Eleventh Annual Monroe E. Trout Premier Cares Award

Descriptions and contact information for award recipient, finalists and semi-finalists

Compiled January 2003

Award recipient

Project Access

Buncombe County Medical Society, Asheville, NC

An initiative of the Buncombe County Medical Society, Project Access provides the full continuum of healthcare to all uninsured county residents with incomes below 200 percent of federal poverty level. More than 500 local physicians in private practice donate their services to the program. Project Access patients receive primary and specialty care, as well as radiology and lab services, free of charge. All hospital services are donated by Mission St. Joseph’s Health System and Community CarePartners (both Premier member organizations); to discourage inappropriate use of the emergency department, ED visits are not covered unless they result in hospital admission. County government provides funding for administrative expenses and medications, and community pharmacies donate dispensing and counseling services. A co-payment of $4 per prescription is waived for those unable to afford it. Patients also have access to transportation if needed.

Among patients enrolled in the program, ED utilization has declined from 28 percent to 8 percent, while total hospital charity care is down 23 percent. The reduced demand for services has yielded savings far in excess of the program’s $390,000 annual operating budget ($280,000 for medications; $110,000 for administrative expenses). Ninety-three percent of Buncombe County residents now have access to primary care – and the program has been replicated in 22 communities around the nation.

Contact:
Alan T. McKenzie, Executive Director and CEO
828.274.2267
ceo@bcmsonline.org
304 Summit Street
Asheville, NC 28803
www.projectaccessonline.org

 

Finalists

Comprehensive Health Investment Project (CHIP) of Virginia

Richmond, VA

Children in poverty seldom have insurance and regular pediatric care. Less healthy than their more affluent neighbors, these children enter school at a disadvantage – less ready to learn and less likely to succeed. The Comprehensive Health Investment Project (CHIP) of Virginia works with the state’s most vulnerable low-income families to promote healthcare in the crucial early years from birth to age six. In CHIP’s unique team-based approach, each family is assigned a public health nurse and a community outreach worker. Home visits give the teams valuable insights and a special rapport with the families they serve. Nurses ensure that children have health insurance and personal physicians who know their medical history, while helping parents understand and follow treatment advice. Outreach workers attend to the environmental and social factors that influence health and development, enrolling children in programs like Head Start; coaching parents in household management, parenting, and discipline; and providing families with information on housing, job training, and educational opportunities.

As a result of CHIP’s efforts, more than 95 percent of the children enrolled are fully immunized by age two. More than 95 percent have a medical home: a physician who not only treats their illnesses, but provides ongoing preventive care. Just six percent of mothers in the program give birth at intervals of less than 24 months. And among parents enrolled in CHIP, both employment and GED completion have increased.

Contact:
Laura Darling, Director of Operations
804.783.2667
chipva@aol.com
701 E. Franklin St., Suite 502
Richmond, VA 23219
www.chipofvirginia.org

 

Indigent Pharmacy

Earl K. Long Medical Cente , Baton Rouge, LA

In 1998, Earl K. Long Medical Center, a state-owned public hospital in Baton Rouge, LA, began offering health education and disease management for patients with chronic conditions such as diabetes, congestive heart failure, asthma, and HIV. Hospital staff realized, however, that even the most sophisticated programs would be useless if patients did not receive the necessary medications. They also knew that very few indigent adults have access to prescription coverage, let alone the money to purchase prescription drugs. The medical center addressed the problem by establishing an outpatient pharmacy, purchasing generic drugs through the state public health service and obtaining expensive name-brand drugs through pharmaceutical company programs.

In fiscal year 2002, the outpatient pharmacy filled more than 91,000 prescriptions with an average wholesale value of $4.6 million. The indigent pharmacy program has now been replicated throughout the nine hospitals in the LSU Health Care Services division. During the last state fiscal year, the hospitals filled nearly 317,000 prescriptions with an average wholesale value of almost $26 million.

