Decrease healthcare costs Improve health outcomes Improve equity Boost quality of life

Healthy Choice the Default Choice

Areas of Focus COMMUNITIE S

SCHOOL S

WORKPLACE S

HEALTHCAR E

Healthy Utah Community This year, 9 new communities were designated, for a total of 43 communities Designation 26

Active Living Strategies

16 Healthy Food Strategies 17 Mental Health Strategies 59 Total Health Strategies Implemented This Year

Stay Connected Newsletters, Social Media

www.gethealthyutah.org

THE UTAH RURAL OPIOID HEALTHCARE CONSORTIUM – COLLABORATIVE CARE MODEL – University of Utah College of Nursing/School of Medicine – Center for Rural Health/Southern Utah(AHEC) – Utah State University Extension – Association of Utah Community Health Centers (AUCH) – Utah Support Advocates for Recovery Awareness (USARA) – Up to 8 clinics in Carbon/Emery/Wayne Counties This program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $2,724,632 with 0% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

©UNIVERSITY OF UTAH HEALTH

UROHC-CCM GOALS AND OBJECTIVES 1. To develop health professions workforce capacity in Utah 2. To prepare and sustain interprofessional rural primary care SUD treatment teams 3. To support rural communities in providing SUD risk prevention and treatment Follow us on Social Media @UROHC-CCM Utah Opioid Healthcare Consortium @UROHC @uofu_UROHC Email me: linda.edelman@nurs.utah.edu ©UNIVERSITY OF UTAH HEALTH

A Lifeline for the Frontline

Health Care Workers Reported Experiencing

93% stress

86% anxiety

Data courtesy of Mental Health America

77% frustration

77% exhaustion & burnout

75%

overwhelmed

Let’s talk about…

getting support

Download SafeUT Frontline

Select Status

26,336

back-and-forth chat messages from July 1, 2022 to June 30, 2023

Utilization by Profession 17%

Health Care 14%

Fire/EMS Law Enforcement

69%

Chat data from July 1, 2022 to June 30, 2023

SafeUT Frontline has an app and website for you to use on your own terms.

If you want, you can download the app now so if you or someone you’re concerned about ever needs it you’ll be ready.

Health Equity in Practice

Dulce Díez Utah Department of Health and Human Services Office of Health Equity Rural Health Association of Utah Conference St George, UT. November 9, 2023

DHHS vision

We will ensure all Utahns have fair and equitable opportunities to live safe and healthy lives

What will you learn today?

1.

Basic terminology

2.

OHE health equity framework

3.

The health equity mindset

4.

How OHE is integrating HE at the system level and in rural areas

Tailored approaches based on ● Area of work ● State and local environments

Same foundation ● Cultivate a HE mindset ● Operate within the same framework ● Speak the same language

To advance health equity requires

Speak the same language

Definitions

▪ Health equity Principle ▪ Health disparities Outcomes ▪ Health inequities Processes

The OHE pathways framework

The health equity mindset

● Be intentional, strategic, and

open-minded about partnerships

The health equity mindset

● Address health in individual and community context ● Recognize and value lived experience ● Foster power building and sharing

● Operate with flexibility and adjust quickly

How OHE is integrating HE at the system level

Department of Health and Human Services (DHHS)

1. BOCA-HE project 2. Data standardization 3. Health disparities reports: Link 3. CHW certification

Projects in rural areas

1. Local health departments - BOCA-HE for LHDs - HE teams - CHWs 2. Tribal organizations 3. Independent rural hospitals

Community engagement

1. COVID Communities Partnership (CCP) 2. Community Health Workers (CHWs) collaborative

Call to action 1. Where do you see your work reflected in this framework?

2. Think about collaborations with other partners to increase the impact of your work in rural Utah.

Compared to their urban counterparts, America’s rural communities continue to be: ● More elderly ● Less well-off financially ● In poorer health ● Experiencing reduced access to care ● Living in communities with hospitals vulnerable to closure ● Struggling with internet inequity and technology skills

Why does this matter to rural?

www.healthequity.Utah.gov

Thank you!

The Grant Scott Bonham Fetal Center at Primary Children’s Hospital Stephen J. Fenton, MD, FACS, FAAP Medical Director Grant Scott Bonham Fetal Center Primary Children’s Hospital

Martha A. Monson, MD, MSCI Director, Fetal Intervention Grant Scott Bonham Fetal Center Primary Children’s Hospital

The Grant Scott Bonham Fetal Center at Primary Children’s Hospital

No disclosures.

