LAWNDALE CHRISTIAN HEALTH CENTER

IN THE EARLY 1980S, A GROUP OF LAWNDALE RESIDENTS DETERMINED THAT THE COMMUNITY DESPERATELY NEEDED A LAUNDROMAT AND A HEALTH CENTER. WORKING THROUGH LAWNDALE CHRISTIAN CHURCH, BOTH THE LAUNDROMAT AND LAWNDALE CHRISTIAN HEALTH CENTER (LCHC) WERE FOUNDED. LCHC, NOW A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER, SERVES SIX ECONOMICALLY DISTRESSED COMMUNITIES (NORTH LAWNDALE, SOUTH LAWNDALE, EAST GARFIELD PARK, WEST GARFIELD PARK, ARCHER HEIGHTS, AND BRIGHTON PARK) ON CHICAGO'S WEST SIDE. LCHC WORKS OUT OF SEVEN SITES TO PROVIDE ACCESS TO A FULL SPECTRUM OF AFFORDABLE, HIGH QUALITY PRIMARY HEALTH CARE SERVICES TO LOW-INCOME PATIENTS. LCHC HAD CLINICAL VISITS OF APPROXIMATELY 222,000, WHICH INCLUDED APPROXIMATELY 188,500 MEDICAL VISITS (FAMILY PRACTICE, INTERNAL MEDICINE, OBSTETRICS/GYNECOLOGY, PEDIATRICS, AND CARDIOLOGY), APPROXIMATELY 16,500 DENTAL VISITS, APPROXIMATELY 12,800 BEHAVIORAL HEALTH VISITS AND APPROXIMATELY 4,600 OPTOMETRY VISITS. APPROXIMATELY 18% OF THESE VISITS ARE PAID FOR ON A SLIDING SCALE BY PATIENTS WHO HAVE NEITHER PRIVATE NOR PUBLIC HEALTH INSURANCE COVERAGE. ANOTHER 63% OF CARE IS PAID FOR BY MEDICAID, 7% BY MEDICARE, AND 12% BY OTHER.

AT LCHC, THE HEALTH SUPPORT SERVICES DEPARTMENT STAFF MEMBERS COLLABORATE WITH THE PRIMARY CARE PROVIDERS TO ADDRESS PATIENTS' SOCIAL AND BEHAVIORAL HABITS THAT LIMIT THEIR ABILITIES TO ACHIEVE OR MAINTAIN GOOD HEALTH. THE DEPARTMENT CONSISTS OF TWO MAJOR AREAS: CHRONIC DISEASE AND MATERNAL AND CHILD HEALTH. MATERNAL AND CHILD HEALTH PROGRAM PROVIDES CASE MANAGEMENT TO MOTHERS AT-RISK FOR COMPLICATED PREGNANCIES AND PROVIDES EDUCATION ON PARENTING AND RELATIONSHIPS. THE CHRONIC CARE PROGRAM EMPHASIZES DISEASE MANAGEMENT, HEALTH AND NUTRITION EDUCATION, AND PHYSICAL FITNESS IN EIGHT KEY AREAS INCLUDING CHRONIC DISEASES SUCH AS ASTHMA, DIABETES, HIV, AND CARDIOVASCULAR DISEASE THAT AFFECT SO MANY PATIENTS. THE CHRONIC CARE PROGRAM WAS CREATED TO FOCUS ON PROVIDING EDUCATION AND SELF-MANAGEMENT TO PATIENTS WITH THESE THREE CHRONIC DISEASES. THE PROGRAM'S STAFF INCLUDES EDUCATORS, A REGISTERED DIETICIAN, A NUTRITIONIST AND OUTREACH WORKERS WHO PROVIDES SCREENING AND EDUCATION THROUGHOUT THE COMMUNITY. THE CHRONIC CARE MODEL, IMPLEMENTED UNDER THE AUSPICES OF HRSA'S BUREAU OF PRIMARY HEALTH CARE, CONSISTS OF SIX INTERRELATED COMPONENTS (COMMUNITY LINKAGES, HEALTH SYSTEMS, SELF-MANAGEMENT SUPPORT, DELIVERY SYSTEM DESIGN, DECISION SUPPORT, AND CLINICAL INFORMATION SYSTEMS) THAT PROMOTE QUALITY HEALTH CARE FOR PEOPLE LIVING WITH CHRONIC ILLNESSES. THE STANDARD MODEL FOR PRIMARY CARE IS A VISIT-BASED MODEL THAT EMPHASIZED THE TREATMENT OF ACUTE SYMPTOMS IN THE CONTEXT OF A ONE-ON-ONE CLINIC VISIT BY A PATIENT WITH A PROVIDER; THIS MODEL FOCUSES ON THE CHIEF PRESENTING PROBLEM. IN A PCMH MODEL OF CARE, A TEAM OF HEALTH PROVIDERS (PHYSICIANS, NURSES, PSYCHOLOGISTS, HEALTH EDUCATORS, ETC.) COLLABORATE TOGETHER WITH PATIENTS TO IMPROVE THEIR HEALTH AND ENCOURAGE OVERALL WELLNESS. THE PCMH MODEL, WITH ITS EMPHASIS ON CARE COORDINATION, IS ESPECIALLY APPROPRIATE FOR LOW-INCOME PATIENTS WITH CHRONIC DISEASE AND FOR POPULATIONS EXPERIENCING HEALTH DISPARITIES. CHRONIC CARE EDUCATORS PLAY A KEY ROLE IN THIS MODEL.