March 2000

Grant Results

National Program

Practice Sights: State Primary Care Development Strategies

SUMMARY

From 1993 to 1995, the Texas Department of Health established the Texas Community Oriented Primary Care Practice Sights Initiative to build upon the state's primary health care program that funds selected sites that are providing primary and preventive care to low-income uninsured persons.

Project staff developed new models of collaborative practice at the local level, utilizing teams including both physicians and mid-level practitioners to meet the needs of underserved populations.

The project was part of the Robert Wood Johnson Foundation (RWJF) Practice Sights: State Primary Care Development Strategies national program.

Key Results

  • Project staff upgraded its needs-assessment process to include physician assistants and provided technical assistance to underserved communities.
  • The first effort at community-based models produced plans for a 30,000-square foot primary care clinic in McAllen, in the Rio Grande Valley region.
  • The Department of Obstetrics and Gynecology at Texas A&M University School of Medicine trained family practice physicians at a community health center in San Antonio to perform normal deliveries, increasing the capacity of the center's prenatal care program.
  • The Texas Community Oriented Primary Care Practice Sights Initiative co-sponsored a statewide conference, "Community-Oriented Primary Care: A Vision for Health," attended by 230 health care professionals, policy-makers and community representatives.

Funding
RWJF supported this project through a grant of $100,000.

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THE PROBLEM

Of Texas' 205 rural or frontier counties, 57 have no hospital, and 34 of those have fewer than three physicians and no mid-level practitioners. Another 62 rural and frontier counties have 50 or fewer hospital beds. Some 171 counties lie fully within designated Medically Underserved Areas. Only 18 percent of physician assistants and 8 percent of nurse practitioners in primary care specialties practice in rural areas.

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THE PROJECT

The Texas Community Oriented Primary Care Practice Sights Initiative (COPC) built upon the state's primary health care program that funds selected sites that are providing primary and preventive care to low-income uninsured persons. The initiative had four main objectives:

  1. Upgrading the state's meeds-assessment process to include mid-level providers, encourage community-oriented self-assessment, and design specific intervention strategies.
  2. Coordinating existing technical assistance efforts directed at provider recruitment and retention and local development of primary care capacity.
  3. Developing and funding new models of collaborative practice at the local level, utilizing teams including both physicians and mid-level practitioners to meet the needs of underserved populations.
  4. Developing a coordinated projects' list of program activities for future phases of the project.

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RESULTS

  • Using grant funds, the Texas Academy of Physician Assistants completed a membership survey that provided information on the location and scope of practice of physician assistants.
  • The first effort at community-based models produced plans for a 30,000-square foot primary care clinic in McAllen, in the Rio Grande Valley region. The clinic, when completed, will serve unincorporated residential areas surrounding the city, many of which lacked water and wastewater service. The site will offer acute care; health education; youth programs; child protective services; and a women, infants, and children nutritional program.
  • The Department of Obstetrics and Gynecology at Texas A&M University School of Medicine trained family practice physicians at a community health center in San Antonio to perform normal deliveries, increasing the capacity of the center's prenatal care program.
  • COPC cosponsored a statewide conference, "Community-Oriented Primary Care: A Vision for Health," was attended by 230 health care professionals, policymakers, and community representatives. Presentation topics included community asset mapping, population-based health care, measurement of health outcomes, health professions training, health system reform, and managed care.

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AFTER THE GRANT

While the community-oriented primary care approach was seen as innovative and appropriate for Texas, the state's plans and progress on recruitment and retention were not sufficient to justify continued RWJF funding. The initiative was taken over by the Bureau of Community-Oriented Primary Care in the state Department of Health, which continued to provide technical assistance to underserved communities.

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GRANT DETAILS & CONTACT INFORMATION

Project

Texas Practice Sights

Grantee

Texas Department of Health (Austin,  TX)

  • Amount: $ 100,000
    Dates: May 1993 to February 1995
    ID#:  022281

Contact

Beverly  L. Koops, M.D.
(512) 458-7321

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Report prepared by: Robert Narus
Reviewed by: Molly McKaughan
Reviewed by: Marian Bass
Program Officer: Michael Beachler

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