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Protecting America's Uninsured:
Southern Region
Note: Not all programs at each institution are listed. To find out about
more programs at each individual institution, please contact the person
listed for additional information.
Florida
Florida State University College of Medicine
Neighborhood Health Services
The FSU College of Medicine has two faculty members working at Neighborhood
Health Services, an indigent care clinic in the center of Tallahassee.
Both faculty members are from the college's department of family medicine
and rural health; they work half-time at the clinic. The AHEC Clinical
Pharmacy Coordinator manages a Coumadin clinic, counsels patients, and
provides pharmaceutical consults for the clinic's providers. The other
faculty member, a family physician, provides care for the patients and
teaches students at the clinic. Through its partnership with FSU College
of Medicine, Neighborhood Health Services has been able to increase its
patient care capacity by 50 percent and provide immediate monitoring for
Coumadin patients.
Community Medicine Rotations
Third-year medical students spend three weeks on a community medicine
rotation designed to broaden their understanding of the role community
service agencies play in supporting patients and improving their quality
of life. Among the agencies to which the students are assigned are county
health departments, area agencies on aging, indigent care clinics, and
home health and hospice organizations. During the assignment, students
observe and assist agency personnel as they provide services to their
clients/patients.
FSUCares
FSUCares is a student organization that conducts service projects in
the local community, such as blood pressure and blood glucose screenings
at a Tallahassee homeless shelter and patient education projects in a
local low-income neighborhood. The group also organizes and sponsors an
annual international spring break medical mission. Supervised by faculty
physicians, nurse practitioners and psychologists, the medical students
in FSUCares have seen hundreds of patients in rural communities of Panama,
Central America, over the last three years. In 2004, they also traveled
to McAllen, Texas, where they provided support for understaffed clinics
on both sides of the U.S.-Mexico border. Students collect medications,
medical books and supplies to support their missions and to leave at the
clinics they visit. Each year, they also set up a make-shift clinic in
an extremely isolated Panamanian village where residents have no access
to regular medical care.
- Contact: Nancy Kinnally, 850-44-7824 or Meredith Brodeur, 850-645-1255
University of Florida College of Medicine
ACORN Clinic Family Health Care
ACORN is a non-profit charity that utilizes alliances with the University
of Florida Colleges of Medicine, Nursing and Pharmacy to provide health
care to the indigent families of Florida. Serving over eighteen counties,
ACORN offers such services as laboratory testing, medications, mental
health counseling, case management and referrals to low income and uninsured
patients.
- Contact: Marilyn Mesh, Executive Director, 352-485-1133
DR HELP
First, second, and senior year medical students are given an opportunity
to spend their spring break providing medical care under the supervision
of volunteer faculty to medically underserved communities in the Dominican
Republic. Medication, glasses and other supplies are brought to the community,
and those supplies not used are donated to clinics and hospitals serving
the poor.
UFCM provides much needed medical attention to poverty-stricken areas,
while at the same time giving future doctors a more sensitive outlook
on the needs of the medically indigent population in their communities.
We Care Physician Referral Network Program
Overseen by the Alachua County Medical Society, the We Care Physician
Referral Network program provides uncompensated primary, preventive and
specialty medical, mental and dental care to poverty level adults and
children. Care is provided in Shands HealthCare offices, as well as at
UF's Family Practice Medical Group and outlying clinics.
- Contact: Susan Crowley, Executive VP, Alachua County Medical Society,
352-376-0715
Equal Access Clinic
A weekly, student-run health clinic, the Equal Access Clinic provides
medical care to the homeless and indigent of Gainesville. Though the clinic's
focus is on providing primary health care to the homeless and indigent,
they will treat any patient regardless of ability to pay. Clinical services
include assessment and care, pharmaceuticals for those unable to pay,
diagnostic lab-work, skin lesion biopsies, HIV counseling and testing,
socio-economic counseling and dental extractions. In the fall of 2000,
the clinic began a monthly "Women's Health Night," which offers more specialized
care, including Pap smears, pelvic and breast examinations, pregnancy
testing and other counseling.