The Grant Scott Bonham Fetal Center at Primary Children’s Hospital

Who What Where

When Why

A journey…

Pediatric Cardiology

Pediatric Neurology Pediatric Nephrology Pediatric Urology

Pediatric Surgery Pediatric Neurosurgery Pediatric ENT

The Grant Scott Bonham Fetal Center at Primary Children’s Hospital

A Culture Shift Patient Centered Multidisciplinary Team

Physician Centered

Fetal Center Team

Fetal Center Pediatric Subspecialist

Fetal Center/Fetal Heart Program

~ 250 – non-cardiac fetal anomaly ~ 150 – congenital heart disease ________________________________ ~ 400 – new patients annually

Fetal Heart Team

Grant Scott Bonham Fetal Center Leadership

All Things Congenital Mother with ANY fetal congenital anomaly

Grant Scott Bonham Fetal Center

Fetal Program

Fetal Heart Program

Fetal Diagnostic Center

Multidisciplinary Conference

Review each patient (new, current, follow-up, complicated) Input and discussion from involved specialties Video conference (local, regional, super-regional MFM/OB providers)

In past, for mothers to pursue fetal intervention

Referred

Fetal Treatment Centers

Requires:

Leaving home

Leaving family

Travelling Sometimes for weeks to months

Fetal Surgery Team This requires expertise and a large concerted effort!

Maternal Anesthesia Fetal Anesthesia Anesthesia Techs Maternal Fetal Medicine Pediatric Surgery Fetal Cardiology Neurosurgery/ENT Fetal Sonographers Scrub Techs (Maternal & Fetal) OR Nurses OR Techs Neonatology NICU Nurse L&D Nurse NICU Techs

Fetal Interventions

Fetal shunt placement Laser based therapy Open Fetal Surgery

Ex Utero Intrapartum Therapy (EXIT)

Open Fetal Surgery Mid-gestational open surgery on fetus to correct or improve underlying disorders.

Myelomeningocele repair (open neural tube defect) Heart failure causing tumors: sacrococcygeal teratoma, pericardial tumors, large lung masses.

Ex Utero Intrapartum Therapy (EXIT) Perform life-saving procedure while on placental support.

EXIT to tracheostomy - Congenital High Airway Obstruction Syndrome (CHAOS) EXIT to intubation - large neck mass

Ex Utero Intrapartum Therapy (EXIT)

Ex Utero Intrapartum Therapy (EXIT)

Grant Scott Bonham Fetal Center Welcomes Back

Martha Monson, MD, MSCI 2012-2019 OBGYN Residency MFM Fellowship

2/2020 – 12/2021 Fetal Surgery Fellowship (mentor Dr. Ramen Chmait)

Fetoscopic Surgery Program

Bladder Outlet Obstruction

Image credit: Yeomens et al. Cunningham and Gilstrap’s Operative Obstetrics, 3rd Ed. c2017.

Bladder Outlet Obstruction

Congenital Pulmonary Airway Malformation

Woodward et al. Diagnostic Imaging Obstetrics 3rd Ed.

https://www.cookmedical.com/products/wh_hfbs_webds/#tab=resources

Congenital Pulmonary Airway Malformation

Radiofrequency Ablation Therapy • •

•

Twin Reversed Arterial Perfusion (TRAP) Sequence Medically Indicated Radiofrequency ablation for Complex Monochorionic Twins •

Discordant anomalous Twins

•

Severe selective fetal growth restriction (Type IIB)

•

Advanced TTTS or TAPS when laser surgery

Placental Tumors (e.g., Chorangioma)

Woodward et al. Diagnostic Imaging Obstetrics 3rd Ed.

https://fetus.ucsf.edu/trap-sequence

Fetoscopic Surgery Equipment!

Fetal Surgery Simulation / Training

Upcoming Fetal Interventions 2023

Now Offering: Fetoscopic laser surgery • TTTS • Selective fetal growth restriction • TRAP Sequence

On the Horizon (2024 and beyond) •

Fetoscopic Myelomeningocele Repair & More Pictured: fetoscopic view of myelomeningocele (left) and myeloschisis (right) neural tube defect lesions

Continued Development

Continued Development

What’s Next?

Open MMC 2021 2014 - 2015

Jan 2016

Sept 2016

July 2020

Twin-Twin 2023

2025/2026??

The Special Delivery Unit at Primary Children’s Hospital

You are Here

The Grant Scott Bonham Fetal Center at Primary Children’s Hospital

Impact of Fetal Diagnosis: A Family Experience Isaac’s Story – Bilateral Renal Agenesis

Community Partners who can bring value and support to your organization. Community Health Workers and Peer Support Specialists

The Value of Peers In Behavioral Health Services Certified Peer Support Specialist (CPSS) • •

Peer support specialist Recovery coach

Family Peer Support Specialist (FPSS) •

Family Resource facilitator (FRF)

How Does Peer Support Help?

The role of a peer support worker complements but does not duplicate or replace the roles of therapists, case managers, and other members of a treatment team.

