Category Archives: Community-based care
For nearly 25 years, Robert Wood Johnson Foundation Community Health Leader Carmen Velásquez, MA, has helped members of Chicago’s immigrant community access the health care they need. She founded the Alivio Medical Center in 1988, which has now grown to six locations that serve 25,000 patients annually. Two more clinics are slated to open later this year.
In recognition of her work, Illinois Governor Pat Quinn proclaimed October 2, 2013 “Carmen Velásquez Day.” At an event celebrating Latino Heritage Month at the National Museum of Mexican Art in Chicago, Quinn called Velásquez “a true pioneer in public health policy and health care affordability.”
“As the immigrant population in the Pilsen neighborhood grew in the 1980s, Carmen Velásquez was among the first to see the crying need for a health clinic, so she went out and built Alivio Medical Center,” he said. “Hundreds of thousands of Illinoisans are alive today thanks to her, proving that one person truly can make a difference.”
Zane Gates, MD, is a Robert Wood Johnson Foundation (RWJF) Community Health Leader and medical director of Altoona Regional Partnering for Health Services in Altoona, Pennsylvania. Gates and Patrick Reilly, president of Impact Health Solutions, founded the Empower3 Center for Health program, which is the model for a new health care law in Pennsylvania.
The Commonwealth of Pennsylvania has recently adopted a law to fund community-based clinics that can demonstrate real impact to the community with regard to increased access, reduced costs, lower emergency room (ER) visits, and improved behavioral health outcomes for the low-income working uninsured. It is modeled on community-based clinics featuring a unique structure that I created along with Patrick Reilly, an insurance consultant from western New York:— Empower3 Center for Health program.
The model we created features an “insurance-less” office concept that allows patients to come in as frequently as needed without worrying about being billed or having any balances to pay. The program has no co-pays, deductibles or balance billing when the patients use the participating community hospital that partners with the program. Since there is no billing at the point of service, there is more face time with the medical professionals to spend creating a true relationship that focuses on care and provides dignity to the patients seeking quality medical care. The office is open five days a week to provide access to patients as needed.
Richard Rieselbach, MD, is an alumnus of the Robert Wood Johnson Foundation Health Policy Fellows program and a professor emeritus and health policy consultant for the University of Wisconsin Medical Foundation.
In the last decade, the nation’s community health centers (CHCs) have doubled their capacity. They now provide care for more than 22 million underserved children and adults in every state. But they’re going to need to do it again. By 2019, some 40 million patients will be in need of care.
The United States does not have enough primary care providers to serve these new patients, and our public investment in health professions education—graduate medical education (GME)—is failing to produce the pipeline we need. Medical students are choosing specialties over primary care at an alarming rate, and a policy vacuum keeps the GME program from being held accountable.
An initiative was launched in 2011 that I think holds great promise: the Teaching Health Center Graduate Medical Education initiative. This five-year, $230 million program was funded by the Affordable Care Act and created to increase the number of primary care graduates trained in community settings.
My colleagues and I have proposed a modified and expanded version of this initiative, called “CHAMP” Teaching Health Centers (CHAMP THCs). Our teaching model would pair CHCs with academic medical centers to develop a THC track that would encourage students to graduate in primary care and practice in urban and rural underserved areas.
Anneleen Severynen, RN, MN, PHN, is a public health nurse working on the South King County Mobile Medical Unit for Public Health Seattle and King County in Washington State.
I work as a public health nurse on King County’s mobile medical unit, traveling south of Seattle in a van, providing for the health care needs of homeless individuals. I perform many “nursing” tasks in my job – taking blood pressures, getting health histories, dressing wounds. But my most important nursing skill is my ability to listen.
This morning I met Charlie. Charlie is a 60-year-old Native American man who reported that he began drinking at age 12, while being passed around to various foster families.
At 17, he went to Vietnam to get away from abuse and neglect, only to be traumatized further by the war.
He called himself a “lost cause” and said he would probably never stop drinking, and knows that he “will die soon.” As I sat silently, I listened to him grieve the loss of his culture and detail the many kinds of discrimination he has suffered. Though he spoke with the slurred speech of a chronic alcoholic, his eloquence moved me. I noticed tears in his eyes as he described a few happy childhood memories with his father—memories not quite lost to him.
This is part of the May 2013 issue of Sharing Nursing's Knowledge.
