Outside New York State Archives - Page 2 of 22

The Trustees of the University of Pennsylvania for the Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center

Firearms are the most common method of suicide among veterans; they account for more than 70% of total deaths by suicide in the veteran community, compared with 20% in the non-veteran community.

Since the beginning of the COVID-19 pandemic, there has been an unprecedented increase in the number of firearms purchased. The Counseling on Access to Lethal Means (CALM) training model is the only training evaluated by peer-reviewed research that shows its efficacy and remains the gold standard for lethal means access counseling. Research highlights the important role that family members play in the support of individuals at high risk for suicide. In the first phase of NYHealth-supported work, a coalition of partners tailored the CALM training for non-clinicians. In 2022, NYHealth awarded the Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center (CVA) a grant to develop and deliver comprehensive suicide prevention training tools to ensure New York’s veterans, family members and caregivers, and veteran-serving organizations are equipped to discuss firearms and safe storage with loved ones who may be in crisis.

Under this grant, CVA will develop workshops and materials with expertise from firearm-owning veterans and family members, members of suicide prevention coalitions, and experts in the field of lethal means safety. It will hold regular meetings and conduct focus groups to ensure that activities reflect the needs of veterans and families. CVA will pilot the workshops in county-level suicide prevention coalitions in Jefferson, Monroe, Orange, Onondaga, and Erie counties. To promote trust and buy-in, workshops will be co-delivered by a local firearm owner/safety expert who has served in the military. To amplify the project’s reach, CVA will host two train-the-trainer sessions for participants from additional veteran-serving organizations and provide guidance on leading the firearm safety workshop. Each trained leader will further conduct a CVA-supervised lethal means safety workshop in their respective communities. CVA will evaluate workshops to assess participants’ knowledge in safe gun storage options, as well as participants’ perceived competence in discussing lethal means safety. It will also update the training website with new resources and work with partners to include the training into core staff training requirements for a range of veteran-serving entities.

Stop Soldier Suicide

New York’s veterans die by suicide at almost twice the rate of their civilian counterparts, accounting for 1 in 7 suicides in New York State.

Research shows that veterans at risk of suicide will not always disclose suicidal thoughts or indicate they are in crisis to a mental health provider. NYHealth partnered with Stop Soldier Suicide in 2020 and 2021 to expand its Disrupt Veteran Suicide program across New York City to target and identify veterans at high risk for suicide through online marketing campaigns and social media. In 2022, NYHealth awarded Stop Soldier Suicide a third grant to expand Disrupt Veteran Suicide across the State, with a focus on high-need areas including rural counties and Western New York.

Under this grant, Stop Soldier Suicide used digital tools to identify veterans who are at risk of suicide, as well as delivered thousands of media impressions through outreach on social media and online forums. It assessed veterans who display moderate- to high-risk of self-harm and connected them to care. Stop Soldier Suicide delivered specialized, culturally competent telemental health care and individualized care plans to veterans at high risk for suicide, and connected clients to services to help alleviate crises. It also strengthened its network of partners to bridge gaps in care, enhanced peer-to-peer support, and provided external clinical services when needed. Stop Soldier Suicide continued to evaluate its model to support ongoing quality improvement and effective implementation. The evaluation served as a blueprint for other statewide expansions of the Disrupt Veteran Suicide program across the country.

Health Care Without Harm

New York State hospitals serve millions of meals annually to New Yorkers, from patients and families to staff and community members, through their food service operations.

Locally grown and produced foods are often healthier because they are fresher and contain more nutrients; they can also support the local economy, the environment, and a safer food supply. Hospitals can have a better impact on the food system and health of their patients and communities by using food purchasing to improve meal quality, increase equitable access for farmers and food producers of color, and encourage farm and food production practices to protect the environment. In 2022, NYHealth awarded Health Care Without Harm (HCWH) a grant to support and train New York State hospitals to purchase nutritious, locally grown food and implement healthy food practices as part of their core business operations.

Under this grant, HCWH established the New York State Hospital Innovation Hub, which engaged hospitals, food systems advocates, and the State’s agriculture sector to increase access to healthy, local food; built understanding among hospital leaders of the role that local food systems play in improving health; and increased hospital engagement in food systems planning efforts. HCWH recruited a cohort of approximately six hospital systems to participate in this project, prioritizing hospitals that serve economically disadvantaged communities in rural and urban areas. It provided hospitals with training and technical assistance and facilitated the following activities: established a baseline for current purchasing; created action plans and targets for local food purchasing; provided tools to support sustained purchasing commitments; implemented effective tracking and evaluation practices; identified opportunities for expansion of local food sources; and built connections with food system partners. An external evaluator worked with participating hospitals to gather key metrics on participation, healthy food access for communities, and spending on local foods. Finally, HCWH developed resources to share best practices with hospitals across the network and created opportunities for participating hospitals to connect with and learn from each other.

