Hawaii State Rural Health Association

The overall goal of the Telehealth Outreach for Underserved Communities of Hawaii (TOUCH) grant is to reduce morbidity and mortality related to behavioral health and substance use disorders by bringing together partners to expand access to and quality of substance use disorder and other behavioral health care services in rural communities of Hawaii. The TOUCH project builds directly on the telepsych network created with RCORP funding and emphasizes training and resources not previously addressed by the Hawaii State Rural Health Association. Special Aim 1: Expand Telehealth infrastructure by doubling the hours of free telehealth services available to rural individuals and families, by introducing: 1) warm handoffs from emergency rooms, 2) psychiatric Collaborative Care Model consultations, 3) virtual withdrawal management; and 4) group therapy visits, increasing services to 300 patients a month and thereby decreasing psychiatric hospital admissions by 2%. Specific Aim 2: Improve the quality and sustainability of rural behavioral health care services through education and care coordination by supporting 6,000 person-hours of substance use disorder and mental health continuing education, 1,000 hours of rural clinical training for health professions students that includes coordinating care for those in need including homeless and those released from incarceration to result in reduced recidivism and a 5% increase in behavioral health workforce. Specific Aim 3: Improve the capacity of rural communities to address risk factors and social determinants of health that affect the behavioral health of rural residents by providing outreach and community education on resiliency, parenting, substance use prevention to 1,000 community members a year and creating local task forces to develop plans for brick and mortar recovery communities resulting in a 2% decrease in substance use. Activities include expanding the free HawaiiUTelehealth.org program to provide 3,600 tele-visits a year to rural residents, including services such as outpatient withdrawal management, warm handoffs from hospitals and clinics to mental health experts, and creating group support sessions; training Social Worker, Community Health Worker, Psychology, Nurse Practitioner and Medical trainees in rural areas to learn the needs and benefits of working in such an area; create a culture of care coordination, resource sharing and communication with the TOUCH students and providers that extends throughout rural communities and prisons/jails; and instill community based, trauma-informed resiliency training, parenting skills and substance use prevention knowledge to 1,000 community members a year. Evaluation will be based on number of visits and trainings, attendance at activities, web hits, telehealth utilization statistics, the size of the workforce, rates of substance use, number of recovery beds, number of emergency visits and admissions for behavioral health and substance use causes, recidivism and deaths from overdose or suicide.