Performance Improvement 2003. Bureau of Primary Health Care


Assessment of Selected Domestic Violence Programs in Primary Health Care Settings

This assessment profiled in-depth the domestic violence programs and protocols of nine Bureau of Primary Health Care (BPHC) funded community-based primary health care centers. The protocol, the foundation of a clinical domestic violence program, served as the plan for identifying and responding to individuals who have experienced domestic violence. Primary health care providers across the country are beginning to acknowledge family and intimate partner violence (FIPV), or domestic violence, as one of the most prevalent and serious public health issues affecting millions. Although domestic violence has devastating consequences for women, men, and their families, it disproportionately affects women. The domestic violence programs identified as complete in this assessment shared features, and developed other unique elements to enhance their program’s service mix and ability to respond to the needs of the communities they serve. Most programs profiled in this assessment served racially, ethnically, and culturally diverse populations, and were located in rural and urban settings. Attempts to highlight programs that were geographically dispersed across the United States were also made during the program selection process. To prevent domestic violence and change social attitudes regarding its acceptance, the majority of domestic violence programs profiled in the assessment conducted some form of outreach or education for their clients and the general public regarding domestic violence.

FEDERAL CONTACT: Dr. Shari Campbell, 301-594-4251 PIC ID: 7284

PERFORMER: North American Management Company, Alexandria, VA


Enabling Services and Perinatal Care: Final Report

Providing enabling services -- key strategy used by all Bureau of Primary Health Care grantees, may include transportation, translation, case management, health education, nutrition counseling and outreach--are not typically reimbursed under managed care. The purpose of this study was to: analyze the types and levels of enabling services provided by Community Migrant Health Centers (C/MHCs), determine how these services have changed, and analyze whether enabling services improve outcomes and reduce costs. The study drew upon aggregate data from the BPHC Uniform Data System, the annual report submitted by all grantees. A total of 650 grantees filed reports in 1996 and 1997. In 1997,  enabling service personnel accounted for almost one-quarter of total direct care staff, and sample grantees expended $211 million on these services (about 13% of total direct service cost). About 95 percent of grantees provided case management and health education services. At the other end of the spectrum, under 20 percent provided child care on-site or operated food banks and/or delivered meals. It was found that health center prenatal care users are twice as likely to be teenagers, and twice as likely to be Hispanic, than is the case for the US prenatal population. As a whole, about 72 percent of C/MHC grantees have specialized obstetrical staff; the average grantee with specialized staff has 1.3 OB- GYN/Certified Nurse Midwife full-time employees. The report concludes that the breadth of perinatal services, coupled with staffing that promotes continuity of care, contribute to appropriate and timely use of prenatal and after-delivery services by mothers and infants.

FEDERAL CONTACT: Fred Butler, 301-549-4281 PIC ID: 7126

PERFORMER: MDS Associates, Inc., Wheaton, MD

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