2009 Archives - Page 2 of 10 - New York Health Foundation

New York Health Purchasing Alliance, Inc., d/b/a HealthPass

With a planning grant from the New York Health Foundation’s “Expanding Coverage Options in the Small Group and Individual Market in New York State” program, HealthPass analyzed the feasibility of adding Healthy NY, a State-sponsored insurance plan that offers coverage to businesses with 50 or fewer employees, sole proprietors, and individuals, to the HealthPass menu of insurance plans.

For those who met the income-based eligibility criteria, the State subsidized benefits, allowing Healthy NY to offer premiums at a lower cost. HealthPass believed that if Healthy NY could be brought into HealthPass, more small businesses would provide coverage to their low-income workers.

This grant was one of five organizations that received a planning grant from the 2008 NYHealth request for proposals (RFP), “Expanding Coverage Options in the Small Group and Individual Market in New York State.” The RFP grew directly out of the Foundation’s desire to generate ideas for expanding health insurance options for small businesses and sole proprietors.

Read an NYHealth special report that contains a summary of findings from this RFP.

Callen-Lorde Community Health Center

Lack of access to pharmacy services is a particular problem for lesbian, gay, bisexual, and transgender (LGBT) communities and people living with HIV/AIDS.

In addition to being unable to afford medications, many of these patients feel stigmatized or judged in health care settings. Numerous studies have found that pharmaceutical access within a multidisciplinary care team improves coordination of care for a patient, increases the patient’s ability to adhere to a prescribed treatment course, and improves health outcomes. In 2007, the Callen-Lorde Community Health Center (CLCHC) found that its membership in the 340B Drug Pricing Program, a Federal program which allows health centers to offer deeply discounted medications to their patients, was being underutilized; only 10-15% of its 44,000 patients were using the designated off-site community retail pharmacy to fill prescriptions. In May 2009, NYHealth awarded CLCHC a grant to establish an on-site integrated pharmacy to improve health care outcomes and increase medication adherence among the underserved populations reached through CLCHC’s primary care and related services.

Callen-Lorde provides comprehensive primary medical services, a continuum of integrated HIV/AIDS care, mental health services, an oral health clinic, case management/care coordination, and an adolescent program. Numerous studies have demonstrated that integrating a pharmacist into a multi-disciplinary care team improves care coordination and medication adherence; bringing pharmacy services under one roof and fully integrating them into the care model will produce better outcomes.

The purpose of this project was to establish on-site integrated pharmacy services to improve care outcomes and increase medication adherence. While Callen-Lorde had participated in the Federal pharmacy program that provides significant savings on pharmaceuticals, only 10% of patients used the designated community retail pharmacy and many patients failed to fill prescriptions once they left the center’s premises, owing to confidentiality concerns and stigma. Through this project, Callen-Lorde was able to take advantage of a Federal program, known as the 340B Drug PricingProgram, which allows health centers to offer deeply discounted medications to their patients, to establish an on-site pharmacy.

Read a white paper from Callen-Lorde describing the factors that other health centers should consider in deciding whether to establish an on-site pharmacy, and detailing the sort of planning and financial projections that are required to succeed in bringing a concept to reality.

New York University College of Dentistry

In mid-2009, a significant proportion of Columbia County’s children in the Capital Region were at high risk for oral disease due to a number of factors, including poverty; lack of water fluoridation; cultural and environmental issues; diet; and limited oral hygiene education.

Access to dental care providers also played an important role in increasing risk; no private dentists within the county accepted Medicaid, despite 750 children relying on it for their medical care. In the city of Hudson alone, there were no pediatric dentists, and the planned discontinuation of Columbia County Memorial Hospital’s dental services program further lessened access to care. As a major provider of dental services to New York State’s Medicaid population, New York University College of Dentistry (NYUCD) decided to intervene and initiated the Columbia County Oral Health Intervention Program. The program intended to reduce dental caries in approximately 1,500 children from kindergarten through sixth grade by 95% over a three-year period. In April 2009, the New York Health Foundation (NYHealth) awarded NYUCD a one-year grant, which was eventually extended to two years, to cover the start-up costs of the program. NYUCD supplied the requisite dental supplies, equipment, clinical resources, and administration, while its faculty, postgraduate pediatric dentistry residents, and graduating dental and dental hygiene students served patients.

A significant number of upstate New York’s Columbia County student population (kindergarten through sixth grade) is at high risk for oral disease due to poverty, lack of dental insurance, lack of water fluoridation, cultural and environmental issues, diet, and limited oral hygiene education. Although 750 children in Columbia County rely on Medicaid, no private dentists within the county accept Medicaid. In addition, Columbia County Memorial Hospital plans to discontinue dental services in mid-2009.

The goal of the Columbia County Oral Health Intervention Program is to reduce the dental caries of approximately 1,500 children in kindergarten through sixth grade over a three-year period. This oral health intervention program will be school-based, initiating in the grade schools within the city of Hudson in year one and expanding to the remainder of the grade schools within Columbia County in years two and three. The proposed program is based on a highly successful dental outreach model for Head Start children piloted by NYUCD in Hudson in October 2008 in cooperation with Columbia Opportunities, the Healthcare Consortium, and Columbia County Memorial Hospital. Based on this experience, NYUCD projects that Medicaid revenues will be sufficient to sustain the program after three years.

Hudson River HealthCare

Yonkers, the fourth largest city in New York State, has been federally designated as a Medically Underserved Area.

The city lacks an adequate primary care infrastructure and access to care for its most disenfranchised residents, resulting in the use of the outpatient clinics of St. John’s Riverside and St. Joseph’s Medical Center as safety nets for low-income individuals. In 2009, as the worsening economic crisis threatened the capacity of these clinics to sustain its services, St. John’s Riverside and Hudson River HealthCare (HRHCare) decided to transition St. John’s two Valentine Lane Family Practice centers to HRHCare’s network of federally qualified health centers (FQHCs). That same year, NYHealth awarded a grant to HRHCare to assist in the transition from Valentine Lane Family Practice centers to HRHCare sites.

Yonkers—the largest city in Westchester County and the fourth largest city in New York State—is faced with the potential loss of primary care services. The vast majority of Yonkers’ low-income individuals lack any health insurance, third party coverage, or resources to pay for increasingly expensive health care. In addition, there is a dearth of physicians willing to accept uninsured or Medicaid patients, and even fewer who offer a sliding fee scale.

HRHCare will take over and operate the Valentine Lane centers as an addition to its FQHC network. This acquisition will allow HRHCare to purchase the sites, consolidate primary care services, operate the facilities at full capacity, and add services such as translation and care management. HRHCare has a track record of acquiring other hospital-operated ambulatory care centers in both urban and rural settings and restructuring them as FQHCs to meet the needs of underserved communities. Designation of the Valentine Lane sites as FQHCs will enable them to receive higher reimbursement rates and achieve sustainability.

Joseph P. Addabbo Family Health Center

These residents have low incomes, high poverty rates, and poor health statuses and by the end of 2008, the situation in this area worsened.

The St. Dominic’s Family Health Center, a primary outpatient center of Mary Immaculate Hospital of Caritas Healthcare, was about to close as Caritas declared bankruptcy. With NYHealth’s support, Joseph P. Addabbo Family Health Center acquired St. Dominic’s from Caritas and incorporated St. Dominic’s into its Federally Qualified Health Center (FQHC) network in 2009. This initiative enabled St. Dominic’s to continue operations under new ownership, expand its services, and become self-sustaining.

Rochester General Hospital

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.

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Year: 2009