Development and Implementation Grant
Requirements
                            Phase Two National Press Release

MSSC PROJECT ACCESS
Wichita, KS  

  

 

        Objectives

      See Program Design

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        Program Design

Project Access is a physician-led, community-based effort to coordinate donated medical care and services for low-income, uninsured residents of Sedgwick County, Kansas.  It is based on a model  implemented by the Buncombe County Medical Society in Asheville, North Carolina.  Project Access has expanded and now coordinates a variety of other projects as well.  Additional activities include a Call-A-Nurse service available for enrolled patients on evenings and Saturdays, a hospital emergency department case management program, several large-scale data studies, a new volunteer dental initiative, and patient and provider education activities.

According to updated 2002 Census Bureau statistics, the population of Sedgwick County includes approximately 453,000 residents.  An estimated 50,000 Sedgwick County residents are uninsured based on figures gathered from a Community Health Assessment Project completed by the University of Kansas School of Medicine-Wichita (KUMC) in 1998 and updated in 2001.

Eligibility determination and enrollment occur through a network of low-cost community clinics when patients need specialty care that is beyond the scope of their primary care clinic providers.  Full time eligibility specialists, employed by the Social Rehabilitation Services, are co-located at these community clinics.  The eligibility specialists determine patients' eligibility for Project Access and other programs including Medicaid, S-CHIP (Healthwave in Kansas), food stamps and other services.

Participating physicians and the primary care residency programs may also request enrollment for their patients on their established caseload.  Staff in the Project Access office processes these enrollments.

Project Access eligibility criteria include patients who:

  • Are US citizens or lawful permanent residents

  • Reside in Sedgwick County

  • Have no health insurance coverage and are not currently receiving Medicaid, Medicare or other medical benefits (although eligible patients will be assisted in applying for these programs when appropriate)

  • Have a household income at or below 150% of the federal poverty level

Patients are enrolled for three months for specialty care and six months for primary care.  They may have their enrollment extended if they are still being treated by participating physicians and are still eligible for the program.  Enrollees receive a Patient Identification Card and a Prescription Card and are then referred to physicians to access care and services.  Project Access offers a prescription program (patients pay a $4.00 co-pay per prescription).  City and County funds cover prescription medication costs.  Providers report the contributions to care to the Project Access office for tracking purposes.  Approximately 75% of Medical Society members participate, all area hospitals donate services, 65 pharmacies fill prescriptions at 15% average wholesale cost and do not charge filling fees, and other providers offer donated services including hospice care, some lab work and some durable medical equipment.  A variety of computer programs are utilized to track patient enrollments, demographics, provider commitments, and administrative data regarding specific care and services provided.

 Project Access has also implemented a hospital emergency department case management project.  Case Management teams (consisting of nurses and social workers) are placed at all four emergency departments.  Teams work specifically with high utilizers of the ERs.  Goals include assisting patients in connecting to primary care providers, providing health related education and information for patients to help them take a more active role in managing their healthcare.

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        Financing & Outreach Strategies

Financing Strategy

Project Access receives in-kind support from the Medical Society of Sedgwick County, Kansas' SRS and participating medical providers.  Funders include the United Way of the Plains, the Sedgwick County Commission, the Wichita City Council, the Kansas Health Foundation, the Robert Wood Johnson Foundation, HRSA's Community Access Program, the Wichita Community Foundation, the Knight Foundation Donor Advised Fund, the United Methodist Health Ministry Fund, and private cash donations.  Cash contributions and grants do not pay for medical care; they fund the administrative expenses and a wide variety of program activities being implemented in the community.

Outreach Strategy

Outreach for the program includes a coordinated enrollment process within the points of entry through low-cost community clinics, residency clinics and private physicians.  Television ads (in English and Spanish) aired on specifically identified cable stations and a communications specialist hired on a contract basis have taken the message to the community.  The program is also listed in the local United Way of the Plains' CareLink, a computerized referral list for social service agencies, the police department, and is accessible through the Internet.  Staff presents to many organizations and have brochures in three languages that are widely distributed.  Ongoing media stories also include information about Project Access.  Project Access has become a resource to area media regarding broader issues associated with the uninsured, which helps with outreach as well.

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        Accomplishments to Date 

From September 1, 1999 through March 1, 2004, 4,700 patients have accessed more than $24 million in donated medical care provided by participating physicians and hospitals.  Nearly $1.75 million in prescription medications have been purchased with City and County funds and an additional $300,000 in donated prescription medications has been leveraged from pharmacy companies; patient assistance programs.  SRS has determined the eligibility of more than 40,000 patients for Medicaid, S-CHIP, (Healthwave in Kansas), Project Access, food stamps, and other programs.  The Call-A-Nurse service offers enrolled patients support, information and assistance in navigating the healthcare system.

Patients are showing significant health status improvement as measured with SF-8 survey (administered pre and post enrollment) and patients and physicians report high rates of satisfaction with the program.  The community has experienced a cost savings of approximately $15 million in care because of the coordinated and organized process of serving this patient population.

More than 1,000 hospital ER patients have received specialized case management services.  The project has measured a 59% reduction in the ER utilization by this patient population.  Significant increase in health status is being measured in these patients, and a significant cost avoidance has been experienced.  Future goals for Project Access include:

  • Strengthening our primary care system by assessing current capacity and future needs, developing a more unified voice when requesting expanded or new federal and local public and private funding, implementing a computerized patient enrollment and tracking system to link clinics and Project Access together to a common database, and other collaborative ventures to redesign the manner in which healthcare services are provided to our area's uninsured.

  • Implementing a broad-based program evaluation that assesses patient and provider satisfaction, patient health status, productivity and locus of control, tracks trends in administrative data provided by participating physicians, dentists and hospitals, trends in prescription usage, and measures overall program outcomes including the hospital case management project and the Call-A-Nurse program.

  • Developing a long-term sustainability plan to continue local support for our successes and to move us forward on new initiatives.

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       Challenges

  • Recruitment and retention of physicians in some specialty areas

  • Issues regarding the special needs of our community's undocumented immigrants

  • HIPAA compliance issues and navigating the Hospital Institutional Review Board process

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        Contact Us

Anne Nelson, MSFT
Project Access Program Director
Central Plains Regional Health Care Foundation
1102 South Hillside
Wichita, KS 67211
Phone: (316) 688-0600
Fax: (316) 688-0831
E-mail:  annenelson@projectaccess.net

Web Address: www.projectaccess.net


       
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