The Mission of the National Center for Health in Public Housing (NCHPH) is to strengthen the capacity of federally funded Public Housing Primary Care (PHPC) health centers and other health center grantees by providing training and a range of technical assistance.
NCHPH, a project of North American Management, receives funding through a cooperative agreement grant awarded by the U.S. Department of Health and Human Services Administration.
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A Year in Program Requirements
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Join NCHPH as we cover HRSA's 19 Program Requirements throughout 2013. Each month the newsletter will feature at least one of the program requirements to provide information and resources.
Program Requirement #1: Needs Assessment
General Requirements: Quick Tips
- Identify community members and leaders
- Ensure community understands health center program's goals and objectives
- Create ways to effectively collect data
- Use trained data collectors to gather data
- Identify the most important factors that affect stakeholders
- Conduct focus groups for stakeholders
Health center programs should have a recent needs assessment. Areas to focus on are getting the needs assessment in writing and mapping the location of the target population (special population).
To improve performance and to reach underserved populations, use tools such as:
1) Bureau of Primary Health Care Policies
2) UDS Mapper
3) HRSA Data Warehouse
Last steps
- Allow the board to review and approve the updated needs assessment.
- When locating the target population, include pertinent information such as exact geographic location, whether it's medically underserved, ethnic/racial data, and income status.
- If there any overlap between health center programs and populations, explain the overlap and show how the health center programs are different.
To learn more about how to conduct a needs assessment, click here for a free toolkit.
Source: HRSA
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January Health Observance: Cervical Health
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The Centers for Disease Control report that in 2008, which is the most recent data available, over 12,000 women were diagnosed with cervical cancer and about a third died from the condition. On average 11,000 women get cervical cancer every year. Although cervical cancer does not represent all cervical health issues, it is one of the most pressing female reproductive health issues in the US.
Cervical health also includes female reproductive health issues. The most common cervical health issue is human papilloma virus (HPV) which is also the most commonly spread sexually transmitted infection (STI) in the US. HPV affects about half of those who are sexually active. HPV may appear as either genital warts or abnormal cells in the cervix. The virus may also remain inactive in the body and can go undetected due to long latent periods. A regular gynecological examination can detect these issues.
Some strains of HPV cause cervical cancer (high-risk) and other strains only cause genital warts (low-risk). HPV can also cause cervical dysplasia, which is a precursor to cervical cancer. Dysplasia is detected as abnormalities on the cervix's surface. Dysplasia serves as an indicator to cancer and treatment of dysplasia can prevent cancer. Unfortunately, unlike some strains of HPV, dysplasia does not present any symptoms, therefore a regular pelvic exam is recommended.
Other cervical health issues include cervicitis and cervical incompetence:
- Cervicitis is the inflammation of the cervix. STIs such as chlamydia, gonorrhea, herpes, HPV, trichomoniasis, and bacterial vaginosis may cause cervicitis.
- Cervical incompetence occurs when the cervix opens up to allow the baby to enter the uterus before the baby is due. This can result in premature birth if a cervical cerclage is not performed to close the cervix before 37 weeks of pregnancy.
Click here to learn more about cervical health.
To listen to a podcast on cervical cancer by the Centers for Disease Control, click here.
Source: CDC, National Library of Medicine, Office of Minority Health, MedlinePlus
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Preventing Cervical Health Problems
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Most reproductive health issues can be detected through a regular Pap test during a gynecological exam. Although some conditions do not present any symptoms, many conditions may show changes during inspection of the cervix.
Ways to prevent cervical health issues include:
- Get scheduled Pap tests.
- Stop smoking as toxins in tobacco smoke perpetuate cancers and other health conditions.
- Use condoms during every sexual act and know partners sexual history.
- Discuss birth control pill use with doctor if using pills for more than five years.
- Limit the number of sexual partners you have.
- Get the HPV vaccine, which can prevent the most common types of cervical cancers. The vaccine is also a protective measure against other gynecologic cancers.
