Project HEALTH: Mobilizing a Pipeline of New Leaders to Change Health Care Delivery Health Action 2010 Conference.

Project HEALTH:Mobilizing a Pipeline of New Leaders

to Change Health Care Delivery

Health Action 2010 Conference

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Prerequisites to Positive Health Outcomes

Social Determinants of Health

Access to Care

Quality of Care

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Resource Needs in America

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Food

Resource Need• Over 17 million Americans are eligible for

but do not receive food stamps

A substantial number of Americans qualify for but do not receive assistance across a number of resource needs

Housing• 6 million renter households in America

receive no housing assistance and have severe rent burden and/or severely inadequate housing

Energy• 50-70% of households eligible for LIHEAP

(Low Income Housing Energy Assistance Program) benefits in cold regions do not receive benefits

Education• Of the 194 million Americans over the age of

25, 14.3%, or 27.7 million, are without a high school education

Employment /

Income• There are 46 million uninsured Americans

and 37 million living below the Federal Poverty Line

Sources• State of the States: 2007 A Profile of

Food & Nutrition Programs Across the Nation; Food Research and Action Center

• HUD (2005): Affordable housing needs report to Congress

• 2008 Annual Social Economic Supplement (2007 data)

• Digest of Education Statistics, 2007, US Department of Education

• Income, Poverty, & Health Insurance Coverage in the United States: 2007, US Census Bureau August 2008

• Health Insurance Coverage of the Nonelderly by Poverty Level, 2007, Kaiser Commission on Medicaid and the Uninsured/Urban Institute Analysis of March 2008 CPS

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Access to Resources Impacts Health Outcomes

Children who experience “food insecurity” – uncertain or limited supplies of nutritious food – are 30% more likely to be hospitalized by age three.2

Children less than 3 years old whose families need but do not receive help paying their gas or electric bills are 30% more likely to be hospitalized.1

1 Frank, D., Neault, N., Skalicky, A., Cook, J., Wilson, J., Levenson, S., Meyers, A., Heeren, T., Cutts, D., Casey, P., Black, M., and Berkowitz, C. “Heat or Eat: Low Income Home Energy Assistance Program and Nutritional Risk Among Children Under 3 Years Old.” Pediatrics, 2006.

2 Cook J.T., Frank D.A., Berkowitz C., Black M.M., Casey P.H.., Cutts D.B., Meyers A.F., Zaldivar N., Skalicky A., Levenson S., Heeren T., and Nord M. “Food insecurity is associated with adverse health outcomes among human infants and toddlers,” Journal of Nutrition 2004; 134:1432-1438.

3 RWJF (2008): Where we live matters for our health

It is well-documented in medical literature that access to key resources – food, housing, fuel assistance – directly & significantly impacts health outcomes.

Approximately 40% of diagnosed asthma among children is believed to be attributable to residential exposures. 3

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Theory of the Problem

• Purpose of health care system: Identify & consider all significant conditions known to affect patient’s health and, where solutions exist, refer patient to solutions.

• Yet U.S. health care system does not provide screening

and referral for social determinants of health

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Theory of the Problem

Why doesn’t the health care system currently address

patients’ unmet resource needs?

1. Lack of effective, affordable clinic-based infrastructure in hospitals/clinics to connect patients to these resources(e.g., Bellevue Hospital has two social workers for 60,000 pediatric patients clinic visits)

2. Insufficient leadership in health care sector (& beyond) to make this infrastructure pervasive

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Project HEALTH’s Vision

100% of clinics serving a

substantial low-income patient population . . .

Screen 100% of patients for key unmet resource

needs . . .

And refer 100% of patients with

such needs to the required

resources

Project HEALTH envisions a health care system in

which patients’ unmet resource needs are routinely

and systematically addressed as a standard part of

patient care.

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Project HEALTH’s Family Help Desk Model

Demonstrates clinics’ capacity to address low-income patients’ resource needs in an affordable, effective manner

Creates a pipeline of leaders with the conviction, knowledge, experience, and efficacy to create fundamental changes in the health care system to improve health outcomes for all Americans, especially those who are low-income

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Project HEALTH Family Help Desk

Health Care providers “prescribe”

Family Help Desk to patientsPatients walk by Family Help Desk

& seek assistance

Intake with clients

Follow-up with clients with clients

Close loop with providers about patients’ needs, resources

provided

Connect to community resources

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Cities (NYC, Boston, Providence, Baltimore, D.C, Chicago)

6 NYC

Family Help Desks in Hospitals/Clinics Pediatric & Adult Primary Care Pediatric Emergency Dep’t Newborn Nursery Ob/Gyn Clinic Community Health Center Adolescent Clinics

18 3

Volunteers 563 73

Total Volunteer Hours (per year) 100,000 (48 FTEs)

8,400

Families Served (per year) 4,051 407

Children & Adults Impacted (per year)

12,153 1,221

Impact: Current Scope of Services

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Impact: On Families & Volunteers

50% of families with whom Project HEALTH NY maintains contact obtain at least one resource they need – i.e., receive food, secure child care, find a job or apartment – within 90 days of receiving services at the Family Help Desk.

Volunteers continue to follow-up with all clients until they receive the resources they need or they can no longer be contacted (14% client disconnection rate)

83% of graduating Project HEALTH NY volunteers engage in graduate study or work related to health or poverty following graduation

100% of those volunteers rank the relative importance of their Project HEALTH experience in the selection of their post-graduate plans as “high” or “very high” (as compared to 7 other factors potentially impacting their plans)

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Contact Information

Chinwe Onyekere

Executive Director- Project HEALTH New York

Phone: 212-939-4135

Email: [email protected]

Website: www.projecthealth.org

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Appendix B: Institutional Partners

Hospitals/Health Centers• Harlem Hospital Center• Bellevue Hospital Center• University of Chicago Comer Children’s Hospital• La Rabida Children’s Hospital• Friend Family Health Center• Boston Medical Center• Children’s Hospital Boston• Upham’s Corner Health Center (Boston)• Hasbro Children’s Hospital/Rhode Island Hospital• Johns Hopkins Medical Center• Johns Hopkins Bayview Medical Center• St. Agnes/Baltimore Medical Systems• Baltimore Health Department/Total Health Care, Inc.• Children’s National Medical Center • Good Hope Road Health Center (Washington, DC)

Universities• University of Chicago• Boston University• Harvard University• Brown University• Columbia University• New York University• Johns Hopkins• University of Maryland Baltimore County• Loyola College • George Washington University

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Appendix C: Representative Project HEALTH Alumni

Tara Abrahams, MBA, Director, Maverick Capital Foundation

Atiya Ali, MPH, Senior Manager, Corporate Responsibility, Pfizer Inc.

Afia Asamoah, JD, Special Assistant to the Principal Deputy Commissioner, Federal Drug Administration

Kathleen Conroy, MD, MPH, Fellow, Department of Pediatrics, Boston Medical Center

Kelly Doran, MD, NYU/Bellevue Emergency Medicine Residency

Emilou Maclean, JD, Director, Medicins Sans Fronteirs

Brian Milder, MBA, Director of Strategy & Innovation, Root Capital

Craig Peskin, Investment Team, Highfields Capital

Miriam Stone, Vice President of Business Development, VisionSpring

Jessica Sultzer, MPA, Manager, Cause Marketing & Corporate Social Responsibility, Nat’l Football League

Arianne Tjio, Sponsorship Committee Coordinator, Clinton Global Initiative Asia