Local Health Improvement Coalitions (LHICs)
DHMH established the State Health Improvement Process (SHIP) in 2012, which focuses on improving population health outcomes and measures every jurisdiction on its performance on 39 population health metrics.
These metrics include reducing emergency department visits related to behavioral health; reducing diabetes-related emergency department visits; and reducing the percent of children considered obese. In support of SHIP, the CHRC has issued two Calls for Proposals in recent years and awarded 24 grants totaling $1.95 million to assist in the planning and implementation activities of Local Health Improvement Coalitions, which are led by local health departments and hospital systems. Seven grants are under current implementation.
The CHRC’s most recent LHIC Call for Proposals generated a total of sixteen applications requesting $3.4 million. Based on available funding, the CHRC awarded 7 LHIC grants totaling $1.3 million. The LHIC Call for Proposals was designed to support the long-term capacity of the LHICs and to support the framework for the State’s future Community Integrated Medical Home model. In addition to CHRC funds, DHMH contributed $191,000 in federal funding to support the activities of these grantees.
The bulk of LHIC grant funds are being utilized to support the costs of hiring new personnel, including community health workers, program administrators, and community health nurses. Non-personnel costs are being utilized by LHICs to support medical equipment in a new patient-centered medical home, purchase of computer equipment, and trainings for new personnel.
LHIC Call for Proposals
In 2011, the CHRC issued its first Call for Proposals to support the work of Local Health Improvement Coalitions (LHICs) in their first year of implementation, awarding 17 grants totaling $600,000. Click here for a list of these awards.
In the spring of 2013, the CHRC issued a second LHIC Call for Proposals. The 16 proposals were evaluated on 8 criteria listed in the RFP:
- The proposal clearly indicates what the areas of greatest population health need are within the geographic area, provides data to support those claims, and puts forth evidence-based or innovative interventions that are likely to address those needs;
- The proposal leverages community health resources (in addition to local health departments) and facilitates innovative partnerships among multiple providers, especially among partners that may not have been part of the LHIC previously;
- The proposal includes a post-CHRC award sustainability plan for maintaining LHIC activities and has a high degree of enabling the LHIC or providers in the region/jurisdiction to participate in the future Community Integrated Medical Home (CIMH) Initiative;
- The proposal includes strategies that will assist in building a collaborative, interconnected, and efficient health care system at the local/regional level;
- The proposal supports continuous quality improvement efforts, clearly indicates what the core goals are, articulates the core goals as measurable outcomes, and includes a statement defining baseline performance on those measures. The proposal should also include a clear evaluation plan to ensure that the goals of the proposal are met;
- The proposal includes specific strategies to address unmet health needs of low-income, uninsured, and underinsured populations;
- The proposal helps reduce health disparities in the region/jurisdiction and advances the overall concept of health equity; and
- The proposal assists the state’s overall implementation of the Affordable Care Act by expanding access for Marylanders who will become eligible for health insurance in 2014.
The top-ranked seven proposals were invited to present to the CHRC Board on June 26, 2013. Following these presentations, the CHRC Board voted to award the following seven grants, totaling $1.3 million. Click here for the release.
Local Health Improvement Coalition (LHIC) Awards
from the Maryland Community Health Resources Commission (CHRC)
Allegany County Health Department (Grant award: $185,048)
This proposal seeks to reduce health disparities and address social determinants of health by deploying community health workers to link patients to community resources. Grant funds would be utilized to create a community resource guide, to support cultural competency provider training, and to provide access to subsidized transportation services.
Cecil County Health Department for Cecil County Community Health Advisory Committee (Grant Award: $120,000)
This proposal seeks to reduce behavioral health-related visits to Union hospital related by embedding a nursing case management program in the hospital to link patients with services in the community. The grant would also support a mobile mental health crisis program in Cecil County, which is supported by Cecil County Government (in addition to CHRC grant funding).
The Partnerships for a Healthier Charles County (Grant award: $125,000)
This proposal seeks to expand access to primary care services in an underserved area in western Charles County and utilizes CHRC grant funds to establish a new Patient-Centered Medical Home (PCMH) in Nanjemoy.
Harford County Health Department (Grant award: $200,000)
This proposal seeks to improve overall health outcomes for high-risk residents by providing comprehensive coordinated care and preventative mental health services to decrease ED utilization. Grant funds would be utilized to hire three “clinical nurse social workers” and to expand the Comprehensive Women’s Health Project care coordination model to 3 additional sites.
Howard County Local Health Improvement Coalition (Grant award: $250,000)
This proposal seeks to increase access to health care and enhance chronic disease prevention by utilizing “hotspotting” data analysis and targeting resources to address the complex health needs of individuals identified in this analysis. Grant funds will be utilized to establish a community health worker program; increase the number of PCMHs in the community; and create shared savings blueprint.
Montgomery County Department of Health and Human Services (Grant award: $200,000)
This proposal seeks to promote obesity prevention efforts and reduce behavioral health-related ED visits. Grant funds would be utilized to promote comprehensive care coordination efforts.
Tri-County/Worchester County Health Department (Grant award: $250,000)
This proposal targets diabetes-related hospital ED visits and develops a comprehensive care coordination model to link frequent ED users with access to primary care services in the community. The model leverages community partnerships and addresses social determinants of health in the Lower Shore. Grant funds would be utilized to develop and implement regional diabetes care management teams to assist diabetic patients in gaining access to a range of health care and social support resources.