Maternity and Infant Care Program
The Maternity and Infant Care program provides prenatal care to low-income
women in a 12-county rural area. Nurse practitioners, nutritionists and
social workers travel to provide multidisciplinary care to women in their
local community settings. The women receive a variety of services, including
sonography, and go to Shands at UF medical center to deliver their babies.
The program provides care to all women in areas with no other service
available. It also offers safety-net and high-risk care in areas where
there are other providers.
AHEC Community Health Scholars Program
The Scholars program, which is funded by the University of Florida Area
Health Education Center, places students in underserved areas and settings
for eight weeks between their first and second years. While serving in
the area, community health organizations develop a question or issue they
would like addressed by the student. Topics include herbal usage in a
rural underserved community, ways of improving communication between providers
of elderly nursing home residents, and summer school for children of seasonal
farm workers.
Eastside Community Practice (ECP) affiliate with Shands @ UF - Gainesville,
FL
Accessing Community Care through Eastside Social Services (ACCESS)
The ACCESS program is a chronic case management model developed to improve
patient health outcomes and to reduce inappropriate emergency room utilization.
Specifically targeted to those patients who have low/no income and no
health insurance, the ACCESS program provides free ongoing health care
and case management. These services include primary care visits with ECP
providers; pharmacy consults regarding medications; psychological services
to address mental health issues; community-based nursing care and social
work management.
- Contact: Rhonda Waddell, M.S.W., L.C.S.W., 352-846-2340
Shands HealthCare (a private not-for-profit healthcare system affiliated
with the University of Florida Health Sciences Center, including Shands
at UF medical center)
Community Health Promotion Programs (CHPP)
Shands HealthCare provides community health promotion programs in all
their service locations, which include Alachua, Bradford, Columbia and
Suwannee counties. The wide range of programs offered by CHPP addresses
the health problems of the community and reduces the risk factors for
the leading causes of death and disability. The programs service both
the insured and uninsured populations of Florida by providing need health
care information. Some of the programs Shands HealhCare provide include
health screenings, health fairs, various publications, flu shot campaigns,
and a mobile screening unit titled Care-A-Van.
- Contact: For a complete listing or for more information on the programs
provided by Shands HealthCare, please contact Shands HealthCare Marketing
and Public Relations at 352-265-0373 or 1-800-535-0373, or the Shands
HealthCare Consultation Center at 352-265-8000 or 1-800-749-7424.
- Web site: www.shands.org
Georgia
Medical College of Georgia
Salvation Army Homeless Shelter Medical Clinic/Women's Free Health
Clinic
The Salvation Army Homeless Shelter Medical Clinic is a medical-student-run
clinic that provides free medical care to the indigent and homeless of
Augusta. The Women's Health Clinic also services this community, but focuses
on women's health issues and diseases.
- Contact: Dr. LeClaire, 706-721-0934
Louisiana
Tulane University Health Sciences Center - New Orleans, LA
Bridging Health Together
Bridging Health Together brings medical students of Tulane's Department
of Family and Community Medicine with residents of Bridge House, a residential
treatment program for people with alcohol or drug abuse problems. Students
provide immunizations, physical exams, basic health maintenance and assess
the need for follow-up at referral centers. In addition to providing medical
attention to the residents of Bridge House, student's also host a fund-raiser
for the program to purchase much needed supplies.
North Carolina
Duke University Medical Center and Health System - Durham, NC
Local Access to Coordinated Healthcare (LATCH)
LATCH is a collaborative effort between Duke University Medical Center's
Division of Community Health, local health agencies, and Durham County
government agencies to reach uninsured Durham residents (primarily Latino
families) in their homes to educate them about their health conditions
and how they can make appropriate use of primary care and preventive health
services.
