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Will County Fills the Gaps of Inequality by Reducing and Eliminating Disparities in Health Care 2002

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Title: Will County Fills the Gaps of Inequality by Reducing and Eliminating Disparities in Health Care 2002


1
Will County Fills the Gaps of Inequality by
Reducing and Eliminating Disparities in Health
Care 2002 Data
  • Will County Community Health Center served
    42,836 patients-including 17,009 uninsured and
    27,600 patients who are members of racial or
    ethnic minority. Reducing and eliminating health
    disparities demonstrates the progress of WCCHC.
    Highlights include the following findings
  • African American women who use WCCHC gave birth
    to low birth weight infants at a rate of 6.1
    percent, in contrast to the national rate of 13.0
    percent. Compared with national figures, WCCHC
    rate represents a 50 percent reduction in this
    disparity.
  • WCCHC uninsured patients received 6,684
    prescription for medications valued at
    461,460.00 thru medication assistance programs.
  • WCCHC uninsured adults are more likely to receive
    counseling on lifestyle issues (such as diet and
    eating habits, physical activity, smoking,
    drinking, drug use, and sexually transmitted
    diseases) than uninsured adults who seek care
    elsewhere because of ancillary programs.
  • Family Planning Program and Illinois Breast and
    Cervical Cancer programs provided at WCCHC have
    been instrumental in cutting racial/ethnic
    disparities in screening. In fact, for
    mammograms, clinical breast examinations, and
    up-to-date pap smears. WCCHC women have far
    exceeded the national rate for comparable women
    through both programs, respectively.
  • Approximately, 74 percent of women who are
    patients of WCCHC receive prenatal care in the
    first trimester. Only 6 percent are enrolled in
    the third trimester. Prenatal care patient base
    is comprised of 48 percent Hispanics and 29
    percent African American.
  • WCCHC practice meets or significantly exceeds
    literature-based standards for treatment of the
    most common conditions of hypertension, acute
    otitis media, diabetes, and asthma on over 80
    percent of the care elements.
  • These findings are not new to WCCHC and the
    patients we serve. For more than 7 years, WCCHC
    has been meeting and exceeding expectations for
    the delivery of quality, cost-effective primary
    and preventive care to those in our community who
    need it most-regardless of their ability to pay.

2
Will County
  • Will County, Illinois is located approximately
    35 miles southwest of the Chicago Loop. The
    County includes the 11th and 13th Congressional
    districts, served by Representatives Jerry
    Weller, and Judith Biggert, respectively. Will
    County encompasses a broad variety of
    communities, including rural and urban areas
    within its boundaries. By population definition,
    Will County is an urban region. As the home of
    approximately 502,266 residents, Will County is
    currently ranked as the fourth largest county in
    Illinois. This is due largely to the dramatic
    40.6 percent population increase that has
    occurred over the past decade. Demographically,
    Will County is composed of 81.8 percent
    Caucasians, 10.5 African Americans, 8.7 percent
    Hispanics and 1.8 percent Asian/Pacific
    Islanders. This composition is quickly changing.
    Hispanics are Will Countys largest growing
    minority group, and have increased by 88 percent
    since 1990, more than twice the statewide
    increase of 41.1 percent.

3
The City of Joliet
  • The City of Joliet, Illinois is at the center of
    Will Countys growth. Joliet is both the
    population seat of Will County, and its fastest
    growing city. The Medically Underserved Area
    (MUA) in Joliet, represented by census tracts
    8812,8813,8820-8822, 8824, 8825, and 8830, is
    located on the Citys east side. As Joliets
    reputed poverty zone, this region is a designated
    HPSA and MUP. Census tract 8819, an area of
    notable poverty, which is contiguous with the
    east side MUA, is included in the target
    community. The Center for Rural Health continues
    to compile data to designate Will County as a
    Dental Health Professional Shortage Area, as
    well. The population boom has resulted in an
    increase in the disparity between, and
    segregation of wealth and poverty in Will County.
    The east side of Joliet represents the Citys
    area of lowest income and highest concentration
    of minorities at 69 percent. Forty four point
    nine percent are African American, 23.8 percent
    are Hispanic, and 3.9 percent are Caucasian. The
    Hispanic district, located at the east side has
    become the comfort zone for the growing numbers
    of immigrants and residents of Hispanic origin.
    The Latinos have formed their own community
    within a community, where Spanish is the chosen
    language. One in every five Hispanic residents
    in the targeted census tracts report speaking
    Spanish as their primary language.

