Blog Archives
By Katherine Susman | Categories: | Comments Off on Caught in the Crossfire
In 1993, Sherman Spears, a paraplegic former gunshot victim working at local CBO Youth ALIVE!, began visiting young gunshot wound (GSW) victims at the Oakland hospital where he had been treated. This became Caught in the Crossfire, the first hospital-based violence intervention program – now a national model.
The program serves youth and adult survivors of intentional injury (gunshot, stab wound, and physical assault) with immediate response upon hospital treatment in the golden moment when the patient is open to long-term support. Continuing post-discharge for 6-12 months, trained intervention specialists from the peer community of the patients will provide case management, mentoring, linkage to mental health and services, safety assessment/retaliation prevention, and other services in the field/community in order to prevent retaliation and reinjury and to promote physical, social, and emotional healing from trauma.
This program coordinates with hospital Administration, Social Services, and Trauma to access patient records, coordinate hospital access to visit patients, and to communicate about follow-up care. Community partners include Youth ALIVE!, Eden Medical Center, Children’s Hospital Oakland, Alameda County Emergency Medical Services, and the City of Oakland.
Program measures include positive outcomes such as attachment to mental health services, education/employment and housing, and reduction in negative outcomes such as arrests and injury recidivism. Without intervention, nationally, up to 44% of patients recidivate within 5 years. In the program, it is less than 3%.
By Katherine Susman | Categories: | Comments Off on ARMC’s Breathmobile
Because asthma is one of the leading causes of school absenteeism as well as the number one reason children go to the emergency room, Arrowhead Regional Medical Center (ARMC) and the County of San Bernardino, in association with the Asthma and Allergy Foundation, have implemented a unique approach to pediatric asthma management by establishing the Breathmobile® program that provides care via an “asthma clinic on wheels. The Breathmobile ® provides coordinated case identification, structured mobile office visits, diagnostic testing, physical exams, pharmacological therapy and patient/family education in asthma management. All services are provided at no cost to the patient.
The goals of the program are to deploy two Breathmobiles to provide free asthma and asthma related care to surrounding, underserved schoolchildren who are otherwise unable to receive this type of care.
The Breathmobile® travels to 40 different school sites throughout the County of San Bernardino, rotating to each site every six weeks. During the school hours the Breathmobile® staff sees patients that attend the school site as well as any child referred from the surrounding area. A complete evaluation, examination, care plan and extensive patient family education are completed at the time of the visit. Follow-up visits require a shorter time span than the initial evaluation. The average visit requires less than 30 minutes of the child’s day. Providing care at a familiar, convenient site, often within walking distance for parents without transportation, has greatly improved patient participation and compliance with follow-up care.
The Breathmobile® staff consists of a pediatric specialty practitioner, a licensed vocational nurse and a respiratory therapist who are specially trained in asthma case management. The Breathmobile® team, in collaboration with school nurses and health aides, facilitates initial identification of patients. Ongoing communication with the school nurses and health aides help the patients remain compliant with their asthma management program.
The Breathmobile® healthcare model has proven to be very successful in overcoming the complex social and economic barriers that can prevent successful chronic disease management in children in lower socio-economic areas. Seventy-five percent of the children participating in this program have their asthma symptoms under control by the third follow-up visit, regardless of the severity of their illness. Evaluation studies have demonstrated decreased school absenteeism, fewer emergency room visits, improved pulmonary function and exercise tolerance, and an overall improved quality of life.
Funding for this program is provided by Arrowhead Regional Medical Center with additional financial support from ARMC’s Foundation.
By Katherine Susman | Categories: | Comments Off on Harbor Place
Champlain Housing Trust (CHT) created Harbor Place, a motel that provides temporary housing and wrap-around case management services to adults, in the Fall of 2013 to address a significant increase in homelessness in Vermont and to establish a more sensible approach to addressing a housing crisis. CHT had two main goals in mind when developing Harbor Place: reduce the cost of emergency housing and get better outcomes for people in crisis. Realizing that people who are inadequately housed require significant health care resources, The UVM Medical Center provided funding to Harbor Place so that patients experiencing homelessness would have somewhere to go upon their discharge from the hospital.
