Project Access Spokane Updates

All of us who have worked with Julie Lake wish her the best of luck in her new endeavor as Chief Operating Officer for Spokane Cardiology. Her hard work and contributions to Project Access are greatly appreciated.

This sad farewell left Project Access with the daunting task of finding a replacement that would be able to collaborate with all our partners to keep the Project Access vision moving forward. We are excited to report that our search for a Director has been successful. Carol Darby of Spokane, Washington has accepted the position of Project Access Director. She brings with her a unique set of skills that highly qualify her to lead Project Access. Her experience in city management, economic/community development, managerial consulting and extensive work with non-profit organizations will be an asset to Project Access and our medical community partners.

Project Access welcomes Carol to the team. We know that we have found the right person to successfully forge us into the future. Please help us welcome Carol to our team at Spokane County Medical Society by contacting her at cdarby@spcms.org or by calling 325-5010 with any of your questions or concerns.

Project Access continues to be a successful program serving our local community. Enrollment has levelled off to about 25 to 30 new patients per week. There appeared to have been a pent-up demand in the first 6 months; however, we are now seeing a more stable continuum of health care problems, from minor to major.

When I wrote our last update in mid-May, we had just received two very prestigious awards for the program. We also had a "Celebration of Caring" event at the Denny Murphy Clinic in downtown Spokane on May 10th to kick off "Cover The Uninsured Week", a national recognition of those citizens who are uninsured. Spokane's Mayor Jim West, City of Spokane Council President Dennis Hession, NATIVE Health of Spokane Executive Director Toni Lodge,

Empire Health Services CEO Garman Lutz, Spokane County Commissioner John Roskelley, and City of Spokane Valley Deputy Mayor Diana Wilhite were guest speakers; however, the most compelling speaker was one of our patients who articulated very eloquently how Project Access had literally saved her life. Her remarks moved many of us to tears and made all the hard work worthwhile.

IMPORTANT REMINDER!! It is crucial your office bill for the services you provide Project Access patients. Please send your usual billing (HCFA 1500 forms) to the following address:

Remember the patient's ID # is their own social security # plus -01. In Block 11-C ("Insurance Plan Name or Program Name"), put "Project Access". While you are not paid for your services, your billing helps us document services provided and gives you the credit you deserve. In addition, we are able to maintain our funding which coordinates all of the patient enrollment and their appointments.

We have worked very hard in our medical society office to insure the integrity of our screening and enrollment process. When a Project Access patient is referred to you for services, you can be sure they have been rigidly screened for residency and income and are truly “low income uninsured”. This isn’t to say that a patient may somehow slip through our process but it’s unlikely and would be rare. Both hospital systems have been wonderful at using their financial service resources to also check our patients for qualified status. We are so grateful for the staff at physician and other provider offices who have become our partners in helping our patients.

Our latest data shows we have now served well over 700 patients – some with major and complicated surgeries or diagnostic tests – but most with simply specialty care consults and prescription medications. Several of our patients have gone on to commercial or government sponsored health insurance. Many have told us they have returned to work full time and are doing well. Remember Project Access is not health insurance – patients are enrolled only when they need treatment and then only for 90 days, although their enrollment can be extended if they are still in treatment.

And now a sad goodbye from me. July 9th will be my last day as the executive director for Project Access. By the time you read this, a new executive director will have been hired and I hope you will give him or her the wonderful support you have given me. Effective July 12th, I will start a new position as chief operating officer for Spokane Cardiology. I have truly enjoyed getting this wonderful project "off the ground" - with the terrific support of my staff (Liz, Wendy & Linda) and the project's founder (Dr. Sam Selinger) plus the Spokane County Medical Society staff and Board of Trustees (especially their CEO Jan Monaco). Thanks so much to all of those physicians, other health care providers and their office staff who have almost always responded to my calls for help with a particular patient or patients. While I will certainly miss all the wonderful people I work with, both internally and in the community, I am excited at the opportunity given me by Spokane Cardiology.

If you have any questions about Project Access, we can be reached at the Spokane County Medical Society office at 532-8877 or via email to Julie@spcms.org.

