Project Grant G2046022

SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT - ADDRESS: 101 S. 10TH ST., RICHMOND, IN 47374 PROJECT DIRECTOR NAME: CARRIE MILES, CEO CONTACT PHONE NUMBERS: 260-458-2641 EMAIL ADDRESS: CARRIE.MILES@NEIGHBORHOODHC.ORG WEBSITE ADDRESS: HTTPS://WWW.NEIGHBORHOODHC.ORG LIST ALL GRANT PROGRAM FUNDS REQUESTED IN THE APPLICATION: $200,000 PER YEAR FOR 4 YEARS MOST OF THE NEIGHBORHOOD HEALTH CENTER (NHC) PATIENT POPULATION ARE LIVING IN POVERTY; 68% ARE AT OR BELOW 200% FEDERAL POVERTY LIMITS (FPL) AND 30% ARE BELOW 100% FPL AND NEARLY 8% OF PATIENTS SERVED ARE SELF-PAY WITH NO INCOME TO SUPPORT HEALTH CARE COSTS. NHC HAS SEEN THESE NUMBERS GROW OVER THE LAST FIFTEEN MONTHS AND EXPECT THIS NUMBER TO CONTINUE TO GROW IN THE COMING MONTHS, PARTLY DUE TO THE IMPACT OF THE COVID-19 PANDEMIC AND THE FACTORS THAT IMPACT RURAL COMMUNITIES MORE SIGNIFICANTLY. RURAL PATIENTS TEND TO BE HIGH-RISK PATIENTS THAT STRUGGLE WITH THEIR HEALTH AND NEED THE SUPPORT FROM A HEALTHCARE TEAM TO IDENTIFY HEALTHCARE CONCERNS, HOW TO CREATE A PLAN TO OVERCOME THESE CONCERNS AND HOW TO REMAIN COMMITTED TO THIS PLAN WHILE ACCESSING CARE AT THE ORGANIZATION AND ADDITIONAL COMMUNITY PARTNERS. NHC HAS HAD A CARE COORDINATION PROGRAM FOR THIS AT-RISK PATIENT POPULATION SINCE THE ORGANIZATION OPENED ITS DOORS IN 2018. NHC PATIENTS WHO SEE BENEFITS OF THIS PROGRAM ARE PATIENTS WHO DEAL WITH CHRONIC DISEASES DAILY AND ARE SEEN FREQUENTLY BY NHC PROVIDERS TO MANAGE THEIR HEALTH. NHC IS LOOKING FOR ASSISTANCE FROM HRSA TO EXPAND THIS PROGRAM, INCLUDE MORE COMMUNITY PARTNERS AND NHC STAFF, INCLUDING CHWS, TO EXPAND THIS PROGRAM DUE TO ITS CURRENT SUCCESS IN IMPROVING HEALTH OUTCOMES. COVID-19 HAS ADDED AN ADDITIONAL, POTENTIALLY DEADLY RISK TO NHC'S HIGHEST RISK PATIENT POPULATION. SOON AFTER THE PANDEMIC STARTED, NHC IMPLEMENTED TELEMEDICINE OPTIONS FOR THESE PATIENTS TO ALLOW THEM TO CONTINUE TO CONNECT WITH THEIR HEALTHCARE TEAM WHILE ELIMINATING THE NEED TO TRAVEL OR ENTER OUR CLINIC AND THUS INCREASING THEIR RISK EXPOSURE. TH ESE VIDEO/AUDIO VISITS PROVIDED AN OPTION FOR PATIENTS TO SEEK CARE BUT UNFORTUNATELY PATIENTS HAD CHALLENGES WITH UTILIZING THIS TECHNOLOGY DUE TO LACK OF INTERNET AND/OR LACK OF SMART PHONE ACCESS. TO BRIDGE THIS GAP, NHC IS PROPOSING THE IMPLEMENTATION OF REMOTE PATIENT MONITORING KITS THAT THE PATIENTS CAN USE AT HOME TO ELIMINATE BARRIERS IN SEEKING CARE AND PATIENT COMMITMENT TO ADHERING TO SCHEDULED APPOINTMENTS AND CARE PLANS AT HOME. IMPLEMENTING REMOTE PATIENT MONITORING IN PATIENT HOMES ALLOWS THEM TO TAKE THEIR BLOOD PRESSURE, PULSE OXIMETER, WEIGHT, TEMPERATURE AND GLUCOSE MONITORING. THIS DATA IS VITAL TO MANAGE THE PATIENT'S CARE, KEEP THEM HEALTHY AT HOME AND PREVENT HOSPITALIZATIONS. NHC IS EAGER TO SUPPORT IMPROVED HEALTHCARE OUTCOMES, EXPANDED CAPACITY AND FINANCIAL SUSTAINABILITY THROUGH THE INTEGRATION OF REMOTE PATIENT MONITORING AND COMMUNITY HEALTH WORKERS TO SUPPORT HEALTHCARE IMPROVEMENTS AND CARE COORDINATION. ADDITIONALLY, NHC HAS DEVELOPED A REPLICABLE MODEL THAT CAN BE INTEGRATED ACROSS VARIOUS POPULATIONS AND SERVICE LINES TO ENSURE HEALTH CENTERS CAN LEARN FROM EACH OTHER AND FOCUS ON IMPROVING HEALTH OUTCOMES AND CARE DELIVERY ACROSS THE COUNTRY.