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Robin Kish: Keeping our community healthy in Palm Beach County. That's what the Health Care District strives to do through its own programs and through the work of other agencies that are also making a difference. How does it work? We'll break it all down for you next in Here for Your Health. Welcome to the Health Care District of Palm Beach County's podcast Here for Your Health. I'm your host Robin Kish. The Health Care District is a unique healthcare system located in Palm Beach County, Florida. We provide County residents access to primary care, hospital and school health services, skilled nursing and long-term care, and life saving trauma and air ambulance services. Through all of these programs, the Health Care District focuses on filling the gaps in the healthcare delivery system and being the safety net for Palm Beach County. One of the ways the Health Care District addresses the needs in the community is by working with and funding programs and services delivered by community organizations. On this edition of Here for Your Health, we'll discuss how the Health Care District goes the extra mile through its Health Care District in the community program. Our guest today is Tom Cleare. The Assistant Vice President for Planning and Community Engagement for the Health Care District. Welcome Tom.

Thomas Cleare: Thanks. It's good to be here.

Host: Tom, how is the Health Care District going the extra mile with its programs designed to deliver services through community organizations?

Thomas Cleare: Oh, the Health Care District delivers many services directly, but the district does not provide all healthcare services. So one of the ways that District fulfills its mission to be the healthcare safety net for Palm Beach County is by leveraging community organizations and the important services they provide, to better meet the needs of Palm Beach County residents. The District really enhances its services by partnering with these community organizations.

Host: Can you tell our listeners more about how the Health Care District enhances its services by working with community providers?

Thomas Cleare: Well, the District currently delivers a wide range of services and those services include a hospital in the rural area of Western Palm Beach County, nursing home, federally qualified health centers around the County, the school health program, the places a nurse in Palm Beach County schools, an air ambulance and trauma program for traumatically injured patients, in a specialty benefit program and pharmacy program for the District's clinic patients. So to sort of enhance and build upon those programs the District identifies each year, what additional programs and services it would like to help provide in the community through partner organizations and leveraging the services of these partner organizations. Truly enhances and extends the services of the District.

Host: Palm Beach County is fortunate to have a really robust network of community agencies that help underserved residents. How does the Health Care District identify which additional organizations best compliment the district's mission?

Thomas Cleare: The District tries to identify programs or that we are not providing ourselves, so for example, we might contract with a community organization to provide durable medical equipment, something that we don't provide directly through our programs. Also, over the years we found that sometimes we funded community organizations that provide services that we do provide, but they provide them in a geographic area that we don't cover by one of our clinics for example.

Host: Overall who benefits from these services?

Thomas Cleare: The services are intended to reach uninsured, under insured, and medically needy populations throughout Palm Beach County. These are the same populations that the Health Care District serves through our clinics hospital and other programs. And often these community organizations serve a niche in the market. So for example, we've had organizations over the years who provide eye exams and eyeglasses to uninsured patients, specifically targeting children. We really like those kinds of programs since they serve an unmet need in the community and they already have an existing patient base. Often the only thing holding these organizations back from serving more patients is funding.

Host: So Tom, it's almost like the Health Care District helps lift up these programs with needed services and in the end lifts up the health of the community at the same time.

Thomas Cleare: It really does. And you know, these organizations are doing such wonderful work out in the community and just having a little bit of assistance from the Health Care District and being able to partner makes a huge difference.

Host: So does the Health Care District require that the organization already provide the service before funding them?

Thomas Cleare: It's not a requirement that, you know, the organization be providing the services. We've had organizations that already deliver some services in the community, add to their services through the funding that the Health Care District has provided. So I'll give you an example an organization, Healthy Mothers, Healthy Babies in Palm Beach County has been an existing community partner offering a centering pregnancy program for prenatal care. This past funding cycle, they proposed an entirely new service, their Circle of Moms program that supports mental health needs of pregnant and postpartum women.

Host: How are organizations like Healthy Mothers, Healthy Babies, which you just mentioned, selected for the Health Care Districts in the community program?

Thomas Cleare: Well, each Fall the Health Care District solicits proposals from community organizations and in their proposals and organization is going to identify the services they provide, the population that will be served and then the specific requests for funding to be able to deliver that service. And then the Health Care District takes that proposal. And with an internal committee sort of pulling from the different expertise we have within our various entities in the organization and recommends them, recommends awards for the programs and recommends the amount of funding for the programs.

Host: What are some of the other types of services that are delivered through these community organizations?

Thomas Cleare: Well for 2020 the Health Care District is funding community organizations that provide medical care, behavioral health and substance use services and social services that address the social determinants of health.

Host: You know, a lot of our listeners who are familiar with the Health Care District may expect that the agency is funding medical and behavioral health services, but they may not have expected to hear that the District is funding social services. Can you elaborate on the services being provided to address what are known as social determinants of health?

Thomas Cleare: Yeah, you're absolutely right. It's not the typical healthcare services most people would think of. The research has really shown that social determinants of health sort of go hand in hand with good health outcomes. So food insecurities, homelessness, transportation barriers and legal challenges to being able to access healthcare are all social determinants of health among others that really have a direct impact on an individual's health. So for example, you know, how can a diabetic adequately control their blood sugar if they did not know where their next meal would come from? Or how can a patient adhere to their treatment program if they are homeless? The social determinants must be addressed, really optimize health outcomes. And since the Health Care District doesn't provide social services directly, it makes a lot of sense to engage community partners who do that work to provide those services.

