Community Voices: Service Program at CFCM

NORTHERN MANHATTAN COMMUNITY VOICES

Northern Manhattan houses less than one-third of the Manhattan population, yet accounts for nearly 60 percent of the Medicaid-eligible persons with disabilities, elderly, or families living under the federal poverty requirement residents in the borough.

In the 1980s, Northern Manhattan received the largest influx of legal immigrants of any New York City neighborhood. Studies indicate that a large number of foreign-born U.S. residents are not covered by health insurance. Northern Manhattan immigrants, who make up a significant portion of the working poor, experience high levels of underemployment and unemployment and a significant lack of health insurance. Language barriers and cultural practices also affect the level and quality of care in this community.

Hospital closings have also had a significant impact on access to health care and the economic health in Northern Manhattan. Between 1967 and 1987, eight neighborhood or nearby hospitals closed. These closings greatly decreased the number of available doctors and deprived the community of thousands of essential jobs.

The entire community struggles to keep up with the rules for government-funded health insurance, such as Medicaid or Child Health Plus (CHP), the state´s Child Health Insurance Program (CHIP). Welfare reform in 1996 ended or amended benefits for many and created fear of deportation among the immigrant population. Even today, many people still do not understand their eligibility for benefits.

Language, transportation, and a difficult application process further contribute to the lack of coverage for those who may be eligible for government-funded health care. The problem is so widespread that more than two-thirds of children without insurance are eligible for CHP insurance, but their parents fail or are reluctant to apply.

PROJECT ACTIVITIES

To address the needs of the uninsured and underinsured in the community, the Northern Manhattan Community Voices Collaborative is:

Using the Community Health Outreach Worker Training Program to promote access to health care services and enrollment in Medicaid and Child Health Plus.
Developing low-cost, high-quality health coverage for uninsured Northern Manhattan residents.
Developing health and wellness education programs through hospitals, churches, and community groups.
Expanding service availability for primary care through expanded office hours and the availability of nurses or physicians for phone consultations.
Offering training to help providers develop stronger partnerships with patients.
Revising Medicaid and CHP outreach materials to make them linguistically and culturally appropriate.
Developing a system for preventing interruptions to Medicaid coverage.
Training dental assistants through the Dental Assistant Training Program. The one-year program is open to high school graduates or those who have passed GED exams. There is no cost to students thanks to a grant from Empowerment Zone.

One important undertaking is the Mannie L. Wilson Senior Citizen project, a $2.8 million construction project located at 124th Street and Manhattan Avenue in the heart of Harlem. The Collaborative is working with a coalition of Harlem Senior Centers, Harlem Hospital, and the Harlem Congregations for Community Improvement on an access plan to ease the path for seniors to get care. This includes a transportation component and other ways to make it easier for the elderly to get comprehensive rather than merely acute care, including much-needed oral health services, to manage chronic conditions instead of just acute care.

Another important project is the Asthma Initiative. The Fund for the City of New York and the Beldon Fund have expressed interest in funding this project. The Fund for the City of New York is interested in assisting the Northern Manhattan Community Voices in coordinating a web-based initiative for community based organizations and residents. The Beldon Fund has expressed interest in helping with the environmental aspects of asthma management so that the Collaborative can work with the Housing Authorities and others to take care of some of the environmental factors contributing to the high prevalence of asthma.

COMMUNITY INVOLVEMENT

The Northern Manhattan Community Voices Collaborative increases access to health services for the uninsured and underinsured in the Central Harlem and Washington Heights-Inwood community. The collaborative addresses community health needs with the following strategies:

Enrollment in Medicaid and CHP. The Northern Manhattan site enrolls uninsured persons who are eligible for Medicaid, Child Health Plus, WIC, and other coverage options.
Affordable primary health care coverage. The Northern Manhattan site is developing low-cost, high-quality health coverage for uninsured Northern Manhattan residents.
Health education and disease prevention programs. The Northern Manhattan site offers training and education on important health promotion and disease prevention strategies.
Access to important health resources. The Northern Manhattan site facilitates access to dental and mental health services that may not be covered by insurance.

Community Voices Northern Manhattan partner agencies also include; the Joseph L. Mailman School of Public Health, Community Premier Plus, Harlem Congregations for Community Improvement, Inc., Isabella Geriatric Center, New York Presbyterian Hospital, Renaissance Health Care Network, West Harlem Environmental Action, Inc (WHE ACT), Arthur Eugene & Thelma Adair Community Life Center, Inc., Inwood Community Services, New York Task Force on Immigrant Health, and the Start Right Coalition.