According to the latest U.S. Census numbers, almost 50 million people across the nation lack health insurance. In addition, countless others are underinsured and have trouble paying for basic medical care. Throughout the years, PHMC has worked with community partners to provide accessible, high-quality health care to the region’s most vulnerable populations. As August 9–15 marks National Health Center Week, PHMC recognizes the important work and impact of its network of community health centers. Our five health care centers provide area residents with a diverse selection of services that help to close the gap on health care disparities.

Helping Philadelphia’s Homeless

PHMC’s Mary Howard Health Center, a comprehensive primary health care center, is the only health center in the city of Philadelphia designed to serve Philadelphia’s homeless population. “Mary Howard is a safe and welcoming place where care is delivered by highly skilled practitioners who truly understand the culture of homelessness,” says Elaine Fox, vice president of Specialized Health Services at PHMC. Mary Howard sits at the corner of 9th and Sansom Streets near historic Jewelers’ Row, where it serves more than 1,200 clients a year. The center is named after Mary Howard, a well-known homeless Philadelphian who died in 1995 after health complications from living on the streets. The center, whose staff includes nurse practitioners, a psychiatric nurse and a social worker, provides clients with primary care, family planning and assistance with benefits. As of 2009, the center also offers clients free vision care and eyeglasses in collaboration with Davis Vision (see article below.)

Serving Philadelphia’s HIV/AIDS Patients

The PHMC Care Clinic, located at 16th Street and Girard Avenue in North Philadelphia, provides primary care to Philadelphians living with HIV/AIDS. The staff includes doctors, physician assistants and case managers. The Care Clinic opened in 1992, as part of St. Joseph’s Hospital, before becoming a part of PHMC in 2005. In addition to its regular primary care offerings, the PHMC Care Clinic provides health services exclusively to women living with HIV/AIDS on a designated day each week.
“Women make up the fastest growing population of new cases of HIV infection worldwide,” says Katie Huynh, physician assistant at the Care Clinic. “Many barriers keep women from care such as: being caretakers, financial stress, anxiety and depression, as well as lack of access. The PHMC Care Clinic empowers women to care for themselves through accessible, female-centered health care and health education.” Services for women include the Women’s Support Group, case management and peer counseling.

Our Health Center is like a safety net."

In addition, PHMC Care Clinic offers Hepatitis C clinics twice monthly to patients co-infected with HIV/AIDS and Hepatitis C. In the near future it will expand to offering specialized supportive services that are not traditionally offered in primary care settings to underserved populations, including mental health and substance treatment counseling.

The Care Clinic recently was designated a Federally Qualified Health Center (FQHC) to provide primary care to underserved, uninsured, and homeless populations living in communities located near the clinic.

Working with the Community

PHMC Health Connection began in 1994 as Temple Health Connection in response to a study conducted by faculty at Temple University’s School of Nursing revealing that 90% of area residents with health insurance did not have a regular primary health care physician. “Our health center is like a safety net,” says clinic director Donna Brian. “We take the people who have nowhere to go and offer them high-quality care.” PHMC Health Connection partners with Norris Homes and Apartments, which are owned by the Philadelphia Housing Authority. The nurse-managed health center, located adjacent to Temple University’s main campus, operates with input from the Temple and PHMC Health Connections Community Advisory Board, half of which is made up of the center’s patients. The council includes community members from Norris Homes and Apartments and from Fairhill Apartments, two housing projects served by the center.

Between 400 to 500 patients come to the center every month for its primary health offerings. “PHMC Health Connections has definitely improved the health of the community,” says Brian. “A lot of children were under-vaccinated and they couldn’t go to school or enroll in Head Start programs. Right now, more than 92% of our children are completely vaccinated.” In addition, “we’ve seen a decreased number of teen pregnancies,” says Brian. “We make it very easy for teens to talk with us about birth control.”

One in 7 adults in Philadelphia has no regular source of primary health care — _{from PHMC's Community Health Data Base}

Like PHMC Health Connections, Rising Sun Health Center collaborates with a housing project to provide residents with quality health care. Rising Sun, located next to the Hill Creek Housing Development in Northeast Philadelphia, was formerly Hill Creek Health Center and joined PHMC in 2004. The nurse-managed health center serves the diverse ethnic population in Philadelphia’s Logan/Olney neighborhoods, as well as residents of Hill Creek. “About 30% to 40% of the residents of Hill Creek use the Rising Sun Health Center for their primary health care needs,” says health center director Mariam Salahou. “The people who live here find it very convenient to come here.” Like PHMC Health Connection, Rising Sun Health Center also incorporates a community advisory council composed of community members and Hill Creek residents.

