Dignity Health-Ak Chin Grant Signed Application 2024

2024 Ak-Chin Indian Community Grant Application Cover Sheet

Name of Applicant: Applicant is a: a City/Town/County (circle)
Dignity Health Foundation — East Valley X Other .
Mayor/Supervisor/Chairman/President: Kevin Hartke, Mayor

Contact Person and Title: Dawn Lang, Deputy City Manager/CFO
Applicant Address (administrative office): Dignity Health: 1727 W. Frye Road, Suite 230

City: Chandler, AZ Zip Code: 85224
Applicant Mailing Address (if different):

City: _ Zip Code:

Phone Number: 480-728-3130 Fax Number: 480-728-3945

E-mail Address: laurel.vetsch@commonspirit.org _

Fiscal Agent for any Applicant that is not a City, Town, or County

(Special Taxing Districts/Fire Districts must have a Fiscal Agent)

Contact Person: Laurel Vetsch

City/Town/County Mailing Address: 1727 W. Frye Road, Suite 230

City: Chandler, AZ Zip Code: 85297

Phone Number: 480-728-3130 _ Fax Number: 480-728-3945

E-mail Address: laurel.vetsch@commonspirit.org

Program or Project Name: Behavioral Health Response and Education

Purpose (Check all that apply) L] education (1 public safety X health LJ environment
C1 promotion of commerce 1 economic and community development
Purpose of Grant (brief statement): Our request to Ak-Chin Indian Community this year is to help provide

a pilot Behavioral Health Program Manager position to guide development of a Behavioral Emergency
Response Team in the emergency room. Also for nurses to teach teen Mental Health First Aid in all CUSD

high school eleventh grade classes,

Beginning and Ending Date of
Program or Project: October 1, 2024 — September 30, 2025
Amount Requested: $206,648 Total Cost: $276,648

Geographic Area Served: East Valley (Chandler, Gilbert, Maricopa, GRIC, Ak-Chin, Mesa, Queen Creek)

By the execution of this Grant Application the undersigned agrees that the information contained in this
Application is true, to the best of the Applicant’s knowledge. The Applicant shall notify the Community if any
information in this Application changes.

Signature: ;
For the Applicant: Beck bE Date:_ 4/15/2024

Lr

Typed/Printed Name and Title: Laurel Vetsch, Grant Director

For the Fiscal Agent: UTC AK. _ Date: 5-3-3902 7, .

(if applicable)
Typed/Printed Name and Title: Dawn Lang, Deputy City Manager, CFO

Dignity Health Foundation — East Valley
Ak-Chin Indian Community Grant Application
Behavioral Health Response and Education

Program Description

Chandler Regional Medical Center is responding to the community’s mental health needs in a variety of
ways. Within the hospital, we must treat the increasing numbers of patients with mental health issues
seeking help in our emergency department. In the community, we are impacting high school students in
Chandler Unified School District to identify and respond to the signs of mental distress. We are
requesting Ak-Chin Indian Community’s partnership with two innovative mental health programs.

Behavioral Health in the Emergency Department. Over the past decade, across the United States, EDs
have seen a 40% increase in adult patients presenting with acute psychiatric crises. Patients with acute
psychiatric conditions that may make them a danger to themselves or others are considered to have
emergency medical conditions and must be evaluated in the ED and cannot be discharged until they are
stable. The boarding of behavioral health patients in the ED is a national issue that has only worsened
after the pandemic. Chandler Regional is seeking to improve the ED behavioral health process for
psychiatric patients boarded in the ED as well as caring for behavioral patients in our inpatient medical
units with an emphasis on compassionate and safe care.

Chandler Regional is creating a pilot program led by a newly created position, a Nurse Practitioner
Behavioral Health Program Manager. In an effort to improve patient care, improve front line staff
satisfaction, and decrease cost, this position will implement mental health response and treatment best
practices into our hospital to provide better, compassionate care. This position will develop programing
to improve the behavioral health patient experience while also improving the satisfaction of front line
staff caring for these patients. And, it will empower nursing and social work staff to collaborate and
innovate ways to improve behavioral patient care.

