WELLSPAN HEALTH

SPECIALIZED TREATMENT AND RECOVERY TEAM (START) - YORK ENHANCEMENTS - WELLSPAN’S SPECIALIZED TREATMENT AND RECOVERY TEAM (START) – YORK ENHANCEMENTS EXPANDS ITS CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC TO SERVE 500+/YEAR, 2,150 IN 4 YEARS. ENHANCEMENTS ARE SUPPORT GROUPS AND EDUCATION IN COMMUNITY SETTINGS, EXPANDING WALK-IN HOURS, ADDING EVIDENCE-BASED PRACTICES SPECIFIC TO PERSONS EXPERIENCING HOMELESSNESS, FORMERLY INCARCERATED, SPANISH-SPEAKING AND LGBTQI+; TRAINING FOR LGBTAIA+ AFFIRMING STAFF, ON-SITE TOBACCO CESSATION, AND EXPANDING COLLABORATION WITH PRISON DIVERSION/RE-ENTRY. THE POPULATION OF FOCUS FOR START IS INDIVIDUALS WITH COMPLEX BEHAVIORAL AND PHYSICAL HEALTH NEEDS, WHO ALSO HAVE PSYCHOSOCIAL AND CULTURAL FACTORS AND/OR COMPLEXITIES PRECIPITATING, AND PROPAGATING HEALTH, MENTAL HEALTH, AND SUBSTANCE USE CONCERNS. MOST PARTICIPANTS ARE FROM YORK CITY, WHERE 44% ARE NON-WHITE, 33% HISPANIC, AND 27.7% LIVING BELOW POVERTY LEVEL. LOCATION IS YORK CITY, ALTHOUGH PARTICIPANTS ARE ACCEPTED FROM ANY GEOGRAPHIC AREA. GOAL 1: TO IMPROVE AND EXPAND THE CARE PROVIDED BY START OBJ 1A: BY INCREASING PEER AND RECOVERY SUPPORT SERVICES AND ADDING COMMUNITY PARTNERS THAT ADDRESS SDOH, START PARTICIPANTS SCORES ON THE DLA20 (IMPLEMENTATION BY MARCH 2023) WILL IMPROVE BY AT LEAST 10% FROM INTAKE TO DISCHARGE BY 9/29/24 AND ANNUALLY THEREAFTER. OBJ 1B: BY OFFERING ON-SITE FREEDOM FROM SMOKING GROUPS AND INDIVIDUAL COUNSELING AT START, THE # OF REFERRALS TO TOBACCO CESSATION WILL INCREASE BY 20% BY 9/29/24 AND ANNUALLY THEREAFTER. OBJ 1C: AS A RESULT OF SEEKING CONSUMER INPUT THROUGH PATIENT ROUNDING AND ENGAGING START COMMUNITY OVERSIGHT/GOVERNANCE GROUPS (CONSUMER ADVISORY BOARD AND CONSUMER ADVISORY COUNCIL) AND CONSIDERING THAT FEEDBACK TO IMPROVE SERVICES AT START, BY 9/1/23 AND ANNUALLY THEREAFTER 85% OF CONSUMERS WILL INDICATE THEY WOULD RECOMMEND THE PROGRAM TO OTHERS AS MEASURED ON MCCLEAN PERCEPTIONS OF CARE EBASIS PATIENT EXPERIENCE SURVEY. GOAL 2: TO INCREASE ACCESS TO AND AVAILABILITY OF HIGH-QUALITY SERVICES TO MEET IDENTIFIED COMMUNITY NEEDS OBJ 2A: AS A RESULT OF OFFERING AT LEAST 15 HOURS/WEEK OF OPEN SLOT (WALK-IN) APPOINTMENTS, BY 9/29/23 AND THEREAFTER, THE AVERAGE TIME BETWEEN REQUESTING AN APPOINTMENT AND HAVING A SCHEDULED APPOINTMENT WILL DECREASE