SUMMER/FALL 2010
IN THIS ISSUE A Message from Our President & CEO (2)… Summer Exercise Tips (2)... What Does Healthcare Reform Mean to You? (3)... PHMC Now Accepting Online Donations (3)... Q&A: Nurse Practitioners and Healthcare Reform (4)... The Phrase that Pays (6)... Targeted Solutions (8)... PHMC Awarded Southeast Regional Key (9)... PHMC Care Clinic Gets New Home (9)... New Federal Policies Signal Paradigm Shift (10)... CHDB Report (11)
DIRECTIONS Linda Creed: Meeting the Healthcare Needs of Women in the Era of Reform
L
ast spring, Peniquia “Pinky” Russell
receiving care. While policymakers continue
called PHMC affiliate Linda Creed
to explore the effects the new legislation
with a desperate request. She had a
will have on Americans, Linda Creed re-
lump in her breast that had tripled in size
mains a vital link to screening and diagnos-
within the span of a month and she was
tic direct care services for uninsured and un-
not sure what to do next. “I didn’t have any
derinsured women in the Delaware Valley.
insurance at the time,” recalls the 29-year-
“The passing of the healthcare reform
old. “When I first called Linda Creed, they
bill will have a major impact on everyone—
asked me if I had a primary doctor. But
not just the women whom we serve at Linda
because I didn’t have health insurance, I
Creed, but all the people we serve through
would go to free clinics, but only if I had to,
PHMC’s programs and health centers,”
not for routine checkups.” Donna Duncan,
says Duncan. “However, the effects of the
executive director of Linda Creed, comes
bill will phase in over time. For instance,
across clients like Russell everyday—
it could be up to four years before our un-
women whose status as uninsured and
insured clients have access to insurance.”
underinsured patients prevents them from
In the meantime, Linda Creed continues to
receiving regular, much-needed care.
help clients like 54-year-old Patricia Evans,
The new healthcare reform legislation
who works part-time and thus does not
seeks to target these very clients who lack
qualify for health insurance. Thanks to
appropriate insurance by extending benefits
Linda Creed, she was able to receive a
and, over time, relaxing restrictions that
mammogram for the first time in years.
previously prohibited such patients from
“
continued on page 7
I didn't have any insurance... I would go to free clinics, but only if I had to, NOT FOR ROUTINE CHECKUPS.” a publication of
PUBLIC HEALTH
management corporation
A MESSAGE from Our President & CEO
P
HMC’s work—as extensive and com-
will give us the first glimpse of how the
prehensive as it is—focuses on the
initial impact of reform is being felt across
public health needs of the region.
southeastern Pennsylvania while providing
Yet we remain very much plugged into the
a clear comparison with the nation’s Healthy
national trends that unquestionably affect
People 2010 goals. With more than 25 years
our work. And at times the things we do
of data, we offer an unsurpassed ability to
impact the national agenda as well.
watch trends regionally and assess them
With this in mind, we have been paying
against national benchmarks.
close attention to healthcare reform leg-
We follow, affect and incorporate US
islation to understand its implications for
policies every day, in every corner of PHMC
our work and, most important, the people
and our affiliates; I invite you to take a
we serve. In this issue, for example, you’ll
moment to read the reflections of our
We thank you for entrusting PHMC with
read about the ongoing critical need for the
employees as they project the impact of
our critical role in the public health of our
programs from our affiliate Linda Creed,
healthcare reform on their activities.
community, and we understand that we
which provides direct breast cancer servic-
Highlighting this integration with na-
most effectively serve those in the region by
es, outreach, education and advocacy for
tional policy, in April we recognized Public
staying abreast of public health issues and
uninsured and underinsured women. And
Health week with a standing-room-only pre-
trends from across the US and worldwide.
in the interview with leaders from affiliate
sentation by A. Thomas McLellan, then-dep-
National Nursing Centers Consortium
uty director of the Office of National Drug
(NNCC), it becomes clear that the provi-
Control Policy, who spoke about behavioral
sions of healthcare reform align with our
health’s place in healthcare reform and
work. In fact, NNCC played a role in advo-
shared the podium with Arthur C. Evans,
cating for key provisions that strengthen
Jr., PhD, director of the Philadelphia Depart-
the role of nurse-managed care and thus
ment of Behavior Health and Mental Retar-
Richard J. Cohen, PhD, FACHE
expand access to health services.
dation Services who reported on the local
President and CEO of PHMC
The completion of the Community Health Data Base 2010 household health survey
Yours in public health,
landscape along with PHMC's own experts in behavioral health services and research.
Summer Exercise Tips
A
s we enjoy August, one of the hot-
training to help young people succeed in
Cover your head while working out. It
test months of the year in our region,
life, and a lifelong runner herself, McDanel
will protect your skin from harmful UV
keep in mind the following exercise
maintains that regular workouts can be an
rays and keep you cool at the same time.
tips from Students Run Philly Style direc-
energizing part of the summer if you keep
T ry to work out in the early morning
tor Heather McDanel. As executive director
the following precautions in mind.
of Students Run Philly Style, the only pro-
S tay hydrated. As the temperatures rise,
gram in Philadelphia that offers marathon
so do your chances of getting dehydrated
I f the temperature is higher than 90 de-
during the hot summer months. Drink
grees Fahrenheit or there is a chance
water both before and after a workout. If
of high humidity, help prevent heat in-
you are running, carry a water pack that
jury by considering other options such
can keep you hydrated during long runs.
as exercising inside or walking through
When working out in the summer, wear light fabrics in light colors that allow your skin to breathe.
page 2 PHMC.ORG
or evening instead of midday, when the sun’s rays are the hottest.
an indoor mall. A lways wear sunscreen while outside, no matter what the season.
