The URL can be used to link to this page

97-181��¢�`,� r ' $ 1 S t Ls t F. �s..r :� �. o c.m RESOLUTION Counoil File # �1 1� t� l Green Sheet # ��` SAINT PAUL, MINNESOTA Presented By Referred To Committee: Date a� R'HEREAS, with the closing of the American Indian Health Clinic in May of 1996, many individuais 2 lost their health care provider, and were faced with finding a new health care options; and 4 WHEREAS, the staffs of the Ramsey County aud Saint Paul Health Clinics have recognized this 5 need, and haue agreed to contract with the Neighborhood Health Care Network to provide health caze 6 services to the American Health Clinic clients; and 7 8 WHEREAS, the plan calls for an RN Outreach Worker to be housed at the American Indian Family 9 Center, and for clients to be refened to altemative neighborhood health clinics for primary health care, health 10 promotion and general family services; and 11 12 WHEREA5, the Ramsey County Boazd of Commissioners has approved a Purchase of Services 13 Agreement with the Neighborhood Health Care Network on December 17, 1996 for the period of January 1, 14 1997 through December 31, 1997 ; now therefore be it 15 16 17 18 14 20 21 22 23 24 25 26 RESOLVED, that upon the recommendation of the Mayor, the Council of the Ciry of Saint Paul does hereby approve participation in the joint CityfCounty effort on behalf of the American Indian Health Clinic clients; and be it FURTHER RESOLVED, that the expenditure of 1997 Community Development Block Grant funds budgeted for the American Indian Health Clinic be utilized in accordance with Attachment A, entitled Service Delivery Plan; and be it FINALLX RESOLVED, that the proper City officials aze hereby authorized to enter in an Agreement with Neighborhood Health Care Network for the provision of health care services to American Indian Health Clinic clients as outlined in Attachment A. Requested by Department o£: By: /[� Adoption Certi£ied by Council Secretary BY � �� .a_..._ ,`\ Approved by Mayor: Date � ��7 �' Approved by Mayor for Submission to Council By: ✓ � _ �t� -�8l UEP11RiMB1TAFFlCEiCOUNCN. DATE INITIA7E J� J J,� HealthDept\PED o�f>o�q� GREEN SH CONTACfPERSONSPFWNE INITIA T INITIAL/DATE m DEPPRTMENT DIAE CITY CAUNCIL Diane Hohngren 292-7712, Bob Hammer s6669 ��GN CRV ATfOpNEY t ITY CLERK NUYBERFOP ) MUST BE ON CAUNGIL AGENDA BY (�AT� RWnNG BUW Ef DIRE `❑ FIN. & MGT. SERVICES DIR. NA OflDEN MAYOR (OR ASSISTAN'� � Bob Hammer, TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REQUESTED: Approval of attached Resolntion wHl aIlow the City to eater into an Agreement with the Neighborhood Heatth Care Nerivork to coord'mate and provide health care services on behalf of former American Indian Health Cliuic clients. RECOMMEN�ATIONS: Approve (A) rn Rejact (R) PEpSONAL SERVICE CONTRACTS MUST ANSWER 7HE FOLLOWING �UESTIONS: _ PLANNING COMMI$$ION _ CIVII SEFYICE GOMMISSION �� Has this personRirm ever worked under a conVact for this departmentt _ CIB COMMIT7EE _ YES NO _ STAFF 2_ Has this personftirm ever been a c�ty employee? — YES NO _ DISTfliCT COURT _ 3. DoES thi5 erson/firm p possess a skill not normally ppssessed by any curtent cfry employee7 SUPPORTS WHICH COUNqL 0&1ECTIVE? YES NO Explain all yes answers on separete sheet and ettach to green sheet INITIATMG PROBLEM, ISSUE, OPPpRTUNITY (Who, What, Whan, Where, Wtry): Both the City's and Ramsey Connty's budgets provide funding for Saint Paul neighborhood health clinics. With the closure of the American Tndian Health Clinic last year, the commnnity lost a siguiticant service provider. To help insure health care for this popnlation� the City of Saint Paul and Ramsey Couaty propose to reallocate the Native American Health Clinic funds to the Neighborhood Health Care Netwark. TLis organization will, in turu, provide criHcal community outreach, client referral to altemative providers, and reimbursement for semces when appropriate. Ramsey Connty has formaIly approved this strategy and funding reallocation. ADYANTAGESIFAPPROVED: . S "' �'' F . _ .