The SKYCAP/Kentucky Case Study involved a series of initial e-mail and telephone contacts followed by telephone-based structured interviews with 14 key stakeholders in the Southeastern Kentucky safety net. Stakeholders included senior leadership in SKYCAP, staff at the Kentucky Primary Care Association, and directors and IT staff at consolidated health centers, clinics, and area hospitals. Providers interviewed included both participants of SKYCAP and non-participants. All respondent organizations are listed below in Table 1. The majority of the stakeholders we spoke with were located in Harlan and Perry counties near Hazard, KY.
Consolidated Health Center Respondents
|Mountain Comprehensive Health Corporation||MCH comprises Kentucky’s largest CHC network, serving approximately 33,000 clients in 190,000 encounters in 2002. MCH is an CHC located in Whitesburg, KY. The main clinic site sits outside the SKYCAP service area.|
|Harlan/Perry Health Care for the Homeless Center||Harlan/Perry HCH is located in Hazard, KY and is the only primarily BPHC funded center squarely within the SKYCAP service area. They provide primary care through contracts with clinics, volunteer physician networks and on-site at area shelters.|
Non-Consolidated Health Center Respondents
|Hazard Appalachian Regional Healthcare (ARH) Medical Center||Both of the hospitals in the SKYCAP region are owned by ARH. We spoke to a physician and administrator who practice at these hospitals and who were involved in the planning stages of SKYCAP.|
|Clover Fork Clinic||Clover Fork Clinic is a primary care community clinic located in Evarts, KY (in Harlan County). The clinic describes itself as being close to a look-alike FQHC and sees 18,000 annual visits in the medical unit.|
|East Kentucky Family Practice Clinic||EKFPC is a rural health and primary care clinic affiliated with the University of Kentucky Center for Excellence in Rural Health (UKCRH). They are applying for FQHC status in the next grant cycle. The clinic sees around 5,000 annual client visits.|
|SKYCAP Program||The SKYCAP program is a rural health outreach and client tracking program serving the underinsured and uninsured of Perry, Harlan, Knott and Leslie counties in Southeastern Kentucky.|
|Kentucky Primary Care Association||KPCA is the statewide primary care association. Based in Frankfurt, it provides its members with services related to provider recruitment, cooperative purchasing, consulting, information, and training.|
|Data Futures, Inc.||Data Futures, Inc. is a Hazard-area software vendor that developed the SKYCAP MIS software.|
|Harlan Countians for a Healthy Community, Inc.||One of the co-administrators of the SKYCAP Program, Harlan Countians for a Healthy Community is a coalition of health care providers, consumers, and other interested agencies formed to improve the health care system in Harlan county.|
Structured interviews with respondents were conducted using open-ended discussion guides. In addition, a tabular form was emailed to information technology staff at 5 respondent health centers prior to the site visit to facilitate collection of standard information relating to infrastructure and technical capacity. For each structured interview, the NORC team prepared materials that outlined our preliminary knowledge of the respondent and highlighted outstanding questions to address during the interview. Examples of discussion guides and preparation materials used in the site visit are included as Appendix A. The table used to gather data on clinic technical infrastructure is provided as Appendix B.