EPID 600 - Introduction to Public Health Practice - Fall 2017

Community Program for Universal Access to Care.

Access for the underserved.

Sheryl Garland MHA, Sherrina Gibson, Michelle Chesser Ph.D..

Key Words: 

General Assembly, Joint Committee, Primary Care, Health Systems, Medical & Dental Scholarships, Educational Outcomes, Practice 'sights', Policy Objectives. Indigent populations, 'Free' clinics. Voluntary care. Access. Under served populations. Targeted illnesses


Government and private non profit agencies and  organizations can stimulate new programs to meet the need of underserved populations.


Following these presentations, students should be able to describe state activities which focus on improving individual and community health status by improving access to primary care, as well as the functions of a 'free clinic'. They should be able to describe the role of the Virginia Health Commission, [an arm of the state legislature responsible for initiating studies to contain cost and improve access to health care]. As well as the Virginia Health Foundation [a private non-profit agency developed by the state legislature] which funnels foundation funds to community agencies which take a lead in improving access to primary care. They should be able to describe the role of 'Free Clinics" in improving access of health care and the value of their linkage to the community public health system. Also, read about one physician's view of the California Doctor's experience during riots of 1992 and what this might have meant to health access for the underserved in California.Think about how the ACA may have changed this.


Health Care Safety Net & Richmond - Sheryl Garland MHA, Also read my comments on the development of the programs. Sheryl refers to the IOM study "Shared Destiny". I have provided a link to the book so you can scan the executive summary (Click on the contents link, then click on the executive summary and read only those pages.).
Scan "Holes in Americas' Safety Net" particularly pages 5-8, also this review of PC graduates and the safety net, Look at the fall 2015 report from Acorn and go to the fourth section on the story about a new program at the Hayes E. Willis Health Center (described in Sheryl's PowerPoint)

and Spreading the Safety Net — Obstacles to the Expansion of Community Health Centers (NEJM-2008)

Virginia Health Care Foundation
: Judith Cash
Look at;
Virginia's distribution of primary care centers
Compare them (note that primary care centers are mainly funded by HHS and the free clinics by the VHCF) then look at the latest description of these entities in the Annual Report of the VCHF 2015.  You can search other states to look at their distribution of Community (Free) Clinics and will not find any with the coverage similar to Virginia.

Other Foundation Models (Where is their focus?)
Robert Wood Johnson Fndn. Clock on "About" tab
W. K. Kellogg (Click on "what we do", when' I was Commissioner, with the help of the Chair of the BOH, Kellogg helped the state set up a series of Child Health Intervention projects in 5 cities to show how combining human services for children into a single entity improved child & family health known as the CHIP program. Look at the CHIP program.
Ford Foundation
Bill & Melinda Gates Foundation
Henry J. Kaiser Family Foundation (mouse over the tabs)

Virginia's Joint Commission on Health Care: Michelle Chesser (Although tthis PPT is 4 years old the functions have not changed.) This commission weas developed by the General Assembly based on work done on primary deficits by the VDH while I was Commissioner.
Examine the JCHC web site, look at the report titles by year and notice the annual foc i, scan this year's studies and reports to review the scope of activities. Look at the staff composition in relation to their expected scope of service.

How much of the JCHC's work do you believe is the result of special interests and how much will address significant health issues affecting the whole population. How much is institutional based and affects ongoing medical interventions, How much addresses ambulatory care and prevention of institutionalization. Look at the options for each suggested intervention and decide where you stand. 

Look at this slide said developed by Dr Lanier to comment upon the role mental health agencies and community action agencies can play in further improving the health of the population with a focus on social and mental issues.

        Three articles are important to this week's discussions as they are to Dr Lanier's presentation next week.
(1) From the Nov. 16 New York Times (9 years later we have not made much progress, despite the ACA of 2010)
(2) Link to Annals of Internal Medicine Article on Physician willingness to support a National Health System, look at the publication date. (But the AMA does not a move to a national system, why do you think the AMA view is so different to that of the Internists?)
 (3) Link to Editorial on above article in Annals of Internal

Use of social media by the Richmond City Health Department,