Eau Claire Cooperative Health Center

Augmenting Access to Healthcare in South Carolina and American Samoa

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Access to affordable, quality primary healthcare remains a stubborn problem for millions, especially those marginalized due to poverty, race, ethnicity, and birthplace. The resultant health disparities place a heavy burden on those least able to bear it. Simply put, people in care, if they can find it, do better.The Eau Claire Cooperative, a community non-profit, addresses this issue through a primary care system serving low resource communities in South Carolina, and plans to deeply augment services there and in its satellite service area in impoverished American Samoa. The Cooperative’s economic model as a federally qualified health center sustains multiple practices but doesn’t generate excess income sufficient to launch new ones to better address persistent health disparities. Deeper infrastructure funding is the necessary force multiplier. Traditionally underserved low-income communities in South Carolina and American Samoa will enjoy access to care, reduced disease burdens, and fewer health disparities with this project.

Problem Statement

Access to care issues revolve around economic and social conditions and any proposed strategies much address both. Low resource communities lack the economic engines to generate sufficient capital to fully address problems and negative social conditions due to limited educational opportunities, unemployment, poverty, and discrimination all summate to make access to quality, affordable healthcare insurmountable. The poor bear the brunt of the burden of multiple health disparities that exist among all age groups, and weigh even more heavily upon minorities and migrants. Their issues of access to care are often not a priority to mega hospital chains that exist to generate profit. Patients cannot be adequately treated in the emergency department for chronic diseases such as hypertension and diabetes. A rationally designed system of deployed primary care assets, accessible and affordable is essential. As harsh as the high poverty and unemployment rates are among the poor and minorities in South Carolina, the situation is more severe in American Samoa, where federal and private investment continues has historically been anemic. Federally qualified community health centers, like the Cooperative, are granted cost-based reimbursement from Medicaid and Medicare to help sustain economically challenging practices located in health shortage areas, in exchange for serving all patients of all income levels and denying no one. This care mechanism can be leveraged with outside funds to create the augmented medical infrastructure which can be sustained by the federally guaranteed health center's cost based reimbursement methodology.

Solution Overview

The Cooperative’s medical infrastructure and access proposal addresses factors limiting the expansion of services to underserved populations. With additional clinical space, housing more robust support services (primary care, pharmacy, optometry, lab and imaging, and outreach) a larger clinical staff, and an in-house internship program for nurses and allied health personnel, the health center will be better positioned to respond the health disparities and provide increased access to care for low resource communities in South Carolina and its satellite communities in Samoa.Tracking multiple clinical parameters and measures established by federal Healthy People 2020 guidelines, progress can be assessed. Clinical data, blinded and extracted from patients’ electronic medical records and demographic trends extracted from the health center's health population module will supply the data points. The five-year impact will be dramatic for the 58,000 Pacific islanders of Samoa; childhood immunization rates will improve and control of hypertension and diabetes will improve. Samoa is within the world's epicenter for highest prevalence of rheumatic fever (New England Journal of Medicine, Aug. 2017) and its resultant chronic heart disease. Rheumatic fever is easily treated with simple penicillin for pennies per day, preventing the heart disease, if primary care is available. In South Carolina, multiple chronic disease burdens exist and their measures will continue to demonstrate improvement within the health center's population of 54,000 over time. Low-income families with geographic, economic, and discriminatory barriers to care will gain access to quality sustainable care, and deep health disparities will be addressed.

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