By Cristina Alcorta
In March 2014, members of the Geisel Urban Health Scholars traveled to Louisiana over spring break to spend time exploring health care and community service in New Orleans. Read all the entries from their trip here.
Happy St. Paddy's Day! Today we had the honor of meeting with Dr. Eboni Price-Haywood at the Ruth U. Fertel/Tulane Community Health Center.
Patient access to care (or lack thereof) was the most striking concept to witness and discuss with health professionals of Louisiana. We listened intently to Dr. Price-Haywood of Tulane Community Health Center as she offered insight on the various issues health-care providers faced on a daily basis. Louisiana already had a “broken” health-care system before Hurricane Katrina hit in 2005. There were several problems at the state level, including misuse of emergency rooms, the low number of insured individuals, and the lack of funding allocated to community health centers. There were some Federally Qualified Health Centers, but not nearly enough to meet the needs of the communities in New Orleans, let alone the rural areas of the state. Overall, Louisiana was (and perhaps still is) one of the poorest states with the worst health outcomes.
In some ways, Hurricane Katrina offered a new beginning to restructure the Louisiana health system. Providers from several community clinics united to create the 504 Health Net, a safety net of providers that worked to meet four important goals:
1. Improve the quality of care
2. Create a standard electronic medical record (many paper records had been lost in the hurricane)
3. Increase community health-care centers, incorporating mental health into primary care
4. Create a medical model of team-based care
In 2007 the region received a $100 million grant from the Centers for Medicare and Medicaid Services (CMS) to promote the sustainability of these four goals along with other funding sources. Although initially the state received multiple grants and donations for the improvement of care and support for Katrina victims, that money began to dwindle after a few years. Clinics ran into the difficulty of maintaining stability and recovery. New Orleans powerfully supports the restructuring of its health-care system by creating organizations such as policy advocating groups and student-run free clinics. However, Dr. Price-Haywood stated that the struggle for stability continues and that the work towards acquiring funding runs on a day-to-day basis. She knows the money will come, but she is never sure from where.
It was wonderful to tour this clinic and learn about the different projects the Tulane Community Health Clinic conducts in order to promote community empowerment. Many of these projects promote both physical and mental health. The center has a community room in which classes are taught about shopping for and cooking healthy food, computer literacy, and texting. Many of these classes are taught by Tulane medical students, who are required to fulfill a service component before graduating. Mental health resources focused more on group discussions, smoking cessation conversations, and mind-body meditation.
We greatly appreciated the time Dr. Price-Haywood took to give us an overview of the issues in the pre- and post-Katrina eras, and how the community strongly continues to build itself anew.