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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?
8
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
19
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
22
Well Rx Survey Responses (N = 1,374)
Presenter: Art
Kaufman
Map of HEROs and their regions
23
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