Presentation Transcript

1. PHPC 101 David Vincent, MSW
2. History of PHPC
3. In 1990, the Public Health Service Act was amended to include the Disadvantaged Minority Health Improvement Act, which under Section 340A, established the Health Services for Public Housing Residents program, known as the Public Housing Primary Care (PHPC) program. Authorizing Legislation
4. Authorizing Legislation(Continued) The cornerstone of the PHPC program is the 340A legislative requirement that grantee programs are to be located on the premises of public housing or at locations immediately accessible to residents of public housing.
5. In 1996, the Health Centers Consolidation Act replaced Section 340A of the Public Health Service Act and consolidated the Health Care for the Homeless, Migrant Health Centers and Public Housing Primary Care Programs under Section 330 of the Consolidation Act, Public Law 104-299. Reauthorized in 2006 Health Centers’ Consolidation Act
6. Health Centers’ Consolidation (Continued) This legislation reauthorized the health center programs as:  330(e) All Health Centers 330(g) Migrant Health Centers 330(h) Health Care for the Homeless 330(i) Public Housing Primary Care
7. PHPC History In 1991, the Department of Health and Human Services, Health Services and Resources Administration (HRSA) established the Public Housing Primary Care Program and funded the first seven health center grantees. The first PHPC programs were: Ella Austin Health Center (now known as CommuniCare Health Care Centers), San Antonio Texas; Family Practice and Counseling Network, Resources for Human Development, Philadelphia, Pennsylvania; Grace Hill Neighborhood Health Centers, St. Louis, Missouri; Great Brook Valley Health Center, Worcester, MA; Primary Care Health Services, Pittsburgh, Pennsylvania; The Clinic at Altgeld (now known as TCA Health, Inc.), Chicago, Illinois; West End Medical Centers, Atlanta, Georgia
8. The PHPC Program Today Today there are 61 PHPC grantees in 24 states and Puerto Rico. These programs provide high-quality comprehensive, case- managed, and family-based preventive and primary health care services to approximately 187,992 residents at over 711 public housing service delivery sites.
9. Administration of the PHPC Program HRSA provides resources to support the PHPC program through a Cooperative Agreement grant to provide technical assistance to PHPC health centers and health centers wishing to provide services to public housing residents. The National Center for Health and Public Housing Training and in additional to technical assistance, provides regional and national trainings, newsletters, white papers, listservs and webinars
10. Patients Served by PHPC Programs
11. Total Number of Patient Encounters 11
12. Patients Served by PHPC Programs In 2011, more than 187,992 public housing residents were served. 12
13. Financial Status of PHPC Patients
14. Insurance Status of PHPC Patients 14
15. Age and Genderof PHPC Patients 15 37% are children ages 0-19 years old 25% of the patients are children ages 0-12 years old 5% are 65 years old and older Female patients constitute 62% of PHPC patients
16. Most Frequent Encounters Depression and other Mood Disorders Hypertension Diabetes Vaccinations Oral health exams Health Supervision of infant or child (ages 0 through 11) Contraceptive Management
17. Overall Health Status The percent of black women self-reporting “fair to poor” health status 18-24 yo: 6% - U.S total 10% - U.S. Black women 26% - Black women in Public Housing 45-64 yo: 15% - U.S total 28% - U.S. Black women 58% - Black women in Public Housing 65+ yo: 22% - U.S total 42% - U.S. Black women 65% - Black women in Public Housing
18. Presence of Chronic Illness Arthritis 14% - U.S Black women 29% - Black women in Public Housing Asthma 11% - U.S Black women 23% - Black women in Public Housing Obesity 39% - U.S Black women 48% - Black women in Public Housing
19. Presence of Chronic Illness(Continued) Depression 7% - U.S Black women 14% - Black women in Public Housing Diabetes 7% - U.S Black women 17% - Black women in Public Housing Hypertension 21% - U.S Black women 39% - Black women in Public Housing
20. Health Status of Residents Healthy Weight Management Poor nutrition and the unavailability of healthy food options in some public housing communities have significantly impacted the weight of many residents in public housing. 31% of residents are considered to be obese, compared to 16% of the general population. Oral Health Care The impact of poor oral health care has devastated many residents of public housing. 23% of residents are missing six or more permanent teeth compared to 12% of the general population.
