091206 Community Health CenterCommunity Health Center
Update
September 12, 2006
Virginia Beach Health
Services Advisory Board
Glenn Snyders, MD
Chair, Virginia Beach Health
Services Advisory Board
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Objectives
Review Virginia Beach Health
•
Services Advisory Board Role
Define the problem of access
•
Describe current sources of
•
primary care and a proposed
Community Health Center
Project
Update efforts and
•
suggest next steps
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Virginia Beach Health Services
Advisory Board
Members
“To actively participate
•Glenn Snyders, MD –Chair
with community
•Vicky Gray, MPH
representatives in the
•Terry Jenkins, Ph.D.
formulation of a
•Buddy King
comprehensive plan for
•Frank Lane
the development,
•Suzanne Love, MD
coordination, and
•Charles McCallum, III
evaluation of local health
•Mary Redd Nelson
services systems, and to
•Susan Hellstrom
make formal
•Linda Reinersten
recommendations to City
•June Robertson, RN
Council and the Health
•Christopher Savvides
Department.”
•Joyce Schmidt, RN
•Helen Shropshire
VaBeachCity Council
•Linda Lilley, PhD
EnactedFebruary7, 1995
•Ronald Wyles, MD
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Access Partnership
•F
ormally established in 2002
•A nonprofit community collaboration of
diverse stakeholders who share a common
goal of improving access to health services
to the uninsured and underinsured
residents of Greater Hampton Roads.
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Virginia Beach Health Services
Advisory Board
•Identified access to basic health
services as top priority
•Reviewed Virginia Beach resources
for primary health care (Hampton
Roads Community Health
Assessment)
•Reviewed other community
approaches to addressing access to
care
•Worked collaboratively with Access
Partnership to connect with
community stakeholders
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9/13/2006
Background of problem of access to
healthcare
Hampton Roads Community Health
•
Assessment
2004 conducted by Stephen Horan, PhD of
–
Community Health Solutions, Inc,
–Estimated 1.3 million people over 800 square miles ,
mostly urban
–Chesapeake, Hampton, Newport News, Norfolk,
Poquoson, Portsmouth, Virginia Beach
–Utilized health data from state, city and regional
sources e.g. Health Dept, Vital Stats etc.
–Used data from Sentara hospitals emergency
department
–Survey of community health professionals
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9/13/2006
Virginia Beach Excerpts from this study
1.Access to Basic Health Services
54,075 Uninsured –24,857 Under 200% Fed Poverty Level
•
($38,500 for family of 4)–Highest # Uninsured in Hampton Roads
5,892 Seniors -Under 200% Fed Poverty Level –Medicare
•
Access Issue
Emergency Departments seeing patients that should be seen in
•
ambulatory settings
2.Access to Chronic Care
Rates for Heart Disease and Chronic Respiratory Disease > than
•
State Average
3.Access to Mental Health and Substance Abuse
Services, Access to Oral Health Services –
Issues
Consistent with Region
4.Access to Maternal and Infant Services
Good News –Lower than State Average Low Birth Weight
•
CurrentSources of Primary Health
Care in Virginia Beach
Beach Health Clinic
•
–Free care for qualified uninsured, 15,000 patient visits/year
–Primary care, specialty care, coordinated diagnostics,
–Multiple sources of operating funds –City of Virginia Beach, United
Way, individual donors
–LIMITATIONS:Do not serve Medicare, Medicaid or individuals
>200% poverty
Local Emergency Rooms
•
–Care for anyone
–May provide referral to community services for follow up care.
–LIMITATIONS:Long waits for primary care with negative impact
on emergent/trauma patients & system
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CurrentSources of Primary Health
Care in Virginia Beach
Virginia Beach Public Health Department
•
Services for targeted populations: Prenatal Ob care,
gynecological services, childrens’preventative and
dental care, immunizations
–LIMITATIONS: acute care, primary care for non-
targeted populations
Private Primary Care Offices
•
–Provide charity care for selected patient population
–LIMITATIONS: majority not accepting new Medicaid
or Medicare patients
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FutureSources of Primary Health
Care in Virginia Beach
Community Health Center
•
–Local, non-profit, community-run primary care
–Serve all population including low income and
medically underserved, Medicare and Medicaid
–Affordable primary care at reduced rates
–Funded by federal grants, local grants and individual
contributions
–Paid administrative staff and medical staff
–Located in areas where care is needed but scarce
–Costs of care rank among the lowest with best quality
–Currently, over 1,000 community, migrant and
homeless health centers serve 3,600 urban and rural
communities in every state and territory.
