Quigg Newton Holistic Health and Outreach Program (QNHOP)
4545 Navajo Street
Denver, CO 80211
Phone: (303) 436-8700
Fax: (303) 436-8609

Director of Health Services: Joan Christensen
PHPC Program Manager: Stephen V. Bailey PA, MBA

Project Description
QNHOP's PHPC program provides holistic health care and mental health care to the residents of Quigg Newton Homes and the Sunnyside neighborhood in northwest Denver. The program provides a complete range of Family Practice care including pediatric, adolescent, adult, geriatric, and obstetric care. Mental health care is provided on site and access to substance abuse, dental, and eye care are provided by referrals.

Services
Door-to-door outreach is provided to the Quigg Newton/Sunnyside residents by a full time Outreach Worker. An outreach worker or case manager conducts home-visits, completing initial assessments and while offering access to available services, or the provision of limited in-home care if needed. Transportation services are offered to and from the health center, the hospital, and to other services providers for patients. Dental and Optical services are offered to Quigg Newton/Sunnyside area residents who cannot afford to pay. The Senior Watch Program provides services to the seniors in the Quigg Newton/Sunnyside area.

Nutritional counseling and smoking cessation classes are provided through Denver Health on- or off-site. Domestic violence support groups are provided on-site for community residents.

Linkages/Partnerships
Denver Area Youth Services (D.A.Y.S.), Safe House, Denver Health, Denver Housing Authority, Friends of Man, The Conflict Center, Quigg Newton Head Start Program, Atzlan Head Start, Remington Elementary, Smedley Elementary, Horace Mann Middle School, North High School, Denver Parks and Recreation Center, Our Lady of Guadalupe Church, Quigg Newton Senior Center, Atzlan Recreation Center, and Denver Police Department District One.

BPHC Collaborative Participation
The PHPC program is involved in the Diabetes Collaborative and has recently begun assessments as a part of the Pediatric Asthma Collaborative.

Public Housing Locations/Sites
Quigg Newton Homes
4407 Mariposa Way
Denver, CO 80211
(303) 433-86011

Statistics
Estimated residents in Public Housing: 1,500
Estimated Project Users: 2,000 which includes the surrounding Sunnyside Neighborhood

Connecticut

Hill Health Center Public Housing Primary Care Program
285 Main Street, West Haven, Ct. 06515
Phone: (203)503-3410
Fax: (203)503-3414

Executive Director: Cornell Scott
PHPC Program Manager: Rebecca J. Powell, LCSW
Medical Director: Karin Michels, MD

Project Description
The Hill Health Center PHPC program operates out of its three Satellite clinics, which are located in New Haven, Ansonia, and West Haven. We use an outreach model which includes assigned satellite staff who provide health education, diabetes, and hypertension screenings on site. Our program currently has three case manager/outreach workers that promote health fairs, facilitate medical, mental health, and substance abuse referrals to the Hill Health Center and to other community providers as required. We provide on site Flu shots and some immunizations, Asthma workshops, and assistance with obtaining medical insurance coverage.

Services
The Hill Health Center offers services such as OBGYN, Prenatal, immunizations, family planning, ultra sound, dental, mental health, child guidance, WIC, diabetes care, hearing screening, nutrition , pharmacy, smoking cessation, podiatry, parent ed, health ed, vision screening, head start, HIV, mammography,internal medicine, podiatry,birth to three, detox and methadone, health promotions, nutrition, and weight promotion.

Linkages/Partnersips
Housing Authority of New Haven, Ansonia, and West Haven. Project Intact New Haven, Amistad Village, New Haven, Dept. of Health West Haven, Northside Substance Abuse Tx. Center New Haven, Valley Counsel of Health and Human Service Organizations, Ansonia Ct. , Yale University, New Haven, Ct., Hosp. Of St. Raphaels and Yale New Haven Hosp., West Haven Discovery Health and Education Partnership, West Haven Board of ED., Family Alliance of New Haven.

BPHC Collaborative Participation
The Asthma and Diabetes collaborative.

Public Housing Locations/Sites
Hill Health Center Clinic
428 Columbus Ave.
New Haven, CT 06519

Dixwell Health Center HHC
226 Dixwell Ave.
New Haven, CT 06511

West Haven Health Center HHC
285 Main Street
West Haven, CT 06516

Community Health Connection HHC
121 Wakelee Ave.
Ansonia, CT 06401

Statistics
Estimated residents in Public Housing: 4,228
Project Users: 2,764

Georgia

Curtis V. Cooper Primary Health Care, Inc.
(Formerly known as Westside - Urban Health Center)
PO Box 2024, 106 East Broad Street
Savannah, GA, 31402
Phone: (912) 527-1005
Fax: (912) 527-1001

Executive Director and PHPC Program Manager: Leon Burton
Medical Director: Fariborz Zaer, MD

Project Description
Curtis V. Cooper Primary Health Care, Inc. operates a health center located in downtown Savannah, which is within close proximity to several public housing communities. The emphasis of the Cooper Primary Health Care PHPC project is increasing health care access through health promotion and disease prevention activities. This model utilizes outreach staff to educate public housing residents and encourage regular visits to the health center.

Services
Primary Health Care for adults, preventive care, chronic and acute care, prenatal care, pediatric and well child care, health screening and care for acute illness, supportive services, enabling services, transportation, nursing case management, outreach, laboratory services (CLIA waived laboratory onsite - additional laboratory services available at main clinic site), pharmacy access, and 24-hour coverage for emergencies and hospitalization, if needed.

Linkages/Partnerships
The Savannah Housing Authority, Chatham County Health Department, Memorial Health University Medical Center, Economic Opportunity Authority, Head Start Program, and the Department of Family and Children Services

BPHC Collaborative Participation
The Cancer Collaborative

Public Housing Locations/Sites
Robert Hitch Village
840-A Hitch Drive
Savannah, GA 31401

Statistics
Estimated Public Housing Residents: 4,000
Project Users: 1,120

West End Medical Center, Inc.
868 York Avenue, Southwest
Atlanta, GA 30310
Phone: (404) 756-6901
Fax: (404) 755-8295

Executive Director: Daisy L. Harris
PHPC Program Manager: Karen Williams
Medical Director: Linda Cannon, MD

Project Description
The West End Medical Center Public Housing Primary Care Program has provided on-site primary care services to public housing residents for the past twelve years. A partnership with the Atlanta and Cobb County Housing Authorities has afforded the greatest accessibility for residents in five sites.

Services
Pediatrics, OB/GYN; Internal Medicine, laboratory testing, dental, health education, nutritional counseling, conflict resolution, social services, case management, outreach

Linkages/Partnerships
Fulton County Health Department, Cobb/Douglas County Health Church, Salem Baptist Church, Mt. Nebo Baptist Church, Georgia Council on Aging, Residents Associations, NPU, Boys and Girls Club Southwest, AUMI Recovery, Luke's Place, and Ruth's Place

BPHC Collaborative Participation
The Diabetes Collaborative and The Reengineering Collaborative

Public Housing Locations/Sites
Bowen Homes
950 Wilkes Circle, NW
Atlanta, GA 30318

Herndon Homes
511 John Street, NW
Atlanta, GA 30318

Thomasville Heights
1178 Henry Thomas Drive
Atlanta, GA 30315

John O. Chiles
435 J. Lowery Boulevard
Atlanta, GA 30310

Fort Hill Roosevelt
397 Roosevelt Circle
Marrietta, GA 30060

Statistics
Estimated residents in Public Housing: 4,800
Project Users: 2,956

Hawaii

Kokua Kalihi Valley Comprehensive Family Services
2239 North School Street
Honolulu, HI 96819
Phone: (808) 791-9400
Fax: (808) 848-0979

Executive Directors: David Derauf, MD
Medical Director: Laura Devilbiss, MD
PHPC Contact: Cynthia Sturdevant, COO

Project Description
Kokua Kalihi Valley (KKV) serves four public housing projects. The population is: Kalihi Valley Homes 969, Kuhio Park Terrace 2161, Kuhio Homes 552 and Hauiki Homes 122. All three sites are low-rise developments with the exception of Kuhio Park Terrace which consists of two adjacent 17-story towers. The population is predominantly Asian/Pacific Islander and low-income. Many are newly arrived immigrants and require translation services.