TO AN AVERAGE OF 3 DAYS (CURRENTLY AT 3.4-DAY AVERAGE). OBJ 2B: AS A RESULT OF PROVIDING PEER AND RECOVERY SUPPORT AND SUPPORT GROUPS IN COMMUNITY LOCATIONS AND INCREASING START’S NUMBER OF LGBTQIA+-AFFIRMING TEAM MEMBERS, THERE WILL BE A 10% OVERALL INCREASE IN UNDUPLICATED INDIVIDUALS SERVED BY 9/29/24 AND MAINTAINED THEREAFTER, AND AT LEAST A 5% INCREASE IN NUMBER OF LGBTQIA+ INDIVIDUALS SERVED BY 9/29/24 AND ANNUALLY THEREAFTER. GOAL 3: TO PROVIDE CARE IN A COMMUNITY-BASED SETTING TO REDUCE OVERALL COST OF CARE OBJ 3.A: AS A RESULT OF INTEGRATION OF CRISIS STAFF WITH START STAFF AND INCREASED COMMUNITY OUTREACH, THE NUMBER OF ED DIVERSIONS WILL INCREASE BY 10% EACH YEAR TO AT LEAST 70/MONTH BY 9/29/23, 77/MONTH BY 9/29/24, 85/MONTH BY 9/29/25, 94/MONTH BY 9/29/26. OBJ 3B: UPON DISCHARGE FROM START TO PRIMARY CARE OR OTHER OUTPATIENT SERVICES, START PARTICIPANTS WILL HAVE A 20% REDUCTION IN ED VISITS FOR MH OR MH/SUD COMPARED TO THE 12 MONTHS PRIOR TO RECEIVING SERVICES AT START BY 9/29/25. OBJ 3C: AS A RESULT OF COLLABORATIVE EFFORTS BETWEEN THE START, COMMUNITY ACTION FOR RECOVERY AND DIVERSION (CARD), YORK COUNTY RE-ENTRY COALITION AND THE COUNTY PRISON SYSTEM, DIVERSIONS FROM THE JUSTICE SYSTEM INTO TREATMENT FOR THOSE WITH MH AND SUD DISORDERS WILL INCREASE BY 20% OVER FOUR YEARS (5% PER YEAR) BY 9/29/26 FROM A 2022 BASELINE OF 27.

POSTDOCTORAL TRAINING IN GENERAL, PEDIATRIC AND PUBLIC HEALTH DENTISTRY AND DENTAL HYGIENE

WELLSPAN MEDICATION ASSISTED TREATMENT (WSMAT) - OVER A FIVE-YEAR PERIOD, WELLSPAN MEDICATION ASSISTED TREATMENT (WSMAT) WILL SERVE 2,140 RESIDENTS OF ADAMS, FRANKLIN, LANCASTER, LEBANON, AND YORK COUNTIES IN SOUTH CENTRAL PENNSYLVANIA (YEAR 1 - 400, YEAR 2 - 420, YEAR 3 - 430, YEAR 4 - 440, YEAR 5 - 450) WHO HAVE OPIOID USE DISORDER (OUD) AND RECEIVE MAT AND RECOVERY SUPPORT FROM WELLSPAN (WS). THE 24/7 WARM LINE CALL CENTER FOR ADDICTIONS WILL BE INTEGRATED INTO OTHER BEHAVIORAL HEALTH SERVICES AND ELEVATED AS A “FRONT DOOR” ACCESS POINT FOR INDIVIDUALS IN NEED OF ADDICTION TREATMENT, RECOVERY SUPPORT, AND RELATED RESOURCES AND EXPAND ITS WORK TO SCREEN CALLERS FOR SUBSTANCE AND TOBACCO USE, INFECTIOUS DISEASE, CO-OCCURRING DIAGNOSES, AND SOCIAL SERVICE NEEDS. RECOVERY SUPPORT WILL BE PROVIDED BY WS-EMPLOYED RECOVERY SUPPORT SPECIALISTS, WHO HAVE PERSONAL EXPERIENCE