Meeting the Health Care Needs of Low-Income Families I. TOPIC Comprehensive Outpatient Primary Care Program II. LOCATION East Central Texas III. SUBJECT Meeting the Health Care Needs of Low-Income Families IV. SUMMARY The Brazos Valley Community Action Agency (BVCAA), a Community Action Agency serving a seven-county area of east central Texas, has been providing family planning services to the low-income population in its service area since the 1970s. During that time, BVCAA recognized gaps in the health and human services available to the low-income population. BVCAA developed programs to fill these gaps, including Women, Infants, and Children (WIC); adult day care facilities; home health and primary home care; HIV/AIDS education, testing, and counseling; and case management. In 1994, by working with a variety of funding sources, especially the Texas Department of Health, and local service providers, BVCAA established a Comprehensive Outpatient Primary Care (COPC) facility. The facility provides services to people from throughout the seven-county region, and BVCAA has expanded this service by opening satellite clinics in each of the remaining six counties. Through the COPC center, low-income individuals and their families receive health care services that include general medicine, pediatrics, family planning, nutritional assistance, psychological counseling, and HIV/AIDS counseling and care. Dental care and medical specialty care is provided by referral. BVCAA has worked closely with Texas A&M University, the private medical community, local hospitals, and health agencies to ensure that the COPC center provides a full range of essential services without duplicating existing programs. V. SUCCESSFUL PRACTICE Established a Comprehensive Outpatient Primary Care facility and six satellite clinics to meet the health care needs of low-income individuals and families in a seven-county area that did not have sufficient health care services for the poor and indigent populations. VI. CONTACT Dale J. Marsico, Chief Administrator Eric Todd, Health Services Administrator Brazos Valley Community Action Agency (A Community Action Agency) 504 East 27th Street Bryan, Texas 77803-4025 409-779-7443 409-822-7758 (FAX) VII. CASE STUDY The Problem: The Brazos Valley Community Action Agency (BVCAA) recognized that its own health care and health-related programs and other health care services and programs in its seven-county service area were insufficient or too dispersed geographically to meet the health care needs of low-income families and individuals. Specifically, the area lacked access to primary care, funding to support the provision of primary care services, and a coordinated system of making primary care available. The Approach Adopted: Because BVCAA administers a number of health and human service programs, such as Head Start, child development, Brazos Transit Systems, Meals on Wheels, and energy assistance, the agency is well aware of the community's needs. As people in the community express needs or gaps in existing services, BVCAA strives to raise funds and develop programs to meet these needs. BVCAA established the Comprehensive Outpatient Primary Care program after clients expressed a desire for an accessible, holistic health and human services center. How They Implemented The Approach: First, BVCAA consolidated its existing clinical services into a centralized location adjacent to the public transportation system's transit center. Secondly, BVCAA surveyed health care providers in the community, built alliances, and established information exchanges and referral services with its allies. Thirdly, BVCAA used its Community Services Block Grant funds and grants from the Texas Department of Health to expand its programs in areas with evident service gaps. Finally, BVCAA implemented a case management approach that serves as a cohesive program component and affords clients greater access to agencies, organizations, and services within BVCAA's service area. Currently, family planning, pediatric, adult, geriatric, ElderAid, case management, psychological counseling, Medicaid, and transportation services are provided at the COPC facility. BVCAA is working with the local Community Development division on construction that will facilitate the co-location of approximately 10 other health and human services organizations at the COPC facility to provide a "one-stop shopping" center for health and human services. This expansion will also allow BVCAA to establish a dental clinic staffed by volunteer dentists and dental assistants and provide space for Texas A&M University to expand its community-based psychological counseling services. Results: By establishing one Comprehensive Outpatient Primary Care facility, BVCAA has laid the groundwork for continued expansion into other counties with insufficient health care accessibility. BVCAA currently operates limited clinic services in six other counties. BVCAA will continue to implement new services at the COPC facility and the six local clinics as it works to establish comprehensive health care delivery systems in all seven counties in its service area. Combined, the COPC facility and six local clinics serve approximately 15,000 people a year. Depending on the center, low-income individuals and families can receive health care services that include family planning, WIC nutritional assistance, pediatric, adult, and geriatric outpatient care, case management, transportation assistance, information, referrals, and HIV/AIDS services. BVCAA is working with Texas A&M University's medical school to integrate the school's medical resident program with the BVCAA health care program. BVCAA is also working with the local dental community to establish a dental clinic for low-income people, indigents, and people with AIDS. VIII. KEY WORDS Adult Day Care AIDS Case Management Community Action Agency Community Services Block Grant Daycare Dental Care Family Planning Geriatric Care Head Start Health Care HIV Home Health Care Human Services Medicaid Medicare Nutrition Outpatient Care Pediatric Care Primary Care Psychiatric Care Women, Infants, and Children ref: brazos.doc