Reaching Chester County’s Farm Workers

Project Salud, a nurse-managed health center operated by PHMC affiliate La Comunidad Hispana and located in Kennett Square, provides Latino members of Chester County with culturally sensitive, bilingual and financially accessible primary health care. In May 2009, Project Salud moved to the new La Comunidad facility. The center’s clients are primarily agricultural workers. In addition to nurse practitioners, Project Salud’s staff includes a nurse midwife who helps provide clients with prenatal care. “We serve a community that faces many barriers, including language and culture,” says Marguerite Harris, clinical director of Project Salud. “We do extensive outreach and education on diabetes, hypertension and cardiovascular health in the context of the patient’s culture.” In addition to providing care at the clinic’s main site, Project Salud partners with local care providers to ensure their patients can afford x-rays, MRIs, blood work, other diagnostic tests and specialty visits. “Without Project Salud here, I think the community would not be so healthy. A lot of people would be hospitalized with complications because they would not be able to afford care or understand their illnesses,” Harris says.

PHMC Helps Homeless
Access Vision Care

In December, 58-year-old Connie Naylor walked into Mary Howard Health Center for a vision care appointment and walked out with a prescription for a free pair of glasses. It was her first pair in over three years. Four years ago, Naylor was homeless, severely depressed, jobless and living in a shelter. Then she found Mary Howard. “I would not be alive now if it weren’t for Mary Howard,” says Naylor. Mary Howard, a health center managed by PHMC, is the only nurse-managed health center for homeless people in Philadelphia; it offers comprehensive primary care. Through Mary Howard, Naylor was able to receive the medical care she needed to heal and move into permanent housing. But even with the help of insurance, she could not afford new glasses. Now, thanks to a partnership between PHMC’s Mary Howard and Davis Vision, a Highmark company, she can.

Before this past fall, free vision care was unavailable to Philadelphia’s homeless population, many of whom are uninsured or underinsured, like 58-year-old Jesse Porter. When he came to Mary Howard Health Center for his vision care appointment, he knew something was wrong. “How are your eyes doing?” optometrist Dr. Tamara Hill-Bennett asked Porter. “Not good,” he replied, struggling to read the top line on the vision chart she held up for him. Porter told her he had been putting off vision appointments for months because he had no insurance, even though his left eye had suddenly gone blurry a couple months before. Dr. Hill-Bennett discovered the problem was no ordinary vision deterioration. “He had some bleeding in his retina,” said Dr. Hill-Bennett. She referred him to a retina specialist.

“We are thrilled to have optometric care provided on-site by Dr. Hill-Bennett,” says Elaine Fox, vice president of PHMC’s Specialized Health Services component. “The free service provided on-site by Davis is a critical component of caring for our homeless patients, many of whom have long-standing health problems such as diabetes that would affect their vision.” The opportunity to provide free vision care to the homeless arose when Davis Vision executives contacted PHMC’s Health Care for the Homeless Project, in which area providers come together to address the health and social services needs of the region’s homeless population.  “Projects like this are consistent with Davis Vision and Highmark’s goal to provide quality vision care to all Pennsylvanians,” said Dr. Joseph Wende, Davis Vision senior vice president of professional affairs and quality management.

As part of the project, Dr. Hill-Bennett will be available to patients once each month. “One of my goals as an optometrist is helping those who need it,” said Dr. Hill-Bennett. “I’m very excited that there’s a clinic for the homeless that provides free vision care.”

Local homeless advocates, who often refer homeless clients to Mary Howard for primary care, frequently encounter clients who need vision care. “Not a day goes by that we don’t have someone asking for glasses,” says Sister Anne Kappler, coordinator of Health Education and Services at Project H.O.M.E. “I’m so glad Mary Howard is now able to offer vision care.” Dainette Mintz, director of the City of Philadelphia’s Office of Supportive Housing, echoed those statements. “Health care is of critical importance to those living on the street,” says Mintz. “I’m thrilled that we have folks partnering with us to provide services like this.”