What Does Healthcare Reform Mean to You?
P
PHMC briefs Honors, Awards and Achievements
reform into law on Tuesday, March 23.
“
of a new era for nurse-led health care.
The Journal of Evidence-Based Social Work
resident Obama signed healthcare
Health reform signals the beginning
For this issue of DIRECTIONS, we
The legislation defines “nurse-managed
published “Effects of Drug Use on Sexual
asked PHMC and affiliate employees: “What
health clinic” in federal law for the first
Risk Behavior: Results of an HIV Outreach
does the passage of healthcare reform mean
time and creates a new $50 million
and Education Program,” an article by Jen-
to you?” Here are a few of the responses.
grant program to support these innova-
nifer L. Lauby, PhD, senior research asso-
“
tive safety net providers. This new grant
ciate; Heather Batson, research associate;
Health Promotion Council’s (HPC)
funding will help ensure that nurse-man-
and Mary Milnamow, research associate, in
core service is to provide health promo-
aged health clinics—including PHMC's
its January 2010 issue. The article includes
tion and prevention services for underin-
nurse-managed primary care centers—
findings from the researchers’ evaluation of
sured and uninsured people. Healthcare
are able to continue to provide care to
PHMC’s Pathways Project, an HIV interven-
reform expands coverage to 1.3 million
low-income and vulnerable communities
tion for out-of-treatment drug users. The re-
Pennsylvanians who do not currently have
for years to come.”
searchers examined the effect of decreases
insurance and to 683,000 residents who
–Donna Brian, CRNP, PhD
have non-group insurance who will now be
PHMC Health Connection, Clinical Director
able to attain affordable coverage through
in drug use on incidence of unprotected sex with main and non-main partners.
“
The Health Reform package offers
“Magic Johnson doesn’t worry about how to
the many provisions includes an essential
enormous relief to working families who
pay for medicine: experiences of black men
benefit package comprising preventive
have been too poor to afford traditional
who have sex with men living with HIV,”
services and chronic disease. Additionally,
insurance yet whose income was too high
written by Lauby, Lisa Bond, PhD, senior
the legislation will include elimination of
for Medicaid. States will now be able to
research associate, and Archana Bodas
cost sharing for preventive care services
cover adults up to 133% of the federal
LaPollo, MPH, senior research associate,
in Medicare, as well as capping out-of-
poverty level. For those of us who serve
along with Chong-suk Han of Middlebury
pocket expenses for low-income families.
vulnerable populations, such as those who
College and Scott Edward Rutledge of Tem-
An example of how this will impact HPC’s
are homeless or living in marginal situa-
ple University, was published in the February
efforts is that 2.2 million seniors will be
tions, there will be additional funding to
2010 issue of Culture, Health & Sexuality: An
able to access free-of-charge preventive
add more clinicians, special services such
International Journal for Research, Intervention
care services. Seniors can now seek pre-
as mental health, dental care or even
and Care. The article presents findings from
ventive services without making tough
funding to expand our health centers. We
PHMC’s Black Men’s Health Survey, which
choices between health and other impor-
will be able to provide more services to a
examines the everyday lives of HIV-positive
tant life expenses.”
greater number of patients.”
black gay, bisexual and other men who have
the health insurance exchange. One of
–Vanessa Briggs, MBA, RD, LDN
–Elaine Fox, MA
sex with men, and focuses on how being a
Executive Director, Health Promotion Council
Vice President, Specialized Health Services
racial minority may influence the ways they manage living with the illness. Philadelphia Treatment Court case man-
PHMC Now Accepting Online Donations
Y
agers John Berry and Mary Santangelo received distinguished service awards for their more than 10 years of contributions and dedicated service to Philadelphia
ou can now make an easy, secure and
You can designate your gift in honor or
paperless donation to PHMC online.
memory of a loved one and you may specify
Every donation is tax-deductible and
the program your donation will benefit.
helps us meet our region’s public health needs and better serve our communities.
Visit PHMC.ORG/donate to make a gift today.
Treatment Court at the court’s 139th graduation ceremony in January.
continued on page 5
DIRECTIONS SUMMER/FALL 2010 page 3
Nurse Practitioners and Healthcare Reform: Opportunities and Challenges Ahead
With new healthcare legislation promising basic health care for millions, there will be a demand for more primary care practitioners—a gap that nurse practitioners are ready to fill. DIRECTIONS editorial staff sat down with Tine Hansen-Turton, executive director of PHMC affiliate National Nursing Centers Consortium (NNCC) and PHMC vice president for Health Care Access and Policy; Ann Ritter, director of health center development and policy at NNCC; and Brian Valdez, health policy manager at NNCC to discuss healthcare reform legislation and the impact it will have on advanced practice nurses.
