Project Safety Net: Web-based Care Navigation

Project Safety Net: Web-based Care Navigation

United States
Organization type: 
nonprofit/ngo/citizen sector
Budget: 
$100,000 - $250,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

I want to help persons who are uninsured or underinsured get health care services. In my community, we have the largest medical center in the world. However, almost a million persons in our city cannot access health care services because they have no health insurance. I want to bring the power of internet technology to map care providers, services offered, eligibility requirements, service locations and times that services are provided. I also want to use the power of mapping to visually depict areas where there is great need for health services so that planners can fill gaps.

About Project

Solution: What is the proposed solution? Please be specific!

The network of safety net providers is a mix of very diverse types of clinics, including city/county clinics, hospital district clinics, federally qualified health centers, charity clinics, school-based clinics and specialty care clinics. Since these providers are often under-resourced, they may lack the ability to network, pool resources, and work together to achieve more efficient provision of health care services. The innovation of our initiative is the unique blending of community engagement (through a Community Health Liaison), technology (through a web-based navigation platform), and philanthropy (providing community benefit and efficient use of grant funds). We have looked across the United States and not found a similar system. We hope this idea can be used by others to “knit together” safety net providers in their own community.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Project Safety Net's primary activity is helping the uninsured and underinsured gain access to primary care. We ask local safety net providers to share clinic information (hours of operation, services, eligibility requirements, and languages spoken). We use this data to create a web-based, searchable database for health care navigators. In addition, we obtain information on safety net service utilization and patients served. We pool and map this data to identify gaps in the safety net. Policy makers and planners can use this information to expand the safety net. Safety net service providers are diverse and often resource limited. Sharing information voluntarily allows us to present it on a common platform and increase connections among safety net providers and clients. Houston has a large low-income community; there approximately 1,000,000 uninsured persons in Harris County. Many persons here (approximately one third of our community members) do not have health insurance or personal funds to be seen in a physician’s office. Although our county has a large health care safety net, it is a complex array of locations, services, eligibility requirements, and language barriers. Persons often wait until a health care problem is acute and then visit a local emergency room. Overcrowding of emergency rooms was one of the factors that led our community to study this problem and find a solution. Our role was to “knit together” the safety net providers and increase awareness of available services. We are basically about connection. Helping people to understand eligibilities and services offered leads to making more health for our county.
About You
Organization:
St. Luke's Episcopal Health Charities
About You
First Name

Jeanne

Last Name

Hanks

About Your Organization
Organization Name

St. Luke's Episcopal Health Charities

Organization Phone

832-355-7701

Organization Address

3100 Main, Suite 865, Houston, TX

Organization Country
Country where this project is creating social impact
How long has your organization been operating?

More than 5 years

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Innovation
What stage is your project in?

Operating for more than 5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

Houston is the fourth largest city in the United States with a population of approximately 2,100,000. Houston is in Harris County which has a population of approximately 4,093,000. Houston and Harris County have experienced rapid population growth over the last 10 years, at 14.4% and 20.3%, respectively. Harris County has a diverse population. Hispanics constitute approximately 40% of the population, followed by non-Hispanic Whites (33%), Blacks (29%) and Asians (6%). Approximately 17% of the Harris County population lives below the poverty level and approximately 30% of the county population is uninsured. Therefore, although Houston is home to the Texas Medical Center, the largest medical center in the world, almost a third of our citizens do not have the insurance or personal funds to access services outside the safety net providers.

Harris County hosts a broad range of local non-profit organizations and government agencies that share a common mission of delivering health care to the underserved. Safety net clinics are non-profit, community-based providers that offer health services to low income people, including those without insurance. Primary care services provided by the safety net clinics include urgent care, acute and chronic disease treatment, mental health, dental, preventive and well child care. Our Gulf Coast community is subject to the hurricanes and the social and economic devastation they bring. The Harris County Healthcare Alliance formed in 2006 to meet the needs of a sudden influx of underserved residents after Hurricane Katrina. SLEHC engages continuously with safety net providers and works to build the collaborative capacity of this group.

