Canyonlands Community Healthcare, a non-profit community health center [Health Center Program grant number (H80CS00448)] offering services to rural communities in Arizona and southern Nevada, is seeking to expand service hours at three of its existing clinics, including Mesquite, NV (Clark County [ZCTA5 89007, 89027 and 89034]), Globe, AZ (Gila County [ZCTA5 85501 and 85539), and Safford, AZ (Graham County [ZCTA5 85546 and 85552]). These communities are located in counties that are geographically large, rural, diverse and extends into portions of these counties which include individuals who live and work on the Navajo Nation (Coconino) and San Carlos Apache Reservation (Graham). The counties within the service area have received HPSA designations due to the shortage of healthcare professionals in general, and particularly for patients who are uninsured, underinsured, or insured through Medicaid. There are significant health disparities among residents due to social determinants of health and barriers to access to care in rural, frontier and tribal communities in the service area. Expanded hours at these sites will occur on Saturdays from 8am to 1pm. Services will include primary medical care at each of the sites for Mesquite and Safford. The Safford site will also have additional evening hours, with pediatric services being offered during those times. In addition to these in-person services, existing telehealth services will also be expanded consistent with these expanded service hours to provide additional appointment options for both primary medical care and behavioral health. Physicians and Advanced Practice Providers will rotate hours and if needed, additional staff will be recruited to fill the expanded schedule. Minor alterations/renovations (A/D) will be made in order to create suitable space at the Mesquite, NV clinic. Renovations will also allow for greater pharmacy volume through increased storage space and dispensing capacity at
the Mesquite clinic on site pharmacy. In addition, minor A/D will be used to improve physical security at the Safford clinic to ensure both patients and staff are safe during service evening hours. These three sites have been selected from Canyonands’ multiple service points in response to there being limited services available to the community on weekends. Globe and Mesquite do not have urgent care facilities, which leave patients with only the option of visiting the nearby hospital’s emergency departments on Saturdays. Meanwhile, Safford residents are reliant on the emergency department during the evenings particularly for pediatric care. Expanding hours on weekends (Globe and Mesquite) and evenings (Safford) would reduce the burden of care on the emergency departments at Mesa View Regional Hospital (Mesquite, NV), Cobre Valley Regional Medical Center (Globe, AZ) and Mount Graham Regional Medical Center (Safford, AZ), all of which have established and ongoing relationships with Canyonlands. In addition to limited service options, patients from these areas have given feedback to Canyonlands asking for more scheduling options that better accommodate work and school schedules. These expanded hours would allow patients to be seen for routine and same-day appointments on a more convenient and regular basis, and would shorten wait time for non-urgent visits. Canyonlands is committed to providing high quality primary health care and behavioral health services for adults and children to advance health equity within the communities it serves. Expanding service hours will allow Canyonlands to continue to support the provision of high-quality health care in these rural/frontier communities which includes increasing access to culturally appropriate care while also strengthening organizational capability through workforce and partnership development.