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Health Authority extends mission beyond access... to wellness
Access to quality health services for all through health insurance, increased primary access points, and health initiatives benefiting the safety net populations has been the focus of the Health Authority's work during its first five years. 2010 was a transitional year, highlighted by a two-day stakeholder retreat last winter followed by a community summit in May. With the Accountability Care Act as impetus, it became clear that the Health Authority needed to do more than provide access to health care services. It needed to ensure access to health.
Planning has begun to implement a network of community and faith-based wellness centers that provide chronic care management, as well as disease prevention and health promotion services. The wellness centers, also known as "health homes," will be developed in concert with local and county health departments, regional disease prevention organizations and health promotion services.
"Detroit and Wayne County rank high among urban areas of the United States for obesity and chronic diseases such as diabetes, heart disease, and asthma," according the Chris Allen, CEO of the Health Authority. "This area is also known to be without accessible fresh food for much of its residential population, causing people to choose less-healthy options for their meals. They have less access to specialty care for chronic diseases and are less likely to assume health promotion behavior."
There are few medical services offering chronic care to Medicaid and uninsured people, causing safety net populations to use expensive emergency services and otherwise compromise their health status. "We want to fill the gap between the primary care services offered by community health centers and hospital-based medical services as a step toward fulfilling the goal of health reform, which is not only an equitable access to health care services, but access to wellness," Allen said.
The wellness initiative has been received enthusiastically by public health professionals who see merit in filling this critical gap in the safety net. Peter D. Jacobson, JD, MPH, Professor of Health Law Policy at the University of Michigan School of Public Health, called the plan "a great example of public entrepreneurship that is essential for improving population health."
Details on this initiative will be announced in the coming months.
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Primary Care Network Council leadership changes
Denise Holmes, Associate Dean for Government Relations and Outreach and Director of the Institute for Health Studies at the Michigan State University College of Human Medicine, and Paul Szilagyi, Regional Vice President, Primary Care & Medical Centers, Henry Ford Hospital and Health Network, have been appointed co-chairs of the Primary Care Network Council. They replace Sister Mary Ellen Howard, Executive Director, Cabrini Clinic, and Richard Bohrer, retired Director of the U.S. Bureau of Primary Care, who will continue serving on the PCNC as chairpersons emeritus. The PCNC is a network of over 40 community health centers, free clinics, and health services addressing primary care needs in the health safety net of Southeast Michigan. It is coordinated and staffed by the Health Authority. |
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Proposed federal funding cuts threatens community health centers
Federally-qualified health centers are at risk due to the House Appropriations Committee proposal to reduce $1.3 billion in funding to community health centers. This threatens the proposed expansion sites as well as established community health centers. The Michigan Primary Care Association has noted that 29 federally qualified health centers stand to lose over $5.5 million in federal funding and about 100,000 people would not have access to their services.
"Fiscally responsibility may be the intent of the proposed cuts, but what they will accomplish is precisely the opposite,"according to Tom Van Coverden, President and CEO of the National Association of Community Health Centers. "This short-sighted proposal will force millions of Americans to seek non-emergency care at already frequently overcrowded hospital ERs; and thousands more will have to put off primary and preventive care and management of chronic conditions like hypertension, diabetes, and cardiovascular disease - with the end result being much higher health care costs to our overall system." NACHC estimates that 127 new health centers will have to close, including two in Michigan.
In December, nine new community health center site applications were submitted to the Bureau of Primary Care for Detroit and Wayne County, funded through the Affordable Care Act. Funding for grantwriting resources was generously underwritten by area foundations.This would be the largest proposed expansion of community health centers in the region's history. However, Congress must appropriate the funds to finance expansion.
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Perspective
Gov. Snyder spares Medicaid provider funds, eligibility
Amid the stress of seemingly endless cuts in state and local government budgets, Gov. Rick Snyder has drawn the line on Medicaid provider cuts and pledged to preserve eligibility. This is somewhat comforting, given the threat to community health center funding at the national level and the demand for provider services when the Affordable Care Act extends the franchise to thousands of newly-eligible Medicaid recipients in 2014. Currently, nearly 2 million people receive health care through Medicaid in Michigan, according to the Michigan Health and Hospital Association.
While provider payments are generally lower than most would like, at least they reimburse physicians and hospitals who choose to care for people insured through Medicaid. In fact, professional organizations have warned elected officials and the public at large that physicians increasingly are pulling out of the Medicaid program or limiting the number of Medicaid patients they will care for. Likewise, health systems serving large numbers of Medicaid and uninsured patients are also experiencing a burden to provide needed care with lower reimbursement.