- . Former cliettts of the American Indian Health Clinic will be pmvided tvith heatth care services. , � E B �;_ j� g� C �� I i �i� f��5�� DISADVANTAGES IFAPPROVED: R�� ouncil Research Cenfer None �� ' ��" F�� 1 � 3997 �dVAYO�"S �FF1C� DISADVANTAGES IF NOT APPROVED: C7ients of the American Indian Health Clinic will not be provided with ontreach, mferral and direct health care services. TOTAL AMOUNi OF TRANSAC710N $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO FUNDIfdG SOURCE AC71VI7V NUMBER FINANCIAL INFORlhAT10N: (EXPlA1N) °►'� - i �' � Option for Redistribution of 1997 City and County American Indian Health Clinic Funding �th the closing of the American Indian Health Clinio in May of 1996, many individuals who received health services from tius clinic were faced with the chailenge of finding a new provider and transferring their health care. Clients of the clinic included American Indian persons from the Saint Paul and Raznsey County area, as well as residents of the East Side of Saint Paul. During 1995, the American Indian Health Clinic reported to the City aud the County that Ramsey County clients made 4,069 visits for medical services and 1,926 visits for dental services. Of these visits, 1,327 medical visits and 164 dentai visits were made by Saint Paul low income/uninswed persons. Some of the former clients of the American Indian Heaith Clinic have received healih care services from the other c4mmunity clinics in Saint Paul. The Neighborhood Health Care Network, through their 489-CARE referral system, has assisted former patients in locating a new medical or dental provider. Many of the obstetrical clients were uansfened to North End Medical Center who hired the American Indian Health Clinids Nurse Pracfitioner. This transfer of care provided some continuity of care for these individuals, and helped ensure continued access to prenatal services. Some dental cfients have transfened care to Model Cities Health Center, However, there is concern that many clients have simply foregone medical and dental care while either waiting for the clinic to re-open, or due to lack of resources to obtain care elsewhere. The American Indian Family Center recently opened at the former locadon of the American Indian Health Ciinia lt is andcipated that the Family Center staff will be referring clients ta the community clinics as well. Since funding for this clinic has been allocated by both the City and the County for 1997, an interim solution is proposed to handle the distriburion of these funds to serve individuais who previously received care, or would have received care, from the American Indian Health Clinic. PROPOSAL The funds which are available from the City of Saint Paul and Ramsey County through the 1997 allocation for the American Indian Health Clinic total $86,750. The proposed use of these funds includes two elements: 1. Hiring a.8 FTE Registered Nurse (RN) through the Neighborhood Health Care Network (conhacting with one of the community clinics), who would be officed at the American Indian Family Center, providing services primarily related to q-1. �� -��' � 2. outreach and education, and would refer peopie to the community clinics for health services. Distribution of the remaining funds to ffie other community clinics to help cover the ea�penses far providing medical and dental care to: - former patients of the American Indian Health Clinic - persons referred to clinics by the RN menfioned above - persons refernd from the American Indian Family Center to one of the community clinics for health care - persons living on the East side of St. Paul BUDGET Funding: $32,849.OQ $53,901.00 $86,'750.00 Expenditures: -13,013.00 -35,Q00.00 $48,013.00 $38,737.00 Ramsey County City of Saint Paui - COPPiCDBG (7une 199b - May 199'n TOTAL 15% overhead/admin fees for oversight, contract, etc. by Neighborhood Health Care Network Salary, fringe, expenses for .8 FI'E RN hired Remaining funding availabie for services provided by the clinics Clinics would be reimbursed on a"per visit" basis, at the rate of $55.40 per visit. This rate is utilized by the Health Care for the Homeless program wlrich also refers people to the community clinics for services. This wouid support 704 visits made to the clinics during the year. Cluucs would seek other reimbursement for persons covered by medical assistance or insurance. A-� t 'l -� 8' � JOB DESCRIPTION - Proposed Job Description: Nurse Education Coordinator Generai summarv of duties: (100% community based) Provide overall coordination of a health education and nursing program for the American Indian Family Center. Provide on-going assessments of health education and nursing needs, and provide advocacy for health education services. ensure that health educafion nceds for the individual, community , schaols