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Quality of Care in Free and Charitable Clinics: Creating a Roadmap to Health Equity

Credit:Photo by Matthew McDermott

Overview

The goal of this Roadmap to Health Equity Initiative is to improve the quality of care and reduce health inequality for the millions of vulnerable and socially disadvantaged patients who seek care in Free and Charitable Clinics nationwide. 

Click the link below to read the Specific Aims of this initiative. 

About the Program

Roadmap Logo

Who

Americares, Loyola University Chicago (“Loyola”) and the National Association of Free & Charitable Clinics (“NAFC”) are partnering together to bring together state free and charitable clinic association executive directors, clinic leaders, technology quality improvement professionals, and health equity experts. 

What

We will convene these key stakeholders in the free and charitable clinic sector during a one-day conference to: 1) establish what is known about the quality of care in the sector and 2) reach consensus on a strategy (or set of strategies) that will allow the free and charitable clinic sector to routinely assess and report on the quality of care in free and charitable clinic across the nation. We anticipate that one piece of the strategy(ies) will involve extracting clinical quality measures from electronic health records, which are reportedly used by more than half of all clinics. Further, we will engage with stakeholders prior to and after the conference on conference calls in advancing issues toward results through systematic planning and thought sharing.

Why

While there are several statewide efforts to collect patient outcomes data, there is no mechanism in place to systematically collect data that can indicate the level of quality of care in this unique provider setting. As such, policymakers, other safety net providers, private philanthropy, the media and the general population have an incomplete picture of the quality of care being provided. The lack of quality data helps to perpetuate myths and misconceptions about free and charitable clinics, which, in turn, can inhibit clinics’ progress toward identifying quality benchmarks, securing resources and forming partnerships.

When

October 16, 2018 - October 17, 2018

Where

Henderson, Nevada

How

The conference will stimulate collaborations, develop a unified method and project plan to measure and report quality metrics in free and charitable clinics, and establish a framework for developing this conference into a multi-year stakeholder convening. 

Committee Details

In the year leading up to the conference, Americares, Loyola University Chicago, and the NAFC will host working groups through video conference calls and webinars to generate materials for the conference, seek initial consensus on quality measures, explore strategies for clinic level buy-in and explore the technological options for leveraging clinics’ electronic health records to obtain patient data uniformly and simply from clinics.

The Steering Committee

Steering Committee

The Steering Committee is charged with ensuring health equity is retained as a strategic priority and that the patient viewpoint is incorporated meaningfully across all of the committees throughout this multi-year initiative.


 

Committee members include:

Faisal Sayed

Muslim American Social Services (MASS), FL

Faisal Sayed is the executive director of Muslim American Social Services, which provides free medical care for any Duval County resident in need. Sayed works closely with providers and support staff to ensure that their free medical clinic runs as smooth as possible. He has participated and served on the boards of several nonprofit organizations and has been working as IT professional for last 27 years.

 

Jemea Dorsey

Center for Black Women’s Wellness, GA

Jemea Dorsey is the CEO of Center for Black Women’s Wellness, a community-based family service center committed to improving the health and well-being of underserved Black women and their families. Jemea works closely with an extensive array of stakeholders to improve the coordination of care and services to those served by the organization.

 

Jody Hopkins

Texas Association of Charitable Clinics, TX

Jody Hopkins, LCSW, ACSW has been in the non-profit sector for over 29 years with the majority of these years in non-profit management. In 2010 Jody was named the Executive Director for the Texas Association of Charitable Clinics. In this role she works with clinics throughout the entire state providing them with information, capacity building resources, and advocacy services. Jody is further involved in the local and statewide nonprofit community and is a member of the community leadership council for the Center for Nonprofits, co-chair of the public policy committee for One Voice Central Texas and serves on the public policy committee for the National Association of Free and Charitable Clinics.

 

Julie Darnell

Loyola University, Chicago, IL

Julie S. Darnell, PhD, MHSA joined the Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago (LUC) as Associate Professor in December 2015. Previously, she was on the faculty of the School of Public Health at the University of Illinois at Chicago where she served as Assistant Professor (2008-2015) and Associate Professor with tenure (2015). Dr. Darnell received her AM (2003) and PhD (2008) in Social Service Administration from The University of Chicago as well as a Master of Health Services Administration degree in health policy (1994) from The George Washington University. Her research focuses on access to, and the delivery and financing of, health care for poor and vulnerable populations and the safety net organizations that serve them. With the support of AmeriCares, she is currently leading an evaluation of two evidence-based chronic disease interventions in free clinics. She is also conducting a national survey of all known free and charitable clinics across the country. She has earned a national reputation for her work on free clinics. Findings from her research on free clinics have been published in the Archives of Internal Medicine and Medical Care and in a report to the U.S. Congress. Her work on free clinics has received numerous awards and recognition from organizations including the Society for Social Work and Research, the National Association of Social Workers Foundation, the Association for Research on Nonprofit Organizations and Voluntary Action, the American Public Health Association, and the Public Health System Research Interest Group of AcademyHealth.