WITH ADDICTION AND RECOVERY. EVIDENCE-BASED PRACTICES SUCH AS MAT, MOTIVATIONAL INTERVIEWING, AND WARM HAND-OFFS, WILL BE USED TO KEEP PATIENTS ENGAGED IN TREATMENT AT LEAST 6 MONTHS, A PREDICTOR OF SUCCESS. FOR THE TARGET POPULATION OF PATIENTS CURRENTLY RECEIVING MAT PROVIDED BY WS IN THE AFOREMENTIONED COUNTIES: FOR PATIENTS WITH DOCUMENTED ETHNICITY, 77.6% NON-HISPANIC, 19.7% HISPANIC; RACE 74.5% WHITE, 7% BLACK/AFRICAN AMERICAN, .7% NATIVE AMERICAN, .3% ASIAN, .2% NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER, .2% MULTI-RACIAL; 64.6% OF THE PATIENTS ARE MALE, 35.4% OF THE PATIENTS ARE FEMALE WITH ONE PATIENT (.1%) IDENTIFIED AS TRANSGENDER; 6.8% OF THE PATIENTS ARE BETWEEN THE AGES OF 18-24, 42.5% 25-34, 30.7% 35-44, 12.4% 45-54, 5.1% 55-64 AND .2% 65+. THERE ARE OVER 20,000 INDIVIDUALS WITH OUD IN THE SERVICE AREA. THE TOTAL POPULATION SERVED BY WS IS 1,610,265 PATIENTS: 81% WHITE NON-HISPANIC, 11% HISPANIC OR LATINO, 5% BLACK NON-HISPANIC, AND 1% ASIAN; 2), AVERAGE PATIENT IS 44; 3) 50.7% OF PATIENTS ARE FEMALE, 49.3% OF PATIENTS ARE MALE, AND 94 PATIENTS HAVE DOCUMENTED IN THEIR ELECTRONIC HEALTH RECORD TRANS OR GENDER NON-CONFIRMING; 4) OVER 90% OF HOUSEHOLDS IN ADAMS, FRANKLIN, AND YORK COUNTIES SPEAK ONLY ENGLISH, 87% OF HOUSEHOLDS IN LEBANON COUNTY, AND 83% OF HOUSEHOLDS IN LANCASTER COUNTY SPEAK ONLY ENGLISH WITH THE MOST COMMON SECOND LANGUAGE BEING SPANISH; 5) AN AVERAGE OF 8.2% OF PERSONS LIVE IN POVERTY IN THE FIVE-COUNTY AREA, WITH THIS RATE INCREASING TO 28% (MORE THAN TWICE THE NATIONAL RATE) FOR YORK CITY WHERE WS SEES ITS HIGHEST POPULATION OF MAT PATIENTS. WSMAT PROJECT GOALS ARE TO INCREASE THE NUMBER OF NEW MAT INTAKES, INCREASE ENGAGEMENT, ABSTINENCE AND GPRA INTERVIEW COMPLETION AT 6 MONTHS, SUPPORT A HOLISTIC APPROACH TO SCREENING AND TREATMENT TO IMPROVE CLIENT OUTCOMES AND REDUCE COST OF CARE. OUTCOMES WILL BE 2,140 NEW MAT INTAKES INCLUDING SPANISH-SPEAKING PATIENTS, 3,000+ CALLS TO THE WARM LINE OVER 5 YEARS, AT LEAST 10 NEW PRESCRIBERS INCLUDING AT LEAST 1 IN RURAL FRANKLIN COUNTY, INCREASED ENGAGEMENT TO REACH 80% ENGAGEMENT AT 6 MONTHS, 90% REPORTING DECREASE IN ILLICIT OPIOID DRUG USE OR PRESCRIPTION OPIOID MISUSE AT 6 MONTHS POST-INTAKE, AND CONSISTENCY IN SCREENING FOR CO-OCCURRING DIAGNOSES, INFECTIOUS DISEASE, AND SOCIAL DETERMINANTS OF HEALTH.

