Organization and Planning Grant Requirements

Phase One National Press Release

COMMUNITY VOICES
El Paso, TX

April 2000

               Background

The early development work, which has now blossomed into Community Voices, includes various collaborative efforts in our community including; Lower Valley Task Force (1985), The Primary Task Force (1992), The Thomason Hospital Primary Care Contracts (1997), and The Hillsborough Feasibility Study (1998).  Community Voices, El Paso, is a non-profit 501 (c) (3) corporation formed on September 29, 1998.  The purpose of Community Voices is:

  • To develop and evaluate polices related to healthcare

  • To help improve the health of underserved and indigent families and individuals in El Paso County, Texas and surrounding regions including West Texas, Southern New Mexico, and Chihuahua, Mexico

  • To engage the raising of funds to be utilized for purposes of the corporation

  • To do any foregoing purposes as shall, at any time appear conductive to, expedient for, the protection or benefit, of the corporation, the individuals and organization it serves, or its objectives.

 Community Voices is funded in part by our RE Thomason Hospital, which has committed $10 million dollars over a five year period, to form Community Voices as well as its sister organization of El Paso First Health Network.  El Paso First Health Network is being developed as a managed healthcare organization to provide infrastructure and healthcare delivery capabilities including; but not limited to; a health maintenance organization, claims management systems, utilization reviews, quality management, disease management programs, physician and provider credentialing and contracting services, and financing strategies via health benefit program options to finance access and provider reimbursements for healthcare.  To this end, El Paso First Health Network has already completed their credentialing and contracting process of over 300 primary care specialist/sub-specialist physicians and two area hospitals.  

Community Voices is one of thirteen "learning laboratories" this is part of the W.K. Kellogg Foundation's five-year Community Voices:  Healthcare for the Underserved National Initiative.  The mission of Community Voices is to improve access to quality healthcare services for those individuals who need it most.  We are "An inclusive binational collaborative promoting community health and strengthening the human spirit."  Our Member Agencies that participate on our Community Voices Governing Board or participate on our Communities in Charge Advisory Group/Steering Committee include, but are not limited to; Alviane No-Ad, Inc. Bien Estar Familiar, Cancer Consortium of El Paso, Black Chamber of Commerce, El Paso Black Hispanic of Commerce, Columbia Health Care Systems, El Paso Oral Health Commission, El Paso Pharmaceutical Association, FEMAP, Hospice El Paso, Kellogg Community Partnerships, La Clinicica Guadalupana, La Mujer Obera, Paso Del Norte Health Foundation, Planned Parenthood, Project Vida, Sierra Providence Health Network, Southwestern General Hospital, Southwest Association of Hispanic Physicians, Texas Department of Health, Texas Tech University Health Science Center, R.E. Thomason General Hospital, Universidad de Juarez, University of Texas at Houston School of Public Health, UNITE El Paso, University of Texas at El Paso College of Health Sciences, and Visiting Nurse Association.  Many of our organizations are service providers who will participate and support our outreach program initiatives.

R.E. Thomason Hospital, the public hospital of our El Paso County Hospital District, is chiefly responsible for providing care to our indigent population.  HCA and Mercer National Health Care consultants recently selected Thomason hospital as one of the top 100 hospitals in the United States.  Unfortunately, and due largely to the great number of people who are underinsured or uninsured in our community, many individuals go without accessing primary care or preventive care services and later present as chronic cases in the emergency room as their first point of entry into our healthcare delivery system.

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         Guiding Principles

Our overall objective of our Community Voices/Robert Wood Johnson Communities in Charge Initiative is to address the needs of the uninsured and underinsured people in our community living at 100% of poverty and under 300% of poverty.  We estimate that approximately 300,000 people in our community fall into this category.  The spirit of our project will focus on; integrating fragmented healthcare services to serve the uninsured and underinsured, developing an overall framework for healthcare delivery to meet community needs, designing and implementing culturally appropriate organizations and consumers developing "one step" programs to enroll individuals and families in these programs, exploring and developing unique health benefit programs and models.

