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Orange County Health Department 6 FY 2007 Community Health Center Grants CATEGORY I -PROGRAM GRANTS I Overview of Organization (1-2 paragraphs) The Orange County Health Department (OCHD) mission is to enhance the quality of life, promote the health, and preserve the environment for the nearly 130,000 residents living in Orange County. It does so through an array of public health services including clinical, dental, health education, home visiting, communicable disease, environmental health, and administrative services. Clinically, the health department has historically focused on preventive health services for women and children such as family planning, prenatal and well child services. Services are provided through two fully functioning Health Department clinics: one in Hillsborough with 2 full-time FNPs and one in Chapel Hill with 1 full-time F'NP. The 50 % Medical Director provides consultation and services in each site. In January 2005, OCHD began to provide primary care services for clients enrolled in preventive services in the Hillsborough clinic. In the start-up first 6 months of operation (January =June 2005), 196 primary care services were provided to 128 unduplicated clients. 50% of clients were Medicaid. Of the 47% on sliding fee scale, 91% were in the 0% - 20% self-pay category. In FY OS-06 (July 2005 -June 2006), the Hillsborough clinic provided 544 primary care services to 279 unduplicated clients. 57% of services were to Medicaid clients and 1 % were to privately insured clients. 42% were to uninsured, self-pay clients, of which 81 were to clients at the 0-20% pay level. Our efforts have been truly focused on reaching the uninsured and medically indigent with quality primary care services. II Community Need (1 page) 15 points With t7NC Hospitals and UNC Physicians and Associates, the number of physicians in Orange County is quite high, yet some residents still face difficulties in health care access due to barriers of cost, language and transportation. A significant portion of Orange County residents lack health insurance which contributes to the ongoing health disparities seen within the population. Minority. groups have lower rates of insurance and higher rates of poverty as well as disease burden than do white residents. In the 2005 BRFSS, 14.8% of Orange County residents stated they had no health insurance, but 42.6% of minority respondents stated that they had no health insurance versus only 7.1 % of white respondents. Also 28.5% of minority respondents stated there had been a time in the past year that they could not access health care due to cost versus only 7.6% of white respondents. At the time of the 2000 census, 14.1% of Orange County residents were living.in poverty; of that number 12.4% were white and 19.5% were black. Among Hispanic households at that time, 30% had a household income of less than $20,000. A growing population of Hispanics has made their home in Carrboro and the surrounding area in the past decade. In addition, a substantial number of Burmese refugees have resettled in the Chapel Hill area and have sought services through the Health Department. An extensive primary care needs assessment was undertaken in the Sulnmer/Fall of 2003 indicating a need for increased access to affordable primary care, most notably in Northern Orange County. Orange County Health Department clients expressed interest in receiving such services through the Health Department. Community physicians supported the concept and the Executive Director (at the time) of Piedmont Health Services, a community health center based in Chapel Hill, who serves as both a Board 6