Finally, the position will iead the development of a Behavioral Emergency Response Team. Comprised of
a psychiatric RN, bedside RNs, social workers, security, and psychiatric providers, the team, led by the
Behavioral Health Program Manager, will round on patients who are dealing with substance abuse,
postpartum depression, dementia, and other psychiatric needs. They will respond quickly to psychiatric
patients entering the ED. When consulting, the team will provide evidence-based recommendations
with pointed interventions. They will help to set up guidelines for managing behavioral patients and
provide psychiatric training to staff.

We are requesting Ak-Chin Indian Community contribute $206,648 towards the pilot Behavioral Health
Program Manager position. After one year of piloting the position and developing Chandler Regional’s
Behavioral Emergency Response Team, we will gather data on the expected results. The data will be
shared with other hospitals in our region. At that point, hospital leadership will evaluate to add the
position permanently and it is expected to grow to manage the behavioral health response at other
CommonsSpirit hospitals throughout Arizona and Nevada.

Teen Mental Health First Aid (tWMHFA). According to the National Center for Health Statistics, suicide is
the second leading cause of death for youth ages 15-19 and nearly 50% of adolescents ages 13-18 live
with a mental disorder (National Institute of Mental Health). Increasingly, teens are coming to the ED in
crisis and currently there are not many resources available to help them. One of the best prevention
tools is education. But we have found that teens needing mental health support don’t usually go to

Dignity Health Foundation — East Valley Page 2
Behavioral Health Response and Education

adults right away. First they go to their friends. We want to teach teens how to provide help and
resources to support their friends.

tMHFA is a classroom-based mental health literacy and skill-building program for students aged 15-18
which promotes mental health literacy and help-seeking behaviors. The program teaches adolescents to
help a peer or friend through a mental health crisis and also helps to reduce the general stigma around
seeking mental health help.

The course includes lectures, films, group activities, creative expression through writing and drawing,
discussions, and skill-building practice through case studies and role play. It does not teach teens how to
diagnose — instead, teens learn information about being a supportive friend, encouraging friends to
seek help and knowing when it’s time to get an adult involved. The program focuses on three pillars:
mental health literacy, health-seeking behaviors, and reducing stigma. It is described as CPR for mental
health.

Topics covered include:
# Common signs and symptoms of mental health and substance use chailenges.
« Common signs and symptoms of a mental heaith crisis, particularly suicide.
¢ ©The impact of school violence and bullying on mental health.
¢ How to open the conversation about mental illnesses and substance use with friends.
e How to seek the help of a responsible and trusted aduit.

In conjunction with Chandler Unified School District (CUSD), Dignity Health began a pilot program in
2022 which introduced the tMHFA program to a small group of nine teens in the 11th grade. The next
year the pilot was expanded to 800 students at one CUSD high school. The students loved the program
and in a survey following the final session, we found statistically significant results showing
improvement in attendees’ mental health literacy, stigma reduction and mental health first aid skills.

The program has been so successful that the Chandler Unified School District has decided to present it
to every eleventh grade student in all CUSD high schools. Classroom instruction is provided with two
instructors, one a social worker and one a nurse. CUSD has received funding for school social workers.
Dignity Health is requesting funding from the Ak-Chin Indian Community for nurses to provide the
medical training component in the classes.

tMHFA instructors are on the frontlines of the program, training teens how to assess, respond and bring
in a trusted adult if a peer seems to be having a mental health or substance use challenge. Instructors
are certified to teach the course from a national curriculum, tailor discussions to their participants and
compile a list of local resources for help. Fifteen nurses would be required to ensure a nurse/social
worker partnership in each class.

Target Population

Behavioral Health in the Emergency Department, The emergency department at Chandler Regional
cares for approximately 2,500 patients per year (1 in 7 patients) who present with the primary diagnosis

of a behavioral health issue. The majority of these patients are transferred to behavioral health facilities
or discharged home with an average length of stay of 10 hours but if they are discharged to a facility, the
wait could be much longer. The annual cost of boarding these patients in the ED while they wait for
transfer is about $2 million per year. In addition, we experience approximately 56 patients a year who

Dignity Health Foundation — East Valley Page 3
Behavioral Health Response and Education

are combative because of mental health issues resulting in 321 incidents of workplace violence. The
Behavioral Health Program Manager and Behavioral Emergency Response Team will be deployed to help
with all these situations, ensuring patients get the help that they need and that staff remain safe in the
workplace. Patients from the east valley who come to Chandler Regional are the targeted population.