Program features include Outreach workers/case mangers who reduce barriers to health care by providing language and culturally appropriate services to the residents; a case-managed system that integrates primary care services; health education with community-based programs and resources; and transportation - including a van and a full-time driver to shuttle clients to and from the main clinic and for transportation to outside referrals. Health Promotion/Disease Prevention is the primary focus on-site at the community halls, with the full range of primary care services at the main health center.

Services
Medical Care for the entire family including prevention, diagnosis, and treatment of acute and chronic medical conditions, prenatal care, women's care, well child checks, immunizations, dental care, behavioral health care, individual and group counseling and support, assessments and referral, psychotherapy and counseling for family violence, substance abuse, post-traumatic stress.

Maternal and Child Health services including family planning education and counseling, pregnancy testing, contraceptives, pap smears, perinatal risk assessment, case management, counseling, delivery, and post-partum care.

Enabling services such as nutrition/WIC education, case management, health education, translation in 17 languages, eligibility assistance, Read-to-Me Programs, and transportation.

Youth services including sports, dance, after school care, tutoring, and health clubs.

Health maintenance, exercise, caregiver support groups, respite care, and home visits for the elderly.

Linkages/Partnerships
Hawaii Primary Care Association, Hawaii Federal Health Care Partnership, Association of Asian Pacific Health Care Organizations, Medical Assistant Program at Heald College and Hawaii Business College, training site for the University of Hawaii Schools of Medicine, Nursing, and Social Work, medical resident placement site for the University of Hawaii OB/GYN and Pediatric residency programs.

Alohacare, an HMO established and governed by community health centers, placement site for the National Health Service Corps, dental residency program site under the Lutheran Medical Center Department of Dentistry, Housing and Community Development Corporation of Hawaii, Keola Mamo - a Native Hawaiian organization, staff are members of the residents association of the two largest housing projects.

BPHC Collaborative Participation
The BPHC Diabetes Collaborative; The Kalihi Valley Collaborative

Public Housing Locations/Sites
Kalihi Valley Homes
2243 Kalaunu Street
Honolulu, HI 96819

Kuhio Park Terrace and Kuhio Homes
1475 Linapuni Street
Honolulu, HI 96819

Hauiki Homes
1574 Meyers Street
Honolulu, HI 96819

Statistics
Total Public Housing Residents: 3,804
Project Users: 2,982

Illinois

Access Community Health Network
1501 South California Avenue
Chicago, IL 60608
Phone: (773) 257-6051
Fax: (773) 257-5110

Executive Director: Donna Thompson
PHPC Program Manager: Kathleen Guerrero

Project Description
This program serves to actively engage residents of Chicago Heights and Ford Heights public housing and Section 8 into primary care. This program provides one-on-one outreach, benefits counseling, and primary medical care.

Services
Case Management, Benefits Counseling, Primary Medical Care.

Linkages/Partnerships
There are two existing linkages with the Chicago Housing Authority and the Ford Heights Housing Authority. These linkages enable us to hold bi-monthly health fairs at each site and conduct weekly on-site outreach.

BPHC Collaborative Participation
Access Community Health Network participates in the South Suburban Health Consortium, a HCAP program with St. James Hospital, and Aunt Martha's to offer a safety network and continuum of care for clients. This consortium is currently working to expand access for the uninsured or underinsured into specialty care services.

Public Housing Locations/Sites
Ford Heights Housing Authority
1055 Berkley
Ford Heights, IL 60411

Chicago Heights Housing Authority
1314 Wentworth Avenue
Chicago Heights, IL 60411.

Olympic Village Apartments
31 Olympic Village
Chicago Heights, IL 60411

Thorwood Apartments
19440-60 Glenwood Road
Chicago Heights, IL 60411

Chicago Heights Public Housing
1214-1222 Mason
Chicago Heights, IL 60411

Statistics
Estimated residents in Public Housing: 9,500
Project Users: 2,192

Mile Square Health Center (University of Illinois)
2045 W. Washington
Chicago, IL 60612
Phone: (312) 413-1261
Fax: (312) 413-7812

PHPC Program Manager: Henry Taylor, CEO
Medical Director: Tamarah Duperval, MD

Project Description
Primary medical and social services to residents of public housing on the Near West side of the City of Chicago. Our primary public housing sites include: Rockwell Gardens, ABLA, and Henry Horner.

Services
Pre-employment screening, sick and wellness checkups for adults and children, geriatrics, emergency services, pharmacy, podiatry, child psychiatry, mental health counseling, school/sports physicals, OB/Gyn; early intervention care, WIC; HIV Clinic, ophthalmology, pediatric; transportation, community outreach

Linkages/Partnerships
Chicago Department of Public Health, James Jordan Boys and Girls Club, West Side Future, St. Leonard's House, Rainbow House Shelter for Women, Chicago Housing Authority, Grace House, Midwest Community Council, UIC Division of Community Health of the Department of Psychiatry/Psychology, Malcolm X Community College, and the Department of Aging

BPHC Collaborative Participation
The Cardiovascular Collaborative

Public Housing Locations/Sites
Rockwell Gardens
2515 W. Jackson #105
Chicago, IL 60612

ABLA
1254 S. Loomis
Chicago, IL 60608

Henry Horner
1936 W. Washington
Chicago, IL 60612

Statistics
Estimated residents in Public Housing: 1,650

TCA Health, Inc.
(formerly The Clinic in Altgeld)
1029 East 130th Street
Chicago, IL 60628
Phone: (773) 995-6300
Fax: (773) 995-7985

Chief Executive Officer: Veronica ClarkeM
Medical Director: Pamela Goodwin-Cole, MD

Project Description
The mission of TCA Health, Inc. is to provide high quality, comprehensive primary and preventive health care and supportive services in an environment of caring, respect and dignity and in a cost effective manner. TCA Health's service area includes Roseland, West Pullman, Riverdale, and the neighboring suburbs of Calumet Park, Blue Island, Dolton, Harvey and Markham.

Services
Dentistry, family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry, pharmacy, nutritional services, WIC, maternal and child health - Healthy Start Initiative, prevention and screening services,, School Health Program located at the Carver Military Academy, employment services, Earnfare Program, and counseling services provides by a licensed clinical social worker

Linkages/Partnerships
TCA has established linkages with both private and public organizations throughout South Chicago. Currently, the health center contracts with the Illinois Department of Human Services for Women, Infants and Children program, Earnfare Program and a School-Based Health initiative. Formal relationships are established with Advocate Trinity and the Roseland Community Hospitals, St Francis and Ingalls Hospital and with the Healthcare Consortium of Illinois. The latter linkage provides a Healthy Start Program under the Federal Maternal and Child Health Grant Program. TCA has also established a linkage with the Carver Military Academy for its Healthy School, Healthy Community Program.