Q A
Why should nurse practitioners and
that’s exactly where our members are: in
funded to do! Our founding goal was to
NNCC-member nurse-managed health
urban, rural and suburban communities
make the nurse-managed health center
centers want healthcare reform? How
across the country. It also focuses on pub-
federally recognized. A big part of our mis-
could it affect them in their everyday
lic health and disease prevention, creat-
sion was accomplished by the bill itself.
patient care roles?
ing new investment in wellness services
Tine Hansen-Turton: Healthcare reform
and preventive care. This fits very well
Brian Valdez: NNCC’s advocacy for a
is a good thing for nurses. This is an op-
with nursing's overarching philosophy
federal grant program dedicated to
portunity for which we have been advo-
of comprehensive, patient-centered care
nurse-managed health centers began
cating for a long time. With the current
that's meant to prevent illness instead of
in earnest with the introduction of the
shortage of primary care physicians, and
just treating the symptoms of disease.
Nurse-Managed Health Clinic (NMHC)
even fewer physicians going into pri-
ate. Although that legislation eventually
healthcare reform legislation?
stalled, NNCC’s advocacy, which included
TH: We were instrumental in assuring that
holding a congressional briefing around
nurse-managed health centers were in-
the importance of NMHC funding, made
cluded in healthcare reform. We laid the
it possible for the bill to be reintroduced
through primary care nurse practitio-
groundwork to help ensure the sustain-
in 2009. Last year, NNCC worked with
ners, who have an opportunity to claim
ability of the nation’s nurse-managed
congressional champions to reintroduce
a significant core of health care delivery.
health centers through the creation of a
the NMHC Investment Act in the Senate
new $50 million grant program. The new
and its companion bill in the US House
Ann Ritter: The law also recognizes that
law is a culmination of 10 years of work po-
of Representatives. Again, NNCC’s mem-
we're going to need community provid-
sitioning nurse-managed health centers
bers engaged in a national advocacy
ers in order to successfully implement
as critical access points for underserved
campaign, involving both senators and
the law. Healthcare reform focuses on im-
populations and as teaching sites for fac-
representatives. Ultimately, NNCC’s con-
proving health care in communities, and
ulty and students. This is what we were
tacts in the Senate and House were able
many as 44,000 physicians in the fields of general internal medicine and family medicine by the year 2025, there really is no other way to meet the need than
Q A
Investment Act of 2007 in the US SenWhat was NNCC’s role in the
mary care, resulting in a shortage of as
page 4 PHMC.ORG
for primary care. If you look at the edu-
included in the final healthcare reform
cational levels of nurse practitioners in
legislation signed into law by President
the United States, they are more highly
Obama earlier this year. We were very
educated than most GPs throughout the
continued from page 3
persistent. We stayed focused and on
rest of the world, yet barriers to nurse
Elaine Fox, vice president of Specialized
message. And we had a very solid team.
practitioner practice remain. So I still
Health Services, who manages Phila-
Tine, the NNCC policy team, our members
think you will see the politics of nurse
delphia’s Health Care for the Homeless
and our interns were invaluable.
practitioners being challenged.
program, moderated “Homelessness: New
Q
Q
Approaches to a Changing Problem,” a Healthcare reform will require more
panel discussion hosted by the Philadelphia
advanced practice nurses as primary
Committee on City Policy (PCCP) in March.
care providers. What types of incentive
Lynne Kotranski, PhD, vice president for
programs would you recommend to
PHMC’s Research and Evaluation Group
AR: The new $50 million funding pro-
encourage nurse practitioners to
and a member of PCCP’s board of directors,
gram is relatively small compared with
choose primary care as their specialty?
provided welcoming remarks. The panel
BV: Practicing in that type of setting is
focused on innovative policy and program-
its own incentive. Our past studies have
matic solutions to address the spectrum of
How will the new legislation affect the nurse-managed health center business model and make such centers more sustainable?
A
some other parts of healthcare reform, but it will go a long way toward improv-
A
shown a high rate of satisfaction associ-
homelessness rarely seen—those who are
health centers. The new grant program
ated with practicing in community health
struggling to break the cycle or are just a
is designed to support the development
centers; part of it is just the indepen-
paycheck away from homelessness.
and operation of nurse-managed health
dence they have, in terms of making their
centers, also called nurse-managed
own practice decisions. That autonomy
The April 2010 issue of Journal of Asthma
health clinics in the legislation. While
is a major incentive. The healthcare bill
included “The Child Asthma Link Line: A
the details still need to be worked out,
also provides incentives for loan repay-
Coalition-initiated, Telephone-based, Care
this will help ensure that many of our
ments for students.
Coordination Intervention for Childhood
ing the sustainability of nurse-managed
Asthma,” an article by Kathleen Coughey,
members, especially the ones that can’t
Q A
PHMC briefs
to get the NMHC grant program language
qualify for existing health center funding
AR: Most nurse practitioners choose
PhD, senior research associate at PHMC;
programs, are able to get the new fund-
that profession because they’re inter-
Caroline West, MPAff, research associate
ing that they need to continue serving
ested in primary care already. One way
at PHMC; Erin McCarville, MPH; Gary
vulnerable patients.
to encourage nurse practitioners to
Klein, PhD; James Diamond, PhD; Abbie
enter primary care and stay there is to
Santana, MSPH; and PHMC affiliate Health
The profile of nurse practitioners
remove unnecessary legal barriers to
Promotion Council board member Michael
is on the rise. What are your
nurse practitioner practice. Nurse prac-
Rosenthal, MD. The article focuses on
predictions about nurse practitioners
titioners are capable of safely providing
Health Promotion Council’s Asthma Link
post-healthcare reform bill?