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       Initial Project Objectives

Our current plan is to address the needs of our indigent population living at or below 100% of poverty through continued efforts by R.E. Thomason Hospital, El Paso First Health Network, other area service providers, and through Community Voices Access to Primary Care pilot project which we started in late 1999.  Funding for these efforts is made possible by the W.K. Kellogg Foundation's five-year Community Voices:  Healthcare for the Underserved National Initiative.

With regard to addressing and meeting the healthcare needs of our non0indigent population that exceeds 100% of the poverty guideline, we intend to support these efforts in part by the infrastructure made possible through our current supporters and exploring other non-public financing sources such as employers, private sector groups, self funded groups, and sources not currently identified.

Strategic Plan

  • Evaluate and consider applicable best practice models to serve the uninsured/underinsured

  • Explore and consider alternative solutions to increase affordable access to healthcare via insurance programs, managed care programs, and other cost reduction programs

  • Evaluate health and public policies that may pose obstacles with regard to our objectives

  • Explore and consider policy related issues and implications to include local school systems,  NAFTA and other related issues

  • Explore and consider linkages with Juarez physicians and other medical providers to leverage linkages with what others are already doing by accessing cross border medical services

  • Explore and consider means to formalize a process to better ensure access to quality healthcare

  • Recruit the support and participation of employers, employees, consumers, providers, and other relevant stakeholders whom may utilize the solutions identified and developed through our process and initiatives

  • Explore and consider linkages with other current projects and activates to increase economic capacity

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        Financing & Outreach Strategy

Financing Strategy

Our long-term vision for sustainability is toward the development of our Regional Community Health Plan to address financing access and reimbursement for healthcare services, and the required infrastructure to support our integrated healthcare delivery system.  We will consider group purchasing endeavors to offer competitive fully insured group health product options.  We intend to develop competitive fully insured individual health benefit product options and partially self-funded groups health and health plans administration service options as well.

Outreach Strategy

We intend to utilize outreach programs via our member agencies to ensure meeting our prevention and primary care objectives through existing resources.  We also intend to utilize competitive provider reimbursement strategies, health access education, twenty-four hour phone triage systems, and disease management protocols in hopes of establishing competitive/affordable access to health quality care and to encourage long-term economic stability for our integrated healthcare delivery system.

Delivery System

Our unique opportunity we will be considering is with regard to access to affordable care provided by physicians, hospitals, dentists, and other medical providers, in Ciudad Juarez, Chihuahua.  We live right on the border and many people in El Paso, including larger partially self-funded groups have been accessing those providers for healthcare services for many years.  The savings for some procedures can be as much as 50% when compared to similar services provided in El Paso, Texas.  One issue that we will address with regard to quality of care provided.  We will be exploring a more formal process that utilizes credentialing and contracting protocols for physicians, dentists, pharmacies, and other medical providers that are similar to standards used in the United States.

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         Challenges

The main challenge we face is dealing with "change" as we prepare to integrate and evolve our current healthcare delivery system.  We have already implemented and will continue team building and consensus building activities.  To this end, we are utilizing the findings of the Texas Institute for Health Policy Research who has already completed fourteen focus group meetings with various community organizations addressing desired benefit options, current healthcare service issues, and community perception issues.

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         Demographics

El Paso is located at the edge of West Texas and has a population of 700,000 people in El Paso County. It is estimated that only 30% of our citizens currently have access to some form of health insurance coverage. About 28%, roughly 196,000 people, live at or below the Federal poverty guideline. Approximately 70,000 people are not eligible for any current public or private insurance coverage. Our community borders Ciudad Juarez, Chihuahua, with a population of 1.4 million people who live mostly in impoverished conditions. We are fairly geographically isolated. The closest city to us with a substantial population base is Las Cruces, New Mexico, which is forty-five miles West of us, with a population of approximately 160,000. El Paso is 434 miles from Phoenix, Arizona, and 633 miles from Dallas, Texas.

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        Contact Us

Frank Apodaca  
Project Director
RWJ Communities In Charge Initiative
1100 North Stanton, Suite 701
El Paso, TX 79902
Phone: (915) 581-9776
Fax: (803) 545-2159
E-mail:  FrankApodaca@aol.com

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 Communities In Charge 2002 is a program of The Robert Wood Johnson Foundation.
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