community groups and other organization aze addressed through referrals, networldng, and parmership with multiple programs. Aevelop, implements and evaluate an annual health education plan, in cooperation with the American Indian Family Center and community clinics. This individual must be well connected to the community, able to work within the Native American community, have a bread knowledge of health related issues, the ability to network, make referraLs and develop referral system as needed for individuals, families and the community. Supervision: Located at the American Indian Family Center and report directly to the public health nurse. Supervised by the community clinic employer. T�p, ical Working Conditions: Normal office environment, community building, health clinics and clienYs homes. Rgquirements: Licensed as a Registered Nurse (RN) by the State of Minnesota. Prefened to haue one year experience in community based health educafion programs. Fxperience wiih prenatal and postnatal homevisiting. Experience developing, implementing and evaluating communiry driven heaith educafion plans. Ability to do health risk assessments for data coll�ting at the family centers that serve American Indian families. Fxperience worldng with mul6disciplinary teams and collaborating with multiple agencies. Knowledge of health organizations within the metro area. Ability to coordinate and/or provide health educarion on a variety of health related topic. Ability to network and make refemals for individuals, families ant the community. Fxcellent written and verbal communication skills. Ability to do public spealdng, adaprive presentation style to specific audiences; desktop publishing and work processing desirable. Sensiflvity to the nceds of inedically underinsured and uninsured popularions. Demonstrate experience working with culturally diverse, American Indian communities and special nceds populations. Examules of Duties: • Assess, develop and implement a health educafion and nursing plan • Develop partnerships with community agencies, commurrity clinics, schools and community groups • Outreach to American Indian population, assist with referrals and follow-up • Assist with coordination of services for pregnant women � Provide specific health education information to clients on chemical dependency, FAS/FAE, smoking prevendon, infectious disease, diabetes, gestarional diabetes, nutridon, breast and cervical cancer, family planning, and other topics as necessary /a- 3 �� , �� • Work with public health nurse on health promorion plans for community • Monitor clienYs condition by documenting vital signs, taking blood pressure, observing client behavior � Act as a client advocate, and appropriately refer clients • Identify, purchase and distribute health education materials within given budget • Provide therapeutic massage as nceded • Provide data collection mechazrisms via health risk assessments, quesfiannaires at community events. 11/21/96 A-y ��¢�`,� r ' $ 1 S t Ls t F. �s..r :� �. o c.m RESOLUTION Counoil File # �1 1� t� l Green Sheet # ��` SAINT PAUL, MINNESOTA Presented By Referred To Committee: Date a� R'HEREAS, with the closing of the American Indian Health Clinic in May of 1996, many individuais 2 lost their health care provider, and were faced with finding a new health care options; and 4 WHEREAS, the staffs of the Ramsey County aud Saint Paul Health Clinics have recognized this 5 need, and haue agreed to contract with the Neighborhood Health Care Network to provide health caze 6 services to the American Health Clinic clients; and 7 8 WHEREAS, the plan calls for an RN Outreach Worker to be housed at the American Indian Family 9 Center, and for clients to be refened to altemative neighborhood health clinics for primary health care, health 10 promotion and general family services; and 11 12 WHEREA5, the Ramsey County Boazd of Commissioners has approved a Purchase of Services 13 Agreement with the Neighborhood Health Care Network on December 17, 1996 for the period of January 1, 14 1997 through December 31, 1997 ; now therefore be it 15 16 17 18 14 20 21 22 23 24 25 26 RESOLVED, that upon the recommendation of the Mayor, the Council of the Ciry of Saint Paul does hereby approve participation in the joint CityfCounty effort on behalf of the American Indian Health Clinic clients; and be it FURTHER RESOLVED, that the expenditure of 1997 Community Development