Peer support workers bring their own personal knowledge of what it is like to live and thrive with mental health conditions and substance use disorders.

By doing so they enhance the clinical team's ability to offer treatment services that are more meaningful to the consume.

Peer support workers

What Does a PSS Do?

inspire hope that people can and do recover; walk with people on their recovery journeys; dispel myths about what it means to have a mental health condition or substance use disorder; provide self-‐help education and link people to tools and resources;and support people in identifying their goals, hopes, and dreams, and creating a roadmap for getting there.

Does Peer Support Make A Difference?

Emerging research shows that peer support is effective for supporting recovery from behavioral health conditions. Benefits of peer support may include:

Increased self-‐esteem and confidence (Davidson, et al., 1999; Salzer, 2002);

Increased sense of control and ability to bring about changes in their lives (Davidson, et al., 2012);

Full references can be found at the end of these slides.

Raised empowerment scores (Davidson, et al., 1999; Dumont & Jones, 2002; Ochoka, Nelson, Janzen, & Trainor, 2006; Resnick & Rosenheck, 2008);

Increased sense that treatment is responsive and inclusive of needs (Davidson, et al., 2012);

Does Peer Support Make A Difference?

Emerging research shows that peer support is effective for supporting recovery from behavioral health conditions. Benefits of peer support may include:

Increased sense of hope and inspiration (Davidson, et al., 2006; Ratzlaff, McDiarmid, Marty, & Rapp, 2006);

Increased engagement in self-‐care and wellness Increased empathy and acceptance (camaraderie) (Coatsworth-‐Puspokey, Forchuk, & Ward-‐Griffin, 2006; Davidson, et al., 1999);

(Davidson, et al., 2012);

Increased social support and social functioning (Kurtz, 1990; Nelson, Ochocka, Janzen, & Trainor, 2006; Ochoka et al., 2006; Trainor, Shepherd, Boydell, Leff, & Crawford, 1997; Yanos, Primavera, & Knight, 2001);

Does Peer Support Make A Difference?

Emerging research shows that peer support is effective for supporting recovery from behavioral health conditions. Benefits of peer support may include:

Decreased psychotic symptoms

(Davidson, et al., 2012)

Reduced hospital admission rates and longer community tenure (Chinman, Weingarten, Stayner, & Davidson, 2001;

Davidson, et al., 2012; Forchuk, MarNn, Chan, & Jenson, 2005; Min, Whitecra>, Rothbard, Salzer, 2007);

Decreased substance use and depression (Davidson, et al., 2012).

What is Required to be a Certified Peer Support Specialist?

In Utah, to become a Certified Peer Support Specialist, you must complete a 40hr classroom training and certification exam which covers topics such as: • • • • • • • • • • • •

Using Your Recovery Story as a Recovery Tool Five Stages in the Recovery Process Problem Solving With Individuals Combating Negative Self-talk Trauma-Informed Care Facilitating Recovery Dialogues Effective Listening and the Art of Asking Questions Crisis & Prevention Shared Decision Making Ethics and Professional Boundaries Building Informal Supports Cultural Competency

“When I saw that other people recovered, it gave me hope that I could, too.”

—Corinna

Questions?

Brian Neilson CPSS/ FPSS Director of Utah Association Of Peer Support Specialists 801-638-2823 brian@uapss.org

Certified Peer Support Specialist

12

TYPES OF PEER SUPPORT

Certified Peer Support Specialist (CPSS)

➔ ◦

➔ ➔ ➔ ➔

Medicaid Billable

Recovery Coach Mentor/Role Model Peer Navigator Family Peer Support Specialist

UTAH CERTIFIED PEER SUPPORT SPECIALIST DEFINITION A Certified Peer Support Specialist is an individual who uses their lived experience in recovery from mental illness and/or substance use disorder, in addition to skills learned in a formal training, to deliver services promoting recovery and resiliency.

https://sumh.utah.gov/education/certification/peer-support

14

UTAH CERTIFIED PEER SUPPORT FOUNDATIONS & PRINCIPLES RECOVERY-ORIENTED PERSON-CENTERED VOLUNTARY RELATIONSHIPS RELATIONSHIP-FOCUSED

TRAUMA-INFORMED

15

UTAH CERTIFIED PEER SUPPORT CORE COMPETENCIES ➢ ➢ ➢ ➢ ➢ ➢

Engages peers in collaborative and caring relationships Provides support Shares lived experiences of recovery Personalized peer support Supports recovery planning Links to resources, services, and supports

➢ ➢ ➢ ➢ ➢ ➢

Provides information about skills related to health, wellness, and recovery Helps peers to manage crises Values communication Supports collaboration and teamwork Promotes leadership and advocacy Promotes growth and development

16

WHAT PEERS DO

WHAT PEERS DO NOT DO

●

Focus on strengths (What’s right?)