Share the story of the founder and what inspired the founder to start this project

In 2004 Houston community leaders identified problems with access to medical care for low-income persons. They moved forward to identify under/uninsured people and map their locations. They later added safety net clinic locations to this map. Superimposing these types of information provided health planners information for locating new safety net clinics. In 2006, the Harris County Healthcare Alliance was formed. This broad-based group of health care providers in Houston and surrounding areas was formed to address the sudden influx of persons in need of healthcare following Hurricane Katrina. In 2006, St. Luke’s Episcopal Health Charities (SLEHC) launched Projects Safety Net, the nation’s first interactive, bilingual and mappable web-site serving as a link between the underserved in the Houston community and the clinics and organizations that offer healthcare to them and their families. Project Safety Net was born from and endorsed by the Houston/Harris County Public Health Council’s Clinic Committee and developed by a team from SLEHC led by SLEHC’s Executive Director, Dr. Patricia Gail Bray. Project Safety Net was inaugurated during an April ceremony attended by the leaders from the Episcopal Diocese of Texas and the President of St. Luke Episcopal Health System. President George H.W. Bush was present and praised PSN “an example that something good can come of a tragedy.” Project Safety Net was a product of Dr. Bray’s commitments to research that actively informs planning and to helping people find hope through affordable health care

Social Impact
Please describe how your project has been successful and how that success is measured

Project Safety Net has been a success by a number of measures. First, we measure success by the response of our Project Safety Net users: care providers and care navigators. Service providers linked into Project Safety Net continuously respond enthusiastically to our efforts at maintaining the accuracy and detail of the website. SLEHC’s Jeanne Hanks, Community Health Liaison, meets yearly with service providers to collect current data on clinic services (hours, services provided, eligibility requirements) and utilization (number and types of visits, types of referrals). Between these yearly updates, providers keep their profiles current in real time by making their own updates to our Project Safety Net site. There are more than 100 providers represented on the site. We also measure our success by hits to the website. We Project Safety Net received over 3,000 hits in the last 12 months despite the fact there is no active marketing of this resource.

How many people have been impacted by your project?

1,001- 10,000

How many people could be impacted by your project in the next three years?

More than 10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

Complete identification of congregational leadership and safety net providers in 8 counties adjacent to Harris County.

Task 1

Work with Episcopal Diocese of Texas to indentify congregational leadership

Task 2

Work with Episcopal Diocese of Texas to indentify congregational leadership

Task 3

Meet with regional stakeholders and safety net providers to enlist participation.

Identify your 12-month impact milestone

Have the 8-county providers listed and have the database searchable by zip code.

Task 1

Complete the list of safety net clinics and enter data profile for each clinic.

Task 2

Receive verification of profile from each service provider

Task 3

Count the numbers of members of that region who are using the clinic (school secretaries, church secretaries, clinics)

How will your project evolve over the next three years?

We will expand Project Safety Net to 57 counties in southeast Texas in the Episcopal Diocese of Texas (DOT). We plan to collaborate with DOT leadership to identify congregations in the region who are interested in working to make health care more accessible, collect information on agencies providing health services and navigation services, and pull together additional community stakeholders and providers. Stakeholders will guide the SLEHC Community Health Liaison (and an additional scholar) to collect and upload new information. We will identify a group of stakeholders willing to take responsibility for keeping the database updated over time. Finally, to facilitate health planning, we will do gap analysis of safety net services to determine geographic areas of unmet need.

Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?

Barrier #1
Keeping the information current as the network expands into the 8 counties.
Plan for Overcoming Barrier:
Identify local leadership. Start with the eight counties nearest to us where we have existing contacts. Work with the Episcopal Diocese of Texas leadership who can identity regional leaders who can introduce us to community stakeholders. Maintain investment of community stakeholders by demonstrating the usefulness of the website for multiple users.
Barrier #2
Technical Questions: How do we make the information useful to local areas? How to load all the information and still have the navigation user friendly? How do we adjust for locality? I.E. for remote areas of Texas, the 50 mile search radius might not be as appropriate as a 100 mile radius.
Plan for Overcoming Barrier:
Ask for input from system consumers at the beginning of the expansion and throughout the roll-out. Ask community members to identify use patterns. Look for lessons learned as each county is included in the system.

Tell us about your partnerships

As a part of this project, we currently collaborate with the leadership of local governmental entities responsible for health services, including the City of Houston, Harris County, and the Harris County Hospital District. We also collaborate with faculty members at The University of Texas School of Public Health. The partnership with researchers builds the applied research components of system. For example, this group has performed a safety net service gap analysis: mathematically modeling the impact of demographic trends on service demand and supply. The gap analysis helps us predict with greater specificity, those areas which are likely to experience an inadequate amount of safety net services. We partner with Houston Community College in the training of health care navigators who are the primary users of the system. Among our agency-level collaborators is the Harris County Healthcare Alliance which builds collaborative capacity for safety net clinics. Finally, we have an ongoing partnership with every clinic that is represented within Project Safety Nets. The SLEHC Community Health Liaison contacts these clinics yearly to update their profiles. In between these times, providers represented on the Project Safety Net site are able to make their own updates to our system.