Block Grant funds budgeted for the American Indian Health Clinic be utilized in accordance with Attachment A, entitled Service Delivery Plan; and be it FINALLX RESOLVED, that the proper City officials aze hereby authorized to enter in an Agreement with Neighborhood Health Care Network for the provision of health care services to American Indian Health Clinic clients as outlined in Attachment A. Requested by Department o£: By: /[� Adoption Certi£ied by Council Secretary BY � �� .a_..._ ,`\ Approved by Mayor: Date � ��7 �' Approved by Mayor for Submission to Council By: ✓ � _ �t� -�8l UEP11RiMB1TAFFlCEiCOUNCN. DATE INITIA7E J� J J,� HealthDept\PED o�f>o�q� GREEN SH CONTACfPERSONSPFWNE INITIA T INITIAL/DATE m DEPPRTMENT DIAE CITY CAUNCIL Diane Hohngren 292-7712, Bob Hammer s6669 ��GN CRV ATfOpNEY t ITY CLERK NUYBERFOP ) MUST BE ON CAUNGIL AGENDA BY (�AT� RWnNG BUW Ef DIRE `❑ FIN. & MGT. SERVICES DIR. NA OflDEN MAYOR (OR ASSISTAN'� � Bob Hammer, TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REQUESTED: Approval of attached Resolntion wHl aIlow the City to eater into an Agreement with the Neighborhood Heatth Care Nerivork to coord'mate and provide health care services on behalf of former American Indian Health Cliuic clients. RECOMMEN�ATIONS: Approve (A) rn Rejact (R) PEpSONAL SERVICE CONTRACTS MUST ANSWER 7HE FOLLOWING �UESTIONS: _ PLANNING COMMI$$ION _ CIVII SEFYICE GOMMISSION �� Has this personRirm ever worked under a conVact for this departmentt _ CIB COMMIT7EE _ YES NO _ STAFF 2_ Has this personftirm ever been a c�ty employee? — YES NO _ DISTfliCT COURT _ 3. DoES thi5 erson/firm p possess a skill not normally ppssessed by any curtent cfry employee7 SUPPORTS WHICH COUNqL 0&1ECTIVE? YES NO Explain all yes answers on separete sheet and ettach to green sheet INITIATMG PROBLEM, ISSUE, OPPpRTUNITY (Who, What, Whan, Where, Wtry): Both the City's and Ramsey Connty's budgets provide funding for Saint Paul neighborhood health clinics. With the closure of the American Tndian Health Clinic last year, the commnnity lost a siguiticant service provider. To help insure health care for this popnlation� the City of Saint Paul and Ramsey Couaty propose to reallocate the Native American Health Clinic funds to the Neighborhood Health Care Netwark. TLis organization will, in turu, provide criHcal community outreach, client referral to altemative providers, and reimbursement for semces when appropriate. Ramsey Connty has formaIly approved this strategy and funding reallocation. ADYANTAGESIFAPPROVED: . S "' �'' F . _ .- . Former cliettts of the American Indian Health Clinic will be pmvided tvith heatth care services. , � E B �;_ j� g� C �� I i �i� f��5�� DISADVANTAGES IFAPPROVED: R�� ouncil Research Cenfer None �� ' ��" F�� 1 � 3997 �dVAYO�"S �FF1C� DISADVANTAGES IF NOT APPROVED: C7ients of the American Indian Health Clinic will not be provided with ontreach, mferral and direct health care services. TOTAL AMOUNi OF TRANSAC710N $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO FUNDIfdG SOURCE AC71VI7V NUMBER FINANCIAL INFORlhAT10N: (EXPlA1N) °►'� - i �' � Option for Redistribution of 1997 City and County American Indian Health Clinic Funding �th the closing of the American Indian Health Clinio in May of 1996, many individuals who received health services from tius clinic were faced with the chailenge of finding a new provider and transferring their health care. Clients of the clinic included American Indian persons from the Saint Paul and Raznsey County area, as well as residents of the East Side of Saint Paul. During 1995, the American Indian Health Clinic reported to the City aud the County that Ramsey County clients made 4,069 visits for medical services and 1,926 visits for dental services. Of these visits, 1,327 medical visits and 164 dentai visits were made by Saint Paul low income/uninswed persons. Some of the former clients of the American Indian Heaith Clinic have received healih care services from the other c4mmunity clinics in Saint Paul. The Neighborhood Health Care Network, through their 489-CARE referral system, has assisted former patients in locating a new medical or dental provider. Many of the obstetrical clients were uansfened to North End Medical Center who hired the American Indian Health Clinids Nurse Pracfitioner. This transfer of care provided some continuity of care for these individuals, and helped ensure continued access to prenatal