Rural health care services outreach grant program - organizational capacity: sterling health solutions, INC. (SHS), headquartered in MT

Sterling, KY, provides comprehensive health services to underserved, low-income and disadvantaged populations in rural kentucky. SHS has been a federally qualified health center since 2012. SHS provides healthcare services to over 30,000 individuals in our service area. SHS services include comprehensive primary care including preventive care, chronic disease management, obstetrics, dental, vision, behavioral health, substance use disorder with mat, pharmacy services, and enabling services including transportation, care management, life skill classes, outreach and enrollment, and translation services. SHS is partnering with the health departments in montgomery, powell, and bourbon counties to help expand access to diabetes education. Also, SHS is collaborating with the barnstable brown diabetes center at the university of kentucky to provide patients with additional resources to help with their diabetes care. These partnerships are based upon years of experience working with each organization to implement other initiatives in the communities we serve. Target population: SHS services the kentucky counties of bath, bourbon, clark, menifee, montgomery, nicholas, and powell. The target population are the underserved, low income, and disadvantaged residents in the counties with diabetes or are pre-diabetic. This population includes the sub-population of migratory, disabled and or homeless individuals in the communities. These individuals are impacted by a high prevalence of diabetes, along with associated comorbidities such as loss of vision, nerve damage, etc. Evidence based model: SHS will utilize the diabetes self-management education and support (dsmes) program as our evidenced based model. The dsmes model provides an evidence-based foundation to help people with diabetes navigate their health. This includes items such as daily management of blood sugar levels, improving overall health and preventing or delaying diabetes complications. The program will provide education to help patients manage diabetes through health education, nutrition, medication adherence, and physical activity. In conjunction this model will incorporate SHS's patient-centered medical home (pcmh) clinics to create a team-based care model that coordinates all aspects of patient care, focusing on prevention, management, and communication. Goals and objectives: utilizing the dsmes model the goal is to improves glycemic control, reduces hospitalizations and diabetes related complications, enhance the quality of life for individuals with diabetes, and increases patient confidence in managing their condition. Expected outcome: the desired outcome is to improve the overall health outcome for individuals impacted by diabetes. SHS and our partners will strive to eliminate barriers to care ranging from transportation, affordability of care, to healthcare literacy. Funding preference: SHS qualifies for regular track funding preference because hrsa has designated the counties we serve as health professional shortage areas and 6 out of 7 counties as medically underserved communities. Also, the rural service area proposed, bath, bourbon, clark, montgomery, menifee, nicolas, and powell counties, are all hrsa designated rural areas.