1. Primary Care Alternatives Update
Cliff Smith, Ed Houck and Jorge Quinonez
Champions

2. Primary Care Alternatives
Convene stakeholders to develop a comprehensive, community-based system of primary care alternatives to the Emergency Room, targeting areas of greatest need. (Key elements may include neighborhood centers/clinics, mobile units, 24/7 access, service for under/uninsured, and possible roles for retired physicians and major employers.) Develop a method for educating non-emergent patients to use the appropriate care settings.

3. Primary Care Alternatives Scorecard
Some improvement is seen in reduced reported Fair or Poor Health. We are better than Florida but worse than the U. S. average, which is also our goal since there is no HP 2020 goal here.

4. Lessons Learned Over Past Decade
Interdependence between social services and medical services
Access to care as important as quality of care
Collaboration/Partnerships are the key to success

5. 6 Year History (start up from 0) 436 Participating Physicians
Largest Program in Country
1,600+ Patients
$32+ million of donated care
In 2015 alone:
Over 2500 hours of free care provided
Over 331 patients served
Total value of care provided $9,675,670
Continues to increase every year.

6. 1 ½ Year History
63 Participating Dentists
454 Patients
$220,000+ of Donated Care

7. United Way Houses 2006 2016 United Way Houses 6 16 Agencies 41 95
People Served
17,000
244,000

8. Operational 18 Months
596 Calls
364 Children Referred to Network

9. New United Way initiative to increase access to services for veterans
Community collaboration that uses existing United Way 211 program as single phone contact to access services
Soft launch in May; official launch in Fall

10. Lee Community Healthcare (LCH) first office in the Dunbar community in 2011 launched by LMHS and United Way House
Expanded to North Fort Myers and Cape Coral
$1 million annual State primary care grant for five years
LCH patient visits 2012 = 8,342 vs = 15,460 (85% increase)
Emergency room referrals to LCH increased 63% from 3,724 to 6,072
Federally Qualified Health Center Look-Alike status in February 2015
LCH received a $1.4 Million AHCA Grant in October 2015

11. Expansion plans: more physicians, new locations in Lehigh and South Lee
Provide women’s health, pediatric and behavioral health services directly
Expand the ECHO / Nurse Case Managers program to increase emergency room diversion of low-acuity patients
Enhance partnerships with local providers like Project Dentists Care, S.W. Florida Free Pain Clinic and Teen Challenge

12. Affordable Care Act passed in 2010
Federal Marketplace opened 2014
Florida had largest enrollment in the U. S.
Region 8 Health Planning Council lead agency
Lee County enrollment more than doubled:
2014 = 22,477 vs = 49,821
Next enrollment 11/1/16 – 1/31/17

13. Then & Now 2006 to 2016
FHC’s footprint in Lee, Charlotte and western Hendry Counties has increased from 55,333 sq. ft. in 2006 to 158,727 sq. ft. in 2016.
In 2006, FHC had 14 office locations with 24 practices compared to 16 office locations with 34 practices in 2016.
In 2006, FHC owned three (3) of its locations compared to 2016 in which we now own six (6) locations.
Provider workforce increased from 48 providers in 2006 to 65 providers in 2016.

14. Then and Now 2006 to 2016
Patient encounters increased from 161,618 in 2006 to 262,637 in 2016.
Combined patient population grew from 52,325 in 2006 to 108,224 in 2016.
In 2006, FHC had a total of 205 FTEs compared to 431 FTEs in 2016.

15. Exciting Areas of Growth
Construction of a 50,000 sq. ft. office building in Lehigh Acres to house FHC’s Medical, Dental and Pediatric practices. Completion is scheduled for late 2017.
Implementation of a new Call Center.
Purchase of 1926 Victoria Avenue to house administrative staff and serve as a training facility.
Agreement with Florida Gulf Coast University for an on campus dental office.
Agreement with Ronald McDonald House Charities to host Lee County’s first Care Mobile to provide medical and dental health screenings.

16. Primary Care Alternatives to the Emergency Department Discussion