Project Overview/Mission/Benefits and Value

PROJECT OVERVIEW

The Bureau of Health Statistics lists the absence of health insurance as the 6^th leading cause of death in the United States . Long-term studies have further verified that persons without health insurance do not seek preventive medical care and lack access to appropriate drug therapy to treat chronic illnesses such as diabetes, hypertension and asthma. Consequently these untreated illnesses eventually become more severe, debilitating and costly to treat.

The Schenectady Free Health Clinic is one of an increasing number of free health clinics nation wide established by volunteer health providers to help improve upon this situation. Staffed through volunteers, The Volunteer Physicians Project of Schenectady, Inc. (VPPS), also known as, The Schenectady Free Health Clinic, provides free, comprehensive health care to low-income, uninsured and underinsured adults in Schenectady County of NY who have no other source of medical care. It is estimated that there are 20,000 uninsured persons in Schenectady County .

MISSION :

The primary mission of Schenectady Free Health Clinic is to understand and serve the health and wellness needs of the medically uninsured/underinsured of Schenectady by providing free access to medical care services to person not otherwise receiving medical care through established programs.

Volunteer physicians and other health care practitioners provide services within an organization of committed community volunteers.

Schenectady Free Health Clinic provides without charge episodic primary medical care and referral specialty care services from a network of participating practitioners, hospitals and human service agencies.

Schenectady Free Health Clinic will continually evaluate its services and make program adjustments to measurably improve the health status of persons served.

COMMUNITY BENEFIT AND VALUE:

The benefit and value of this project include:

1.       An increase in capacity of community safety net medical services for low-income, uninsured Schenectady County residents.

2.       Continuity of care for low-income, uninsured resident to treat chronic conditions before they result in debilitating and costly treatments, the bulk of which will be bore by the county through increased Medicaid costs.

3.       Collaboration with mainstream providers across public and private entities to strengthen and coordinate access to care throughout the Schenectady community.

4.       Narrowing of access to care gaps in primary and specialty care for low income, uninsured Schenectady residents.

5.       Improved health status of the uninsured population being served by providing essential medical, medications and health education services.

6.       Remove these patients from the ER’s of our hospitals – cost effective.

Scope of Services:

The Schenectady Free Health Clinic began seeing patients in August 2003 at Bethesda House in downtown Schenectady , N.Y. In December of 2004 we moved to our current location at 600 Franklin Street, Suite 205 , also in downtown Schenectady . Since this time over 5,500 patients have been seen totaling over 9,299 patient visits. The clinic primarily serves patients who live in Schenectady County . Seventy-five percent of the patients seen in the clinic live in the city of Schenectady . They are generally between the ages of 20 and 60 years (85%), unemployed (60%) with no source of primary health insurance (96%).

The clinic relies on the volunteer services of 65 physicians, RN’s and other professionals who volunteer their services to see patients at the clinic and another 30 volunteer physicians who provide specialty care services from their offices. Ellis, St. Clare’s and Sunnyview hospitals provide diagnostic and lab work free of charge for Schenectady Free Health Clinic patients.

A paid Executive Director is available to make referrals to specialists in the community, obtain medications and supplies, coordinate case management services and promote continuity of care.

The clinic is open Monday and Thursday from 2:00-5:00 pm. Currently we are seeing 60-90 patients/session. The Monday session was added in May of 2005. In January of this year we added a session on Friday afternoon for appointments with specialists at the Clinic. We are now averaging some 130-160 patients/week.

We assist patients with public entitlement program process and paperwork moving individuals who qualify into these established programs. This allow the clinic to provide services to those individuals who do not qualify for these entitlement program; essentially the working poor, individuals waiting for Medicaid approval, and low income individuals without prescription drug coverage who otherwise could not afford essential medications.

Since August 2003, the Schenectady Free Clinic has seen a total of 5,500 individual patients and provided:

§         9,299 on-site primary care clinic visits

§         1,227 referrals for consults and/or specialty care in volunteer physician offices

§         2,081 on-site laboratory tests

§         3,137 off-site laboratory tests at area hospitals

§         10,497 on-site prescriptions

§         4,537 off-site prescriptions

§         1,344 diagnostic/imaging testing at area hospitals

§         Approximately 11,500 hours of volunteer medical services

§         149 individuals were enrolled in appropriate government entitlement programs or pharmaceutical prescription assistance programs

A yearly summary for the first three-years and projection for year-4 follows:

* The Value of services provided in 4^th year will exceed $1,800,000.

