Health Center and Public Housing National Symposium. How Investing in Public Housing Residents Changed a City

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1 Health Center and Public Housing National Symposium How Investing in Public Housing Residents Changed a City

2 RCHD: Resource Centers I. Background and History II. Academic Partnerships III. Community Advocates

3 Richmond

4 People say living in Richmond is good because it s two hours from everything the mountains, the ocean, Washington, D.C. That s cool, but it s also one minute from itself.

5 Why Resource Centers? By almost every major public health indicator, Richmond City ranks in the bottom five of localities throughout the Commonwealth. Highest clusters of teen pregnancy, sexually transmitted infection, including HIV, and infant mortality are concentrated in public housing communities.

6

7 Formation of the Resource Centers Title X Expansion Grant Focus Groups Tenant Councils Upgrade former clinics with NP Richmond Redevelopment and Housing Authority (RRHA) partnership Development of Community Advocates Program Partnerships with Local Medical Homes Funding Partnerships

8 Timeline of Resource Centers 2008: Received Title X funding 2009: November- Fairfield Resource Center opens 2010: March- Received funding from The Community Foundation May- Whitcomb Resource Center opens December- Receive RMHF & VHCF funding 2011: March- Title X funding ends, First Community Advocates hired, Creighton Resource Center opens April- Mosby Resource Center opens 2013: April- Hillside Resource Center opens

9 Whitcomb Opening May 10 th, 2010 Units: 447 Population: 1,287

10 Opening of Mosby April 6 th, 2011 Units: 453 Population: 1,190

11 Inside Creighton Resource Center Average clinic size: sq/ft.

12 Inside Creighton Resource Center Units: 503 Population: 1,232

13 Resource Center Service Model

14 Staffing Model Resource Center Supervisor (RN/MSN) Nurse Practitioner Public Health Nurse Community Advocates Medical Assistant / Clerical Support Volunteers from RRHA Public Housing Communities RCHD Deputy Director

15 Services Provided Reproductive Health and Family Planning Pregnancy Testing & Referral Birth Control Plan First Program Breast and Cervical Cancer Screening & Referral STD / HIV Prevention Education, testing & treatment, referral. Chronic Disease Blood sugar screening & referral Blood pressure screening & referral Service Referral & Navigation Medical Home Referral Medical Specialty Referral Behavioral Health Referral Oral Health Referral Medicaid / FAMIS Referral Health Education Health Education Classes Health Education Events Clinical Training (Undergraduate and Graduate) Practicum experiences Internships

16 RC s Service Profile (2012) Total unduplicated medical patients: 2,190 Total patient visits: 2,931 Total patients referred to community resources: 3,465 Patients referred to a medical home: 534

17 Community Partnerships Financial Support Bon Secours VCU School of Nursing RCHD Richmond Behavioral Health Authority Challenge Discovery VCU Center on Health Disparities In-kind donations Richmond Redevelopment & Housing Authority Church & Dwight Inc Richmond City Agencies Richmond Healthy Start Initiative Community Partners Family Life Line AHA Educational Support 7 th District Wellness Initiative Campaign to Prevent Pregnancy Embrace Richmond Senior Connections Richmond Promise Neighborhoods Referring Agencies Capital Area Health Network - FQHC Daily Planet - FQHC Crossover Bon Secours VCU Health Systems Center for High Blood Pressure Service Providers Fan Free Minority Health Consortium

18 Community Resource Referrals Resume building Job/career development Housing Counseling Summer camps Early childhood development Food and clothing resources Dental Van Pregnancy Local medical homes

19 Medical Home Referrals Identify participating medical homes MOUs Designated Agency Personnel Staff Training Referral Tracking

20 Awards NACCHO AWARD Winner of the NACCHO 2011 Model Practice Award from the National Association of County and City Health Officials NAHRO AWARD VHCF AWARD RRHA and RCHD received the National Association of Housing and Redevelopment Officials (NAHRO) 2011 National Award of Merit in Resident and Client Services for the establishment of communitybased Resource Centers. The Richmond Redevelopment and Housing Authority (RRHA) and RCHD were awarded the 2013 Unsung Heroes Award in the Teamwork category for the collaborative efforts in implementing the Resource Centers.

21 Grants THE COMMUNITY FOUNDATION RICHMOND MEMORIAL HEALTH FOUNDATION VIRGINIA HEALTHCARE FOUNDATION Long-term contraception Outreach Worker Community Advocate Program Creighton Mosby

22 Organizational Funding BON SECOURS Sponsoring Creighton VCU SCHOOL OF NURSING Sponsoring Mosby Nursing students & NP

23 Other Funding Sources Richmond Behavioral Health Authority (RBHA) Challenge Discovery Projects Richmond Healthy Start Initiative Shalom Farms VCU Center on Health Disparities

24 II. Academic Partnerships Value of academic partnership Public Health Workforce Development Public Health Training: Classroom vs. Community

25 II. Academic Partnerships Graduate and undergraduate students from Virginia Commonwealth University, University of Virginia, and Old Dominion University: Nursing Medical Social work MPH Community Education Dental Pharmacy

26 Success Stories Two current RCHD nurses: Courtney Sloan Jessica Garayua-Johnson

27 III. Community Advocate Program Advocates are a truly unique component of the Resource Center Model Advocates are trained, indigenous leaders, who understand the inherent barriers of their own community Advocates are health experts who educate, motivate, and inspire other community members to make positive lifestyle choices All 5 have previously lived in public housing, and now use their life experiences to encourage the community around them.

28 Development of Community Advocates Creation of CA initiative Recruitment Strategic Hiring Training Accountability One-on-one meetings Staff meetings Drop-in visits Monthly reports Vision building

29 Challenges of Training Local Residents Lack of professional work experience Lack of Resource Center staff dedicated to supervision of Advocates Legal and criminal backgrounds Generational poverty Family structures Personal challenges

30 Lessons Learned Lack of thorough reference checks Inability to address diverse and multifaceted community needs Lack of evidence base for generalist CA role Difficulties in creating a new role Unclear knowledge of CA role and expectations Need for constant flexibility for CAs and Supervisor Necessity of regular evaluations

31 Overcoming challenges Goal setting Frequent trainings Encourage feedback and suggestions of staff Maintaining high expectations Foster individual strengths and passions of CAs Provide role models for the CAs

32 Strategic Impact Improved clinical outcomes Education of students and researchers CAs become role models for the community Professional development of CAs Conduits for community change

33 Success Stories Chinary Hall, Community Advocate It is more than just service provision; it is about building trust and building relationships as well as about building people up, realizing their needs and helping them achieve their goals.

34 Strategy for Richmond City Affordable Care Act Help uninsured individuals sign up for health insurance Shift culture away from ED to primary and preventive care Community Advocates as the model for Richmond

35 Thank You! Thank you!

36 Contact Danny TK Avula MD, MPH Amy Popovich RN, MSN

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