care that’s comparable to a primary care
Line,
TH: There are about 150,000 practicing
physician, but many states place regula-
based call center that coordinates medical
nurse practitioners right now, and about
tory hurdles in their way. These hurdles
appointments, asthma education and other
5,000 to 6,000 graduating every year. I
don’t improve patient safety, but they
health and social services for families
would bet that, 10 years from now, nurse
make nurse practitioner practice less
affected by asthma.
practitioners will be the face of primary
efficient and they are immensely frus-
care—an accepted face. Nurse prac-
trating to nurse practitioners. Getting
On April 20, 2010, Tammi Fleming, director
titioners are very highly skilled. Most
rid of these barriers would go a long way
of Plain Talk National Replication Center,
other countries have something called
toward increasing the number of nurse
received a certificate from the United Way
a general practitioner, known as GPs,
practitioners providing primary care.
Young Leaders Program after completing its
an
award-winning,
community-
board orientation program. The program provides networking and volunteer op-
For expanded answers to these questions and more Q&A with the
portunities to United Way Leadership donors under age 40.
healthcare experts, visit PHMC.ORG/DIRECTIONS .
continued on page 7
DIRECTIONS SUMMER/FALL 2010 page 5
The Phrase that Pays “Education is the passport to the future, for TOMORROW BELONGS TO THOSE WHO PREPARE FOR IT TODAY.” -Malcom X // “WORDS MEAN MORE THAN WHAT IS SET DOWN ON PAPER. It takes the human voice to infuse them with shades of deeper meaning.” -Maya Angelou // “The difference between school and life? In school, you're taught a lesson and then given a test. IN LIFE, YOU'RE GIVEN A TEST THAT TEACHES YOU A LESSON.” -Tom Bodett
F
or Shanice, a student in PHMC’s
and Buster's gift card while the third
life…. Moving has not only impaired my
Homeless Teen Education Project,
place winner received movie tickets and
childhood and schooling, but my outlook on
the phrase that paid was from Tom
complimentary transportation to the mov-
life…. This unstable upbringing has shown
Bodett. “As I read the quote I cannot help
ie theater. All contestants received certifi-
me how important stability is…. In order
but reflect upon my life experiences past,
cates commending their work.
for me to achieve this I must get an educa-
present, and future. I reminisce about the
The Homeless Teen Education Project,
tion so that I can pursue a career that will
tests and lessons I have endured,” Shan-
a program of PHMC’s Specialized Health
ice wrote in her essay that garnered her
Services component, provides homeless
Since the contest, Shanice and her fam-
first place—and a new digital camera—in
teens with tutoring, mentoring and edu-
ily have moved into permanent housing.
PHMC’s “The Phrase that Pays” Black His-
cational case management services, in-
Shanice plans to attend Kutztown Univer-
tory Month essay contest.
provide me with financial support.”
cluding intensive interventions to improve
sity in Kutztown, PA in the fall. “I want
Shanice and 10 other students partici-
attendance, behavior and academic perfor-
to study biology or pre-med so that I can
pated in the contest, selecting one of 10
mance. Although most of the participants
become a surgeon or pediatrician one day,”
provided quotes, identifying its author and
in the program live in emergency shelters
she says. When asked what she thought of
writing a 300-word essay inspired by the
and transitional housing, some are former-
healthcare reform, she noted that she had
chosen phrase. “Each year we try to give
ly homeless and live in permanent housing.
not been following it very much but that
the teens a writing experience and this
In her essay Shanice writes: “I have
she thought getting people treatment was
is the second year we have had this par-
overcome several obstacles in my life such
the most important thing. “I would treat a
ticular contest,” says Deborah McMillan,
as being homeless, death in my family, and
child first before asking their parents for
assistant vice president for Social Service
having a single parent mother with a bad
proof of insurance.”
Programs at PHMC.
heart condition. All of these circumstanc-
Shanice was the only student to select
es have been my most challenging tests
Bodett’s quote. “There were a lot of good
in life. I have been moving from place to
quotes, but I really liked how this one was
place, city to city, and state to state all my
For more information on the Homeless Teen Education Project, visit PHMC.ORG.
phrased,” she says. Elaine Colbert, teen education specialist, and volunteer tutor Catelyn Coyle coached the teens on writing their essays. Six judges, including a representative from the School District of Philadelphia and PHMC’s vice president of communications Dina Baker, evaluated the essays for format, clarity, style, originality and organization. On April 7, PHMC held a recognition ceremony and dinner for the contest participants and presented awards to the first, second and third place winners. The second place winner received a $50 Dave
page 6 PHMC.ORG
willing to keep ht path and you’re rig e th wn do g in “If you’re walk Barack Obama ogress.” -President pr e ak m ll u’ yo ly walking, eventual y lifetime I look me across in m co I y it un rt po Every op ccess… . And to my path to su es on st ng pi ep upon it as st eet [them], might never m st ju I or il fa s even if my goal g and set important thin xt ne e th to d I must move on I keep trying an t a quitter and no I’m . s… al new go hat gets in my t no matter w gh ri it t ge I l trying unti cceed in life ng it takes to su lo w ho r te at way… . No m e can. if we believe w n ru ng lo e th r we’ll make it fo -Second plac e
essayist
Linda Creed... continued from page 1
PHMC briefs
Roxanne Stockdale, a stay-at-home mom
have difficulty keeping up with living ex-
raising six children with her husband, a
penses such as rent and utilities,” says Bel-
small-business owner, is also uninsured.
da Chan, project coordinator at Linda Creed.
