Hunter Health Clinic, Inc (HHC) is proposing a 4 in1 project that ensures the best possible health outcomes for our Urban Indian patients, while also increasing recruitment of any eligible Urban Indian patients in our service area. This project proposes goals with evidence-based approaches to achieve better health while utilizing our integrated care model to ensure patients receive holistic care. It is HHC’s mission to provide our community with access to healthcare for both body and mind.
HHC proposes maintaining our current high-quality care model by supporting two current staffing positions a substance use treatment counselor/integrated care consultant and an integrated care consultant. In addition, we are requesting funds to ensure adequate behavioral responses for patients who may be anxious or escalated due to life stressors, behavior, or substance use. We are also requesting funding to ensure providers can easily access patient data while in the room with a patient. This will support patient-determined and strengths-oriented goals. In addition, we are requesting outreach supplies such as a portable scanner to ensure patients can have medications sent to community partners and promotional materials to increase our patients’ engagement in their healthcare and increase the number of patients visiting the clinic.
We have made the following goals to ensure that the 4 in 1 grant goal of best possible health outcomes is met:
• Provide care to 125 unduplicated patients by end of year one.
• Complete outreach activities to engage patients in preventative vaccines including flu, pneumonia and COVID-19 vaccinations.
• Decrease the percentage of patients 18-75 years of age with diabetes who had hemoglobin A1C >9.0% from an average of 33.5% to 30% by end of year one.
• Create at home hypertension monitor program.
• Create Mobile Unit to bring outreach to reservation patients.
• Host large influenza vaccination event.
• Report on immunization services to Area Immunization Coordinator.
• Complete 50 SBIRTs by the end of year 1.
• Complete 200 assessments and interventions by end of year 1.
HH will use grant funds to establish and continue training on the following evidence-based approaches: Crisis Intervention Training, Diagnostic Assessment, Motivational Interviewing, Cognitive Behavioral Therapy, Solution Focused Therapy, Dialectical Behavioral Therapy Techniques, SBIRTs, depression screening with every patient, Diabetes Education (Individual and Group Sessions), Chronic Disease Self-Management Group, Diabetes Care Self-Management Group, outreach and utilization of behavioral staff to assist with any concerns about the ability to ensure vaccines are completed, and validation of learned skills by executive and leadership team members.
Hunter Health exists to improve the health and well-being of everyone in our community. We believe our project will increase patient health status for diabetic care, hypertension, screening and referral to substance use treatment and behavioral health services for applicable patients.