Health Extension Regional Offices

1
Health Extension Regional Offices

• Community-Campus Partnership to improve New
  Mexicos Health

2
Problem Statement

• Community Health Indicators in New Mexico are
  among the worst in the US.
• Most of NMs rural areas experience critical
  health professional shortages.
• The diversity of our health professionals does
  not reflect New Mexicos diverse cultures.
• Access to medical, behavioral and oral health and
  preventive services is inadequate, especially in
  uninsured, minority and geographically isolated
  populations.

3
UNM-Community Partnerships

• Mobilize UNM HSC resources to address the major
  health problems affecting New Mexicans
• Improve the health of underserved
• Reduce health disparities
• Address the social determinants of disease

4
Successful History of UNM-Community Partnerships

• Education (12 Rural Family Medicine Residencies,
  RHIP, Preceptorships, rural residency rotations,
  AHECs,)
• Service (RAPS and GAPS, PALS, Project ECHO,
  SBIRT, Locum Tenens, UNM Care, Primary Care
  Dispatch, 24 Hour Health Advice Line)
• Research (RIOSNet, Cancer Alliance)
• Policy (Affordable pay policy for uninsured,
  favorable licensure for DDS work in rural and
  underserved areas)

5
Deficiencies in UNM-Community Partnerships

• Too reliant on external funding, on pet projects
  of individuals and organizations.
• UNM programs often "siloed" and not coordinated
  for community benefit.
• UNM has not had a consistent process to listen
  and learn about community needs, inventory assets
  or elicit a communitys collective wisdom.
• UNM provides certain needed services, but does
  not always expand community capacity. It cannot
  be all things to all people.
• Example no correlation between physician
  training mix and state needs for primary
  providers.
• UNM research outcomes are not consistently shared
  with the communities studied.
• Institutional barriers (high indirect rates,
  difficult administrative systems, cumbersome
  contracting).

6
Hypothesis 1

• In order to collaboratively address community
  health issues and the core mission of UNM-HSC,
  the campus-community partnership needs to be
  institutionalized and sustainable.

7
Hypothesis 2

• Change Agents
• A system of local Health Extension Regional
  Offices (HEROs), will
• Act as liaisons between communities and a HSC
  Community Partnership Office
• assure campus-community communication and
  coordination,
• provide the institutional framework for
  sustainable partnerships,
• produce targeted projects addressing community
  needs, and
• sustain the financing and delivery system to
  improve community health status indicators.

8
Existing Building Blocks in NM Communities

• Community Health Councils
• Community hospitals, community health centers,
  and private practices
• County and regional non-profit organizations
• Agricultural Cooperative Extensions
• Local Colleges, Branch Campuses
• AHECs

9
Selecting Community Partners

• Strong local/regional connections with diverse
  community groups
• Track record of working collaboratively and
  inclusively
• Governance through a diverse, community-based
  local Board
• Basic physical, administrative and human
  resources infrastructure
• Level of in-kind contributions and dollar match
• Some experience working with University system
• Ability to gather and analyze data for evaluation
  purposes

10
Volunteer Pilot Sites

• First Choice Community Health Center, Albuquerque
• St. Vincents Hospital/Northern NM Family
  Practice Residency Program, Santa Fe
• Hidalgo Medical Services/The Wellness Coalition,
  Lordsburg/Silver City
• Sandoval County Health Alliance, Bernalillo
• Eastern New Mexico University, Roswell
• Area Health Education Center-Las Vegas
• Guadalupe County Hospital, Santa Rosa
• Health Centers of Northern NM, Santa Fe
• Lee County/Maddox Foundation, Hobbs
• La Clinica de Familia, Las Cruces
• Crownpoint Indian Health Services

11
HERO Profile Example

• Name The Wellness Coalition
• Geographic Area covered Luna, Grant, Catron,
  Hidalgo Counties
• Mission To improve the quality of life and build
  community capacity among Catron, Grant, Luna and
  Hidalgo Counties through fostering partnerships,
  activating collaborative processes, and
  developing resources.
• Governance 8 board members, two from each
  county, recommended by Health Councils, one
  at-large president. Members represent consumers,
  providers and health councils.
• Collaborative relationships with the following
  organizations 4 Health Councils, 3 Community
  Health Centers, regional mental health provider,
  regional DD provider, DV Shelters, JPPO, Homeless
  services provider, NMSU AHEC, Youth serving
  organizations, NM Forum for Youth, NGO-NM, NM
  Commission for Community Volunteerism
• Organizational Capacity (administrative, staff,
  IT, data collection and evaluation)
• ED and CIO 2 admin staff, staff evaluator,
  central office in Silver City, videoconferencing
  capacity, data collection based on Health Council
  Community Profiles.
• History of collaboration with UNM RHIP
  Coordination
• Priorities for working with UNM Building
  capacity and partnerships for community based
  research grants, workforce development
  (continuing ed, professional recruitment,
  internships), service learning opportunities

12
HERO Long-term Goals

• Improving the ability of NM communities to
  recruit health professionals in training at UNM
• Improving rural communities ability to train
  health professionals outside of UNM
• Assist in improving quality of health services
  provided locally through tele-medicine and
  increasing on-site delivery of locally specified
  services (ex. Project Echo, Specialty Extension
  Services)
• Enable communities to work with UNM to apply for
  research funding addressing community priorities

13
1st year Priorities

• Education
• Residency Programs
• Pipeline Programs
• Tele-education
• Service
• Provider support,
• Capacity Building
• Specialty extension
• Research
• Community based/initiated research projects
• Distribution of research data, feedback to
  communities
• Pilot best practices, develop models
• Policy
• Health Status Priorities Development, addressing
  health disparities
• Health System Changes incl. System
  Integration/Communication
• Access to Health Services

14
HERO Scope of Work

• Facilitation Match UNM resources with community
  needs
• Coordination Navigate the academic world on
  behalf of the community
• Tracking, evaluation and quality improvement
  evaluate performance of partnership, system
  improvements and health outcomes Report Card
• Resource Development Work collaboratively to
  identify financing (Grants, Public Funding) for
  statewide and local priorities
• Public relations advocacy, legislative and
  programmatic support at UNM for local needs
• Participation in Statewide CHEO Network

15
Roles and Responsibilitiesof UNM-HSC

• System change university-wide dialogue on
  community engagement integrate into mission,
  activities and budget open silos to communities
• Resource Development Aligning UNM programmatic
  development with statewide priorities
• Coordination and Facilitation one office for
  communities to connect to build community and
  HERO capacity build trust through long-term
  engagement independent form grant/project funding
• Evaluation coordinate tabulation of data from
  HERO Network

16
Implementation Steps

• Pilot HEROs through joint community, UNM and
  State funding
• UNM office, website and 1-877 established
• Development of health status priorities and
  project priorities
• Development of tools, budget, evaluation plan
• Data collection and interpretation
• Seek full Funding for statewide system