Providing Health Care Services to Underserved and Unserved
                    Individuals and Families

I.   TOPIC          Panhandle Family Health Resource Center

II.  LOCATION  Gering, Nebraska

III. SUBJECT        Providing Health Care Services to Underserved and
                    Unserved Individuals and Families

IV.  SUMMARY

     In October 1994, the Division of Shortage Designation of the Nebraska Department of
     Health and Human Services designated Scotts Bluff County as a primary medical care
     health professional shortage area. Before 1993, Panhandle Community Services (PCS), a
     Community Action Agency serving the area, provided health care services to the
     underserved and unserved population through contracts with local doctors. PCS sought to
     address the continuing shortage of services by opening a Family Health Resource Center.
     The targeted population of the health center is the underserved/unserved of the area.
     Services are allocated on a sliding fee basis with no one turned away because of inability
     to pay. The new PCS facility houses dental and medical health services, nutrition
     services, and a family resource center. The Family Health Resource Center also contains
     an X-ray room and treatment facilities for minor surgery, casting, etc. As of March 1995,
     the Center employs 80 licensed medical professionals including doctors, dentists,
     physician assistants, registered nurses, dietitians, and practical nurses. One of the
     Center's objectives is to increase the number of two-year-olds who are current on their
     immunizations.
     
V.     SUCCESSFUL PRACTICE

     Developed a full array of family health services and opened a new health care facility to
     meet the needs of the underserved and unserved population.
     
VI.    CONTACT

     Joan Cromer, Executive Director
     Panhandle Community Services
     (A Community Action Agency)
     3350 Tenth Street
     Gering, Nebraska 69341
     308-635-3089
     FAX: 308-635-0264
     VII.   CASE STUDY

     The Problem: In October 1994, the Division of Shortage Designation of the Nebraska
     Department of Health and Human Services designated Scotts Bluff County as a primary
     medical care health professional shortage area.
     
     The Approach Adopted: Panhandle Community Services (PCS), a Community
     Action Agency, had been providing health care services to the area's underserved and
     unserved population through contracts with local doctors. To meet the continuing
     shortage of health care, PCS planned a new medical facility. The center would provide
     services on a sliding scale basis with no one being turned away because of inability to
     pay.
     
     How They Implemented The Approach: PCS built a 12,300 square foot health
     care facility and family resource center. The building houses dental and medical health
     services, nutrition services, and a family resource center. Services are provided in 10
     medical exam rooms and four dental exam rooms. The facility also has an X-ray machine
     and facilities for minor surgery.
     
     PCS has significantly increased the number of medical professionals serving the area by
     retaining 80 physicians, physician assistants, dentists, registered nurses, dietitians, and
     practical nurses.
     
     PCS has instituted a Continuous Quality Improvement Committee through which PCS
     can assure that the services provided meet high medical and dental standards and are
     accessible, affordable, and efficient. The Committee is responsible for performing chart
     reviews, documenting findings, planning and implementing corrective actions, and
     dealing with patient complaints.
     
     Panhandle Community Services is a subcontractor to the Nebraska Department of Health
     to provide migrant health services and operates the only migrant program in the state of
     Nebraska. PCS also has a strong emphasis on education and preventive health care,
     including the Women, Infants, and Children program and the Commodity Supplemental
     Food Program. Health services staff collaboratively plan and conduct monthly education
     classes for prenatal, postpartum, and teen mothers and for mothers who speak only
     Spanish. A diabetes support group meets monthly at the agency and many educational
     videos and handouts are available during the clinic hours.
     
     Results: The new PCS facility has made 80 new professional medical personnel
     available to the community. From January to December 1994, there was an increase of 48
     percent in the number of people in the community served. During the six-month period
     from October 1994 to March 1995, dental services averaged 192 clients per month and
     219 visits per month as compared to no clients or visits in 1993. During that same period,
     the Center averaged 589 clients and 782 visits. Immunization programs are up, with 898
     immunizations given from October 1994-March 1995.
     
VIII.  KEY WORDS

     Child Development Programs
     Commodity Supplemental Food Program
     Community Action Agency
     Community Services
     Family Services
     Health Care
     Migrant Health
     Nutrition
     Women, Infants, and Children
     Youth
     



ref:   panhandl.doc