Community Oriented Primary Care A Practical Assessment, Vol. 2: Case Studies (1984) / Chapter Skim
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Montefiore Family Health Center
Montefiore Family Health Center
Pages 115-136
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From page 115... ...
for over a century, the Montef lore Hospital has demons strafed a consistent social concern for the people of the Bronx, and has been a major innovator in cononunity-based health programs. The Family Health Center developed the f irst home health program in 1939 and later in the 1940s began the f irst Department of Social Medicine.
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From page 116... ...
Staf f and Facilities one practice group consists of six physicians, four family nurse practitioners, and the full-time equivalent of f ive family practice res idents. Additional clinical stat f include a f till-time social worker, a nutritionist working half the, and a health educator working one-third t=e at the Family Health Center.
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From page 117... ...
Finally, it was felt that the geographic areas were designated arbitrarily and did not describe any meaningful social or cultural entity toward which a single health care team could d irect i ts attent ion. Med ice 1 Reco rds The medical records of the Family Health Center are organized by family and filed within a family folder.
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From page 118... ...
The Family Health Center is the practice site for the family practice residents in the Department of Family Medicine. me training program was begun in 1974 as a track in the Residency Program in Social Medicine, and predates the department which was founded in 1978.
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From page 119... ...
The department also provides occasional senior medical student electives at the health center, but has no general responsibil ity f or underg raduate medical education. Through the Department of Family Medicine there is also active participation with and collaboration in a variety of academic pursuits both with the Department of Social Medicine at Albert Einstein College of Medicine as well as with the Sophie Davis School of Biomedical Education at the City College of New York.
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From page 120... ...
2. TABLE 7.1 Sources of Revenue for Family Health Center by Year 19801 1981 1982 1983 % Medicaid 28,006 197,125 893,232 1,213,056 Medicare 680 17,150 9, 760 29, 960 Other Insurance 320 21,425 11,100 22,460 Self-pay 760 19,686 52,700 117,936 TOTAL 29,766 255,386 966,792 1,383,412 65% Grants: BHCDA Grants 1,745,000 1,3tO,000 1,251,500 Sea, 000 27% Robe rt Wood Johnson Foundation2 12,500 lS7,652 143,185 93,243 27% Other -- -- - -- -- - -- -- - 79,200 4% TOTAL 1, 787, 268 1, 783, 038 2, 361,477 2,138, 8S5 100% 1 Incomplete year .
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From page 121... ...
THE CO.MUNITY Demography The community for which the Family Health Center accepts responsibility is def ined geographically to include nine health areas in the Bronx. me component area is broken into two parts with two health areas lying immediately to the east of the Bronx Park.
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From page 122... ...
that meets regularly to consider problems in the delivery of primary care that affect the residents of the Bronx. Recently the PCDU has collaborated to produce a common statistical representation of the health status, utilization, and health needs for residents of the Bronx, as well as shared service contracts and a collaborative school health program {Montef lore Family Health Center, 1983; The Community Service Society'.
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From page 123... ...
The effort also provides training in group skills and health related topics necessary to eventually function as community health leader s. The pro ject is supported by a small grant from the Montefiore W~en's Auxiliary.
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From page 124... ...
~ . In addition, a number of special efforts that required modif ications in the health program that went beyond the reason of the pr imary care services were necessary to meet the needs of the Cambodian population.
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From page 125... ...
Using outreach workers the effort hopes to target specif ic small geographic areas in the cc~unity of known high morbidity. The outreach effort will be based on a community health participation project initiated several years ago by the Department of Social Medicine {Albert Einstein College of Medicine}, in which individuals from specif ic large muleif~ily housing units were offered training and a small stipend to be health ombudsmen.
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From page 126... ...
The proposal was currently under review at the time of the site visit. AS a second line of intervention, several planning discussions had taken place between oaf f of the health center and the Sophie Davis School of Biomedical Education of CONY, directed toward a joint training/research/service effort to deal with the high rate of poor pregnancy outcomes in the community served by the health center.
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From page 127... ...
. ANAI YSIS OF TOE FAMILY REALM CENTER AS A COPC ORGANIZATION The Functions of COPC Defining and Characterizing the Community There is no reliable list that enumerates all of the individuals living within the geographic catchment area of the Family Health Center.
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From page 128... ...
The unit uses existing data to compile an annual needs assessment for the Bronx, with indicators broken down for each of the community health centers (Montef tore Family Health Center, 19 83)
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From page 129... ...
Stage IV for this function describes program modifications that employ both primary care and community health program strategies, and also actively target those services on the identified high risk subset of the community. We Family Health Center has incorporated into its strategy to address adverse pregnancy outcomes, a process to identify and actively provide services to a discrete pocket of high risk ind ividuals .
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From page 130... ...
Special projects have been initiated over the past three years by students in the New York City Stammer Progress for Medical Students and Res idents, and through the community med. ic ine proj ects that are a requirement of the Residency Program in Social Medicine.
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From page 131... ...
It is interesting that within the organizational structure of the health center that there are no personnel designated specif ically as outreach workers. This has not always been the case and in its f irst years, the health center employed family health workers, who carried out door-to-door surveys, marketed the health center, and conducted patient education.
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From page 132... ...
This is most evident in the case of the Cambodian patients, many of whom have severe English language cliff iculty and have a myriad of ad just:ment problems in dealing effectively with the health and social support system within the Bronx. AS a recipient of a W330 grant., the Family Health Center must also con ply with a maximum cost per visit standard that is set at 326.00.
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From page 133... ...
program associated with the Family Health Center. me emphasis on community orientation extends well beyond the family practice residents at the Family Bealth Center and in apparent in the many and varied community-oriented primary care activities undertaken by the professional staff, often well beyond the requirements of their clinical responsibilities.
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From page 134... ...
PRENATAL refers to the efforts to reduce adverse pregnancy outcomes.
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From page 135... ...
Streloick, M.D., Residency Program in Social Medicine and Department of Family Medicine, Montef lore Hospital and Medical Center Patricia Shonubi, R.N., Residency Program in Social Medicine and Department of Fancily Medicine, Montef lore Hospital and Medical Center Jack Essex, Executive Off icer, Montef lore Family Health Center Lang Leang, Clinical Assistant, Montef tore Family Health Center Denise Rodgers, M.D., Montefiore Family Health Center Lauren E Poole, R.N., F.N.
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From page 136... ...
~ Your Family Health Center . Montef lore Family Realth Center .
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