Project Access-New Haven (PA-NH) increases access to medical care and services for underserved individuals in the Greater New Haven area.
Project Access-New Haven (PA-NH) was founded in 2009 by a group of dedicated physicians who were concerned about inadequate access to care – and resulting health disparities – in Greater New Haven. They partnered with local hospitals, community-based health centers, physician groups, community organizations, and other stakeholders to assess the problem and explore ways to improve care for the underserved. They identified the Project Access model, which has been implemented in over 150 other communities across the U.S., as a promising approach for addressing community needs and created PA-NH to pursue this mission. PA-NH increases access to care for underserved individuals in Greater New Haven by expanding the network of care available to this population and providing intensive patient navigation to ensure that they are able to access high-quality, comprehensive, culturally competent care in a timely and coordinated fashion.
Our Urgent Specialty Care program utilizes a volunteer provider network to provide free medical care to low-income, uninsured adults with urgent medical conditions. This is made possible through partnerships with 300+ local physicians, Yale-New Haven Hospital (YNHH), and many other providers and partners that provide services free of charge to our patients. For example, YNHH donates a full spectrum of ancillary services and hospital-based services (e.g., diagnostic testing, surgical facilities, inpatient care), Quinnipiac University donates physical therapy and radiology services, Metro Taxi provides free taxi rides to medical appointments, Quest Diagnostics provides free laboratory testing, and VNA Community Healthcare donates home-based care.
A hallmark of PA-NH is our model of intensive patient navigation, which helps patients overcome barriers that may prevent them from accessing medical care in a timely fashion. Upon enrollment, each patient meets with a Patient Navigator for an extensive intake interview that includes a review of health status and needs, health literacy assessment, and discussion of potential barriers to care. Our team then works closely with the patient to coordinate care and remove barriers, for example by scheduling and reminding them of appointments, helping them understand medical information, assisting with transportation, translation, or other services, ensuring follow-through with recommended care or treatment, and connecting them with other community resources.
While Urgent Specialty Care remains our largest program, we have expanded our programming to reach larger and broader populations of underserved patients. From 2013-2015 we conducted a pilot program for Medicaid-insured, frequent users of the emergency department (ED) designed to increase engagement in primary care and reduce avoidable ED visits and hospitalizations. In August 2015 we launched a Breast Health Navigation program that ensures timely diagnostic testing and follow-up for women with abnormal breast cancer screenings and comprehensive treatment for those diagnosed with cancer. In April 2016, we began a Colonoscopy Screening Program that provides free colonoscopies and recommended follow-up for low-income, uninsured individuals. Finally, in July 2016, we launched an innovative eConsult Program that allows primary care providers at Fair Haven Community Health Center to obtain electronic consultations (eConsults) from Yale Medicine specialists for Medicaid patients.
Our primary need is financial support for general
program operations. Through the incredible generosity of our volunteer providers and community partners, we are able to provide urgently needed medical care to underserved patients at no cost. However, we have an ongoing need for financial support to sustain the patient navigation services and administrative functions that allow us to mobilize these donated healthcare resources and ensure that our patients receive care in a timely and coordinated fashion. Our unique volunteer provider network allows us to generate a substantial return on investment in terms of the value of medical care provided to those in need for each dollar spent on program operations. In 2015, for each dollar invested in PA-NH, $8.95 of donated medical care was provided to our patients.
Dear Friends & Supporters,
Project Access-New Haven (PA-NH) has been providing urgently needed medical care to underserved Greater New Haven residents since September 2010 and I am so proud of what we have accomplished in just six years. Most importantly, we have served over 1,600 individuals and coordinated the delivery of more than $28 million in donated care to those in need. Our incredible team of bilingual Patient Navigators helps patients overcome access barriers and ensures that they receive this care in a timely and coordinated fashion.
Our Urgent Specialty Care program is now in its seventh year of operation and continues to meet a critical need in the community. This program provides donated medical care and services to uninsured patients with urgent medical needs and is made possible through partnerships with physicians, hospitals, community organizations, and businesses that provide free services to our patients. While Urgent Specialty Care remains our largest program, we have expanded considerably in the past year. In August 2015, we launched a Breast Health Navigation program that provides patient navigation for uninsured and underinsured women with abnormal breast cancer screenings to ensure that they receive timely and appropriate diagnostic testing and follow-up. Those diagnosed with breast cancer also receive intensive navigation to support them through cancer treatment. This program has been very successful and was recently awarded the 2016 Power of Pink Innovative Program of the Year award by Susan G. Komen of Southern New England. Most recently, we launched an Electronic Consultation (eConsult) program that allows primary care providers at Fair Haven Community Health Center to obtain eConsults from Yale Medicine specialists for Medicaid patients and provides patient navigation for those referred for specialty office visits or test through the eConsult process. eConsults are an innovative approach to improving access to specialty care for Medicaid patients. To our knowledge, ours is the only eConsult program in Connecticut to incorporate navigation or care coordination.