services. Some dental cfients have transfened care to Model Cities Health Center, However, there is concern that many clients have simply foregone medical and dental care while either waiting for the clinic to re-open, or due to lack of resources to obtain care elsewhere. The American Indian Family Center recently opened at the former locadon of the American Indian Health Ciinia lt is andcipated that the Family Center staff will be referring clients ta the community clinics as well. Since funding for this clinic has been allocated by both the City and the County for 1997, an interim solution is proposed to handle the distriburion of these funds to serve individuais who previously received care, or would have received care, from the American Indian Health Clinic. PROPOSAL The funds which are available from the City of Saint Paul and Ramsey County through the 1997 allocation for the American Indian Health Clinic total $86,750. The proposed use of these funds includes two elements: 1. Hiring a.8 FTE Registered Nurse (RN) through the Neighborhood Health Care Network (conhacting with one of the community clinics), who would be officed at the American Indian Family Center, providing services primarily related to q-1. �� -��' � 2. outreach and education, and would refer peopie to the community clinics for health services. Distribution of the remaining funds to ffie other community clinics to help cover the ea�penses far providing medical and dental care to: - former patients of the American Indian Health Clinic - persons referred to clinics by the RN menfioned above - persons refernd from the American Indian Family Center to one of the community clinics for health care - persons living on the East side of St. Paul BUDGET Funding: $32,849.OQ $53,901.00 $86,'750.00 Expenditures: -13,013.00 -35,Q00.00 $48,013.00 $38,737.00 Ramsey County City of Saint Paui - COPPiCDBG (7une 199b - May 199'n TOTAL 15% overhead/admin fees for oversight, contract, etc. by Neighborhood Health Care Network Salary, fringe, expenses for .8 FI'E RN hired Remaining funding availabie for services provided by the clinics Clinics would be reimbursed on a"per visit" basis, at the rate of $55.40 per visit. This rate is utilized by the Health Care for the Homeless program wlrich also refers people to the community clinics for services. This wouid support 704 visits made to the clinics during the year. Cluucs would seek other reimbursement for persons covered by medical assistance or insurance. A-� t 'l -� 8' � JOB DESCRIPTION - Proposed Job Description: Nurse Education Coordinator Generai summarv of duties: (100% community based) Provide overall coordination of a health education and nursing program for the American Indian Family Center. Provide on-going assessments of health education and nursing needs, and provide advocacy for health education services. ensure that health educafion nceds for the individual, community , schaols community groups and other organization aze addressed through referrals, networldng, and parmership with multiple programs. Aevelop, implements and evaluate an annual health education plan, in cooperation with the American Indian Family Center and community clinics. This individual must be well connected to the community, able to work within the Native American community, have a bread knowledge of health related issues, the ability to network, make referraLs and develop referral system as needed for individuals, families and the community. Supervision: Located at the American Indian Family Center and report directly to the public health nurse. Supervised by the community clinic employer. T�p, ical Working Conditions: Normal office environment, community building, health clinics and clienYs homes. Rgquirements: Licensed as a Registered Nurse (RN) by the State of Minnesota. Prefened to haue one year experience in community based health educafion programs. Fxperience wiih prenatal and postnatal homevisiting. Experience developing, implementing and evaluating communiry driven heaith educafion plans. Ability to do health risk assessments for data coll�ting at the family centers that serve American Indian families. Fxperience worldng with mul6disciplinary teams and collaborating with multiple agencies. Knowledge of health organizations within the metro area. Ability to coordinate and/or provide health educarion on a variety of health related topic. Ability to network and