●

Dwell on limitations & barriers

●

Listen to individuals experiences

●

Interpret experiences

●

Show that recovery IS possible

●

Offer advice or “fixes”

●

Accept people just as they are

●

Define what recovery looks like

●

Offer support!

●

Enforce behavior

17

Why Peer Support Works

➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢

Allows for the opportunity to establish an Instant identity Normalizing Effect Based on Empowering Relationships Allows for Mutual Self-Disclosure Establishes Social Role Models Networking Self-Determination Experiential Knowledge

18

Recovery Community Organization The Utah Support Advocates for Recovery Awareness (USARA) is a non-profit founded in 2006.

▪

We provide non-clinical Recovery Support Services

▪

We celebrate all pathways to recovery

▪

Services provided at no cost

Mission: USARA connects & inspires communities to advocate for addiction recovery.

Vision: We envision a Utah where recovery community and connection are recognized as the most valuable asset for people to recover from addiction.

USARA Services RSS

Recovery Support Services

Peer Recovery Coaches (PRCs) provide non-clinical support using lived experience • Provides support to help achieve long-term recovery & overall wellness • Focused on increasing Recovery Capital over time • Creates Individualized Recovery Management Plans • Meeting in Person or Virtual •

Statewide RSS: 385-210-0320

USARA Services

Family Support

Community Reinforcement & Family Training (CRAFT)

Reduce your Loved One’s Harmful Substance use • Engage your Loved One into Treatment/Recovery Support • Weekly Family Groups Monday through Friday, In-person and Virtual • CRAFT Connect offers education, support groups, and one-on-one coaching virtually for families •

Family Support Call/Text: (385)582-1300

https://www.myusara.com/support/craft/

USARA Services Meetings

Mutual Aid Support Meetings

USARA believes in supporting multiple pathways to recovery ■ SMART Recovery-Self Management and Recovery Training ■ Recovery Dharma-Buddhist inspired path to Recovery ■ Coffee & Recovery-Multiple Pathway Meeting ■ LifeRing-Secular Recovery ■ Fit to Recover ■ Seeking Safety ■ 12-step Recovery-AA, NA, CMA, HA, Double Trouble, etc. https://www.myusara.com/about/multiple-pathways/

Our Call to Action “If you have found recovery, consider giving the community your story as an instrument of hope and healing. If you have been blessed by resources that helped you find and sustain recovery, then join the fight to expand resources for those still suffering.”

-William White

Contact USARA for Rural Support

Marcie Gray, LSUDC, CPSS Office: (435) 319-8800 Email: mgray@myusara.com Website www.myUSARA.com On our website you can find our weekly calendar for community events, activities, trainings and meetings.

Community Health Worker Workforce In Utah

Community Partners who can bring value and support to your Organization

Kamaile TrippHarris, CHW Health Equity Consultant & CHW Coordinator 1 - University of Utah Department of Family & Preventive Medicine - Division of Public Health

2 - University of Utah Spencer Fox Eccles School of Medicine, Health Equity - Dean’s Office of Equity, Diversity, Equity & Inclusion

Native Hawaiian, Mother of 4 18 years experience in Mental/Behavioral Healthcare Former Hawaiian Heritage Teacher Producer/Co-host The Island Wave

3 - Western Governors University - Associate, Learner Records ● ●

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Oreta Mapu-Tupola, CHW/PC UCHWA

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●

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Community Health Worker - 25+ years Mother of 4/Grandmother of 3 Eldest of 3 children and Eldest Grandchild Community Volunteer Serve on Local, State and National Boards Serve as a leader in my Faith Bachelors in Social Work Masters in Social Work Courses EDd Organizational Leadership COO Of PI Community Based Organization Program Coordinator, UCHWA Business Owner

Objectives ● ● ● ● ● ●

Laie, Oahu, Hawaii

Kailua, Oahu, Hawaii

Provide clear understanding of the CHW Workforce Scope of Practice UCHWA Introduction CHW Expertise: Lived Experience/Connections in Community CHW Outreach Methods CHW Partnerships in Utah

Who are Community Health Workers?

A frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.

A community health worker also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support, and advocacy.

Scope of Practice 1. Cultural Mediation 4. Coaching and Social Support - Help understand how to use healthcare and social services.

- Supporting and coaching individuals.

- Teaching services about community cultures and - Motivating and encouraging people to seek care and perspectives. services.

- Promoting clear communication between different cultures - Aiding in self-management of disease and health conditions. in healthcare.

- Leading support groups.

5. Advocating for Individuals and Communities 2. Culturally Appropriate Health Education - Speaking up for the needs and views of communities.

- Giving health education in a way that matches language - Connecting people to resources and advocating for basic and culture. necessities like food and housing.

- Providing information to prevent diseases and manage - Advocating for policies that benefit individuals and health conditions. communities.

