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At least 19 recordsLinked to original sources
PubMed1995

How an academic health center and a community health center found common ground.

Despite their divergent missions, academic health centers (AHCs) and community health centers (CHCs) are natural partners. This is becoming more obvious as national attention is focused on greatly increasing the number of primary care providers. AHCs are responding to this pressure and now need more sites to train primary care physicians, and CHCs need more primary care physicians (the AHCs' graduates) as staff. Thus these two types of institutions have a common interest. Other major themes of health care reform are also likely to drive AHCs and CHCs together, such as providing access to the uninsured, placing more emphasis on prevention and public health, and coordinating care in managed care systems to improve outcomes and control costs. Yet partnerships between these two kinds of institutions are still rare. This article describes a successful joint program begun in 1991 between the Lincoln Heights Health Center, which serves a poor, predominantly black community, and the University of Cincinnati Medical Center. All the program's activities are monitored by a policy committee made up of representatives from both institutions. For the first five years, the main hospital of the medical center is supporting the relationship with a $350,000 grant. Both parties retain their independent governance, yet collaborate closely and feel the relationship yields high value to each party and the community. For example, medical education in out-of-hospital settings has increased greatly, as have referrals to the AHC. The CHC has been able to recruit and retain high-quality physicians; its balance sheet has been favorably affected also.(ABSTRACT TRUNCATED AT 250 WORDS)

Academic Medical Centers↗
PubMed1996

[Supporting roles of health centers in community health practice by municipalities].

Staff of community health centers are expected to support those of municipalities so that they can identify health relevant issues in their communities, plan strategies to resolve the issues, implement them and evaluate the action. To illustrate the role of community health centers, the authors report the process of health promotion practice in Taisho-cho, Kochi prefecture, which was supported by Kubokawa health center. The health center took the initiative in identifying issues in community health through analyzing available information. In a practice setting, the health center facilitated involvement and participation by the residents and cooperated with other community resources. The process of support is discussed from the point of view of community organization practice.

Ambulatory Care Facilities↗
PubMed1985

Strategies for increasing productivity and revenues in community mental health centers.

Community mental health centers are challenged with the development of strategies for growth and prosperity in a cut-back environment. This paper shares strategies developed by two centers to increase productivity and revenues through the implementation of performance contracting and staff incentive plans. The process of development and implementation of the strategies is described, and the financial and program results are evaluated. Both Centers report substantial increases in productivity and revenues during a multi-year evaluation period. The paper concludes with a discussion of the issue multi-year evaluation period. The paper concludes with a discussion of the issues for community mental health centers to consider in the development of similar strategies.

Community Mental Health Centers↗
PubMedDate not supplied

Case study of the integration of a local health department and a community health center.

As rural communities struggle to sustain health services locally, innovative alternatives to traditional programs are being developed. A significant adaptation is the rural health network or alliance that links local health departments and community health centers. The authors describe how a rural local health department and community health center, the core organizations in publicly sponsored primary care, came to share a building and administrative and service activities. Both the details of this alliance and its development are examined. The case history reveals that circumstance and State involvement were the catalysts for service integration, more so than the need for or the benefits of the arrangement. The closure of a county-owned hospital created a situation in which State officials were able to broker a cooperative agreement between the two agencies. This case study suggests two hypotheses: that need for integrated services alone may not be sufficient to catalyze the development of primary care alliances and that strong policy support may override any local and internal resistance to integration.

Community Health Centers↗
PubMed1975

Following the Blackfoot Indians: toward democratic administration of a community mental health center.

Community mental health centers have been held back by authoritarian administrative structures, inherited from the traditional medical model, from fulfilling their original promise of innovative approaches to mental health and responsiveness to the community. This is a 10-year case history of one mental health center's struggle "to put its own house in order" to further staff morale, productivity, more egalitarian attitudes toward clients, and a sense of partnership with each other and the community. The paper shows the development of democratic structures and processes, how line staff and administrators confronted their taboo on power, the traditional hierarchy among disciplines, staff participation in administration, and their vulnerability within the wider bureaucratic system.

Administrative Personnel↗
PubMed1996

The community health center and family practice residency training.

Community health centers (CHCs), sponsored by US Public Health Service (USPHS) Section 330, represent successful models of the application of community-oriented primary care principles. Recently, increased interest has been shown in conducting medical education programs in CHCs. The USPHS has tried to facilitate this interest, particularly through its support of establishing linkages between CHCs and family practice residency programs. In this paper, we describe an integrated CHC-family practice residency continuity training clinic program. We discuss the challenges inherent to conducting family practice residency training in the CHC, including the educational content of clinical experiences, the impact of provider productivity expectations, the academic and operational governance of the program, and the financial considerations pertinent to the integrated function of the program. We conclude that while the clinical experiences available in the CHC differ somewhat from mainstream family practice, successful adaptations can be made, and a CHC offers a rich educational environment. We also conclude that the challenges inherent to integrated CHC-family practice residency programs can be successfully addressed. Of great concern, however, are financial considerations relevant to the operation of such integrated programs. These considerations underscore the urgent need for a reassessment of the funding of ambulatory clinical medical education.

Ambulatory Care↗
PubMed1975

Citizens' boards for Philadelphia community mental health centers.

Community participation is a frequently discussed and controversial aspect of the community mental health center program. To many professionals and lay people, the community mental health center concept includes a basic commitment to a participatory process of the community in the planning and implementation of the community mental health center program. However, this commitment is not readily evident in the federal and Pennsylvania regulations. This paper presents an approach taken by the Philadelphia Office of Mental Health and Mental Retardation to insure that its 13 centers and base service units have a meaningful partnership with their catchment area communities. Specifically the paper presents the community participation regulations developed by the Philadelphia office, as well as the conditions that led to the development of these regulations. A conclusion of the paper is that additional regulations are needed to insure that community participation becomes an integral part of the community mental health center program.

Community Mental Health Services↗
PubMed1995

Analysis of the cost of training residents in a community health center.

BACKGROUND: Currently one federal program funds community health centers (CHCs) to provide services in underserved communities, and a second supports development of primary care teaching programs. Teaching CHCs respond to both program's goals, but their development is hindered by restrictive regulations of the two programs and lack of information regarding cost. METHOD: Spreadsheet software was used to develop a model that allocates cost components of a CHC-based residency. Productivity and staffing data from a teaching CHC program were used to estimate the cost of training and its sensitivity to selected variables. Data from 1992 through 1994 were collected from the family practice residency sponsored by the Brown University School of Medicine, the Memorial Hospital of Rhode Island, and the Blackstone Valley Community Health Center. RESULTS: An educational supplement of $13.21 per visit would be required for the program to be cost-neutral relative to staff. The cost of outpatient training for a resident averaged $13,935 per year. Residents would "break even" if they saw patients at 19% above the average rate recommended by the residency review committee. If staff physicians instead of residents had provided the patient care, the CHC would have saved $6,171 per resident. Additional savings from improved physician recruiting and decreased turnover would increase the value of the program to the CHC. Cost was most sensitive to resident productivity, precepting arrangements, nursing staff support, and staff turnover. CONCLUSION: Developing graduate medical education programs in CHCs can be a cost-effective way of increasing the pool of appropriately trained primary care physicians and increasing health care access for underserved populations. If teaching CHCs are to expand, provisions will need to be made for adequate reimbursement of their costs.

Community Health Centers↗