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Health Care Initiatives

Public Life Foundation of Owensboro has addressed Health Care Initiatives in a number of ways. Following is a summary of work undertaken from August 2000 through March 2013.

Health Needs Assessment

In 2000, the foundation was the initiating sponsor of a regional (seven-county) health

needs assessment conducted by the University of Kentucky Center for Health Services

Management and Research. Two priority issues emerged from the study: health care

access; behaviors and lifestyles. At that time, health care access appeared to be getting

less community attention than lifestyle issues; consequently, health care access was the

initial follow-up focus.

People’s Health Project

The UK study results were adapted into a dialogue guide and, over a period of 18 months,

trained volunteer facilitators conducted 52 public forums throughout the community:

schools, churches, community centers, fire stations, and more. The objective: to

complement the data in the UK study with personal experiences. Results and analysis of

these forums were included in the 2002 report All Is Not Well: Citizens Speak Out About

Health Care in Daviess County.

Advocacy Group

Following the report on the forums, the foundation convened a core group of participants

who were interested in staying involved. We helped them examine options, organize,

prepare articles of incorporation and by-laws, develop a mission statement and program

ideas. The group became Citizens Health Care Advocates (CHCA). We trained leaders

and facilitated retreats. We provided office space and a part-time executive director

while allowing them to be an autonomous organization.

CHCA has approximately 115 members and more than 500

citizens attended the organization’s meetings. CHCA meetings were broadcast

on public access television and were a premiere forum for health care in our

community.

CHCA meetings typically featured a speaker or panel discussion on a current health care

topic-issue facing our community. CHCA members asked tough questions. They pushed for

improved health care for the underserved. CHCA programs have examined the nursing

shortage, health care costs, the dissolution of the midwife program by the health

department, substance abuse, a cigarette tax increase proposal, needs of the uninsured,

and much more.

CHCA presented two awards: one to honor health care professionals who provide

compassionate care for the uninsured; another to honor citizens outside the field who

have made significant contributions to health care.

CHCA not only accomplished things as an organization, it developed leaders who

are better prepared to get involved in related initiatives. For example, several CHCA

leaders were key leaders in the ODC-Smoke Free initiative that led to a countywide

ordinance to restrict smoking in public places.

Directories

Recognizing the difficulty many people have in navigating the health care delivery

system, in 2002, the foundation published directories on primary care and community

health centers to identify which physicians and walk-in clinics accept Medicare,

Medicaid, and uninsured patients – and under what circumstances.

The directories were updated by Audubon Area Community Services and are used

routinely by social workers, public health workers, medical office managers, ministers,

and others who direct people to sources of care.

Prescription Drugs

When prescription drug costs emerged as one of the most pressing citizen concerns from

our health care forums, our foundation commissioned a report on the topic to identify

models for community-based initiatives: Paying for Prescriptions: The high cost of drugs

and what we can do about it, published in 2002.

Subsequently, we formed a Prescription Drug Task Force that developed a model for a

Community Prescription Drug Service Center that was largely incorporated into a

broader health care access program developed by a three-way partnership involving the

health department, county government, and hospital.

The foundation also made grants to the McAuley Clinic and the Free Clinic to enhance

their capacity to provide prescription drugs to their uninsured patients. This included a

computer software program to expedite the eligibility process for patients who quality for

prescription drug assistance programs.

Health Insurance

Upon learning that state employees and teachers in our community pay much higher

insurance premiums than other areas of Kentucky, in 2003 we commissioned a report to

get to the bottom of it: Health Insurance Premiums in Daviess County: Why do we pay

more than other Kentuckians? What can we do about it?

Since then, a different provider entered the market, secured the state employee-teacher

contract, offered considerably lower premiums, but then lost the contract a year later.

The primary causes of high premiums in our community (high utilization, high provider

charges, etc.) will continue to drive the cost of insurance premiums in the future.

The report was updated in the article, “Does health care still cost more in Owensboro

than other places?” by Fran Ellers (Public Life Advocate, Jan. 2007, Vol. 4, Issue 1)

Medical Transportation

The foundation organized a citizen task force on medical transportation which, through

the help of Audubon Area Community Services, led to the development of an enhanced

computer system to coordinate the best available transportation options for those in need

of such services. Medical office managers, social workers, and others frequently use the

system.

Health Care Access Program

In 2000, the foundation sponsored a presentation by a representative of an Asheville,

North Carolina health care access program that subsequently became the prototype for

the DC-CAP (Daviess County Community Access Project) program designed by the

health department, county government, and OMHS. An executive director was been

hired, physicians were recruited, and space was provided in a new health department

facility. Through DC-CAP, primary care physicians share the burden of uninsured

patients and provide a medical home for qualifying patients. Cards are issued, care is

coordinated and tracked, transportation and prescription drug assistance is provided.

There were 107 physicians enrolled (more than half the physicians in Daviess County),

representing 22 specialties. In 2008, the 248 program participants received more than $2

million in care through 1180 office visits and used the emergency room 30 percent less

than in 2007.

Hospital Buyout/Public Accountability

The foundation took a keen interest in the Owensboro-Daviess County Hospital (parent

entity of Owensboro Mercy Health System) buyout of the Mercy system and the

subsequent governance restructuring. We urged a thorough and open public process to

ensure ample opportunity for the public to understand and examine the options facing the

OMHS and ODCH boards.

Subsequently, ODCH, Inc. purchased the Mercy interest for $36 million. ODCH, Inc.

dissolved, and OMHS remained a private, nonprofit entity. Consequently, the hospital is

no longer subject to open meetings-open records laws, but it agreed to make one public

presentation per year.

Community Summit on Healthy Lifestyles

Healthy Horizons, organized and supported by OMHS, represents an extensive crosssection

of health and community leaders who focus on ways to improve health and

healthy lifestyles. The foundation proposed that Healthy Horizons join with other

community groups in organizing a Community Summit on Healthy Lifestyles.

Benchmarks were identified to assess our current health standing. Goals were established

connected with nutrition, fitness and smoking. The summit attracted approximately 200

people for a half-day Saturday event.

Several years later, action teams continue to report to Healthy Horizons on programs to

promote healthy lifestyles in homes and neighborhoods, workplaces, schools, civic

groups, churches, and other settings.

Articles

The foundation has published articles on the midwife program cuts, substance abuse,

presidential health care proposals, medical malpractice, a proposed clean air ordinance,

the future of clinics and more.

Issue Briefs/Dialogue Guides

The foundation has published several discussion guides on health care issues for use in

public forums on topics such as:

  • Care for the uninsured
  • Should we pass a clean air ordinance?
  • Should OMHS build a new hospital?
  • Dental care for disadvantaged youth
  • Prenatal care for the poor
  • Coal-fired power plants
401 Frederica Street, B-203
Owensboro, Kentucky 42301
(270) 685-2652 Phone
(270) 685-6074 Fax

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