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Partnerships for Health Award Recipient
Coalition to Care: The Galveston County Community
Health Access Program
Represented at the CCPH conference by the following
individuals (listed alphabetically):
- Becky Walsdorf, Executive Director
for Community Health Promotion, Office of Community Outreach, University
of Texas Medical Branch at Galveston
- Ted Hanley, Executive Director, The Jesse Tree
- Dr. Ben Raimer, Vice President for Community Outreach, The University
of Texas Medical Branch at Galveston
- Kathy Tiernan, Outcomes Manager, Office of Community Outreach, University
of Texas Medical Branch at Galveston
|Original members of Galveston's
Community Health Access Program Coalition with Dr. Marilyn Gaston
The Coalition to Care: The Galveston County Community
Health Access Program (GCHAP) is a 24-member coalition that seeks to reduce
health disparities and improve access to health care and quality of life
for all Galveston County residents. Established to build a strong and
diverse partnership among health and social service providers, much of
the work of the 2-year-old coalition, located in Galveston County Texas,
has focused on the goal to improve access to health care and related services
for the indigent population. The coalition's partnership strategies include
service learning, community-based participatory research, and establishing
a broad-based community partnership organized around a single goal. Partners
include citizens of Galveston County; community health centers and hospitals;
the public education, health, and safety departments; social services
and faith-based organizations; local government; and The University of
Texas Medical Branch at Galveston including an academic teaching hospital,
Schools of Medicine, Nursing and Allied Health and Graduate School of
|First Galveston CHAP Pacing
The genesis of the Galveston County Community Health
Access Program came early in 2001 when the Galveston County Medical Society
convened a work group to examine the issue of indigent health care and
the associated overwhelming costs to the Galveston County community. The
work group championed the cause with the Galveston County Commissioners'
Court, the governing body responsible for the administration of the county's
indigent health care budget. As a result, the Commissioners' Court appointed
a 40-member Galveston County Task Force for Indigent Health Care to develop
a cost-effective means of providing health care to those in need in Galveston
County. At the same time a coalition of Galveston citizens had formed
determined to apply for and receive a Community Access Program (CAP) Grant.
This community coalition and the Medical Society work group joined forces
to implore the Commissioners' Court to provide additional funding for
indigent health care. The commissioners did approve a $500,000 increase
in the county's budget for indigent health care and the GCHAP received
year two funding for the CAP grant in September 2002.
|Resource coordinators work
with CHAP clients
Overall, Galveston County Health Access Program (GCHAP)
has a goal of improving the quality of life for all Galveston County residents.
GCHAP is designed to bridge gaps in access to healthcare in Galveston
County. The GCHAP targets all persons at or below 200% of the federal
poverty level who are either uninsured or underinsured. The goal of the
program is to meet community needs by increasing access to care and improving
health status. By increasing access to community-oriented programs in
the areas of health education, prevention and primary care the costs associated
with emergency services and long-term or chronic care will be reduced.
In year one, the goals of GCHAP emphasized the need
for access to high quality, cost-effective health care for everyone. During
that timeframe, the goals of GCHAP focused on access to care issues, including:
- Augmenting existing transportation system, increasing the number of
trips to medical appointments and reducing current monthly denials
- Improving and expanding the existing technical infrastructure, effectively
creating and interface between social services, religious ministries
and medical providers to facilitate and coordinate access to all spectra
of service for the uninsured
- Implementing formal, community-based care coordination for the uninsured
- Coordinating and enhancing community-based prevention programs
- Expanding the web-based data collection and reporting system to monitor
and evaluate the effectiveness of medical and social service delivery
for the uninsured
- Implementing a system of on-going evaluation and assessment, resource
coordination, project development and quality assurance
The Planning group of the GCHAP reviews progress on
these goals and provides guidance for change. Now on a regular basis,
the planning group also invites faculty interested in community research
to share their grant opportunities and determine compatible community
partners and strategies.
- Breast Cancer Awareness Coalition
- Community Action Council
- Coastal Area Health Education Center (AHEC): Coastal AHEC seeks to
improve the health of the populations we serve, especially the underserved,
by creating partnerships among community and academic organizations.
