US Department of Health and Human Services REGION IX update 57 th Meeting of the Pacific Islands...

US Department of Health and Human ServicesREGION IX update

57th Meeting of the Pacific Islands Health Officers’ Association

March 9th – 12th, 2015Koror, Palau

HHS Region 9 Update Topics• Organizational update• Health Resources and Services Administration activity• Office of the Assistant Secretary for Health/Regional Health

Administrator– Office of Pacific Health– Office of Population Affairs/Office of Family Planning– Office of Minority Health– Office on Women’s Health– Let’s Move Initiative

• Office of the Assistant Secretary for Preparedness– Regional Medical Reserve Corps

Sylvia Burwell

Secretary

Office of the Assistant Secretary for Health

Assistant Secretary for Health (Acting)

Karen B. DeSalvo. MD, MPH, MSc

Principal Deputy Assistant Secretary for Health Wanda K. Jones, DrPH

Executive OfficerMichon Kretschmaier

ACA

National Vaccine Program Office

Deputy Assistant SecretaryBruce Gellin, MD, MPH

ACP

Office of the Surgeon General

Surgeon General Vivek H. Murthy, MD, MBA

VADM, USPHSACM

Office of Disease Prevention and Health Promotion

Deputy Assistant Secretary Don Wright, MD, MPH

ACL

Office of Population Affairs

Director (Acting)Susan Moskosky, MS, RNC

ACG

Office on Women’s HealthDeputy Assistant Secretary

Nancy Lee, MDACB

President’s Council on Fitness, Sports and Nutrition

Executive DirectorShellie Y. Pfohl, MS

ACE

Office of Research Integrity

Director (Acting)Donald Wright, MD, MPH

ACF

Office of HIV/AIDS and Infectious Disease Policy

Deputy Assistant SecretaryRonald Valdiserri, MD, MPH

ACJ

Office of Minority Health

Deputy Assistant Secretary J. Nadine Gracia, MD, MSCE

ACC

Deputy Assistant Secretary for Health(Science and Medicine)

Anand Parekh, MD, MPHACA

Presidential Commission for the Study of Bioethical IssuesExecutive Director

Lisa Lee, PhD, MS ACA

Office of Adolescent HealthDirector

Evelyn Kappeler

ACR

Office for Human Research

ProtectionsDirector

Jerry Menikoff, MD, JDACN

Regional Health Administrators

Regions I-XACD

Office of CommunicationsDirector

Jonathan Beeton ACA

HHS Leadership Updates

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Acting Assistant Secretary for HealthKaren B. DeSalvo, MD, MPH, MSc

Surgeon GeneralVADM Vivek H. Murthy, M.D., M.B.A.

U.S. Department of Health & Human ServicesOffice of the Assistant Secretary for Health, Region IX

90 7th Street, Suite 5-100San Francisco, CA 94103

Tele: (415) 437-8096; (415) 437-8004

RADM Nadine Simons, MS, RNRegional Health Administrator

(415) 437-8102

CAPT Betsy Thompson, MD, DrPHDeputy Regional Health Administrator

(415) 437-8070

Denise FarrAdministrative Assistant

(415) 437-8096

Office of Minority Health

Christina Perez, MN, WHC-FNPRegional Minority Health

Consultant (415) 437-8124

__________________________

Ray MoralesProgram Assistant

(415) 437-8124

Office of Population Affairs/ Office of Family Planning

LCDR Rebecca McTall, PA-C, MPAS

Regional Program Consultant (415) 437-8403

_____________________________

David A. MillerPublic Health Advisor

(415) 437-8403_____________________________

Kellee RunnelsProgram Assistant

(415) 437-8074

Medical Reserve Corps

Jill Littlefield, BSRegional Coordinator

(415) 437-8071

Office of Pacific Health (OPH)

San Francisco

Subroto BanerjiSenior Advisor(415) 437-8114

________________________

OPH-Honolulu CAPT Cathy Wasem, MN, RN Senior Program Management

Officer300 Ala Moana Blvd, Rm 6-247

Honolulu, HI 96850(808) 541-2015

HIV/AIDS Regional Resource Network Program

Adriann McCall, MNARegional Coordinator

(415) 437-8071

Office on Women’s Health

Kay Strawder, JD, MSWRegional Women’s Health

Coordinator(415) 437-8119

_________________________

Sheila JamesPublic Health Advisor

(415) 437-8075

Emily ClaymoreORISE Fellow(415) 437-8651

Health Resources & Services Administration (HRSA)Select Programs in the USAPI

• Community Health Centers (Clifford’s update) (BPHC)• Primary Care Office (PIHOA) (BHW)• Maternal and Child Health (MCHB)