Contact:
Fred Cerise, MD, CEO and Medical Director
225.358.1085
RTowns1@lsuhsc.edu
Earl K. Long Medical Center
5825 Airline Highway
Baton Rouge, LA 70805
www.lsuhsc.edu

 

Generation Excellence

Collier County Health Department, Immokalee, FL

The American agricultural system employs thousands of migrant farm workers in places like Immokalee, an isolated, unincorporated community in Collier County , FL. To most migrant workers, preventive healthcare is a new concept. Generation Excellence provides health screening and educational services for seniors in the farm worker community – to reduce the incidence of chronic conditions such as heart disease, hypertension, and diabetes. At screenings, healthcare professionals identify people with high blood sugar or high blood pressure and refer them for treatment. The goal is to complete follow-up appointments and bring abnormal results under control. Among this transient population, the program has achieved successful outcomes and follow-up at the rate of almost 90 percent.

Generation Excellence also focuses on prevention – offering education, nutritious meals, and exercise programs at a senior center as well as an after school cardiovascular fitness program at a local elementary school. In addition to learning about healthy behaviors, the children acquire computer, math, and writing skills. Over a two-year period, average attendance for the after school program exceeded 98 percent. Generation Excellence also offers internships in rural health through a partnership with the School of Nursing at Florida Gulf Coast University .

Contact:
Nancy Frees, Health Center Administrator, Collier County Health Department
Koko DeLisi, Program Manager
239.658.7330
koko_delisi@doh.state.fl.us
Collier County Health Department
419 North First St.
Immokalee, FL 34142
www.collierhealthdept.org

 

Medically Fragile Children’s Program

Palmetto Health, Columbia, SC

Placing children in foster homes can be difficult under the best of circumstances. For medically fragile children with chronic disabilities or functional limitations, the difficulties are compounded many times over. These children may even be abandoned in hospitals when foster parents are overwhelmed by the demands of caregiving. The Medically Fragile Children’s Program was created to address these needs.

Through the teamwork of Palmetto Health, Medicaid, and the Department of Social Services in Columbia, SC, the program provides comprehensive, coordinated healthcare services centralized in a day center designed for children with medically complex conditions. Children receive primary and nursing care; physical, occupational, speech, and respiratory therapy; psychological and social services; nutrition and personal care; and medications, durable medical equipment, and supplies.

Medicaid reports savings of $10,000 per child per year, even though the children receive more care and services. Fifty-five percent of those in the program have exceeded clinical expectations; 25 percent have been mainstreamed out of special needs classes. Sixty percent of children in the Medically Fragile Children’s Program have been adopted.

Contact:
Pat Votava, Director
803.434.4467
pat.votava@palmettohealth.org
5 Richland Medical Park Drive
Columbia, SC 29203
http://www.palmettohealth.com/community/mfcp/fragile_children.html

 

Resource Mothers Program

Family Outreach Center, Lorain, OH

The Resource Mothers Program helps low-income, high-risk women and children access healthcare during pregnancy and the crucial first year of life. The “Resource Mothers” are local women, trained to provide home visiting and support services to pregnant women coping with poverty, domestic violence, or cultural barriers involving education or language skills. Before becoming Resource Mothers, these women were themselves dependent on public assistance. They now serve as mentors and advocates for expectant mothers, helping them find healthcare services, as well as housing, transportation, employment, and educational resources. Other services include parenting skills development, training in infant massage techniques, a “boot camp” for new fathers, advocacy training, and bereavement support. At any given time, Resource Mothers has a caseload of 140 women and families in its long-term program. A short-term program that provides infant formula, diapers, and other basic needs in emergency situations serves over one thousand families annually.

In 2000 and 2001, 95 percent of clients' babies weighed at least 5.5 pounds at birth, thus avoiding the complications associated with low birth weight. More than 97 percent of infants in the program are fully immunized.