3. Care Coordination and Support - Helping coordinate care and manage cases.

- Referring people to services and following up.

- Assisting with transportation and breaking down barriers to accessing care.

- Keeping records of individual and community health data.

- Sharing information about community strengths and challenges.

Community Health Work: A Community Health Worker's Guide for Improving Healthcare Access, Quality, and Outcomes

Scope of Practice 1. Helping People Get Stronger - Helping individuals become healthier and more capable.

2. Strengthening the Community - Making the whole community healthier and better.

3. Teaching and Training - Teaching and training CHWs or groups to do their jobs better.

4. Providing Basic Services - Doing simple medical tests like checking blood pressure and helping with basic health needs.

5. Assessing the Community - Studying the community to understand its strengths and problems.

6. Reaching Out to People - Finding and inviting people to use health services and supporting them at home.

7. Taking Part in Research - Helping to figure out if CHWs and programs are working well. Getting community members involved in research and sharing the results. Encouraging others to take action based on research findings.

Utah Community Health Worker Association

The Utah Community Health Worker Association (UCHWA) is an organization that was developed to serve the needs & empower community health workers by supporting, organizing and promoting the workforce at a state-wide level.

UCHWA supports the Utah CHW workforce by providing professional development, career advancement, mentorship and networking opportunities through trainings, events, education, mentorship, support and connection.

Group Discussion Expertise: Lived Experience/Connections in Community

"How can community health workers with strong lived experience and deep connections in rural communities effectively bridge the gap between healthcare systems and local residents?"

Outreach Methods 1)

Personalized Home Visits: CHWs often conduct home visits to build trust and provide one-on-one support. They can assess living conditions, educate families, and connect individuals to healthcare services. Home visits are a valuable way to address individual health needs and create a personalized care plan.

2) Community Workshops and Education: CHWs organize and lead community workshops to educate residents on various health topics.

These workshops empower community members with knowledge and promote healthy behaviors. By delivering information in a group setting, CHWs can reach multiple people at once, making their outreach efforts more efficient.

3)

Cultural Competence and Language Skills: CHWs often share the cultural background or language of the communities they serve. This helps bridge communication gaps and build trust among community members who may feel more comfortable discussing their health concerns in their native language or with someone who understands their cultural values.

4)

Peer Support and Mentoring: CHWs often serve as role models, providing peer support to community members facing similar health challenges. Their ability to relate and empathize helps individuals feel understood and motivated to make positive health choices.

5)

Leveraging Existing Community Networks: CHWs tap into existing community networks, such as faith-based organizations, social clubs, or local leaders. They collaborate with these networks to reach a wider audience and encourage community members to access healthcare services and resources.

Research and Data Projects in Utah ● ● ● ● ● ● ●

University of Utah School Of Medicine CHW Team University of Utah School of Dentistry CHW Team Utah Center for Promotion of Work Equity Research/Total Worker Health Utah Area Health Education Center H.E.A.L. Core Skills Training; USU, Refugee Center, SUU, DHHS, AUCH CHW Coalition Latest Projects | Office of Health Equity (utah.gov)

Success Stories

References/Resources ·1 U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions. (2007). Community Health Worker National Workforce Study. ² World Health Organization Policy brief: Evidence and Information for Policy, Department of Human Resources for Health Geneva, January 2007 https://www.who.int/hrh/documents/community_health_workers_brief.pdf

·³Center for Disease Control: Communities Transforming to make health living easier.

How Can Public Health Practitioners Collaborate with Community Health Workers?

Collaborating with Community Health Workers to Enhance the Coordination of Care and Advance Health Equity Issue Brief https://www.cdc.gov/nccdphp/dch/pdfs/dch-chw-issue-brief.pdf

The Future of Rural Health in Utah: Exciting Advancements in Virtual Care Delivery November 9th, 2023

Jaleen Johnson, BS, Certified Digital Equity Professional Programs Manager NRTRC, UTN jaleen@utn.org www.NRTRC.org

Matt McCullough Rural Hospital Improvement Director Utah Hospital Association matt@utahhospitals.org www.utahhospitals.org/

Disclaimer 

Any information provided in today’s talk is not to be regarded as legal advice.

Today’s talk is purely for informational purposes.



Always consult with legal counsel.



We have no relevant financial interest, arrangement, or affiliation with any organizations related to commercial products or services discussed in this program.

Today’s Topics 

Northwest Regional Telehealth Resource Center (NRTRC) Resources



Federal Telehealth Policy Updates



Evolution of Telehealth



Digital Equity Initiatives for Telehealth



NRTRC Annual Conference

The National Consortium of Telehealth Resource Centers

The NRTRC is a part of the National Consortium of Telehealth Resource Centers (NCTRC).