Specific references to the health care safety net in Gov. Snyder's proposed budget include:
· $437.5 million added to the Medicaid budget for increases in the number of Medicaid recipients and increased utilization of services.
· $138 million was allocated to fund the Adult Benefits Waiver program that provides basic health coverage for low-income childless adults.
· $645.1 million was proposed for health promotion, disease prevention and services to senior citizens and families, including $37.4 million in grants to local public health departments (which is a $1.7 million reduction in funding to public health departments).
· Elderly and disabled individuals eligible for both Medicare and Medicaid will be integrated into a managed care service delivery model, which Gov. Snyder says will save $30 million.
An important point noted by the Michigan State Medical Society is the governor's acknowledgement that prevention and wellness can plan a role in reducing health care costs in the state - which corresponds to the Affordable Care Act's wellness provisions. This underscores the importance that the Health Authority pursue a strategic direction that emphasizes wellness centers, both in community settings and within faith-based organizations.
The Health Authority believes that extending access to health care services, coupled with access to disease prevention and health promotion services and management of chronic disease, will reduce urgent demand on hospital emergency and acute care services. In addition, over time, these initiatives will reduce the number of specialty physician visits, and will help achieve our goal of a healthier community.
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Kresge Foundation awards two-year grant to the Wayne Children's Healthcare Access Program (WCHAP)
The Kresge Foundation has awarded a two-year grant to the Wayne Children's Healthcare Access Program (WCHAP) to implement a proven medical home model in Detroit-Wayne County. WCHAP will provide direct services to 2,500 to 3,000 low income children, and impact 25,000 children through advancing innovation, best practices, and partnerships. Working in collaboration with primary care practices, health plans, state and local health departments, mental health professionals, educators, community-based organizations, and families, WCHAP will pursue the following goals
- Increase quality, well-child visits and care coordination.
- Decrease costs by lowering unnecessary emergency visits and hospitalization.
- Support primary care practices and school health clinics improve "medical homeness."
- Facilitate specialty area collaborations: Asthma, pediatric integrated obesity and maternal-child-teen health
Modeled after the KentCHAP program in Grand Rapids, WCHAP is the second pilot to go 'live' in Michigan. Supported through planning grants from the Early Childhood Investment Corporation and Great Start Collaborative Wayne, WCHAP's strategic partners include the Health Authority, Michigan Department of Community Health, and the Michigan Chapter of the American Academy of Pediatrics.
"This award is a continuation of the Kresge Foundation's commitment to supporting innovation and outcomes-focused initiatives that will positively impact the health and wellness of our community," explained Jametta Lily, WCHAP Project Director. "Dr. Teresa Holtrop, WCHAP Medical Director and our WCHAP team, are excited and deeply appreciative of the Kresge Foundation's investment in assuring that low income children and local providers gain the benefits of the CHAP model. Working with our dynamic practices and community partners we are uniquely positioned to impact systems change in our community and through out the State of Michigan."
For more information, contact Jametta Lilly at 313-871-3751, email jamettal@gmail.com or Teresa Holtrop, MD, WCHAP Medical Director at tholtrop.wchap@gmail.com. |
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Wayne County announces Walking Clubs, Multicultural Health Conference, and Health Expo 2011
The Wayne County Health and Human Services Department has announced three major initiatives for the Spring-Summer seasons: establishing a cadre of walking clubs to coincide with its efforts to promote First Lady Michelle Obana's "Let's Move" program, a multicultural health conference, and a return of the Health Expo to Cobo Conference Center.
Wayne County Multicultural Advisory Council Walking Clubs
In collaboration with its Multicultural Advisory Council and Michigan Minority Health Month, the department is developing a three-year initiative to combat the obesity epidemic that currently threatens the health and well-being of Wayne County residents. Wayne County has been identified as the seventh most obese county within the United States. The Celebrating Healthy Life Styles Initiative will accelerate existing efforts to address obesity.
Walking clubs will specifically target African Americans, American Indians, Arab Americans, Asian Americans and Hispanic Americans, among other minorities. Recognized community leaders in each group will be asked to enroll members in walking clubs that will hold an initial kickoff walk in April. The walking clubs will follow guidelines established by the Presidential Active Lifestyle Award, enabling each member completing the requirements to receive a personal award from President Obama. The clubs will be open to adults over age 18 and involve 30 minutes of sustained physical activity, five days a week, for six out of eight weeks. The county hopes to recruitment as many as 2,000 walkers and walk a collective 100,000 miles.