– MCHB• 5 year assessment – (tie-in with NPHII - 1 Community Assessment) • CoIIN: Collaborative Improvement and Innovation Network (process)

– EMSC: Emergency Medical Services for Children• PIER [Pacific Island Emergency Management]

• Health workforce grants (BHW)– AHEC program: [decrease funding]

• Hawaii Pacific AHEC – Palau, Yap, CNMI, AS• Guam Micronesia AHEC – Guam, RMI, FSM-Pohnpei, Chuuk, Kosrae

– USAPI HRSA/DOI nursing – covered all 6 jurisdictions [end report out]

– Public Health Training Center: University of Arizona (Pacific-PIHOA)– Primary Care / Behavioral Health Integration – PBHCC Center of Excellence

HRSA Infant Mortality Collaborative Improvement and Innovation Network (CoIIN)

Common Agenda:More first birthdays.

Goal:Reduce infant mortality and improve birth outcomes through collective Impact.

Pacific IM CoIIN: Common Agenda

• Pacific Basin Provisional Aim Statement

By July 2016, we will improve the integrity, quality, availability, and usefulness of infant mortality data within the Pacific Basin through focused action on implementing the policies, standards, structures and processes, and/or appropriate staffing and training within each jurisdiction and the region overall.

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Improve Safe Sleep Practices(n = 36)

Reduce smoking before, during and/or after

pregnancy(n = 22)

Pre & Interconception Care

(n = 33)

Social Determinants of Health (n = 25)

Reducing EED and increasing

progestogen use(n = 21)

Risk Appropriate Perinatal Care (Perinatal Regionalization)

(n = 14)

National Infant Mortality CoIIN Strategies & State Selections

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CDR Maria BenkeMCHB/HRSA [email protected]

Vanessa LeeMCHB/HRSA [email protected]

Piia HansonAMCHP [email protected]

Pacific Basin Infant Mortality CoIIN Points of Contact

mailto:[email protected]



Grants to the Outer Pacific ReportFY 2014 federal funding to Pacific jurisdictions

AS

CNMI

Guam

FSM

RMI

ROP

$0 $200,000,000 $400,000,000 $600,000,000

$151,094,515(15.2%)

$132,440,974(13.3%)

$474,493,898(47.8%)

$124,918,058(12.6%)

$82,616,708(8.3%)

$27,747,267(2.8%)

Federal Funding

Paci

fic Ju

risd

ictio

nsN = $995,294,267

HHS Region 9Office of Pacific Health

Grants to the Outer Pacific ReportFY 2014 federal funding to Pacific jurisdictions by U.S. Department

N = $995,294,267

USDA DOC/EDA

ED HHS DHS/FEMA

HUD DOI/OIA

DOL DOT/FTA

EPA SBA$0

$50,000,000

$100,000,000

$150,000,000

$200,000,000

$250,000,000

$300,000,000

$350,000,000

$400,000,000

$450,000,000

$184,729,829(18.6%)

$2,481,884(0.2%)

$110,537,637(11.1%)

$198,840,755(20.0%)

$6,305,504(0.6%)

$55,088,569(5.5%)

$393,208,000(39.5%)

$8,361,121(0.8%) $2,589,450

(0.3%)

$32,153,000(3.2%)

$998,518(0.1%)

U.S. Departments

Fede

ral F

undi

ng


Grants to the Outer Pacific ReportFY 2014 Health and Human Services

SUMMARY OF HHS FUNDS AWARDEDDepartment/

AS CNMI Guam FSM RMI ROPAgencyTotal

HHS/ACF $8,477,643 $5,964,850 $19,886,974 $297,492 - $1,503,522 $36,130,481 HHS/ACL $1,314,511 $796,568 $4,352,224 - - - $6,463,303 HHS/ASPR $642,671 $630,079 $840,020 $700,206 $646,595 $579,667 $4,039,238 HHS/CDC $2,399,831 $2,820,782 $5,363,361 $3,977,727 $2,617,355 $2,316,005 $19,495,061 HHS/CMS $17,552,795 $25,296,920 $50,949,480 - - - $93,799,195 HHS/HRSA $5,170,433 $3,542,352 $4,629,767 $2,785,836 $1,913,940 $1,773,170 $19,815,498 HHS/OASH/OFP $247,000 $179,800 $284,000 $324,300 $125,960 $136,300 $1,297,360 HHS/SAMHSA $2,490,569 $2,427,494 $5,419,009 $2,220,136 $1,470,302 $1,790,262 $15,817,772 Total $38,295,453 $41,658,845 $91,724,835 $10,305,697 $6,774,152 $8,098,926