The UVM Medical Center’s Case Management & Social Work department purchases bed nights at Harbor place so patients can be discharged there when they leave the hospital. The Community Health Centers of Burlington provide medical and onsite case management services, as does Howard Center. The Champlain Valley Office of Economic Opportunity provides management of the case management at Harbor Place and provides direct support staffing. Other community partners and support include:
Vermont Agency of Human Services/DCF: The State’s DCF administers the program that funds motel vouchers and agreed to a long-term contract guaranteeing 30 out of 55 rooms at Harbor Place. The State also helped fund an operating reserve.
Fanny Allen Foundation: contributed a $25,000 grant towards an operating reserve.
Vermont Community Loan Fund: made a $1.7 million loan to finance the purchase of the motel.
Vermont Housing & Conservation Board: provided $265,000 for the acquisition and rehabilitation of the property.
United Way of Northwest Vermont: provided $50,000 in funding towards the operating reserve.
Howard Center: provides onsite mental health and substance abuse counseling services to residents of Harbor Place.
Women Helping Battered Women: provides onsite support and counseling .
Community Health Centers of Burlington: provides case management and medical services.
Champlain Valley Office of Economic Opportunity: provides overall management of the case management at Harbor Place, as well as providing direct support staffing.
Since Harbor Place’s program inception in 2013, the Medical Center has paid for a total of 1,720 nights for 153 patients through 2016 (approximately $51,600). To measure Harbor Place’s impact on patient cost of care, UVM compared utilization and direct costs for a group of 147 patients, both three months prior to and three months after their stay at Harbor Place. The evaluation included inpatient and emergency department encounters. For this group, there was a 73% reduction in direct cost in the three months following their stay at Harbor Place compared to the three months prior.
By Katherine Susman | Categories: | Comments Off on TECH/TEACH
The TECH and TEACH programs at Broadlawns Medical Center were developed to provide education, training and awareness for career opportunities that exist in health care. Specifically, the TECH and TEACH programs identify candidates who are at-risk or from the underserved neighboring communities. TECH and TEACH are paid training and education programs, and participants complete the program having earned a CNA degree.
TECH and TEACH are programs for Training and Educating for a Career in Healthcare. TECH is geared for high school students, and TEACH is geared for adults. Both programs provide mentoring, professional development and training for healthcare positions ie: technicians, phlebotomists and patient access representatives. By drawing participants from underserved, neighboring communities, Broadlawns is committed to educating and employing the individuals from the neighborhoods that have the highest concentrations of unemployment and poverty.
The TECH and TEACH programs are a product of cross-department work, including administration, human resources, marketing, the hospital foundation, community outreach, physicians, and nursing staff. Broadlawns has also involved numerous external organizations in the development of the TECH and TEACH programs. Urban Dreams and iJAG have assisted greatly in identifying candidates for participation in the program. United Way of Central Iowa has provided some financial support for the TEACH initiative. Other community partners include Signature Healthcare, Des Moines Public Schools, Wesley Life, Creative Visions, Evelyn K. Davis Center, the Department of Human Services, and the Polk County Health Department.
The first group of TECH students completed their training in April 2017. Seven of the ten TECH high school students were hired by Broadlawns upon completion of the training program.
By Katherine Susman | Categories: | Comments Off on Pathways to Housing Program
JPS Health Network in Ft. Worth, Texas, partners with the Salvation Army for the Tarrant County Pathways to Housing program. The program supports medically vulnerable homeless patients by providing permanent housing rental assistance, long-term comprehensive case management, with medical and supportive services in scattered site apartments within Tarrant County. Eligible patients are high utilizers of local emergency rooms who are experiencing homelessness, medical and behavioral health challenges. Care Connections for the Homeless team provides outreach based medical care and medical case management. This medical team works in collaboration with The Salvation Army housing case managers to identify and engage program participants. Amerigroup, as the largest provider of Medicaid services in the Tarrant County area, also serves as a partner in the project to augment behavioral health supportive services and care coordination for clients.