Wayne County Health Expo 2011 continues efforts to reach the uninsured
Several community organizations will gather to provide information and support for the uninsured in Wayne County on Friday, April 15, in the Riverside Room of Cobo Conference Center, 8 a.m. to 5 p.m. Specific goals of the Health Expo include:
- Continue to raise awareness about the complex issue of the uninsured and underinsured by engaging opinion leaders, elected officials, and major stakeholders;
- Build and sustain a strong coalition that reflects health systems, medical providers, homeless shelters and community-based agencies, as well as ensuring the ethnic diversity of Wayne County;
- Create a Health Expo that will provide enrollment opportunities for health coverage offered by Wayne County and the state, including MIChild and Healthy Kids, as well as Medicaid. Also, the Expos will promote City of Detroit Wellness and Promotion programs;
- Programs will include health screenings for HIV, sexually transmitted diseases, glucose, blood pressure, obesity body mass index, oral health, general blood tests, and podiatry. There will be an Ask the Doctor Exhibit as well as Massage Therapy.
Second Annual Multicultural Advisory Council Conference
The second annual Multicultural Advisory Council Conference will be held on Wednesay, July 13.The purposes of this conference are to address health disparities,obesity, and to showcase best practices for healthier lifestyles, exercising and nutritional modifications across cultures. The Advisory Council continues to improve upon a structured process to address issues of access to health coverage and health disparities common to multicultural communities. The conference is designed to offer participants involved in the health and wellness systems, restaurant chains, food service industries, sports venues, suggestions including an open and inclusive opportunity to dialogue, share concerns, address issues and seek consensus that can help us (as consumers) lead healthier, more enriched lives with realistic short and long term outcomes.
- Increase awareness and knowledge of the strength of diverse communities in Wayne County and the impact of cultural competence in the delivery of healthy living options, nutritional choices and humane services and intervention.
- Share best practices for delivering culturally based education, motivation and improved nutritional services that impact social determinants of health in Wayne County with an emphasis on healthy lifestyles, exercise, urban gardening and advocacy.
- Provide a forum for developing inter-organizational and community cooperation and collaboration aimed at addressing disparities in health care services.
Intended participants include all health care professionals, all disciplines and health settings, nurses, health systems directors, physicians, dentists, public health professionals, community agency directors, policy makers, social workers, medical health providers, clinic directors, emergency room directors, governmental health program directors, community advocates, businesses, merchants and others.
Conference Registration is $75 and includes one program booklet, workshop attendance, continental breakfast and lunch. Scholarships will be considered upon request. Submit scholarship request to Rose Khalifa @ 313-963-8383 or email, rosekccrn@yahoo.com. For other information on any of these programs, contact Lorenzo Lopez: llopez@co.wayne.mi.us (313) 833-3438.
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MOSES focuses on 'Healthy Heartland' equity initiative
Detroit and Southeast Michigan will be among six Midwest regions in the country to participate in "Healthy Heartland: A Community-Driven Plan for Building a Healthy America." The collaborative, which includes Minnesota, Ohio, Wisconsin, Missouri, and Kansas, intends to use community organizing to achieve sustainable and livable communities. The program embraces the World Health Organization's definition of health equity - "the absence of unfair and avoidable or remediable differences in health among population groups defined socially, economically, demographically, or geographically."
The initiative will involve health professionals, community organizers, and other stakeholders involved in community health organizing. "Health Heartland Partners use specific issues to achieve incremental progress toward achieving health equity while recognizing that these issues also serve as a vehicle for developing the community's collective power," according to an initiative backgrounder. |
Coalition, Downtown Circle of Care announce medication initiative
The Downtown Circle of Care, organized by the Interfaith Health & Hope Coalition, has developed an initiative the helps homeless people get medications in the downtown area. About 3,000 homeless people live in the area. With funding from the Metro Health Foundation, and a collaboration with the Waller Health Center, agencies referring the homeless client for health care will provide them with an identification card and identifier number for the program's software. Griswold Pharmacy, located in Capitol Park, will provide common generic drugs for $5, not typically available in Detroit, to treat chronic illness. The software will allow the service providers to track and trend adherence to medications and correlate with physical outcomes such as blood pressure and glucose monitoring.
This collaborative model is big step to providing the vulnerable in Downtown Detroit more consistent access to medication for chronic disease. Charissa B. Shawcross, NP, of the NOAH Project at Central United Methodist Church has led this effort. Other congregations involved include St. Aloysius Catholic Church, Fort Street Presbyterian Church, and Second Avenue Baptist Church. Covenant Community Care consulted in developing this project.