Statistics
Estimated residents in Public Housing: 4,500
Project Users: 6,500

Indiana

Citizens Health Center
Health and Hospital Corporation of Marion County
1650 North College Avenue
Indianapolis, IN 46204
Phone: (317) 396-0311
Fax: (317) 927-3098

Chief Executive Officer: Ruth Stevens, MD
Project Director: Gerrie Whitaker

Project Description
The target populations for this project are the four public housing/senior sites in Marion County as well as the surrounding community. While the Health and Hospital Corporation of Marion County is the grantee of record, services are provided by Citizens Health Corporation via a co-applicant agreement.

Comprehensive primary health care services are delivered at the Barton Annex location. Transportaion to and from the health center is provided to residents living in the other three housing/senior sites. The medical team consists of a physician, a registered nurse, and a medical assistant, with a social worker providing case management services. All public housing residents have access to full dental services through the dental department located at the College Avenue location.

Services
Primary care, podiatry, social services, mental health counseling, pharmacy, and dental (College Avenue location only)

Linkages/Partnerships
Midtown Mental Health, Indianapolis Housing Authority

BPHC Collaborative Participation
Citizen's Health Center is currently participating in the Midwest Cluster of the Health Disparities Collaborative: Diabetes Phase II and Asthma Phase I.

Public Housing Location/Site
Barton Annex
301 North East Street
Indianapolis, IN 46202

Statistics
Estimated residents in Public Housing: 570;
Project Users: 176

Louisiana

Primary Health Services Center
PO Box 7495
Monroe, LA 71211
Phone: (318) 388-1250
Fax: (318) 388-0948

Executive Director: Catherine M. Tonore
PHPC Program Manager: Teresa Buckley
Medical Director: Tammy Stewart-Dixon, FNP-C

Project Description
Primary Health Services Center (PHSC), a private, not-for-profit primary care center, was founded in 1997 by local citizens with a mission to provide access to comprehensive, high quality primary care and preventive health services to residents of Ouachita Parish, Louisiana, without regard to their ability to pay. PHSC grew to a comprehensive provider of primary care services having extended its reach into five contiguous parishes of northeast Louisiana.

Services
Medicaid enrollment center; transportation; pharmaceutical services; diagnostic and laboratory; referral services; case management; preventive dental services; outreach services; perinatal care; prenatal care; health education; and primary health care.

Linkages/Partnerships
Monroe Housing Authority; Novartis; Merck; Dr. Goffrey Achillihu; Aventis; Lilly; Glaxo-Wellcome; Abbot Laboratories; TAP; Pfizer; American Heart Association; Together Rx; S & S Pharmacy; James H. Gray Foundation; DHH Office of Addictive Disorders; Mt. Zion Baptist Church; Piney Grove Baptist Church; Jerusalem Baptist Church; Calvary Baptist Church.; Starlight Baptist Church;

Debra Blanson, FNPC; Medical Specialty; LSU Medical Center; ULM- Dental Hygiene; ULM- Marriage and Family Therapy; ULM- Department of Foreign Language; United Way, LA State Legislature; Governor Kathleen Blanco; GO Care (Ryan White); Camelot College; Ouachita Independent Bank; Monroe Mayor Jamie Mayo; Louisiana Primary Care Association; Ouachita Council on Aging; Louisiana Department of Mental Health; OIC of Ouachita Parish.

BPHC Collaborative Participation:
PHSC is currently participating in the Health Disparities Cardiovascular Collaborative and is in the process of spreading to another site; PHSC plans to spread also to the Diabetes collaboratives in the next year.

Public Housing Locations/Sites
Primary Health Services Center/S. D. Hill Site
1805 Jackson Street
Monroe, LA 71202

Primary Health Services Center/DeSiard Street
2913 DeSiard Street
Monroe, LA 71202

Statistics
Estimated residents in Public Housing: 5,000
Project Users:2,600

Southwest Louisiana Center for Health Service, Lafayette
PO Box 92492
800 Gilman Road
Lafayette, Louisana 70501
Phone: (337) 244-6269
Fax: (337) 439-8898

Executive Director: Eric Taylor
PHPC Program Manager: Vanessa Thomas-Guillory, MD

Project Description
The SWLA satellite clinic is located in an urban environment in the inner city of Louisiana. The city of Lafayette is in Lafayette Parish, one of seven parishes in Louisiana Public Health Region 4 in the state's 7th Congressional District. The target census tracts in Louisiana are 1, 2, 7, 8, 9, 11, 12, and 13, and they have been determined by the US Department of Health and Human Services to be Medically Underserved Areas (MUAs) and Health Profession Shortage Areas (HPSAs). The population is 71% African American and 28% white. There are no federally qualified health centers in Lafayette Parish, and there are no oral health providers that provide dental services for uninsured persons. The patient mix of new users is projected to include self-pay, Community Care (managed care), Medicaid, Medicare, and commercial insurance. The Health Center is located on and near public housing property and the users will be both general population and public housing residents. At full operating capacity, the center will provide new access to care for 4,445 users, general some 16,757 encounters.

Services
SWLA's current services include immunizations and early screenings, family practice, OB-GYN, family planning, special populations, internal medicine, medical laboratory, pharmacy, and radiology, prevention/outreach services, and supplemental services including health education, translation, eligibility, social services and transportation. The new clinic also will have a dental clinic onsite. Mental health services will be provided via referral.

Linkages/Partnerships
Lafayette Housing Authority, Our Lady of the Lourdes, Lafayette General, Community Health Center, Southwest Medical Center, Highland Mental Health, and Cross Roads.

Public Housing Locations/Sites
Moss Street Development
1106 Moss Street
Lafayette, LA 70501

Simcoe Street Development
1660 Simcoe Street
Lafayette, LA 70501

Macon Street Development
300 Macon Street
Lafayette, LA 70501

Delahoussaye Street Development
112 Delahoussaye Street
Lafayette, LA 70501

Kattie Street Development
115 Kattie Street
Lafayette, LA 70501

Irene Street Development
1101 Irene Street
Lafayette, LA 70501

Statistics
Estimated residents in Public Housing: 2,150
Project Users: Estimated 1,505 from public housing and 4,446 in total

Maine

York County Community Health Services, Inc.
147 Shaker Hill Road
P.O. Box 820
Alfred, ME 04002-0820
Phone: (207) 324-1137
Fax: (207) 324-5290

Director, Health Care Services: Mary Ann Gleason

Project Description
York County Community Health Services is comprised of the main health center site, which is located in the York County Community Action Program facility and three satellite centers, which are located in public housing facilities: two senior housing developments and one family housing development. The main health center site serves a community with many Section 8 units.

Services
Primary health and preventive care, dental services, mental health services, case management, and health education on a range of issues including women's health, cardiovascular disease, hypertension and HIV/AIDS.

