PRINCETON, N.J. - Fourteen communities have received three-year grants from the Robert Wood Johnson Foundation to develop programs to help organize, finance and provide health care services to people without insurance.
The grants, which average $700,000, were made under a program called Communities in Charge: Financing and Delivering Health Care to the Uninsured, which encourages communities to rethink how funds and services are organized for the uninsured.
"Increasingly, the challenge of providing health care to the uninsured is falling disproportionately to local communities," said Judith Whang, senior program officer at the foundation. "Communities in Charge is intended to give communities the chance to test new ways of organizing and financing care locally for the uninsured."
Examples of projects include the Inland Northwest In Charge Initiative in Spokane, Wash., which will link regional health care, business and civic leaders to enrich and expand the services of the existing enrollment organization, Health For All.
The new funding will assist Health For All in identifying more uninsured people and offering them improved access to affordable and comprehensive health care services. The Inland Northwest In Charge Initiative plans to strengthen this effort by building relationships with providers, health plans, local and state government to provide the uninsured with health insurance or direct access to affordable health care services.
The project will also seek state support for new ways to subsidize and enroll high-risk uninsured people in disease- management programs. INIC further aims to enrich current health programs for the uninsured, such as low-cost pharmaceuticals, school-based health services, asthma management and improvements in access to mental health services.
In the District of Columbia, community leaders of the D.C. Primary Care Association plan to use the district's tobacco settlement dollars toward decreasing the number of uninsured by expanding Medicaid eligibility to more uninsured people, improving Medicaid enrollment and retention, strengthening the current primary care safety net through clinic improvement, and engaging local policy makers and voters in health reform efforts.
"Health care is a local issue in terms of financing, managing, and delivering care," says Terry Stoller, project director of Communities in Charge and a principal at Medimetrix, which is coordinating the program.
"Communities in Charge gives local organizations the opportunity to develop effective, sustainable models that tailor services and financing to their particular communities."
As a result, she says, "we expect that these communities' programs will build leverage at the local level to ensure that their uninsured residents receive affordable and comprehensive health care, and ultimately identify a new set of tools and approaches for other communities around the country facing similar challenges."
All 14 communities selected were required to have a population of at least 250,000, of which at least 37,500, or 15 percent, of their populations are low-income and uninsured.
The program provides these communities with financial and technical assistance to address the problems of the uninsured in several ways: by better organizing and promoting prevention and early intervention; by improving coordination and integration of services; by monitoring access and quality; and by spreading financial risk among providers.
This is the second phase of Communities in Charge. Phase I covered organization efforts.
The purpose of these grants was to help communities better understand the extent of their uninsured problem, develop strong relationships with key players, review potential solutions, and begin to design their delivery and financing systems. During Phase II, the 14 selected communities will implement plans to put their solutions into action.
Communities in Charge is directed by Medimetrix, a national health care business consulting and marketing firm with offices in Cleveland and Denver. Medimetrix will also provide consulting services to the grantee communities.
Grants for the Communities in Charge: Financing and Delivering Health Care to the Uninsured program:
Coordinated Health System of Jefferson County, Birmingham, Ala.; Michael Griffin, project director, 205-327-8254
Alameda Health Consortium, Oakland, Calif.; Ralph Silber, project director, 510-567-1550
District of Columbia Primary Care Association, Washington; Brian McNeill, project director, 202-638-0252
Shands Jacksonville Medical Center, Jacksonville, Fla.; Bernard M. Cohen M.D., project director, 904-244-2175
Medcen Community Health Foundation Inc., Macon, Ga.; Ethel A. Cullinan, project director, 478-633-7395
The Medical Society of Sedgwick County, Wichita, Kan.; Anne Nelson, project director, 316-688-0600
Louisville and Jefferson County Health Department, Louisville, Ky.; John Morse, interim project director, 502-852-2211
MaineHealth Portland, Maine; Warren Kessler, project director, 207-775-7001
Jackson Medical Mall Foundation, Jackson, Miss.; James Malloy, project director, 601-957-9991
City of New York, Brooklyn; Joan Levitt, project director, 718-802-3857
HealthForALL of WNY Inc., Buffalo, N.Y.; Amber L. Slichta, project manager, 716-898-4743
Multnomah County Health Department, Portland, Ore.; Michael Sorenson, project director, 503-988-3674
Indigent Care Collaboration, Austin, Texas; Diana Resnik, project director, 512-324-7031
Health Improvement Partnership of Spokane County, Spokane, Wash.; Daniel Baumgarten, project director, 509-444-3088