Western Wayne Circle of Care celebrates seventh anniversary
It is hard to believe that the Coalition, in collaboration with the Oakwood Health Care System, is soon entering into a seven-year anniversary for our first Circle of Care in Western Wayne, which encompasses the communities of Wayne, Westland, Romulus and Inkster. The group has grown with a current roster of over 65 members which include pastors, parish nurses, community service agencies and other representatives from the community. We currently hold our monthly meeting from 12 p.m. to 2 p.m. at Oakwood's Annapolis Hospital on the third Friday each month. In addition to Western Wayne, Oakwood sponsors two other Circle of Care collaboratives, one in the Downriver area and the other in Dearborn/Southwest Detroit group.
The Downriver group is going into its third year. It alternates sites between Oakwood Southshore Medical Center in Trenton and Oakwood Heritage Hospital in Taylor - it meets on the second Friday of the month from 12 noon to 2 p.m. Its membership is over 50. Our newest group, the Dearborn/Southwest Detroit area, started this past October and has a roster of 30 members. It meets on the first Thursday of the month from 12 p.m. to 2 p.m. at Trinity St. Marks in Detroit.
For more information on the Coalition's Circles of Care visit www.healthaccess1.org, then click the Interfaith Health & Hope Coalition link.
Ron Beford
Executive Director
Interfaith Health & Hope Coalition |
Feds offer tips on how community and faith-based leaders can help promote health care careers
Workforce development in the health care sector is critical, particularly for the safety net. The Health Authority is committed to providing training opportunities and community outreach to encourage students to pursue health care careers and for providers to remain in medically underserved areas. Through its partnership with the MI-AHEC, sponsored by Wayne State University, the Health Authority expects to make a major impact on health career awareness in Southeast Michigan.
Recently, the federal government published these tips on how communities and faith-organizations can help:
1. Tell members in your community or congregation about opportunities in health careers and job training programs:
These opportunities will help to increase the diversity of the health care workforce, to ensure that there are health care workers in underserved areas, and to prepare the health care workforce to meet the needs of the aging population. The Affordable Care Act is supporting the training of primary care physicians, nurse practitioners and physician assistants through grants to medical schools, hospitals, nursing schools and other entities.
For more information, go to http://bhpr.hrsa.gov/grants/affordablecareact.htm
The Health Resources and Administration Department (HRSA) also supports both scholarship and loan programs for disadvantaged students participating in certain health professions training programs. Participating schools make scholarships and select loan recipients through these need-based, competitive programs.
For more information, go to http://www.hrsa.gov/loanscholarships/index.html
2. Tell members in your community or congregation about the new scholarship opportunities for primary care training.
The National Health Service Corps gives scholarships for primary care training. This money covers tuition, fees, living, and other costs related to training for jobs such as doctor, nurse, mental health provider, and dentists. In exchange, people serve in the Corps for two to four years. Find out more at: http://nhsc.hrsa.gov/scholarship/
The Indian Health Service Scholarship Program gives American Indian/Alaska Native students money for classes to improve the basic skills needed to get trained as a primary care provider, classes leading to a college degree needed to become a primary care provider, and primary care provider training classes.
For more information on the scholarship program or where to apply, go to http://www.scholarship.ihs.gov/learn_more.cfm
3. Tell the primary care and mental health providers in your community or congregation how they can get their student loans repaid.
The National Health Service Corps (NHSC) offers up to $170,000 tax-free to repay student loans. In return, people serve in the Corps either full-time or half-time at a NHSC-approved site.
Federally qualified health centers, rural health clinics, and other sites that care for low-income and uninsured people can become NHSC-approved sites where dentists, dental hygienists, primary care physicians, nurse practitioners, certified nurse midwives, physician assistants, and mental health professionals who are eligible for loan repayment funding or have received scholarships can fulfill their service obligation.
For more information about NHSC Loan Repayment Program go to http://nhsc.hrsa.gov/loanrepayment/
4. Let your community or congregation or health ministry know if there is a community health center in your area.
Federally-funded community health centers provide primary care for individuals and their families, even if they have no health insurance. You pay what you can afford, based on your income. If you cannot afford to pay, you will not be turned away.
For more information about becoming a NHSC site, go to http://nhsc.hrsa.gov/communities/
5. Let your community or congregation or health ministry know if there is a community health center in your area.
Federally-funded community health centers provide primary care for individuals and their families, even if they have no health insurance. You pay what you can afford, based on your income. If you cannot afford to pay, you will not be turned away.
htttp://findahealthcenter.hrsa.gov/Search_HCC.aspx
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The Detroit Wayne County Health Authority's mission is to coordinate efforts to meet the health needs of the uninsured and underinsured residents in Detroit and Wayne County by assuring access and improving the health status of all people.
"It's about access for all." |
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