Category Archives: Medical Aid

How a New Partnership for Health Began in a Sports Stadium in St. Lucia

By Abigail Schultz, Latin America and Caribbean Programs

Two years ago, AmeriCares received an email from Raise Your Voice St. Lucia, an advocacy group that promotes women rights, education and empowerment on the island. Their message to AmeriCares was clear – St. Lucia’s health system was in desperate need of medicines and medical supplies. AmeriCares wanted to find a way to help, and my team, the Latin America and Caribbean Programs team, took up the challenge.

We started having more in-depth conversations with Raise Your Voice about the health infrastructure on the island. How many public hospitals and clinics are on the island? What medicines are they lacking? What are the most common diseases and health concerns of St. Lucians? Are there any NGOs operating in the health sphere?

At that time, we knew there were definite holes that AmeriCares could help fill. But there was an issue: Raise Your Voice did not have the ability to import sea containers of medicines, nor did they have licensed medical professionals on staff. Because of AmeriCares partnership model, it is absolutely critical to find a strong partner with these capabilities. We rely on our partners to assess offers of medicines and supplies, and then distribute the donations among a network of beneficiaries. Their collaboration is key to delivering health care to more people in the most effective way possible, and we were determined to find a partner in St. Lucia.

We were then connected with one of the two public hospitals on the island, St. Jude Hospital, which had a strong interest in partnering with AmeriCares and receiving medical donations. St. Jude was the ideal partner. They had dedicated staff, strong importation capabilities, and significant shortages of medicines and supplies. Even more remarkable was the fact that St. Jude’s original hospital had burnt down in 2009, and since then they had been operating out of the George Odlum Sports Stadium.  They had actually set up shop in this sport facility, abandoned in 2003, where they were providing high quality health care with so few resources that we had to help!

Almost a year after the initial conversation took place, in September 2015, we sent a test shipment to St. Jude Hospital. As with all test shipments, this was AmeriCares first opportunity to present the mechanics of our shipment-building process and partnership expectations to St. Jude staff. The shipment was a huge success and cleared customs faster than we had ever experienced in the region. We were impressed, to say the least, and decided to visit St. Lucia to formalize the partnership.

We continued to be impressed throughout our entire visit – with the health care institutions themselves and the staff at each institution. The institutions we visited were extremely clean and had well-maintained pharmacies. In many ways, the facilities exceeded AmeriCares management standards. We were confident that St. Jude Hospital was in an excellent position to become an AmeriCares partner and thrive in the relationship. After assessing the health needs on the island and the sophisticated management of the health care institutions, we are assured that this will be a strong partnership with national reach.

The Latin America and Caribbean Programs team is looking forward to growing this partnership in St. Lucia and continuing to expand our work in the Caribbean over the coming years!

When a 10-Minute Drive is an Ocean Away

Last week I paid a visit to the University of Miami’s Pediatric Mobile Clinic (UMPMC). The 40-foot bus was parked outside the Center for Haitian Studies in Miami’s Little Haiti neighborhood as usual – the big blue bus took over the parking lot, with staff, interns, residents and volunteers providing care both in the mobile unit and throughout the Community Center. The services provided to the children visiting the clinic are highly integrated and holistic, ranging from sports physicals and immunizations to specialty care in cardiology, dermatology, endocrinology, hematology and nutrition. How does one mobile clinic possibly provide this breadth and depth of care?

Telemedicine. And an innovative medical director committed to serving her young patients with the highest level of continuous care.

The Pediatric Mobile Clinic provides live interactive videoconferencing consultations in which young patients and/or their care givers interact directly with a specialist off site. As Dr. Lisa Gwynn, clinic director explained, “There are major barriers to the 10-minute drive to the closest hospital, from transportation costs and cultural barriers to fear of a bill and inability to pay.” Telemedicine removes those barriers by bringing a specialist right into the clinic with a portable videoconferencing tool that allows patients to interact directly with a provider in the comfort and convenience of their medical home. Gwynn notes she saw the clinic’s patient compliance rate sky-rocket with the integration of this technology in 2013, with 35% of her patients following through and meeting with their specialists to now over 90% of her patients meeting with their specialists.

