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Community Health Works
A Regional Center for Health Innovation
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Health Care Central Georgia dba Community Health Works (CHW), a multi-sector nonprofit organization in Central Georgia, has been leading a cohesive, regional effort for years to improve the health of residents and bolster the capacity of the local health care community. Over the past decade, Community Health Works has transformed from a small organization, to a broad-based alliance of leaders and regional partners representing the top minds in business, government, academia, information technology, and healthcare. Now entering into its second decade, CHW continues the successful evolution to meet the health needs of Central Georgia and the ever-changing landscape of healthcare. 

Community Health Works was originally organized over a decade ago, when a group of local leaders organized a coalition of more than one hundred regional leaders to discuss ways in which they might collaborate to better serve the needs of central Georgia's uninsured and medically underserved residents. After extensively studying the current state of uninsured medical care in the region, the collaborative applied for and received a Communities in Charge grant from the Robert Wood Johnson Foundation to develop a region wide enrollment-based healthcare program to serve both adults and children who lack regular access to primary care. During the course of this initial grant, CHW grew into a vertically integrated network of almost 100 physicians, 2 clinics, 22 pharmacies, 2 behavioral health providers, 8 public health departments, 5 hospitals, and multiple social service agencies focused on assuring access to a full continuum of preventive, primary, and specialty care; necessary labs and diagnostics; life-sustaining pharmaceuticals; and health promotion and disease management. This network, known as Rx for the Uninsured, received significant additional funding from Health Resources Services Administration’s Healthy Communities Access Program (HCAP) and was recognized throughout the state and across the nation with awards and commendations from the Georgia Hospital Association, the Georgia Rural Health Association, the Office of the Governor of Georgia, the Robert Wood Johnson Foundation and the National Association of Counties.

Meanwhile, Community Health Works convened Central Georgia healthcare leaders to work on establishing a coalition to fight cancer through education and early detection efforts. That effort resulted in the establishment of the Central Georgia Cancer Coalition in 2003 to connect cancer patients, cancer survivors, and cancer care providers to available resources, enhance the continuum of care and reduce health disparities through cancer education and prevention, screening, and treatment. The Coalition currently represents over 650,000 people in 26 central Georgia counties and works closely with regional health partners, including the Cancer Life Center at The Medical Center of Central Georgia, Houston Healthcare, First Choice Primary Care, Oconee Regional Hospital, and Taylor Regional Hospital, among others. 

In 2004, the Georgia Governor’s Office of Planning and Budget invited Community Health Works to be one of four Georgia organizations to investigate ways to assist employers in providing affordable workplace-based health insurance coverage. This effort has culminated in Middle Georgia Multi-Share, a program designed to bring traditional employer and employee contributions together with non-traditional funding, to decrease the cost of providing health insurance.

As HCAP funding began to dry up, Community Health Works began focusing on other ways to increase access to affordable, high-quality primary health care and to ensure that all individuals, regardless of insurance coverage, have a primary care medical home. To that end, CHW worked with local stakeholders to develop plans and secure funding for First Choice Primary Care, a federally qualified health center located in Bibb County. After helping establish FCPC, CHW conducted extensive planning throughout the service area and determined that additional counties were ready to receive and support similar care centers. This resulted in the establishment of Monroe Primary Care, a Rural Health Center supported by the Monroe County Hospital and a secondary office of First Choice Primary Care located in Houston County. In addition, CHW received a Health Center Planning Grant to lead a year-long planning project to determine an optimal healthcare delivery mechanism for Peach County.

In 2008, Community Health Works devoted a great deal of time, energy and other resources to a major facilitation project. We were one of six organizations in Georgia to be awarded a Rural Health Safety Net Planning Grant from the Georgia Department of Community Health’s Office of Rural Health. Our charge was to create a plan for improving health and healthcare in Central Georgia, and to fulfill the charge, we facilitated Consumer, Provider, and Business Community Workgroups. Working with the Georgia Health Policy Center, we conducted research and provided the workgroups with information to enable them to make decisions and select choices that have the potential to make Central Georgia one of the most innovative regions in the country when it comes to health and healthcare delivery— and to provide the State of Georgia with a $180,000,000 return on its investment. 

CHW also assisted its healthcare partners in proper implementation of Health Information Technology (HIT). Seeing the lack of creditable, nonbiased, vendor neutral HIT resources in the area, CHW is now leveraging its capacity to provide HIT resources to the entire Central Georgia community as a whole. As the local designee for the Georgia Health Information Technology Regional Extension Center administered by the National Centers for Primary Care at Morehouse School of Medicine, CHW workes with local partners to support and enable medical professionals throughout Central Georgia to adopt meaningful use of EHR (Electronic Health Records), and thus meet new regulatory guidelines and qualify for government incentives. The end goal of the initiative is to develop a seamless HIT network among physicians, hospitals, clinics, behavioral health and ancillary medical providers in order to improve patient care and efficiencies throughout the regional health system. 

