Friday, November 22, 2024
11/22/2024
The Michigan Department of Health and Human Services (MDHHS) is applying for $744,847 of federal funds plus cost sharing that exceeds 10% to bring together a network of primary care clinics, health systems, and supporting partners to address disparities in colorectal cancer (CRC) screening at the clinic level in four areas of Michigan (MI). They are the city of Detroit, Central MI, Southwest MI, and the city of Flint. Although the statewide CRC screening rate in Michigan is relatively high, there are clear disparities in CRC screening and burden that emerge when reviewing geographic, population-level, and clinic-level data. MDHHS will target subpopulations that are less likely to receive appropriate CRC screening in MI based on the 2018 MI Behavioral Risk Factor Survey (BRFS). They are: 1) racial category other than white non-Hispanic; 2) unemployed; 3) uninsured or Medicaid alone; 4) report having a high school education or less; and 5) income less than $20,000 (using Living in Poverty as a proxy). MI’s target population includes people with any of these indicators alone or in combination. The purpose of MI’s proposal is to increase colorectal cancer screening rates at individual primary care clinics that provide services to the target population. MDHHS will establish formal partnerships with primary care clinics and health systems with low (below 60%) CRC screening rates and support implementation of evidence-based interventions (EBI). The primary outcome will be to increase clinic-level CRC screening rates in order to increase the number of cancers prevented, increase diagnosis of early stage CRC, and ultimately reduce CRC incidence and mortality with a special focus on reducing health disparities. In year 01, MDHHS will partner with four FQHCs, one health system with two clinics that serve the Arab American community, and two tribal clinics that are part of a Tribal Health System for a total of eight clinics. MDHHS identified these clinics and health systems through a rigorous, data-driven process that identified areas of highest-need and the clinics that serve the target populations in those areas. The clinics and health systems provide services to the target populations in the chosen geographic areas, and their CRC screening rates are below 60%. MDHHS will conduct an implementation readiness assessment of participating primary care clinics using comprehensive needs assessment and semi-structured interview. Based on the results of the assessment, MDHHS will work with each clinic to select two EBIs out of a menu of four: 1) Patient Reminders; 2) Provider Reminders; 3) Provider Assessment and Feedback; 4) Reduce Structural Barriers. MDHHS has lined up three main partners to support clinic implementation of EBIs. The American Cancer Society (ACS) will provide quality improvement (QI) instruction and support to the primary care clinics and health systems. The MI Primary Care Association (MPCA) will recruit and confirm the commitment of the primary care clinics and coordinate education on EBIs and patient navigation. MI Public Health Institute (MPHI) will provide support to clinics and health systems related to healthcare informatics as well as providing additional quality improvement support. In addition to the support provided by these partners, MDHHS will support the clinic partners through monthly Technical Assistance (TA) calls and at least two site visits with clinic staff in the first year. Increasing CRC screening is important, but follow-up of positive screening tests is also important. MDHHS will work with clinics to ensure clients receive appropriate CRC diagnostic and treatment services as needed. Additionally, MDHHS will use federal funds to pay follow-up colonoscopies for a limited number (up to 25) of uninsured clients when no other resources are available.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