The neighborhood of Little Haiti is home to one of the largest populations of Haitian immigrants in the country, with the majority of its residents of Haitian origin or descent. It is also an area of high levels of poverty and a lack of primary care providers. 45% of the residents of Little Haiti earn less than $12,000 a year and 40% of its residents have no insurance, compared to 16% of all Floridian residents that live below the poverty line and 20% across the state that have insured.  These demographics and a shortage of providers make it the ideal neighborhood for the Pediatric Mobile Clinic, which rolls out of its parking spot at the University of Miami 5 days a week to park in different high need neighborhoods throughout the city.

On my visit last week, I watched as Gwynn photographed the back of an infant’s head on her cellphone. She then uploaded the photo to an app on her phone which pushed the photo to a pediatric dermatologist for her diagnosis. This store-and-forward technology is yet another telemedicine tool used by the clinic to ensure continuity of comprehensive care. “Telemedicine is absolutely critical for compliance,” Gwynn explains. “My main concern is quality care for patients and their safety.”

a telemedicine machine

 

Established in 1992 by the Children’s Health Fund as a response to hurricane Andrew, the UMPMC has provided medical care to uninsured children in need for nearly two decades. Services provided include well-visits, sports physicals, immunizations, management of chronic conditions, urgent care, mental health, and social work. To learn more the Pediatric Mobile Clinic, click here.

Meeting the Growing Need for Affordable Dental Care

Sal-Migliaccio-blogger
By Sal Migliaccio, Associate, U.S. Programs

Although the Affordable Care Act (ACA) has helped approximately 22.8 previously uninsured people gain medical coverage, hundreds of thousands in the United States still lack access to critical care. Uninsured and underinsured people are faced with astronomically high medical bills, and the ACA has worked to address this broader issue directly. One specific area of human health which goes largely unnoticed, however, is the lack of affordable high quality dental care for those people who do not have the financial means for insurance coverage and/or access to services.

The expansion of Medicaid in 31 states and D.C. is primarily responsible for the large number of previously uninsured people who have gained coverage since the ACA became law in 2014. Medicaid, however, generally does not cover preventative care meaning that dental care is only covered when it intersects with a patient’s larger medical need. According to the National Association of Dental Plans, 126.7 million people in the U.S. lack dental coverage, and of that number only an estimated 17.7 million could gain coverage through some state’s expansion of Medicaid. Only 4.5 million adults are expected to gain extensive dental benefits through Medicaid and only 800,000 adults will gain dental benefits through the health exchanges.

Despite a direct and documented knowledge of the high need for affordable dental care, most free clinics and safety net providers cannot offer these services due to their tight operating budgets. One free clinic in West Virginia, however, has made it a priority to bring dental care to an affordable setting for the uninsured, underinsured, and low-income members of their community.

Wheeling Health Right in Wheeling, West Virginia, has been working on a year-long project to add dental health to the list of high-quality services they provide at no cost to uninsured and underinsured patients. The project, according to Executive Director Kathie Brown, was driven by need. Until recently, uninsured adults in Wheeling could receive free dental care at one of the city’s public school-based health centers. However, with school security and children’s safety in mind, the city decided that public schools were no longer appropriate venues for adults to receive dental care. This, of course, created a gap in the health services available to Wheeling’s most vulnerable populations. For a time, many dentists in the Wheeling area agreed to see uninsured people at no cost to the patient, although, as Brown describes, this did not allow for the continuity of care her free clinic patients needed.

With the help of public and private grant money, Wheeling Health Right has identified space and begun construction for the dental clinic within their existing free clinic facility. They have engaged local dentists who may be interested in volunteering some of their time to provide free dental care with seven already officially committed. In addition, the clinic has been working with manufacturers of dental products to secure lower prices for their charitable program. They plan to offer dental services to their existing pool of uninsured patients with the hope of eventually expanding it to insured patients who simply lack dental insurance.

This project has been put into motion by a local organization that identified a need in their community and sought a way to change things. AmeriCares is proud to support safety net health care organizations like Wheeling Health Right that are making issues of public health personal.

The dental clinic at Wheeling Health Right is scheduled to open in early 2016.

As the nation’s largest provider of donated medical aid to the U.S. health care safety net, AmeriCares works with over 800 free clinics and health centers in all 50 states. Supported by the GE Foundation, our U.S. Programs help partner clinics to increase capacity, provide comprehensive care, improve health outcomes and reduce costs for patients. Our vision is for every person in this country to have access to affordable and high quality health care regardless of their ability to pay. Wheeling Health Right in Wheeling, West Virginia is one of our safety net partners.

