Five million dollars in grants from last year’s state budget will allow New Jersey to expand primary care in its federally qualified healthcare centers, or FQHCs, by hiring more nurses and physicians.The grants, announced February 13 by New Jersey Governor Jon Corzine and NJDHSS Commissioner Heather Howard, will increase access to healthcare and decrease healthcare disparities through the hiring of more midwives, adding extended hours of service, and purchasing medical equipment.
“As a result of funding, we will be able to take a two-sided approach to promote good health in women,” says Theresa Beck, RN, MPA, vice president, Community Initiatives, Visiting Nurse Association of Central Jersey, Red Bank. “With more nurses on staff, we can increase primary care sessions by two days each week, and we will also be able to increase prenatal time at three sites,” she says.
Because of the downturn in the economy, there is an increase in prenatal visits at VNACJ’s Women’s, Infant, and Children Nutrition Program locations, but Beck believes primary care locations will be affected as well. Some who have historically sought out private physicians are now using healthcare centers or delaying care because of the economic situation, she says.
The extended care at VNACJ health centers will begin in Asbury Park, ranked as the third highest New Jersey city in perinatal risk, according to state statistics. “This VNACJ location provides care for a significant number of women who seek prenatal care late in pregnancy,” says Beck. “The challenge is to get women in early for care, to reduce the risk of low-birth weight, infant mortality, and poor birth outcomes,” she adds.
Roseann Fiasonaro, RN, prenatal nurse, describes her clients at Asbury Park as diverse, including African-Americans, Hispanics, and Haitians, with the average age in the 20s. “Many are fearful to seek care,” says Fiasonaro. “We want clients to know that they can receive care regardless of their insurance or migration status,” she says.
The grant funding will allow expanded outreach to community grassroots organizations, to educate the community about the importance of prenatal care and encourage them to spread the word that there is a place where women can receive care.Patti Whyte, RN, certified nurse midwife, VNACJ Community Health Center, performs a prenatal assessment.
Opportunity for Extended Care
“This is an opportunity for primary care nurses, who are important to our program,” says Linda Flake, MBA, president/CEO, Southern Jersey Family Medical Centers in Hammonton. Because of the funding, additional staffing will include a nurse midwife or an OB/GYN, or both.
Southern Jersey Family Medical Centers operates eight healthcare centers in Atlantic, Burlington, and Salem counties, and plans to increase accessibility to prenatal care in Atlantic City and add prenatal care at the Pleasantville healthcare center. Last year, over 600 babies were delivered by Southern Jersey Family Medical Centers providers.
Director of Nursing Serena Hammie, RN, BSN, MBA, says, “Nurses at Southern Jersey are looking at this as a chance to expand their expertise in the area of women’s health, while providing quality services to a needy population.”
Holding Up the Net
According to Howard, 16 of 20 New Jersey FQHCs are receiving funding, with grants ranging from $153,600 to $664,250. “FQHCs are an essential part of our healthcare safety net that provides medical homes to the medically underinsured,” says Howard. “The healthcare system is under stress like never before, and during this time of economic recession, it is critical that we support the healthcare safety net, which this funding allows us to strengthen,” she says. Since their establishment about 40 years ago, FQHCs have provided care for the medically underserved, with each local health center owned and directed by the people it serves.
Helping the Needy
More than 1.3 million in New Jersey do not have health insurance. The typical person who visits the FQHC is uninsured, underinsured, or unemployed, enrolled in FamilyCare, or a recipient of Medicaid or Medicare. More than 70% of patients seen at the health centers are children and women of childbearing age.
According to NJDHSS, 324,225 patients flow through FQHCs annually. Visits are expected to increase between 3% and 4% because of the economic downturn.
FQHCs provide primary medical care services with a culturally sensitive, family-oriented focus to anyone in the state’s high-need regions and rural areas who needs care, regardless of ability to pay. The broad array of preventive, primary, and acute care medical services include dental, well baby care, school-based services, preventive screenings for cancer and other chronic illnesses, diagnostic laboratory and radiological services, case management of specialty and inpatient services, emergency medical services, family planning, and health education. Because these centers serve low-income people, they often provide transportation, outreach, and translation.
A 2001 study of Medicaid beneficiaries in five states concluded that those who received care at health centers were significantly less likely to be hospitalized or to visit hospital EDs for ambulatory care-sensitive conditions than those who received care from other providers.
New Jersey FQHCs
New Jersey FQHCs that have received expansion funding:
Camcare, $303,776 to hire staff and buy medical equipment and supplies for a new site, HOPE VI, in southern Camden
Eric B. Chandler, New Brunswick, $251,880 for equipment
Community Health Care, Cumberland County, $240,526 to expand women’s services at four sites
Henry J. Austin Health Center, Trenton, $255,600 to expand OB/GYN services and hire staff to operate a call center for patients seeking appointments
Horizon Health Center, Jersey City, $298,468 to staff a satellite facility in Bayonne, where a prenatal clinic closed in June 2006
Jewish Renaissance, Perth Amboy, $276,742 to hire a dentist and hygienist and to buy a new ultrasound system
Metropolitan Family Health Network, Jersey City, $266,700 to hire an OB/GYN and nurse midwife
Monmouth Family Health Center, $275,000 for renovations and dental supplies
Newark Community Health Center, $365,400 to hire an OB/GYN, nurse midwife, and expand OB/GYN services
Neighborhood Health Services Corp., Plainfield, $644,250 to ensure access to a medically underserved population affected by the closing of its community hospital
North Hudson Community Action Center, $450,000 for salaries, equipment, renovations, and program expenses for its Hackensack site
Ocean Health Initiatives, $200,000 for expansion services to seniors in Manchester and Lacey Township
Paterson Community Health Center, $153,625 to fund an outreach manager and workers
Southern Jersey Family Medical Centers, Hammonton, $240,000 to expand OB/GYN services
Visiting Nurse Association of Central Jersey, $176,154, to fund nurse midwife consultants, hire an outreach worker, and buy medical supplies
Zufall Health Center, Dover, $200,000 to make renovations to its new satellite in Morristown
Lorraine Steefel, RN, DNP, CTN, is a senior staff writer for Nursing Spectrum.