Contact:
Tom Stuebner, Director
440.246.2087
Tom_stuebner@HMIS.org
Family Outreach Center
3700 Kolbe Road
Lorain, OH 44053

 

Semi-finalists

Amish Initiative

Punxsutawney Area Hospital, Punxsutawney, PA

With more than 3,000 Amish residents in its service area, Punxsutawney Area Hospital needed to better understand the Amish culture and meet the needs of the population. Hospital staff accomplished those goals by meeting with Amish residents in group settings to learn about their health perceptions and needs, working with state agencies serving the Amish, and educating both hospital and medical staff about the Amish culture. A primary care center was located in the heart of the Amish settlements, staffed by a husband-and-wife physician team who live in the community and provide primary care, free health screenings, and house calls. Following a 1993 measles crisis in the community, the initiative succeeded in eliminating measles in the county over a five-year period. The hospital also petitioned the Department of Health and Human Services to waive Hill-Burton application requirements, enabling the Amish to receive financial assistance for healthcare without violating their beliefs.

Contact:
Ben Hughes, Director, Professional and Corporate Services
814.938.1826
bhughes@pah.org

 

Childhood Immunization Program

Sullivan County Regional Health Department, Blountville, TN

Serving northeast Tennessee since the 1930s, the Sullivan County Regional Health Department’s Childhood Immunization Program provides vaccinations for diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, haemophilus influenza, hepatitis B, varicella, and pneumococcal disease. The goal is to ensure that children receive necessary immunizations when they need them. Program staff conduct assessments of children enrolled in WIC, licensed day care facilities, Head Start, and schools, and follow up when a child has not received the necessary immunizations. The program also provides free immunizations at local malls and community health fairs, supplies educational materials to physician offices and the county Department of Human Services, and sponsors educational programs for physicians. Sullivan County’s immunization rate rose from 90.8 percent in 1999 to 94 percent (the highest in the state) in 2001. Among children enrolled in Head Start, the immunization rate is 99.7 percent.

Contact:
Laura Littleford, Marketing Coordinator
423.323.5746
llittleford@sullivanhealth.org
P.O. Box 630
154 Blountville Bypass
Blountville, TN 37617
www.sullivanhealth.org

Hear for You Deaf Services

Olathe Medical Center Charitable Foundation, Olathe, KS

Since Olathe is home to the Kansas School for the Deaf, the area has an unusually large deaf and hard-of-hearing population – almost nine percent of the city’s residents. To help them access healthcare, the Olathe Medical Center (OMC) Charitable Foundation’s “Hear for You” program maintains a staff of 15 sign language interpreters, available day and night at OMC and at Miami County Medical Center in Paola, KS. Services are also provided in 16 clinics and approximately 35 staff physician offices. Interpreters are available for emergencies, surgeries, diagnostic procedures, labor, delivery, consultations, hospice, home health, and community education classes. When OMC began offering interpreting services in physician offices in 1993, 29 percent of interpreting services were provided in the emergency department. Now only 15 percent of services are provided in the ED, indicating that improved communication between physicians and patients has resulted in better compliance.

Contact:
Frank H. Devocelle, CEO
913.791.4224
20333 W. 151 st Street
Olathe, KS 66061
www.ohsi.com

 

Kids for Health

Washington Regional Medical Center, Fayetteville, AR

Kids for Health is an educational program focusing on disease prevention and health promotion in grades K-3. Primarily funded by Washington Regional Medical Center in Fayetteville, AR, the program currently reaches 6,500 children in weekly sessions at 19 local public schools. The curriculum, which incorporates health education standards mandated by the state Department of Education, encourages healthy habits during the formative years. The educational effort extends to families through weekly health tips and the biannual HouseCall newsletter. Since its inception in 1994, 52,000 children have participated in the program. During the first year, there was a four-fold increase in health knowledge. The Arkansas Department of Health now plans to expand the program statewide.

