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In partnership with

  Erie County Department of Health

  Northwest PA Area Health Education
  Center

  John Snow, Inc. (consultant)
Access to care is “the timely use of
personal health services to achieve the
best possible health outcome”—Institute
of Medicine
Population of Erie County in 2006 is 280,843
2008 Federal Poverty Level is $10,400 for the first family member,
$3,600 for each additional
More than 32,000 people (11%) live below the federal poverty
level (FPL)
Almost 45,000 (16%)live at or below 200% of the FPL
55,298 enrolled in public insurance programs;
51,792 (18%) are Medical Assistance eligible, but not enrolled,
19,448 (7%) are uninsured;
3680 children are enrolled in the CHIP program in Erie County*
3506 are CHIP-eligible, but not enrolled in the program*

*as of 9/1/2006
Community Health Net
Hospital Clinics
Hospital Emergency Rooms
MHEDS
St Paul’s Free Clinic
Private Physician Offices
General dentistry & oral surgery greatest
need (only 50% of those surveyed visited
a dentist in the past year)
49% of the county’s population utilized
services of the “safety net”
56% of people living below 200% of FPL
are served by the “safety net”
88% have a regular doctor or other
health care provider
72% had a “checkup” in the past year
35% go to the ER for primary care
59% had medical assistance insurance
and 17% had none (of the people
surveyed)
22% needed to see a doctor/provider
but didn’t because of the cost
Lack of health insurance
Cost
Culture/language
Health literacy (knowing when & where
you should go)
Transportation—especially in rural Erie
County
1. Implement community-wide initiatives to
   improve quality and health outcomes
2. Increase understanding of who is not
   currently receiving appropriate primary
   care services and frame a strategy for
   reaching remaining underserved groups
3. Increase primary care access throughout
   the County, leveraging federal and other
   resources to reach as many low-income,
   underserved residents as possible
Implement community wide initiatives to
  improve quality and health outcomes
Expand community efforts to increase
enrollment in public insurance programs
› Currently nearly 50% of people who are
  eligible for public insurance (including
  Medicaid, CHIP) are not enrolled. Since lack
  of insurance is directly related to both
  appropriate access and health outcomes,
  increasing enrollment is an essential first step
  in improving access and quality
Expand the concept and
implementation of providing a primary
Medical Home for all Erie County
Residents
Utilize the collaborative approach across
providers and apply the chronic care
model to improve care management
and outcomes for people with chronic
illness;
Transform practices to provide more
patient-centered and evidence-based
care
Increase understanding of who is not
currently receiving appropriate primary
care services, identify needed services
and frame a strategy for reaching
remaining underserved groups
Increase understanding of who is not
currently receiving appropriate primary
care services, identify needed services
and frame a strategy for reaching
remaining underserved groups.
Identify people who are not currently in
  care or who do not have appropriate
  access to primary care.
These are likely to be some of the hardest
  to serve and most in need populations
  such as those who are homeless,
  culturally and linguistically isolated,
  chronically uninsured, or suffering with
  co-morbidity such as diabetes and
  mental illness.
Increase primary care access
throughout the County, leveraging
federal and other resources to reach as
many low-income, underserved residents
as possible
Take advantage of 330 funding, FQHC
Look-alike, or RHC status within the
context of a rational service delivery
plan for the County.
› Could include:
   Expanding CHN sites and services
   Converting existing primary care sites (e.g.
   some hospital sites that serve a significant low-
   income population) into FQHCs either
   independent or as part of CHN
Working with other safety-net providers
(hospitals, MHEDS, St Paul’s Free Clinic) to
determine their role in the service delivery
system and maximizing their ability to provide
services; and

Developing new sites where these other
options are not appropriate
In order to maximize the County’s
options for expanding FQHC and RHC
sites, continue to explore and follow-up
on opportunities for federal HPSA and
MUA/MUP designations
Dental
› Applied for funding to open a new dental
  clinic. CHN to receive awards of:
    $210,000 from the Highmark Foundation
    $80,000 from the Erie Community Foundation
    $50,000 from the Hamot Health Foundation


› Plan opening soon at the Bayfront Nato
  Martin Luther King Junior Center
Thank You!