As I write this update (mid-May), Project Access is receiving national attention as a model for replication of a successful charity care program. The Robert Wood Johnson Foundation in Princeton, New Jersey, our primary administration grant funder, has expressed excitement at the success of our program here in Spokane County – and the American Project Access Network in Asheville, North Carolina, has praised the Spokane community for their commitment to getting the low income uninsured healthy and back to work. As noted in last month’s newsletter, the Washington Health Foundation awarded the Spokane County Medical Society their “Heroes of Health Care” award for collaboration in the community – an honor rarely given to a medical society. And locally, United Way of Spokane County, awarded Dr. Sam Selinger, founder and medical director of Project Access, their prestigious “Volunteer of the Year” award in late April.

All of that recognition and honor though would not be possible without the selfless dedication of our local heroes, you the provider community who have stepped up and provided services at no charge to our patients. A very few of you were understandably skeptical at first that the patients were indeed deserving of “free care”; however, we have worked hard in our medical society office to insure the integrity of our screening and enrollment process. When a Project Access patient is referred to you for services, you can be sure they have been rigidly screened for residency and income and are truly “low income uninsured”. This isn’t to say that a patient may somehow slip through our process but it’s unlikely and would be rare. Both hospital systems have been wonderful at using their financial service resources to also check our patients for qualified status. We are so grateful for the staff at physician and other provider offices who have become our partners in helping our patients.

Our provider network is nearly complete but we still have a need for general surgeons at this time. Our deepest thanks go to those providers we inadvertently overlooked at first – those who we would not normally schedule patient appointments with – such as pathologists and anesthesiologists. I would personally like to apologize to these physicians for not contacting them early on. It was an oversight on my part. We are all grateful most of you have taken it in stride and provided care to the patients when they needed it.

Our latest data shows we have now served over 700 patients – some with major and complicated surgeries or diagnostic tests – but most with simply specialty care consults and prescription medications. Several of our patients have gone on to commercial or government sponsored health insurance. Many have told us they have returned to work full time and are doing well. Remember Project Access is not health insurance – patients are enrolled only when they need treatment and then only for 90 days, although their enrollment can be extended if they are still in treatment.

If you have any questions about Project Access, we can be reached at the Spokane County Medical Society office at 532-8877 or via email to Julie@spcms.org.

Project Access continues to enroll about 25 to 30 new patients per week. As of the end of March, we had served almost 600 patients. We are so grateful to those physician offices and other health care providers for agreeing to see our patients. We continue to hear how grateful our patients are for the services being provided. Many of our patients have been able to return to work after receiving much needed treatment. Several of them have already gone on to employer-sponsored health insurance.

Important Update on Malpractice Protection!! Governor Gary Locke recently signed into law a new expansion to the "Good Samaritan" protection for those who provide charity care. Until now, only if you donated your services in a charity/free clinic was your threshold for proving malpractice at the much higher level of "gross negligence" - but if services were performed outside the clinic, then the threshold was at a much lower level, e.g. "preponderance of the evidence" (greater than 50%). The new law allows the higher level of proof to be at "gross negligence" if you're providing charity care through an organized program such as Project Access. Most of our physicians provide charity care and now you have the opportunity to have more protection if your charity care patients are enrolled in Project Access and we have an agreement with you for participation. (RCW: 4.24.300)

Don't forget, if your medical practice has existing patients who may qualify for Project Access, please don’t hesitate to refer their name and phone number to us. We’ll contact the patient for screening and possible enrollment. When enrolled, existing patients count as part of your Project Access pledge commitment. Please note patients cannot be eligible for Medicaid, Medicare or any other health coverage program. In addition, patients must provide proof of residency in Spokane County and proof of income.

Important Notice: Please don't forget to submit all of your Project Access patient claim forms to the PHCO! It is crucial we have documented data to support our grant funding. Even though you are providing charity care and you will not be paid for your services, you will receive credit for all the services you provide. The documentation helps us retain our funding so we can continue the program.

Please don’t hesitate to call us if you have questions or concerns about Project Access. For more information or to enroll as a participating physician, please contact Julie Lake at the Medical Society (532-8877). You can also contact Julie via email at julie@spcms.org.

Clear articulation in Medicare regulations states that providing charity care and not billing patients will not affect their Medicare reimbursement rates and is not a violation of regulations related to referrals between providers.

Project Access continues to enroll patients and coordinate with clinics and physician offices. We are so grateful to those physician offices and other health care providers for agreeing to see our patients. We continue to hear how grateful our patients are for the services being provided.

