Optimizing Health and Primary/Preventive Health
Community based interventions to improve health by promoting health supportive behaviors for all ages, ethnicities and geographic areas of the region. Programs highlighted below represent examples of our population health interventions. This is not an exhaustive list of all Community Health and Wellness Programs.
In 2012 Tahoe Forest Health System began collaborating with Tahoe Truckee Unified School District (TTUSD) to improve immunization rates in response to poor kindergarten immunization rates and the whooping cough epidemic in Nevada County. This collaboration became known as the Truckee North Tahoe Immunization Coalition. The initial goal is to increase kindergarten immunization rates and 7th grade T-DAP immunization rates in TTUSD and improve adult T-DAP immunization booster rates. As a direct result of program interventions:
- Kindergarten immunization rates have increased;
- Tahoe Forest Hospital outpatient clinics are enrolled in the California Immunization Registry (CAIR);
- Immunization updates are integrated into the outpatient Electronic Health Record (Epic); and
- Communication and collaboration between TFHS, local medical providers, TTUSD and county health departments has greatly improved.
Affordable Lab Screenings and Blood Pressure Education
The Wellness Neighborhood supports monthly affordable lab screenings in Truckee and Incline Village. In 2015, the Wellness Neighborhood Team began offering education as well. While community members are waiting for their lab draw they can have their blood pressure screened and have access to an array of community health news including information on immunizations, nutrition and upcoming events.
ReThink Healthy! consists of prevention education including community outreach events, presentations and classes plus magazine, newsletter and email articles with a rotating focus. It also includes long-term projects such as seeking the American Heart Association's Fit and Friendly Workplace Certification, installing a walking trail in coordination with Nevada County and promoting Mental Health in the Mountains in collaboration with the Suicide Prevention Coalition.
Check out our ReThink Healthy! Programs and Services:
Nutrition Coalition and Harvest of the Month
The Truckee Tahoe Nutrition Coalition and Harvest of the Month began in 2006 to increase knowledge, access and preference for fresh fruits and vegetables for the children and families of our community. Harvest of the Month activities include monthly tastings of in-season fruits or vegetables and yearly farmer visits.
To date: over 2,000 students per month have explored and tasted an in-season fruit or vegetable since 2007. Teachers and parent volunteers report increased interest and preference for fruits and vegetables. This program is financially supported by school Parent Teacher Organizations (PTOs).
Be Fit in Tahoe (B-FIT) began in the Tahoe Truckee Unified School District in 2011 to provide additional physical activity, in the form of "activity bursts" in the classroom, to elementary school youth. Physical activity provides many benefits that can positively affect children's health, their mental and social well-being, and their performance in the classroom. It plays an important role in combating the growing epidemics of obesity and diabetes, it is an important antidote to depression and low self-esteem, it can reduce the effects of stress, and it stimulates brain activity and increases the ability to concentrate. Reducing stress can make it easier for children to develop physically, mentally, intellectually and socially. Ultimately, this may help them perform better in the classroom. Finally, engaging in physical activity during childhood increases the chance of remaining physically active as an adult.
Truckee North Tahoe (TNT) Youth Health Initiative
The TNT Youth Health Initiative's mission is to build a sustainable, integrated continuum of health supports and services for adolescents in the Truckee-North Tahoe area through the partnership of community organizations committed to leveraging and expanding existing community and school-based programming and resources. Initiative Partners include the Wellness Neighborhood of Tahoe Forest Health System, Tahoe Truckee Unified School District, Placer County Health and Human Services, Nevada County Health and Human Services and the Community Collaborative of Tahoe Truckee. The four key strategies of the Initiative are:
- Create a cohesive Wellness Network that links youth with local health and wellness services and includes a school-linked Youth Health Navigator to help coordinate care for adolescents.
- Increase access to confidential reproductive health services through the expansion of education and clinic services.
- Increase access to behavioral health and alcohol and other drug services through school-based therapists, expanded peer mentoring and strengthening substance use services.
- Increase access to oral health services and education through the creation of a Dental Coalition, including pediatricians, dentists, school nurses, volunteers and community health professionals.
Access to Care and Care Coordination
Improve health and reduce health care costs and unnecessary emergency department and hospital admissions though personalized support for our highest risk patients. < something about establishing a primary care provider or medical home.
Tahoe Forest Hospital has a great opportunity to participate in The Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program. We chose two focus areas that aligned with our strategic plan. These include: Chronic Non-Malignant Pain Management and Million Hearts Initiative. These projects were selected because they address the health care needs of our community and support the identified organizational goals and project aims through the utilization of care coordination, prevention and screening programs, and evidenced-based care management tools. The partnerships of medical providers, community members and regional health organizations will build a shared vision of multidisciplinary/multimodal approach to population health management.
