extension for health in new mexico

EXTENSION FOR HEALTH

IN NEW MEXICO

Presenter: Sonja

Koukel

Presenters

Dr. Arthur KaufmanVice Chancellor for Community Health

University of New Mexico Health Sciences Center

Dr. Sonja KoukelCommunity & Environmental Health Specialist

New Mexico State University Extension

Carolina NkouagaDirector of Operations, Community Health

University of New Mexico Health Sciences Center

Agenda• NM Cooperative Extension: Building Health Extension [Koukel]

• Partnering with the Academic Health Center [Kaufman]

• The Health Extension Toolkit [Nkouaga]

Presenter: Sonja

Koukel

Presenter: Sonja

Koukel

58%

23%

10%

9%

ChartTitle

1stQtr 2ndQtr 3rdQtr 4thQtr

BasedontheNa onalPreven onStrategyAc onPlan,U.S.DepartmentofHealth&HumanServices

BAA (Board on Ag Assembly) – BoHS (Board on Human Sciences)

Presenter: Sonja

Koukel

33 Counties18 HEC1 Tribal

Funding:• Federal• State• County

Programs• Discretion of Agents

• Based on Community Need

• Incentives for Program Delivery

Presenter: Sonja

Koukel

Challenges to Collaboration

225 miles

Presenter: Sonja

Koukel

Challenges to Collaboration• The name: Health “Extension”

– History and Structure: Cooperative Extension and the Medical System - Parallel, non-communicating systems

– Competition: Land grant vs Flag ship Universities for funding and recognition

– Confusion: Cooperative “Extension” is a “brand.” Health Extension can cause confusion for funders and legislators

– Proof (deliverable): Does cooperation really help communities? Is it really a win-win?

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Presenter: Sonja

Koukel

• Start fresh - modeling existing extension programs

• Refocus existing extension programs to focus on health outcomes

• Hybrid - approaches that include some of each of the first two ideas

Building Health Extension

Presenter: Sonja

Koukel

Building Health Extension• 2013 Memorandum of Understanding

• Academic Affiliation• Service Affiliation• Research Affiliation

Presenter: Sonja

Koukel

Selected Collaborations and Deliverables– Academic Affiliation: Explore opportunities for providing

public health students to work alongside/partner with County Extension agents in community program development, delivery and assessment

• Deliverable:

– NMSU Extension partners with UNM College of Nursing

» Community nursing – required class toward degree requirements

» Extension Emergency Preparedness Program

» Individuals with chronic conditions are discharged into home settings

» UNM provides expertise in caring for medically fragile individuals in emergencies

Presenter: Sonja

Koukel

Selected Collaborations and Deliverables

– Service Affiliation: Provide opportunities to work collaboratively in health-related educational delivery

1. Deliverable– NMSU Extension subcontracted under a UNM contract funded by

NM Health Insurance Exchange

– Provide activities through the higher education system to maximize enrollment and provide health insurance coverage information

– Five county agents held nearly 50 events reaching more than 6,000 New Mexicans

Presenter: Sonja

Koukel

Selected Collaborations and Deliverables2. Deliverable

– Cooking school program for people with diabetes

– Jointly funded by Extension and NM Dept. of Health

– UNM Health Extension Rural Office (HERO) agent working with largely immigrant Hispanic population

– Dept. of Health provided funding to this Family Clinic

– Extension collaborated with HERO to provide the cooking program

WIN-WIN!– NM Dept. of Health provided funding

– HERO provided audience

– Extension provided dietician, educator, food supplies, and curriculum

Presenter: Sonja

Koukel

Selected Collaborations and Deliverables– Research Affiliation: Explore collaborations on grant-

writing to support shared models of education and service spanning the agricultural and health sectors

• Deliverable– Extension Health Specialist working with UNM Occupational

Therapy Graduate Program to develop an AgrAbility Program Grant Proposal for New Mexico

» AgrAbility – Assistive Technology Program for Farmers with Disabilities

» Works through non-profit disability organizations

» Works across discipline areas including Agriculture and youth programs.

Presenter: Sonja

Koukel

New Institutional Vision Statement

“The University of New Mexico Health Sciences Center will work with community partners to help New Mexico make more

progress in health and health equity than any other state by 2020.”

Presenter: Art

Kaufman

Comments from a Sampling of Community Health Leaders

• You’re known as the “University of ABQ”

• You’re only present while grant funds last

• You don’t build upon local wisdom, organizations, and programs

• You need to commit to long term partnerships

• You need to have full-time presence in all communities like the Agriculture College

Presenter: Art

Kaufman

Establish Health Extension Rural Offices

• Place full-time agents in rural communities across the state

• Link community health priorities with UNM resources

• Monitor effectiveness of university programs in addressing community health needs

Kaufman, A, et al: Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease. The Annals of Family Medicine, Jan. 2010, vol. 8 No. 1.

Presenter: Art

Kaufman

McKinley County – Crownpoint

Youth/Pipeline Development into Health Professions

• “Grow our own”

• “Health Summit” – Eastern Navajo Mid-Schoolers

• Future mentoring

Presenter: Art

Kaufman

Example of HEROs and CES Collaboration

• Local Primary Care Health Centers without resources for patient education

• HEROs recruited Extension Agents to teach nutrition classes within clinics

• HEROs link own pipeline programs to Cooperative Extension’s 4-H program to recruit kids into health careers

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Presenter: Art

Kaufman

Health Extension, Cooperative Extension and CHWs Working Together on Social Determinants

Cooperative Extension gives nutrition classes in primary care clinics

Food Co-op

Economic development

ollas

honey

eggs chickens

plants

Housing renovation

Urban Gardening

Presenter: Art

Kaufman

Presenter: Art

Kaufman

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Well Rx Survey Responses (N = 1,374)

Presenter: Art

Kaufman

Map of HEROs and their regions

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ComponentsofHEROHub

LocalHigherEduca onIns tu ons

CommunityHospitals&

HealthCenters

CivicOrganiza ons

CountyHealthCouncils

AreaHealthEduca onCenters

UNMHSCPrograms&Resources

HelenTso,Shiprock

JulianaAnastasoff,Taos

AlishaHerrick,SilverCity

MarnieNixon,LasCruces

EvelynRising,Hobbs

ElaineLuna,LasVegas

FranciscoRonquillo,Albuquerque

CharlenePoola,Albuquerque

Presenter: Art

Kaufman

Funding for HEROs• $344,000 health insurance exchange

• $600,000 AHRQ HEROTrails

• $1 million AHRQ IMPaCT grant(of $4 million nationally)

• $3 million AHRQ SHEPERD grant(of $120 million nationally)

Presenter: Art

Kaufman

Presenter: Carolina Nkouaga

The Health Extension

Toolkitwww.healthextensiontoolkit.org

Presenter: Carolina Nkouaga

PARTNER

ENGAGED

INSTITUTIONS

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

Presenter: Carolina NkouagaUniversity of New Mexico Health Sciences Center

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

Presenter: Carolina Nkouaga

THANK YOU!The Beginning…2012 PriesterConference• Kansas• Kentucky• New Mexico• Oregon