“Our income is such that our children quali-
Linda Creed client Johanna Madigan
continued from page 5
fy for the State Children’s Health Insurance
worked for six years as a housekeeper at
Social Work in Health Care published a book
Program but the program they have for adults
a resort in the Poconos until she was diag-
review in its March 2010 issue by Anya
isn’t available for us. To pay for it on our own
nosed with breast cancer. After undergoing
Goldberg, MSS, MPH, LSW, CPH. Goldberg,
is impossible,” says Stockdale. She called
a mastectomy, she was unable to work as
a forensic therapist at PHMC’s CHANCES,
Linda Creed’s toll-free hotline and obtained
she continued radiation and then chemo-
reviewed Righteous Dopefiend, a book by
a free mammogram. When the test showed
therapy treatments. She moved in with her
Phillipe Bourgois and Jeff Schonberg about
an abnormal result, Linda Creed arranged
daughter to reduce her living expenses and
the world of homeless drug users. “Righteous
for a follow-up biopsy. Says Stockdale, “Peo-
reached out to Linda Creed after her sav-
Dopefiend is a phenomenal contribution and
ple can be condescending if you don’t have
ings started to run out. “I had been call-
must-read for all disciplines concerned with
insurance, but Linda Creed saw our needs.”
ing around and I needed some assistance,”
public health… . Professionals from various backgrounds will find this extremely frank
“
I’ve come across women with breast cancer who have GONE BANKRUPT PAYING FOR THEIR TREATMENTS.”
and transparent study an invaluable addition to the field,” writes Goldberg. In June, Rachel Kirzner, program director for PHMC’s Maximizing Participation Project (MPP), presented a poster session about MPP
The passage of the bill may help meet the needs of clients like Evans and Stockdale.
says Madigan. “Linda Creed understood my
at the Administration for Children and Fami-
situation and I really appreciate it.”
lies’ 13th Annual Welfare Research and Eval-
According to Duncan, the legislation’s provi-
Duncan notes that although healthcare
sion that insurance companies can neither
reform will benefit millions, it still includes
uation Conference held in Washington, DC.
deny coverage to patients with pre-existing
co-pays that add up for patients with breast
After serving two years as president-elect
conditions nor set lifetime caps on coverage
cancer. “Breast cancer is an expensive dis-
for the Pennsylvania Public Health Associa-
will significantly alter the state of women
ease with all the chemotherapy and radia-
tion (PPHA), Jessica Boyer, senior program
looking to maintain optimum breast health.
tion treatments. The cost can easily run
officer at PHMC, began her term as presi-
It will especially help those women cur-
into six figures. Every doctor’s visit, medi-
dent in the fall of 2009. Boyer, an active
rently undergoing treatment. “If you are a
cine and some tests still require co-pays.
member of PPHA since 2003, previously
woman with breast cancer, often you have
There are a lot of out-of-pocket expenses.”
served as treasurer.
been stuck in the healthcare system. Some
As for Russell, Linda Creed was able
insurance companies do not cover pre-exist-
to connect her with a healthcare provider,
Sulaiman A. Wood, program manager of
ing conditions such as breast cancer, while
PHMC’s Rising Sun Health Center, where
Focus on Fathers for PHMC affiliate Re-
others have a waiting period for coverage.
she learned her cancer was growing quick-
sources for Children's Health, was invited
Therefore, you have to pay out-of-pocket for
ly and that she needed a mastectomy im-
to join the Advisory Committee to Review
treatments. I’ve come across women with
mediately. Linda Creed found her a breast
the Effects on Children of Incarcerated Par-
breast cancer who have gone bankrupt pay-
cancer surgeon at a local hospital partner
ents convened by the Pennsylvania Joint
ing for their treatments,” says Duncan.
and she is currently in recovery and under-
State Government Commission after pas-
To meet that need, Linda Creed estab-
going follow-up radiation treatments. As
sage of Pennsylvania House Resolution 203
lished the Patient Assistance Fund, which
the recent legislation continues to expand
and Senate Resolution 52. The committee
provides nonmedical financial assistance to
coverage to patients such as Russell, pub-
will study the effects on children of having
help women fill the gaps that can occur in
lic health partners such as Linda Creed and
incarcerated parents and recommend a sys-
insurance coverage, as well as other inci-
PHMC’s other programs continue to pro-
tem for assessing their needs, the services
dental expenses related to recovery. “Most
vide much-needed support and care.
of the women who apply for our Patient Assistance Fund, even if insured, still face financial hardships including co-pays, money for medication and time off from work. Many
available to them and the barriers to accessing those services.
For more information about Linda Creed, visit LINDACREED.ORG or call toll-free 1.877.99.CREED.
continued on page 9
DIRECTIONS SUMMER/FALL 2010 page 7
Targeted Solutions Takes a Group Approach to Technical Assistance As Targeted Solutions supports organizations in the process of growing and changing to meet new challenges and realities, we also continuously expand and enhance
12 p.m., Targeted Solutions will host a group technical assistance workshop on Outcomes Measurement. To register for this and future workshops, visit
our services to meet our clients’ needs.