The NRTRC is a collaboration of 12 regional and 2 national Telehealth Resource Centers,

Center for Connected Health Policy (CCHP)

The National Telehealth Technology Assessment Center (TTAC)

Northwest Regional Telehealth Resource Center (NRTRC) Alaska

Idaho

Montana

Oregon

Utah

Washington

Wyoming

Visit us!

The Northwest Regional Telehealth Resource Center (NRTRC)

Federal Legislative Updates 

The Consolidated Appropriations Act of 2022 

HR2617 extends the telehealth flexibilities through December 31, 2024. These flexibilities include:  Temporary suspension of the geographic site requirement  Medicare reimbursement for telehealth services provided to patients at home  Medicare reimbursement for an expanded list of eligible providers, such as occupational

therapists, physical therapists, speech-language pathologists, and audiologists

 Medicare coverage of audio-only telehealth for non-mental health visits  Reimbursement of FQHCs and RHCs as distant site telehealth providers for non-mental health

services



The CONNECT for Health Act of 2023 

The CONNECT for Health Act of 2023 would permanently expand access to telehealth services— ensuring that Medicare beneficiaries can continue to receive essential care

Federal Telehealth Updates-Teleprescribing Drug Enforcement Administration (DEA) and Department of Health and Human Services: Temporary Rule



The Drug Enforcement Agency, (DEA) issued a temporary rule extending the allowance for physicians and practitioners to prescribe controlled medications to new patients based on a relationship solely established through telemedicine. 

This includes live video or telephone to prescribe for buprenorphine until Dec. 31, 2024.



This extension will give the DEA time to consider permanent changes to their rules around prescribing controlled substances moving forward.

Federal Medicare Telehealth Updates-Hospitals CMS FAQs for Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency 

Hospitals Without Walls Initiative expired at the end of the day on May 11, 2023 



Hospitals will continue to be able to bill for mental/behavioral health services furnished to beneficiaries in their homes by hospital staff using telecommunications technology permanently

Through the end of 2023, hospitals can continue to bill for outpatient physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP) services, Diabetes Self-Management Training (DSMT), and Medical Nutrition Therapy (MNT) provided to beneficiaries in their homes through telecommunication technology by hospital-employed staff. 

These providers should continue to bill for these services when furnished remotely in the same way they have been during the PHE

https://ruralhealthlink.org/wp-content/uploads/2023/07/PostConference-Guide-OAT-2023-Conference.pdf

Federal Telehealth Policy Updates for Clinicians Medicare Policy

Status

FQHC/RHC Distant Site Provider Behavioral Health Telehealth Services (BHTS) Patients’ Homes for BHTS Removal of Geographic Restrictions for Originating Site for BHTS Audio-Only for Eligible BHTS FQHC/RHC Distant Site Provider Physical Health Telehealth Services (PHTS) Patients’ Home for PHTS

Permanent

Removal of Geographic Restrictions for PHTS

Permanent Permanent Permanent Expires December 31, 2024 Expires December 31, 2024 Expires December

The 2024 Physician Fee Schedule has been released!

Stay Tuned and visit the CCHP Website!

State of Telehealth Prior to COVID-19

Present State

Future State

Crisis aversionpurchasing of telehealth equipment

Investment in telehealth integration and workflow optimization

Potentially incorporating enterprise models to connect care models Clinically integrated telehealth models

Restrictions on Regulations in originating site, flux, trying to provider types, keep current types of service, and

Promoting Health Equity with Digital Equity And Inclusion 

Virtual care can improve access to quality healthcare services for all individuals, including members of rural and underserved communities.



Telehealth can only be a solution if these populations are able to access and utilize telehealth 

Broadband connectivity



Access to a device



A private spot to have the visit



Translation and interpretative services



Support of a digital navigator

Digital Equity as a Social Determinate Of Health • Applications for employment and social services are increasingly and exclusively online • Sources of health information and patient portals have been digitized • Increased use of telehealth widening disparities

• Costs of equipping a person to use the Internet and devices to manage healthcare are more sustainable than treating active conditions Sieck, C.J., Sheon, A., Ancker, J.S. et al. Digital inclusion as a social determinant of health. npj Digit. Med. 4, 52 (2021). https://doi.org/10.1038/s41746-021-00413-8

The Future is now!

• Check out our call to action and resources here

The Future is now!

• Check out our call to action and resources here

The Utah Digital Connectivity Plan

SCAN THIS CODE TO SUBMIT A TAP!

• Uses the terms “navigator” and “participant” to promote adaptability of the course • 3 Main Sections: • Intro to Telehealth for Navigators • Telehealth Navigator and Participant Resources • Process maps and Participant Considerations for Telehealth Navigation

“The Next Generation of Telehealth: From Reactionary to Visionary” 

This groundbreaking event will dive into the transformative journey of telehealth, from its reactive stage of the last three years to unlocking its visionary potential.



