The document summarizes healthcare access issues in Erie County, Pennsylvania. It finds that over 32,000 residents, or 11% of the population, live below the federal poverty level. Nearly 50% of eligible residents are not enrolled in public insurance programs. The document outlines three goals: 1) implement initiatives to improve quality and outcomes, 2) increase understanding of underserved groups and how to reach them, and 3) increase primary care access through leveraging federal resources. It recommends strategies like expanding community health centers, pursuing federal health center designations, and opening new dental clinics to address the identified needs.

2. In partnership with
Erie County Department of Health
Northwest PA Area Health Education
Center
John Snow, Inc. (consultant)

3. Access to care is “the timely use of
personal health services to achieve the
best possible health outcome”—Institute
of Medicine

4. Population of Erie County in 2006 is 280,843
2008 Federal Poverty Level is $10,400 for the first family member,
$3,600 for each additional
More than 32,000 people (11%) live below the federal poverty
level (FPL)
Almost 45,000 (16%)live at or below 200% of the FPL
55,298 enrolled in public insurance programs;
51,792 (18%) are Medical Assistance eligible, but not enrolled,
19,448 (7%) are uninsured;
3680 children are enrolled in the CHIP program in Erie County*
3506 are CHIP-eligible, but not enrolled in the program*
*as of 9/1/2006

5. Community Health Net
Hospital Clinics
Hospital Emergency Rooms
MHEDS
St Paul’s Free Clinic
Private Physician Offices

6. General dentistry & oral surgery greatest
need (only 50% of those surveyed visited
a dentist in the past year)
49% of the county’s population utilized
services of the “safety net”
56% of people living below 200% of FPL
are served by the “safety net”

7. 88% have a regular doctor or other
health care provider
72% had a “checkup” in the past year
35% go to the ER for primary care
59% had medical assistance insurance
and 17% had none (of the people
surveyed)
22% needed to see a doctor/provider
but didn’t because of the cost

8. Lack of health insurance
Cost
Culture/language
Health literacy (knowing when & where
you should go)
Transportation—especially in rural Erie
County

9. 1. Implement community-wide initiatives to
improve quality and health outcomes
2. Increase understanding of who is not
currently receiving appropriate primary
care services and frame a strategy for
reaching remaining underserved groups
3. Increase primary care access throughout
the County, leveraging federal and other
resources to reach as many low-income,
underserved residents as possible

10. Implement community wide initiatives to
improve quality and health outcomes

11. Expand community efforts to increase
enrollment in public insurance programs
› Currently nearly 50% of people who are
eligible for public insurance (including
Medicaid, CHIP) are not enrolled. Since lack
of insurance is directly related to both
appropriate access and health outcomes,
increasing enrollment is an essential first step
in improving access and quality

12. Expand the concept and
implementation of providing a primary
Medical Home for all Erie County
Residents
Utilize the collaborative approach across
providers and apply the chronic care
model to improve care management
and outcomes for people with chronic
illness;

13. Transform practices to provide more
patient-centered and evidence-based
care

14. Increase understanding of who is not
currently receiving appropriate primary
care services, identify needed services
and frame a strategy for reaching
remaining underserved groups

15. Increase understanding of who is not
currently receiving appropriate primary
care services, identify needed services
and frame a strategy for reaching
remaining underserved groups.

16. Identify people who are not currently in
care or who do not have appropriate
access to primary care.
These are likely to be some of the hardest
to serve and most in need populations
such as those who are homeless,
culturally and linguistically isolated,
chronically uninsured, or suffering with
co-morbidity such as diabetes and
mental illness.

17. Increase primary care access
throughout the County, leveraging
federal and other resources to reach as
many low-income, underserved residents
as possible

18. Take advantage of 330 funding, FQHC
Look-alike, or RHC status within the
context of a rational service delivery
plan for the County.
› Could include:
Expanding CHN sites and services
Converting existing primary care sites (e.g.
some hospital sites that serve a significant low-
income population) into FQHCs either
independent or as part of CHN

19. Working with other safety-net providers
(hospitals, MHEDS, St Paul’s Free Clinic) to
determine their role in the service delivery
system and maximizing their ability to provide
services; and
Developing new sites where these other
options are not appropriate

20. In order to maximize the County’s
options for expanding FQHC and RHC
sites, continue to explore and follow-up
on opportunities for federal HPSA and
MUA/MUP designations

21. Dental
› Applied for funding to open a new dental
clinic. CHN to receive awards of:
$210,000 from the Highmark Foundation
$80,000 from the Erie Community Foundation
$50,000 from the Hamot Health Foundation
› Plan opening soon at the Bayfront Nato
Martin Luther King Junior Center

22. Thank You!