Last month we listed those physicians and others who have agreed to see our patients. As might be expected, a few were left out inadvertently. Our sincere apologies for the oversight. In particular, we wanted to point out Inland Imaging was one of our earliest and strongest supporters and they continue to see our patients whenever we ask them. We also noted our newsletter printer reformatted our update - resulting in some errors in the alphabetical listing. Therefore, we are again listing all of our Project Access participants as follows - and again, if you have pledged to take our patients and your office is not listed, please call us ASAP - this listing is current as of today, January 14th:

Advanced Dermatology & Skin Surgery, Alder Family Chiropractic Arthritis Northwest, Lauren C. Bathurst, D.C. (Cheney Spinal Care) Bender & Wurst Neurology, Berg and Sorensen Bond Chiropractic Health Center Leroy J. Byrd, M.D. Cancer Care Northwest, H. Kennedy Cathcart, M.D. Central Chiropractic, PLLC Child Neurology Christ Clinic, James Colquhoun, M.D. Columbia IPA Primary Care Physicians Community Health Association of Spokane Clinics - all of them! Cowley Center for Plastic Surgery (Alfonso Oliva, M.D.) Deaconess Medical Center Deer Park Hospital, Deer Park Physical Therapy Ronald Douglas, DPM, East Central Community Organization Clinic Eye Consultants Family Home Care Roger D. Fincher, M.D., Four Seasons Physical Therapy Timothy J. Gardner, M.D., Michael Golden, M.D. Heart Clinics Northwest Heart Institute of Spokane Holy Family Hospital Hospice of Spokane Houk Chiropractic Clinics House of Charity Clinic Infectious Disease Clinic of Inland Empire Gastroenterology Inland Eye Center Inland Imaging Inland Neurosurgery & Spine Associates Inland Orthopaedics of Spokane Inland Vascular Institute Internal Medicine Spokane Klock & Whitehouse Philip A. Lenoue, D.C., NATIVE Health of Spokane Neurology Associates Spokane North Market Chiropractic Clinic North Spokane Gynecology, North Spokane Pulmonary Clinic Northside Physical Therapy & Sports Rehabilitation Northwest Heart & Lung Surgical Associates Northwest Neurological Northwest, Orthopaedic Specialists Northwest Pediatric Cardiology Orthopaedic Specialty Clinic of Spokane Terri A. Oskin, M.D., Pathology Associates Medical Laboratories (PAML) Pearson & Weary Pain Relief Clinic Pediatric Associates of Spokane People's Clinic Physical Therapy Associates Rockwood Clinic Roybal Chiropractic Sacred Heart Medical Center, Shriners Hospital for Children Spokane Cardiology, Spokane Chiropractic & Sports Injury Clinic Spokane Digestive Disease Center, Spokane Ear, Nose & Throat Clinic Spokane Eye Clinic Spokane Falls Family Clinic Spokane Obstetrics & Gynecology, Spokane Respiratory Consultants Spokane Sports & Physical Therapy, Spokane Urology

Project Access is beginning its 4th month of operations and we're excited to report things are going very well. By January 1st, we will have over 100 patients enrolled and about the same number pending receipt of documentation. Our patients continue to tell us how grateful they are for this service. As we start our new year, we thought it appropriate to thank those physicians and other health care providers who have agreed to accept our patients. So here's our list as I write this update (which is December 8th!) - if your office has pledged to take our patients and you don't see your name/group, please call me ASAP!!!

We still have a need for general surgeons, endocrinologists and additional urologists. If your medical practice has existing patients who may qualify for Project Access, please don’t hesitate to refer their name and phone number to us. We’ll contact the patient for screening and possible enrollment. When enrolled, existing patients count as part of your Project Access pledge commitment. Please note patients cannot be eligible for Medicaid, Medicare or any other health coverage program. In addition, patients must provide proof of residency in Spokane County and proof of income.

Project Access continues to grow and we’re working hard to make sure it works smoothly for physician offices as well as patients. Our enrollment (which is for a maximum of 90 days for each patient) is approaching 100 and we have about 65 patients pending documentation. We continue to add physicians to our network; however, we still need some from sub-specialty areas. Please remember that if everyone participates, no one has to take an unfair number of charity care patients. All hospitals in Spokane County are participating and have been absolutely wonderful to work with as we put the processes in place. Special thanks to the financial services staff at both Empire Health Services and Providence Health Care for their support and advise – it’s been invaluable.

