Health Extension Regional Offices Community-Campus Partnership to improve New Mexico’s Health

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

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

Successful History of UNM-Community Partnerships  Education (1+2 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)

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 community’s 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).

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.

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.

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

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

Volunteer Pilot Sites First Choice Community Health Center, Albuquerque St. Vincent’s 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

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

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

1 st 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

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

Roles and Responsibilities of 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

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