Teen Mental Health First Aid. Adolescents throughout the Chandler area are the targeted population.
This past spring, the tMHFA program was presented to 800 Chandler Unified School District students in
one high school. The results were so impressive that the program is again expanding to include every
eleventh grade student in the district’s six high schools — about 4,300 students — for the 2024-25
school year.

Program Goals

Behavioral Health in the Emergency Department. Together, the Program Manager and the Behavioral
Emergency Response Team will be engaged as soon as a patient needing assistance enters the ED and

throughout their ED or hospital stay, if admitted. The team will help staff to assess the situation, calm
the patient, determine next steps, and make appropriate referrals. The goals of the Behavioral Health

Program Manager and the Behavioral Emergency Response Team are to:

e Deliver quality patient-centered and trauma-centered care;

e improve patient safety and staff safety during behavioral health emergencies;
e Reduce the number of patient encounters that turn combative;

« Decrease staff burnout;

* Reduce the use of involuntary physical and chemical restraints; and

e Ultimately, reduce costs for the hospitals and need for resources.

Teen Mental Health First Aid. All Chandler high school juniors will participate in three 90-minute
educational sessions. The classes are highly interactive and have been found to be interesting and
engaging for student participants. The goals of the program for the teens are:

« Recognize early warning signs that a friend is developing a mental health or substance use
challenge.

e Recognize warning signs that a friend may be experiencing a mental health or substance use
crisis.

e Describe how to talk to a friend about mental health and seeking help.

e Explain when and how to get a responsible adult involved.

« Discuss where to find appropriate and helpful resources about mental health challenges and
professional help.

«= Apply the tMHFA Action Plan to help a friend with a mental health or substance use challenge or
crisis.

Pre- and post-surveys reveal a significant increase in the students’ mental health literacy, help-seeking
behaviors, and decreased stigma, Students have been reporting overall positive experiences based ona
subjective question at the end of the survey.

“think all students should get a class like this.”
-CUSD Eleventh Grade Student

Dignity Health Foundation — East Valley
Behavioral Health Response and Education

Program Timelines

Page 4

BEHAVIORAL HEALTH PROGRAM MANAGER
BEHAVIORAL EMERGENCY RESPONSE TEAM

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Statistics show a
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tMHFA

certification
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using pretesvpost-test design

11/2022

Current Funding Sources

CUSD expands
tMHFA to 2400
students and 3
high schools
oO 2023-2024

CUSD expands school year

tMHFA to 800 junior
students 3/2023

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CUSD will expand
UMHFA district-wide
to 6 high schools
and 4300 students
2024-2025 schoo!
year

Behavioral Health in the Emergency Department. We are requesting $109,148 from the Ak-Chin Indian

Community which would match an already existing $70,000 provided through other grants. This would
allow us to create the full-time one-year pilot position of Program Manager who would guide the
formation of the Behavioral Emergency Response Team.

Dignity Health Foundation — East Valley Page 5
Behavioral Health Response and Education

Teen Mental Health First Aid. CUSD has received grants enabling school social workers to teach the
tMHFA program. Ak-Chin’s contribution of $97,500 would enable Dignity Health nurses to provide the
program’s medical component of the trainings.

Project Partners

Behavioral Health in the Emergency Department. The Program Manager and team will develop
relationships with behavioral health organizations throughout the community such as Southwest

Behavioral and Health Services, Mind 24/7, Copper Springs, and additional resources for counseling, in-
patient treatment, and other referrals.

Teen Mental Health First Aid. This program is primarily a partnership between Dignity Health and
Chandler Unified School District. After further analysis of the data, it is hoped that the program will
expand to other school districts.

Sustainability

Behavioral Health in the Emergency Department. The Program Manager and Behavioral Emergency
Response Team are a new project. Initially, the new position will support Chandler Regional. Following
analysis of the data, it is hoped the position will be sustainable by being operationalized and may grow
to lead Dignity Health’s behavioral health response efforts throughout our region.