Linkages/Partnerships
Sanford Housing Authority

Public Housing Locations/Sites
East Side Acres
127 Emery Street
Sanford, ME 04073

Senior Housing
Village View
13 Pleasant Street
Springvale, ME 04083

Mayflower Place
21 Mayflower Drive
Sandford, ME 04073

Statistics
Estimated residents in Public Housing: 2,000

Massachusetts

Community Health Connections
275 Nicholas Road
Fitchburg, MA 01420-1931
Phone: (978) 857-7021

President and CEO: Robert Johnson
CHC Director and Public Housing Director: Nicholas Apostaloras

Project Description
Community Health Connections, Inc. (CHC, Inc.), a FQHC organization, currently operates two community health centers in north central Massachusetts. CHC, Inc. was awarded a grant to start a New Access Point satellite health center to serve local people who are publicly housed or homeless. This new program, Healthcare for the Homeless and Publicly Housed of North Central MA (HCHPH) will operate a mobile medical service, a dental service, and behavioral health services. The parent organization also operates a 340b pharmacy, which is available to all patients of CHC, Inc. health centers.

Services
Serves Fitchburg Public Housing sites with its mobile medical/behavioral health services.

BPHC Collaborative Participation
HCHPH participates in the BPHC Depression Collaborative

Public Housing Locations/Sites
Green Acres Village
Normandy Road
Fitchburg, MA 01420

Wallace Towers
Wallace Avenue
Fitchburg, MA 01420

Olde English Village
152 Manca Drive
Gardner, MA 01440

Great Brook Valley Health Center
Public Housing Primary Care Program
19 Tacoma Street
Worcester, MA 01605
Phone: (508) 852-1805
Fax: (508) 853-8593

Interim CEO: Leah Gallivan
PHPC Program Manager: Sue Schlotterbeck
Chief Medical Officer: Janet Yardley

Project Description
The Great Brook Valley Health Center (GBVHC) Public Housing Primary Care program serves residents of public housing and the surrounding community. GBVHC is located within the largest public housing complex on the outskirts of the city where residents are culturally, linguistically, economically, and geographically isolated from the rest of the city.

GBVHC is committed to population-based, culturally competent medicine and has built a client centered and family-based service delivery model. Services are provided by multicultural staff that speaks 29 languages and comes from 36 countries. (78% of staff are bilingual, 17% of which are trilingual.)

Services
Medical Services include comprehensive primary care; urgent care; nurse case management for diabetes, hypertension, asthma, depression, HIV, Hepatitis C; screening for breast and cervical cancer; counseling and testing (HIV, STD, Hepatitis); family planning; optometry; nutrition; and childbirth education and breastfeeding support. GBVHC has an on-site pharmacy, laboratory, mammography and ultrasound. Specialists are available on site for podiatry, pulmonology, urology, cardiology, dermatology, ophthalmology, gynecology, and infectious disease services.

GBVHC also provides Mental Health and Social Services, i.e., therapies including prescription medications, psychiatric services, ADHD evaluation and treatment, parenting education, crisis intervention, support groups, advocacy, referrals, assistance with benefits applications, transportation, perinatal case management, and domestic violence screening and intervention. Dental Services provided at two sites in Worcester and a third site in the neighboring town of Clinton include prevention and treatment, as well as Oral Surgery.

Other services include HIV and substance abuse programs for youth, HIV programs in prisons and jails, alternative to violence programs, community health issues trainings, and comprehensive health services at six School Based Health Centers. GBVHC has a 24-hour answering service and is open Monday-Saturday. Childcare is available on site.

In 2004, GBVHC opened the Framingham Community Health Center (FCHC) serving the region west of Boston. FCHC has two medical sites, a dental site, and is opening a school based health center. While not formally part of the PHPC program, FCHC provides access to comprehensive health care services for numerous Framingham's public housing residents.

Linkages/Partnerships
In collaboration with the Worcester Housing Authority, GBVHC is an active and founding member of the Great Brook Valley/Curtis Collaborative, a group of about a dozen agencies that partner with residents of public housing to assess their needs and interests, develop programs, and search for resources to address unmet needs.

GBVHC partners with Daybreak, the local battered women's shelter, to provide on-site services for domestic violence. To address the high infant mortality rate in Worcester, GBVHC collaborates with the community as grantee and lead agency for the Worcester Healthy Start Initiative, through which services are provided to many families living in public housing.

GBVHC collaborates with the other 330 funded agencies in the city (Family Health Cneter of Worcester and Community Healthlink) on services to HIV/AIDS infected patients, perinatal patients, the homeless, cancer prevention and access to treatment, and numerous other activities.

BPHC Collaborative Participation
On the national level, GBVHC was part of: 1) a Depression Collaborative, 2) a National Collaborative on Pediatric Asthma through the National Institute of Children's Healthcare Quality, and 3) the ADHD Collaborative of the Institute for Healthcare Improvement. GBVHC has applied information gathered through the Collaboratives to inform other of its initiatives such as Breast Cancer Screening, Diabetes, and Prenatal Dental Care.

Public Housing Locations/Sites
Great Brook Valley Health Center
19 Tacoma Street
Worcester, MA 01605

Statistics
Estimated residents in Public Housing: 9,800
Project Users: 7,961 in 48,331 encounters

Whittier Street Health Center
1125 Tremont Street
Roxbury, MA 02120
Phone: (617) 427-1000
Fax (617) 989-3247

Executive Director: Frederica M. Williams, FCIS, MBA
PHPC Program Manager: Dumas Lafontant
Medical Director: Kamau Karanja, MD

Project Description
Whittier Street Health Center, serves five (5) public, federally subsidized and privately managed housing developments within walking distance from the Center. In 1999, Whitter moved into a 33,000 square foot state-of-the-art facility owned by Northeastern University which is known as the Renaissance Park Building.

Services
Whittier is a JCAHO accredited urban community health center providing primary health care and social services to nearly 12,000 individuals from diverse communities. Whittier's patients are predominantly low-income, uninsured, and underinsured. The Center serves the homeless, elderly, disabled, and chronically ill populations. The mission is to provide high quality, reliable and accessible primary health care and support services to promote wellness and eliminate health and social disparities. Whittier Street Health Center has more than 30 core services and Mission based services including: adult medicine, counseling/ behavioral health, eye care, oral health, OB/GYN, orthopedics, pediatrics and adolescent health, creative arts therapy (drama, music and art therapy), podiatry, prevention, health education and promotion, geriatrics, dermatology, laboratory, physical therapy, radiology, mental health and substance abuse counseling, nutrition, clinical pharmacy program, medical interpreters, specialized clinics to address diabetes prevention and management, pediatric asthma and overweight, urgent care, Post-Prison Release Collaborative, Men's Health, W.Y.S.E. (Youth Program), Women Awareness Resources (W.A.R.) Project, HIV/AIDS, Women Infants and Children (WIC), prevention education, family care, advocacy and legal services, refugee health assessment, and domestic violence prevention and education.

Linkages/Partnerships
Whittier has an extensive network of memberships, partnerships, collaborations and affiliations that come together to provide an array of resources and services for the target population served.

