Public health nursing case management program - founded in 1986, the great plains tribal leaders health board (gptlhb) stands as a formal representative board of the seventeen tribal nations and one…

Public health nursing case management program - founded in 1986, the great plains tribal leaders health board (gptlhb) stands as a formal representative board of the seventeen tribal nations and one service unit in the great plains area (GPA) of south dakota, north dakota, nebraska, and iowa. The mission of gptlhb, a 501(c)(3) community-based tribal entity, is to work with tribal communities and provide quality public health support and healthcare advocacy to improve the health status and eradicate health disparities among the region's estimated 265,837 tribal members (according to provisional 2020 U.S. Census data). In 2019, the oglala sioux tribe and cheyenne river sioux tribe authorized gptlhb to manage their shares of the IHS health care facility in rapid city, south dakota. Gptlhb assumed administration of IHS' sioux SAN facility, renaming IT oyate health center (OHC). OHC has established an integrated healthcare model, providing patients with expanded comprehensive services and improved access to behavioral health. In 2022, gptlhb assumed the rosebud sioux tribe's IHS health care shares and began the development of a tribally managed health system that serves as a specialty care referral site for urgent care and primary preventative services. The STI burden across the GPA is substantially higher among american indians/alaska natives (AI/ANS) than non-hispanic whites. AI/an populations in the dakotas bear a considerably higher burden of syphilis and other recent outbreaks than in other GPA states. From 2012-2015, AI/an in south dakota (SD) accounted for 62% of the gonorrhea cases. Over that same three-year period, AI/an cases accounted for 40.5% of SD's chlamydia cases. Overall, south dakota's syphilis cases have increased by 2,183% compared to the five-year running baseline (five-year YTD through july 2022) of cases in the state. Three out of four south dakota syphilis cases are among AI/an. Gptlhb and OHC recognize the need to expand current public health nursing capacity due to skyrocketing regional STI rates and the increasing number of patient-relatives presenting at OHC as at-risk for or diagnosed with stis. Gptlhb's public health nursing (PHN) case management program will address disparities in the treatment of infectious diseases and provide critical support for direct STI health services in south dakota's AI/an communities. The program will target the OHC service population, which consists of over 32,000 annual patient-relatives representing federally recognized tribes from the GPA. Most patient-relatives are adults over the age of 19 and reside in rural areas of pennington county or within the urban area of rapid city, SD. Program staff plan to mitigate the prevalence of stis within indian country through a case management model focused on two year 1 objectives: 1) improve treatment rates by 1 % for AI/an with stis within the first 12 months of the program, and 2) enhance STI education in the community by participating in eight events within the first 12 months of the program. Based on existing patient-relative data, a 1% increase will improve the health outcomes of 268 high-risk individuals. In year 1, the program will hire a public health nurse (PHN) who will complete a community assessment, develop case management services in coordination with tribal communities, and implement these services to improve health outcomes for AI/an in OHC's service population.