Agenda - 12-12-2006-5f - Laserfiche WebLink

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Orange County Health Department 7 of Health member and a County Commissioner, voted in favor of it. The Orange Community Health Assessment completed in December 2003 further substantiated this need. The number one issue identified by the community was `Barriers to receiving services:. cost of healthcare, lack of insurance, and geographic availability of services'. Since January 2005, primary care services have been offered to clients enrolled in our traditional prevention programs -Family Plaauling, Prenatal, and Well Child Services - in our Hillsborough clinic. Primary care services include diagnosis and treatment of acute health conditions as well as monitoring and care of chronic diseases. Since the advent of primary care services at the Hillsborough clinic, clients accessing preventive services at our Southern Human Services Clinic in Chapel Hili have also requested the provision of primary care. Currently they must either travel to the Hillsborough clinic for such services or be referred elsewhere. Carrboro Community Health Center, a Federally Qualified Health Center serving low- income clients, has had a 3-month waiting period during the summer of 2006 for new patients. Many new prenatal patients who could, not be seen there have been referred to OCHD for services. In addition, iTNC Hospitals recently discontinued their Urgent Care Clinic associated with the Emergency Department. This further limited accessibility for clients without a medical home. In the recently completed 2006-11 OCHD Strategic Plan adopted by the Board of Health, expansion of primary care services to Southern Human Services Center was identified as an implementation strategy in FY 06-07. III Project Description (2 pages) 25 points OCHD initiated primary care services in its Hillsborough clinic on January 4, 2005. The goal was to provide a medical home for the growing uninsured and medically indigent population in the rural northern and central parts of the county. Additionally, to improve access to care, OCHD initiated evening clinic hours (9:30 AM - 6:30 PM) one day per week at each site (Hillsborough -Tuesday and Chapel Hill -Thursday). Open access scheduling (same day appointments) was instituted while services were offered in an integrated fashion (any type of service any day of the week, much like a family practice). The addition of primary care services increased the volume and complexity of health care visits to the health department clinics. Acute and chronic health conditions were now being addressed in addition to psychosocial, nutritional and preventive health needs. Additional lab services were offered as well as provision of limited pharmaceuticals to 0-20% self-pay clients. Referrals to UNC Physicians have been arranged for assessments and/or treatment of complicated conditions. Admissions to UNC Hospitals have been through our Medical Director, affiliated with UNC Family Practice. Based on a growing need for access to care for uninsured and medically indigent populations in Chapel Hill, Carrboro and rural southern Orange County, we propose to expand primary care services to the Chapel Hili office of the Orange County Health Department located in the Southern Human Services Center. This clinic is on the free bus route in Chapel Hill-Carrboro, thus reducing transportation as a barrier to care. As in the Hillsborough primary care program, we anticipate offering primary care services to clients enrolled in our traditional prevention services: Maternity, Family Planning and Well Child Services. We seek to provide a medical home and continuity of care for individuals/families we serve. Services will be provided on a sliding fee scale that slides to $15. Low-cost stock pharmaceuticals will be available at $3/prescription for 0-20% clients with acute needs. A reduced cost pharmacy program for individuals with chronic diseases will be offered in coordination with pharmaceutical companies. 7