To find more resources and information on designing a cervical health awareness event, click here to access a cervical health toolkit.
Sources: CDC
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Cervical Cancer
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Not all cervical cancers are caused by HPV, but the majority of them are. In the U.S., there are geographic differences in cervical cancer prevalence and cervical cancer mortality. Click here to see data collected by the CDC.
Minorities and Cervical Cancer Screenings
In the US, incidence of cervical cancer is higher in Hispanic women, but mortality is highest in black women. Pap test screening rates are highest in black and Hispanic populations with more black women being tested than any other race or ethnicity. In addition, data shows that there is a health disparity between women and education levels. To learn more about health disparities and cervical cancer screenings, click here.
Click here to access a fact sheet on cervical cancer.
In September of 2012, HRSA awarded $44 million to community health center programs to increase cervical cancer screenings in underserved communities. Of the health center programs awarded, 38 grantees were Public Housing Primary Care (PHPC). Once again, congratulations are in order for your tireless efforts. See below for awarded grantees:
| Access Community Health | Chicago, Illinois | | Alta Med Health Services Corporation | Los Angeles, California | | Anthony L. Jordan Health Corporation | Rochester, New York | | Brooklyn Plaza Medical Center, Inc. | Brooklyn, New York | | Care Alliance | Cleveland, Ohio | | Columbus Neighborhood Health Center | Columbus, Ohio | | Communicare Health Centers, Inc. | Davis, California | | Community Health Center of Lubbock | Lubbock, Texas | | Community Health Centers of the Center Coast | Nipomo, California | | Consejo De Salud de Puerto Rico, Inc. | Ponce, Puerto Rico | | Cornell Scott Hill Health Corporation | New Haven, Connecticut | | Curtis V. Cooper Primary Health Center Inc., | Savannah, Georgia | | Edward M. Kennedy Community Health Center, Inc. | Worcester, Maine | | Elaine Ellis Center of Health | Cheltenham, Maryland | | Family Health Centers of San Diego, Inc. | San Diego, California | | Franklin Primary Health Center | Mobile, Alabama | | Grace Hill Health Centers, Inc. | Saint Louis, Missouri | | Heart of Texas Community Health Center, Inc | Waco, Texas | | Houston Area Community Services, Inc. | Houston, Texas | | Kokua Kalihi Valley Comprehensive Family Services | Honolulu, Hawaii | | La Maestra Family Clinic | San Diego, California | | Lifelong Medical Care | Berkeley, California | | Los Angeles Christian Health Centers | Los Angeles, California | | Macoupin County Public Health Department | Carlinville, Illionois | | Mobile County Health Department | Mobile, Alabama | | Montefiore Medical Center | Bronx, New York | | Neighborcare | Seattle, Washington | | North Central Texas Community Health Care | Wichita Falls, Texas | | Primary Care Health Services, Inc. | Pittsburg, PA | | Primary Health Services Center | Monroe, Louisiana | | Public Health Management Corporation | Philadelphia, Pennsylvania | | Quality of Life Health Services, Inc. | Gadsden, Alabama | | San Mateo County Health Services Agency | San Mateo, California | | Southern Illinois Healthcare Foundation | East Saint, Illinois | | The Brevard Health Alliance, Inc. | Melbourne, Florida | | The Floating Hospital | Long Island City, New York | | United Neighborhood Health Services | Nashville, Tennessee | | University of Pittsburgh | Pittsburgh, Pennsylvania |
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Treating Cervical Health Issues
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Source: National Library of Medicine
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Grantee Corner
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Feature: Access Community Health Network
ACCESS Community Health Network is a large health center program that provides care to about 200,000 patients in the Chicago-metro and surrounding areas.
There is a countless number of members within the network that reach special populations, such as public housing, and that provide unique services. Click here to get the full list of health center programs in the network.
ACCESS offers low-cost cancer screenings for women through the Stand Against Cancer (STAND) program. The services include breast and cervical screenings for Illinois residents who are uninsured or those who are below 200% of the federal poverty level. The program also helps women who are diagnosed with cancer get Medicaid coverage.
