Grantee Sourcebook Rural Health Network Development Grant Program, 2014 - 2017 Published: August 2018 525 South Lake Avenue, Suite 320 │ Duluth, Minnesota 55802 (218) 727-9390 │ [email protected] Get to know us better: www.ruralcenter.org/rhi This is a publication of Rural Health Innovations, LLC (RHI), a subsidiary of the National Rural Health Resource Center. The Technical Assistance for Network Grantees Project is supported by Contract Number HHSH250201400024C from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Federal Office of Rural Health Policy. TABLE OF CONTENTS Sourcebook Overview ........................................................................... 2 Background and Purpose ....................................................................... 3 Impact of Networks Across the Country ................................................... 4 Impact Beyond the Network ................................................................... 7 Grantees by State (Map) ....................................................................... 8 Grantees by State (List) ........................................................................ 9 Grantees by Focus Area ....................................................................... 12 Individual Grantee Profiles ................................................................... 16 RURAL HEALTH INNOVATIONS 1 Sourcebook Overview The Rural Health Network Development (RHND) Grantee Sourcebook tells the story of the fifty-four 2014-2017 RHND grantees by highlighting their grant projects’ achievements and solutions to challenges during the life of their grant. The document begins with the “Background and Purpose” section, providing a description of the RHND Program Grant funding opportunity and is followed by a high-level summary of grant project accomplishments in terms of impact on rural communities, including sections on “Impact of Networks Across the Country” and “Impact Beyond the Networks”. A directory listing of grantees is also provided. The listings are organized first by state and then by grant project focus areas. These listings allow for easy navigation through the document. The second part of the Grantee Sourcebook includes individual grantee profiles, organized in alphabetical order by state. These profiles include: • Network Description • Contact Information • Mission and Vision • Member Types • Environmental Analysis o Population Needs o Population Served o Blocks and Levers • Grant Project Description o Background o Strategic Objectives o Key Initiatives • Challenges and Innovative Solutions • Network Continuation • Project Officer’s Contact Information The information published within the Grantee Sourcebook was gathered through: • Input directly from the RHND grantees through Network TA Assessments conducted by the Rural Health Innovations (RHI) network technical assistance (TA) team throughout the 2014-2017 program • RHND grant project final reports, provided as reference documents to RHI network TA team from the Federal Office of Rural Health Policy (FORHP) • RHND Year 3 Performance Information Management System (PIMS) Report, published in 2018 RURAL HEALTH INNOVATIONS 2 Back to Table of Contents Background and Purpose The purpose of the RHND Grant Program, funded by the FORHP, is to assist health-focused networks in developing and maintaining sustainable networks with self-generating revenue streams. These networks implement activities that benefit both network partners and the communities served by the network; increasing access and quality of rural health care and ultimately improving the health status of rural residents. The RHND Grant Program provided federal funding up to $300,000 annually over three years of the program (2014-2017) to 54 rural health networks. Each network consisted of at least three separately owned health care providers who signed a Memorandum of Agreement or a similar formalized collaborative agreement. While specific network activities varied, each network was required to focus on at least one of the three legislative charges described below. Legislative Charge I: Achieve Efficiencies Topical Area I: Integrated health networks will focus on integrating health care services and/or health care delivery of services to achieve efficiencies and improve rural health care services. Legislative Charge II: Expand access to, coordinate, and improve the quality of essential health care services Topical Area I: Integrated health networks will collaborate to expand access to and improve the quality of essential health care services by focusing on projects and/or network activities directly related to the evolving health care environment. Legislative Charge III: Strengthen the rural health care system as a whole Topical Area I: Networks will improve population health by implementing promising practices, evidence-informed and/or evidence-based approaches to address health disparities in their communities. Topical Area II: Integrated Health Networks will collaborate to achieve population health goals through the use of technology. RURAL HEALTH INNOVATIONS 3 Back to Table of Contents Impact of Networks Across the Country Through analysis of grantee final reports and summarized PIMS results, some common themes emerged regarding network impacts. Following is a summary of key findings and common themes, organized by legislative charge. It should be noted that a distinct separation of impacts by legislative charge is challenging, as an improvement in one area tends to meld into another. For example, improved integration of health care services often leads to improved access and quality of care. However, all of the impacts feed into the overall goal of improving the rural health care system and the health of the populations it serves. Legislative Charge I: Achieve Efficiencies Grantees rose to the challenge of achieving efficiencies primarily through improved integration of health care services. Examples of programs’ successes include: • Connecting chronic disease patients with outpatient support services • Coordination between providers and schools • Increasing emergency department diversions with hospital referrals for oral health care • Integration of behavioral health through either “warm handoffs” from clinicians to behavioral health professionals, or co-locating primary care services at mental health centers • Integrating social service support (e.g., financial and transportation assistance) into medical practice through referrals • Training, certification, and employment of Community Health Workers to serve as vehicles for care integration of medical, behavioral, and social services In order to achieve efficiencies, many of the networks participated in or supported at least one quality improvement initiative during the grant period. Care coordination was the most common target of quality improvement initiative. Legislative Charge II: Expand access to, coordinate, and improve the quality of essential health care services By the end of the grant period, new programs or services were implemented because of network activities funded through the RHND program. These programs and services provided new or expanded access. Examples of programs’ successes include: RURAL HEALTH INNOVATIONS 4 Back to Table of Contents • Improved access to oral health, behavioral health, health education, and health care enrollment • Improved quality of care for patients with chronic disease or with co- morbidities, those at risk for stroke, or diabetes • Use of telemedicine to improve access to mental health providers and medical specialists The most commonly reported new or expanded services were health education, health promotion/disease management, case management, and mental/behavioral health. Legislative Charge III: Strengthen the rural health care system as a whole Technology played a critical role in grantees’ efforts to strengthen the rural health care system. Many award recipients indicated that they had implemented, expanded or strengthened at least one form of Health Information Technology (HIT) during the course of the grant period. The most commonly reported change was to electronic medical records. Other identified changes were telehealth/telemedicine and health information exchange. Common technology-related successes include: • Improved data analytics and reporting capacity • Standardized data collection practices across network members RURAL HEALTH INNOVATIONS 5 Back to Table of Contents Breadth of Grantee Projects Focus on Improved Health The 54 grantees self-identified areas of project focus. The 10 focus areas, all of which aim at improving health and rural communities, are derived from the three legislative charges, and are listed below. Note: many grantees identified more than one focus area. Figure 1. Self-identified focus areas of the RHND projects. RHND Grantee Self-Identified Project Focus Areas Accountable Care Org Workforce Quality Improvement School-based Care Oral Health Telehealth Integration Population Health Behavioral Health Health Information Technology Care Coordination 0 5 10 15 20 25 Number of Grant Projects The grantee project focus areas included in Figure 1 corresponds to the listing of Grantees by Focus Area section included within this Grantee Sourcebook and as part of the Individual Grantee Profiles section. RURAL HEALTH INNOVATIONS 6 Back to Table of Contents Impact Beyond the Network Unexpected Reach When grantees were asked about the unexpected impact of network activities,