Foundation Grantees Report Findings From Rural Health Grants

The Blue Cross of Idaho Foundation for Health awarded $190,000 in grants that support rural Idaho, and each of the grantees presented their findings to the Foundation as their grants concluded this month.

GRANTEE: University of Idaho, $75,000

The $75,000 grant to the University of Idaho supported its Project ECHO program, and the work that resulted from the grant delivered desired positive results.

Project ECHO (Extension for Community Healthcare Outcomes) provides a mechanism for healthcare providers to gain continuing education credits, certifications and network with peers to seek professional advice on real cases remotely via videoconferencing.

“It’s simple, but it’s very innovative and transformative,” said Lachelle Smith, director, ECHO Idaho. “ECHO helps build capacity for the healthcare system as a whole to treat more people.”

The grant allowed ECHO Idaho staff to visit 11 Idaho communities and attend 12 statewide conferences to engage with healthcare providers. A survey to 300 providers also was distributed. Staff also received training for how to best communicate strategically to providers around the state regarding Project ECHO.

The outreach worked. Participation numbers in Project ECHO significantly increased from 2018 to 2019.

ECHO USAGE 2018 2019
Number of people 224 403
CME Hours attained 850 1,317
Number of organizations 103 180
Number of communities 47 61

ECHO Idaho currently has two programs for Idaho healthcare providers

  1. Opioid Addiction and Treatment Series
  2. Behavioral Health in Primary Care Series

You can watch a video featuring Idaho healthcare providers’ thoughts on Project ECHO.

GRANTEE: Southwest Health District, $75,000

The purpose of this grant was for the health district to implement a pilot practice to advance the current behavioral health crisis center into a system model that coordinates care and addresses the needs of rural and vulnerable populations.

The grant focused on Western Idaho Community Crisis Center in Caldwell, which opened in April 2019, as a pilot. The scope of the project included the following work:

  • Assess stakeholder readiness for change in current environment
    • Stakeholders include behavioral health providers, dispatchers, law enforcement, prosecuting attorneys, indigent fund coordinators, hospitals, primary care providers, EMS, families, etc.
  • Map the current system, connections and coordination points and identify gaps
  • Assess gaps in behavioral health delivery system
    • Identify things that inhibit care coordination, access to care, availability of services and ability to demonstrate value
  • Identify gaps and needed modifications in the crisis system to address needs of rural and vulnerable populations with emphasis on equity for all communities

Idaho currently has seven regional crisis centers — Boise, Caldwell, Coeur d’Alene, Idaho Falls, Lewiston, Twin Falls and Pocatello. They are designed to decrease arrests, limit involuntary mental holds and costly trips to the emergency room. The centers are for adults experiencing a crisis due to mental health and/or substance abuse.

Services provided at crisis centers include outpatient acute stabilization, peer support, recovery coaching and connection to community resources. Individuals can stay at a crisis center for 23 hours and 59 minutes at a time.

GRANTEE: Idaho Community Foundation and Idaho Rural Partnership, $40,000

The Voice of the Community Project was designed to increase the understanding of health-related challenges in rural communities from the perspective of residents.

Six rural communities were targeted — American Falls, Cascade, Council, Pierce, Salmon and Shoshone — and 87 total community members participated in focus groups held in each city.

Each group was asked a series of questions:

  1. Do you have a regular doctor you see for health and/or medical care? Is the doctor located in this community or another? If not, where is your doctor located?
    1. 92 percent have a primary care provider
    2. 62 percent see the doctor in their community
    3. 23 percent drive an hour or more to see the doctor
  1. When you think about the general health of your family members, friends and neighbors, what would you say are their most pressing medical or health issues?
    1. Average age of residents increasing
    2. COPD, hypertension and diabetes are top concerns
    3. No transportation for seniors who don’t drive, lack of follow-up care
    4. Some communities have no assisted living facilities
    5. Lack of dental care in some communities
  1. What new health related facilities and services would have the greatest positive impact on the community?
    1. Mental health services, affordable and accessible locally
    2. Substance abuse treatment
    3. Transportation services
    4. Comprehensive medical home with care such as chiropractic, acupuncture, functional medicine
    5. Expanded EMS
    6. Community center for education and recreation
    7. Affordable and livable housing
  1. Have you ever interacted with a doctor or other health care professional by video (aka telemedicine)? If yes, what did you think of this option? If no, what do you think of this possibility?
    1. Most participants hadn’t used telehealth
    2. Healthcare providers using for inter-facility and/or accessing specialists for consults
    3. Lack of broadband availability seen as a deterrent
  1. What other information and/or questions would you like to share with us regarding health and medical issues here in the community?
    1. Most themes from Question 3 were restated