Small Investments In Health Care Yield Big Payoffs For Poor, Uninsured & Underserved
Health and Human Services Deputy Secretary Kevin L. Thurm today named five innovative local health programs "Models That Work" for providing better, lower cost health care for people with few options, and for a positive economic and social impact on communities.
The HHS Models That Work campaign--a public/private sector partnership that promotes replication of grassroots programs--identified the five projects in El Paso,Texas; Los Angeles, Calif.; Philadelphia, Pa.; Tampa, Fla.; and Monroe, Mich., for showcasing and replicating in other communities. The replication success of 1995 Models in East St. Louis, Ill., and Vista, Calif., were also featured.
"Models That Work offers good sense, big payoff solutions for communities wanting to improve health care services, save dollars and create jobs," Deputy Secretary Thurm said. "These programs exemplify the best in local problem solving to meet local needs--we want to multiply these successes."
Applying innovative solutions to tough problems, doctors, nurses and community health care workers are providing care in public housing, migrant farmworker camps and poor rural communities. Successes include fewer emergency room visits; higher childhood immunization rates; better informed and educated individuals, families and health care workers; help for homeless youth; and volunteer and paid jobs for community workers.
Some 41 million Americans--most of them in working families--have no health insurance. Additionally, cultural, geographic and language barriers block access to basic health care for many individuals and families. They postpone or forego needed care, miss time at work or school, and end up caught in a vicious cycle of poor health and lost productivity.
"These Models That Work break the cycle," said Ciro Sumaya, M.D., M.P.H.T.M., administrator of the Health Resources and Services Administration (HRSA), the HHS agency primarily responsible for putting health care services and professionals in underserved areas and sponsor of the Models That Work campaign.
"Built on the assumption that local health and economic problems are connected, Models That Work attacks both problems at once, and then helps replicate these programs elsewhere at minimal cost," Sumaya added.
More than 250 local programs competed in this year's Models That Work competition. The winners, selected for innovation, effectiveness, community involvement and replicability, are:
Tampa, Fla., Hillsborough County Health Care Plan: Has enrolled 27,000 poor and uninsured county residents in its own version of managed care. The plan has seen its members' hospital admissions drop 28 percent, hospital stays decrease 40 percent and per person health care cost plummet 61 percent. Hillsborough County estimates it has saved $6 million by diverting 8,000 emergency room visits to outpatient primary care.
El Paso, Texas, Project Vida: Provides primary health care, education and social services to poor, uninsured, predominately Hispanic people and families. Recruits patients to become volunteer or salaried community health workers. Project estimates it saves the local health system $150,000 annually in uncompensated and unnecessary emergency room visits.
Los Angeles, Calif., Los Angeles Free Clinic Hollywood Center: Reaches out to homeless youth with medical, dental, psychiatric, substance abuse and pregnancy care. Provides HIV testing, job training and placement. Relies on peer counselors to move troubled, vulnerable young people off the streets and into more stable living arrangements.
Philadelphia, Pa., Resources for Human Development: One of the first nurse-operated managed care programs in the state. Serves two public housing communities. Has dramatically increased child immunization rates, sharply decreased incidence of low birthweight, cut health care costs and created jobs for public housing residents.
Monroe, Mich., Camp Health Aide Program: Trains migrant and seasonal farmworkers as health aides to provide health education, first aid and other health and social services to their peers, and to train health care providers in cultural sensitivity. Encourages and assists aides to complete nursing or medical assistant training programs.
Two of the first Models That Work, chosen last year, shared their success in helping others: East St. Louis, Ill., East Side Health Care Coalition, has several replications in the works, the first in a Springfield, Ill., community of 23,000 with no other health care resources. Also honored was Vista, Calif., Fund for Moms, which offers low cost loans to cover the costs of prenatal care and has several replications in the works.
The Models That Work campaign pays travel and other expenses for project staff to teach others in similar circumstances how to provide basic health care and related social services to underserved communities. It also supports conference workshops that highlight these outstanding grassroots programs, a directory and on-line data base of model programs, and guidelines and technical assistance to spawn replications.
The program was developed at the HRSA Bureau of Primary Health Care. "This is part of our effort to be a 'catalyst' for new primary care delivery sites,' said Marilyn Gaston, M.D., assistant surgeon general and BPHC director. The benefits of innovative Models That Work may be felt among community and migrant health centers and health care programs for the homeless and residents of public housing, funded by HRSA in every state, the District of Columbia and Puerto Rico.
HRSA's major partners in Models That Work include the W.K. Kellogg Foundation, Pharmacia & Upjohn and the Robert Wood Johnson Foundation.
Within HHS, the Health Care Financing Administration and the Centers for Disease Control and Prevention co-sponsor MTW. The HRSA Maternal and Child Health Bureau and the Office of Rural Health Policy also co-sponsor the campaign.