Explain your selections

Project Safety Net is currently funded 100% by my organization, St. Luke’s Episcopal Health Charities.
In 1997, out of a sense of mission and a spirit of generosity and concern for the underserved, the Episcopal Diocese of Texas and St. Luke's Episcopal Health System (the System) chose to set aside $150,000,000 in a designated fund to establish and sustain St. Luke's Episcopal Health Charities. Their vision was a unique one; to create a one-of-a-kind public charity anchored in public health principles and focused on reducing health disparities among the most underserved and vulnerable populations throughout a Texas 57-county service area. The Charities is able to accomplish this goal through its community-based research and informed grant making. The mission of the Charities is to increase opportunities for health enhancement and disease prevention, especially among the underserved, and make possible measurable improvement in community health status and individual well-being. Funding this project is part of the community benefit program of St. Luke’s Episcopal Health System, one of our two parent organizations.

How do you plan to strengthen your project in the next three years?

We plan to strengthen our project by three strategies: expansion to a broader geographic service area, expansion to specific conditions of focus (mental health), and improved metrics. As detailed above, we are interested in expanding Project Safety Net beyond Harris County to the eight counties adjacent to Harris County and, ultimately, to the 57 counties within the Episcopal Diocese of Texas. We also plan to expand Project Safety Net to include specialty web portals for conditions of focus such as mental health. (As an example, we are partners with the Breast Health Collaborative of Texas and jointly manage the Breast Health Portal that has specialized data sets in breast cancer screening. This specialized data includes incidence and mortality rates, racial ethnic breakouts, and socioeconomic factors specific to breast cancer. This allows us to focus our research and service development.) Currently Harris County policy leaders are interested in a more granular focus on mental health issues and related service provision. We have plans to strengthen PSN by expanding to this area. Finally, we plan to strengthen PSN by improving our metrics. Currently we measure hits to the PSN site but we need to strengthen our metrics so that we have more information about the types of users to PSN.

Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.

PRIMARY

SECONDARY

Lack of insurance/financing options for healthcare

TERTIARY

Lack of physical access to care/lack of facilities

Please describe how your innovation specifically tackles the barriers listed above.

We address lack of affordable care and insurance by connecting persons who need health care with safety net providers. This is difficult. Not every provider offers every service. Clients, navigators, and providers need current information about where to access services. Changing eligibilities and funding streams for safety net care add complexity. Users of our site tell us we do a good job of providing valuable, current information. Expansion will move us into rural areas of our state with fewer providers and less physical access facilities. We will collaborate with local stakeholders to identify unmet needs. As usual, we will partner with local provider groups, awarding grants (to be matched by others) to expand services in areas of unmet need.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.

PRIMARY

SECONDARY

Enhanced existing impact through addition of complementary services

TERTIARY

Influenced other organizations and institutions through the spread of best practices

Please describe which of your growth activities are current or planned for the immediate future.

Within the next year we plan to grow the impact of Project Safety Net through expanding the searchable website’s geographic reach to include safety net clinics within the eight counties adjacent to Harris County. Within the next year we also plan to enhance impact by adding complementary services, expand the PSN to focus more intensely on mental health services. From our leadership role in this project we hope to influence other philanthropic organizations to take a high impact approach to distributing funds. We are already expanding our influence by publishing our work so that others may learn from our work and install Project Safety Net look-alikes in their own communities.

Do you collaborate with any of the following: (Check all that apply)

Government, Technology providers, NGOs/Nonprofits, Academia/universities.

If yes, how have these collaborations helped your innovation to succeed?

Our collaborations with the government have led to ability to access a broad array of governmentally funded services, from city-funded health clinics to federally qualified community health center. Our collaborations with technology providers have allowed us to access web-based platforms to enhance our outreach. Our collaborations with the non-profit clinics, including stand-alone, charity clinics allow us to complete the array of clinic types. Finally, our collaboration with our academic partners have kept up on the cutting edge of modeling safety net service provision and practical application of our data for policy and planning purposes.