We link health care resources to build and strengthen community-based
education programs. Coastal AHEC serves Brazoria, Chambers, Galveston,
Hardin, Jefferson, Liberty, Matagorda, and Orange counties.
- Galveston County Health District:
The Galveston County Health District focuses on the task of ensuring
conditions in which people can be healthy.
- Galveston County
Four Cs Clinic: The Galveston County Health District (GCHD), a government
entity, provides public and personal health services to residents of
Galveston County. Through its 4C's Clinics, medical and dental services
are provided to qualified Galveston County residents seeking treatment
regardless of their ability to pay.
County Immunization Coalition: Established in 1993, the Galveston
County Immunization Coalition's mission is to increase immunization
rates for all Galveston County residents through collaboration.
County Social Services: Galveston County Social Services provides
social services including adult and child protective services and confirm
eligibility for state welfare programs including temporary aid for needy
families, food stamps, and Medicaid.
- Gulf Coast Center: Since opening its doors in 1969, the Gulf Coast
Center has been providing mental health and mental retardation (MHMR)
services for residents of Brazoria and Galveston counties. The Center
also offers substance abuse recovery programs under the sponsorship
of the Texas Commission on Alcohol and Drug Abuse.
The Jesse Tree: The goal of the
Jesse Tree is to help all members of our community locate and utilize
available services, to advocate for new or expanded services, and to
provide tools, resources, and in-service training to improve existing
services. The Jesse Tree helps to coordinate community services through
many community faith-based organizations.
|Friday Food Fair at
the Jesse Tree
Society Clinic: The Luke Society Medical Mission to the Homeless
operates an open-air clinic to help meet the health needs of the homeless
in Galveston. Clinic services include screening for medical problems
and basic treatment of wounds and infections. There is no fee for clinic
- Mainland Medical Center:
Since 1992, Mainland Medical Center has been saving lives and improving
the quality of life. Each year, over 62,000 outpatient procedures are
performed and more than 8,000 persons are admitted to MMC from the Greater
Galveston County region.
- St. Vincent's
- Salvation Army
- Social Security: The Social Security Office aids in declaring eligibility
for Medicare and supplemental secondary income (SSI), which is welfare
for the aged and disabled.
- Texas Department Human Resources:
The mission of the Texas Department of Human Services is to provide
financial, health, and human services that promote the greatest possible
independence and personal responsibility for all clients.
- Teen Clinics, Ball High, Central Middle School, Austin Middle School
- University of Texas Medical Branch:
The University of Texas Medical Branch (UTMB) is dedicated to educating
health science professionals and researchers, caring for patients, and
advancing human health through research.
- UTMB Community Outreach:
Community Outreach brings together several outstanding programs that
connect UTMB to the many communities it serves. Community Outreach is
proud to represent UTMB and to play a vital role in assisting the university
realize its core purpose of generating, disseminating and applying knowledge
to better the health of society. We envision a Texas in which each person
has optimal access to health care.
Strong Partner Involvement Strategies
|Galveston County Health
Fair Student Committee
All members of GCHAP contribute significant resources
to the coalition, along with a sincere desire to do what is right and
what is best for the Galveston County community.
GCHAP pursues a number of community-campus partnership
strategies but they have focused mainly on the development and operation
of a broad based coalition. Healing old wounds and forgetting old fights,
the partnerships have made major strides to sit with equal power and resolve
to make Galveston a better place to live. As they had hoped, the improved
communications and planning has opened the door for service learning and
- Broad-based community partnerships: One of
the most significant accomplishments of the GCHAP coalition has been
to bring the right people and organizations to the table to organize
around a single goal. Included in the coalition are a major academic
medical center and a private, for-profit hospital that used to be in
direct competition with each other but now work hand-in had to address
the issue of health care for the indigent. Churches and religious-based
organizations have joined hands with politicians and political activists
to further the cause of cost-effective and accessible health care. Also
included in the coalition are concerned individuals and volunteers;
providers of social services like the Salvation and the United Way of
Galveston; and individual providers and agencies who know first-hand
the high costs to society of untreated health concerns.