4
History of Development
  • The Will County Community Health Center is
    located at 501 Ella Avenue, in the heart of
    Joliet's designated MUA and HPSA area. The target
    population on the east side of Joliet is
    estimated at 32,211. The eight designated HPSA
    tracts on the east side are also a designated
    MUA. Five of these tracts have been designated
    MUA since 1970s. The residents of this area are
    a designated Medically Underserved Population
    (MUP), as well, based upon low-income, index of
    medical under service and documented access
    barriers. The Will County Health Department
    participated in the Illinois Project for Local
    Needs Assessment in 1994, in an effort to
    determine the particular services most needed in
    the community. The results of the assessment
    revealed inadequate primary care resources,
    especially for the uninsured and underinsured
    residents on the east side of Joliet. Rather
    than expanding the Health Departments Clinic
    Service Division, which provided part-time hours
    for STD/HIV, Immunizations, Family Planning and
    Public Nursing, the Will County Board of Health
    chose to create a new entity. The delivery
    system focuses upon the direct delivery of
    primary and preventive services for the
    communitys disenfranchised. This option is
    viable because private providers are not able to
    absorb the costs of the communitys large
    Medicaid, working poor and uninsured population.
    The Will County Community Health Center first
    began seeing patients in 1995, and earned status
    as a Federally Qualified Health Center look-alike
    on December 3,1996. The Will County Community
    Health Center is a typical governmental model
    with its own 501 (c)(3) status.

5
Will County Community Health Center
  • The Health Center was established under the
    auspices of Will County Health Department, and is
    a community health center governmental public
    entity model under Section 330 and BPHC
    guidelines. WCCHC earned its 330 status in March
    2001. As the only grant funded health center,
    WCCHC serves as the primary source of affordable
    medical care for the 43 percent of the target
    population that is uninsured. The Center
    strategic location in the heart of the Citys MUA
    has facilitated its growth and reputation as the
    medical home of the disenfranchised. Patient
    visits have increased by more than 500 percent
    since the inception, totaling 68,000 in 2002. In
    addition, the number of patient visits for the
    first quarter of 2002 was 15 percent higher than
    the first quarter of 2001, while the number of
    undocumented/uninsured Hispanic patients was 29
    percent higher. Historically, the Center offered
    health promotion and educational activities that
    are now being emphasized by managed care
    organizations. The Center is a viable player in
    the health care market, because of the
    accessibility of quality and affordable primary
    care in the service area. The Health Center
    staff is sensitive to the educational, cultural
    and socioeconomic orientation of the target
    community. We have an established internal and
    external monitoring system to ensure cost
    effective quality care. Through partnerships,
    health promotion and prevention efforts, we
    strive to address the needs of our patients that
    go beyond primary care… we assure our patients a
    complete continuum of care.

6
Dental
  • Of 201 licensed dentists in Will County, only 34
    accept Medicaid patients in their practice, and
    only 16 of these are accepting new patients.
  • The Dental Clinic, part of the Will County
    Community Health Center, provides complete
    preventive and restorative care. Emergency
    appointments are available daily.
  • Pediatric patients are targeted and adults are
    seen with a referral through WCCHC physicians.
  • To improve the overall oral health of the
    community, Will County Dental Clinic initiated a
    pilot program (March 2003), School-Based Dental
    Awareness Program targeting in Joliet Elementary
    School District and Headstart Programs. A
    survey of Will County school nurses, representing
    101 schools, illustrated that 59 percent of the
    schools did not provide oral health education.
  • In 2002, 4,862 dental patient visits were
    recorded compared to 2,578 in 2001.
  • The U.S. Surgeon Generals Report, Oral Health in
    America, identified persons suffering the worst
    oral health in America as being those who are low
    income, lacking education, members of minority
    ethnic and racial groups, those without access to
    fluoridated water, and those with special health
    care needs (May 2000).
  • 14 of children in Illinois have one or more
    dental sealants, although such treatments have
    been equate to be as valuable in dental health as
    immunizations are in physical health. Will
    County Dental Sealant Program serves eligible
    school children at 6 Joliet schools.

