The mission of Damian Family Care Centers is to:
- Improve the health status of our patients;
- Provide staff who are culturally sensitive and appropriately credentialed to diagnose and treat our patients;
- Provide care to the underserved populations;
- Provide safe quality primary and specialty services regardless of language, cultural barriers or ability to pay.
DFCCs was originally established as Samaritan Health Services, in 1996, by Samaritan Village, Inc. (SVI), and a large residential and outpatient drug treatment program. Recognizing the important linkage between primary care and populations in need of substance abuse treatment, SVI had previously incorporated primary care clinics at each of its residential drug treatment facilities.
These co-located health centers have been operational for approximately twenty years.
The DFCCs system performs approximately 56,000 patient encounters annually and has approximately 6,004 unduplicated users. Four of our six clinical sites (Starhill, Highbridge, 53rd Street and Ellenville) are co-located within residential drug treatment communities owned and operated by Samaritan Village, Inc. (SVI) and Palladia, Inc. These are two large not-for-profit agencies offering a wide-array of services to substance abusers with long histories of chemical dependency, incarceration, homelessness, HIV/AIDS, Hepatitis C (HCV), mental illness and multiple chronic disease co-morbidity. The co-located 53rd Street Health Center is beginning to provide medical services to approximately 170 homeless males, and continues to provide care to 48 Mentally Ill Chemically Abusing (MICA) veterans in recovery who reside at the SVI 43rd Street Veterans Residential Drug Treatment Program. Our free-standing Damian Family Care Center (DFCC) is immediately adjacent to a large SVI residential drug treatment program whose clinical program focuses on individuals with Co-Occurring Disorders (COD’s). In coordination with SVI, DFCCs is now providing care to returning veterans from Iraq and Afghanistan who suffer from chemical dependency, mental illness and cognitive brain disorders induced by battlefield trauma. Twenty-five female veterans reside in a new facility located in Ellenville. Additionally, SVI has opened another veteran’s facility in Richmond Hill whose residents receive their specialty medical care with the DFCCs.
In March 2012, DFCCs opened our sixth site, the Fire House Health Center, 162nd Street Jamaica, NY, 11432. DFCCs is proud to have built this site with New York State Department of Health HEAL Queens funding. We received this grant to construct a health center in the 11432 Jamaica zip code to replace services lost to the community due to the closure of Mary Immaculate Hospital. The Fire House has a comprehensive license. This site is providing services to a large pediatric and adolescent population and continues to grow new users on a daily basis.
In 2012 DFCCs responded to City of New York Department of Health and Mental Hygiene Negotiated Acquisition for the Provision of Correctional Health Care Services to Inmates in New York City Jails. Through this competitive process, DFCCs was awarded a contract to provide comprehensive health care services within two Detention Centers. In October 2013, DFCCs began providing health care services including substance abuse/criminal behavior services at the Vernon C. Bain Center (VCBC) located in the Bronx, N.Y. VCBC houses approximately 860 male offenders on a daily basis and logs over 18,000 admissions per year. The average length of stay for these inmates is 44-48 days. DFCC has worked closely with NYCDOHMH Correctional Health Services to establish protocols of care and intends to administer this site within FQHC design and format. We believe, DFCCs is developing and implementing a new model of care for correctional health facilities.
Clinical Services: DFCCs has a long history of service to the underserved. Since receiving our FQHC status, we have strengthened our care systems and added new components, including the Health Disparity Collaborative Model, which have furthered our ability and reputation to serve the dominant health conditions present in our community, including HIV/AIDS, Hepatitis C (HCV), diabetes, cardiovascular disease, mental illness, asthma, smoking cessation and sexually transmitted diseases. In addition to these conditions, many of our patients present with co-morbidities, multiple chronic health conditions along with mental illness. Our systems and staff are designed to address these critical health care needs in a comprehensive, one-stop approach.
Our success at developing the systems required by the underserved in our community and particularly our targeted efforts to meet the needs of low income and homeless individuals has created significant demand for services. DFCCs has witnessed an increase in our homeless since 2003. Services to our homeless patients have increased nearly 400% and accounts for 68% of our current population.