make refemals for individuals, families ant the community. Fxcellent written and verbal communication skills. Ability to do public spealdng, adaprive presentation style to specific audiences; desktop publishing and work processing desirable. Sensiflvity to the nceds of inedically underinsured and uninsured popularions. Demonstrate experience working with culturally diverse, American Indian communities and special nceds populations. Examules of Duties: • Assess, develop and implement a health educafion and nursing plan • Develop partnerships with community agencies, commurrity clinics, schools and community groups • Outreach to American Indian population, assist with referrals and follow-up • Assist with coordination of services for pregnant women � Provide specific health education information to clients on chemical dependency, FAS/FAE, smoking prevendon, infectious disease, diabetes, gestarional diabetes, nutridon, breast and cervical cancer, family planning, and other topics as necessary /a- 3 �� , �� • Work with public health nurse on health promorion plans for community • Monitor clienYs condition by documenting vital signs, taking blood pressure, observing client behavior � Act as a client advocate, and appropriately refer clients • Identify, purchase and distribute health education materials within given budget • Provide therapeutic massage as nceded • Provide data collection mechazrisms via health risk assessments, quesfiannaires at community events. 11/21/96 A-y ��¢�`,� r ' $ 1 S t Ls t F. �s..r :� �. o c.m RESOLUTION Counoil File # �1 1� t� l Green Sheet # ��` SAINT PAUL, MINNESOTA Presented By Referred To Committee: Date a� R'HEREAS, with the closing of the American Indian Health Clinic in May of 1996, many individuais 2 lost their health care provider, and were faced with finding a new health care options; and 4 WHEREAS, the staffs of the Ramsey County aud Saint Paul Health Clinics have recognized this 5 need, and haue agreed to contract with the Neighborhood Health Care Network to provide health caze 6 services to the American Health Clinic clients; and 7 8 WHEREAS, the plan calls for an RN Outreach Worker to be housed at the American Indian Family 9 Center, and for clients to be refened to altemative neighborhood health clinics for primary health care, health 10 promotion and general family services; and 11 12 WHEREA5, the Ramsey County Boazd of Commissioners has approved a Purchase of Services 13 Agreement with the Neighborhood Health Care Network on December 17, 1996 for the period of January 1, 14 1997 through December 31, 1997 ; now therefore be it 15 16 17 18 14 20 21 22 23 24 25 26 RESOLVED, that upon the recommendation of the Mayor, the Council of the Ciry of Saint Paul does hereby approve participation in the joint CityfCounty effort on behalf of the American Indian Health Clinic clients; and be it FURTHER RESOLVED, that the expenditure of 1997 Community Development Block Grant funds budgeted for the American Indian Health Clinic be utilized in accordance with Attachment A, entitled Service Delivery Plan; and be it FINALLX RESOLVED, that the proper City officials aze hereby authorized to enter in an Agreement with Neighborhood Health Care Network for the provision of health care services to American Indian Health Clinic clients as outlined in Attachment A. Requested by Department o£: By: /[� Adoption Certi£ied by Council Secretary BY � �� .a_..._ ,`\ Approved by Mayor: Date � ��7 �' Approved by Mayor for Submission to Council By: ✓ � _ �t� -�8l UEP11RiMB1TAFFlCEiCOUNCN. DATE INITIA7E J� J J,� HealthDept\PED o�f>o�q� GREEN SH CONTACfPERSONSPFWNE INITIA T INITIAL/DATE m DEPPRTMENT DIAE CITY CAUNCIL Diane Hohngren 292-7712, Bob Hammer s6669 ��GN CRV ATfOpNEY t ITY CLERK NUYBERFOP ) MUST BE ON CAUNGIL AGENDA BY (�AT� RWnNG BUW Ef DIRE `❑ FIN. & MGT. SERVICES DIR. NA OflDEN MAYOR (OR ASSISTAN'� � Bob Hammer, TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) ACTION REQUESTED: Approval of attached Resolntion wHl aIlow the City to eater into an Agreement with the Neighborhood Heatth Care Nerivork to coord'mate and provide health care services on behalf of former American Indian Health Cliuic clients. RECOMMEN�ATIONS: Approve (A) rn Rejact (R) PEpSONAL SERVICE CONTRACTS MUST ANSWER 7HE FOLLOWING �UESTIONS: _ PLANNING COMMI$$ION _ CIVII SEFYICE GOMMISSION �� Has this personRirm ever worked under a conVact for this departmentt _ CIB