N=$196,857,908


Grants to the Outer Pacific ReportDiscussion points

• Opportunities for use of this data– Sharing data files with jurisdictions– Posting report to the PIHOA site

• FY15 report – Program effective measures– Awareness of additional funding data

• Impact to include into the current process


HHS-PIHOA Communication Proposal

• Background of the proposal• Updated document for Board review and resolution• HHS insular policy group changes


Veterans living in the Territories & FAS • Assessment by VA contractor of Veteran access to health services - last

spring– Focus – Scaled back to territory only assessment – Report – anticipate release in late spring – Opportunity to work with VA to identify site visits – connected them to

CHCs in Guam and AS • Outcome – following assessment, added CHC in Guam and AS to list

of providers through which veterans can access specialty care• Recent – allow access to primary care through CHCs – VA reimburse

CHCs for services • Data on veterans residing in territories and FAS [data points]

– VA data bases – Census data – US Census does include question on veterans

• FSM census has question • Palau and RMI don’t

– Health Facilities Systems Data [Hospital, OPD, CHC] HHS Region 9Office of Pacific Health

Veterans living in the Territories & FAS

• Next Steps–Data - workgroup –Meetings with VA (VA-Pacific Island Health Care System) & VISN

• San Francisco VISN –Subroto Banerji• Honolulu Tripler and VA-PIHCS – Cathy Wasem

–PTSD • Clinician education on PTSD for FAS

–Dr. Hirsch, Traumatic Stress Disorders Program, VAPIHCS –COL Diebold, MD, Tripler Behavioral Health Department

–Take advantage of release of support • Advocacy for FAS


Capacity Building in USAPI Nursing Education • RWJ Partners Investing in Nursing’s (PIN) Future grants –Partner approach

– Director, faculty, preceptor development, overall program capacity building, quality improvement activities (formation PINNED)

• DOI/HRSA AHEC Supplemental Grant (PINNED work) – all 6 jurisdictions– Simulation training, Faculty Development, Preceptor Training, Resource

educational materials including testing materials, strategic planning • Access to BSN education by distance / Lacking distance-based program in

Pacific/UOG – University of Maine Ft. Kent – RMI: Marshall Islands Nurses – Summer Immersion* at UMFK

• 1st cohort – 14 started in SU’12; 12 graduated in Dec. 2013• 2nd cohort – Started in SU’14; 15 on-track to graduate Dec. 2015

– AS: American Samoa Nurses –UMFK instructor to PCC –intro session (8wk) 1st cohort – 19 started Oct. 2013; (10 lost /scholarship); 7 – complete May 15.

– FSM: FSM Nurses – UMFK instructor to Pohnpei for intro session• 1st cohort – 14 started in Oct. 2014 (8 wk. session); 11 on-track to date by Dec.

2015 – CNMI: Discussions HHS Region 9

Office of Pacific Health

Capacity Building in Nursing Education

• Continued Activities – Guam-Micronesian AHEC - FSM preceptor training

• Next steps – Last PIHOA meeting, Mrs. Terry Ngirmang, director of PCC Nursing Program updated PIHOA – PIHOA asked PINNED to come back with specific request – Nursing program directors wish to do so at next PIHOA Board meeting– Approach

• Integrated Education-Service Approach • Creative ways – tapping into all Regional resources


REGION IX OFFICE OF FAMILY PLANNING

2157th Annual PIHOA Meeting

LCDR Rebecca McTall, PA-C, MPASRegional Program ConsultantOffice: (415) 437-8403Email: [email protected] A. Miller, MPH Public Health AdvisorOffice: (415) 437-7984Email: [email protected]

FY2015 ANNOUNCEMENT OF ANTICIPATED AVAILABILITY OF FUNDS FOR FAMILY PLANNING SERVICES

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FOA# JURISDICTION DUE DATE

PA-FPH-15-028Commonwealth of the Northern Mariana Islands (CNMI) April 13 2015

PA-FPH-15-027Republic of the Marshall Islands (RMI) April 1 2015

PA-FPH-15-026 Guam April 1 2015

• www.Grants.gov, search on CFDA #93.217 • Eligibility: Governmental or non-profit entity organizations • Applicants do not have to provide services to entire service area (e.g.,

Ebeye CHC could apply under RMI to only provide services in Ebeye).