- Service learning in health professional education:
The School of Allied Health Sciences at UTMB has initiated a new
service learning curricula. Over a three-year period, occupational therapy
(OT) and clinical psychology (CP) students will participate in service
learning activities that include web-based cultural competence module,
in community service agencies located in the city of Galveston and throughout
Galveston and Brazoria counties. The Partnerships Project will also
develop and implement a joint OT and CP internship to provide community-based
mental health services. In addition, four community-based clinical training
sites will be expanded to provide collaborative OT and CP mental health
services, including those that focus on alcohol and drug recovery, health
promotion, prevocational and vocational skill development, peer resistance
and skill-building for youth at risk, and life skills coaching.
In addition, Galveston County Health Fair is an annual event coordinated
by 50 student volunteers from UTMB's schools of medicine, nursing, allied
health and graduate biomedical research. The students work with GCHAP
coalition members to provide free health screenings and patient education
opportunities to all residents of Galveston County, with an emphasis
on the uninsured and under-insured. Approximately 1,000 individuals
have taken part in the 2001, 2002, and 2003.
- Community-based participatory research: The
addition of an outcomes research specialist to the GCHAP team will allow
GCHAP to build its community-based, participatory research programs.
During the first year, GCHAP did initiate one research project to determine
the health status of the Galveston County community. The telephone survey
provided the Coalition with helpful information. In the past two years
researchers interested community research have included: Department
of Occupational Therapy; Dept of Ob/Gyn; Center for Addiction Research,
Department of Preventive Medicine and the Department of Family Medicine.
In year two, The Health District received a Robert Wood Johnson grant
to further their diabetes education program and UTMB secured a Dell
grant to enroll kids into CHIP through schools.
Achieving Tangible Results
|Former Galveston Mayor Bo
Quiroga receiving his flu shot
The GCHAP mission has been to eliminate administrative
barriers inhibiting access to health care. Some of the activities and
outcomes toward this mission are described below.
Increased Access: In year two,
almost 6,000 residents were newly enrolled into health care at the 4C's
clinic. Many of these were cased managed through an innovative mini-registration
process with process from the Mainland Medical Center and UTMB Emergency
Rooms to the Health District. Both programs expanded staffing to include
social service and mental health referrals. Our 'for profit' hospital
received a HCA award for innovative programs that demonstrate cost savings.
Partnering with the Jesse Tree, the network expanded to provide 3722 social
services for 3548 clients. Over 200 clients were referred for mental health
and another 108 for substance abuse treatment.
Assessment and Comprehensive Reports
have Improved Services: The Galveston County health district has used
the results of a self study to conduct clinic redesign and realign staff
into high priority needs. Jesse Tree made serious improvements in their
Web Care program. Comprehensive reports have helped their fundraising
and accountability with churches making contributions. The Galveston County
Medical Society has used the information and its influence with the Texas
Medical Society to help bring the issue of indigent health care to the
attention of key policy-makers within the state
Improved Health Professions Education:
The School of Allied Health Sciences within UTMB has built on its
interest in service learning to implement the Partnerships for Healthier
Communities Project with goal of increasing the number of occupational
therapists and clinical psychologists practicing in underserved areas
of Texas. The Coastal Area Health Education Center has provided personnel,
staff, and funding to support GCHAP's patient education programs, as well
as develop an asset map for Galveston County that includes both health
care and social services resources. They also trained 31 community health
workers who last year reached 5772 school aged children in impoverished
school systems with the 'Tooth Fairy' decay prevention program.
Leveraged funding and collaboration: The Jesse
Tree was able to successfully leverage CAP Grant funding received by the
coalition to secure financial support from VISTA to fund nine VISTA volunteers
whose efforts are focused on mental health, a health equipment loan program,
community asset mapping, patient education, congregational nursing, services
for the homeless, financial screening, nutrition, and senior outreach
programs. Mainland Medical Center provided funding to expand the scope
of The Jesse Tree by opening a site to serve the mainland residents of
For more information on the Galveston County Health
Access Program (GCHAP), contact Becky Walsdorf at email@example.com
Partnership Website: www.galvestonchap.org