Thursday, June 5, 2025
6/5/2025
Paul Coverdell National Acute Stroke Program - The Massachusetts Department of Public Health (MDPH) seeks funding to continue its participation in the Paul Coverdell National Acute Stroke Program (PCNASP), addressing the significant public health challenge posed by stroke, particularly among historically marginalized communities. Analysis of electronic health records (EHR) from 2021 reveals profound racial disparities, with non-Hispanic Black and Hispanic residents in Massachusetts (MA) experiencing higher rates of stroke and hospitalization compared to White residents. These inequities are compounded by systemic barriers to healthcare access and adverse social determinants of health, such as economic instability and unhealthy living conditions. MDPH employs a racial equity framework to tackle these inequities, engaging African American Black and Hispanic populations in geographic areas with high stroke and HTN burden, including Brockton, Springfield and Roxbury during year 1, and Bristol and Worcester counties in subsequent years. MDPH proposes to build on the success of the existing PCNASP by integrating current Coverdell participants into Learning Collaboratives (LCs) led by the National Cardiovascular Health (NCVH) and Innovative Cardiovascular Health (ICVH) Programs. This effort will result in a comprehensive Stroke System of Care (SSoC) that includes care providers across the continuum as well as community-based organizations, Community Health Workers (CHWs), and other key partners. The proposed project is a multi-faceted approach to stroke prevention and treatment, focusing on enhancing HTN detection and control, improving stroke care through data driven quality improvement, and linking community resources. The program aims to build on recent Medicaid program advancements aligned with program goals to track clinical and social services, promote team-based care approaches, and link individuals to community resources. MDPH, within the Executive Office of Health and Human Services, oversees several health initiatives through its Division of Health Protection & Promotion. These include PCNASP, NCVH, ICVH, and the Diabetes Health Equity program. These programs operate LCs involving clinical and community partners to address health-related social needs (HRSN). The Office of CHWs supports all CHW strategies, advocating for workforce development, while the Office of Statistics and Evaluation provides epidemiological expertise to evaluate cardiovascular disease interventions. MDPH also collaborates with the Massachusetts League of Community Health Centers and the American Heart Association to align stroke care initiatives, ensuring quality care and data management across PCNASP-participating CHCs, hospitals, EMS agencies, and post-hospital providers. This proposal aims to enhance these collaborations, expand LCs, and strengthen the SSoC in MA. The evaluation plan will assess the effectiveness of stroke and cardiovascular health initiatives using both quantitative and qualitative methods. Efforts will focus on high-risk regions, identifying individuals at high risk of stroke, increasing referrals to social services, and improving clinical outcomes. MDPH will utilize MDPHnet, a large EHR data warehouse, to inform targeted interventions and enhance program efforts through collaborations with local health centers and community partners. MDPH’s organizational capacity, relationships, and data-driven approach position it to effectively expand and sustain the SSoC model, integrating community-based organizations to mitigate barriers and improve health outcomes in high stroke burden communities. Through strategic data collection and a robust evaluation framework, MDPH aims to address health inequities, improve stroke care, and advance health for all MA residents.
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).