“Do you have any questions for me?”

By Lindsay O’Brien, Associate Director, U.S. Programs 

We all know that it’s a good idea to have a list of critical questions ready for our short visits with the doctor in order to maximize those precious few minutes with an expert. (With doctors’ appointments averaging about 18 minutes1,  it makes sense to come prepared). And yet how many of us have given a quick “no” at the end of an appointment when asked, “Do you have any questions for me?” Whether it’s because we’re unprepared or embarrassed, the appointment is ended on an incomplete note, and we may have missed an opportunity to give our care providers an important piece of the puzzle.

The Greater Killeen Free Clinic in Killeen, TX is working to solve this problem.

healthblog3On a visit to the clinic in the spring, I was struck by the impressive health outcomes of the Killeen’s Chronic Care Clinics. These “clinics” are actually year-long education series and wellness visits for individuals suffering from a chronic disease – diabetes, hypertension, heart diseases, asthma or COPD and/or thyroid disorders. (The national statistics on these preventable health problems are staggering: about ½ of all adults in this country have a chronic health condition, and these chronic conditions are the leading cause of death and disability in the U.S.2 These conditions are also notoriously difficult to treat.3) Patients enrolled in the Chronic Care Clinics at Killeen are provided with education on subjects including proper nutrition, exercise regimens and disease and prescription management. They learn effective ways to manage their disease.

Before acceptance into a Chronic Care Clinic at Killeen, patients sign a contract promising to attend mandatory appointments and education sessions. The contract explicitly states the dates and times of quarterly appointments as well as the ramifications of missed appointments. An addendum to Killeen’s Patient Contract is the Pledge of Care. Both patients and Killeen staff pledge to adhere to 14 different standards of care, including mutual “respect, honesty and compassion” and always telling the truth.

healthblog2One pledge really caught my attention: Killeen promises their patients that they will “listen to and answer your questions.” On the flip side, the patient pledges to ask questions when he/she does not understand “until I do understand.” There is an expectation at Killeen that patients will learn everything that they can about their conditions, and they will come to appointments prepared and leave informed. Just as importantly, Killeen staff are committed to ensuring that their patients are empowered with the information to make informed decisions about their care.

Explained by Executive Director Marlene DeLillo, “Patients in the program are wholly committed to improving their health. The Patient Contract clearly explains the program expectations and our commitment to serving as their medical home. And the Pledge ensures that patients know how much we care about them while also demanding participation and honesty. The contract and pledge have definitely enabled the success of the Care Clinics.”

The results of this comprehensive, patient-centered care at Killeen are impressive. Of the 188 diabetic patients participating in Killeen’s clinics, 153 showed an average of 3% point decline in A1C levels over the course of 24 weeks. “One patient’s A1C level dropped from 11.4 to 6.2 in 12 months. We were thrilled,” said Sheila Brooks, clinical supervisor.

When Brooks asks her chronic care patients, “Do you have any questions for me?,” you can bet she doesn’t take no for an answer.

As the nation’s largest provider of donated medical aid to the U.S. health care safety net, AmeriCares works with over 800 free clinics and health centers in all 50 states. Supported by the GE Foundation, the U.S. Programs help partner clinics to increase capacity, provide comprehensive care, improve health outcomes and reduce costs for patients. Our vision is for every person in this country to have access to affordable and high quality health care regardless of their ability to pay. The Greater Killeen Free Clinic in Killeen, TX is one of our safety net partners.

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1 http://www.washington.edu/news/2008/07/14/rx-for-time-crunched-physicians-communication-skills-that-increase-physician-efficiency-and-patient-satisfaction/
2 http://www.cdc.gov/chronicdisease/overview/
3 http://ecp.acponline.org/augsep98/cdm.htm#Note1

Much More than Disaster Relief

By Doug Graves, AmeriCares Multimedia intern
By Doug Graves, AmeriCares Multimedia intern

As a rising senior studying film at the University of Colorado, I was lucky enough to spend my summer as the Multi-Media Intern at AmeriCares. While growing up in Stamford, I had heard about the great work that AmeriCares was doing. However, the real extent and global reach of this organization was not apparent to me until I started working here on my first assignment. Searching through the images captured over the years from countries all around the world, including the United States, I discovered that AmeriCares is so much more than a disaster relief organization.