O
On September 22, from 9 a.m. to
targetedsolutions.phmc.org.
ver the past year, Targeted Solutions
While imparting new skills and knowledge,
ganization’s capacity in that particular area.
has developed and refined a group
the process is highly reflective and focuses
The group model combines some of the
technical assistance model that
on participants’ application of information
best aspects of training, such as providing
will form part of our continuum of services
and concepts to current issues within their
peer learning opportunities and exchanges,
moving forward. The group model serves
organizations. For example, participants
with the features of more in-depth, individ-
as a bridge between time- and resource-
might be asked to bring organizational docu-
ualized consulting projects, but in a man-
intensive individual consulting projects and
ments such as a strategic plan or logic mod-
ner less costly for organizations in terms of
basic, introductory training.
el to assist in this reflective process.
time and money. In the field of adult learn-
While training often focuses on the indi-
Unlike traditional training, the group pro-
ing, there is extensive research-based evi-
vidual and on specified knowledge or skill
cess does not end after a single session. Tar-
dence that adults learn best in small peer
development, group technical assistance fo-
geted Solutions consultants follow up with
groups and that much of that learning is
cuses on the organization as a whole and en-
attendees to help them identify next steps,
informal. With the new program model, Tar-
courages multiple staff members to attend.
clarify concepts and generally advance the or-
geted Solutions aims to increase networking and information sharing among participating groups, thereby strengthening their
Group Technical Assistance Individual Consulting
Training
High resource investment
Organizationally focused
Balance of organizational and individual impact
High organizational
Repeat contact be-
Moderate resource
impact
tween consultant/ trainer and client
investment development/ knowledge acquisition
Low individual
impact
Networking
Informal peer-topeer learning Individual professional development/knowledge acquisition
Low resource
respective sectors as a whole. “We’re very fortunate,” says Amy Fried-
investment
lander, vice president for Management
Low organizational
Services and Special Initiatives at PHMC,
impact
“that William Penn Foundation, which gen-
High individual
erously supports Targeted Solutions, is
impact
interested in these new ways to effectively provide technical assistance.”
about
Targeted Solutions, the consulting practice of Public Health Management Corporation, helps nonprofit organizations in the region address many of the challenges of today's changing health and human services environment. From improving communications with funders and donors to carrying out mission-critical initiatives and increasing operating efficiencies, PHMC’s Targeted Solutions offers practical, strategic, proactive consulting services and products tailored to meet the needs of client organizations. For a full list of Targeted Solutions products and services, please contact Farrah Parkes at fparkes@phmc.org or 267.765.2343.
PHMC briefs
PHMC Awarded Southeast Regional Key
I
continued from page 7
New Grants
n May, PHMC received a contract from
as subcontractors. PHMC also will evalu-
In January, CVS Caremark Charitable
the Pennsylvania Department of Public
ate providers to assess their quality levels
Trusts Awards presented Linda Creed
Welfare’s Office of Child Development
based on the Keystone STARS system,
with a $10,000 check to continue providing
and Early Learning (OCDEL) to serve as
an initiative of OCDEL to improve, sup-
screening and diagnostic testing to women
the Southeast Regional Key (SERK) for
port and recognize the continuous quality
in the community.
its Pennsylvania Early Learning Keys to
improvement efforts of early learning pro-
Quality initiative, a statewide quality im-
grams in Pennsylvania. Participating pro-
PHMC’s Specialized
provement program targeting childcare
viders are ranked on a scale from STARS
(SHS) component received $187,000 in
providers. SERK is one of six regional keys
Level 1 to STARS Level 4, with Level 4 rep-
April from the Pew Fund for Health and Hu-
working in partnership with OCDEL to
resenting the highest level of quality. Pro-
man Services, part of The Pew Charitable
develop and implement an integrated and
viders receive grants or merit awards from
Trusts’ Philadelphia Program, to implement
coordinated system of program quality im-
SERK for achievement of higher STARS
the Homeless Early Intervention Project.
provements and professional development
Levels. They also receive higher subsidy
Currently, SHS provides assessment servic-
supports for early childhood education.
rates through the state’s Child Care Subsi-
es to children living in shelters. The grant
Health
Services
As the Southeast Regional Key, PHMC
dy Program. Keystone STARS is managed
will help expand services to children in tran-
will offer technical assistance and profes-
through a partnership between OCDEL and
sitional housing and aid efforts to remove
sional development to childcare providers
the Pennsylvania and Regional Keys.
barriers to the early intervention system for
in Philadelphia, Delaware and Montgomery Counties through specialized staff as well
homeless children ages three to five.
For more information, visit pakeys.org. The Leo & Peggy Pierce Family Foundation
“
awarded PHMC affiliate Interim House,
SERK represents an opportunity for PHMC to leverage and coordinate several largescale initiatives to benefit children and youth in the region. ChildLink, our early intervention system for children age three and younger experiencing developmental delays and disabilities, and OST, the city's Out-of-School-Time initiative that we manage, will work in partnership with SERK to offer supports and services to early childhood education providers as they pursue continuous quality improvement.”
which provides a continuum of comprehensive services to women addicted to drugs and alcohol, with a $30,000 two-year grant. Community Health Data Base recently received four grants from major area foundations, including an additional $1 million over four years from The Pew Charitable Trusts and new support of $10,000 each from Philadelphia Foundation, CIGNA Foundation and Green Tree Community Health Foundation.
