MRT Innovations in Social Determinants of Health Initiative

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Q1 Please provide your contact information below.

Name

Title and Organization

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Christopher Wolf–Gould,MD

Physician, Gender Wellness Center

1 Foxcare Drive

Oneonta

NY

13820

christopher.wolf–gould@bassett.org

607–434–0521


Q2 Please describe your company or organizations overall goals and mission.

The goal of the Gender Wellness Center is to bring healthcare (including behavioral health) for transgender and gender non–conforming individuals from the margins into the mainstream.


Q3 Please indicate which category your organization falls under.

Health Care Provider


Q4 Innovation Executive Summary. Please describe the innovation, and how it addresses the social determinants of health. Please identify how the innovation addresses the 6 innovation criteria (i.e. ROI, scalability, feasibility, evidence–based support for innovation, relevance to the Medicaid population and speed to market).

Our Provider Training Project will train teams made up of primary care and behavioral health providers. The teams will be trained in the skills necessary to provide knowledgeable and affirming care to transgender and gender non–conforming individuals. Behavioral health providers will be recruited from the county mental health centers, starting in upstate NY. We will start in 1 region of the 11 regions delineated in the New York State Regional Planning Consortium, and then gradually spread the training opportunities to eventually include all county mental health clinics in the 11 regions in NY state. Primary care providers would include practicing physicians, nurse practitioners, and physician assistants who take Medicaid insurance.

The training program would include appropriate clinical training for the providers, and cultural competency training for both providers and associated office staff. The buy–in from office staff is crucial to the provision of affirming care to this population. Medical trainers would be recruited from physicians already providing this care through our Gender Wellness Center, and other similar clinics. Mental health trainers would be recruited providers at our Gender Wellness Center, and other affiliated groups such as the Choices Counseling Center in Albany, NY.

The initial training sessions would be held on site at the county mental health clinics and nearby medical clinics. Subsequent training sessions would be held remotely, through an ECHO type of program.

The goal would be to start the training program on March 1st, 2019, and to train 15 medical and 15 behavioral health providers in Otsego and contiguous counties in the Planning Consortium´s region by February 29th, 2020. In year #2 of this pilot project we would aim to spread the training to 20 providers for both medical and mental health categories in two additional regions in the Consortium. The overall goal is to assure that there are 1–2 clinicians in each of our state´s county mental health clinics, teamed with local primary care providers, who are able to provide this type of care.

Collaboration between the behavioral health and medical providers will be fostered through joint training opportunities, and multidisciplinary rounds.

Both sets of trainees will be expected to complete necessary requirements to become certified as providers by the World Professional Association For Transgender Health.

The return on investment will be tremendous, since the costs for training clinicians who are already practicing in our clinics will be relatively small. The returns will be manifested with increased work productivity as the high levels of anxiety and depression often associated with gender dysphoria are reduced through appropriate treatment. The project would start with the counties in one region of the consortium, and ultimately be scaled up to include all counties in the 11 regions in the state over a 5–year period.

There is a growing body of evidence that treatment for gender dysphoria leads to higher levels of functioning in a number of dimensions. However, at present we have an exploding demand for this type of care AND a significant lack of supply of appropriately trained clinicians. A large proportion of our patients at the Gender Wellness Center have Medicaid insurance, so this project directly addresses their ability to access healthcare. This project could be initiated within 6 months. We anticipate completion of training within a 5–year timetable.


Q5 Was your innovation implemented? If so, please explain when, the number of people impacted, and the results.

No


Q6 Please identify the SDH Domain that your innovation addresses. (Select all that apply.)

Health and Health Care,


Q7 I give the Department of Health the right to share the information submitted in this application publicly (for example: on the DOH website). I understand that there is no monetary reward/reimbursement for my submission or for attending the summit should my innovation be selected.

I consent to have my innovation shared