All DFCCs health centers are located in communities designated as Medically Underserved Areas (MUAs) and four are located in Health Professional Service Areas (HPSAs). Our Target Population includes the people in the service areas with incomes below 200% of the federal poverty level (FPL), including: adults and children without access to health insurance, people with HIV/AIDS and/or Hepatitis C, and individuals and families with histories of chemical dependency, mental illness, incarceration and homelessness. Approximately 85% of the patients receiving care at DFCCs have recent and long histories of incarceration and approximately 60% enter our program after discharge from Riker’s Island or from Alternative to Incarceration Programs. The Target Population mirrors the ethnic/racial minorities in the service area.
Immigration has been a key issue in our Target Population. People’s ability to increase healthy behaviors and improve their health status and the overall health of the community is influenced by the conditions in which they live. A healthy environment includes adequate housing, neighborhood resources such as food markets, parks, community services including day care and safety is essential in preventing disease and promoting overall community health. The DFCCs Target Population has a high incidence of not graduating from high school, living in poverty and feeling unsafe in their neighborhoods. In Jamaica alone, 27% of people over 25 did not graduate from high school; 38% are immigrants and 41% feel their neighborhood is unsafe.
Access to Care: DFCCs continues to meet the targets for increasing unduplicated users and patient encounters as outlined both in our competitive grant and budget renewal applications to the Bureau of Primary Health Care. Since 2003, DFCCs has increased our HIV population by 31%, increased our unduplicated dental users by 42%, have received both state and national recognition for our comprehensive Hepatitis C prevention and treatment program. We provide comprehensive HIV medical and specialty care, risk-reduction education and comprehensive case management to individuals with HIV/AIDS.
Homeless Services: DFCCs received additional funding for Expanded Medical Capacity for Homeless Services. This additional funding has permitted us to expand our model of care focusing on the fundamental issues related to homelessness and health care. Homeless individuals are at higher risk for abuse, have unstable housing, manifest behavioral health problems, have cognitive and physical impairments, are at high risk for communicable disease and have serious and complex medical problems. We believe the model of care for these individuals should include clinical sites that provide a broad array of clinical and enabling services, provide integrated and interdisciplinary services, is a flexible service system and provides access to a mainstream system for health and human services. DFCCs continues to believe the first door a homeless person enters should lead to all of the other service doors the individual may require.
Governance: DFCCs continues to have a Board of Directors fully compliant to all 330(e) regulations. The DFCCs Governance Business Plan focuses on Board growth, development and sustainability that is essential for long-term survival and growth of the organization. There is over one-hundred years of recovery on the Board and three members were formerly homeless.
Participation in the Primary Care Health Information Consortia (PCHIC): In 2007, DFCCs was selected a Wave One participant in the NYCDOHMH Primary Care Information Project (PCIP) Electronic Health Record Project and was awarded software licenses enabling DFCCs to replace our existing outdated and unsupported practice management system (Healthpro) and install an electronic health record. DFCCs has virtualized our HIT network to seven sites to provide the redundancy required for the health record. DFCCs installed eClinicalWorks, a totally integrated practice management system and electronic health record and went “live” with the practice management system on July 2, 2007. DFCCs also received several very generous hardware awards from City Council funding. DFCCs went live with our Electronic Health Record (EHR) in March 2008. Our entire system is linked to the EHR through our HIT network and we are now able to share our demographic data with other agencies, including the NYSDOHMH. Additionally, DFCCs is a founding member of the Interboro Regional Health Information Network (RHIO) and participates with 38 FQHCs in the HRSA funded Health Center Controlled Network (HCCN), the NYS HCCN.
Medical Home and Meaningful Use: DFCCs is a Level 3 Medical Home, has received NCQA certification. We continue to file our Attestations for Meaningful Use and have either achieved or succeeded current parameters for payment.
NYSDOH Medicaid Health Homes: DFCCs is proud to announce acceptance into several NYSDOH Medicaid Health Homes. Specifically we are Class B members of Coordinated Behavioral Care, Inc. (CBC) a partnership of over 60 not-for-profits community based primary care, behavioral health, substance abuse, homeless, housing and other social service organizations. DFCC is also a member in the Health and Hospital Corporation Medicaid Health Home in Queens, the Bronx and Manhattan.
Conclusion: DFCCs mission and our past and current actions of expanding our model of care demonstrate our continuing commitment of expansion to include providing care for underserved populations. We believe strongly in the partnership model and have developed niche markets for providing care to foster patient care activities to increase access to appropriate care, reduce health disparities through the chronic care model and provide a broad continuum of cost-effective integrated services by providing a "medical home" concept.