Advantage Health Centers
Waller Health Center Pediatric Suite Expansion
Description & Cost
With this project Advantage Health Centers (AHC) plans to expand the existing building for a Pediatric suite. This addition will include a waiting area with an Interactive Learning Center; four pediatric exam rooms; a pediatric office; two offices for pediatric behavioral health services; a pediatric triage area and a mechanical room. In 2007, Waller Health Center became one of Michigan’s Primary and Behavioral Health Integration pilot programs. It is being used as a model to expand other integration programs. Waller Health Center, with over a 25 year history of treating the homeless, was previously expanded to serve a traditional homeless population; therefore, the expanding pediatric volume is not only putting a strain on space, but the space itself is not conducive in caring for the pediatric population.
Meeting Community Need, Increasing Access, Expanding Services
Per capital income in this area is extremely low: $16,391. Just over 87% (87.4%) of the population consists of ethnic minorities with 79.4% being African American. Just over 35% (35.2%) of individuals under the age of 18 are at or below 100% of poverty and 59.2% of this group is at or below 185% of the poverty level (Detroit Kids Data). Detroit also had the highest low birth weight rate of 56 cities (13.1% versus 8.3% average). The all-cause mortality rate for Detroit children ages 1-17 was 100.7/100,000 versus 19/100,000 nationally. Fourteen percent are in foster care status. In addition, the 2009 Youth Behavioral Risk Survey of Detroit youth grades 9-12 reports health behaviors, perceived risks and health status. When compared to national averages: more likely to carry a gun to school (7.6% to 5.6%); have been in a physical fight (25.4% to 11.1%); felt unsafe at school (19.1% to 5.0%); have become sexually active before age 13 (18.2% to 7.4%). Detroit also experienced higher than average rates of sexually transmitted disease.
This facility is planned to accommodate the medical and behavioral health personnel needed to attend to the needs of the children and adolescents of this area. It will expand access to pediatric clinicians and behavioral health services as well as facilitate access to secondary and tertiary care. AHC will work with its large array of community partners to provide community outreach to homeless service providers and other community organizations to increase awareness and access to children and adolescents in need of physical and behavioral health care. etroit 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 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
The target population for this project consists of children and adolescents residing in the Cities of Detroit, Hamtramck and Highland Park, Michigan, between the ages of birth and 18 years old with special emphasis in providing needed services to Detroit’s insured, underinsured, uninsured, and homeless men, women, and children.
The goal of the expansion of the pediatric center is to increase access to comprehensive, quality primary care services and be a gateway to additional needed services. It is anticipated that the addition of the pediatric center will provide access to an additional 2,000 pediatric medical patients and 100 pediatric behavioral health patients, as well as allowing capacity for AHC to provide access for 3,000 additional adult patients. The expansion will allow for expansion of programs such as the Adolescent Care program. Currently, the program is just open to the "at risk” adolescents in Foster Care and pregnant teens. The addition of the pediatric wing will give the space needed to expand the program to many more teens in the service area. The plan is to enhance risk assessment surveillance by using the Center of Epidemiological Studies Depression Scale for Children (CES0DC) and the Comprehensive Addition Severity Index for Adolescents (CASI-A) or similar tools to assess teens in a variety of settings and generate referrals to Waller’s integrated primary/behavioral health care unit.
