Evergreen Health “THRIVES” +

With an Updated Tobacco Control Workflow 

Evergreen Health, a Federally Qualified Health Center (FQHC) in Western New York, serves socially and economically disadvantaged populations, including Black, White, Spanish, LGBTQ+, and low-income individuals. The organization specializes in addressing health disparities, focusing on vulnerable communities, and has a long-standing commitment to innovative and unconditional care. 

Through its behavioral health THRIVE program, Evergreen partnered with Health Systems for a Tobacco-Free New York (HSTFNY) to integrate tobacco use treatment into its medical and behavioral health workflows. 

Challenge 

The high smoking rates among the Evergreen patient population, many of whom face significant social and economic barriers, posed a substantial health risk. Additionally, as a nontraditional health provider, Evergreen required tailored solutions that aligned with its holistic approach to care and its diverse community needs. 

Approach 

1. Building Relationships: 
   Initial connections were facilitated through a physician at Roswell Park who linked HSTFNY with Evergreen’s patient navigation and behavioral health teams. 
   
   Collaboration was formalized through a Memorandum of Understanding (MOU) in December 2022. 

2. Integration into Workflow: 
   Tobacco treatment was embedded into Evergreen’s organizational workflow and electronic health records (EHR), ensuring sustainability beyond external support. 
   
   Providers were trained in hands-on Nicotine Replacement Therapy (NRT) and connected with the New York State Smokers’ Quitline for additional support. 

3. Specialized Training: 
   A behavioral health specialist was trained as a Tobacco Treatment Specialist (TTS) through a scholarship-funded program at Roswell Park. This champion now provides in-house expertise to address tobacco use among patients. 

4. Expanding Services: 
   Tobacco treatment was extended to multiple Evergreen locations, including Jamestown and North Buffalo, ensuring widespread access to care. 

The Outcomes 

HSTFNY helped integrate tobacco dependence treatment as a permanent feature within Evergreen Health’s system. In December 2022, a formal Memorandum of Understanding (MOU) was signed, and by January 2023, Evergreen Health had incorporated the treatment workflow into its electronic health records (EHR), ensuring systematic implementation. 

HSTFNY coordinated with Evergreen Health’s THRIVE program to create a workflow that included tobacco dependence treatment as a standard part of patient care. THRIVE serves diverse communities, including low-income, LGBTQ, and marginalized groups.  

The incorporation of dependence treatment into Evergreen’s EHR guarantees that tobacco use treatment will persist beyond HSTFNY’s involvement, creating a sustainable systems change. This milestone ensures that patients routinely encounter dependency support during visits, reinforcing the organization’s commitment to serving vulnerable communities.