Improving Access to Care A Rural Model

Network

Rural Primary Care Clinics Community Chitimacha Health Clinic St. Mary Chamber of Health Iberia Comprehensive Community Health Center Teche Action Clinic Coalition Public Health Social Service St. Mary Community Action Agency Office of Public Health, Region III Rural Hospitals State Hospitals Franklin Foundation Hospital Teche Regional Medical Center Leonard Chabert Medical Center LSU-University Medical Center

HISTORY

1997:

First Meeting

1998:

Incorporated

1999:

Rural Network Development Grant

2000:

St. Mary Chamber of Health -501C3, nonprofit status -Community Access Program Grant -Community Based and Rural Health -AHRQ -ORHP Outreach Grant

Why?

Partnership with LRHAP in 1999 First Meeting in early 2000 Community Forums & H.A.B.I.T.S

 -Faith-Based

Identification of Five Key Needs

 -Governmental    -Educational -Health Care -Social Service

Establishment of Respective Committees

Network’s First Strategic Plan

Chamber of Health Consumer Education Information & Help Center Telemedicine/ Education Community Outreach Medication Pharmaceutical Assistance Consumer Finance Information & Help Center Primary/ Specialty Care

LRHAP & SWLAHEC Physician Recruiter

* H.E.L.P

Transportation Transportation Task Force Library Help Center

ByNet Board of Directors

ByNet Executive Director

Executive Assistant

ByNet Board of Directors

Chamber of Health

Help Center Operations Director Help Center Operations Director Help Center Coordinator -Main Office Help Center Coordinator -FFH Emergency Dept Outreach/DME Coordinator

ByNet Executive Director

Finance Manager Franklin Pharmaceutical Coordinator AARP Pharmaceutical Coordinator Chitimacha Pharmaceutical Coordinator (PT) Volunteer Coordinator ICCHC Pharmaceutical Coordinators (2)

Community Volunteers

Rx/Outreach/Help Center Executive Asst Marketing Coordinator

Community Health Team Outreach Sites (Help Center) Extension Sites

MAIN SITE

-Help Center -Rx -DME -Transportation

Non-Grant Funding

Program Revenue Transportation Donations Fundraising Medicaid Enrollment Administrative Consultation (ED & CFO) AmeriCorps Community Donations

In-Kind Funding

Space, Phone, Internet, Maintenance, Utilities at Five Network Locations Network CEO’s Time and Staff Partners’ Time and Staff

Local Government & Community

Community Volunteers Community Understanding “Provider-Issue” Vs. Community Problem with Community Solutions

> 120 Hours/Month

Volunteers

Program Implementation

…assess what is in place?

Initially through creation of a hardcopy community resource directory Creation of Database for Electronic Referral Distribution of Newspaper Resource Directory

Information & Help Center

ByNet’s Main Site Franklin Foundation Hospital ED St. Mary Parish Library Extension Site

Don’t Miss the Opportunity

EDUCATION Chronic Disease Management/ Prevention

-Informative Packets -Support Groups -Community Classes

Patient Responsibility

-Fitness/Medication Compliance

ENROLLMENT Health Plans

i.e. Medicaid, Medicare, QMB, LaChip, VA

Assistance Programs

-i.e. Food for Seniors, Utility Assistance, Care for the Caregiver

SCREENINGS/ VACCINATIONS

-i.e. Blood Pressure Checks, Diabetes Testing, Flu Shots

AWARENESS/ ADVOCACY

-Community Involvement/Ownership, -State Partnerships, -Policy Change

Basic Demographics

Program Eligibility: Income…

Resource Directory

Bi-Annual Newspaper Directory 44,000 Distributed end of 2 nd Year Program Service Update

ED HELP CENTER

ED Referral Client Triage  Eligibility for Medicaid, LaChip & Medicare Savings 

Community Care

Education  Social Service and Health Care Needs Community Referrals Tracking & Follow Up

ED Help Center Survey

Community Health Teams Food, Education, Enrollment & Screenings 2500 2000 1500 1000 500 700 0 Jan of 2003 1800 2300 August Jan of 2004

Health Equipment Loan Program H.E.L.P

Donations: $200,000 Inspection & Repair Community Donation DME

Rx

State Insurance

food

EDUCATION

Transportation

Coordination of Existing Services Development of Transportation Task Force Sharing of hardware, software, coordinator and driver Triage and Referral

Transportation

Veteran (VA) 62+ (Council on Aging) Job Program/In-Parish Public Transit (CAA) Disabled (BIMS) Local Churches

Physician Samples Local Social Service Organizations Discount FQHC Pharmacy Drug Manufacturers’ PAP Programs Drug Manufacturers Discount Card Programs Local Pharmacy Assistance Private Foundations Veterans Affairs

…triage according to need and the most cost and time efficient means to obtain assistance.

Other 2 Charity Hospitals FQHC (TAC) FQHC (ICCHC)

Medicare Savings Share the Care

340b Drug Manufacturer’s Discount Card Programs & PAP St. Vincent de Paul (Free Pharmacy) Emergency Aid, Community Action Agency (Social Service) Faith Based Community

CAH T.C.

C.A.A

LSU OPH DHH Tulane R. H.

FQHC FQHC FQHC FQHC CHSL FQHC FQHC FQHC FQHC FQHC LSU C.H.

LSU-HSC

Documentation of In-Kind & ROI

In-Kind Monthly Reporting Procedures in Place Finalizing Incorporation of Reports in Monthly Finance Report Continued Focus on ROI  (i.e. Jan. 2003 Oct. 2004, ByNet’s Medication Assistance Program has procured an estimated $7,063,320 (Top 4 Meds + VIH Average))  Annual In-Kind Donations: >$136,000/year  Top Four Medications Procured Total $1,166,685.30/Yr

Physicians

120 100 80 60 40 20 0 Physician Participation

Implementation 6 Months To Date

Health Access Barriers in the State

25% 20% 15% 10% 5% 0% Claims of Rx Barrier 2000 2003

Non Emergent ER Care

% Primary Care Visits at Franklin Foundation Hospital 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Jan 03 Feb 03 Mar 03 Apr 03 May Jun 03 03 Jul 03 Aug Sep 03 03 Oct 03 Nov Dec 03 03 % Primary Care Visits