“National Nurses Week gives us a chance to recognize the contribution of the health care providers at the heart of our health care system. Every day, nurses provide leadership, innovation and advocacy to meet the health care needs of Americans… The health care law’s emphasis on keeping people healthy, preventing illness, and managing chronic conditions, opens new opportunities for nurses to shape and lead the future delivery of healthcare and capitalizes on the expertise of the nursing profession… Please join me in thanking our nation’s nurses for the critical work they do in bringing better care and better health to all Americans.”
-- Health & Human Services Secretary Kathleen Sebelius, HHS Secretary Kathleen Sebelius on National Nurses Week, HHS.gov, May 6, 2013
“There are just over 180,000 APRNs [Advanced Practice Registered Nurses] in the United States, most of them in primary and long-term care ... extensive research finds they are able to handle 80 percent to 90 percent of primary care cases — and achieve outstanding results. APRNs can handle the vast majority of primary and preventive care needs and leave the more complex cases to physicians. This is a win-win situation, that frees nurses and physicians to spend more time with the patients who need them most. Utilizing APRNs provides the fastest and most cost-effective strategy for meeting the health and health care needs of millions more Americans … Millions of Americans need help maintaining healthy lives or managing chronic conditions. Millions of older people need care in their homes. And millions of soon-to-be-insured patients need a health care provider with the time and training to listen, diagnose and educate. Unleashing the skills of nurse practitioners will improve health care. It is the right thing to do and it is the right time to act.”
-- Sheila Burke, Malcolm Wiener Center for Social Policy, Harvard University, and Future of Nursing: Campaign for Action strategic advisory committee (SAC); and Bill Novelli, McDonough School of Business, Georgetown University, and Future of Nursing: Campaign for Action SAC, Advanced Nurses Lower Costs, Improve Care, Politico, May 6, 2013
Gabriel Rincon, DDS, is the founding executive director of Mixteca Organization, Inc., in Brooklyn, N.Y., which provides a broad scope of health and education programs, including literacy and computer classes, English-language courses, and afterschool programs, to thousands of Hispanic New Yorkers each year. He is also a 2011 recipient of a Robert Wood Johnson Foundation (RWJF) Community Health Leader Award. The Human Capital Blog asked Rincon to reflect on his experience as an RWJF Community Health Leader.
Human Capital Blog: How did you come to found the Mixteca Organization?
Gabriel Rincon: In the 1990s distribution of information about AIDS was on the rise in developed nations such as the United States, but in immigrant communities—particularly Hispanic ones—levels of HIV/AIDS infection and general ignorance of the disease was still high. The City of New York was one of the locations with the highest number of Hispanics infected with HIV/AIDS. In 1991, I witnessed the lack of information available in Spanish. I decided in 1992 to take action by designing a slide presentation and organizing talks about HIV/AIDS, signs and symptoms its risks, forms of prevention, and treatments. With the use of a portable projector and informational pamphlets, I made presentations in factories, churches, houses and community centers, and on radio and TV. In 2000, together with other community members, my work was formalized; Mixteca Organization, Inc., obtained its official status as a non-governmental, non-profit community based organization.
Ten individuals who have overcome significant challenges to help improve health and health care in their communities will be named 2012 Robert Wood Johnson Foundation (RWJF) Community Health Leaders at an awards ceremony in San Antonio.
These remarkable individuals are providing vital health services to residents in their communities, from Anchorage, Alaska to Charleston, South Carolina, and in cities and towns in between. They are helping: refugees grappling with the after-effects of war; low-income workers without insurance; children facing obesity; survivors of sexual violence; senior citizens who live in remote, rural areas; and substance abusers at risk for overdose.
The 2012 Community Health Leaders Award recipients are:
- Kay Branch, MA, elder/rural health program coordinator, Alaska Native Tribal Health Consortium, Anchorage, Alaska;
- Fred Brason, CEO of Project Lazarus and Project Director of the Community Care Network Statewide Chronic Pain Initiative, Wilkes County, N.C.;
- Debbie Chatman Bryant, DNP, RN; assistant director for cancer prevention, control, and outreach, Hollings Cancer Center at the Medical University of South Carolina, Charleston, S.C.;
- Beth Farmer, MSW, international counseling and community services program director, Pathways to Wellness Project, Lutheran Community Services Northwest, Seattle;
- Amy Johnson, JD, executive director, Arkansas Access to Justice Commission, Little Rock, Ark.;
- Ifeanyi Anne Nwabukwu, RN, BSN, chief executive officer, African Women’s Cancer Awareness Association (AWCAA), Silver Spring, Md.;
- Cristina Perez, MA, director of community outreach and counselor, Women Organized Against Rape, Philadelphia;
- Marlom Portillo, executive director, Instituto de Educacion Popular del Sur de California (IDEPSCA), Los Angeles;
- Darleen Reveille, RN, senior public health nurse, Garfield, N.J.; and
- Kathi Toepel, director of senior services for the Mother Lode Office of Catholic Charities – Diocese of Stockton, Sonora, Calif.
