Free Clinics: Partnering Together for the Health of the Community Volunteers in Medicine Clinic Hilton Head Island, SC Hilton Head Island, SC 1993 Voted one of the top 25 places to retire by AARP Magazine 1
Hilton Head Island, SC 1993 Hosting two national sports tournaments Hilton Head Island, 1993 50% of the population was composed of affluent retirees 2
Hilton Head Island, 1993 75% of island population lived in gated communities Hilton Head Island, SC 1993 Primary island industry: Tourism 3
Hilton Head Island, 1993 Well water for non-plantation dwellers was still not up to standards 30% of the workers in hospitalityrelated jobs commuted from off island to work every day Native islanders, local workers, the poor and unemployed and their children had no health care Hilton Head Island, SC 1993 This is what people didn t see: 4
or this or this 5
.or this Enter a man on a mission.. 6
Obstacles Licensure Malpractice Insurance Space/land/building Resistance from community Fundraising Administration Volunteers in Medicine 1993 VIM was primarily a walk-in clinic 538 patients were treated VIM worked out of a spare space at the local hospital Funding was achieved primarily through large and local endowments and foundations The first annual operating budget was less than $100,000 7
Vision Statement May we have eyes to see those rendered invisible and excluded, Open arms and hearts to reach out and include them, Healing hands to touch their lives with love, And in the process heal ourselves. Volunteers in Medicine 2010 5 disease management clinics Surgery Program Women s Program 5 dental operatories Full Pediatric dental program Full medical, pharmacy and dental school rotations with several universities Electronic patient records 8
Volunteers in Medicine 2010 Full patient navigation Pharmacy program Vision care Community outreach programs for pediatric dental, mammograms and diabetes Mental health program Validation 2010 Since 1993 the clinic has managed nearly 274,000 patient visits The clinic saves the local hospital over $16 million in non-emergent ER visits We provide over 700 mammograms per year in the community and follow-up care as needed. Medical visits cost $52.00 per patient and dental visits cost $35.00 patient 9
Validation 2010 One uninsured individual costs the state $1,926.00. In 2009 alone we saved the state of SC over $25 million Volunteers in Medicine is now used as a template for 74 free clinics across the country. Volunteer Support 26 dentists 15 dental assistants 82 nurses 112 physicians 2 physician assistants 6 phlebotomists 244 lay volunteers 2 dieticians 12 mental health professionals 2 optometrists 2 Chiropractors 2 massage therapists 515 Total 10
Now What? 30% of the Beaufort County population suffers from chronic disease Obesity is the most common, but Diabetes is catching up The single most common reason for a child to miss school is dental disease 21% of all people discharged from Beaufort County hospital ER rooms are uninsured. High Blood Pressure, Diabetes, and Obesity are Inter-connected: This is a Community Problem Total Hypertensive Patients 3,691 706 Hypertensive Only 19.13% Hypertensive & Diabetic 4.17% Hypertensive & Overweight 47.49% Hypertensive, Overweight, & Diabetic 29.21% 1,753 154 1,076 Total Diabetic Patients 1,723 Diabetic Only 9.23% Hypertensive & Diabetic 8.94% Overweight & Diabetic 19.27% Hypertensive, Overweight, & Diabetic 62.57% 159 332 2,994 Total Overweight Patients 6, 157 Overweight Only 48.63% Overweight & Diabetic 28.47% Hypertensive & Overweight 5.39% Hypertensive, Overweight, & Diabetic 17.51% 11
Childhood Obesity Rages On Obesity rate in SC high school students = 16.7% Obesity rate in SC elementary school students = 15.3% SC funding for public health: $24.52 per year per capita Breast Cancer in South Carolina Although SC has a lower rate of incidence than many other states, we have one of the highest rates of death from the disease 3400 new cases are expected to be diagnosed in SC this year; 600 will die from the disease. Although Caucasian women are diagnosed more often, African American women are more likely to die from the disease. According to a study by Hollings Cancer Center, African- American women are 60% more likely to die than white women in SC. This is the largest disparity in the nation. 12
Collaborative Effort Beaufort County Alliance for Human Services Develop a unified vision of human service needs/gaps Track and measure improvements in the quality of life in Beaufort County Promote multi-system collaboration and best practices Focus on outcomes and accountability based on results Educate the public on trends, issues and needed actions Facilitate mechanisms to link the general public to needed services or assistance Collaborative Effort Together for Beaufort an intensive community-wide process to identify issues confronting the citizens of Beaufort County, SC develops a series of indicators that allow us to monitor progress as we address these issues. 13
Collaborative Effort: Best Chance The Best Chance Network (BCN) provides free breast and cervical cancer screening for medically underserved women in South Carolina who: Lack insurance or have insurance that only covers hospital care Are between the ages of 47 and 64, and Meet certain income guidelines Collaborative Effort South Carolina AHEC The South Carolina AHEC offers Elective Rotations to 4th year medical students from accredited medical schools & accredited schools of osteopathic medicine. 14
Collaborative Effort Eat Smart. Move More Lowcountry (Obesity Initiative) Objectives require cultural changes within the family dynamic by introducing children to an environmental change with regard to choosing healthy foods, better cooking practices and accessibility to safe and fun physical activity. AccessHealth South Carolina AccessHealth SC: Connecting People for a Healthier South Carolina Supports communities in creating and sustaining coordinated data-driven provider networks of care that provide medical homes and ensure timely, affordable, high quality healthcare services for low income uninsured people in South Carolina. 15
The challenge Cultural disparities Turf issues Isolation History of conflict and mistrust Poor access due to road conditions Absence of public transportation Limited pool of professional talent including leadership capabilities The Win Improve effectiveness of service delivery Resource sharing Collaboration for grant-seeking opportunities Community experiences less absenteeism and improved health Create synergy through partnership, mutual support and networking Continued development of capabilities and trends 16
The single,most important element: A leader has the vision and conviction that a dream can be achieved. He inspires the power and energy to get it done. ~Ralph Nader 17