Chronic Care Management (CCM)
CCM is a patient and family-centered program that assists people living with two or more chronic conditions better manage their condition. The Care Coordinator assists in teaching self-management skills, goal setting, and effective communication with Primary Care Providers (PCP) and provides links to community resources. Care Coordination services can be home visits, phone calls and accompanying patients to PCP visits. CCM continues for as long as the person has two or more chronic illnesses that are expected to last at least 12 months and that place a person at significant risk of death, acute exacerbation or functional decline.
Transitional Care Management (TCM)
In the TCM program the Care Coordinators' focus is on facilitating a smooth transition from the hospital to the home. The service starts with the coordination of care between the hospital's interdisciplinary team, the patient, family and the Primary Care Provider and continues for 30 days following discharge from the hospital. The Care Coordinator works closely with the patient, family, Primary Care Provider, Home Health Care Staff and other Community Resources to formulate a patient-centered holistic care plan. After 30 days post hospitalization, the patient may consent to enter into the Chronic Care Management program.
Youth Care Management (YCM)
The Truckee North Tahoe (TNT) Youth Health Initiative emerged in 2014 from community-based collaborative efforts to address critical health needs in the region. Local health disparities, rural isolation and the status of adolescent health in the TNT region led to the formation of a regional partnership focused on improving youth health outcomes and addressing persistent health inequities experienced by Hispanic youth. TNT Youth Health Initiative Partners include the Wellness Neighborhood of TFHS, Tahoe Truckee Unified School District, Placer and Nevada County Health and Human Services and the Community Collaborative of Tahoe Truckee. An in-depth analysis showed Access to Care as a significant need for TNT adolescents. In response, the Wellness Neighborhood is developing a Youth Care Management program to increase access to care, improve health literacy among teens and their parents and improve service integration between the hospital, counties and school district.
Promotore (Community Health Worker) Program
The Promotore Program is a collaboration with the Wellness Neighborhood, North Tahoe Family Resource Center and Family Resource Center of Truckee to address ethnic disparities present in the community. Promotores assist clients in meeting their primary health care needs by identifying and referring clients to community practitioners and activities designed to promote health literacy and self management, good dental health practices, immunizations, physical exercise and healthy diet as well as providing direct services through workshops and one-on-one consultations.
A strategy that came directly out of the TNT Youth Health Initiative was the creation of a local Dental Coalition to...
Substance Use and Misuse
Reduce substance misuse in the community and reduce the normalization of drug use community-wide with an emphasis on school-age children. Educate on the dangers of alcohol, prescription and recreational drug misuse.
Screening, Brief Intervention, and Referral to Treatment (SBIRT) services are an evidence and community based practice designed to identify, reduce, and prevent problematic substance use disorders. We are beginning to integrate SBIRT screenings for all the primary health clinics to improve the quality of care and help address patients substance use.
AlcoholEdu is a highly scalable online program that allows high schools to reach all students with a consistent message and empower them with the necessary skill set to make safer and healthier decisions about alcohol. First implemented in the 2012/13 school year, students have found the program helpful in guiding them to make healthy decisions about alcohol.
The Wellness Neighborhood helps to promote the values of good training habits, proper nutrition, strong communication skills, model citizenship and a drug-free lifestyle through participation with Athlete Committed kick-offs at the start of each athletic season. Athlete Committed is a program promoted by TTUSD and Truckee Tahoe Future Without Drug Dependence (TTFWDD). It engages all aspects of high school athletics, including coaches, athletic directors, administrators, parents, communities, prevention professionals, and most importantly, the athletes themselves to reduce substance abuse and increase positive lifestyle choices among student athletes.
Prescription Take Back Events
The Wellness Neighborhood collaborates with Truckee Tahoe Future Without Drug Dependence (TTFWDD) and local law enforcement to promote annual Prescription Take Back Events. Unused, expired or unwanted medications can be dropped off to help protect the environment, reduce youth access to prescription drugs, and prevent misuse or mistakes by seniors.
In addition to the annual Take Back Events, prescription drugs can be dropped off year-round at the Truckee Police Department and Placer County Sheriff's Station.
Truckee Policy Department: 10183 Truckee Airport Road Truckee, CA 96161 Hours: 8:00 to 5:00 Monday - Friday. For more information, please call (530) 550-2323.
Placer County Sheriff's Station: 2501 North Lake Blvd. Tahoe City, CA 96145 Hours: 9:00 to 5:00 Monday - Friday. For more information, please call (530) 581- 6369.