Host: And what you're saying makes so much sense when someone has to potentially choose between putting food on the table and buying medications and so forth. So with that in mind, what are the other community organizations that the Health Care District is funding and what services do they provide?

Thomas Cleare: Let's go through the list of those community organizations. That's such wonderful programs and I'll sort of highlight, you know, the service that the District has partnered with them for. But these organizations provide you know, far more services than even we're partnering with. But I'll start with the seven organizations that are providing services that address social determinants of health. The Cancer Alliance of Health and Hope is providing transportation and supplemental nutrition services for the clients and patients they serve. Care Dad Center is screening patients and providing legal housing and food assistance. The Glades Initiative, a program in Belle Glade in the Western part of Palm Beach County, is providing nutrition education and they're teaching residents how to eat healthy for less by preparing healthy meals on a limited budget feed. The Feed the Hungry Pantry provides weekly food to seniors and disabled clients and their families. The Legal Aid Society helps resolve unmet legal needs and remove legal barriers that impede access to care. My clinic, a clinic in Jupiter, Florida provides health outreach awareness and referral services all with the intent of connecting them to social services, medical services or behavioral health services that they may need. The South Florida Hunger Coalition provides a food pharmacy and these, they pop these food pharmacy centers up that deliver food in this case specifically to patients with diabetes, with the food being provided, having been looked at by a nutritionist specifically designed for that diagnosis.

Host: And we know that's so important for good health outcomes when it comes to that population. You know, I can't help but notice all of these programs help improve access to quality healthcare, which is exactly what the Health Care District focuses on in all of its programs. And we know from various needs assessments that behavioral health services are sometimes difficult to access. The Health Care District CL Brumback primary care clinics provide behavioral health services. What kind of behavioral health services does the District help to fund and provide through community providers?

Thomas Cleare: Yes, this is a great example of how the Health Care District extends and really enhances the services that are provided through the CL Brumback Primary Care Clinics. The clinic staff, psychiatrists, psychologists, and mental health counselors as part of their integrated behavioral health model, the district then works through its community partners to provide very focused behavioral health services to further enhance access in the community. So Catholic Charities provides mental health first aid training. The Center for Child Counseling provides behavioral health services in the form of individual family and group therapy. The Center for Family services provides mental health and substance use counseling. The Center for Trauma Counseling provides therapies for those who suffer from various forms of trauma, abuse, depression, suicidal tendencies, and post traumatic stress disorders. Families First, they provide behavioral health services and targeted outreach for pregnant women at risk for HIV. Mental Health America of Palm Beach County provides behavioral health screenings, helpline assistance and referrals and peer mentoring. And the National Alliance of Mental Illness provides psychiatric hospital discharge support. So you can see that some of these are just very targeted and specific services that there's just a gap and these organizations are able to come in and really fill that gap.

Host: It's an impressive network and there are more. You mentioned earlier that some of the community partners also provide traditional medical services. Can you share a little bit about those community organizations?

Thomas Cleare: Yes. we have a really unique organization. One clinics can help is their name and their organization provides durable medical equipment, DME to vulnerable populations. Community Health Center of West Palm Beach provides vision services and chronic disease management and the Diabetes Coalition provides risk assessment screenings, care coordination and self management training.

Host: Tom, can we go back to something you mentioned earlier, services for pregnant women. Can you explain those as well as services for the homeless and other underserved patients in need of medical services like specialty care?

Thomas Cleare: Yes. And as previously mentioned Healthy Mothers, Healthy Babies and they're providing this pregnancy centering program and they do this at multiple locations throughout the County where groups of pregnant women come together for this really nationally recognized program for prenatal care. And then their newer program, the Circle of Moms program is providing maternal mental health services to pregnant women and postpartum women. Just great programs. The Lord's Place is a program here in Palm Beach County that's providing health support and coordination of services for homeless individuals and their families. And the Palm Beach County Medical Society Services provides care coordination and linkage to providers through their project access initiatives. And this is where physicians will volunteer to provide office visits, procedures, even surgeries to uninsured residents who have really no other option.

Host: This really is an impressive list of community organizations and such important services they provide to the community.

Thomas Cleare: It really is. You know, we're very fortunate in Palm Beach County to have this wonderful group of community organizations that are really committed to meeting the needs of the community.

Host: Tom, thanks for joining us today. This is such an important topic and I'm sure there are some organizations that folks who might be able to avail themselves of these services didn't know about until now.

Thomas Cleare: Well, thanks so much for having me. It's been a pleasure.

Host: Thank all of you for joining us today to learn how the health care district goes the extra mile through the health care district and the community program. To learn more about our community funded agencies, visit our website at www.hcdpbc.org/resources/sponsored-programs and you can check out our other Health Care District podcasts at healthcaredistrictpodcasts.org. Today's podcast is brought to you by the Health Care District of Palm Beach County. If you or someone you know needs a medical home or a primary care provider, please call the Health Care District CL Brumback primary care at 561-642-1000 to make an appointment or visitwwwdotbrumbackclinics.org.