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Summit will address health-care access

By William K. Alcorn

Sunday, August 31, 2008

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Youngstown Mayor Jay Williams

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U.S. Rep. Tim Ryan of Niles

By William K. Alcorn

No one entity can solve this problem by itself.

YOUNGSTOWN — The problem of caring for the burgeoning numbers of uninsured and under-insured Mahoning Valley residents has health-care competitors working together toward a solution.

Humility of Mary Health Partners and Forum Health, along with Ohio North East Health System, took lead positions in the newly formed Mahoning Valley Access to Care Network, the primary goals of which are to raise awareness about the health-care crisis and identify potential solutions.

Nine months of work by the three health-care organizations, along with Jacqueline Taylor, a research economist in Youngstown State University’s Center for Urban and Regional Studies, will culminate Friday with the first “Access to Care Community Breakfast and Summit.”

The event is from 8 a.m. to 12:30 p.m. at YSU’s Kilcawley Center Chestnut Room.

Several people have been invited to participate, from the mayors of area cities to county commissioners to hospital officials to nonprofit organizations to foundations.

The Access to Care Network was formed by the two major hospital systems, HMHP and Forum, and Ohio North East Health System “to see how we can work together collaboratively to address the medically uninsured population in our community,” said Dr. Ronald Dwinnells, ONEHS’s chief executive officer.

“Truthfully, there are differences of opinion on how best to approach this. HMHP is interested in trying to obtain community funds to help subsidize the care of medically uninsured population,” Dwinnells said.

SDLqMy thoughts are: Why not utilize and support our organization, which is established and specifically structured to take care of the indigent population through our federal funding support and various entitlements such as federal medical malpractice coverage and the federal drug pricing program,” he said.

He suggested the two hospital systems work collaboratively with ONEHS, through support of possibly resident physicians and on the emergency room issue. “We could see the nonemergency patients and they can see the urgent patients,” Dwinnells said.

While much has to be worked out — and Friday’s summit is aimed at getting that process started on a wider basis — the parties all say they agree on at least one thing: No one entity can solve this problem by itself.

“We all need to work together for the betterment of this community and keep our organizations financially sound so we can continue to provide vital health services and keep our citizens healthy,” Dwinnells said.

Money is not the only key issue.

In an interview, Michael Robinson, director of primary care and community outreach at HMHP; Michael Cicchillo, vice president of external affairs at Forum; and Elizabeth Haddle, chief operating officer for Ohio North East Health System; all said of primary importance was establishing a medical home for people without family physicians.

“From Forum’s perspective, what we’re really looking for is continuity of care for the community. We’re looking for a system where patients don’t use or regard the hospital emergency room as their family doctor or medical home. The emergency department provides only episodic care,” Cicchillo said.

“When we look at health care, we want to make sure that people get care in an appropriate place; that they aren’t treated in the ER unless it is a true emergency,” Robinson said.

Surprisingly, the leading diagnoses in the ER are not for life threatening conditions, Haddle said.

Having a medical home or family physician, in which a patient/doctor relationship is developed, leads to better care, Robinson said.

Phase One of forming the Mahoning Valley Access to Care Network was about gathering information, including looking at other sites across Ohio and how they have addressed what is a very complex problem, Cicchillo said.

Phase Two, Cicchillo said, will be the formation of a larger steering committee that will establish subcommittees to work on topics such as funding and clinical care.

“Our goal is to have something in place by the end of 2009 or early in 2010,” Cicchillo said.

Hospitals will continue to provide charity care, but patients are falling between the cracks and we don’t want that to happen,” Cicchillo said.

“As we’re working together, we’re trying to come up with a strategy to bring more community leaders to the table. This is not just the hospitals’ problem, but a community-wide problem, and we are looking for the community at large to get behind this initiative,” Robinson said.

“We’re not at the point where we can say we need a certain dollar figure. But, it will take collaboration and financial contribution from other organizations and government to address the problems,” he said.