These include:
Action for Boston Community Development, African Health Community Initiative, Boston HealthNet, Boston Housing Authority, Boston Public Health Commission, Boston Medical Center, Boston Healthnet,Boston Children's Hospital, Churches Organized, Save Tomorrow Research; Inc., CHANCE House (Faith Based), AIDS action Committee, Alice Taylor Resident Service, Black Ministerial Alliance, Boston Medical Center OB/Gyn, Boston Alcohol Detoxification Project IncCodman Square Health Center, Department of Neighborhood Development, Dana Farber Cancer Institute, Dimock Community Health Center, English High School, and Fenway Community Health Center, Joslin Diabetes Clinic, Neighborhood Health Plan

Harvard School of Public Health - Channing Lab, Harbor Lights Center, Hyde Park Square Task Force/La Sociodad Latina, Harvard Street Community Health Center, Latino Health Institute, La Alianza Hispana; Lennox/Camden Tenants Association, La Socidad Latina, Lower Roxbury Coalition, Lower Roxbury Youth Workers Alliance, Madison Park Development Corporation, Multicultural AIDS Coalition, Massachusetts AIDS Coalition, Massachusetts Department of Public Health, New Covenant Church, Nuestra Communidad, Northeastern University, Partnership Program, People's Baptist Church, Somali Development Center, Self Esteem Boston Educational Institute; Inc., St. Francis-St. Philip Des Sales Church, Roxbury Community Alliance for Health, SPAN, Stanley Jones Clean Slate Project, and Suffolk County House of Correction

BPHC Collaborative Participation
The Diabetes Collaborative
National Health Disparities Collaborative Cancer Demonstration Project (colon, breast and cervix)

Public Housing Locations/Sites
Whittier Street
Whittier Street Housing Development
Boston, MA 02120

Lenox Camden
Camden Street Housing Development
Boston, MA 02120

Alice Heywood Taylor
260 Ruggles Street, Housing Development
Boston, MA 02120

Hope VI
631 Parker Mission Main
Boston, MA 02120

Statistics
Estimated residents in Public Housing: 55,000
Projected Medical Users: 8,157
Actual Public Housing Users: 6,770

Missouri

Grace Hill Neighborhood Health Centers, Inc.
2524 Hadley Street
St. Louis, MO 63106
Phone: (314) 814-8716
Fax: (314) 814-8720

Executive Director: Alan Freeman
PHPC Program Manager: Villie M. Appoo
Medical Director: Yolette Brown, MD

Project Description
Grace Hill Neighborhood Health Centers has developed a collaborative approach to providing coordinated and comprehensive health care to the residents of public housing. The five Grace Hill health center sites are all located in some of the most underserved neighborhoods of St. Louis, all sites are within walking distance or within a one mile radius of public housing complexes.

Services
The residents of public housing complexes receive comprehensive health care through numerous Grace Hill services coordinated along an integrated continuum of care. The services provided include: Primary Health Care including adult medicine, pediatrics, OB/GYN, prenatal care, dental, optometry, pharmacy, developmental and mental health services for children, targeted services for the frail elderly, social services, nurse case management services, WIC, out posted DFS services and transportation.
Extensive outreach services are conducted by Grace Hill's outreach team on the three Health To Go Vans (Salud en Marcha) which go to several public housing complexes and Section 8 units on a regular, scheduled basis. Outreach staff on these vans provide health education, screening, make appointments for patients at various health center locations, and arrange transportation and other services needed to help the patient access health care.

Linkages/Partnerships
Adolescent Peer Counseling allows neighborhood youth to serve as peer counselors. Parenting Courses are provided for parents with special needs. Mental health services are provided for children with developmental delays and behavior problems up to the age of 12 years. This program has been expanded and coordinated by Grace Hill's Children's Developmental Center (CDC).
The PHPC Coalition comprising of representatives from the TMC's, area agencies, AIDS Service Organizations, other tenants and consumers meets monthly. This group reviews progress reports, provides input into decisions impacting their neighborhood, shares information on new resources and helps problem solve in a supportive and sharing environment.

BPHC Collaborative Participation
The Diabetes, Asthma, Breast and Cervical Cancer Collaboratives and The Cardio Vascular Disease Initiative. Grace Hill has also participated in the IHI sponsored 'Redesigning the Patient Visit' collaborative and has since been implemented at all sites. Using a similar model and PDSA strategies, Grace Hill also implemented the following four initiatives:
- Smoking Cessation
- Lead Poisoning Initiative
- Advanced Access - "With Every Heartbeat is Life" Initiative to address cardiovascular health for African Americans living in Public Housing.

Public Housing Locations/Sites
Clinton Peabody
1308 Dillion Street
St. Louis, MO 63104

LaSalle Park Village
1260 LaSalle
St. Louis, MO 63104

Vaughn Developments
1912 O'Fallon
St. Louis, MO 63106

Hope VI
Cochran Developments
1228 N. 9th Street
St. Louis, MO 63106

Blumeyer Developments
3330 Page
St. Louis, MO 63106

Darst-Webbe
4100 Lindell Blvd.
St. Louis, MO 63108

Senior Housing
Badenfest Elderly
8220 N. Broadway
St. Louis, MO 63147

Les Château
1330 Château
St. Louis, MO 63104

Cochran Towers
1112 N. 9th St.
St. Louis, MO 63106

Blumeyer Elderly
3210 MLK Blvd.
St. Louis, MO 63106

Statistics:
Estimated residents in Public Housing: 6,000
Project Users: 2,235 clinical users
Total Users: 4,749

Minnesota

West Side Community Health Services
1544 Timberlake Road, Suite 235
St. Paul, MN 55117
Phone: (651) 602-7545
Fax: (651) 558-2205

Executive Officer: Mavis Brehm
PHPC Program Director: Mary F. O'Connell
Medical Director: Mary Nesvig, MD

Project Description
West Side serves two public housing sites in St. Paul, MN that serve a predominantly refugee population (Hmong) and a growing Latino population. One clinic is located in the public housing community center and the other is community-based, approximately 2.5 miles from the public housing site. We provide comprehensive primary care services 5 days per week and offer extended hours urgent care services through our main clinic facility.

Services
Family Practice Care, midwifery services, bilingual/bicultural health education and outreach, diabetes case management services, social services, and Hmong Women's Support Groups for Depression and PTSD

Linkages/Partnerships
The Boys and Girls Club, PHA - Space and Outreach Activities, ECFE - Education of Parent's Children, and Hmong Women's Health Coalition - Community baby showers and educational events

BPHC Collaborative Participation
BPHC Redesign Collaborative, The Diabetes Collaborative

Public Housing Locations/Sites
McDonough Homes Clinic
1544 Timberlake Road
St. Paul, MN 55117

Roosevelt Homes (outreach only)
1575 Ames Avenue
St. Paul, MN 55106

East Side Family Clinic
860 Arcade Street
St. Paul, MN 55106

Statistics
Estimated residents in Public Housing: 7,000
Project Users: 3,488 (10,649 patient visits)

New York

Brooklyn Plaza Medical Center, Inc.
650 Fulton Street
Brooklyn, NY 11217
Phone: (718) 596-9800
Fax: (718) 596-9889

Executive Director: Gregory Haskins, DDS
PHPC Program Manager: Dianne Houston, LPN

Project Description
Brooklyn Plaza Medical Center (BPMC), a NY State licensed Article 28 Diagnostic and Treatment Center and non-profit community-based facility, operates three sites in the Fort Greene/Clinton Hill area of North Brooklyn. The main site is a Community Health Center, the second a School Based Health Center located in the Benjamin Banneker Academy (a New York City Board of Education Charter School), and the third a Public Housing Primary Care program to serve the residents of the Whitman, Ingersoll and Farragut public housing community.

Services
Geriatrics, adolescents, pediatrics, HIV/AIDS medical services, OB/GYN, and dental

Linkages/Partnerships
BPMC's 25 years in the community have lead to many long-standing linkages and partnerships with agencies including the Brooklyn Queens Community Health Center Network. Linkages and partnerships developed from the PHPC program include:

- New York City Housing Authority
- Respective tenant associations for Whitman, Ingersoll and Farragut housing
- Local Public Schools
- Community-based agencies including Community Counseling and Mediation
- Services and the Brooklyn Bureau of Community Services Daycare Program
- Local faith-based agencies
- St. Michael's Catholic Church and Church of the Open Door

BPHC Collaborative Participation
BPMC is currently participating with the Brooklyn Alliance of Clinical Collaboratives in the Prenatal Care clinical collaborative, and is starting Phase I participation in the Childhood Asthma collaborative with a WIFHC provider as the Team Leader.

