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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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