DIRECTIONS summer/fall 2010

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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