La Red Health Center - 2001

Sussex County is the largest of Delaware’s three counties and has a population of 156,638. The entire county is federally designated as a medically underserved area, a low-income health professional shortage area, and a dental health professional shortage area. The dearth of health care providers represents an enormous barrier to health care for residents who are uninsured, underinsured, or living in poverty.

These challenges are further exacerbated by the lack of public transportation. There is only one taxicab service in the area, and it has a limited fleet of vehicles. The only bus service in the area caters to the tourist industry on the eastern seaboard of the county instead of to rural residents living in the central and western sections of the county.

La Esperanza sought to establish a community-based health center to improve access to care for Latinos, African Americans, families living in poverty, and other rural residents with health care needs. La Red’s network included five partners—La Esperanza Community Center; Nanticoke Health Services, a local community hospital; a network of 20 bilingual rural private practice physicians; the Division of Public Health; and the Episcopal Diocese of Delaware. Each network organization provided financial and inkind resources to support the project.

La Red Health Center officially opened its doors to patients on February 21, 2001, as the only ambulatory primary care site in the community that offered a sliding fee scale for medical services to uninsured individuals. La Red also participated in Medicare and Medicaid and most insurance plans offered by local employers.

The center was modeled after the Public Health Service’s Community Health Center Program (Section 330). It offered fully bilingual staff members, including a receptionist, a case manager, an outreach worker, a part-time family nurse practitioner who donated her time toward the completion of her degree, and two part-time, contracted primary care physicians. Funding from other sources enabled the project to contract with a part-time bilingual psychiatrist, hire an outreach worker to address HIV prevention and childhood immunizations targeting the Latino community, hire an additional caseworker, and hire a part-time pediatrician.

The project obtained broad-based community input through a needs assessment and focus group discussions with representatives of target populations. The data gathered during the assessment phase played an important role in informing the scope of services to be offered through La Red Health Center. La Red received donated clinical space to provide bilingual primary care services, health screenings, medical referrals, case management, and outreach services, including transportation.

In addition to providing a full-life continuum of pediatric, adolescent, and adult primary care services, La Red now offers community outreach and education programs focusing on childhood immunizations, diabetes, and HIV prevention. La Red is the only community health center in Delaware that offers bilingual mental health and substance abuse counseling services. The women’s health initiatives of the center have expanded dramatically in response to the growing number of uninsured pregnant women seeking care. The project also offers diagnostic breast and cervical cancer screening to qualifying women as part of Delaware’s Screening for Life program.

La Red is considering the possibility of opening satellite centers throughout the county to make it easier for target populations to access care. Project leaders are in the process of developing the collaborative arrangements necessary to make this vision a reality. The project hopes to expand to include family planning services and increased HIV surveillance and prevention services. It also is stepping up its marketing activities to attract a larger number of insured patients.