Expand and strengthen quality out-of-hospital health care for the most underserved and vulnerable populations.
Note: Projects under Health Objective 2 must contribute to both Result A & B below.
- Increase in number of underserved and vulnerable New Yorkers benefitting from one or more of the following:
- Primary care from a “Patient-Centered Medical Home” or comparable out-patient community-based provider
- Coordinated care, care management, and/or multi-disciplinary support provided in an accessible community- or home-based setting, with a focus on programs targeting New Yorkers living in poverty with multiple chronic or behavioral health conditions, or who are home-bound or transportation-challenged, including frail elders
- Services aimed at reducing unnecessary hospital admissions, readmissions, or emergency room use, and successfully transitioning patients into out-of-hospital care and care management
- Advance in knowledge, policies, and practices capable of contributing to the “triple aim” of improved quality of care and patient experience; improved health in the population served; and, where consistent with quality, reduced or contained cost of care
(Priority will be given to programs capable of future sustainability with earned or public sector revenue and/or to projects capable of producing outcomes of long-term value in a relatively short period of time.)
The Bridge, Inc.
$100,000 (over 18 months)
To support start-up of Coordinated Behavioral Care, Inc., and development of its capacity to coordinate and provide care management and support for Medicaid recipients with multiple health, mental health, and behavioral health conditions
Calvary Hospital, Inc.
To provide a third year of support for refinement and evaluation of the Palliative Home-Care model
Community Health Care Association of New York State
To help support CHCANYS's efforts to pursue the objectives set forth in its strategic plan for 2011-14, with a focus on efforts to expand, strengthen, and enhance the sustainability of health centers serving low-income communities in NYC
The Institute for Family Health, Inc.
To help implement InstituteLink at eighteen additional partner organizations in New York City, complete an evaluation of its impact, and disseminate results
The New York Academy of Medicine
To help support a needs assessment aimed at informing efforts to enhance health programs and services at New York City's Innovative Senior Centers
Primary Care Development Corporation
To support the development of a care coordination model for use by primary care providers, to pilot the model with clinics and practices serving low-income Brooklyn residents, and disseminate results (over two years)
Visiting Nurse Service of New York
To help support development and implementation of a training program for peer outreach workers aimed at enhancing effective member engagement for the new NYS-designated VNSNY Health Home