COMMIT7EE _ YES NO _ STAFF 2_ Has this personftirm ever been a c�ty employee? — YES NO _ DISTfliCT COURT _ 3. DoES thi5 erson/firm p possess a skill not normally ppssessed by any curtent cfry employee7 SUPPORTS WHICH COUNqL 0&1ECTIVE? YES NO Explain all yes answers on separete sheet and ettach to green sheet INITIATMG PROBLEM, ISSUE, OPPpRTUNITY (Who, What, Whan, Where, Wtry): Both the City's and Ramsey Connty's budgets provide funding for Saint Paul neighborhood health clinics. With the closure of the American Tndian Health Clinic last year, the commnnity lost a siguiticant service provider. To help insure health care for this popnlation� the City of Saint Paul and Ramsey Couaty propose to reallocate the Native American Health Clinic funds to the Neighborhood Health Care Netwark. TLis organization will, in turu, provide criHcal community outreach, client referral to altemative providers, and reimbursement for semces when appropriate. Ramsey Connty has formaIly approved this strategy and funding reallocation. ADYANTAGESIFAPPROVED: . S "' �'' F . _ .- . Former cliettts of the American Indian Health Clinic will be pmvided tvith heatth care services. , � E B �;_ j� g� C �� I i �i� f��5�� DISADVANTAGES IFAPPROVED: R�� ouncil Research Cenfer None �� ' ��" F�� 1 � 3997 �dVAYO�"S �FF1C� DISADVANTAGES IF NOT APPROVED: C7ients of the American Indian Health Clinic will not be provided with ontreach, mferral and direct health care services. TOTAL AMOUNi OF TRANSAC710N $ COST/REVENUE BUDGE7ED (CIRCLE ONE) YES NO FUNDIfdG SOURCE AC71VI7V NUMBER FINANCIAL INFORlhAT10N: (EXPlA1N) °►'� - i �' � Option for Redistribution of 1997 City and County American Indian Health Clinic Funding �th the closing of the American Indian Health Clinio in May of 1996, many individuals who received health services from tius clinic were faced with the chailenge of finding a new provider and transferring their health care. Clients of the clinic included American Indian persons from the Saint Paul and Raznsey County area, as well as residents of the East Side of Saint Paul. During 1995, the American Indian Health Clinic reported to the City aud the County that Ramsey County clients made 4,069 visits for medical services and 1,926 visits for dental services. Of these visits, 1,327 medical visits and 164 dentai visits were made by Saint Paul low income/uninswed persons. Some of the former clients of the American Indian Heaith Clinic have received healih care services from the other c4mmunity clinics in Saint Paul. The Neighborhood Health Care Network, through their 489-CARE referral system, has assisted former patients in locating a new medical or dental provider. Many of the obstetrical clients were uansfened to North End Medical Center who hired the American Indian Health Clinids Nurse Pracfitioner. This transfer of care provided some continuity of care for these individuals, and helped ensure continued access to prenatal services. Some dental cfients have transfened care to Model Cities Health Center, However, there is concern that many clients have simply foregone medical and dental care while either waiting for the clinic to re-open, or due to lack of resources to obtain care elsewhere. The American Indian Family Center recently opened at the former locadon of the American Indian Health Ciinia lt is andcipated that the Family Center staff will be referring clients ta the community clinics as well. Since funding for this clinic has been allocated by both the City and the County for 1997, an interim solution is proposed to handle the distriburion of these funds to serve individuais who previously received care, or would have received care, from the American Indian Health Clinic. PROPOSAL The funds which are available from the City of Saint Paul and Ramsey County through the 1997 allocation for the American Indian Health Clinic total $86,750. The proposed use of these funds includes two elements: 1. Hiring a.8 FTE Registered Nurse (RN) through the Neighborhood Health Care Network (conhacting with one of the community clinics), who would be officed at the American Indian Family Center, providing services primarily related to q-1. �� -��' � 2. outreach and education, and would refer peopie to the community clinics for health services. Distribution of the remaining funds to ffie other community clinics to help cover the ea�penses far providing medical and dental care to: - former patients