With seven counties, three PPSs, and demographic and geographic challenges that further complicate health care delivery, the Hudson Valley region does not have a “one size fits all” answer to improving health outcomes. MHVC realized from the beginning of DSRIP that the keys to reaching these diverse communities are the community organizations that understand local populations and problems; that have long-term relationships with other public, private, and religious organizations that serve their community; and that know the local health care system -- including its gaps -- well.
Creating New Community- and County-Wide Networks
Crisis Stabilization Mapping
The goal of the Crisis Stabilization Project (3.a.ii) is to provide readily accessible behavioral health crisis services that will allow access to appropriate levels of service and providers, supporting a rapid de-escalation of the patient’s crisis. MHVC is part of a dynamic collaboration of three PPSs — MHVC, Westchester Medical Center (WMC), and Refuah Community Health Collaboration — that was formed to take on this challenge in a unified, collective way.
Over 40 partners participated in developing the foundation of the project and in producing an exhaustive report on the honest opportunities and challenges of the project. The project highlights the power of three PPSs to talk to state government about what needs to change, and to be a template for other regions in the state and other parts of the country.
To date, crisis mapping sessions have been held in Westchester and Orange counties and will be planned for the remaining counties of the PPS. The interactive sessions give participants new understanding of roles and relationships between, among others, hospitals, government, first responders, providers at all levels, and community organizations, as they rationalize services and interactions in five key areas: mobile, respite beds, intensive services, and follow-up services. New awareness of who does what, when, and how it impacts others, will lead to better patient outcomes.
The state’s Medicaid Accelerated Exchange (MAX) Series Program provides a high-intensity, fast-track mechanism to effect immediate and long-lasting results in a community. We are fortunate that two teams of MHVC partners participated in the first MAX Series: St. Luke’s Cornwall Hospital and St. Joseph’s Medical Center. While both teams successfully engaged high utilizers in their hospital systems, St. Luke’s focused on high utilizers in the emergency department (ED), and St. Joseph’s on inpatient (IP) admissions. MHVC partner, HealthQuest, has been selected to participate in the current MAX Series round.
The MAX Series is a quality improvement initiative and an intensive eight-month learning collaborative aligned with DSRIP projects and measures. Participating organizations create multidisciplinary “Action Teams” comprised of subject matter experts both from within their organizations and external partnering organizations. The collaborative is phase-based and includes an assessment and preparation phase, followed by three full-day workshops and intermediary improvement cycles, concluding with a reporting period.
Public Health Campaigns
Anti-Tobacco Marketing Campaign
The Hudson Region DSRIP Public Health Council, a partnership between the Montefiore Hudson Valley Collaborative, Westchester Medical Center and Refuah Community Health Collaborative, has developed an anti-tobacco marketing campaign targeted to teens and their caregivers. The campaign is focused on the harmful effects of electronic smoking devices like vaporizers, e-cigarettes and electronic hookahs.
The ads, available for download here, have been distributed to Hudson Valley middle and high schools throughout the region. Local schools have used the ads to enhance student involvement in national initiatives like the Great American Smokeout, Lung Cancer Awareness Month, and Kick Butts Day.
In order understand the status of tobacco cessation efforts in its partner network and to identify areas for intervention and support, MHVC conducted an assessment of readiness and capacity to establish and enhance a continuum of tobacco cessation services. The “Tobacco Cessation and Tobacco-Free Policy Survey” of MHVC partner organizations covered three general areas: patients, employees, and smoke-free policies. The major finding was that there is a high rate of tobacco use among both employees and patients at behavioral health (BH) sites, while integrated sites (clinical and behavioral) reported higher levels of uncertainty regarding patient smoking rates. Integrated sites also offer the greatest mix of cessation services. In terms of smoke-free policies, clinical sites and integrated sites have the strictest smoke-free policies, and a greater proportion of BH sites allow outdoor smoking in designated places. Enforcement is the most frequent barrier identified by all types of sites. The survey results will help MHVC tailor its consultation and technical assistance for network partners.
The leading cause of premature death, and the second leading cause of overall death, in the Hudson Valley is cancer. Our Community Needs Assessment (CNA) showed there are “hot spots” for certain cancers in certain regions; not surprisingly, screening rates for these cancers are lower in the Hudson Valley than State average. Given this gap, MHVC intends to target cancer prevention (particularly among minority populations) for preventive care initiatives. Central to our project plan is incorporating the New York State Prevention Agenda goals to improve preventive care, particularly among minority populations.
“It’s Up to You(th)”: SAS Hosts PSA Contest and Anti-Vaping Leadership Event
MHVC Innovation Grant helps spread the message
MHVC is sponsoring an exciting contest designed to empower high-school students across the Hudson Valley and the Bronx to spread the message about the harmful effects of e-cigarettes (“vaping”) to their peers. The “It’s Up to You(th)” Public Service Announcement (PSA) contest, coordinated by Student Assistance Services (SAS), was launched at SAS’s student leadership event in White Plains YMCA on November 28th, 2018. Sixty-five students from 32 Westchester Schools participated in a student leadership event held at the YWCA in White Plains.
Students will submit short videos on the following themes: Most teens are NOT vaping; refusal skills (ways to say NO); how vaping ads target youth; and the costs of vaping to health. A presentation describing these effects, and the contest rules, can be viewed here. Submissions are due March 30, 2019; later in the spring, these short videos will be premiered and one will be chosen to win a grand prize of $1,500.
Student Assistance Services (SAS) is a longstanding organization in Westchester County, established in 1985. Their mission is to provide support and training to a variety of members in the community -- students, parents, educators, and more -- in order to prevent substance use and bullying among high- and middle-schoolers. The National Youth Tobacco Survey (NYTS) found that there is an alarming increase in e-cigarette use among kids within the past year. Its widely-used poster (link here) illustrates a 78% increase in use among high school students and a 48% increase in use among middle school students from 2017 to 2018.
The initiative is part of coordinated strategy by MHVC that began last year with vaping training for pediatricians and parents, and will reach a key milestone at the May PSA “Red Carpet” award ceremony. MHVC will continue its anti-vaping campaign by disseminating the winning PSAs on social media and communications platforms, and making information available to partners, such as these “101 on e-cigarettes” posters here and here.
Judy Mezey, Director of Community Based Programs at SAS, said “To me, it’s not the kids that are the problem, it’s the adults. Young people are doing what their brains are wired to do: they’re looking for risks, they’re looking to fit in. This crisis is a product of what we adults have created.” Mezey is hopeful that this type of programming and the support that SAS offers will help change things, starting with the students who attended this meeting. “I love working with student leaders; you just have to help amplify their voices.” For more information, contact firstname.lastname@example.org.