Contact:
Kandy Johnson, Program Director
479.756.9551
kidsforhealth@jcf.jonesnet.com
P.O. Box 326
Springdale, AR 72765
www.kidsforhealth.com

 

Not On Tobacco (N-O-T) Teen Smoking Cessation Program

American Lung Association of Hawaii, Honolulu, HI

According to a survey conducted in Hawaii in 2000, almost 25 percent of teenagers in grades

9-12 reported that they had smoked within the past 30 days. Today, tobacco use accounts for 16 percent of deaths in Hawaii and costs the state more than $328 million annually. To address the problem, the American Lung Association of Hawaii launched the N-O-T (Not On Tobacco) teen smoking cessation program. The core curriculum, delivered in one-hour sessions over 10 weeks, addresses the entire process of smoking cessation, from analyzing the reasons that teens start smoking to preventing relapses. The youth-focused program is presented separately to boys and girls, since the reasons for smoking or relapsing may vary by gender. During the program’s two-year existence, approximately 28 percent of participants have stopped smoking.

Contact:
Debra Odo, Director of Tobacco Control
808.537.5966, ext. 305
lung@ala-hawaii.org
245 N. Kukui Street, Suite 100
Honolulu, HI 96817
www.ala-hawaii.org

 

Opening Doors

Community Action Organization, Washington County, OR

Although Washington County, part of the Portland metro area, has the state’s highest per-capita income, more than 50,000 of its residents earn less than 150 percent of federal poverty level. A 1996 study showed that 23 percent of low-income women in the region did not enter prenatal care in the first trimester, putting them at high risk of delivering low-birth weight babies requiring expensive medical care. In the Opening Doors program – a project of Community Action Organization, a private, non-profit social service agency – AmeriCorps volunteers approach women in their homes, at grocery stores, and in laundromats (as well as through traditional social-service channels), educating them about the state’s managed-care system and helping them obtain social services. Outreach workers recruited from the community have firsthand experience of the challenges facing clients. Ninety-four percent of clients completing the program deliver babies weighing at least 5 lbs. 4 oz., and 99 percent of babies born to clients are insured by the time they exit the program.

Contact:
Pamela White, Grants Coordinator
503.648.6646
contact@caowash.org
1001 SW Baseline Street
Hillsboro, OR 97123
www.communityaction4u.org

 

STOP (Stop TObacco in Pregnancy) Program

University of Pittsburgh Medical Center, Pittsburgh, PA

Smoking during pregnancy results in fetal growth deficits, low birth weight, premature delivery, and exorbitant healthcare costs. The STOP program – a project of the University of Pittsburgh Medical Center – delivers smoking cessation services to underserved pregnant women in various locations throughout the city. Among 100 women enrolled in the program to date, the program has achieved a quit rate of 28 percent (a conservative estimate, based on the assumption that all dropouts continue smoking). If women who have attended at least three sessions are included, the quit rate rises to almost 50 percent; almost 60 percent of women who enter the program as “spontaneous quitters” remain so through delivery. Eighty-one percent of babies born to non-smokers were in the normal birth weight range, compared to 29 percent of babies born to smokers. Babies of non-smokers had an average gestational age of 39 weeks (versus 35 weeks for smokers) and a complication rate of 18 percent (versus 56 percent for smokers).

Contact:
Patricia A. Cluss, Ph.D., Program Director
412.647.2933
www.upmc.com

 

Wesley Nurse Health Ministries

Methodist Healthcare Ministries, San Antonio, TX

Wesley Nurse Health Ministries serves a diverse population of low-income Hispanics, Caucasians, and African-Americans with varying levels of literacy and little or no access to healthcare. The program’s 40 full-time registered nurses, assigned to communities in a 72-county region in southwest Texas, facilitate access to holistic preventive health services as well as medical supplies and equipment. Other services include setting up food pantries and clothing closets, helping clients in unsafe living conditions find funding for repairs, helping eligible clients apply for Medicaid and other social services, arranging transportation to medical appointments, and making home visits to shut-ins. Wesley’s Diabetes Management Program has partnered with vendors to fund more than $122,000 worth of supplies for the impoverished, while its Prescription Assistance Program has provided more than 1,600 people with free medications valued at approximately $877,650. In its seven-year existence, the program has served more than 118,000 clients.

Contact:
Miriam Perez-Cuevas, R.N., Director of Nursing Programs
800.489.8863
210.692.0234
mperez@mhm.org
4507 Medical Drive
San Antonio, TX 78229
www.mhm.org/programs/wesley.asp

 

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