LCH: Making a Difference Leadership Council Meeting January 22, 2014 1 Overview 2 Mission To help low income residents of southern Chester County to stay healthy, build strong families and lead productive lives by providing high-quality, culturally welcoming services. 3 Strengths Bilingual and bicultural organization that is culturally welcoming to the needs of the population served. 91% of staff are fluent in both Spanish and English; of those, 76% are Hispanic. Nurse-managed healthcare that creates a comfortable, familiar environment that encourages honest communication between provider and patient. LCH is the only organization that offers a comprehensive scope of healthcare, social services, adult education and legal assistance within a single entity thus improving the outcomes of each service. 4 Impact In 2013, LCH cared for nearly 5,270 individuals providing primary health and urgent care, women’s health, community and family services, legal assistance and adult education. Hispanics comprise 90% of persons served. In the Health Center, LCH provided care for 2,789 individuals, resulting in 9,180 care visits - 86% do not have health insurance. Services are provided without regard for ability to pay. In Community Services, LCH provided community and family services, legal assistance and adult educational classes to 2,481 individuals last year. LCH also engages everyone in the community through special programs in partnership with various local and national organizations. This year 1,200 people attended Vive tu Vida Get Up Get Moving and over 300 families and 325 children were helped through special programs. 5 Needs Growing numbers: In 2010, the population of Latinos in Chester County more than doubled from the previous US Census to 32,503. Based on LCH’s 2013 Needs Assessment, an estimated 46% of Latinos (14,000) live in the southern part of the county and 51% are under the age of 25. Poverty: 19.4% of Hispanics had income an income in the past 12 months below poverty. Hispanics perform hard physical year round work in the mushroom industry, horse farms and other industries where the average pay is $8 - $10 per hour. Inadequate Healthcare: LCH’s services is designated a medically underserved population of farmworkers and non-English speaking Hispanics by the federal government. 40.7 % of Hispanics in southern Chester County do not have a regular source of health care. 62.7% of Hispanics in southern Chester County are without health insurance. In the State of PA, 22% of Hispanics are without a primary health care provider. Language and Cultural Barriers: The majority of Latinos over 18 in southern Chester County (81.8%) are foreign born. Low Levels of Education: 61% of Hispanics in southern Chester County have less than a high school diploma. 6 Challenges to Our Community Poor, undocumented, uninsured: Transition from manual labor to higher paying jobs is difficult and keeps individuals in low paying jobs. Lack of documentation contributes to staying in low wage jobs. Often, these low wage jobs do not provide health insurance. Barriers to access services: Those without insurance have limited access to care. Sliding fee scale not typically offered. Confusion around what services offered by different agencies and often there is duplication of efforts. Low levels of formal education and limited English: Difficulty learning English with low literacy levels, have full-time work and raising a family. Often difficult to help children in school. Growing Education Gap: Latino school children perform significantly lower on standardized tests as compared to the rest of school children. Drop out rates are high for Latinos in high school and college. Isolated and often invisible: Transportation continues to be an issue in the area. 7 Specific Challenges: Health Services in Chester County The Community Health Needs Assessment of Chester County, completed in 2012, identified five strategic questions that need to be address as a community. How can the community expand the concept of cultural competence to ensure access and use of services, including early prenatal care and health screenings? How can the community partner to provide a seamless, highly coordinated network of services that address an individual’s physical and behavioral health issues? How can the community increase awareness of and education about health and social services to help them meet their basic needs? How can the community encourage and support individuals to take action in their own health management and well-being, including prevention? How can community leaders help create supportive environments to ensure the health and safety of their communities? 8 Focusing on the Future 9 Who best to meet these challenges? HRSA award and NCQA recognition Provider of multiple services New “green” facility Advocate for Latino community Trusted and culturally welcoming 10 Rationale LCH’s 5-Year Strategic Plan is informed by the Community Needs Assessment and LCH’s own needs assessment. HRSA grant requires LCH to expand access to care and double the number of patients served in the health center to 4,600 by 2017. Integration of services will ensure that more clients will access our health services and be supported through access to other enabling services HRSA grant has helped to focus LCH on measuring outcomes of all services provided. Access to knowledge is critical for improved outcomes and requires information technology that supports and enhances work and allows for tracking and measuring outcomes, not just at LCH but across a seamless network of service providers in Chester County. A user majority board, as required by HRSA, provides an opportunity for promoting services as well as engaging the community we serve. Engaging volunteers and the community is key to our success and will benefit all residents of southern Chester County 11 Vision With access to high-quality, culturally welcoming services to those in need, all residents of Southern Chester County will be able to more fully benefit from and contribute to the social vibrancy and economic prosperity of the region. 