With the rapidly changing healthcare environment in the U.S. and Connecticut, it is important to adapt and respond to the healthcare needs of underserved individuals in our community on an ongoing basis. Toward this end, we recently completed a strategic planning process that culminated in the development of a new 3-year strategic plan. This provided a wonderful opportunity to reflect on how much we have accomplished to-date and establish a framework to guide growth and expansion in the coming years.
I hope that the information on this website illustrates our substantial accomplishments and steadfast commitment to our mission of increasing access to medical care and services for the underserved in Greater New Haven. With an outstanding staff and devoted Board of Directors, we continue to strive to be the community champion for access to care for those most in need. While I realize that there are many options for charitable giving in Greater New Haven, I hope you will recognize the value in the meaningful work that we do and consider supporting PA-NH.
With warm regards, Darcey Cobbs-Lomax MPH, MBA Executive Director
Seven years ago, a small group of community physicians met in the cafeteria of Yale-New Haven Hospital. We were committed to understanding and responding to the problems we faced obtaining medical care for individuals without health insurance. Although the problems of access were myriad, we focused on urgent specialty care. With the support from the Yale University-Robert Wood Johnson Clinical Scholars program, we researched best practices across the country and determined that a system of patient navigation would give our neediest patients the opportunity to access services in a timely fashion.
We had tremendous support from our community of physicians, who chose to donate their care to our patients. These physicians also were our first financial supporters, offering the seed money to start our project. Soon after, we received an initial grant from the Community Foundation for Greater New Haven. Yale-New Haven Hospital offered resources, personnel, office space, and financial support. The hospital also generously donated all ancillary and hospital-based medical care for our patients. As time passed, our organization began to take root and grow. We created wonderful relationships with Fair Haven Community Health Center, Cornell Scott-Hill Health Center, Yale Surgical Co., Metro Taxi, Quinnipiac University, Yale University, Quest Laboratory, and many others.
Today, we are a well-established community-based nonprofit organization. We are very proud of our many achievements. To date, we have provided patient navigation services to over 1,600 patients and the value of donated medical care provided through PA-NH is estimated to exceed $28 million. Our patients keep 97% of their appointments, make fewer trips to the emergency room, and report improved health and quality of life in the year following enrollment. Our patient navigation model provides support by creating close relationships with our staff through frequent contact, which helps to ensure that our patients complete their medical care. Our model of patient navigation has been presented at several national forums and is informing discussions about innovative models of healthcare delivery. These achievements would not have been possible without the generous support of our friends, volunteers, donors, and volunteer providers.
As the health care landscape changes regionally and nationally, we will continue to advocate for the medically underserved. Unfortunately, barriers to care prevent timely and appropriate access for many of our neediest patients, regardless of insurance status. We are continually working to address these concerns and be the community champion for access to care for those most in need. We are grateful for the strong support we have received from the New Haven community and are looking forward to continuing to work together to improve access to care for our neighbors in need.
The PA-NH Urgent Specialty Care program provides free medical care and services to low-income (≤250% Federal Poverty Level), uninsured adults with urgent medical conditions who reside in Greater New Haven. This is made possible through our extensive volunteer provider network, which includes 300+ local physicians, Yale-New Haven Hospital, and many other providers and partners that provide services free of charge to our patients. At the center of the program are Patient Navigators who coordinate care and remove access barriers. Upon enrollment, each patient meets with a Patient Navigator for an extensive intake interview that includes a review of health status and needs, health literacy assessment, and discussion of potential barriers to care. Our team then works closely with the patient to coordinate care and remove barriers, for example by scheduling and reminding them of appointments, helping them understand medical information, assisting with transportation, translation, or other services, ensuring follow-through with recommended care or treatment, and connecting them with other community resources.
We are committed to rigorous evaluation of our program and utilize
a variety of tools to monitor progress and measure outcomes and impact.