 

Lindsay O'Brien

Americares, CT

Lindsay O'Brien serves as the Senior Director of U.S. Programs & Partnerships at Americares. In this role, she focuses on building capacity within the health care safety net throughout the country. Lindsay's responsibilities include expanding and strengthening the partner network through targeted initiatives and both growing and generating efficencies in Americares Access to Medicines Program. Prior to joining the U.S. team, Lindsay served on the Emergency Response and Recovery Team at Americares, overseeing the distribution of grant funds, medicines and supplies to hospitals, clinics and other nonprofit organizations post-Super Storm Sandy in October 2012 and the Oklahoma Tornadoes in May 2013.

Lindsay holds her Master's in Public Administration with a focus on Nonprofit Management from New York University and holds a certificate in Leadership Management from the Thunderbird School of Global Management. She is a graduate of Amherst College.

 

Marisel Losa

Health Council of South Florida, FL

Marisel Losa, President and CEO of the Health Council of South Florida (Council), directs a team of dedicated health professionals committed to providing services in a variety of areas which include strategic health planning and service coordination; program development and evaluation; chronic disease management and health disparities; and promotion of wellness and healthy lifestyles for both Miami-Dade and Monroe Counties.

 

Nicole Lamoureux

National Association of Free and Charitable Clinics, DC

Nicole Lamoureux, is a Chief Executive Officer who works daily with the National Association of Free and Charitable Clinics (NAFC), its 1,200 member organizations, its Board of Directors and its partners to advance the mission of ensuring the medically underserved have access to affordable, quality health care.

Nicole has testified before Congress, is a regular TV commentator – having been featured on MSNBC, FoxNews and the Dr. Oz Show to name a few – and has published numerous articles on the important role of America’s safety net and charitable care providers.

Nicole holds a Master’s Degree in American Government and a Bachelor of Arts Degree in Politics from The Catholic University of America and she resides in Alexandria, Virginia with her husband Mark.

 

Christina Newport

Americares, OK - Committee Manager

Christina Newport serves as the Associate Director of the U.S. Program at Americares. Her current portfolio includes overseeing the U.S. Program's Mental Health Initiative (MHI) to improve access to care in the U.S. behavioral health care safety net and leading and managing the Americares BD Advancing Community Health: Driving Quality Outcomes Patient-Centered Medical Home (PCMH) Initiative.

Christina is also involved in the U.S. Programs efforts to build capacity in free and charitable clinics (FCCs). She previously managed the implementation of two innovative pilot programs in FCCs which involved research studies conducted by Loyola University at Chicago; one on diabetes prevention implementing the CDC’s Diabetes Prevention Program and one on implementing the ECHO (Extension for Community Health Outcomes) model for hypertension through a partnership with ECHO-Chicago and the IL Association of Free and Charitable Clinics.

 


 

Click here for all Steering Committee meeting dates and times. 

The Case for Quality Data Committee, “The Why”

The Case for Quality Data Committee, "The WHY"

This committee is addressing how to appeal to clinic leaders who may be hesitant to embark on a national quality data infrastructure project. The committee is identifying all the possible reasons why a clinic might be reluctant to participate in this collective effort and work to generate compelling rebuttals. For some clinics, the objection may be based on concerns about their limited resources and the (technical) capacity to participate. For others, the opposition may be more philosophical in nature about the appropriate role of free and charitable clinics. Still others may question the “need” and/or value of such data. The committee is crafting different arguments (i.e., it’s good for business, it’s good for patients, it’s expected, it’s doable, etc.), to satisfy all the probable concerns. Armed with a strong defense of the value and feasibility of the national quality data infrastructure project, the committee is working to change attitudes through repetition of the core message. 


 

Committee leaders include:

Judy Haasis

CommunityHealth, IL

Judith Haasis, MSSW, ACSW is the Executive Director of CommunityHealth, the largest free clinic in the nation. She has more than 20 years of senior management experience in the nonprofit sector where she has spearheaded the growth of organizations involved in direct services, advocacy, leadership development and philanthropy at both the community and national levels. Ms. Haasis is a founding member and Chair of the Illinois Association of Free and Charitable Clinics and serves on the Board of the Chicago based South Side Healthcare Collaborative. She is a member of the Community Leadership Board of Presence Saints Mary and Elizabeth Medical Center, the Community Advisory Council of the University of Chicago Medicine and the Health Advisory Committee of the Illinois Coalition for Immigrant & Refugee Rights. A fellow of the Institute of Medicine of Chicago, Ms. Haasis has been the recipient of numerous honors, including the Henry P. Russe, MD Citation for Exemplary Compassion in Health Care and the 2017 Community Leadership Award from the Chicago Health Executives Forum.