Public Housing Locations/Site
Whitman Ingersoll Farragut
297 Myrtle Avenue
Brooklyn, NY 11205

South Brooklyn Health Center
120 Richards St
Brooklyn, NY 11231

Statistics:
Estimated residents in Public Housing: 20,000
Project Users: 817

Hudson River HealthCare, Inc
William E. Shands Community Health Center
807 Main Street
Peekskill, NY 10566
Phone: (914) 788-5251
Fax: (914) 788-3963

Executive Director: Anne K. Nolon
PHPC Program Manager: Allison Dubois
Medical Director: Paul Kaye, MD

Project Description
Hudson River HealthCare operates a health center in the Public Housing Authority during business hours with capability of making home visits. The clinical primary health care team conducts services both onsite at HRHCare, offsite at the William Shands Community Health Center at Bohlman Towers, in the homes of targeted residents of public housing and within the Emergency Room at the local hospital.

The Clinical Services Team is comprised of a Physician, a Primary Care Case Manager, RN, and a MSW/health education specialist. Residents requiring ongoing primary, dental, mental health and substance abuse treatment and follow up are referred and tracked at HRHCare and their network of specialty care providers.

HRHCare also implemented an onsite Public Housing Health Education Resource Center for residents and the surrounding community. An outstationed hospital based Community Care Resource Specialist is available to serve residents of public housing accessing emergency room care.

The Maternal-Infant Care Partner program, a dynamic support program for pregnant and newly parenting women, has been implemented onsite at public housing.

Services
Health care services: Family Medicine, Internal Medicine pediatrics/adolescent medicine, gynecology, perinatal care, obstetrics, family planning, nutrition (referral for treatment), optometry, podiatry, and psycho-social support

Additional services: Dental, mental health, HIV counseling & testing, WIC, contract pharmacy, HIV case management and education, laboratory, disease prevention, alcohol/substance abuse, family and youth services, and outpatient treatment

Linkages/Partnerships
Peekskill Housing Authority's Tenant Associations, Hudson Valley Task Force for the Homeless and those at risk of Homelessness, Peekskill Public Housing Authority, Peekskill City School District, Department of Social Services, Peekskill Community Service Center, Public Health Services - Region II

Westchester Housing Action Council, Hudson Valley Hospital, Northern Westchester Coalition for Housing and Homeless, Salvation Army - Family Resource Center; Peekskill Pastor's Association, Westchester County Department of Community Mental Health/Office of Alcohol and Substance Abuse, Dominican Sisters Family Health Services, Hudson River Housing

BPHC Collaborative Participation
Diabetes and Pilot Prevention Collaboratives

Public Housing Locations/Sites

Bohlman Towers
807 Main Street
Peekskill, NY 10566

Dunbar Heights
Peekskill, NY 10566

Barham House
951 Main Street
Peekskill, NY 10566

Statistics
Estimated residents in Public Housing: 2,000
Project Users: 1,300

South Bronx Health Center for Children and Families

Community Pediatric Programs of Montefiore Medical Center
871 Prospect Avenue
Bronx, NY 10459
Phone: (718) 991-0605
Fax: (718) 991-2931

Executive Director: Karen Redlener, MS
Senior Medical Director: Alan Shapiro, MD
PHPC Administrative Director/Medical Practice Manager: Marie Segares, MPH
PHPC Medical Director/Key Clinical Quality Person: Peter Meacher, MD, AAHIVS, FAASP

Project Description
The South Bronx Health Center for Children and Families (SBHCCF) of the Community Pediatric Programs (CPP) at Montefiore Medical Center is a "medical home" to children and families in a community that has historically lacked access to a health care system. The Health Center is located in the Motts Haven/Hunts Point section of the Bronx.

The health center has 12 medical exam rooms, two treatment rooms, a warm and inviting waiting area, and a large community meeting space. Additional sites include a satellite health center a few blocks away in the program's original storefront site, where WIC and dental services are provided.

Services
Pediatrics, adult primary care, women's health care, Ob/Gyn, prenatal services, family planning, birthing and parenting classes, mental health and developmental counseling, social work case management, adolescent and peer support groups, entitlements and insurance enrollment assistance, nutrition counseling and education, asthma treatment and education, subspecialty care referral and management, HIV care, primary dental care services, pediatric literacy project, and health education. A community partner provides free legal services on-site.

Linkages/Partnerships
WIC Program - NYCHHC Morrisania Neighborhood Family Care Center, Police Athletic League, Hispanic AIDS Forum, New York Legal Assistance Group, ASPIRA of New York, Osborne Association, Abraham House, Argus Community ACCESS Program, Trabajamos Community Head Start, Bronx Community Pride Center, Therapeutic Imprints, United Bronx Parents Inc., Banana Kelly Community Improvement Association, The Point Community Development Corporation

BPHC Collaborative Partnership
Northeast Redesign Collaborative

Statistics
Estimated residents in Public Housing: 65%
Project Users: 5,670

Ohio

Care Alliance, Inc.
1795 West 25th Street, Suite 251
Cleveland, OH 44113
Phone: (216) 781-6228
Fax: (216) 781-6256

Executive Director: Francois Afram-Gyning
PHPC Program Manager: Ann McDermott R.N.

Project Description
This program provides comprehensive primary health and dental care to residents of Public Housing in Cleveland. It is focused at two PHPC health center sites, one at the King-Kennedy Estates and one at Riverview Towers Estates. Services are both physically and culturally accessible to the target population, and strive to provide consistent, quality health and dental care to clients without regard to their ability to pay, utilizing a sliding scale of fees.

Services
Oral health care, STD testing and treatment, prenatal and postpartum care, well-child visits, immunizations, cancer screenings, gynecological examinations, subspecialty referrals, health education, podiatry, focus on diabetes through participating in a Diabetes Health Care Collaboratives and health outreach.

Linkages/Partnerships
AIDS Task Force, City of Cleveland Department of Public Health, Project SAFE Cuyahoga County Department of Senior and Adult Services, Neighborhood Family Practice, Northeast Ohio Neighborhood Health Services, Projector Luz, Ryan White Title 1 Consortium, Ryan White Title 2 Consortium, University Hospitals of Cleveland, YMCA, and Y-Haven. Scott Sazima, DDS; Dwight Scoot, DPM; Edward Falkner, DDS; Frank Karfes, DDS; John McDonald, DDS; Scott Sazima, DDS; Community assessment and Treatment Center, St Malachi, and Alternative Agency, Inc

BPHC Collaborative Participation
Diabetes Collaborative

Public Housing Locations/Sites
Kind-Kennedy Estates
6001 Woodland Avenue
Cleveland, OH 44104

Riverview Towers Estates
1745 West 25th Street
Cleveland, OH 44113

Statistics
Estimated residents in Public Housing: 5650
Project Users: 1,292

Columbus Neighborhood Health Center, Inc.
3433 Agler Road, Suite 2800
Columbus, OH 43219
Phone: (614) 645-1600
Fax: (614) 645-1347

Executive Director: Carl I. Walters II,
PHPC Program Manager: Pearline Byrd

Project Description
Columbus Neighborhood Health Center, Inc. (CNHC), was established in 1997 through a merger of five Section 330 (e) Consolidated Health Centers and a Section 330 (h) Health Care for the Homeless program.

