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.
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.
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.
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.
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.
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.
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)
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.
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.
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.
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.
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.
The foundation has published several discussion guides on health care issues for use in
public forums on topics such as:
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