Urban Institute

Medical debt is a crushing burden for New Yorkers. A recent survey found that more than half of New Yorkers struggle to pay medical bills.

Low-income communities and communities of color outside of New York City have been particularly hard hit by medical debt, exacerbating existing health and socioeconomic inequities. A coalition of partners has run a successful End Medical Debt in New York campaign, with NYHealth and other philanthropic support, to advocate for solutions. In 2022, NYHealth awarded the Urban Institute a grant to examine the scope and nature of medical debt across New York State.

Under this grant, the Urban Institute examined the scope and nature of medical debt across New York State and its disproportionate burden on certain communities, including people of color and those with low income. It produced a report that demonstrated how medical debt varies across New York State, regionally and in select counties, and identified medical debt hot spots for common themes such as racial/ethnic composition, income and poverty levels, and uninsurance rates. Urban also examined the average amount of medical debt in communities and saw which ones stand to benefit from credit reporting changes. It produced supplemental data tables that was used to engage policymakers. Findings provided consumers, advocates, and policymakers with the most comprehensive picture of medical debt patterns in New York State to date.

NYHealth also supported two complementary initiatives for ending medical debt in New York State, with grants to the Public Policy and Education Fund of New York and the Volunteer Lawyers Project of Central New York.

Farm to Table, Inc.

Robust regional food systems support healthier residents; resilience and food security; jobs and economic growth; and New York State’s agriculture.

Food systems planning is a collaborative process among farmers, retailers, consumers, nonprofits, health systems, and government to develop priorities and implement policies and practices that shape how local or regional food systems operate. Changes in food procurement at public institutions, revisions to urban gardening codes, and better access to local food are some examples of improvements that have resulted from food systems planning. NYHealth is supporting a cohort of local and regional groups to develop local healthy food plans tailored to their regions. In 2022, NYHealth awarded Farm to Table a grant to provide technical assistance to these grantees and help them build their capacity as they undertake their projects.

Under this grant, Farm to Table partnered with the Johns Hopkins Center for a Livable Future’s Food Policy Networks to assess each of the grantees and develop tools and support tailored to their needs. For example, grantees received assistance with: community outreach and messaging, strategic planning, outreach to policymakers and public agencies, and evaluation metrics. Farm to Table provided consultations, led in-depth learning sessions and workshops, and participated in monthly co-learning circles with the grantees. It met regularly with grantees to work on joint problems, share lessons learned and best practices, and fostered collaboration. Through this project, grantees acquired tools and resources to further accelerate their plans as well as collectively advocate for policies that result in a stronger food system in New York State.

The grantees who participated in the healthy food systems planning initiative are: Adirondack Health Institute, Bedford Stuyvesant Restoration Corporation, Catholic Charities of the Diocese of Rochester Food Bank of the Southern Tier, Common Ground Health, Equity Advocates, Good Food Buffalo Coalition, and Newburgh Urban Farm and Food Initiative.

Beth Israel Deaconess Medical Center

Shared visit notes, often referred to as open notes, are an important way to help consumers become active participants in their own care.

Established in 2010, OpenNotes is a national effort to give patients access to the visit notes written by their doctors, nurses, or other clinicians. Shared visit notes can help patients and families remember and act on information discussed during a visit, including treatment plans, medication, and care coordination. NYHealth has long supported the spread of open notes throughout New York State, including at 10 hospital systems and 6 federally qualified health centers and other non-hospital settings across the State. NYHealth has also awarded Beth Israel Deaconess Medical Center, where the national OpenNotes program office is based, grants in 2019 and 2021 to help NYHealth grantees implement their open notes projects. Building upon this momentum, NYHealth issued a Request for Proposals (RFP) in 2021 to support hospital facilities in New York State in sharing open notes in compliance with new federal rules and in going beyond compliance to use open notes to more meaningfully engage patients. Through this RFP, NYHealth is funding 16 New York hospitals to participate in this initiative. In 2022, NYHealth awarded a grant to the Beth Israel Deaconess Medical Center to support these 16 hospitals as they undertake their projects.

Under this grant, OpenNotes leadership at Beth Israel Deaconess Medical Center provided technical assistance to help this cohort of grantees implement and expand open notes at their hospitals. Specifically, OpenNotes staff led a 12-month technical assistance and learning network, which included monthly group sessions and access to individual support from the OpenNotes team. Hospitals learned from experts and each other, focusing on strategies to ensure that (1) providers were equipped with the tools to make note-sharing easy and useful; and (2) patients knew how to access and use their visit notes productively. The learning collaborative covered a range of topics, including understanding the new federal mandate; sustaining clinician engagement; adopting effective communication strategies to introduce open notes to both providers and patients; and sharing notes in the context of adolescent, pediatric, inpatient, and behavioral health settings, among other areas.

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