 

Julie Darnell

Loyola University, Chicago, IL

Julie S. Darnell, PhD, MHSA joined the Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago (LUC) as Associate Professor in December 2015. Previously, she was on the faculty of the School of Public Health at the University of Illinois at Chicago where she served as Assistant Professor (2008-2015) and Associate Professor with tenure (2015). Dr. Darnell received her AM (2003) and PhD (2008) in Social Service Administration from The University of Chicago as well as a Master of Health Services Administration degree in health policy (1994) from The George Washington University. Her research focuses on access to, and the delivery and financing of, health care for poor and vulnerable populations and the safety net organizations that serve them. With the support of AmeriCares, she is currently leading an evaluation of two evidence-based chronic disease interventions in free clinics. She is also conducting a national survey of all known free and charitable clinics across the country. She has earned a national reputation for her work on free clinics. Findings from her research on free clinics have been published in the Archives of Internal Medicine and Medical Care and in a report to the U.S. Congress. Her work on free clinics has received numerous awards and recognition from organizations including the Society for Social Work and Research, the National Association of Social Workers Foundation, the Association for Research on Nonprofit Organizations and Voluntary Action, the American Public Health Association, and the Public Health System Research Interest Group of AcademyHealth.


 

Committee members include:

April Cook, Lake Norman Community Health Clinic, NC

Beth Armstrong, People’s Health Clinic, UT

Cheryl White, Centre Volunteers in Medicine, PA

Christina Newport, Americares, OK - Committee Manager

Donney John, NOVA ScriptsCentral, VA

Heather Stephenson, Samaritan’s Touch Care Center, FL

Janet WarrenHope Health Clinic, Inc., KY

John Hostetler, Open Arms Clinic, OK

Justin Brox, Dr. Gary Burnstein Community Health Clinic, MI

Kat Mastrangelo, Volunteers in Medicine, Clinic of the Cascades, OR

Kris BarnesFundación Manos Juntas, OK

Lauren Rahe, Ubi Caritas Health Ministries, TX

Lee Ann Kroon, TOMAGWA HealthCare Ministries, TX

Lindsay Obrien, Americares, CT - Committee Manager

Mara Servaites, mjs Consulting Associates, VA

Mary Kiger, Tennessee Charitable Care Network, TN

Megan Boogaart, Lake County Free Clinic, OH

Monika Fischer-Massie, WelcomeHealth, AR

Paul Anne LewisSan Jose Clinic, TX

Paul Tyrer, Southeast Indiana Health Center, IN

Suzie Foley, Greenville Free Medical Clinic, SC


 

Click here for all Why Committee meeting dates and times. 

The Quality Measures Committee, “The What”

The Quality Measures Committee, 'The WHAT"

Seeking input from stakeholders across the country both within and outside the FCC sector, the Quality Measures Committee is charged with recommending the quality measures for the national data infrastructure project. The proposed conference is providing a forum to discuss the committee’s recommendations plus measures lacking universal agreement as well as any new measures that emerge during the two-day meeting.


 

Committee leaders include:

Fred Bauermeister

The Free Clinic of Simi Valley, CA

Fred Bauermeister is the Co-founder and Executive Director of the Free Clinic of Simi Valley, providing medical, dental, legal and counseling services to individuals and families regardless of their ability to pay. Fred has served the clinic since its inception in 1971.

Fred currently serves on the Executive Board of the California Association of Free and Charitable Clinics, an association he co-founded that is comprised of Free Clinics throughout the state of California.Fred also serves on the Board of Directors of the National Association of Free and Charitable Clinics, the only national voice working on behalf of Free Clinics throughout the United States.

In Simi Valley, Fred is a member of the Leadership Simi Valley Steering Committee and is a recipient of a Lifetime Achievement Award bestowed by the Simi Valley Community Foundation.

 

Gretchen Geist

Gretchen Geist

Open Arms Free Clinic and WAFCC Standards Committee, WI

Gretchen Geist, MSN, APNP, FNP-BC practices at Open Arms Free Clinic (OAFC) with an interdisciplinary team providing care to low income, uninsured persons in rural Walworth County, WI. She is a charter member of the Wisconsin Association for Free and Charitable Clinics (WAFCC) Standards Committee. Gretchen contributed to crafting and editing the standards and continues to consult on their implementation.