Services
A fulltime Medical Director administers a provide staff of physicians, nurse practitioners and medical professionals offering: interpreter services; family practice; internal medicine; OB/GYN; pediatrics, dentistry, optometry, health and wellness; patient education; case management; referral services; podiatry; smoking cessation; mental health services; nutrition services; homeless services; enabling services; laboratory services through a contract with Grant/Riverside (limited testing is done in-house); transportation and social services are all available in the five, urban, state-of-the-art facilities within the health care deliverly model. In addition, pharmacy services include: 340B under a contract with Kroger Pharmacy; Sharing to Care; P.A. - Patient Assistance Program and a Tobacco Program.

Linkages/Partnerships
- Hospitalization Services: Grant/Riverside Hospital, Ohio State University Hospital, Children's Hospital, and Mount Carmel Hospital

- Ancillary and Reference Laboratory Services: Grant/Riverside Hospital Behavioral

- Health/Substance Abuse: Netcare/Access, Inc. Southeast Recovery and Mental Health Services , and Children's Hospital

- School-Linked Health Care Services: Mifflin Middle School, Mifflin Senior High School, and City of Columbus Public Schools

- Public Health Services: Columbus Public Health and Ohio Department of Health

- Housing: Columbus Metropolitan Housing Authority and OMNI Management Group Ltd.

- Education, Training and Employment: Franklin County Department of Human Services, Somali Community Association, Mifflin Youth Association, Ohio Dominican College, My Brother's Keeper Health Ministry, New Salem Community Reinvestment Corporation, Dayspring Christian Community Development Corporation, Greater Linden Community Development Corporation, Columbus State Community College; Columbus Housing Partnership, The Private Industry Council; Northeast Area Commission, and Urban Concern

- Churches: Love Zion Baptist Church; Mt. Hermon Baptist Church, New Salem Baptist Church, and First Church of God

Public Housing Locations/Sites
Providence Glen
2421 Adonai Boulevard
Columbus, OH 43219

Crossroads Village Apartments
2943 Cassady Court
South Columbus, OH 43219

Agler Green
2744 Gateway Court
Columbus, OH 43219

Cassady Village
3089 Cassady Village Triangle
Columbus, OH 43219

Capital Park Apartments
2144 Agler Road
Columbus, OH 43219

Renaissance Village
2626 Kenbridge Drive
Columbus, OH 43219

Senior Housing
Corban Commons
3426 Corban Commons Drive
Columbus, OH 43219

Statistics
Project Users: 2,762

Pennsylvania

The Family Practice & Counseling Network
4700 Wissahickon Ave
Philadelphia, PA 19144
Phone: (215) 298-0404
Fax: (215) 215-298-0501

Executive Director: Donna Torrisi
Primary Care Director: Lester Cohen

Project Description
The Family Practice & Counseling Network is comprised of four Community Health Centers located in low-income neighborhoods in Philadelphia. Each of the health centers focus on residents of public housing and uninsured people. The first site opened in 1992 in the Abbottsford Public Housing Development, with the other three opening in 1994, 2002, and 2003.

Services
Primary Health Care, dentistry, mental health services, prenatal care, health education, nutrition education, health promotion services, special programming for patients with chronic illness, social services programs, smoking cessation group, diabetes group, cancer support, drug and alcohol recovery, home visitation for education on asthma and lead toxicity, creative arts programs, The Peaceful Posse, Daring Interventions - Voices of Adolescence for Girls, Teens Making a Difference, violence prevention, Reach Out and Read, Physical Therapy, Podiatry.

Health care is provided by Nurse Practitioners, Registered Nurses, Nurse Midwives, Mental Health Therapists, Dentists, Physical Therapists, Podiatrist, and Psychiatrists.

Transportation is provided for patients to specialists, dentists, and to the other health centers when necessary. If needed, staff will accompany patients to off-site health care visits. The social workers, primary care team and outreach workers assist patients with obtaining medical insurance if they are eligible.

Linkages/Partnerships
We strengthen and enrich our centers' services by partnering with Physicians for Social Responsibility, the Institute for Safe Families, Philadelphia Housing Authority, Drexel University, and the Family Planning Council.

Additional partnerships include community advisory boards comprised of representatives from several local resident leadership councils.

BPHC Collaborative Participation
Family Practice & Counseling Network has participated in the Depression Collaborative and has internally spread to Diabetes.

Public Housing Locations/Sites
Eleventh Street Family Health Services
850 N. 11th Street
Philadelphia, PA 19123

Health Annex
5803 Kingsessing Avenue
Philadelphia, PA 19143

Abbottsford Family Practice & Counseling
3205 Defense Terrace
Philadelphia, PA 19129

Statistics
Estimated residents in Public Housing: 6,200
Project Users: 9,800

Philadelphia Health Management Corporation
260 S South Broad Street #18
Philadelphia, PA 19102
Phone: (215) 985-2500

President/CEO: Richard J. Cohen
PHPC Contact: Elaine R. Fox

Project Description
Philadelphia Health Management Corporation is the parent organization for Philadelphia's Health Care for the Homeless Program and two satellite public housing health centers. The public housing sites are The Rising Sun Health Center and the PHMC Health Connection. Both PHPC programs provides residents of public housing communities comprehensive health care services through the direct provision of primary care, disease prevention activities, STD identification and treatment and counseling and social work services on the premise of these public housing developments.

Services
Both Rising Sun and PHMC Health Connection provide primary health care to children and adults, family planning for men and for women, health education, outreach, diagnostic, laboratory and social work/behavioral health services to the public housing community and surrounding neighborhood.

Linkages/Partnerships
PHMC has established multiple collaborations in the community including hospitals, the Philadelphia Department of Health, mental health and substance abuse programs, local colleges and universities. Access to emergency needs (shelter, food, clothing), job training, assessment for entitlements, dental services, optometry, and advocacy for cultural and linguistic appropriate services are provided.

BPHC Collaborative Participation
Diabetes Collaborative

Public Housing Locations/Sites
The PHMC Health Connection
1035 W. Berks Street
Philadelphia, PA 19122

Rising Sun Health Center
500 Adams Avenue
Philadelphia, PA l9120

Primary Care Health Services, Inc
7227 Hamilton Avenue
Pittsburgh, PA 15208
Phone: (412) 244-4700
Fax: (412) 244-4992

Executive Director: Wilford A. Payne
PHPC Program Managers: Elizabeth A. Quinn and Len Lavender
Medical Director: Jerome Gloster, M.D.

Project Description
Primary Care Health Services (PCHS) provides a comprehensive program of primary and preventive health care through a staff model practice that includes a Family Practice Physician, Pediatrician and OB/Gyn. A nurse manager and two medical assistants support the physician providers. A dentist, dental assistant and outreach worker complete the overall staffing. Special emphasis is placed on prevention through health education and health screening. Well child care (including immunizations), and early prenatal care are continual program priorities.

Services
Primary Medical Care for adults and children; diagnostic laboratory, diagnostic test/screens, 24-hour coverage, family planning, HIV testing, immunizations, follow hospitalized patients, OB/Gyn care, dental, mental health, hearing screening, pharmacy, podiatry, vision screening, WIC, case management, discharge planning, health education, outreach, transportation, and translation (24-hour contract with translation services)

BPHC Collaborative Participation
In concert with local providers, PCHS has initiated the development of a Pittsburgh Diabetes Collaborative with input from the Bureau of Primary Health Care.

