Provider Perspectives: Celebrating Health Equity Progress in Monroe County (Part 1)
Bloomington Health Foundation’s President & CEO, Michelle Gilchrist, recently sat down with a panel of leaders from IU Health, HealthNet Bloomington and the Monroe County Health Department as part of the Monroe County Health Equity Council’s Health Summit to discuss achievements and challenges when it comes to health equity in Monroe County.
Quotes have been lightly edited for clarity and length.
Michelle Gilchrist: When there’s a need to have difficult conversations like health equity, we tend to focus on the negatives and lead with a negative perspective. Our objective here is to understand what has been done, for us to ponder and consider what needs to be done, and then come to a consensus about what we’re going to do. What are some of our community’s greatest successes as it relates to health equity?
Shelley Sallee, Center Manager at HealthNet Bloomington Health Center: HealthNet is a Federally Qualified Health Center, which means that we will see anyone, no matter what their background is, and regardless of their ability to pay. That’s a hard thing to do, but, by golly, we do it. What I’m so proud of is that we look at each patient as an individual and we try to work where they are.
For instance, we do refugee physicals for the southern Indiana community. We have 47 different languages spoken in our center as well as 50+ cultures represented medically. We work really hard to have bilingual staff and we’ve been very successful.
One of the things that’s near and dear to my heart is the homeless population within our community and the care they’re getting. We now have the very first medical street outreach team in the state of Indiana in our wonderful community. We have a nurse practitioner, a psychiatric nurse practitioner, and then we will have another NP starting in December. They are out on the streets. They’re in the encampments. They’re in some of the shelters. We’re also hiring a nurse and we have two outreach workers to help with that work. It’s been a huge success and it’s saving lives.
Michelle Gilchrist: To add a bit more context, this idea of street outreach was born out of an interest in really doing something about the problems we talk about. We talk about homelessness. We talk about their lack of healthcare access. We talk about immigration issues—because if you’re an immigrant, you don’t have a Social Security Number, so you can’t access the same kind of care. But to recognize that these are individuals in our community who are entitled to have access to care—and to care enough as a community health organization to do something about it—it’s a wonderful example of recognizing a problem and not just seeing it as a problem, but devising reasonable solutions that improve overall long-term care.
Because Shelley is modest, she didn’t mention that because of the level of compassion for delivering care to a marginalized population, HealthNet was one of two organizations in the nation to receive a Street Medicine Award from the Street Medicine Institute. This merits recognition.
Now, I’m going to turn to Denzil, who recently came to Bloomington to lead IU Health’s South Central Region. What has been your biggest achievement in the past eight months when it comes to health equity?
Denzil Ross, IU Health South Central Region President: As I think back over some of the successes we’ve had as an organization, particularly in Monroe County, I look at three buckets: outcomes, access, and community health.
From an outcomes perspective, we look at the mortality index, which essentially means that the longer you stay in the hospital, the higher your risk of infection and, ultimately, death. It has been really important to us to transition patients to the next stage of care in a timely manner—and methodically. As a result, we’ve been successful in reducing the mortality index to top decile performance.
Another metric we look at for outcomes is reducing readmission rates. We want to treat you the way you deserve to be treated from a healthcare perspective the first time. And I’m proud to say that Medicare has recognized IU Health Bloomington as one of only two hospitals in the state for low readmission rates. That’s a big deal. Nationally, we’re ranked 116th out of 4,000+ hospitals.
When it comes to access, we know there have been challenges within the community around being able to access a physician when you need it. In an effort to drastically improve healthcare access, we’ve hired 13 new primary care providers to reduce the need to utilize the emergency department and better manage chronic illnesses. By increasing access to clinical care providers, wait times for appointments have been reduced 50%. People in our community are able to get in to see a doctor a lot faster than prior years.
We’ve also looked at multiple different access points to care, and this summer, we opened a new urgent care facility on the west side of town that has provided another access point for patients who have non-life-threatening emergencies.
And then from a community health network standpoint, our Nurse Family Partnership Program is ranked sixth in the nation. That has a lot to do with their support to keep the community healthy, including breastfeeding rates, premature birth rates, birth weights, and immunization rates. There’s also our Women, Infants and Children (WIC) program that’s rated number one in the state for Monroe, Greene, Brown, and Morgan Counties.
Michelle Gilchrist: Lori, I want to pose a slightly different question to you. What is most important in the Department of Health when it comes to achieving and pursuing health equity in our community?
Lori Kelley, Health Administrator for the Monroe County Health Department: The Monroe County Health Department is here to serve all individuals in Monroe County, and we’re definitely focused on that. One of our greatest successes happened on August 9, 2023, when our Monroe County Commissioners signaled their commitment to making Monroe County a healthier place to live and work by opting into Health First Indiana.
Health First Indiana provides additional funding to local health departments who opt in, and in exchange, we are required to provide some core public health services for every individual in Monroe County. One of the areas we’ve been able to use this additional funding is for three new positions that are focused solely on some of those core public health services, chronic disease prevention, and access and linkage to care.
So while we may not be providing direct health services as you might see in healthcare centers or hospitals, we can provide a linkage and a referral to individuals and help connect them with the services they need.
Health First Indiana has provided us with a great opportunity to build on the services we were already providing to the community, but then also focus on new services that we were not providing before.
Michelle Gilchrist: I want to highlight that before agreeing to be part of Help First Indiana, Monroe County received less than a quarter of a million dollars in funding per year, and now it’s closer to $1M. That’s a huge difference. Those are dollars we’re putting to work in the communities where we live, work, and do business, and I’m very proud of those efforts.
Follow Bloomington Health Foundation on LinkedIn and watch for the continuation of Michelle’s conversation with Shelley, Denzil, and Lori.
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