INTEGRATING BEHAVIORAL HEALTH INTO PRIMARY CARE THROUGH TELEHEALTH EVIDENCE-BASED TELEHEALTH NETWORK - A. TITLE: WELLSPAN BEHAVIORAL HEALTH REFERRAL NETWORK (WBHRN) B. APPLICANT: WELLSPAN HEALTH (WSH) C. ADDRESS: 45 MONUMENT RD STE 200 YORK, PA 17403-5071 D. WEBSITE: HTTPS://WWW.WELLSPAN.ORG E. REQUESTED AWARD AMOUNT: $1,260,553 F. FACILITY TYPE: FROM NOFO SECTION III. 1. B. - C, E, I, J, M G. PROJECT DIRECTOR: DR. SHANNON TERRELL GORDON, LCSW, CFRE, VICE PRESIDENT - WELLSPAN BEHAVIORAL HEALTH NETWORK H. PROJECT DIRECTOR CONTACT INFORMATION: 478-954-6802 | SGORDON7@WELLSPAN.ORG I. FUNDING PREFERENCES: (B) SERVICES -THE WBHRN PROJECT AIMS TO PROVIDE MENTAL HEALTH CARE THROUGH TELEBEHAVIORAL HEALTH SERVICES (TBHS) . J. SERVICE AREA: ADAMS (A), FRANKLIN (F), LANCASTER (LA), LEBANON (LE), AND YORK (Y) COUNTIES IN SOUTH-CENTRAL PA (3,501 SQ MILES, 1,412,463 RESIDENTS). MUA-A, LE, MUP-F,LA,Y, LE-DEN HPSA, Y-MH HPSA. POPULATION IS PRIMARILY WHITE, 10% HISPANIC/LATINO, 20% ELDERLY (65+), AND 10% DISABLED WITH 9% LIVING IN POVERTY, 8% UNINSURED, AND 17% NEEDING ASSISTANCE WITH HEALTH MATERIALS. AVERAGE MENTAL HEALTH PROVIDER RATIO IS 652:1 (PA-400:1). SURVEYED BEHAVIORAL HEALTH (BH) FACTORS REPORT AN AVERAGE OF ~20% WHO SMOKE, DRINK EXCESSIVELY, USE MARIJUANA, REPORT TRAUMA SYMPTOMS. 8% HAVE A PHQ-8 DEPRESSION INDICATOR, 40% REPORT MENTAL HEALTH NEGATIVELY IMPACTED BY COVID, AND 64% REPORT EXPERIENCING > 1 DAYS WITH DEPRESSIVE SYMPTOMS IN A 2-WEEK PERIOD. K. NEEDS, OBJECTIVES, AND PROJECTED OUTCOMES: OF 436,805 PATIENTS SERVED BY WSH IN FY23 (7/1/22 – 6/30/23), 49% HAD BH SYMPTOMS AND 1,330 ADULT AND 520 YOUTH PATIENTS ARE ON THE WAIT LIST FOR SPECIALIZED AMBULATORY BH SERVICES. THE OBJECTIVES OF THE WBHRN PROJECT ARE: 1) CONTRACT WITH A NATIONALLY RECOGNIZED VIRTUALIST PROVIDER AND IMPLEMENT VIRTUALIST BH COLLABORATIVE CARE MODEL (COCM) IN 2 RURAL AND UNDERSERVED ORIGINATING SITES ALONGSIDE A BROADER 64-SITE NETWORK; 3) SERVE AT LEAST 6,012 RURAL OR UNDERSERVED PATIENTS WITH TBH COCM (YEAR 1: 668, YEAR 2: 1,336 PATIENTS, YEAR 3: 1,336 PA TIENTS, YEAR 4: 1,336 PATIENTS, YEAR 5: 1,336 PATIENTS); 4) DEVELOP AN