— Amy Friedlander, Vice President for Management Services and Special Initiatives
Correction In the Winter 2010 issue of DIRECTIONS, we incorrectly reported the amount raised in
PHMC Care Clinic Gets New Home
I
n March, PHMC’s Care Clinic moved
ing primary care, pediatric care, specialized
from St. Joseph’s Hospital to 1200 Cal-
supportive services and family planning to
lowhill Street. The Care Clinic, part of
public housing residents and underserved,
PHMC’s network of health centers, is a
uninsured and homeless populations living
Federally Qualified Health Center provid-
in communities located near the clinic.
PHMC’s 2009 United Way Employee Giving Campaign. The correct amount is $131,753. We apologize for the error.
DIRECTIONS SUMMER/FALL 2010 page 9
Heard at PHMC: New Federal Policies Signal Paradigm Shift in Addiction Treatment and Prevention
F
orty years after President Richard
McLellan, who stepped down from
and also a speaker at the April event,
Nixon declared a “war on drugs”
ONDCP this summer, has been a major
agrees. “Addiction is a chronic condition,
the White House released a national
voice for identifying and treating addic-
but the current system is set up to treat
drug policy that aims to fight a disease,
tion as a chronic illness. Among the na-
it on an acute basis,” he noted. Evans dis-
not a war, by treating illegal drug use as a
tion's leading researchers on addiction,
cussed a paradigm shift in the delivery of
public health issue and investing more re-
he has more than 30 years of experience
addiction services in Philadelphia, which
sources into prevention and treatment.
in addiction treatment research.
he said aligns with the direction of the new drug policy and is based on a recovery-
“
Healthcare reform will do for substance use
disorders WHAT BROWN VS. THE BOARD OF EDUCATION DID FOR SCHOOL DESEGREGATION.”
oriented system of care with emphasis on early intervention and sustainability after leaving treatment. Like McLellan, Evans noted that addiction should be monitored continually and managed much like other chronically relapsing medical conditions such as asthma, diabetes and hypertension. “The integration of substance abuse
The new drug control strategy, released
“Healthcare reform will do for substance
treatment into primary care centers rep-
in May, promotes community-based anti-
use disorders what Brown vs. the Board of
resents a critical paradigm shift that will
drug programs, encourages healthcare pro-
Education did for school desegregation,”
help decrease the stigma associated with
viders to screen for drug problems before
McLellan told lecture attendees, referring
seeking help for addiction while also in-
patients become dependent, and expands
to the historic segregation of addiction
creasing access to care for thousands of
treatment beyond specialty centers to
treatment from the rest of health care. The
consumers who wouldn’t otherwise receive
mainstream healthcare facilities.
healthcare reform bill will integrate addic-
it,” says Leslie Hurtig, MPA, vice presi-
In April, A. Thomas McLellan, then dep-
tion treatment into primary care settings,
dent for Behavioral Health Services at
uty director of the Office of National Drug
making substance use treatment more ac-
PHMC and a co-speaker at the event with
Control Policy (ONDCP), spoke at PHMC to
cessible. In addition, it requires all health-
Lynne Kotranski, vice president of PHMC’s
outline the priorities and share the latest de-
care plans to cover substance use disorders,
Research and Evaluation Group. Research
velopments in federal drug control policies
address prevention and promote workforce
shows that individuals receiving care in spe-
and their implications for addiction treat-
development, essential factors in substance
cialty behavioral health programs represent
ment in public health, behavioral health and
use disorder services and overall health care.
a small minority of those who need it, and that
primary care. PHMC presented the program
The new drug strategy encourages health-
half of all mental health care in the United
“Highlighting the Federal Agenda for Drug
care professionals to solicit information
States is delivered by medical practitioners.
Control Policy” in recognition of National
about patient drug use even during routine
“Providing behavioral health treatment in
Public Health Week. “Given the release of
treatment so that early intervention is pos-
healthcare centers, as we do here at PHMC,
the first-ever National Drug Control Strat-
sible. “Putting treatment into the primary
allows us to greatly expand the availability
egy, Dr. McLellan’s visit to PHMC was very
healthcare setting is critical,” says Elaine
of these services in settings where patients
timely and appropriate for those of us com-
Fox, vice president of Specialized Health
already feel a sense of trust and safety, and
mitted to addressing the addiction needs of
Services at PHMC. “Our Federally Qualified
often have long-standing relationships with
Philadelphia and the region,” says PHMC
Health Centers specialize in providing sup-
their primary care providers,” says Fox.
president and CEO Richard Cohen, PhD,
portive services not traditionally offered in
According to Hurtig, “Providing good
FACHE. “Having a national drug policy that
primary care settings, such as mental health
behavioral care is essential to providing
recognizes drug abuse and addiction as com-
and substance treatment counseling.”
good primary care. In fact, integrating be-
plex public health issues, not just criminal
Arthur C. Evans Jr., PhD, director of the
havioral health and primary care makes so
justice issues, is critical to our mission and
Philadelphia Department of Behavioral
much sense that I wonder why we haven’t
extremely advantageous to the work we do.”
