Organization and Planning Grant Requirements

 

Phase One National Press Release

JACKSON MEDICAL MALL FOUNDATION
Jackson, MS

April 2000

               Background

The Jackson Medical mall Foundation planning began in early 1999. However, community health planning had be ongoing since 1992 through a health provider/business consortium named Health Futures.  The Community Coalition formed in the spring of last year and has been very active since then.  It consists of representatives from the JMMF, University of Mississippi's School of Nursing, Jackson-Hinds Comprehensive Health Center, Central Mississippi Health Services, and City of Jackson's Mayor's Office, the Hinds County Board of Supervisors, the State Board of Pharmacy, and the Mississippi Human Services Coalition.  Care to the uninsured is provided primarily through the federally qualified health center, a FQHC look-alike, the university hospital's outpatient clinics and the emergency departments of the four major health systems in Metro Jackson.  The major health systems alone provided over $50 million of uncompensated charity care and bad debts to Hinds County's uninsured of underinsured in 1999.

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         Guiding Principles

This Program's goal is that the 45,125 uninsured of Hinds County will have access to an insured integrated delivery system (IDS) for comprehensive healthcare.  This "medical home" will be provided through a collaborative practice model, and inclusive consortium of providers, payers and consumers, and connectivity that will allow for a virtual health record for all participants.  The Jackson Medical Mall Foundation will act as the lead agency.  Through an innovative project to revitalize inner city area, an 800,000 sq. ft. declining shopping mall was tranformed into a Medical Mall.  Since opening in 1997, it has served over 250,000 clients.  Primary care providers will include the University of Mississippi Medical Center's Outpatient Primary Care and Specialty Clinic, Jackson Hinds Comprehensive Health Center (a FQHC), Central Mississippi Health Services, Inc., (a FQHC look-alike), University of Mississippi's School of Nursing UNACARE Clinics and The Children Defense Fund.

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         Initial Project Objectives

Working closely with the state Medicaid program Children's Health Insurance Plan (CHIP), Health Features and the Metro Jackson Chamber of Commerce, we will examine carefully the managed health plans that each provide for their constituencies.  This will be done to determine if one could use to serve the uninsured that we will identify.  The health plan must provide preventive health services, screenings and outreach to have services delivered to the uninsured at the right place at the right time for the right price.  Improved access and continuity of care through a "medical home", rather than using the hospital emergency departments for episodic care will be provided through an envisioned model.  We will be serving both urban and rural populations and will take advantage of existing telemedicine capabilities and shuttle services to overcome transportation problems often encountered by the population served.  A thorough community assessment will be conducted through the School of Nursing to design a program to meet the unique needs of our communities.

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        Financing & Outreach Strategy

Financing Strategy

Mississippi is the first state in the nation to set aside its entire Tobacco Litigation Settlement of $4.1 billion in a Health Care Trust Fund to preserve the fund and generate earnings to be spent on healthcare improvements, including $50 million this year.  The State's Attorney General who helped lead this initiative, is actively supportive of seeing part of these funds utilized for a program for the uninsured.  In addition, the business community will be approached through the Metro Jackson Chamber of Commerce and Health Futures to gain support for a private/public funding of an essential health plan for the uninsured.  Sixty-five percent or more of the uninsured are already working.  Therefore, it is imperative to show the business community how a reasonably priced health plan for their employees will actually constitute a good investment and positively impact their "bottom line."

Outreach Strategy

It will be imperative to involve all levels of city, county and state government who deal with the provision of healthcare services.  The four major health system have enthusiastically agreed to work together on this program for the uninsured.  We do believe that the business community will sign on to this effort through the Health Futures coalition and the metropolitan Chamber of Commerce.  The Metropolitan Council of Chambers will also partner with us in providing outreach to the uninsured.  In addition, some type of community outreach worker who has experienced firsthand the difficulties will also be asked to promote this program for the uninsured.  Our objective is simple.  It is to eradicate the category of uninsured in this county.  If successful we intend to try to replicate this model in the remaining 81 counties of the state.

Delivery System

Through a redesign of the healthcare delivery system assisted by the research faculty of a historically black college and university, namely Jackson State University, we expect to be more effective in improving access for the uninsured.  However, we will also deal with the diversity issues, in the delivery of essential healthcare services to this part of our community.  Emphasis will be placed on outreach management, health promotion and disease prevention.  Health screening and education programs will be stressed through churches and schools.  The services will be provided through those who have traditionally cared for the working poor and uninsured.  Yet efforts will be made to include the entire community of providers who wish to participate in this program.  The services will likely be provided through some type of managed care health plan that emphasized quality assurance utilization review, case management and outcome evaluation.

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         Challenges

The initial hurdle we experienced in putting together the Community Coalition had to do with who was to be the lead agency.  One of the community health centers proposed to be the lead agency or be a co-lead agency.  The Robert Wood Johnson Foundation found it unacceptable to have a co-lead agency.  After some deliberation among the parties involved, it was agreed that the Jackson Medical Mall Foundation could do the best work as lead agency.  In terms of hurdles we face, it will be important to have expressed commitment and cooperation among the varied segments of the provider community.  We will then want to identify the best health plan both in terms of benefits and services that can effectively serve the uninsured who will be enrolled in this program.  Politically, we will have to convince the State Legislature to prioritize this program for the uninsured among numerous competing causes.  The program must be affordable for the participants and cost effectively managed.  Organizationally, we have to create an atmosphere of teamwork, harmony and effective execution of the plan that will be developed in Phase I so that it can be implemented, evaluated and designed for replication in Phase II of this Communities in Charge Initiative.

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         Demographics

Hinds County in central Mississippi has a population of 255,233, of whom 17.68% or 45,125 are uninsured for health benefit coverage. We will have to triage those who are uninsured to determine who are eligible for Medicaid, who qualify for the CHIP Program (with eligibility for children within families with income up to 200% of the federal poverty level) and who remain for the health uninsured program we will develop up to 200% of the FPL.

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        Contact Us

James Malloy M.P.H.
Project Director
Jackson Medical Mall Foundation
350 West Woodrow Wilson, Suite 615
Jackson, MS 39211
Phone: (601) 957-9991
Fax: (601) 957-3626
E-mail:  jmalloy@son.umsmed.edu

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