CERVICAL CANCER

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• ACOG Committee (Handout) / LCDR Rebecca Meese on committee

• RECOMMENDATIONS: The following are acceptable alternative cervical cancer screening methodologies where cytology-based screening is not feasible or practical:

o Human Papillomavirus (HPV) testing with subsequent treatment for women with positive test results, with or without intermediate triage using visual inspection with acetic acid.

o Where HPV testing is not available, visual inspection with acetic acid followed by treatment with cryotherapy.

o Effect: Family Planning funds can be used to for VI-Acetic Acid screening


REGION IX OFFICE OF MINORITY HEALTH

Christina L. Perez, MN, NP, RNRegional Minority Health Consultant

Office: (415) 437-8124Email: [email protected]

Website: http://www.minorityhealth.hhs.gov Data Website: Data.gov/AAPI

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http://www.minorityhealth.hhs.gov/

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• Represent health interests of American Indians/Alaska Natives and Asian Americans, Native Hawaiians, and Pacific Islanders

• 12 voting members, four-year term• Advise the Office of the Secretary, Assistant Secretary for Heath on:

– improving the health of racial and ethnic minority groups– activities to improve the health status and outcomes of racial and ethnic

minorities

• Nominations close April 15, 2015, 5pm EST• www.minorityhealth.hhs.gov or

https://www.federalregister.gov/articles/2015/01/15/2015-00522/solicitation-of-nominations-for-appointment-to-the-advisory-committee-on-minority-health

CALL FOR NOMINATIONS: FEDERAL ADVISORY COMMITTEE ON MINORITY HEALTH

http://www.minorityhealth.hhs.gov/




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REGION IX OFFICE ON WOMEN’S HEALTH

Kay A. Strawder, JD, MSWRegional Women’s Health

CoordinatorOffice: (415) 437-8119

Email: [email protected]


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Region IX Office on Women’s HealthPacific Activities FY 2014:

– Catalogue of Promising Practices which Address Non-Communicable Diseases in the USAPI – 308 promising practices addressing binge drinking, physical inactivity, tobacco use and unhealthy eating.

– Women’s Health Leadership Institute training in Guam • 25 Pacific community health workers trained- public

health systems approach to health disparities.

http://www.pihoa.org/library/index.php

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Region IX Office on Women’s HealthPacific Activities

FY 2015:– Region IX Prevention Strategy Summit, Asian American,

Native Hawaiian and Pacific Islander Women & Their Families: Healthy Eating, Active Living and Tobacco-Free, held August 27-28, 2014, Honolulu, HI.

• Second catalogue of about 90 NCD promising practices submitted by participants

REGION IX Let’s Move Initiative

Sheila James, BSPublic Health AdvisorOffice: (415) 437-8075


57th Annual PIHOA Meeting 29

Sub - initiative of First Lady’s Let’s Move! Initiative.

CNMI is the only Pacific Island participating in Let’s Move Cities, Towns and Counties.

Governor Inos signed up to participate in LMCTC-July 2013.

CNMI created Let’s Move Marianas Alliance-30+ partners.

◦ CNMI created 3 additional goals to benefit the entire society:1. Village to village outreach. 2. Focus on natural environmental strategies.3. Building education and capacity within the

community.

Governor Inos created and signed a NCD directive.All government sectors, statuary bodies & Civil

Society assist efforts to address NCD crisis through Let’s Move Marianas

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Accomplishments:Mayors of Rota and Tinian creating local

wellness plans.Developing a healthy restaurants policy.Community Health Assessment to gage

community habits, behaviors and perception of diabetes.

“Healthy Food Stores” - provide healthier produce and place in high traffic areas.

Working with local home farmers to teach community members how to garden.

Working on implementing island-wide sugar and salt reduction campaign

NEXT STEPS – If interested, contact Sheila James

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REGION IXMEDICAL RESERVE CORPS


Jill Littlefield, BSRegional CoordinatorOffice: (415) 437-8071


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medical reserve corps

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• The Medical Reserve Corps (MRC) national network of volunteers, organized locally to improve the health and safety of their communities.

• MRC volunteers - medical and public health professionals, as well as other community members without healthcare backgrounds. MRC units - engage volunteers to strengthen public health, improve emergency response capabilities and build community resiliency, promote healthy habits.

• Goals of the regional MRC office: • Support the growth and maintenance of MRC units.• Strengthen the internal capacity to support MRC

units

• As of February 2015, there are MRC units in Guam, American Samoa, CNMI, FSM and the Republic of Palau

Pacific islandsmedical reserve corps

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Unit Contact MRC Direct Email

American Samoa Benjamin Sili [email protected]

Commonwealth of the Northern Mariana Islands Warren Villagomez

[email protected]

Federated States of Micronesia Arthy Nena [email protected]

GuamPatrick Lujan

[email protected]

PalauMelinda Lawrence [email protected]

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