By Madeline White | Categories: | Comments Off on Social Needs Screening and Interventions
The Promotora and African American Health Conductor programs were initially birthed at our Bay Point Family Health Center in 2002 and 2005. The initial goal of these programs was to create more effective cultural bridges between Contra Costa Health Services, a county-run health system, and the Latino and African American communities through the utilization of indigenous community representatives in order to assist the populations in better utilizing and navigating the Contra Costa Health Services system of care. The core functions of these two programs included: assisting patients with health navigation, community health education, assisting with group medical visits and conducting community outreach. In July 2016 through a collaboration with Health Leads (a nationally recognized resource linkage organization) some of these staff were trained on the Health Leads REACH tool – a very sophisticated resource linkage software tool which allowed these staff to screen patients for social needs, input patient demographic data, link patients to appropriate resources and agencies, track actions and follow up on each patient assisted, and measure impact.
Contra Costa Health Services partners with a community non -profit, the Center for Human Development to employ and oversee these staff. However, the staff receive direct supervision from two Health Services staff. The contract with the non-profit is primarily funded through the Health Services budget with supplementation from Medicaid revenue generated by the staff, as well as occasional grants. The two programs are housed in five of the 11 Contra Costa Health Services health centers. They work closely with health center administrative leadership, with medical providers, with our Health Leads advocate partners and with many community based organizations.
From July 11, 2016 – April 14, 2017, The West County Health Center Health Leads pilot program has served over 750 patients with a 86-91% linkage connection success rate – according to Health leads one of the highest in the country. The Promotoras and Health Conductors have assisted over 2,000 households with health navigation, and conducted over 7,791 community outreach encounters.
By Madeline White | Categories: | Comments Off on Mobile Palliative Care Homeless Outreach Program
Harborview Medical Center joined with the Seattle/King County Health Care for the Homeless Network to pilot the Mobile Palliative Care Homeless Outreach Program beginning in 2014, to address the needs of homeless people with life-limiting illnesses. The program’s primary goals are: 1) provide end-of-life care and pain management to a population that is poorly served by traditional palliative care programs; 2) empower people who are homeless by giving them more control to make decisions about life management and dying as their illness progresses; 3) prevent unnecessary emergency department visits and prolonged hospital admissions; and 4) eliminate barriers to accessing healthcare by traveling to patients and meeting them on the streets, in shelters, at meal programs or wherever they are living.
By Madeline White | Categories: | Comments Off on Road to Better Health
The Road to Better Health Coalition (RTBH) was formed in 2008 following a community health assessment that identified serious needs in the areas of teen pregnancy, access to care, obesity and other health-related issues. It also confirmed that the community faced significant health disparities related to race, income and education. Leaders took action and formed RTBH, a coalition of over 70 partners and stakeholders, to identify health priorities for Spartanburg County and improve health outcomes through data-driven decision-making. The current priority areas are access to care, adult oral health, behavioral health, birth outcomes, health equity, obesity prevention and tobacco cessation.
The RTBH Coalition is guided by an Advisory Board that includes key leaders from 18 organizations. The Advisory Board provides leadership and strategic input on the operations and activities of RTBH and serves as the collective decision-making body. RTBH taskforces have been formed to establish goals and monitor progress across each of the priority areas. The hospital and participating organizations leverage partnerships and resources and equally share the expenses of the coalition. Although the RTBH focuses on all residents of Spartanburg County, particular emphasis is placed on disparate populations.
The RTBH Coalition strives to connect and mobilize partners who are working to improve local health outcomes. The hospital along with representatives from academia, non-profits, government, philanthropy, and the business community offer their skills, expertise, and resources to the coalition and are committed to bringing about positive change as engaged members of RTBH taskforces and initiatives.
RTBH stakeholders come together every three years to review and prioritize the critical health issues identified in the Spartanburg Community Indicators Public Health Report. They also convene annually to assess progress toward collective goals. The following initiatives serve as select examples of successful efforts to address community health concerns and reduce healthcare costs.
- AccessHealth Spartanburg (AHS) connects uninsured residents to a network of donated care, a medical home, and other services including behavioral health care. The success of AHS has contributed to the decrease in charity costs at Spartanburg Medical Center from $116 million (2008) to $64 million (2016). For every $1.00 invested in AHS, there is $12.62 returned in benefits.
- Collaborative efforts among local institutions and multiple community partners have led to a remarkable reduction in teen birth rates. The overall teen birth rate for 15-19 year olds in Spartanburg County decreased by 50% from 2010 – 2016. The most substantial decline occurred among African American females; decreasing by 68% from 2010 to 2016.
- Spartanburg County’s County Health Ranking improved from 21st in 2010, to 18th in 2014, to 14th in 2017.