Another big vote of thanks to ancillary health care providers such as physical therapy and chiropractors – they have really stepped up to offer free slots to patients who may need their services.

Linda Crum has now joined the staff as our second patient care coordinator. Linda has many years experience in the health insurance industry as a provider relations specialist and knows many of the physician office staff. Our Project Access staff is now complete with one executive director (yours truly), one executive assistant (Liz Burris) who is in charge of us all, and our two patient care coordinators (Wendy Woods and Linda Crum). In addition, Stacey Blount serves as our communications, data tracking and web site coordinator.

Another, special thanks to Molina Health Care who let us “raid” their basement once again for office supplies and small office furnishings. This kind of support is so valuable since we don’t have to spend our limited resources on such items.

If your medical practice has existing patients who may qualify for Project Access, please don’t hesitate to refer their name and phone number to us. We’ll contact the patient for screening and possible enrollment. When enrolled, existing patients count as part of your Project Access pledge commitment. Please note patients must not be eligible for Medicaid, Medicare or any other health coverage program. In addition, patients must provide proof of residency in Spokane County and proof of income.

Please don’t hesitate to call us if you have questions or concerns about Project Access. For more information or to enroll as a participating physician, please contact Julie Lake at the Medical Society (509-532-8877). You can also contact Julie via email at julie@spcms.org.

Project Access staff are working feverishly to make sure Project Access is implemented smoothly and without complications for our patients and physicians. We opened officially on September 2^nd, and have been screening and enrolling patients as quickly as possible. As with any new program, we’ve had some “bumps” in the road but we ask that all physician offices remain patient and we’ll get everything worked out. Generally, operations are running smoothly. And along the way, we’ve even had some comical situations develop. Our patients are so grateful for the program and continue to tell us how it is helping them. We are collecting their “stories” and, sometime in the future, we will share some of them with you.

Although we still have a couple of gaping “holes” in our network, we continue to add physicians to our panel. We now have over 60% of local physicians pledged to take our patients. In addition, as noted before, we have all 5 Spokane County hospitals participating. We also have received strong support from allied health care providers such as physical therapy, home care, podiatry and chiropractors.

On October 16^th, we added our final staff member. Linda Crum is our second patient care coordinator and comes to us from Molina Health Care where she was a provider relations specialist.

We are especially grateful to those physician offices who have stepped up when we needed them immediately for a patient in crisis. And a special note of thanks to the PHCO for their strong support and help with our database management system and the pharmaceutical contracting. Our local funders continue to be strongly supportive as well: Foundation Northwest (our local funding partner), Providence Health Care, Group Health Community Foundation, Health Improvement Partnership, Community Health Plan of Washington, Washington Trust Bank, and the Yakima Valley Farm Workers Clinic. The main CHAS clinic and Spokane Falls Family Clinic have been our partners in screening and enrolling patients and this has helped us enormously.

If your medical practice has existing patients who may qualify for Project Access, please don’t hesitate to refer their name and phone number to us. We’ll contact the patient for screening and possible enrollment. Then these patients will count as part of your Project Access pledge commitment. Please note patients must not be eligible for Medicaid, Medicare or any other health coverage program. In addition, patients must provide proof of residency in Spokane County and proof of income.

For more information or to enroll as a participating physician, please contact Julie Lake at the Medical Society (325-5010). You can also contact Julie via email at julie@spcms.org.

On September 4, 2003 we celebrated the official launch of Spokane County Medical Society Project Access. Speakers included: Samuel Selinger, M.D., Medical Director Project Access; Mayor of Spokane John Powers; Spokane City Councilman Steve Corker; Mr. Skip Davis, CEO Providence Services Eastern Washington; Mayor of Liberty Lake Steve Peterson; Ms. Peg Hopkins, CEO CHAS Clinics; Ms. Sallie Neillie, Director of Health Access, Washington Health Foundation; and Ms. Kristen West, executive director CHOICE Regional Health Network, Olympia.

Dr. Selinger opened the proceedings with the following comments: “Welcome to our celebration of the launch of Project Access– the start of patient care - and our “thank you” to everyone who has helped us during development.