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9/13/2006
Virginia Beach Health Services
Advisory Board
May 2005
•
–Voted to endorse feasibility study and
pursuit of Federally Funded
Community Health Center in Virginia
Beach
Goal
•:
–to improve access to primary care for
all residents –uninsured, Medicare,
.
Medicaid and privately insured
June 2005
•
–Presented to City Council & received
support to move forward.
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9/13/2006
CHC Project Summary
Steering Committee formed
•
Representatives:
•
–Virginia Beach Health Advisory Board, Virginia Beach
Department of Public Health, Access Partnership, United
Way of South Hampton Roads, Sentara Healthcare,
Samaritan House, Sentara Medical Group, VPCA and
community residents.
Goals
•
–Community collaboration
–Secure funding for feasibility study and grant writing
–interview candidates to manage a feasibility study and project
coordination.
–Interview and researched grant writers to facilitate the grant
proposal process.
–Prepare a complete grant for HRSA December 1 application
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9/13/2006
CHC Project Summary
Planning Committee Formed
•
–Roundtable Discussion held July 2005 VB Central Library.
–Over 100 community members invited. Nearly 50 people attended
and offered their support.
–Subcommittees formed to support process and participate in the
project to develop plan for the grant.
Committee Members
•
–Access Partnership, Beach Health Clinic, Bon Secours, CINCH,
EVMS, Interfaith Advisory Board, JCOC, Minority Health Coalition,
NSU, ODU, Operation Blessing, PICH, Portsmouth Community
Health Center, Samaritan House, Senior Services, Sentara
Healthcare, The Planning Council, TCC, United Way, Virginia
Beach Department of Public Health, residents and other
community leaders.
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Planning Begins
Federal Grant Requirements Reviewed
–Grant opportunity announced by HRSA (Health Resources
and Services Administration).
–Grant application due December 1, 2005
Cost of Project
–Project Coordination -$12,000
–Grant Writer -$42,000
–Administrative cost -$10,000
–Total $65,000
Funding Commitments
–City of Virginia Beach $10,000
–Sentara Health Foundation $15,000
–United Way of SHR $40,000
–Total $65,000
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9/13/2006
CHC Planning
Needs Assessment & Grant Development Services
•
J. Sarkiss& Associates of Birmingham, Alabama
Project Management
•
The Planning Council, VPCA and Access
Partnership
Planning Subcommittees
•
–Site Selection
–Community Outreach
–Business Planning
–Health Service Planning
Steering & Planning Committees
•
Met on regular basis to discuss project, edit grant, share
information and data and identify community needs.
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9/13/2006
Unexpected Changes
November 2005
Federal funding changes due to
greater demand for federal
assistance related to hurricane
Katrina, notified there would be no
RFP (request for proposals) for new
Community Health Center sites.
Application is as complete as
possible without final RFP
instructions
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9/13/2006
Other Options Explored
The Virginia Beach Health Advisory Board and Access
Partnership continue to identify timely & economical
solutions to increase access to care
Options Explored:
1.Invite an existing CHC to expand services to Virginia
Beach
2.Start as a CHC Look-Alike
3.Start a family medical practice with an existing medical
group to serve medically underserved
4.Do nothing
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9/13/2006
Expansion Option Selected
Health Advisory Board, Steering committee and
Planning committee agree:
Expansion of a current CHC site is most comprehensive and
cost-effective option
•Brings all existing services and resources to Virginia
Beach without a “learning curve”
•Most likely avenue for future federal funding
Sentara Health Foundation Provides Grant
•$300,000 start-up funding grant announced in April 2006
•Request for Proposals publicized (newspaper, letters of
invitation )
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9/13/2006
After review of RFPs, the Steering
Committee recommends:
The Peninsula Institute for Community Health
•Established in 1978
•JCAHO Accredited
•24,000 unduplicated visits in 2005
•3 primary care sites in Newport News and Suffolk
•Healthcare for the Homeless
•Dental Services
•Pharmacy Care of Hampton Roads (central-fill pharmacy)
•Community Access to Care (program for uninsured to
access diagnostic and specialty services)
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9/13/2006
NEXT STEPS
Facility to open January 2007
Steering Committee
will serve as Advisory Committee
Planning Committee
divided into work groups:
Site Selection
•
Building Renovations
•
Moving & Setup
•
Supplies & Equipment
•
Marketing & Promotion
•
Search for site underway –
must be in or near MUA
(medically underserved area) and be a minimum of 2,000
square feet with ability to expand.
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9/13/2006
QUESTIONS ??
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