of the American Indian Health Clinic - persons referred to clinics by the RN menfioned above - persons refernd from the American Indian Family Center to one of the community clinics for health care - persons living on the East side of St. Paul BUDGET Funding: $32,849.OQ $53,901.00 $86,'750.00 Expenditures: -13,013.00 -35,Q00.00 $48,013.00 $38,737.00 Ramsey County City of Saint Paui - COPPiCDBG (7une 199b - May 199'n TOTAL 15% overhead/admin fees for oversight, contract, etc. by Neighborhood Health Care Network Salary, fringe, expenses for .8 FI'E RN hired Remaining funding availabie for services provided by the clinics Clinics would be reimbursed on a"per visit" basis, at the rate of $55.40 per visit. This rate is utilized by the Health Care for the Homeless program wlrich also refers people to the community clinics for services. This wouid support 704 visits made to the clinics during the year. Cluucs would seek other reimbursement for persons covered by medical assistance or insurance. A-� t 'l -� 8' � JOB DESCRIPTION - Proposed Job Description: Nurse Education Coordinator Generai summarv of duties: (100% community based) Provide overall coordination of a health education and nursing program for the American Indian Family Center. Provide on-going assessments of health education and nursing needs, and provide advocacy for health education services. ensure that health educafion nceds for the individual, community , schaols community groups and other organization aze addressed through referrals, networldng, and parmership with multiple programs. Aevelop, implements and evaluate an annual health education plan, in cooperation with the American Indian Family Center and community clinics. This individual must be well connected to the community, able to work within the Native American community, have a bread knowledge of health related issues, the ability to network, make referraLs and develop referral system as needed for individuals, families and the community. Supervision: Located at the American Indian Family Center and report directly to the public health nurse. Supervised by the community clinic employer. T�p, ical Working Conditions: Normal office environment, community building, health clinics and clienYs homes. Rgquirements: Licensed as a Registered Nurse (RN) by the State of Minnesota. Prefened to haue one year experience in community based health educafion programs. Fxperience wiih prenatal and postnatal homevisiting. Experience developing, implementing and evaluating communiry driven heaith educafion plans. Ability to do health risk assessments for data coll�ting at the family centers that serve American Indian families. Fxperience worldng with mul6disciplinary teams and collaborating with multiple agencies. Knowledge of health organizations within the metro area. Ability to coordinate and/or provide health educarion on a variety of health related topic. Ability to network and make refemals for individuals, families ant the community. Fxcellent written and verbal communication skills. Ability to do public spealdng, adaprive presentation style to specific audiences; desktop publishing and work processing desirable. Sensiflvity to the nceds of inedically underinsured and uninsured popularions. Demonstrate experience working with culturally diverse, American Indian communities and special nceds populations. Examules of Duties: • Assess, develop and implement a health educafion and nursing plan • Develop partnerships with community agencies, commurrity clinics, schools and community groups • Outreach to American Indian population, assist with referrals and follow-up • Assist with coordination of services for pregnant women � Provide specific health education information to clients on chemical dependency, FAS/FAE, smoking prevendon, infectious disease, diabetes, gestarional diabetes, nutridon, breast and cervical cancer, family planning, and other topics as necessary /a- 3 �� , �� • Work with public health nurse on health promorion plans for community • Monitor clienYs condition by documenting vital signs, taking blood pressure, observing client behavior � Act as a client advocate, and appropriately refer clients • Identify, purchase and distribute health education materials within given budget • Provide therapeutic massage as nceded • Provide data collection mechazrisms via health risk assessments, quesfiannaires at community events. 11/21/96 A-y