It is wonderful to look around and see so many of the people who have helped with the launch of Project Access during the last year and a half. Now here we are the first Project Access in the northwest to actually provide care for our neighbors. What is Project Access? Project Access is a physician led community partnership to provide the full range of medical care to the low income uninsured, those who do not qualify for any insurance. In our community 75% of low-income uninsured are working poor. At this time we have over 500 doctors signed up to donate care and we would like to thank them for their compassionate generosity. Through Project Access the physician, hospital and pharmacist care is all donated. However, funding is required for administration and at cost pharmaceuticals.

A second reason for celebration is the national recognition by the Robert Wood Johnson Foundation through an administrative grant of this community’s united effort. Foundation Northwest is our lead funding partner. This grant with matching community dollars will fund our startup and bring $800,000 of new money into Spokane.

Project Access is a story about bringing a community to life - one person, one group at a time to provide care for our neighbors. Project Access provides a common language and the ability to work toward a common mental model of what is being done and why. Project Access consists of doctors, nurses, hospitals, pharmacists, government, businesses, labor, churches and patients all working toward a healthier community, toward increased productivity and decreased absenteeism, and toward efficient access to primary and specialty care and pharmaceuticals.

Integral to obtaining the grant and starting Project Access was $100,000 for at cost pharmaceuticals from the City of Spokane. Other Project Access communities return $10 of charity medical care for every dollar of pharmaceuticals. We would like to thank the Mayor of Spokane and Spokane City Council for their leadership.

Both hospital systems in Spokane (5 hospitals) have agreed to treat Project Access patients without charge. We would like to thank Providence Services Eastern Washington & Empire Health Services. In addition Skip Davis, CEO of Providence Services Eastern Washington, had the faith to give us an initial grant so we could hire Julie Lake as full time executive director.

I mentioned earlier that funding for pharmaceuticals is important to the physicians who donate their services. (Why have a charity network if patients cannot access the medicines to recover health?) We have gone to most of the other cities with in the County to ask for a contribution ($1.25/ per population) to fund pharmaceuticals in all the cities. Spokane County has helped with money from a Community Block Grant. We have received endorsement and funding this year from Liberty Lake (Mayor Peterson), Medical Lake (Mayor Hill), Airway Heights (Mayor Perry) and as of 2 days ago Spokane Valley (Mayor DeVleming). We have also received endorsement and a promise to be included in the 2004 budget process from Cheney (Mayor Sooey), Deer Park (Mayor Wolfe), and Millwood (Mayor Baston). Thank you Mayor Peterson for leading this effort with the all these other cities.

Project Access is working closely with all the clinics in Spokane to improve efficiency and quality of care through rapid access to specialists. I would especially like to acknowledge the three federally qualified clinics: Native Health of Spokane (Ms Toni Lodge), Spokane Falls Family Clinic who has hosted us here (Mr. Carlos Olivares), and the Community Health Association of Spokane (Ms Peg Hopkins).

In closing, I would like to thank all of you, individually if at all possible, for helping take Project Access from theory to action. Project Access works because of the dignity, hope, determination and local passion. With your continued support we can document through stories and data how we have made our community healthier and more productive. The major challenge we face is funding for pharmaceuticals so patients do not return sick repeatedly because they are unable to fill their prescriptions. Please support us as we work with all government leaders throughout the cities and county of Spokane to fully fund this complement to the charity of doctors, hospitals and pharmacists.

There are now 22 Project Access programs in 14 states. Ours is the first in the Northwest. Look at the American Project Access Network online at www.apanonline.org.

By: Julie Lake, Project Access - Project Access staff are very busy getting ready for implementation on September 2^nd – since the 1^st is a national holiday, our actual start date is the 2^nd. We continue to recruit additional physicians and fine-tune our screening and enrollment processes. In addition, our database management system is now installed and usable. Wendy Woods, our patient care coordinator, is entering all of the participating physicians by groups and Liz Burris, our executive assistant, is double-checking reporting fields and required information.

On Thursday afternoon, September 4^th, we will have an official “launch” with our partners and sponsors at the Spokane Falls Family Clinic on West Mission. Local media plus city and county officials will be invited to celebrate our implementation of Project Access.

We have compiled our benchmark data in order to measure outcomes as effectively as possible. For example, patient’s self-reported health status – via the SF-12 health survey form – will be measured at enrollment and disenrollment – to determine if the patient reports an improved health status. One of our most important measures will be the cost of charity care delivered in the hospital setting, especially in the emergency department. Project Access in other communities has had a significant impact at keeping patients out of the emergency department since they are able to be seen for their health problems in a more appropriate setting, e.g. in the primary care setting or for specialty care as necessary.

