Developing a Standard of Care to Incorporate Fiscal Health in a Primary Care Setting 2014 Assets Learning Conference September 18 th, 2014
History Established in 1887 as a settlement house Became Community Health Center in 1970 s FQHC in 2009 NCQA PCMH Level 3 in 2013
At A Glance 22,704 Active Patients 116,130 Annual Patient Visits With over 300 employees, we are one of the largest employers in the area 52% of our staff come from the neighborhood Services provided in English, Cape Verdean Creole, Portuguese, Spanish and Vietnamese
Patient Characteristics Over 95% of our patient population lives at or below 200% of the federal poverty level. 35% Asian (predominantly Vietnamese), 29% African American or self-identified Black, 18% White, 15% Hispanic/Latino and 3% biracial. Over 8,000 patients indicate that they are best served in a language other than English. Over half of our patients are insured through Medicaid/Medicare, with 12% uninsured
Comprehensive Services
Link to Essential Resources Medical-Legal Partnership Ropes & Gray LLP has provided over 8,000 hours of pro bono service last year. Issues include: housing/utilities, immigration, education, public benefits and family law. Free Tax Prep Since 2001, Dorchester House been a member of the City of Boston s Earned Income Tax Credit Coalition, providing free tax preparation and other financial support services to individuals who earned less than $52,000/yr For tax year 2013 approximately 1200 returns were filed with $775,948 in EITC credits and $2 million in refunds Food Pantry Operating for over 20 years Serving 1400-1500 individuals a month. In 2013, the Dorchester House food pantry distributed almost 255,000 pounds of food to clients living in Dorchester
Building a Foundation Taking a risk and investing in asset building at Dorchester House BNY Mellon National Summit on Community Health Center Lending and Innovation Bank of America City of Boston EITC Coalition and other community resources CFED Asset Initiative Partnership
Fiscal Health Vital Signs: Addressing Social Determinants of Health Medical Home Across the Lifespan Fiscal Health Education Social Capital Healthy Individual Premise - IF the healthcare system addresses the social as well as biological determinants of health, then patients will be: More stable Better able to pursue health and education for themselves and their children Members of a thriving community richer in assets and opportunities
Standard of Care Income supports Food Security Patient Assessment Legal Issues Family Supports
Asset Initiative Partnership Technical Assistance Referral Pipeline Asset Building Strategies Know Your Customers Service Entrance Points Expanding the conversations Conversation Opportunities PT Motivation Staff Comfort & Knowledge Cultural Implications
Asset Strategies Brief Assessment Income Supports Getting Banked VITA Services Savings Goals Budgeting
Highlights One of my client s did not know how to write a personal check to pay her bills. She would purchase money orders instead. She now has a bank account to pay her monthly rent and utilities with her own personal checking account. This gives her a stronger degree of financial independence. Having a bank account also gives her the skills to budget her resources. It makes managing money easier, and over time it will save her family money. During a home visit met with a mom and about 10 minutes into the visit mom reported that she didn't have enough SNAP benefits last month. She was going to her friend's house with her 2 children to be able to eat the last few days of the month. I provided mom with the Food Source Hotline number and a list of other food pantries in her area, since she couldn t make it to our Food Pantry. I also asked if she would like to complete a budgeting worksheet to see where her money was being spent. I also suggested writing a food shopping list before going shopping to avoid buying things she didn t need. After we did both, the Mom was able to see she was purchasing a lot of junk food for her kids and not spending enough on whole foods. She was able to start cutting back on junk food and has begun creating a food shopping list to better budget her SNAP benefits each month.
Touch points 212 Patients triaged for Financial Health 148 Patients set FH goals 135 Patients Completed their goals 19 new SNAP Families Ropes & Gray accepted 13 income support cases from our clients where benefits were denied or reduced 25% of our tax clinic clients this year were Dorchester House patients
Continuing Efforts CM Trainings Money Talks Motivational Interviewing Service Flow Updated Brief Assessment Electronic Medical Record Integration Community Empowerment Promotion of VITA Financial Health Workshops
Thank You For more information please visit www.dorchesterhouse.org Michelle Nadow, Chief Administrative Officer 617.740.2521 Michelle.Nadow@dorchesterhouse.org Marika Michelangelo, Family Wellness Manager 617.740.2572 Marika.Micheangelo@dorchesterhouse.org