Program Innovation / Model of Delivery
The proposed project is designed as an integrated pediatric model that will focus on the "whole” child. The plan is to consider physical, developmental and mental health together. In partnership with Children’s Hospital of Michigan (CHM), one pediatrician, pediatric residents and one family practice nurse practitioner with be the clinicians who provide primary care. The CHM network will provide secondary and tertiary care. AHC will contract with The Children’s Center (TCC) and will purchase the services of a MSW with psychiatric oversight to provide the behavioral health services, including intake assessments, crisis intervention, and ongoing treatment and planning for all patients referred for behavioral health services. Recently, AHC initiated a Wednesday evening (3:00-7:30 PM) Adolescent Care session as part of a strategy to encourage teens to choose healthy lifestyles and provide needed care and counsel. The mission of Advantage Health Centers is to improve the health status of the individuals and the communities we serve by providing access to high quality, respectful, and efficient health care services. It utilizes the Federally Qualified Health Center model of comprehensive, quality primary care, cooperating with the HHS Health Resources and Services Administration’s quality programs. It also functions as a primary care medical home providing team-base, integrated care including medical, dental, behavioral health and additional services such as community outreach, translation, case management and benefit assistance to assure access to and effective use of needed services.
Community Collaboration / Service Integration
Discussions are ongoing with Children’s Hospital of Michigan’s (CHM) Chair of its Pediatric Residency Program, Lynn Smitherman, MD regarding placement of a faculty member on staff at the proposed Waller pediatric suite. CHM is a facility of Detroit Medical Center (DMC). The resultant relationship will assure access to specialty care at CHM. AHC also recently took over responsibility of the Detroit Medical Center’s (DMC’s) Children’s Dental Center, retaining leadership of its dental residency program. In addition, AHC’s Waller Health Center is located in the development area of the Woodward Corridor Initiative—Part of the Living Cities Initiative, a five-city initiative including Detroit providing grants and loans to improve access to education, health care, housing, transit and jobs. AHC is participating in the planning process to improve access to health services. AHC collaborates with many area organizations. It works with Voices of Detroit Initiative (VODI), a not-for-profit organization of local safety-net providers (Wayne County Health Department, Detroit Department of Wellness & Health Promotion, area FQHCs and free clinics) and area health systems (Detroit Medical Center, St. John Providence Health System and Henry Ford Health System). In addition to systematically assisting in placement of the uninsured in medical homes, it is a recipient of a Beacon grant for a program utilizing health information exchange (HIE) to improve chronic disease. AHC is also a member of the FQHC Council of SE Michigan, a collaboration of eight FQHCs, FQHC Look-Alikes and an IHS Title V Urban Indian Health Program. AHC collaborates with these and many other organizations in the Detroit area in order to also be a catalyst for access to health care and other resources for those who would otherwise go unserved.
Innovation in Design
AHC plans to maximize energy efficiency in this project, including HVAC, electrical and plumbing. To this end, the RFPs issued for this project will contain the required language to stipulate that "green and sustainable materials” be used and appropriate engineering standards be followed to deliver the maximum in energy efficiency. This project will meet all requirements for commercial medical space. HC plans to renovate the building utilizing green design principles within the scope of its project.
Impact on Social Determinants of Health
- Integration with/contribution to community development: The proposed development contributes directly to the area designated as the Woodward Corridor Initiate—part of the Living Cities Integration Initiative providing needed care to area residents and being a community anchor contributing to its built environment. The University Cultural Center Association (UCCA), The Kresge Foundation and the Skillman Foundation are coordinating the effort in partnership with Michigan State Housing Development Authority, the City of Detroit, NCB Capital Impact, Vanguard Community Development Corporation, Data Driven Detroit and major anchor institutions, including the Detroit Medical Center, Henry Ford Health System, and Wayne State University.
- Improved transit options: Expansion of services at this location increases convenient access to care, since it is located adjacent to Woodward Avenue, the main thoroughfare of Detroit on its main bus lines.
- Contribution to job creation: Expansion of the clinical and support staff will add well-paying medical jobs with benefits to this area in active redevelopment. It will also add short-term construction employment.
- Improved neighborhood safety: Upgrades and securing of the parking area will contribute to patient safety. Site improvements include a new, secured parking lot entrance along Warren Avenue with appropriate curb cut, fencing, resurfaced parking lot, sidewalks and landscaping.
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160 E. Warren (on Cathedral Green)
Detroit, MI 48201
1,350 sq. ft.
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