Once implemented, Project Access will contribute to a healthier community, support businesses by increasing productivity and reducing absenteeism, and give low income, uninsured patients easier access to specialized medical care and prescription drugs.

For more information or to enroll as a participating physician, please contact Julie Lake at the Medical Society (325-5010). You can also contact Julie via email at julie@spcms.org.

By: Julie Lake, Project Access – Well it’s now official! A grant from The Robert Wood Johnson Foundation (RWJF) has been awarded to Spokane County Medical Society Foundation for administrative support of Project Access. The $425,000 matching grant will be received over a 36-month period beginning July 1^st of this year and was made under RWJF’s Local Initiative Funding Partners (LIFP) program.

To even be considered for the grant, the Spokane County Medical Society Foundation had to be nominated by a local funder and obtain local match funding. Those funds, totaling over $500,000 over the three-year period, have been pledged by Foundation Northwest (our local nominating funder), Providence Services Eastern Washington, Group Health Community Foundation, Community Health Plan of Washington, Yakima Valley Farm Workers Clinics, and Health Improvement Partnership. The total funding will bring in approximately $1,000,000 to the local Spokane economy over the three-year period. In addition, several local businesses donated in-kind services or furniture/equipment valued at well over $200,000. Those businesses include the Physician Hospital Community Organization (PHCO), Molina Health Care of Washington, Rotary Club Downtown, Kiwanis Club, Itronix and Premera Blue Cross.

The RWJF Local Initiative Funding Partners program is highly competitive. This year’s awards were selected from among an original national pool of 313 very strong applications. Of those, 80 were invited to submit full proposals and only 18 projects (less than 6% of the original applicants) were awarded RWJF matching funds. Using rigorous criteria, the LIFP program identifies community-based projects that develop new approaches and collaborations to resolve health care needs. Project Access is considered a potential national model by RWJF.

The Robert Wood Johnson Foundation, based in Princeton, NJ, is the nation’s largest philanthropy devoted exclusively to health and health care. It concentrates its grantmaking in four goal areas: to assure that all Americans have access to quality health care at reasonable cost; to improve the quality of care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social and economic harm caused by substance abuse—tobacco, alcohol, and illicit drugs.

In other Project Access news, with confirmation of the grant funding, we were able to hire two staff members. Liz Burris, an executive assistant, will not only coordinate all of the in-office administrative support but will also oversee the pharmacy program for Project Access participants. Wendy Woods, a patient care coordinator, will coordinate all clinic, physician and hospital patient referrals for Project Access. Wendy will also coordinate the screening and enrollment of prospective Project Access patients and the ongoing recruitment of all health care providers.

For more information or to enroll as a participating physician, please contact Julie Lake at the Medical Society (325-5010). You can also contact Julie via email at julie@spcms.org.

PROJECT ACCESS UPDATE – JULY 2003

By: Julie Lake, Project Access – We’re in a “holding pattern”, pending confirmation we will receive our grant funding from the Robert Wood Johnson Foundation. As noted last month, we expect to hear something this month (it’s now mid-June!). In the meantime, we continue to gear up for implementation on September 1^st. As part of our operational strategies, we’re feverishly working on establishing our baseline measures for the major outcomes we’ve set, e.g. health status improvement among the targeted population, reduced charity care costs, increased access to medical care and prescription drugs, etc. We’re also continuing our efforts to recruit physician participation. On that front, we have been very successful! Overwhelmingly our physician community has recognized the value of participating and have pledged to take their fair share of patients.

Within the next 3 weeks, we will hire a couple of staff. We will also purchase our computer software and two servers to accommodate the database management of patient enrollment and physician appointment scheduling. We’re also working on our “Provider Manual” and an internal “Operational Manual”.

On another front, we recently received the news we had been awarded a one year $30,000 grant from Foundation Northwest, our local Community Foundation! These funds will be used for administration. Foundation Northwest is our local nominating funding partner for the Robert Wood Johnson Foundation grant request. We’re particularly grateful to Peter Jackson and Candy Hanford, CEO and Vice President respectively, of Foundation Northwest for their invaluable assistance and advise with our site visit in March and the followup work done on our grant application.

