Thea Bowman Community Health Center COMPLETED
Advantage Health Centers (AHC), a Michigan 501c3 corporation operating as a Federally Qualified Health Center (FQHC), is seeking assistance to acquire a significant piece of property in pursuit of providing a comprehensive Patient-Centered Medical Home in the northwest Detroit community (West McNichols and Greenfield). AHC presently occupies the building on a leased basis, utilizing 12,500 square feet formerly operated by a Wayne State University residency program. The building has a 32,000 square foot footprint, and the property includes a 110-space fenced parking area. In addition, plans include the provision of dental services, co-location of behavioral health services (New Center Community Mental Health), and the Jet-Vet education and job training program (Development Centers, Inc.). Building purchase price is $650,000 with remaining project costs of $350,000 for needed renovation and improvements, including a natural gas powered emergency generator.
- Location: 15400 W. McNichols St., Detroit, MI 48235
- Contact: Joe Ferguson, Executive Director| 313.416.6217
- Project Cost: $1,000,000
- Size: 32,000 sq. ft.; 2 floors; 110 car contiguous surface parking lot (important access issue for urban Health Centers)
Meeting Community Need, Increasing Access, Expanding Services
Detroit has high poverty and the need for access to multiple health services, as well as need for job training and assistance. This proposal would contribute to all of these through the proposed expansion of usable renovated space. In addition to the provision of comprehensive Health Center services, including medical and dental services, AHC’s proposal includes facilitating co-location of mental health services as well as job training and assistance programs—greatly needed to respond to Detroit’s unemployment challenges.
Reaching Special Populations
Advantage Health Centers, formerly Detroit Health Care for the Homeless, serves the City of Detroit from multiple locations open to all. This proposed facility improvement is located in northwest Detroit near the major intersection of McNichols and Greenfield. It serves a target population similar to much of the City of Detroit primarily consisting of 94.68% ethnic minorities, 92.39% African American most having low income and many without health insurance. Nearly all of Advantage Health Centers’ patient population have incomes below the Federal Poverty Level (FPL): <100% FPL 89.7%; <200% FPL 99.4%. Only 1% of its patients have private insurance coverage; 60% are uninsured; 32.2% receive Medicaid benefits, and 4% are Medicare beneficiaries. Of its 11,903 patients 1,793 (15.06%) are homeless. In 2006, Detroit had the highest low birth weight rate among 56 U.S. cities (13.1% versus 8.3% average). For the period 2006-08 the all-cause infant mortality rate, a health sentinel indicator, for children aged 1–17 was 100.7/100,000 versus the national rate of 19/100,000—more than five times the national rate!
Significant clinical and financial improved outcomes will result from the acquisition of the Thea Bowman Health Center. The improved clinical outcomes center on the provision of complete primary care, both medical and dental, for a low sliding fee charge of $20 that includes laboratory test fees and 340b prescription for our uninsured patients (60%). While presently AHC doesn’t have the empirical data corroborating the finding, anecdotally it has been demonstrated that this small all-inclusive fee (unique when compared with the policy of other Detroit FQHCs) helps its patients with chronic diagnosis, such as diabetes, asthma, COPD, etc. to be more compliant with the follow-up visits required to adequately monitor and manage these serious conditions. Better compliance means better outcomes and better health status. AHC will be in a position, as a result of the elimination of $8,000/month in rent expenses, to pay for the laboratory tests and medications for these uninsured patients. In fact, more uninsured will be able to access these critical services as well. As one of seven FQHCs in the City of Detroit participating in the Southeast Michigan Beacon Community effort to provide a compilation health data (Health Information Exchange) on the diabetic population, AHC is hoping to demonstrate the positive impact that reducing such financial barriers has on improving chronic conditions. The acquisition of the Thea Bowman site will greatly enhance the financial integrity of AHC. FQHCs have unique and complex revenue cycles which are often constrained due to issues of an agency’s control. Federal and State decisions can have a great effect on Medicaid and grant funding, the agency’s two biggest sources of revenue. With a decrease in monthly rent expense and the addition of a capital asset, improved financial performance and measures will enable the agency to pursue much needed cash management tools that are currently out of reach, such as lines-of-credit and the creation of reserve funds.
Program Innovation / Model of Delivery
As a Federally Qualified Health Center, AHC by definition provides a comprehensive model of delivery including primary medical care, OB/GYN, behavioral services, and oral health services. Presently, each individual site operated by AHC cannot accommodate each service line within the site, but that is the direction AHC is moving as evidenced by this specific proposal. This endeavor will bring AHC more into compliance with the community wide effort to have FQHCs be PCMH recognized as well as be fully compliant with Meaningful Use requirements for EHR.
Community Collaboration / Service Integration
This proposed project will co-locate and integrate medical, dental, behavioral health, and enabling services such as translation and case management in a culturally sensitive manner. AHC resumed direct provision of dental services with the July 1, 2011, acquisition of the Children’s Dental Center and the renovation proposed here will provide for the expansion of those services from the current Alexandrine location to this site. There is planned space for co-location of New Center Community Mental Health and the development of integrated services. The proposal also provides for a stable, sustainable venue for the Development Centers, Inc. (DCI) Jet-Vet job training and placement program. The Jobs, Education and Training Program (JET) of Development Centers, Inc., a Michigan Works! Affiliate, in partnership with the local Michigan Department of Human Services is designed to assist Temporary Assistance for Needy Families (TANF) recipients with employability and training skills which will lead to self-sufficiency. The VET program provides for additional training & additional assistance.
Innovation in Design
AHC plans to renovate the building utilizing green design principles within the scope of its project.
Impact on Social Determinants of Health
With the acquisition and renovation of the Thea Site described in this proposal AHC will create a safer and more stable environments for this major cross roads in what will become one of Detroit’s "Good Neighborhoods”. Such stability will allow the ongoing revitalization of the surrounding area and identify the surrounding properties as sound business locations. All of these activities will have a positive impact on the Social Determinants of Health.
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