7
Fundraising
  • Fundraising Dinner
  • Carsons Days
  • Garage Sale
  • Princess House Sale
  • Gompers Jr. High
  • Personal Donations

8
Annual vs.-Financial Operational Support
Statistics
  • 20 percent from County of Will
  • 20 percent from Grants (both Federal and State)
  • 60 percent from donations and time of service
    collection
  • Fiscal year 1995, 1.5 million dollars allocated
    from health levy to support WCCHC
  • Fiscal 2002, allocation reduced to 1.3 million
    dollars from health levy

9
Organizational Chart
10
Diabetic Collaboration
  • The Diabetes Collaborative Care Model ,
    collaboration with the Bureau of Primary Health
    Care Health Disparities Collaborative Diabetes 2,
    was instituted at the Center in April 2001.
  • Currently 735 patients are actively enrolled
    200 out of 735 are children.
  • Phase I- 100 patients were enrolled in the
    program
  • Phase II 281 by August 2002/ 552 patients as
    of March 2003
  • Formed a the Fit for life group which targets
    over maintenance for children.
  • Local YMCA donated the use of their facility to
    encourage walking and exercise to overweight
    children.
  • External partnership have been formed with a
    local Ophthalmologist to provide reduced cost
    retinal exams.

11
Enabling Services
  • Illinois Breast and Cervical Cancer Program
  • Cooperative effort between the Illinois
    Department of Public health, Office of Womens
    Health and the Centers for Disease Control
    Prevention
  • WCCHC enlisted into a partnership with Kankakee
    County Health Department.
  • WCCHC acts as a subcontractor to IBCCP as a
    provider of comprehensive breast and cervical
    examination.
  • Immunization
  • Immunization at local DHS office
  • Immunization Record Review for private physicians
  • Back-To-School-Fair
  • Partner with Senior Service for Influenza Vaccine
  • Refugee and Immigration Screenings
  • Performed refugee screening for 29 Kosovo
    families
  • Designated Civil Surgeon for medical examination
    of aliens seeking adjustment of status
  • Provides health care follow-up

12
Collaboration With Other Agencies
  • Catholic Charities for physicals
  • The Back To School Fair
  • Gompers for School Physical
  • Medical Director gave presentation on NO
    Drugs-NO Tobacco
  • Practicuum site for Nursing Students
  • Practicuum site for Masters and Bachelors
    completion program
  • Partner with Senior Service for Influenza
    Vaccination in the community at Senior sites.
  • Newborn T-Shirt Program for newborns that comes
    in for their first well-child visit.
  • Read Out and Reach
  • Initial ROR Program made possible by a donation
    from a community philanthropist.
  • Goal is to address literacy as an important
    element in well child development.
  • Book donations from Joliet Library and other
    local businesses.
  • 4,000 books have been distributed
  • Linus
  • Providing comfort measures for children and teens
    during crisis situations
  • Local groups makes blankets and quilts
  • Providing Security Through Blankets… Charles
    Schulz (creator)
  • Asthma Prevention and Education
  • Laboratory Incentives with the collaboration of
    Illinois Primary Health Care Association

13
Public Entity Model
  • Medicaid Presumptive Eligibility
  • Onsite Medicaid outstation- concentration on
    prenatal care
  • Registered 971 application with less than 5
    percent rejection rate
  • Kid Care Program
  • Onsite Medicaid outstation- concentration on
    parents with children
  • Registered 532 application with less than 3
    percent rejection rate
  • Newborn Eligibility
  • Integrated follow-up system for applying newborn
    infants
  • Followed up and applied 734 newborn within a
    seven day notice from birth
  • CD/DIS
  • 2,870 CD investigations complete in 2002 82
    percent increase from 2001.
  • HIV counseling, testing and referral on site
    average of 100 patients tested per month.
  • STD contacts, tracing and treatment
  • Epidemiologist onsite with Will County Health
    Department
  • Coordination with Environmental Health of food
    bourne illness, investigation and/or follow-ups
  • Internal Lab and two local hospital labs report
    communicable diseases to Health Department
  • Lead Program
  • 1,058 Pb specimens drawn in 2002
  • Partnership with WIC and Family Health Services
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