Realizing that prevention is one of the best ways to effect the overall health of the region, Community Health Works, launched the Central Georgia Regional Health Summit (CGRHS) in October of 2009 aimed at discovering ways to prevent and reduce the impact of chronic disease associated with obesity, sedentary lifestyle, tobacco use, and other unhealthy behaviors. The Health Summit serves as a multi-year, health promotion and chronic disease prevention initiative whereby residents and community leaders from our seven-county core service area are working together, across sectors, to reduce obesity and unhealthy behaviors and support healthy living through local programs, policies, and improvements to the built environment. A critical outcome of the summit was that leaders from each county agreed to meet quarterly in separate county-wide groups to discuss local health issues and to convene once a year as a seven-county regional health summit. The quarterly meetings in each county offer opportunities for various stakeholders to become involved creating community-specific action plans, while the annual summits provide critical opportunities to share best practices and lessons learned, to celebrate the previous year’s accomplishments, and to set the pace for the coming year. To date, more than 170 individuals from across seven central Georgia counties are working closely with CHW staff and partners to develop community action plans to end obesity and prevent chronic disease in the region by supporting efforts to play, work, and live healthy every day. In addition, this model of community action through local and regional coalition building has met with concrete success, evidenced by the practical implementation of action projects, including walking trails, farm-to-school initiatives, a “day without TV” for young people, senior center wellness programming, and pilot distribution of healthy, farm-fresh foods through local churches. Of particular note are CHW’s Mulberry Street Farmers’ Market initiative, which established and continues to promote a year round producers-only farmers’ market, and CHW’s Veggie Van program, which is one of Georgia’s only mobile farmers’ markets targeting the underserved population in food deserts using EBT cards.

 

Major Milestones in Community Health Works' History

 

  • July 2000: Volunteers Plan CHW
  • January 2001: $700,000 Robert Wood Johnson Foundation Grant
  • June 2001: Rx for the Uninsured program begins
  • August 2001: $966,873 Community Access Program Grant
  • February 2002: $200,000 DCH Demonstration Grant and $200,000 Access Georgia Grant
  • May 2002: Rx for Uninsured expanded to all seven counties in region
  • December 2002:  CHW begins work on Central Georgia Cancer Coalition
  • April 2003: More than 60 Physician Volunteer Partners
  • July 2003: 2500 members screened and over $1,400,000 medicines obtained
  • February 2003: Georgia Health Policy Center Evaluation shows Rx for Uninsured Members use ER 13% less and are hospitalized 27% less
  • April 2004: Free Medicines Acquired for Members Totals $900,000
  • July 2004: National Association of Counties Best Rural Program Award; $14,300,000 Total Care Coordinated
  • August 2004: $998,998 Healthy Communities Access Program Grant; GHPC Evaluation shows Rx for Uninsured use ER 31% less and are hospitalized 49% less
  • July 2005: Department of Community Affairs Commissioner visits Community Health Works
  • August 2005: $699,299 HCAP Grant; $200,000 Cancer Regional Program of Excellence Grant; $84,000 CGCC Care Giver Grant
  • October 2005: Georgia Rural Health Association names Dr. Fred Gaton Outstanding Rural Practitioner of Year and Drs. Patton Smith and J. Ray Grant Outstanding Rural Practice of Year
  • May 2006: Houston County Teen Health Forum Reaches 2000 Teenagers; $30,000 Susan G. Komen Foundation Grant; $145,000 Healthcare Georgia Foundation Multi-share Grant
  • March 2007: $32,000 Prostate and Colorectal Cancer Grant awarded by DCH
  • July 2007: $250,000 Regional Cancer Centers of Excellence Grant (Now called the Regional Cancer Coalitions of Georgia, or RCCG)
  • December 2007: $307,000 awarded by Georgia DCH to expand the Rural Health Safety Net
  • December 2007:  $20,000 Community Development Block Grant awarded by the City of Macon for Dental Health Access Program
  • July 2008: $46,690 HRSA Care Management grant awarded
  • February 2009:  $62, 500 awarded by DCH for the development of Monroe Primary Care
  • September 2009: $80,000 Crawford Peach Health Center Planning Grant awarded by HRSA
  • October 2009: Community Health Works kicks off the first year of the Central Georgia Regional Health Summit initiative
  • January 2010: Quarterly action planning meetings commence in each of the seven core counties for the Regional Health Summit initiative
  • February 2010: Central Georgia Stroke Coalition is organized and begins strategic planning
  • July 2010: Community Health Works becomes local designee for the Georgia Health Information Technology Regional Extension Center, administered by the Centers for Primary Care at Morehouse School of Medicine
  • September 2010: Community Health Works engaged by the Georgia Department of Community Health to establish the Federally Qualified Health Center (FQHC) Development Incubator Program
  • January 2011: Community Health Works partners with the American Cancer Society and Americans For Nonsmokers’ Rights to lead the Breathe Easy coalition effort for the city of Macon.
  • April 2011: CHW partners with Macon Roots and the City of Macon to launch the Mulberry Street Market, an outdoor farmers’ market selling local produce.
  • May 2011:  Bibb County’s Ingram-Pye Elementary School hosts inaugural “Farm to School” event introducing locally grown strawberries to provide more healthy options to school lunches; CHW partners with Children’s Healthcare of Atlanta to host “Strong 4 Life Unplugged” event at Central City Park in Macon.
  • July 2011: CHW implements debit, credit and EBT card reader at the Mulberry Street Market in downtown Macon and the International City Farmers’ Market in Warner Robins. EBT card users receive double their dollars thanks to a grant with Wholesome Wave Georgia.
  • September 2011: CHW launches Veggie Van food access initiative; CHW reached a major milestone of providing HIT assistance to over 400 primary care providers throughout Central and Southeast Georgia.
  • March 2012: CHW recognized by the Health Information and Management Systems Society (HIMSS) to the Leaders and Innovators Strategic Advisory Panel.
  • May 2012: CHW introduces Free Mammogram Reminder Service.
  • September 2012: CHW recieves Farmers' Market Promotion Grant to help promote, organize, and sustain the Mulberry Street Farmer's Market.
  • October 2012: CHW recieves USDA Farm to School Grant to assist Peach County Schools in introducing fresh locally grown produce into their school lunch menus.

 

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