Engage with industry experts, thought leaders, and innovators as we discuss cutting-edge technologies, best practices, and the evolving landscape of digital inclusion in healthcare access.



Don't miss this opportunity to be part of the reshaping of telehealth to embark on a path from reacting to healthcare challenges to envisioning a brighter, healthier future.

Register Today for the NRTRC Conference

Telehealth Claims in Utah – www.utn.org

3,000 %

87%

13%

Telehealth Claims in Utah – www.utn.org

Top 3 20-34 yrs. old

Telehealth Claims in Utah – www.utn.org

$114 $107

BRFSS – Telehealth Survey 

The telehealth data as a variable is now available to query on IBIS. https://ibis.health.utah.gov/ibisphview/query/builder/brfss/LandlineCellAgeAdj5_Telehealth/Telehealth.html



In the past 12 months, have you used telehealth or telemedicine for any of the following medical services? Select all that apply. 

Routine Checkup



Urgent or acute health question or concern



Chronic condition management



Group classes for prevention or self-management of chronic conditions



Mental health services



Other services



Haven’t used telehealth or telemedicine



Don’t know / Not sure



Refused

BRFSS – Telehealth Survey

BRFSS Telehealth Survey

BRFSS Telehealth Survey

BRFSS Telehealth Survey

BRFSS Telehealth Survey

BRFSS Telehealth Survey

BRFSS Telehealth Survey

Hailey Judd hjudd@utah.gov

Telehealth Legislation in Utah  www.utn.org  2022, H.B. 166 - Mental Health Professional Licensing

Amendments

 2021, S.B. 161 - Mental Health Systems Amendments  2021, S.B. 41 – Mental Health Access Amendments  2020, H.B. 313 – Telehealth Parity Amendments  2019, H.B. 392 - Telemedicine Reimbursement Amendments  2018, H.B. 431 – Telemedicine Reimbursement Amendments

Gunnison Valley Hospital – Virtual Triage

Leveling the Healthcare Playing Field 

Problem: Small rural and Critical Access Hospitals/clinics can’t hire all of the specialists needed.



Why?: Workforce shortages, recruitment challenges, patient volume



Solution 1: Leverage the virtual care services of larger systems

Intermountain Health Crisis Care Critical Care Oncology Infectious Disease Newborn Critical Care Pediatric Care Pain Management

University of Utah TeleStroke TeleBurn TeleICU TeleBehavioral health TeleNeurology ECHO

Leveling the Healthcare Playing Field  Solution 2: Offer virtual care services directly to patients  Home care  Virtual triage  Virtual nursing  Telehealth platform for acute care  Remote Patient Monitoring (RPM)  Education (DSME)

Rural Healthcare Matters Let’s make “geography is destiny in medicine”, irrelevant!

Thank you!

Any Questions?

Jaleen Johnson info@nrtrc.org

Matt McCullough matt@utahhospitals.org

How to Utilize Project ECHO

©UNIVERSITY OF UTAH HEALTH

First things first, what is Project ECHO? PROJECT ECHO®

Project ECHO® is a distance education model that connects specialists with numerous PCPs via simultaneous video link for the purpose of facilitating case-based learning.

Move knowledge, not people...

Project ECHO is committed to addressing the needs of the most vulnerable populations by equipping communities with the right knowledge, at the right place, at the right time.

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

PROJECT ECHO®: 4 CORE PILLARS 1. Use technology to leverage scarce resources 2. Sharing “best practices” to reduce disparities 3. Case-based learning to master complexity 4. A web-based database to monitor outcomes

The ECHO model develops knowledge and capacity among community clinicians through ongoing tele-mentoring & education.

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

DEMOCRATIZING KNOWLEDGE: IMPROVING HEALTH THROUGH PROJECT ECHO® The mission of Project ECHO® to de-monopolize knowledge and amplify the capacity to provide best practice care for underserved people all over the world.

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

THIS IS HOW PROJECT ECHO® WORKS

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

What does an ECHO® look like?

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

® ECHO vs. Referral/Telemedicine

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

What is an ECHO Hub and how is Project ECHO Different than a Webinar The heart of the ECHO model™ is its hub-and-spoke knowledge-sharing networks, led by expert teams who use Zoom to conduct virtual clinics with community providers.

The hub is made up of one or more expert team members that connect with spokes (community providers).