EVIDENCE-BASED PSYCHOEDUCATION LIBRARY FOR EACH SERVED CONDITION; 5) TEACH FAMILY PRACTICE RESIDENTS REGARDING COLLABORATIVE CARE. PROJECTED OUTCOMES INCLUDE: 1) 6,012 RURAL OR UNDERSERVED PATIENTS SERVED AND 2) AT 120 DAYS POST COCM ADMISSION, PATIENTS WILL SEE AN 8-POINT REDUCTION IN PHQ-9 OR GAD-7 SCORES AND 40% OF PATIENTS WILL ACHIEVE PHQ-9 OR GAD-7 SCORE OF LESS THAN 5 PRIOR TO COCM DISCHARGE. L. TWO RURAL AND/OR UNDERSERVED ORIGINATING SITES WILL BE SUPPORTED M. TOTAL PATIENTS SERVED: CY23-FAIRFIELD (4745), PENN NATIONAL (6263), YEARS 1-5-FAIRFIELD (24, 48, 48, 48, 48), PENN NATIONAL (48, 96, 96, 96, 96) N. SELF-ASSESSMENT: PROGRESS WILL BE MEASURED THROUGH THE USE OF WSH'S ELECTRONIC HEALTH RECORD, EPIC, WHICH, ALONGSIDE WSH INTERNAL TRACKING OF INCURRED COSTS AND DATA SUBMITTED BY PAYORS, WILL PROVIDE VARIOUS PATIENT DATA RELATED TO ENGAGEMENT IN COCM, PHQ-9 AND GAD-7 SCORING, PARTICIPATION OF PRACTICES AND PROVIDERS AS WELL AS THE # OF REFERRALS, ACTIVE EPISODES OF COLLABORATIVE CARE, AVERAGE PATIENT ENGAGEMENT DURATION, OVERALL HEALTHCARE COSTS OF PATIENTS, AND WAIT TIMES TO APPOINTMENTS. PROVIDER EXPERIENCE SURVEYS WILL ENSURE CONTINUED PROVIDER EDUCATION, SATISFACTION, AND ENGAGEMENT. O. OUTCOMES: WBHRN WILL EVALUATE THE OVERALL EFFECTIVENESS OF INTEGRATING TBHS INTO THE PRIMARY CARE SETTING. EVALUATION OF PROJECT-RELATED DATA WILL INFORM IF TBHS CAN BE MADE MORE ACCESSIBLE TO UNDERSERVED AND RURAL PATIENTS THROUGH COLLABORATION BETWEEN A VIRTUALIST PROVIDER AND REGIONAL HEALTHCARE SYSTEM. P. ADDITIONAL ACTIVITIES: NONE Q. SUSTAINABILITY: FEES BILLED FOR SERVICES WILL SUSTAIN THE NETWORK. R. WSH IS NOT A CURRENT EB-TNP AWARDEE S. WSH HAS NOT APPLIED FOR EB-TNP FUNDING OR SERVED AS AN ORIGINATING SITE T. GRANTS.GOV ALERTED WSH TO THE OPPORTUNITY U. STATE CONSULTATION: WSH SUBMITTED ITS PROJECT ABSTRACT TO THE PA STATE OFFICE OF RURAL HEALTH ON 3/20/24. THE PASORH HAS P ROVIDED A LETTER OF SUPPORT.

NHLBI: SERVICE: INTERVENTIONAL CARDIOLOGY SERVICES: SEVERABLE

THE PURPOSE OF THIS ORDER IS TO AWARD INTERVENTIONAL CARDIOLOGY SERVICES

8509990459!OTHER PROFESSIONAL SERVICES

CPR CERTIFICATION CARDS