The LATCH program's multi-agency team of bilingual, culturally competent
staff offer uninsured patients assistance navigating the health system,
as well as education and support for patients with chronic diseases who
need to better manage their conditions. Partner agencies receive subcontracts
to broaden their services, such as: providing communicable disease testing
and treatment, group health education and injury prevention at El Centro
Hispano; peer health education for teens through Planned Parenthood; primary
care through Lincoln Community Health Center; and mental health/substance
abuse through Catholic Social Ministries. LATCH patients are screened
for Medicaid and SCHIP eligibility and receive assistance completing applications
with help from a Social Services eligibility worker placed at El Centro
Hispano.
All LATCH services are delivered at no charge to patients. LATCH is funded
by the U.S. Department of Health and Human Services, Bureau of Primary
Care to Duke's Division of Community Health. The Division of Community
Health is a joint division of Duke's Department of Community and Family
Medicine and the Duke University School of Nursing.
- Contact: Susan Yaggy, M.P.A., Division of Community Health, Department
of Community and Family Medicine, 919-681-3188
Lyon Park Clinic
The Lyon Park Clinic, a joint program of Lincoln Community Health Center
and the Duke Division of Community Health, was designed to meet the health
needs in this southwest central Durham community. The clinic is housed
within the Community Family Life and Recreation Center of the West End,
Inc., which also houses Headstart, after-school programs, a senior center,
summer enrichment, GED, and job training classes.
The clinic treats patients from all age groups and has a bilingual provider.
Because of the partnership with Lincoln Community Health Center, Lyon
Park patients pay on a sliding scale and no patient is denied service
because of inability to pay. Opened in April, 2003, the clinic is slated
for expansion this spring.
- Contact: Susan Yaggy, M.P.A., Division of Community Health, Department
of Community and Family Medicine, 919-681-3188
School-Based Clinic Program
Keeping children healthy and ready to learn is the goal of four school-based
clinics in Durham, administered by the Duke Division of Community Health.
The schools have a total enrollment of 3,052 youngsters in the three elementary
schools and one high school served. Supporting partners include Durham
Regional Hospital, Duke Hospital, Triangle Family Practice and the Center
for Child and Family Health, which provides mental health services to
two of the elementary schools.
The school-based wellness centers give children access to medical and
mental health services during school hours. Each wellness clinic is staffed
with a part-time physician, nurse practitioner or physician assistant
and office manager. Durham Public Schools donates renovated clinic space
and utilities, plus the office manager for most clinics.
Any student can receive services at their school-based clinic regardless
of ability to pay. The wellness clinic staff will coordinate with a child's
primary care physician if the child is enrolled in another practice. Services
offered include: physical exams; medical care for chronic illness; eye
exams; treatment of injuries; gynecological exams for high school students;
nutrition counseling; evaluation, counseling and referrals for mental
health needs; and referrals to specialists as needed.
- Contact: Susan Yaggy, M.P.A., Division of Community Health, Department
of Community and Family Medicine, 919- 681-3188
Promising Practices™
Promising Practices provides in-home chronic disease treatment and case
management for patients in Durham, particularly the elderly or those with
disabilities who are unable to access office-based care. Developed by
a local coalition including Lincoln Community Health Center, Durham County
Health Department, Durham Department of Social Services and Duke University
Health System, this collaboration utilizes the services of each of its
partnering organizations to provide care to patients who are low income,
many of whom are uninsured.
Promising Practices visits patients in their homes, offering medical
care through a team of Duke nurse practitioners and physician assistants,
under the direction of a Duke physician. Patients also receive in-home
health education and case management to obtain other necessary health
and social services.
- Contact: Susan Yaggy, M.P.A., Division of Community Health, Department
of Community and Family Medicine, 919-681-3188
The University of North Carolina at Chapel Hill School of Medicine
Student Health Action Committee Clinic
The Student Health Action Committee Clinic is the oldest student run
clinic in the United States, and whose clear purpose is to provide a free
medical clinic for the underserved population in Orange and other North
Carolina counties. SHAC offers quality, efficient care, including prevention,
education and referral to the uninsured community.
Operating as an interdisciplinary program, SHAC is able to provide a
wide range of service to a community that would otherwise have no or very
little medical treatment. One of their highlighted programs is to run
a special immunization clinics in the fall and winter to help underserved
children receive better health and entry into school.