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Accessto primarycareineriecounty

  • 1.
  • 2. In partnership with Erie County Department of Health Northwest PA Area Health Education Center John Snow, Inc. (consultant)
  • 3. Access to care is “the timely use of personal health services to achieve the best possible health outcome”—Institute of Medicine
  • 4. Population of Erie County in 2006 is 280,843 2008 Federal Poverty Level is $10,400 for the first family member, $3,600 for each additional More than 32,000 people (11%) live below the federal poverty level (FPL) Almost 45,000 (16%)live at or below 200% of the FPL 55,298 enrolled in public insurance programs; 51,792 (18%) are Medical Assistance eligible, but not enrolled, 19,448 (7%) are uninsured; 3680 children are enrolled in the CHIP program in Erie County* 3506 are CHIP-eligible, but not enrolled in the program* *as of 9/1/2006
  • 5. Community Health Net Hospital Clinics Hospital Emergency Rooms MHEDS St Paul’s Free Clinic Private Physician Offices
  • 6. General dentistry & oral surgery greatest need (only 50% of those surveyed visited a dentist in the past year) 49% of the county’s population utilized services of the “safety net” 56% of people living below 200% of FPL are served by the “safety net”
  • 7. 88% have a regular doctor or other health care provider 72% had a “checkup” in the past year 35% go to the ER for primary care 59% had medical assistance insurance and 17% had none (of the people surveyed) 22% needed to see a doctor/provider but didn’t because of the cost
  • 8. Lack of health insurance Cost Culture/language Health literacy (knowing when & where you should go) Transportation—especially in rural Erie County
  • 9. 1. Implement community-wide initiatives to improve quality and health outcomes 2. Increase understanding of who is not currently receiving appropriate primary care services and frame a strategy for reaching remaining underserved groups 3. Increase primary care access throughout the County, leveraging federal and other resources to reach as many low-income, underserved residents as possible
  • 10. Implement community wide initiatives to improve quality and health outcomes
  • 11. Expand community efforts to increase enrollment in public insurance programs › Currently nearly 50% of people who are eligible for public insurance (including Medicaid, CHIP) are not enrolled. Since lack of insurance is directly related to both appropriate access and health outcomes, increasing enrollment is an essential first step in improving access and quality
  • 12. Expand the concept and implementation of providing a primary Medical Home for all Erie County Residents Utilize the collaborative approach across providers and apply the chronic care model to improve care management and outcomes for people with chronic illness;
  • 13. Transform practices to provide more patient-centered and evidence-based care
  • 14. Increase understanding of who is not currently receiving appropriate primary care services, identify needed services and frame a strategy for reaching remaining underserved groups
  • 15. Increase understanding of who is not currently receiving appropriate primary care services, identify needed services and frame a strategy for reaching remaining underserved groups.
  • 16. Identify people who are not currently in care or who do not have appropriate access to primary care. These are likely to be some of the hardest to serve and most in need populations such as those who are homeless, culturally and linguistically isolated, chronically uninsured, or suffering with co-morbidity such as diabetes and mental illness.
  • 17. Increase primary care access throughout the County, leveraging federal and other resources to reach as many low-income, underserved residents as possible
  • 18. Take advantage of 330 funding, FQHC Look-alike, or RHC status within the context of a rational service delivery plan for the County. › Could include: Expanding CHN sites and services Converting existing primary care sites (e.g. some hospital sites that serve a significant low- income population) into FQHCs either independent or as part of CHN
  • 19. Working with other safety-net providers (hospitals, MHEDS, St Paul’s Free Clinic) to determine their role in the service delivery system and maximizing their ability to provide services; and Developing new sites where these other options are not appropriate
  • 20. In order to maximize the County’s options for expanding FQHC and RHC sites, continue to explore and follow-up on opportunities for federal HPSA and MUA/MUP designations
  • 21. Dental › Applied for funding to open a new dental clinic. CHN to receive awards of: $210,000 from the Highmark Foundation $80,000 from the Erie Community Foundation $50,000 from the Hamot Health Foundation › Plan opening soon at the Bayfront Nato Martin Luther King Junior Center