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UNHS Uses Grant Funds to Finance Additional Services and Programs - Medically Speaking, Volume Two, Number Two, 8/21/2014

Even with recent reports, and surveys, about the financial strength of Utah Navajo Health System, Inc., the landscape for all medical organizations, still has to include a healthy infusion of grant funding.

For UNHS, the chore of researching and writing successful grant applications falls to Stephanie Makihele. Stephanie works with administrators, and heads of the various UNHS departments, to identify areas where available grant funds might be useful. She then begins the work of creating grant scenarios, getting them approved and writing the actual grant application. Sounds simple, doesn't it? Well, it's not. But Stephanie has developed a knack for writing successful grants that have been highly beneficial for UNHS over the past nine years.

Stephanie is a graduate of San Juan High School, in Blanding, and the daughter of Lewis and Donna Singer. She received her Masters of Public Administration from Brigham Young University, and began her career with UNHS in 2005. While in her MPA program at BYU she studied grant writing and non-profit management. Her first assignment for UNHS was working with the Federal RECEP program, developing a grant to assist with testing uranium miners to find those who might have contracted cancer. When she first started, the existing RECEP grant had to be revamped and resubmitted so it would serve UNHS patients. Stephanie worked with other UNHS officials, including those who worked on the original grant, asking questions and getting additional information to rework the grant. It was eventually approved.

"A lot of what we write obviously, is health related. Either medical, dental or behavioral health. As the Board of Directors identifies new priorities, Mike (CEO Michael Jensen) usually shares that with me and I just look at or specifically search out funding opportunities for the types of services or programs we are either trying to maintain or implement," she explained. "Sometimes, because of other grants we've received in the past, we receive notification about new funding opportunities that may not be specific to exactly what we're doing, but we will still look at those as opportunities for our organization."

Most recently, a lot of the newer opportunities Stephanie has pursued have to do with clinical pharmacy services. The National Pharmacy Association is trying to revise or implement new legislation at the federal level so that clinical pharmacists visits with a patient can be reimbursable. Such visits are not currently reimbursable and never have been, according to Stephanie. This has to do with visits patients have with UNHS PharmD's for medication therapy management, and Stephanie says a lot of the what she's been pursuing is to help support those positions because a patient cannot currently be charged for that visit.

"But what we've found over the past year and a half is that those visits have a significant impact on the health outcomes for those patients," Stephanie explained. "You have a very large population with a diabetes diagnosis. In the past few years, we've found out that we have a lot of patients that either just won't take their medication, or they won't take it as prescribed because they don't understand why they are taking it or how it can help them if they take it as prescribed. So a lot of what the pharmacists do is take each of their prescriptions and literally take the pill out of the bottle and show them what it will do and how it will help them. We've seen a lot of success with that program."

Stephanie is also working with UNHS Behavioral Health Director, Rick Hendy, on new behavioral health grants that are specific for suicide prevention and awareness training. A mini-grant was submitted to the State of Utah to fund the ASIST (Applied Suicide Intervention Skills Training) classes that have been taught throughout south- eastern Utah by Hendy and his staff. A larger grant was submitted to SAMHSA (Substance Abuse Mental Health Services Administration), a division of the Department of Health and Human Services at the federal level. This grant is specifically targeted toward suicide prevention.

"One of the challenges of writing grants for this area, specifically for our patient population, is it's really hard to use state resources because their data collection for this area is almost non-existent. They either don't work very hard with local agencies to get the data, or the local agencies aren't reporting it," she said. "They have county level data, but if you look at just the data that we track from our clinics or our health center, and compare it to county data, there are significant clinical measures or health measures that are not consistent at all.

"Like the diabetes prevalence rates. If you get money out of the state system, they don't look anything like the numbers we see on a daily basis. We have better systems in place to track the data from our health centers. That data is sent to the state only when they ask for it and a lot of times they don't. I talked to a lady once last year and she said, 'you know we really don't have a mechanism for receiving what you have,' which I thought was an odd answer," she added. "We know of, in the last seven months, six different suicide attempts and three or four were completed. So we know that in the last seven or eight months the number of suicides in our area have increased exponentially, compared to the population. But that kind of data they don't have."

Stephanie Makihele has become a vital component of the success UNHS has had over the past decade. But she says her part is minimal compared to the role everyone else plays at UNHS.

"We would not get funded for any proposal we prepare if not for the people who work here. It's really the people who work here that make those proposals successful," she stressed. "They're the ones who make it look good on paper by what they do every day. Once we get the funding they're the ones who make it work. They make those programs and services successful. It's nothing I do."

In reality, the success of the grant-writing program at UNHS is very much a team effort. And Stephanie Makihele is the point man, using the information she gleans from co-workers and other sources to write successful grant proposals and ensure the grant funding continues to flow over the financial and medical landscape of UNHS.

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