Health and Mental Retardation Services
been doing this forever!”
page 10 PHMC.ORG
Measuring Access to Care in Pennsylvania
T
PHMC's Household Health Survey Summer 2010
his summer, PHMC’s Community
vania have inadequate coverage. In 2008,
Did you recently get a call asking you to par-
Health Data Base (CHDB) fields its
4.2% of children under age 18 in the region,
ticipate in a brief phone interview about your
2010 Southeastern Pennsylvania
or about 39,000, had no private or public
household’s health? It may have been PHMC's
Household Health survey, providing an op-
insurance. Across the five-county region,
Community Health Data Base. Conducted ev-
portunity to measure some of the earliest
Philadelphia had the highest proportion of
ery two years, the Southeastern Pennsylvania
regional effects of changes in access to
uninsured children (5.1%).
Household Health Survey examines the health
care resulting from healthcare reform. The
and healthcare experiences of area residents. Survey data help in the planning and enhance-
creased security to Americans who already
Profile of Uninsured Pennsylvanians*
have insurance while expanding coverage
N ationally, about 30% of young adults
The survey encompasses approximately 10,000
to an additional 32 million uninsured Amer-
are uninsured. In southeastern Penn-
households across the region. By taking a few
icans over the next several years. Although
sylvania (SEPA), young adults are more
minutes to answer questions, you played an im-
many of the provisions of healthcare re-
than twice as likely to be uninsured com-
portant role in improving local health care ser-
form will not be enacted until 2014, many
pared with any other age group: one in
vices. We thank all who participated.
Americans, particularly children and young
five adults ages 18–29 (19.5%) are un-
adults, are already benefiting from a num-
insured, compared with 8.5% of adults
ber of immediate provisions. Under the new
30–39, 9.1% of adults 40–49, and 6.1%
law, coverage for young people under their
of adults 50–64. Young adults are also
parents’ plan is extended until age 26. The
more likely to lack insurance than chil-
legislation also bars health insurance com-
dren (19.5% and 4.5%, respectively).
panies from denying coverage to children
A higher proportion of men are unin-
with pre-existing conditions and rescinding
sured than women (11.2% and 8.7%,
new legislation is expected to provide in-
coverage after a policyholder gets sick.
respectively).
ment
of local and regional health services.
For more information on the
Other key provisions of healthcare re-
R acial and ethnic minorities represent
form focus on health disparities and will
only one-third of the total US population,
likely impact ethnic and racial minorities.
yet they comprise more than 50% of the
Such provisions include efforts to expand
nation’s uninsured. In SEPA, racial and
access to health care through Medicaid ex-
ethnic minority adults are more likely to
The Community Health Data Base (CHDB)
pansion and health exchanges, as well as
be uninsured than white adults: 29.8% of
Southeastern Pennsylvania Household Health
workforce development—particularly in
Latino adults are uninsured, followed by
Survey is one of the largest regional health
black/African American adults at 14.5%.
surveys in the nation, covering Bucks, Chester,
medically underserved areas—and expansions of community health centers. PHMC conducted its last survey in 2008, documenting disturbing disparities in care among uninsured and insured persons in Southeastern Pennsylvania. Approximately
In SEPA, 7% of black children are unin-
Community Health Data Base, visit chdbdata.org.
Delaware,
Montgomery
and
Philadelphia
sured compared with 2.7% of white chil-
Counties, and now Schuylkill, Lancaster, Berks
dren and 4.5% of Latino children.
and Centre Counties. It has been conducted
1 4.1% of SEPA children with asthma do not have insurance.
every two years since 1994. The Pew Charitable Trusts, the William Penn Foundation, United Way
one in 10 adults ages 18–64 (9.8%)—repre-
A dults living below 200% of the federal
of Southeastern Pennsylvania and over 350 local
senting about 237,400 individuals—did not
poverty level are more than four times as
agencies from the health, government, nonprofit
have public or private health insurance. Na-
likely to be uninsured than those living at or
and academic sectors help to support CHDB.
tionally, an estimated 46 million Americans,
above 200% of the federal poverty level.
nine million of them children, are uninsured. Despite provisions such as the federally funded State Children’s Health Insurance Program, better known as SCHIP or CHIP, many children in southeastern Pennsyl* Data from 2008 Southeastern Pennsylvania Household Health Survey
For more information about the Community Health Data Base or access to care, contact CHDB director Francine Axler at francine@phmc.org.
DIRECTIONS SUMMER/FALL 2010 page 11
Nonprofit Org. U.S. Postage PAID Permit No. 1734 Philadelphia, PA 19102-5085
Public Health Management Corporation (PHMC) is a nonprofit public health institute that builds healthier communities through partnerships with government, foundations, businesses and other community-based organizations. It fulfills its mission to improve the health of the community by providing outreach, health promotion, education, research, planning, technical assistance and direct services.
Paul A. Dandridge, Esq Chairman of the Board
PHMC has served the region since 1972. For more information on PHMC, visit PHMC.ORG
PHMC provee servicios bilingues para nuestros clients sin costo alguno.
Richard J. Cohen, PhD, FACHE President and CEO John G. Loeb, MSS Senior Vice President Marino Puliti, MBA Chief Financial Officer Dina Wolfman Baker Vice President of Communications
A United Way of Southeastern Pennsylvania Community Partner | Donor Code: 2050
Š 2010 Public Health Management Corporation
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