21. Health Status of Residents (Continued) Chronic Disease Prevalence Smoking can have significant health care effects for many, especially those with chronic health conditions. 28% of residents smoke compared to 17% of the general population. The percent of residents with diabetes is 12%, compared to 5% of the general population. 32% of residents have hypertension, compared to 19% of the general population.
22. Residents Characteristics General Information Across the nation there are over 2.2 million residents living in public housing, and another 6.5 million residents living in Section 8 and Housing Choice Voucher Housing. Over 21% of residents remain in public housing more than 5 years and nearly 17% of residents also remain in Section 8 housing for more than 5 years. People with Disabilities 19% of public housing, 17% of Section 8 and 18% and Housing Choice Voucher households include a family member who is disabled.
23. Residents Characteristics (Continued) Families with Children There are approximately 1 million children who live in public housing. They represent 40% of the total population of residents who live in public housing. Approximately 2.3 million children live in Section 8 housing, representing 47% of residents who live in Section 8 housing. 37% of public housing, 22% of Section 8 housing and 48% of Housing Choice Voucher households are headed by single female with children. Seniors Nearly 330,000 or 15% of residents in public housing are seniors (age 62 and above), and approximately 400,000 or 8% of residents of Section 8 housing are seniors.
24. Outreach to Residents in Public Housing Developing an Outreach Plan Identify the Need Determine the Goals and Objectives Making sure they are measureable Identify Community Partners Figure out logistics Outreach Schedule Develop a training module Recruit staff 24
25. Outreach to Residents in Public Housing Use of Community Members as Outreach Workers Identifying Community Leaders Issues Effectively using Partnership with Housing Authority Tenant Advisory Boards Floor Captains Attending Community Meetings Hosting and Tabling at Community Events Challenges and Barriers Hard to reach areas Scattered sites Safety Concerns 25
26. Becoming a PHPC Grantee In general, PHPC grantees must demonstrate compliance with all Section 330(e) and Section 330(i) requirements, as well as all applicable HRSA guidelines. Specific Section 330 (i) requirement includes a Formal agreement with the local Public Housing Authority. The application must include a copy of the MOU. Sample available through the National Center for Health and Public Housing. Grant announcements can be found on grants.gov 26
27. Preparing for your PHPC application PHPC programs have established highly effective partnerships with public housing authorities and resident/tenant organizations to facilitate the delivery of services. Residents are actively involved in the design of services and program governance, and are routinely trained or employed as outreach workers and case managers.
28. Preparing for your PHPC application (Continued) A Needs Assessment must be conducted The National Center has a toolkit on their website (www.nchph.org) specifically on developing a needs assessment for residents in public housing. Needs Assessment must include local and state statistics Identify your service area’s public housing developments, as per HRSA guidelines, e.g., Urban, Rural & High Poverty) Determine how many residents and the local demographics associated with the Housing Authority Determine how many of those residents access your clinic(s) primary health care services Describe the public housing residents’ health disparities, e.g. hypertension, asthma, etc. List, in your service area, other primary health care providers?
29. Preparing for your PHPC application (Continued) What are the other community agencies located near the target public housing community How are they currently working with these residents How are you partnering with these agencies currently. What type of partnership opportunities might be available. Community Partnerships are critical to the success of the PHPC program
30. PHPC Application Program Design What will the service delivery model be? Onsite, Close by, Mobile Medical Units What factors influence this decision? Lack of transportation of residents In ability to build onsite Units are spread out What will staffing look like Must meet the needs of target community (seniors, children, adolescents) Will your model include residents Successful applications should answer the 5 W’s and H (Who, What, When, Where, Why and How)
31. PHPC ApplicationLetters of Support Must include a letter of support from your State Primary Care Association. You must have a letter of support from your local housing authority (and preferably a copy of your MOU – a sample MOU can be found at www.nchph.org). A letter of support from the resident council, noting how they were included in the drafting of the proposal and how they will continue to work after funding, is recommended. If your target public housing community is in the same area as another health center, it is strongly recommended that you have a letter of support from that health center.
32. Administration of the PHPC Program: Contact Information For more information, contact: Contact: Lieutenant Commander Kevin Bates, Health Resources and Services Administration, Bureau of Primary Health Care, Office of Minority and Special Populations kbates@hrsa.gov, (301) 443-7340. Astril Webb, MD, North American Management/National Center for Health and Public Housing, Project Director, HRSA Cooperative Agreement (703) 812-8822. Health and Human Services, Bureau of Primary Health Services (HHS): http://bphc.hrsa.gov PHPC website: www.nchph.org