Teen Mental Health First Aid. As described above, this is an expanded project based on a smaller pilot
project. It will be sustained through school district partnerships and additional fundraising activities
including individual gift opportunities and corporate and foundation support.

indian Tribe Requests

Pending and unsuccessful requests within the last eighteen months include:
e Fort McDowell Yavapai Nation ~ Support for the purchase of additional point of care ultrasound
devices (unsuccessful)
¢ Gila River Indian Community - $500,000 for cystoscopy equipment (unsuccessful)
¢ Gila River Indian Community - $193,000 for point of care ultrasound equipment (unsuccessful)

Funded requests in the last five years include:

e ~Ak-Chin Indian Community - $120,505 awarded for point of care ultrasound equipment

¢ = Ak-Chin Indian Community - $199,782 awarded for GME construction

¢ Ak-Chin Indian Community - $240,000 awarded for tower construction at Chandler Regional
Medical Center

¢ Salt River Pima-Maricopa Indian Community - $150,000 awarded for children’s dental services
and $100,000 for medications for the uninsured

« Gila River Indian Community — $119,000 awarded for ECMO pump purchase

Dignity Health Foundation — East Valley Page 6
Behavioral Health Response and Education

Budget

DESCRIPTION

Behi i : co : : :
Salary 85,943 | $66.11/hour x 25 hours x 52 weeks

(additional 15 hours paid for by another
grant)

Employee Benefits 23,205 | 0.27 x salary

TOTAL Program Manager $109,148

Teen Mental Health First Aid

Nurse Salaries to deliver tMHFA in 37,500 | Full Delivery at each high school is 50

high schools (15 nurses) hours. $50 x 50 hours =$ 2,500 x 15
nurses = $37,500

Nurse Salaries to take the certification 18,000 | Time during the three-day (24-hour)

course course, that would be $50 x 24 = 1,320

per nurse x 15 = $18,000

Certification course for nurses 27,000 | tMHFA 3-day certification "train the
trainer" course---15 nurses x $1800 =
$27,000

Supplies for high school classes 15,000 | Incentives such as food gift cards, pipe

cleaners for fidgeting, and cardstock for
certificates

TOTAL tMHFA $97,500 | Programming for 2024-2025 school
year in all six high schools

TOTAL REQUESTED $206,648

Internal Revenue Service Department of the Treasury
P.O, Box 2508
Cincinnati, OH 45201

(> ry
Date: FEB 00 2015 Employer Identification Number:
74-2418514
DIGNITY HEALTH FOUNDATION EAST Person to Contact - 1D Number:
VALLEY Ed Schiaack - 0203326
1727 W FRYE RD STE 230 Contact Telephone Number:
CHANDLER, AZ 85224 877-829-5500 Toll-Free

Dear Sir or Madam:

Our letter dated October 9, 2012 stated that you were exempt from federal income tax under
section 501(c){3) of the Internal Revenue Code and classified as a public charity under
section 509(a)(3) of the Code.

Based on your request dated October 22, 2014, we have determined that you meet the
requirements for reclassification as a Type 1 supporting organization under section
509(a)(3). A Type 1 is operated, supervised, or controlled by, a Type 2 is supervised or
controlled in connection with, and a Type 3 is operated in connection with one or more
publicly supported organizations. Since your exempt status was not under consideration,
you continue to be classified as an organization exempt from federal income tax under
section 501(c){3) of the Code.

For important information about your responsibilities as a tax-exempt organization, go to
www. irs.gov/charities. Enter “4221-PC’” in the search bar to view Publication 4221-PC,
Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping,
reporting, and disclosure requirements.

We have sent a copy of this letter to your representative as indicated in Form 2848, Power
of Attorney and Declaration of Representative.

Because this letter could help resolve any questions regarding your foundation status, you
should keep it in your permanent records.

If you have any questions, please call our toll free number shawn in the heading of this
letter.

Sincerely,

re

ovat esac Key wearin, d

HEALTH Director, Exempt Organizations
DIGNITY
FOUNDATION EV

FEB
9 2015 Letter 4716 (5-201 1)

Catalog Number 57711M