foreword The American Medical Association Committee on Community Health Care, through its Task Force consisting of designated Committee members and AMA staff, made a series of site visits to 30 selected community health delivery systems. The site visits were begun in February 1969 and completed in the early fall of 1971. They were designed to study a broad range of new or alternative patterns and systems of community health delivery programs. This publication is an outgrowth of the Task Force's efforts and is presented in two sections. The first section is the report adopted in December 1971 by the House of Delegates of the American Medical Association. This report consists of a brief analysis of the collected data, summary and conclusions, and recommendations for physician involvement, either directly or indirectly, in community health programs. The second section includes individual narratives about the community health programs visited by the Task Force. Included is information concerning geographic location, administration, finance, demographic structure of the area served, medical and health services provided, manpower utilization, and physical facilities used. All descriptions of individual programs are based on information that was current at the time of the site visits, and some changes have probably occurred in many of the programs since then. Some program narratives highlight aspects of the program that their representatives perceived as innovative and that were thought to have promise for use in other locations in alleviating some of the basic problems of health care delivery at the community level. The AMA has for many years supported the concept that there is no single approach—no single master plan-that can suit the needs of every community. The diversity of community approaches to meeting the needs of varying communities presented herein emphasizes the merits of continuing to have a multiplicity of patterns of health care delivery. Copyright© 1972, Revised 1973 American Medical Association 535 North Dearborn Street Chicago, Illinois 60610 All rights reserved PD-210-1804-1380:2M5C:135-J:4/73 For additional copies write to: Department of Community Health AMERICAN MEDICAL ASSOCIATION 535 North Dearborn Street Chicago, Illinois 60610 table of contents Foreword/ iii SECTION II--NARRATIVES ON COMMUNITY HEALTH PROGRAMS VISITED BY TASK FORCE Community Health Programs Visited by Task Force, Feb/69-Sept/71 Atlanta Southside Comprehensive Health Center, Atlanta, Georgia / 14 East Baltimore Medical Plan, Baltimore, Maryland / 15 Bunker Hill Health Center, Boston, Massachusetts / 17 Harvard Community Health Plan, Boston, Massachusetts / 18 Health, Incorporated, Boston, Massachusetts / 20 Tufts-Columbia Point Health Center, Boston, Massachusetts / 21 Hope Medical Center, Estancia, New Mexico / 31 Fresno County Medical Society-Firebaugh and Mendota Health Care Services Program, Fresno County, California / 33 East Jacksonville Neighborhood Health Center, Jacksonville, Florida / 34 King City Health Center, King City, California / 36 Lafayette County Health Center, Lafayette County, Florida / 37 South Central Multipurpose Health Services Center, Los Angeles, California / 38 University of Miami Projects, Miami, Florida / 40 Brooklyn-Cumberland Medical Center, New York, New York / 41 East Harlem Triangle Community Health Project, New York, New York / 43 Samaritan Health Service, Phoenix, Arizona / 45 Surgicenter, Phoenix, Arizona / 46 Mission Neighborhood Health Center, San Francisco, California / 47 Presbyterian Medical Services, Santa Fe, New Mexico / 48 Remote Area Health Project, Santa Fe, New Mexico / 50 Wakita Health Center, Wakita, Oklahoma / 51 Upper Cardozo Health Center, Washington, D.C. / 52 George Washington University Medical Center Delivery System, National Medical Association Foundation, Washington, D.C. / 56 A Task Force of the Committee on Community Health Care, composed of designated members of the Committee and staff, conducted a series of site visits to selected community health delivery programs. Initially, data were gathered on neighborhood health centers; however, the Task Force soon recognized that a study limited only to neighborhood health centers would be inadequate since the intent was a study of representative types of community health programs. The Task Force expanded its study to include satellite clinics, ambulatory surgical facilities, closed-panel prepaid group practices, and a number of experimental and innovative programs. In a majority of the visits, the Task Force utilized a multipage data form to secure uniform information on the many aspects of the projects visited. Visits were made to 30 programs (see Section II) which were selected on the basis of geographic location, sponsorship, information from local medical societies and other health groups, innovative approaches to problems, and receptiveness of program administrators to inclusion in the study. In addition to the site visits, data were obtained by mail survey from other community delivery programs. Although there was no effort to have this study include a statistically valid sample of programs, the Task Force arrived at some conclusions formed as a result of the information gathered. This report summarizes the information obtained, includes a brief analysis of the data, and presents recommendations for involvement by physicians and medical societies that are intended to help improve community health programs. SPONSORSHIP AND FINANCING The programs were sponsored by a variety of groups, including medical societies, medical schools, medical society foundations for medical care, private *Submitted as Council on Medical Service Report B and adopted by the AMA House of Delegates, December 1971. |