Family Practice and Counseling Network

Addressing the Special Health Care Needs of Public Housing Residents -
  Particularly Behavioral Care

Background & Goal

Public housing residents often are exposed to violence. As a result, they suffer trauma, post-traumatic stress disorder (PTSD) and many other physical and mental health issues. Furthermore, many public housing residents have problems accessing primary health care.

Family Practice and Counseling Network brings care directly to public housing residents in a cost-effective manner that fosters better care through nurse-managed clinics comprised of an inter-disciplinary health team that has been trained to address public housing residents’ special needs.

Center Description

Family Practice and Counseling Network (FPNC) is a system of three nurse-run health centers located in or near public housing communities in Philadelphia. They are based on a “one-stop shopping” model where patients receive care – seeing a behavioral health therapist, podiatrist, optometrist, dentist all on the same day. Prescriptions can be filled at the pharmacy or dispensary and patients can be transported to and from the health center via the health center van. There is a special $4 prescription fee for uninsured patients. Centers are accessible by means of location, ease of appointment, acceptance of all patients regardless of ability to pay and by creating a warm, inviting and friendly atmosphere. The primary care visit is charged on a sliding scale, based on federal poverty guidelines for patients who are uninsured, and lab work is included in that fee.

Evidence of Success

In 2011

• Received $500,000 HRSA Award to open a new site in York, PA to serve public housing residents. Only 2 awards were given in PA and60 in the country.
• FPCN was accepted into the state Phase 2 collaborative aimed to improve chronic and preventive care outcomes. It is a three year initiative.
• FPCN was subcontracted to provide services through a state grant called PA Cure Grant. The grant is a three year initiative that will be studying the effects of drug and alcohol screening, treatment, and referral in a primary care setting.
• FPCN was awarded a PEW grant to place Peer Specialists in health centers to improve the mental and physical health of patients with serious mental and physical health problems. A Peer Specialist is someone with lived experience with metal illness who acts as a coach and mentor to their patients.
• FPCN has demonstrated their capacity to manage the fiscal operation and has realized a surplus in all but one of its nineteen years. This year’s surplus is 1.1 million dollars. 

2009 Clinical Outcomes

• 70% of pregnant patients received prenatal care in the first trimester
• 85% of children age two were fully immunized
• 63% of Diabetic patients had HbA1c under 9
• In 2009, 98% of Diabetic patients were taking renal protective medication (ACE or ARB) and 100 % had self-management plans and had received smoking cessation/reduction counseling

Financial Outcomes

• Number of patients grew from 6,391 in 2005 to 14, 645 in 2009
• Number of visits in all disciplines increased from 30,254 in 2005 to 66,453 in 2009 and is projected to reach 75,000 in FY 2011
• Prescriptions filled grew from 5,800 in 2007 to 11,964 in 2009. Center pharmacies under the 340B federal drug program allowed the health center to shift from spending $70,000 for medications for uninsured patients to gaining a surplus of $70,000 from insured patients – money which then was used to purchase drugs for uninsured patients.