Contact ACCESS for more information about STAND or the Community Health Network:
ACCESS
222 N. Canal Street
Chicago, IL 60606
1-866-882-2237
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Cervical Cancer Screening Recommendations and Policy
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Updated Cervical Cancer Screening Recommendations
The United States Preventive Task Force (USPTF) has updated its cervical cancer screening recommendations for the first time since 2003. The recommendations updated in 2012 include more guidance on the appropriate age ranges and frequency of screening, including a new recommendation that women younger than age 21 years not be screened because the evidence shows no net benefit. The USPSTF now recommends screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years or, for women age 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years. Please visit the USPTF website for more information.
Free Health Program and Policy Resource
The Guide to Community Preventive Services (The Community Guide) is a free resource which provides evidence-based recommendations and findings to improve public health. Information contained in the Community Guide is systematically reviewed to determine which techniques work or do not work by health topic. For example, there is strong evidence that provider reminder systems help to increase screenings for breast, cervical and colorectal cancer. Another provider oriented way to increase cancer screenings is provider feedback and assessment. Additional suggestions on ways to prevent and control cancer as well as other health topics can be found at the Community Guide website.
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Policy Changes to the PCMH Standards and Guidelines
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National Committee of Quality Assurance (NCQA) updated the PCMH 2011 Standards and Guidelines by issuing PCMH 2011: Clarifications & Policy Changes on 11/16/2012. This is a bi-annual update and this document is meant to be used complementary to the PCMH 2011 Standards and Guidelines.
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Grant Application Tips
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Are you prepared to apply for funding opportunity announcements? HRSA has 10 tips to consider when applying for grants. One of those tips includes "Keep your audience in mind." Do not assume that grant reviewers are familiar with your organization or anticipated service area. Grant reviewers can only use the information contained in your application to assess the application. It is up to you to clearly present information regarding the capabilities of your organization and the health care needs in your community.
Below is a short example of how to present the health care needs of an area:
The City of Viola, Virginia has a population of 22,565, consisting of a non-White population of 38.6% according to the 2010 Census. Additionally, 23.5% of the City of Viola population is 0-19 years of age and 44% are between the ages of 20-49. Approximately 43% of children living in this city under age 18 are living below the Federal Poverty Line (FPL). According to 2012 County Health Rankings, residents of the City of Viola have a risk of premature death rate of 14,197 per 100,000 population. This is more than twice as much as the Virginia rate and nearly three times higher than the national benchmark. This possibly indicates that the City of Viola is a high risk area with a need for targeted resources.
The adult obesity rate in the City of Viola is 38%-10% higher than the Virginia state average and 13% higher than the national benchmark of 25%. This statistic may be due to the ratio of population to primary care physicians in the City of Viola. The ratio in the City of Viola is 1,324:1 which is higher than the state average of 1,034:1 and the national benchmark of 631:1. The measure represents the population per one provider (County Health Rankings, 2012). Primary care physicians include practicing physicians specializing in general practice medicine, family medicine, internal medicine, pediatrics, and obstetrics/gynecology. This statistic is important because having access to provider care requires not only financial coverage but also access to providers.
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The National Center for Health in Public Housing (NCHPH), a project of North American Management, is supported in part by a cooperative agreement grant awarded by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA).
This publication was made possible by grant number U30CS09734 from the Health Resources and Services Administration, Bureau of Primary Health Care and its contents are solely the responsibility of the authors and do not necessarily represent the official views of HRSA.
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Upcoming Events
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for a list of January webinars
January 20-19, 2013 Atlanta, GA
February 7-9, 2013 Kansas City, MO
4th Cancer Targets & Therapeutics ConferenceFebruary 25, 2013 Las Vegas, NV
March 9-12, 2013 Memphis, TN
May 7-10, 2013 San Diego, CA
June 4-6, 2013 Denver, CO |
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Health Observances
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January is also...
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