OUTCOME EVALUATION:

The project will be evaluated using an outcome evaluation model currently being developed by Professor Martin Strosberg of the Graduate College of Union College, program in Health Services Management. Specific outcome and performance measures will be developed to measure the projects effectiveness in three primary areas:

• A hospital impact study to determine the impact of the project on emergency department utilization by the uninsured.
• A chronic diseases study to evaluate the effectiveness of services provided on chronic disease treatment such as hypertension and diabetes outcomes within the target population and
• Patient and volunteer satisfaction with their experience at the Schenectady Free Health Clinic.

The outcome evaluation will be conducted in collaboration with Dr. Strosberg, a Union College graduate student, the clinic’s Executive Director, Medical Director and clinic volunteers. Data collection will be conducted both prospectively and retrospectively over a 12 month time period. It is anticipated that the clinic will be in a position to undertake this evaluation study beginning in 2007. This will allow the project to secure the resources necessary to conduct the study and gain experience with the outcome and performance measures unique to the population it serves.

MEDICATIONS

The Schenectady Free Health Clinic dispenses medications on site in recognition that low income, uninsured individuals lack access to appropriate drug therapy, which significantly compromises their health. Medications dispensed are primarily obtained through free samples donated by local pharmaceutical representatives and physician offices. A drug formulary, which contains a list of cost-effective medications to treat the most common diseases, serves as a guide to ensure that the basic medications most commonly prescribed are available. The clinic utilizes volunteer pharmacists and students to advise the medical staff on the formulary and inventory management, assist physicians with cost-effective prescribing, and counsel patients on appropriate medication use.

The clinic has an arrangement with a local pharmacy to accept prescription vouchers for which the clinic pays for medications not available at the clinic. By using sample medications and a pharmaceutical formulary we reduce the need to use vouchers, which are more costly per prescription. These cost savings allow our program to serve more patients while operating with a limited medication budget.

Patients requiring long-term medications for chronic illnesses such as hypertension and diabetes are screened for eligibility for prescription assistance programs with drug manufacturers. Clinic volunteers assist the patient in completing the paperwork required and qualifying patients receive their medications directly from the drug manufacturer at no cost to the clinic or patient.

PHYSICIAN MALPRACTICE INSURANCE/LICENSURE DOCUMENTATION

Physicians, pharmacists and registered nurses provide licensure documentation to the clinic, which is kept on file and updated annually.

The Clinic carries malpractice insurance for volunteer physicians who are retired and have let their malpractice insurance lapse. The Clinic also provides malpractice /liability insurances for all other volunteers and member of the Board of Directors. To date, there has been no malpractice suits filed against the Schenectady Free Health Clinic.

FINANCIAL SUPPORT

The Schenectady Free Health Clinic does not bill patients or insurers for medical care. The long-term success of the program is dependent on community financial support in addition to the very important resources provided by the volunteer physicians and other professionals. The clinic is using a combination of private, foundation and grant funding to meet its annual operating budget.

COMMUNITY SUPPORT/ SUSTAINABILITY

The Volunteer Physicians Project of Schenectady, Inc. sees as our greatest successes: achieving the continued goal of providing a total continuum of patient care from general to specialty care needs and impacting the community with healthier citizens.

The Project utilizes a combination of factors both within the organization and in the broader community enabling the clinic to make the most of available funding and sustain viability. These factors include State and local health department support, strong community support, collaboration among key community health care providers and other organizations, as well as a capable Board of Directors and project manager practicing effective business strategies.

The clinic is stable and services a growing number of patients. The medical services provided have a goal of total patient care through the on-site clinic or off-site referrals. Community, volunteer and financial support for the Schenectady Free health Clinic is growing, and based on the goodwill created in the community, and the positive outcomes of the services it provides, the outlook for continuation is very positive.

12/8/06