Safe Prescribe Practices
TFHD has developed an Advisory Group that includes medical leaders in our community who have joined efforts to improve pain management practices. The Advisory Group encourages all medical practitioners to follow best practice safe prescribe guidelines. These guidelines include:
Pain Medication Agreement
Patients who require controlled medication for more than three months should have a Patient Medication Agreement. Patients who need long acting opioids also meet the definition of chronic pain and warrant a pain agreement. The agreement sends an important message to both the patient and the provider that the medications can be dangerous and that there are laws and regulations related to these prescriptions. The agreement does not protect from liability.
Prescription Drug Monitoring Program (PDMP) and Controlled Substance Utilization Review and Evaluation System (CURES)
The Wellness Neighborhood is striving to increase awareness around safe prescribing practices and is coordinating efforts for Medical Providers to register with CURES in California and PDMP in Nevada. These two data bases allow providers to identify drug-seeking behaviors and treat patients appropriately. The Wellness Neighborhood is also developing standardized pain contracts to be used with all local Medical Providers including dentists.
Patients diagnosed with chronic pain who are prescribed an opioid and who have a Patient Medication Agreement will require an annual urine toxicology screen which will be documented in the medical record. This procedure will improve safety standards and overall quality of care.
Mental and Behavioral Health
Increase screening and identification of mental health needs, access to mental health care, and community support and awareness.
Tahoe Forest Health System plans to assure minimum screening recommendations (based on evidence-based guidelines and the United States Preventative Services Task Force recommendations) for all primary care health clinics to include Depression Screening. Routine screenings for psychosocial problems such as depression are important indicators to help manage patients and improve quality of care, especially if the patient is also suffering from a chronic disease such as diabetes or hypertension.
Stress Reduction for Teens
Breathing, Movement & Visualization for Stress Reduction is presented in TTUSD school health and physical education classes to decrease stress levels in students thereby reducing stress-related diseases, decrease drug and alcohol use and improving mental health.
Students at TTUSD have personally reported that the classes help reduce stress during tests, provided tools they can use to deal with stress at home and at school and improved mood (less depression and anxiety) and athletes have reported fewer sports-related injuries and quicker recovery.
Stress Relief Programming for Seniors
The Wellness Neighborhood supports equipping seniors with the tools to mitigate stress, improve mood, and reduce negative emotions while also improving balance and mobility. Through Sierra Senior Services, Stress Relief Classes are taught to seniors weekly.
Suicide Prevention Coalition
The Suicide Prevention Coalition formed in 2013 in response to significant community need around suicide awareness and prevention. The Coalition has focused on prevention by promoting the Know the Signs campaign and organizing educational events such as Positive Psychology with Christopher Old, MFP, LPCC and Supporting Ourselves and Our children in Difficult Times with Kim Bateman, PhD and Jackie Hurt-Coppola, LMFT.
The Steering Committee includes TFHS's Wellness Neighborhood, Placer County Health and Human Services, Nevada County Health and Human Services, Tahoe Truckee Unified School District, Tahoe Safe Alliance and the Community Collaborative of Tahoe Truckee. All community members are invited to be a part of the Coalition.
Mental and Behavioral Health Resource Directory
The Mental and Behavioral Health Resource Directory is updated yearly and includes provider and practice information, payments accepted including insurance or sliding scale, if the provider offers services in Spanish, gender and license of the provider.
Multi-Modal Therapies for Chronic Pain Resource Directory
The Multi-Modal Therapies for Chronic Pain Resource Directory includes provider and practice information, including what type of service is provided and the types of payment accepted.
Chronic Illness Support Group
This support group provides a safe environment to discuss and explore the ways in which lives have been changed by chronic illness and/or pain. The goal of the group is to help and support one another in order to live a lighter and happier life. The group meets at the Center for Health and Sports Performance every second and fourth Tuesday of the month from 10:00am to 11:30am.
For more information please contact Sandra Dorst at (530) 582-6521
Whole Hearts, Minds and Bodies
The Wellness Neighborhood is partnered with Gateway Mountain Center and their Whole Hearts, Minds and Bodies program to target at-risk youth. The program uses a holistic treatment model for youth who are experiencing mental health challenges including behavioral and/or substance abuse issues.
Their concept of Nature-Based Therapeutic Mentoring combines caring mentorship, expansive experiences, and self reflection to support participants as they navigate life. The team consists of mentors with training as therapists, school counselors, mountain guides, teachers and practitioners in the healing and holistic hearts who guide youth through multi-hour, activity-based sessions that help them increase their sense of empowerment, strengthen their resiliency, expand their self image and reduce their vulnerability to stress and depression.