Region: Finger Lakes

Rochester has a large and growing population of refugees. While they come from different parts of the world, these refugees often share inadequate past medical care, exposure to undetected/untreated disease, exposure to torture and terrorism, poverty, and language barriers that make it difficult to access health care.

Across the State, many refugee health programs have had to close because refugees lose their Medicaid coverage despite remaining eligible, interpretation services are very costly, standard Medicaid rates are too low, and there is often a lack of coordination among community resettlement agencies. Previously, refugee health services in Rochester were provided by two small community health centers, but both centers have stopped serving new refugees due to unsustainable costs of serving this population. NYHealth awarded RGH a grant to serve as the health care provider for Rochester’s newly arriving refugees and develop and implement a more sustainable model.

The Rochester General Health System (RGHS) comprises the Rochester General Hospital—a 528-bed tertiary center—and seven affiliates, including the Rochester General Medical Group (RGMG). The RGMG is a multi-specialty group practice of 250 physicians that provide care at 37 health care centers in Monroe and Wayne counties. RGHS holds approximately one-third of the market share in the Rochester area.

Rochester has a large and growing population of refugees. While they come from different parts of the world, these refugees often share inadequate past medical care, exposure to undetected/untreated disease, exposure to torture and terrorism, poverty, and language barriers that make it difficult to access health care. Across the State, many refugee health programs have had to close because refugees lose their Medicaid coverage despite remaining eligible, interpretation services are very costly, standard Medicaid rates are too low, and there is often a lack of coordination among community resettlement agencies.

Previously, refugee health services in Rochester were provided by two small community health centers, but both centers have stopped serving new refugees due to unsustainable costs of serving this population. RGHS agreed to serve as the health care provider for Rochester’s newly arriving refugees and used these start-up funds to develop and implement a more sustainable model. Under its program, all new refugees receive their refugee health assessments that are federally mandated to be provided within 90 days of arrival, and have an established a relationships with a primary care provider. Additionally, RGHS—with assistance from the Finger Lakes Health Systems Agency—has identified the barriers that caused previous refugee health programs to fail and has developed strategies to overcome them.

Mental health problems are a significant health concern for children in foster care. On any given day, approximately 510,000 children are in foster care, with total foster care placement estimated at 795,000 annually in the United States.

Seventy percent of children have been admitted to foster care because of child abuse and neglect, which are strong predictors of poor long-term outcomes. These children suffer from high rates of chronic medical, developmental, and mental health problems. Starlight Pediatrics is a model pediatric medical home in Rochester, serving all 700 children in family-based foster care in Monroe County through 3,400 visits per year. Operating for nearly two decades, Starlight Pediatrics is the oldest existing centralized medical home model for children in foster care in the country. In addition to providing comprehensive primary care services, Starlight Pediatrics provides all health care management services for children in foster family care. To address both the primary care and mental health needs of children in foster care, Starlight Pediatrics implemented the Fostering Connections program, which integrated on-site mental health services and parent training in the same location where medical care is provided. In 2009, NYHealth awarded University of Rochester and Starlight Pediatrics a grant to support Fostering Connections.

In New York State, approximately 58,000 children in foster care have mental health disorders resulting from abuse, neglect, chaotic parenting, and ongoing personal loss. Support from NYHealth funded Fostering Connections—an ambitious project run out of Starlight Pediatrics to create a more comprehensive and centralized model to address both the primary care and mental health needs of children in foster care.

Nationally renowned, Starlight Pediatrics was established nearly 20 years ago and is the oldest existing centralized medical home model for children in foster care in the country. In addition to providing comprehensive primary care services, Starlight Pediatrics provides all of the health care management services for children in foster family care. The project integrated on-site mental health services and parent training under the same roof where medical care is provided.