Gretchen was managing partner at Rockwood Family Health, a solo independent family medicine clinic in small town Wisconsin for 20 years. In 2006, they were the first practice in Wisconsin to begin reporting quality measures to CMS while using a paper medical record. She has also served on the board of directors at Rock River Free Medical Clinic in Jefferson, WI.

Gretchen received her nursing degree from Duke University, a Masters in Nursing with education focus from Edgewood College and a Post-Masters Certificate as a Family Nurse Practitioner from Alverno College. 

 


 

Committee members include:

Adam Bradley, Luke’s House: A Clinic for Healing and Hope, LA

Alison Sergio, Health Care Network, Inc., WI

Allison Colby, Culmore Clinic, VA

Angie McLauglin, Community Health Care Clinic, IL

Angie Settle, West Virginia Health Righ, Inc., WV

Ariana GordilloNational Association of Free & Charitable Clinics, DC - Committee Manager

Christina NewportAmericares, OK - Committee Manager

Diane Westcot, HOPE Medical/Dental Clinic, TX

James (Jim) Beckner, Richmond Academy of Medicine/Access Now, VA

Jill T Schneider, Clinica Colorado, CO

Kristi Mattzela, Centre Volunteers in Medicine, PA

Larry Robins, PediPlace, TX

Mark Brault, Grace Clinic, WA

Marlene DiLillo, Greater Killeen Free Clinic, TX

Melissa Maguire, The Illinois Association of Free and Charitable Clinics, IL

Stephanie Garris, Grace Medical Home, FL

Teresa Harms, Clinic with a Heart, NE

Teresa Tyson, Health Wagon, VA

Trudy Wilson, Ohio Valley Health Center, OH


 

Click here for all What Committee meeting dates and times. 

The Operationalizing Quality Measurement Committee, “The How"

The Operationalizing Quality Measurement Committee, "The HOW"

This committee is recommending the practical and technical means by which the agreed upon quality measures (recommended by the Quality Measures Committee) will be obtained from the clinics. It also is responsible for ensuring that the quality data to be collected are standardized across clinics. Thus, “The How” and “The What” Committees are working together to craft common definitions to operationalize the measures and develop equivalent processes across clinics for collecting the data. Anticipating that respondent burden is a major concern, this committee is also working closely with “The Why” Committee to understand the resource and technical constraints to reporting quality data and act to minimize the burden. This committee is interfacing with clinics and with the leading EMR vendors in establishing recommendations for any adjustments to clinic-level practices to generate uniform data in a standardized format. This committee is also researching and providing recommendations for extracting data from those clinics without an EMR as well as dashboard solutions for collecting and aggregating data.


 

Committee leaders include:

Cindy Jones

North Carolina Association of Free & Charitable Clinics, NC

Cindy Jones, RCP has been with the Association since 2005. In her role as Director of Training and Support she assists members with the NCAFCC Accreditation process, Annual Outcomes Survey, Federal Tort Claims Act, and related regulatory, compliance and liability issues. Cindy has a clinical background as a respiratory therapist as well as healthcare administration and management. Her 20+ years of professional experience has been beneficial in helping members with best practices and implementation of policies and procedures.

 

Lindsay O'Brien

Americares, CT

Lindsay O'Brien serves as the Senior Director of U.S. Programs & Partnerships at Americares. In this role, she focuses on building capacity within the health care safety net throughout the country. Lindsay's responsibilities include expanding and strengthening the partner network through targeted initiatives and both growing and generating efficencies in Americares Access to Medicines Program. Prior to joining the U.S. team, Lindsay served on the Emergency Response and Recovery Team at Americares, overseeing the distribution of grant funds, medicines and supplies to hospitals, clinics and other nonprofit organizations post-Super Storm Sandy in October 2012 and the Oklahoma Tornadoes in May 2013.

Lindsay holds her Master's in Public Administration with a focus on Nonprofit Management from New York University and holds a certificate in Leadership Management from the Thunderbird School of Global Management. She is a graduate of Amherst College.