12 Strategic Initiative • Expand access to services through outreach and enrollment activities, enhanced productivity and improved efficiencies. • Integrate services through the design and implementation of a new comprehensive model of care and delivery that relies on information technologies to improve access to knowledge and tools for measuring effectiveness • Invest in people and foster organizational cultures of excellence internally and approach clients with respect and intent of building a relationship where clients are making progress toward self-directed care. 13 Expand Access Integrate Services Invest in People • Add a medical exam room buy converting an office into an exam room • Make minor modifications to front entrance to enhance patient flow • Increase parking by purchasing the adjoining property • Develop a person centered model of care (IPCS). • Adopt a service delivery model for the person centered model of care • Invest in information technologies that improve knowledge through access to data • Assess which services to continue to provide, refer to other agencies or create • Establish a system for more effective collaboration • Hire skilled staff whose function reinforced integration • Conduct leadership management training for all supervisors • Train staff in customer service • Hire staff focused on the integration of services: LCSW, SW, ACA Enrollment Specialists • Hire specialized Billing and Information Management Systems staff 14 Details on Expanding Access Provider productivity • • • • Optimal number of exam rooms is 2 per provider Currently we have 7 exam rooms which limits us to 3 providers at any given time The addition of one more medical exam room would allow 4 providers at a time At the current provider productivity rate, in 4 hour slot providers could see an additional 11 patient Patient flow • • • Minor changes to front entrance would facilitate the work of a “greeter” and create several distinct waiting areas. Changes would provide for more privacy to facilitate eligibility and enrollment. Changes would provide easier access (less doors) for disabled persons. Parking in adjacent lot • • • Monday and Thursday morning are lab draw mornings and there is no available parking between 8:30 and 10. Staff is up to 32 and taking up over 50% of the parking spaces. Evening sessions that draw community also have limited parking. 15 Details on Integrated Services The Person-Centered Model of Care Encounters Services Integrated Person Centered Services Relationships Community 16 Details on Investing in People Staff that helps to integrate • • • • Three tiers of service within Community Services Licensed clinical social worker to integrate behavioral health. Social worker and case managers to integrate medical legal services. Clear roles at each level of service. Specialized staff • • Billing specialist to maximize accounts receivable from insurance companies. Information systems manager to support direct service staff. Leadership training and development • • Leadership training for all supervisor level staff Development training for all staff in needed areas 17 Making a Bigger Difference Expand Access • • • • • • Increased number of patients seen Increased number of insured patients Better tracking of patient outcomes Improved enrollment and eligibility screening Increased provider productivity Parking available Integrate Services • • • • • • Measure & increase % of patients receiving multiple services Improved customer satisfaction Tools for knowledge based care Better tracking of follow up activities Measures of relationship building Improved follow up & tracking across organizations Invest in People • • • • • • • Improved effective team work in the delivery of services Increase in program revenues Achieve financial metrics Ease of data tracking & reporting Increase in accounts receivable Improved follow up & tracking across organizations Engage community volunteers 18 Four Year Budget Actual Prior Years Revenues Foundation & Corporations Contributions from individuals Total Revenues 50,000 760,000 1,000,000 1,000,000 1,050,000 1,760,000 Expenses Personnel (on-going) Consultants (one time) Total Expenses Capital Expenditures Purchase Adjoining Property Add Medical Exam Room Minor Modifications to Current Facility Information Systems Software & Custom Development Total Capital Grand Total Year 1 410,500 120,000 530,500 Year 2 Year 3 Year 4 Total 200,000 200,000 370,000 370,000 570,000 570,000 200,000 370,000 570,000 1,410,000 3,110,000 4,520,000 410,500 120,000 530,500 410,500 120,000 530,500 1,642,000 480,000 2,122,000 85,000 85,000 350,000 75,000 75,000 415,000 915,000 410,500 120,000 530,500 350,000 110,000 460,000 75,000 75,000 110,000 260,000 $ 990,500 $ 790,500 110,000 110,000 $ 640,500 $ 615,500 $3,037,000 19 Campaign Overview 20 $4,520,000 Goal Elizabeth R. Moran & Alice K. Moorhead Co-Chairs The goal of the Fortyforward Campaign is to raise $4,520,000 over the next four years as follows: $2,537,000 Program/Capacity Funds to help LCH expand and improve programs and develop fully integrated services combining health care, social services, education and legal assistance in order to serve more of those in need. $ 500,000 Facilities Funds to add an additional medical exam room, make minor modifications to front entrance and increase parking by purchasing the property adjacent to LCH. $1,483,000 Sustaining Funds to provide funds for general operations during these transition years and for the long-term growth of the organization. The Fortyforward initiative & campaign was announced at the reception on November 13, 2012. 21 Where We Stand $1,633,528 Raised/11 Donors $2,886,472 Remaining to Goal Cash - $696,936 – Pledges Due - $936,592 22 Campaign Profile Gifts Levels: • • Leadership: 62% of Gifts ($2,800,000) – 8% of donors (9) Major: 37% of gifts ($1,680,000) – 40% of donors (70) First-time Donors: • 14% of donors (16 Donors)/6% of Gifts ($40,000) Source of Gifts: • • • Individual gifts - 80% Foundation gifts – 10% Business gifts – 10% (72 Donors) (18 Donors) (18 Donors) 23 Prospects by Ask Amount LEADERSHIP GIFTS MAJOR GIFTS INDIVIDUALS TOTAL GIFT RANGE GIFTS CATEGORY TOTAL CUMULATIVE TOTAL % OF TOTAL $400,000 & Above $250,000 – $499,999 $100,000 – $249,999 3 $1,600,000 $1,600,000 37% 2 $500,000 $2,100,000 47% 6 $700,000 $2,800,000 60% $50,000 – $99,999 11 $610,000 $3,410,000 76% $25,000 – $49,999 23 $600,000 $4,010,000 90% $10,000 – $24,999 $5,000 – $9,999 Below $5,000 ($2,500) 34 14 $400,000 $70,000 $4,410,000 $4,480,000 93% 98% 68 108 $40,000 $4,520,000 $4,520,000 100% 24 Prospects by Constituency GIFT RANGE PROSPECTS Board Campaign Leadership Individuals Foundations Corporations Organizations 9 7 56 18 17 1 PROSPECT LEVEL $128,500 $1,501,000 $1,325,500 $1,340,000 $200,000 $25,000 TOTAL 108 $4,520,000 $1,633,528 RAISED DONORS $500,000 $981,028 $87,500 $15,000 $50,000 0 2 4 3 1 1 0 11 25 How to Help Participate in the Leadership Council Identify & introduce prospects Invite prospects for meetings & tours Give & ask others to join you Advocate in the community 26 Feedback Questions…. 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