Public Housing Locations/Sites
Hill House Health Center
1835 Center Avenue
Pittsburg, PA 15219

Statistics
Estimated residents in Public Housing: 1,850
Project Users: 1,353

University of Pittsburgh, Matilda Theiss Health Center
373 Burrows Street
Pittsburgh, PA 15213-2261
Phone: (412) 383-1550
Fax: (412) 383-2133

Executive Director and PHPC Program Manager: Mary Patricia Nowalk, PhD, RD
Medical Director: Dawna Woodyear, MD

Project Description
The Matilda Theiss Health Center, targeting populations in the Hill District, Terrace Village, Oak Hill, West Oakland and South Oakland, is located four miles from the Pittsburgh central business district. The residents of these neighborhoods have difficulty accessing health care. Medicaid enrollees in the target area are less likely to receive chronic disease screening than individuals enrolled in local commercial health insurance plans.

Services:
24 hour coverage for general primary medical care, family planning, HIV testing and counseling, OB-GYN, prenatal, labor, delivery and post-partum care, mental health screening, on-site evaluation and referral services, preventive and restorative dental care services, vision screenings, and on-site pharmacy dispensing service

Public Housing Locations/Sites
Terrace Village/Oak Hill

Statistics
Estimated residents in Public Housing: 4,600
Project Users: 1600

Texas

CommuniCare Health Centers
(formerly Barrio Comprehensive Family Health Care Center, Inc.)
3066 East Commerce Street
San Antonio, TX 78220
Phone: (210) 233-7070
Fax: (210) 277-5199

Chief Executive Officer: Debbora A. Thompson
PHPC Program Manager: Augustin Sicard, PhD, MPH, ND,

Project Description
CommuniCare Health Centers acquired the Public Housing Primary Care project when it merged with the Ella Austin Health Center in 2000. Ella Austin Health Center was one of the 7 original PHPC grantees. CommuniCare's PHPC project serves pproximately 82 public housing developments in San Antonio and Bexar County.

Services
Outreach - Address special needs of public housing and Section 8 residents with medical, dental, nutritional, and behavioral health services; Hospital and home visits

Health Education - Individual and group health classes; individual health checks (blood pressure, blood sugar, cholesterol); diabetes education, immunizations; STD prevention; family planning

Behavioral Health - Couple and individual counseling; problem solving; listening and communication skills; psychiatric consultation; support groups

Linkages/Partnerships
San Antonio Housing Authority, Housing Authority of Bexar County

BPHC Collaborative Participation
CommuniCare Health Centers is a participant in the Diabetes Health Disparities Collaborative.

Public Housing Locations/Sites
Wheatley Courts
1821 Hays Street
San Antonio, TX 78202

Statistics
Estimated residents in Public Housing: 18,900 families, 38,923 individuals
Project Users: 3,789 unduplicated

Centro de Salud Familiar La Fe, Inc.
608 South St. Vrain
El Paso, TX 79901
Phone: (915) 534-7979
Fax: (915) 534-7601

Executive Director: Salvador Balcorta,
PHPC Program Manager: Concepcion Reyes

Project Description
Centro de Salud Familiar La Fe provides comprehensive primary health care services to residents of public housing. Services are provided at a family housing site and a senior high rise.

Services
Primary medical and dental services, immunizations, OB/GYN, family planning, free pregnancy and HIV testing, comprehensive HIV Care Center, laboratory, X-rays, pharmacy, health promotion, disease prevention, WIC, Senior Companion Program, CASASTART Program, Banco del Barrio (Time Dollar), CHIP Program, Child and Adolescent Wellness and Cultural and Technology Center

Linkages/Partnerships
El Paso City County Health District, Texas Department of Health, Texas Tech Health Sciences Center, Paso del Norte Health Foundation, West Texas HIV Assembly, Cancer and Chronic Disease Consortium, Superior Health Plan, National Council of la Raza

BPHC Collaborative Participation
The West Central Cluster-Diabetes Collaborative

Public Housing Locations/Sites
Lisbon Satellite Clinic
560 Lisbon
El Paso, Texas 79905

Sun Plaza Satellite Clinic
1221 San Antonio
El Paso, Texas 79901

Statistics
Estimated residents in Public Housing: 6,899
Project Users: 2,230

Heart of Texas Community Health Center
1600 Providence Drive
Waco, TX 76707
Phone: (254) 750-8200
Fax: (254) 750-8326

Executive Director: Roland Goertz, MD
Medical Director: Tim Barker, MD

Service Sites:
Bell's Hill Elementary
2125 Cleveland
Waco, TX 76706
(254) 754-2600

Family Practice Center
1600 Providence
Waco, TX 76707
(254) 750-8200

Elm Street Clinic
609 Elm Street
Waco, TX 76704
(254) 754-0001

Waco Lung Associates
Office B
6901 Medical Parkway, Suite 205
Woodway, TX 76712

Connally Community Clinic
715 North Rita
Lacy Lakeview, TX 76705
(254) 412-2101

Women's Health Center
3115 Pine Ave
Suite 306
Waco, TX 76708
(254) 756-2466

Family Counseling and Children's Services
5020-A Lakeland Circle
Waco, TX 76710
(254) 751-1777

South 18th Street Community Clinic
1800 Gurley Lane
Waco, TX 78706
(254) 296-0123

McGregor Community Clinic
500 South Johnson Drive
McGregor, TX 76657
(254) 840-9171

Bellmead Community Clinic
3400 Bellmead Drive
Bellmead, TX 76705
(254) 867-0400

Washington

Puget Sound Neighborhood Health Centers
905 Spruce Street, Suite 300
Seattle, WA 98104
Phone: (206) 461-6935
Fax: (206) 461-8583

Executive Director: Mark Secord
PHPC Program Manager: Joseph Sparacio
Medical Director: Grace Wang, MD

Project Description
Our PHPC project provides community health education, mental health and chemical dependency counseling and related outreach services to residents in three public housing sites: Rainier Vista, New Holly, and High Point.

Services
PSNHC provides comprehensive primary medical, dental, OB, mental health, chemical dependency counseling and ancillary services to all public housing residents. PSNHC's services are provided in a manner that encourages patients' active participation in improving and maintaining their own health. This includes a strong emphasis on health promotion education and preventive services.

Our health center services are provided in teams; a provider or mid-level works with a nurse, medical assistant, front desk staff member and interpreter. The mental health counselors work closely with the medical providers. Our health educators work in a team with the outreach staff and our public housing resident advisors to deliver information that is requested and relevant to meeting residents' expectations.

Linkages/Partnerships:
Seattle Housing Authority, Neighborhood House (social services), Seattle University (faculty and student nurses), Jobs Plus; Public Health Seattle/King County, and Seattle Public Schools

BPHC Collaborative Participation
The Asthma, Diabetes, and Depression Collaboratives

Public Housing Locations/Sites

Rainier Park Medical Clinic
4400 37th Avenue South
Seattle, WA 98118

Rainier Beach Medical Clinic
8444 Rainier Avenue South
Seattle, WA 98118

Georgetown Dental Clinic
6200 13th Avenue South
Seattle, WA 98108

Central Area Dental Clinic
2101 East Yesler
Seattle, WA 98122

Southeast Family Dental Clinic
3800 South Myrtle
Seattle, WA 98118

Statistics
Estimated residents in Public Housing: 24,000
Project Users: 4,868