Operational data, including referral and enrollment rates, wait-times and
show-rates to appointments, patient navigation activities, and amount, type,
and value of services provided, are collected on an ongoing basis using an
electronic patient tracking system and reviewed monthly. In addition, patients
complete an extensive intake interview and are surveyed one year after
enrollment to assess health status and needs, quality of life, health literacy,
access/barriers to care, health service utilization, and program satisfaction.
A provider survey is also conducted periodically to measure satisfaction and
obtain feedback for program improvement. Health care utilization and cost data
are obtained through our collaboration with YNHH. Finally, we have a long-standing partnership with the Yale University-Robert Wood Johnson Foundation (RWJF) Clinical Scholars Program. Several Scholars helped found PA-NH and were influential in developing our initial evaluation processes and tools. We continue to collaborate with RWJF Clinical Scholars on projects that advance our research and program evaluation agenda.
The Urgent Specialty Care program has served over 1,300 individuals. These patients have shorter wait-times (14 days) and higher show-rates
(97%) for medical appointments compared with similar, non-PA-NH patients
who seek care at hospital-based specialty clinics (estimated to be 6 weeks-1 year and 66%). They also report improvement in health and access to care when surveyed at intake and 1-year follow-up. They are more likely to say their health is "excellent" at follow-up (15% vs. 4%) and less likely to report “fair/poor" health (37% vs. 54%). The percent who say their health did not limit their usual activities in the past month increases from 53% to 70%, and the percent who were limited for 15+ days – a substantial negative impact on quality of life – decreases from 18% to 10%. Nearly all (96%) report improved access to care and fewer say they delayed getting needed care in the past year (11% vs. 46%).
PA-NH Patient Testimonials:
"I was embarrassed having to ask for help after losing my job and health benefits, but the Project Access staff took the time to understand my situation with grace, and treated me with dignity. I will be forever grateful.”
“They would call me to ask me how my appointments went and it made me feel like they cared about my health... Before the program, I was only able to work 3-4 hours a day. Now I am able to work more hours which helps me and my daughter financially. I am very grateful for Project Access.”
“The cataract surgery eliminated my disability. I have a much better quality of life and greater enthusiasm for reading, which is my hobby. There really are no words to describe my appreciation for the help I received.”
The PA-NH Breast Health Navigation Program provides patient navigation to underserved women in Greater New Haven who have abnormal breast cancer screenings. Services are designed to promote timely access to - and utilization of - appropriate follow-up testing and treatment, link patients with community resources, and educate and support patients and their families as they move through the Breast Cancer Continuum of Care. Our model of navigation emphasizes patient engagement in care, builds trusting relationships between navigators and patients, breaks down barriers that may prevent patients from accessing care in a timely fashion, and facilitates the delivery of compassionate, culturally competent care.
In July 2016, we launched an innovative eConsult Program that allows primary care providers (PCPs) at Fair Haven Community Health Center, a local community-based, federally qualified health center to obtain electronic consultations (eConsults) from Yale Medicine specialists for Medicaid patients. Medicaid patients often experience barriers to specialty care due to shortages of physicians who accept Medicaid, long wait-times for appointments, and social factors that limit their ability to follow through with appointments and medical care. eConsults can improve care for this population by providing PCPs with expeditious access to specialty expertise, increasing their ability to manage care in the primary care setting, and reducing avoidable specialty office visits. Our program also patient navigation to individuals who are referred for specialist office visits or testing via the eConsult process to remove access barriers and ensure timely care. To our knowledge, ours is the only eConsult program to incorporate patient navigation or care coordination in the state of Connecticut. We are currently working to expand the program to include additional specialties and referral sites.
Our community partners and funders include:
Indirect Public Support HelpIndirect public support represents revenue received through solicitation campaigns. This includes funding United Way and other federated fundraising organizations, but does not include donor designated contributions.
Earned Revenue HelpEarned revenue represents income generated in direct exchange for a product or service.Earned income includes income from government contracts.
This profile, including the financial summaries prepared and submitted by the organization based on its own independent and/or internal audit processes and regulatory submissions, has been read by the Foundation. Financial information is inputted by Foundation staff directly from the organization’s IRS Form 990, audited financial statements or other financial documents approved by the nonprofit’s board. The Foundation has not audited the organization’s financial statements or tax filings, and makes no representations or warranties thereon. The Community Foundation is continuing to receive information submitted by the organization and may periodically update the organization’s profile to reflect the most current financial and other information available. The organization has completed the fields required by The Community Foundation and updated their profile in the last year. To see if the organization has received a competitive grant from The Community Foundation in the last five years, please go to the General Information Tab of the profile.
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