Community Health Centers Responding to Disparities in Eye Care

1. 1 Community Health Centers Responding to Disparities in Eye Care

2. 2 What Are Health Centers? Health Centers are local, non-profit, community-governed health care facilities that provide a vast array of health services to low income and medically underserved communities Historically a Federal strategy to providing comprehensive primary care to underserved First CHC demonstration project in 1965 at Columbia Point, Boston MA Congress authorized health centers in 1975 For 40 years, health centers have provided primary care and preventive health services to the nation�s most vulnerable populations

3. 3 How Many CHCs in US? 1000 Community Health Centers 5500 Unique service locations In every State, Commonwealth, Territory and District of Columbia Located where economic, geographic, or cultural barriers would otherwise limit access to primary health care

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6. 6 CHC Patients in 2004 14 Million unique patients which accounted for 52 million visits: 59% = Female; 41% = Male Medical visits = 38 million Dental visits = 5 million

7. 7 Health Center Users By Race/Ethnicity in 2004

8. 8 CHC Patients By Age, 2004

9. 9 Health Center Patients By Insurance Status, 2004

10. 10 How CHCs Address Disparities(Source: NACHC Sept 2005 Fact Sheet #0405) Located in federally designated high-need underserved areas Governed by community boards, majority of whom are patients at center - unique structure Open to all residents, regardless of income or insurance status, sliding fees Provide comprehensive health and enabling services (e.g. translation, advocacy, travel) Tailor services to community, culturally and linguistically competent (care management) Follow rigorous performance and accountability requirements clinically, operationally and financially

11. 11 Research has shown that CHCs are effective in improving health (#0405) Disparities in health status do not exist among health center patients (Shi et al) Effective preventive services � timely screenings for mammograms & pap smears compared to nation Fewer low birth weight babies � compared to national counterparts Effective management of chronic disease � diabetes, cardiovascular disease, asthma, depression, cancer, HIV disease, hypertension

12. 12 However, there remains significant Visual Health Disparities at CHCs

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14. 14 UNMET NEED: Vitale S, et al. Prevalence of visual impairment in the United States. JAMA 2006; 295:2158-2163

15. 15 ASCO: What is the role of schools and colleges of optometry with CHCs? 2006 AOA Survey: ASCO and CHCs (AAO POSTER SESSION) Opportunity for Schools and Colleges Form affiliations with state & local PCAs Partner with CHCs to open comprehensive eye care programs Develop clinical Rotations & Residencies Teach community health principles via front line clinical service/education Contribute to workforce development (ASCO approval in November, 2006 of �Community Health Optometry� residency)

16. 16 ASCO: What is the role of schools and colleges of optometry with CHCs? �Exposing trainees to community-based clinics that provide care for the underserved will provide important experience in addressing the health care needs of this patient population and will expose trainees to inspirational role models.�

17. 17 AOA: What if Eye Care Were a Priority �Must Have� Service in the Next Decade? By 2016 with appropriate funding and incentives for ODs to work at CHCs: Open a new Eye Service in 1000 CHCs (That�s roughly 100 new programs/year!) Hire 2000 optometrists to work at CHCs (That�s approximately 15-20% of all new graduates over the next 10 years) We could provide over 4 million eye visits annually � the beginning of improved visual health status for the underserved

18. 18 CHCs are a Major Part of the Solution: Further Information Roger Wilson, OD Chair, American Optometric Association Community Health Center Committee c/o New England Eye Institute 1255 Boylston Street Boston MA 02215 617.236.6229 www.aoa.org wilsonr@neco.edu