This is part of a series introducing programs in the Robert Wood Johnson Foundation (RWJF) Human Capital Portfolio.
Each year, the Robert Wood Johnson Foundation Community Health Leaders Award honors 10 of America’s best―unsung heroes who have forged their own solutions to the shortcomings and challenges facing our nation’s health care system.
On Wednesday, RWJF will announce its selection of the 2012 Community Health Leaders, who have surmounted significant challenges to improve health and health care in their communities.
Community Health Leaders see unmet health needs in their neighborhoods and communities, and they move tirelessly to fill those gaps. They have taken matters into their own hands and accomplished what others may have believed was impossible. And often, they have overcome daunting personal obstacles in their quest to serve others.
Community Health Leaders are nurses, physicians, dentists, pharmacists, clergy, attorneys and judges, school officials, activists and advocates. The problems they tackle are varied and complex: promoting statewide policies to improve and expand access to health care services, providing HIV/AIDS education and breast cancer detection, helping low-income people control their children’s asthma, establishing accessible health centers and clinics, and much more.
Now in its 19th year, the Community Health Leaders Award raises awareness of the leaders’ extraordinary contributions through a $125,000 award, national visibility, and networking opportunities. RWJF has honored more than 200 outstanding Community Health Leaders from nearly all 50 states, the District of Columbia, and Puerto Rico.
In the coming weeks, the RWJF Human Capital Blog will hear from the 2011 Community Health Leaders about what they’ve experienced during their first year as Leaders.
For details on how to submit a nomination, including eligibility requirements and selection criteria, visit www.communityhealthleaders.org.
This year, the National Diaper Bank Network is recognizing the week of September 10-17 as National Diaper Need Awareness Week, and local diaper banks across the country have asked their state and local officials to do the same. But more than merely declaring a week, we are acknowledging that the country is becoming more and more aware of the fact that diapers are a basic need for infants, toddlers, and those who suffer from incontinence, and that more people are willing to do something about it.
We have come very far in bringing attention to diaper need in the eight years since I began this journey in 2004. When I started The Diaper Bank in New Haven, CT there were very few diaper banks in America, so I looked to the example of the Diaper Bank of Southern Arizona, the nation’s first diaper bank. That program began in 1994 when a small consulting firm in Tucson, Arizona held a diaper drive during the holiday season to assist a local crisis nursery. Encouraged by the enthusiastic response, and seeing the great need in their community, the firm made the December Diaper Drive an annual tradition, and within five years they were collecting 300,000 diapers each December, benefiting families at 30 local social service agencies. In 2000, the diaper drive effort was spun off into an independent non-profit organization, the Diaper Bank of Southern Arizona, which continues to provide desperately needed diapers to the people of southern Arizona.
The Diaper Bank of Southern Arizona served as my inspiration in 2004 when I decided to start a diaper bank. Through my work with families in need New Haven, I learned that many of the hygiene products I took for granted, such as toilet paper, toothpaste, and diapers, were not available to people who had only food stamps to buy their groceries. The need for diapers, which are so critical for a baby’s health and comfort, was particularly acute. I started small, working out of my living room, but in a few years time, with the help of many others, what started as The New Haven Diaper Bank (now, The Diaper Bank) has grown into the nation’s largest diaper bank, distributing over 14 million diapers since its inception.
Human Capital News Roundup: Rising Medicare expenses, community-based health care, breast cancer prevention and more.
Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program site director Ana Diez Roux, MD, PhD, MPH, and RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) co-investigator Christopher Ruhm, PhD, were cited in a Bloomberg column by former Office of Management and Budget director Peter Orszag. The research of both investigators shows, counter-intuitively, that life expectancy rises during periods of economic downturn.
Dawn Alley, PhD, an alumna of the Health & Society Scholars program, is the lead author of a study that finds that obesity—and the chronic conditions that often come with it—are a major contributor to the growth in Medicare expenses. Each obese beneficiary adds an additional $149 a year to Medicare, Reuters reports.
An assessment tool used by the federal government to determine if a community health center is functioning as a “patient-centered medical home” may not accurately reflect the quality of the diabetes care the health center provides, according to a study led by RWJF Clinical Scholar Robin Clarke, MD. The researchers found no significant relationship between passing the assessment and the quality of diabetes care provided, Cardiovascular Business reports. Health Canal also reported on the findings.