- Contact: Lynn Wooten, Media
Relations Manager, 919-966-6046
Inner-Faith Council for Social Service Community House Psychiatric
Clinic
For the past six years, the University of North Carolina's Department
of Psychiatry has provided a psychiatric clinic within IFC Community House.
Originally started to provide short-term analysis and treatment of the
underserved population of Orange County, the program has recently intensified
its mission to specifically address the needs of the homeless mentally
ill.
With estimates that over 30% of the current homeless population suffers
from severe and persistent mental illness, IFC Community House and the
Department of Psychiatry provide a challenging community with medical
attention that would otherwise be difficult to obtain.
Wake Forest University Baptist Medical Center - Winston-Salem, NC
Downtown Health Plaza of Baptist Hospital
For the financially disadvantaged, DHP provides a lifeline to primary
and specialty care. The $10 million, state-of-the-art community health
facility recorded more than 71,000 annual patient visits in fiscal year
2005, with about 30 percent of patients uninsured. Fees are charged on
a sliding scale for services that include pediatrics, OB/GYN, adult medicine
and radiology, as well as selected specialty and disease management clinics.
DHP also provides offices for the Department of Social Services and Forsyth
County Public Health.
- Contact: Michael Clements, Director, 336-716-9622
BestHealth®
A community resource center located at one of North Carolina's largest
and busiest shopping malls, BestHealth provides a multimedia library of
health information, more than 600 classes each year (almost all free),
and hundreds of free health screenings. The staff of registered nurses
hosts the center, which logs more than 70,000 visitors each year.
- Contact: Joanna Lyle, 336-716-1277
Children's Health Outreach
Wake Forest University Baptist Medical Center faculty have developed
innovative, collaborative community programs to improve health care for
children. Programs include in-school health clinics established with the
School Health Alliance of Forsyth County and a pediatric mental health
initiative developed with the Northwest Area Health Education Center and
CenterPoint Services.
- Contact: Jane Foy, M.D., 336-716-2984
Puerto Rico
Universidad Central del Caribe - Bayamon, Puerto Rico
Decreasing High Risk Conduct Leading to School Desertion and Health
Complications in Adolescents
Universidad Central del Caribe School of Medicine first-year medical
students interact with public school adolescents to increase their knowledge
on health. In addition to serving as role models, medical students provide
factual information, help identify and relieve societal and peer pressures,
and give guidance in lifestyle changes to improve health and academic
performance.
The program helps obtain accurate information about adolescent lifestyle
issues that affect school performance, such as health status, living arrangements,
and income ensuring a more precise approach to helping the children.
Texas
Baylor College of Medicine - Houston, TX
Healthcare for the Homeless - Houston
Baylor is helping expand access to health care through its partnership
with Healthcare for the Homeless - Houston (HHH), a community organization
that gives free care to the homeless. HHH improves the health status of
the homeless population of Houston and Harris County by encouraging and
enabling access to new and existing health care, dental services, mental
health, and substance abuse facilities, as well as enhancing communication
and collaboration among agencies that serve homeless individuals.
The Baylor College of Medicine/Star of Hope Center for Counseling
The Baylor College of Medicine/Star of Hope Center for Counseling serves
homeless Houstonians residing at the Star of Hope Transitional Living
Center (TLC). At any given time, the TLC provides housing for 110 adults
and 125-175 children. Families are allowed to stay 12-18 months, during
which time adults attend recovery, personal development, and career development
programs, and children attend school and after-school programs. The Center
for Counseling provides individual, family, and group therapy, as well
as medication management, psychological testing, health coaching, and
social skills classes.
School Based Clinics Program
In an effort to meet the needs of the community, Harris County Hospital
District (HCHD) has funded 8 school-based clinics in conjunction with
four local independent school districts to bring health care services
closer to home for students and their siblings. At each school-based clinic,
services offered include well-child/adolescent exams, immunizations, treatment
of acute and minor illnesses, management of chronic conditions such as
asthma, and health education. Referral for problems beyond the nurse practitioner's
scope of practice are made to the linking community health center and/or
to tertiary services located within one of two full-service hospitals
operated by HCHD.
