Global Health Presentation

January 2014 COSGP Meeting

Humanitarian Relief Material or logistical assistance provided for

humanitarian purposes, typically in response to humanitarian crises including natural disaster and man-made disaster. The primary objective of humanitarian aid is to save lives, alleviate suffering, and maintain human dignity

vs.

Development Aid

Seeks to address the underlying socioeconomic factors which may have led to a crisis or emergency

Contents

• Domestic

• Spotlight: Street Medicine

• Roadblocks to Starting Domestic Clinic

• How to Finance Global Outreach

National Association of Free and Charitable Clinics • Founded in 2001 in Washington, DC

• Mission o “Broaden access to affordable health care for the medically

underserved by increasing public awareness, promoting volunteerism, and supporting and advocating for the nation’s safety net of Free and Charitable clinics.”

• Only nonprofit organization whose mission is solely focused on the issues and needs of the more than 1,200 free and charitable clinics and the people they serve in the US

C.A.R.E. Clinics

http://www.youtube.com/watch?v=K3m7nKkTqy8&list=UU9RrOfEXNpZel3PpO0GCSEw

Is there a NAFC in your area??? • The following states have NAFC associations

o AR, CA, CO, FL, GA, IL, IN, KY, IA, LA, MI, MO, NC, NY, OH, OK, PA, SC, TX, VT, VA, WA, WV

• Information on how to start a free clinic or how to find a free or charitable clinic in your are

• More information provided at http://nafcclinics.org/

Spotlight: Street Medicine

• Homelessness is a spectrum o Intermittent vs. chronic

o In shelters vs. on streets

o Unaccounted (Living in cars, with family/friends)

• More than 3.5 million Americans o 2010 Statistics (estimates)

▪ 1.3 million individual adults

• 67,000 elderly

• 160,000 veterans

▪ 600,000 people in families

▪ 350,000 unaccompanied minors

• Life expectancy: 47 years (in shelters) U.S. Department of Housing and Urban Development (HUD). (2011). The 2010 Annual Homeless Assessment Report to Congress.

Washington, DC. [2010 AHAR]

Street Medicine Cont’d

• Started in 1992 in Pittsburgh

• Brings medical care to those living and sleeping on the streets through mobile services such as walking teams, medical vans, and outdoor clinics

• Compassionate, accessible, and cost effective care to an often overlooked population

http://streetmedicine.org/wordpress/about-the-institute/

Street Medicine Agencies

• Street Medicine Institute o Organization to help Street Medicine groups

o Host International Street Medicine Symposium

• Safe Ground Sacramento o Alcohol free, Drug free, Violence free

o Take opportunities to reintegrate into society

o invisiblepeople.tv

Street Medicine and related Programs

For full list of agencies: http://en.wikipedia.org/wiki/Street_medicine

Global Health Brought Home

“We have now just enshrined, as soon as I sign this bill, the core principle that everybody should have some basic security when it comes to their healthcare”.

-Barack Obama

Osteopathic Clinics Serving the Underserved*

OMT Clinics: UNE, Amish Clinic (DMU), WVSOM, Touro-NV

Free Clinics:Pomona Homeless Outreach Program (Western U), Pomona

Community Health Action Team (Western U), Biddeford Free Clinic (UNE), CommunityHealth Chicago (CCOM), Mobile Clinic (DMU), Majesty Care Clinic (LECOM at Seton Hill)

Reduced Rate Clinics: Montclair Clinic (Western U)

Health Fairs/Community Screening: All respondents

indicated participation in community health screening!!

*This information is based only on the responses I received from the AACOMmunities thread on underserved medical community outreach

The Free Clinic: A brief overview of what to

consider before starting a clinic

General Considerations:

• Location

• Cost

• Liability

• Staffing

• Supplies

Guide/Checklist for starting a clinic:

Goldin GL and Hanson SH (2002). Starting a Free Clinic: A Volunteers in Health Care Guide. Pawtucket, RI: Volunteers in Health Care.

LINK: http://nafcclinics.org/sites/default/files/resources/start%20a%20free%20clinic.pdf

Location, Location, Location

• Community Need o uninsured population

o underinsured population

• Accessibility o Patients

o Physicians

Cost- Raising $$$$

• AMA Foundation http://www.ama-assn.org/ama/pub/about-ama/ama-foundation.page?

o $10,000-25,000 Grants

o 1.3 million awarded thus far to 61 free clinics

• AMWA: American Medical Women’s Association http://www.amwa-doc.org/awhs/supported-clinics o $2,000-3,500

• Grassroots Fundraising

• Partnering

• State Grants

Liability- Protecting Yourself

• Free Clinics o VPA: Volunteer Protection Act

▪ Excludes Gross Negligence, Sexual Crimes, Hate Crimes

▪ States can opt out

o Good Samaritan Act

▪ State Specific

o FTCA: Federal Tort Claims Act

▪ Qualifying clinics are immune to medical malpractice claims http://bphc.hrsa.gov/ftca/freeclinics/index.html

• Reduced Rate Clinics o Not protected under VPA and GSA

o Must maintain malpractice insurance

Staffing the Clinic

• Medical Director

o reputable physician in the community

o respondeat superior

o recruit other physicians

• Clinic Manager(s)

o training, fundraising, medical supplies, maintain financial records, maintain database (EHR)

• Quality Volunteers

o Medical Students, Nurses, Reception

• Hours of Operation

o limited hours/days can help to offset the staffing struggles

Goldin GL and Hanson SH

(2002). Starting a Free

Clinic: A Volunteers in

Health Care Guide.

Pawtucket, RI: Volunteers

in Health Care.

Supplies

• Donations o Retired equipment

• Pharmaceutical Samples

• Patient Assistant Programs o pt. by pt. basis

o www.rxassist.org

• Pharmacy partners o Bulk purchasing

o Waived dispensing fees

Financing Global Outreach

• Check with your school

• SOMA - International Medical Relief/Medical Mission Scholarship o $250 scholarship

o Soma membership required

o Deadline Feb. 14 2014

• Medical Specialty Societies o Societies have scholarships for students interested in

work in their field

Financing Global Outreach

Links:

Medical Specialties: http://www.ama-assn.org/ama/pub/about-ama/our-people/the-federation-medicine/national-medical-specialty-society-websites.page

Boston School of Medicine: http://www.bumc.bu.edu/ihbusm/funding/

Questions??