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 additionalMore than 32,000 people (11%) live below the federal poverty level (FPL)Almost 45,000 (16%)live at or below 200% of the FPL55,298 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 NetHospital ClinicsHospital Emergency RoomsMHEDSSt Paul’s Free ClinicPrivate 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 provider72% had a “checkup” in the past year35% go to the ER for primary care59% 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 insuranceCostCulture/languageHealth 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 ResidentsUtilize 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 servicesConverting 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!