Through Project ECHO primary care providers enhance their knowledge and stay up to date with evidence-based specialty level care for their patients in their own communities. While the team of specialist also gain knowledge of what is happening at the community level. https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

About University of Utah Health Project ECHO

©UNIVERSITY OF UTAH HEALTH

University of Utah Project ECHO Started in 2011 We were the third site to replicate the ECHO model starting with HCV ECHO

2009

2010 2011

2004

Now there are over 792 hubs worldwide in 69 countries https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

Our website https://physicians.utah.edu/echo

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

The University of Utah Project ECHO So far in 2023, University of Utah Project ECHO has 13 active programs: • 2965 attendances of 161 sessions with over 1145 unique providers • Had 187 case presentations by 63 providers • Had 108 didactic presentations from 90 ECHO facilitators Since starting in 2011, University of Utah Project ECHO has had 29 programs: • 22,503+ attendances from 1679+ sessions with over 3,758 unique providers • Had 4,697+ case presentations by 408+ providers • Had 908+ didactic presentations from 372+ ECHO facilitators

In Utah we are Building a network of support

106 unique zip codes 24/29 counties 240 Health centers reached

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

Our ECHO Hub Reach across the country

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

Offer great didactic learning opportunities Pregnancy Care

Safe and Healthy Families

Long COVID & Post-viral Syndromes

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

The opportunity to submit patient cases or clinical questions

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

® PROJECT ECHO , GENERAL PROCESS FOR CASE SUBMISSION •

Identify patient

•

Fill out a case presentation survey on our website

•

Attend ECHO session, present patient to group, and receive recommendations.

•

Treat patient accordingly with newly gained insights

•

Re-present patient as indicated.

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

® PROJECT ECHO , BENEFITS •

Continuing Education credit for all disciplines through U of U CME officeCase-based learning

•

Enhanced provider knowledge and confidence- practicing at top of license

•

Creates collegial professional “knowledge network”

•

Reduced travel for patients—transferring knowledge, not people

•

Increased access to specialty care- mitigates disparity of location of care

•

Improved patient outcomes from trusted providers - Right care, right place, right time

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

Questions?

https://physicians.utah.edu/echo ©UNIVERSITY OF UTAH HEALTH

Project ECHO What is Project ECHO?

(Extension for Community Healthcare Outcomes)

Project Echo provides knowledge-based teachings to

Who Can Attend:

providers, communities, and caregivers through virtual

Providers, Nurses, Nursing Staff, Pharmacists, Pharmacy

learning. These sessions bring specialty learning to

Technicians, Social Workers and Other Front-Line

people wherever they are.

Caregivers.

Learning Sessions Discussed: • Cognitive Bias and Errors

Benefits Include:

• Diabetes Management

• Sessions are 1 – 1.5 hours

• Hypertriglyceridemia Induced Pancreatitis

• Sessions are hosted online via Microsoft Teams

• MRSA Here, MRSA There, in the Nares and Everywhere?

• Providers can earn CME and CEU credit

• Neurosciences Case management

• Opportunity to network with professional colleagues

• Nutrition and Eating Disorders

Please CLICK HERE for more information

• ….Ready For It? Local ASPs and Regulatory Readiness • Reproductive Health and Eating Disorders • Social Work – Behavioral Health, Opioid Use, Discharging From the Floor to Outpatient

RURAL HEALTH

ASSOCIATION

OF UTAH CONFERENCE

December 1, 2022

RURAL HEALTH

ASSOCIATION

OF UTAH CONFERENCE

December 1, 2022

• • • • •

RURAL HEALTH

ASSOCIATION

OF UTAH CONFERENCE

December 1, 2022

Comagine Health ECHO™ Hub Sara Phillips, MBA, BSN, CPHQ November 9, 2023

• Comagine Health is a national, nonprofit, health care consulting firm. We work collaboratively with patients, providers, payers and other stakeholders to reimagine, redesign and implement sustainable improvements in the health care system. We cover a six State area including Utah, Nevada, New Mexico, Oregon, Washington, and Utah.

• ECHO™ Series: o Funded by external partners and free to participants o Topics are driven specific goals defined by external partners o Most sessions are not offered to the general public o Series are time limited o Sessions are focused on quality improvement

26

Current ECHO™ Series Target Audience Long Term Care Staff Utah and New Mexico

Emergency Department Physicians and Staff in the QIN/QIO States Critical Access Hospitals – Utah Physicians and Clinic Staff in Utah

Topic Utah LTC Infection Prevention

Management of Opioid Use Disorder in the Emergency Department

Presenter/Dates Multiple Presenters Ongoing thru 9/24 Dr. Alexis LaPietra 9/23 to 2/24

CAH QI

Multiple Presenters Starting 2/24 How to Implement Medications for Opioid Use Multiple Presenters Disorder Starting 1/24

This material was prepared by Comagine Health, a Medicare Quality Innovation Network-Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity 27 herein does not constitute endorsement of that product or entity by CMS or HHS. 12-SOW-GEN-23-QIN-303

Thank you!

This material was prepared by Comagine Health, a Medicare Quality Innovation Network-Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12-SOW-GEN-23-QIN-303