The Baylor Family Medicine Women's Health Program
The program meets the needs of the growing population of uninsured women
requiring women's health and maternity services. The program has three
Harris County Hospital District community health clinics, and five Harris
County Health Department public health centers meeting the needs of the
underserved population of Harris County. The Baylor Family Medicine Inpatient
Obstetric Service is the department's inpatient service for the obstetric
patients. Obstetrics patients belonging to Baylor Family Medicine residents
and faculty are admitted to this low risk obstetrics service.
Hospital-Based Care - Urgent Care Center
Emergency department overcrowding is a problem of national concern that
has impacted the Ben Taub General Hospital Emergency Center. As one of
only 2 hospitals in the area providing care to the indigent and uninsured
residents of the Harris County Hospital District, Ben Taub is also a highly
visible entry point for many who seek access to the health care system.
From January 1, 2003 to September 30, 2003, the UCC treated 7,372 patients
with conditions including extremity fractures, simple lacerations, abscesses
and soft tissue infections, upper respiratory tract infections, urinary
tract infections, back or joint pain, dental pain and dental infections,
diabetes mellitus type 2, and high blood pressure.
Community Mental Health
The Thomas Street Clinic Psychiatry Clinic provides services to HIV-infected
individuals in a medical clinic setting for Harris County Hospital District
eligible patients, including routine and emergency diagnostic assessments,
medication management, individual psychotherapy and outreach development.
Linkages are established with community-based organizations to diminish
a sense of isolation, depression and anxiety related to HIV diagnosis.
Losses, lack of family support, and the stigma of HIV diagnosis are all
discussed in a confidential, compassionate and secure forum.
Community-Oriented Primary Care (COPC) Project
The overall purpose of the COPC Project is to improve the health status
of community populations served by the health care providers, including
the neighborhoods surrounding the six health centers staffed by BCM for
the Harris County Hospital District. Representative COPC projects include
the following: an assessment of the nutritional status of food served
in shelters for the homeless; an assessment of elders' perceptions of
mistreatment by their caregivers; and a project to develop an occupational
medicine clinic to treat work-related health problems and environmental
exposures among employees of nearby petrochemical plants.
University of Texas Medical School at Houston
Uncompensated Care
In fiscal year 2003, physicians at the University of Texas Medical School
at Houston provided more than $107 million in uncompensated care to the
community through its affiliated hospital and clinic programs.
Acres Home Partnerships
UT Medical School at Houston provides medical and health education services
to the residents of Acres Homes, fostering health promotion and disease
prevention projects, such as Student Nurse Isolated Elderly Program and
Acres Homes Project, "PALS."
- Contact: Bryant Boutwell,
Dr.P.H., assistant dean for community affairs and public education,
713-500-5109
Rusk School-Based Clinic
Using an interdisciplinary model, UT Medical School at Houston faculty
and students provide preventive and curative care, health assessments,
and dental care to predominantly uninsured or underinsured Hispanic elementary
school students. Colleagues from the University of Houston also provide
optometry services as well as social support to students and their families.
Part of this project focuses on introducing health promotion and wellness
concepts into the elementary school curriculum.
- Contact: Bryant Boutwell,
Dr.P.H., assistant dean for community affairs and public education,
713-500-5109
Texas-Mexico Mobile Van and Telemedicine Project
Through grant support, an infrastructure of telecommunication lines
links the UT Houston medical school and the school of public health to
four elementary schools in Hidalgo County and to the Hidalgo County Health
Department. Telemedicine equipment at the UT Health Science Center at
Houston Mobile Clinic provides clinical education for the medical students,
as well as health care services for children and families in the underserved
areas of Hidalgo and Cameron counties. In 2002, the mobile clinic provided
services to over 2,300 patients and provided immunizations to 2,366 local
children.
- Contact: Bryant Boutwell,
Dr.P.H., assistant dean for community affairs and public education,
713-500-5109
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