For more information or to enroll as a participating physician, please contact Julie Lake at the Medical Society (325-5010 or 532-8877). Please note the 532-8877 phone number is new and was installed specifically for Project Access. You can also contact Julie via email at julie@spcms.org.

PROJECT ACCESS UPDATE – JUNE 2003

We continue to receive pledges from physicians for Project Access patients! We’re so grateful our physician community is supportive and understands that if we all take our fair share, we can make a big difference in the lives of the uninsured. While we continue to work with physician’s offices, we’re also finalizing operational processes such as eligibility screening, enrollment and referrals for the various places patients would present for treatment. The main medical society Project Access office, main CHAS clinic and Spokane Falls Family Clinic will all have full capability to screen and enroll patients. Other clinics and hospital facilities will refer patients directly to the medical society Project Access office. Another ongoing project is writing and producing a “Provider Manual” for physician offices to use to expedite the administrative process of seeing Project Access patients.

Sometime during late May or early June, we expect to hear from the Robert Wood Johnson Foundation on our grant request. Until that news is received, we’re somewhat in a “holding” pattern – planning to implement but not knowing for sure if we will be able to do so!

We did receive some good news on another grant application! The Community Foundation of South Puget Sound has awarded Project Access the maximum amount allowed of $25,000 – for the purchase of prescription drugs.

Lots of exciting developments to report this month! First of all, a big thanks to Itronix for the donation of a great laptop computer! It has made our work life here so much easier. The laptop came with all the above average amenities and we deeply appreciate the generosity of Itronix. Thanks should also go to Tom Burns, a retired business executive who volunteers his time with Project Access, for helping secure the donation. Secondly, we also wish to thank Molina Health Care of Washington for the donation of our office furniture and supplies. As you can imagine, both of these donations saved us a great deal of money since we do not have to purchase these items.

We've also been busy getting our pharmacy program organized and our local community has really stepped up. Following the City of Spokane's lead (you may remember our City Council voted unanimously to provide $100,000 for purchase of prescription drugs in 2003), several smaller incorporated cities (including the new City of Spokane Valley) have endorsed providing a per head amount of funding for prescription drugs.

Our pharmacy committee co-chairs (Doug Crafton, pharmacist/owner of Jones Pharmacy, and Kyle Downey, clinical pharmacist for the PHCO) are busy organizing the retail and chain pharmacies for their participation. In addition, our local Group Health offices have agreed to allow any Project Access patient to use the Group Health pharmacies located in the Group Health Care Centers.

We also received some good news recently about our application for some of the community development block grant funding. The Spokane County Housing and Community Development Department recommended Project Access for $20,000 and the Spokane County Commissioners approved the recommendation. Final approval must come from the U. S. Department of Housing & Urban Development. These funds would be used for the purchase of prescription drugs.

We have also recently stepped up our physician recruitment efforts. Physicians who have not been contacted earlier will shortly receive a letter with an enclosed pledge form. If your office receives such a letter, please feel free to contact this office for additional information or to request an in-office presentation.

Finally, we wish to thank Eastern Washington University for sending us an intern to assist with planning, especially physician recruitment. Since we're being especially frugal with administrative spending pending notice of our grant applications, the EWU intern is a godsend. As noted in last month's update, Eastern will also be assisting us with pre-implementation data collection and ongoing evaluation of the program.

As I write this, we are just a couple of days removed from our Robert Wood Johnson Foundation (RWJF) site visit (held on Friday, March 14th). Overall, we feel the site visit went very well and we were able to show the strong community support we have been able to attract for Project Access. In particular, the site visit team was impressed with our ability to obtain commitments for the local matching funds required by their grant request. If we are granted the full $500,000 from the RWJF, we have a local match of another $500,000 in place for the three year grant period. That means our community would have $1,000,000 in funding available for this project. We don't expect to hear anything about our grant request until early to mid-May at the earliest. The final award would be announced by the RWJF in mid to late June, with funding scheduled at 6 month intervals beginning in mid-July.