 

Committee members include:

Andrea Mantione, The Edward R. Leahy Jr. Center Clinic for the Uninsured, PA

Cherrie Pullium, Health For All, TX

Dennis Skrajewski, Wisconsin Association of Free and Charitable Clinics, WI

Donna LooperGeorgia Charitable Care Network, GA

Jamie Mercurio, athenahealth, MA

Janet Jarrett, Albermarle Hospital Foundation, NC

Jill TempleInterfaith Clinic, AR

Julie Scott Bilodeau, CrossOver Healthcare Ministry, VA

Karen Kaashoek, Catherine’s Health Center, MI

Karen SalernoTaylors Free Medical Clinic, SC

Kim Prendergast, MetroWest Free Medical Program, MA

Lara HamiltonChrist Clinic, TX

Leona Doner, Shepherd’s Care Medical Clinic, NC

Linda Judah, Social Welfare Board and MI State Association, MO

Liz DickeyHealth For All, TX

Lynette Schreur, Exalta Health, MI

Raymond L Cox, Volunteers in Medicine Hilton Head, SC

Sandy MotleyDavidson Medical Ministries - Davidson Health Services, NC

Shelby Miller, Hope Clinic & Care Center, WI

Sheri Rettew, Hope Clinic, NC

Steve MaierVermont Coalition of Clinics for the Uninsured, VT

Suzanne HobanFamily Health Partnership Clinic, IL

Taylor JoynerAmericares, CT - Committee Manager


 

 Click here for all How Committee meeting dates and times. 

Program Advisors

Program Advisors

 Aswita Tan-McGroryAswita Tan-McGrory, MBA, MSPH

Deputy Director, The Disparities Solution Center

Aswita Tan-McGrory, MBA, MSPH, in her role as Deputy Director at the Disparities Solutions Center, works closely with the Director to chart the Center's future growth and strategic response to an ever-increasing demand for the Center's services. She is a key member of the senior management team and supervises the broad portfolio of projects and administration of the Center. These include collaborations with internal and external partners on guidance on collecting race, ethnicity, language and other social determinants of health data; developing disparities dashboards that stratify quality measures by race, ethnicity, and language; and developing recommendations for data collection in pediatric patients. In addition, Ms. Tan-McGrory currently serves on the MA Executive Office of Health and Human Services' Quality Measurement Alignment Taskforce. 

Ms. Tan-McGrory also oversees the Disparities Leadership Program, an executive-level leadership program on how to address disparities, as well as the Healthcare Quality and Equity Action Forum, a national conference for healthcare leaders interested in addressing disparities in quality. Ms. Tan-McGrory serves on several executive committees, including the MGH Diversity Committee, the MGH Executive Committee on Community Health and the Partners Health Equity and Quality Committee. In addition, Ms. Tan-McGrory sits on the board of the Massachusetts Public Health Association. 

She received her Masters of Business Administration from Babson College and her Master of Science in Public Health, with a concentration in tropical medicine and parasitology, from Tulane University School of Public Health and Tropical Medicine. Ms. Tan-McGrory is a Returned Peace Corps Volunteer where she spent 2 years in rural Nigeria, West Africa, on water sanitation and Guinea Worm Eradication projects. 

 

Marjie G. Harbrecht, MD

MGHealthcare Insights, LLC

Marjie Grazi Harbrecht, MD, is a CEO with over 25 years of experience in healthcare working as a Family Practice Physician, risk management consultant, and patient safety/quality improvement specialist. She has dedicated her career to transforming healthcare delivery and payment systems to optimize health outcomes, improve patient safety, control costs, and improve the healthcare experience for patients and their healthcare teams. For eighteen years, Dr. Harbrecht lead HealthTeamWorks, a nonprofit multi-stakeholder collaborative working to redesign healthcare delivery and promote integrated communities of care, using evidence based medicine and innovative systems.

As one of the pioneers in this area, Dr. Harbrecht has served on multiple boards and committees both at the local and national levels.  Among these are the Colorado Regional Health Information Organization (CORHIO), the Center for Improving Value in Healthcare’s All Payer Claims Database (APCD) Committee, the Patient-Centered Primary Care Collaborative (PCPCC) Payment Reform Taskforce and the NCQA PPC-PCMH Advisory Committee to help develop the 2011 and 2014 PCMH standards.After stepping down as CEO of HealthTeamWorks, Dr. Harbrecht continues to use her years of experience to educate and provide consulting services nationally for healthcare transformation and payment reform, with particular emphasis on culture change and true coordination of care across health systems and communities.

We're all in this together! Let's start down the path of measuring quality and addressing health equity on a national scale.

Questions?

Questions about this Roadmap Initiative? Click the link below to contact us.

Quality Measures

The measures used in this initiative to assess and compare the quality of health care organizations are classified as either a structure, process, or outcome measure. Known as the Donabedian model, this classification system was named after the physician and researcher who formulated it.

Disclaimer

Funding for this conference was made possible by Grant #: 1 R13 nMD012759-01 from the National Institute on Minority Health and Health Disparities. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

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