We would like to thank all those who took time out of very busy schedules, in the middle of a work day, to attend the site visit and express their strong support to the RWJF site visit team. They include Peter Jackson and Candy Hanford, CEO/President and Vice President respectively of Foundation Northwest (our lead funding partner); Cynthia Norwood, CEO of the PHCO; Garman Lutz, CFO of Empire Health Services; Sharon Fairchild, a Vice President for Sacred Heart Medical Center; Bill Akers, District Administrator for Group Health Cooperative; Carlos Olivares, Executive Director for the Yakima Valley Farm Workers Clinic (parent of the local Spokane Falls Family Clinic); Abie Castillo, Director of Community Health Plan of Washington; Karen Slean, Spokane Operations Manager for Molina Health Care of Washington; Dorothy Detlor, Dean of the Intercollegiate College of Nursing; Dee Martin, Dean of the College of Business & Public Administration for Eastern Washington University; Dan Baumgarten, Executive Director for the Health Improvement Partnership; City of Spokane Mayor John Powers; Spokane City Councilmen Dennis Hession and Steve Corker; Doug Crafton, Pharmacist/Owner of Jones Pharmacy; Kyle Downey, Clinical Pharmacist & Chief Information Officer for the PHCO; Brad Harland, CPA for the Spokane County Medical Society; Dr. Bob Hartman and Dr. Doug Norquist, President and Vice President respectively of the Spokane County Medical Society; Kim Thorburn, Chief Health Officer of the Spokane Regional Health District; Barbara Savage, Vice President for Mission Services with Providence Services of Eastern Washington; and Nancy Wilbert, Assistant Clinic Administrator for Spokane Falls Family Clinic.

Our internal work team also deserves an enormous debt of thanks for their hard work and dedication: Dr. Sam Selinger, founder and medical director for Project Access; Jan Monaco, CEO of the Spokane County Medical Society; Karen Hagensen, Operations Manager for the Spokane County Medical Society; Tom Burns, our community liaison with the business community; and Liz Burris, Project Access administrative assistant. A site visit of this magnitude requires a great deal of planning and hand wringing. With the additional outstanding support of the Deaconess Health & Education facility staff, the site visit was considered a success.

We now begin more operational planning, including a renewed focus on physician recruitment and detailed pharmacy operations. While we have over 300 physicians committed to Project Access, an intern loaned to us by EWU will assist with reaching out to the remainder of the physician community. Our pharmacy committee will now focus on how to implement that piece of the project. We will also be working closely with the EWU Institute for Public Policy & Economic Analysis to collect and analyze benchmark data. Eastern Washington University will be our partner in data collection, analysis and outcome studies. In each of the other nationwide Project Access sites, a local university has been intimately involved in this piece of the project.

For more information or to enroll as a physician participant, please contact Julie Lake at the Medical Society (325-5010) or via email at Julie@spcms.org.

Since our last update (written in mid-December), Project Access has been notified Community Health Plan of WA will contribute $30,000 in funds to use for administration and as part of our local match in the event we receive funding from the Robert Wood Johnson Foundation. In addition, Dr. Sam Selinger presented to the Regional Chamber of Commerce Policy Committee – for endorsement of Project Access as a program which will be good for local business. Due to the economic downturn, both statewide and specifically in Spokane County, the uninsured population is expected to increase significantly. In addition, due to the severe budget constraints in Olympia and the governor’s proposal to delete adults with no children from the Basic Health Plan, an even larger number of low income uninsured is expected.

As indicated in our last update, during the first quarter, we will be concentrating on recruitment of physicians. Accordingly, a recruitment package will be sent to all physician groups not currently enrolled as participants in Project Access. When considering participation, please remember all potential patients are rigorously screened for financial eligibility (if eligible for Medicaid or any other insurance, they are not enrolled in Project Access). Project Access patients cannot have an income exceeding 200% of the Federal Poverty Level (currently $23,880 for a family of 2). In addition, patients must sign a “Responsibility Agreement” which explains their responsibility to show up for appointments on time. Project Access staff in the Medical Society call all patients within 24 hours of their appointment as a reminder and to make sure they have transportation. Patients who “no show” a second time – without a valid reason – are immediately dropped from the program. Patients are enrolled for only 90 days – although the enrollment may be extended at the request of a physician – and are re-screened for eligibility every 3 to 6 months to determine ongoing eligibility and the need for treatment.

We recognize Project Access is not the final solution to our health care system’s problems and is, at best, a temporary “patch”; however, we feel it does help physicians – who already see many “free” patients – better manage and coordinate the care of these patients.

For more information or to enroll as a physician participant, please contact Julie Lake at the Medical Society (325-5010) or via email at Julie@spcms.org.