Bread for the City

A few weeks ago ago, the DC Primary Care Association honored our own Jeannine C. Sanford as one of this year’s Unsung Hero award recipients.

So what makes Jeannine an Unsung Hero? In short, she is able to get things done that we have never done before, or in some cases that no one has ever done before.  In fact, that’s how Jeannine first came to Bread 19 years ago.

You see, our medical clinic kept seeing patients with no income who were clearly disabled, yet their SSDI applications had been inexplicably rejected. The providers knew they needed lawyers to step in and represent these patients in court. Enter Jeannine.  Jeannine was Bread’s first staff attorney and she ran our legal clinic until 1999 when she then became our very first COO.

Jeannine’s first project as COO was outlining the steps necessary to build a new facility and medical clinic in Anacostia. Her steps were the right ones and the project was a smashing success. I was impressed, that I asked her to manage an $8.25 million project to expand our medical clinic and build a new dental clinic at our 7th Street location. Jeannine did so without disrupting daily operations, she stayed under budget, and because she was coordinating all details, Dr. Randi (our medical clinic director) got to spend her time seeing patients.  In true Jeannine fashion, the needs of the patients had come first.

While this mammoth project was in full swing, Jeannine continued to foster growth throughout the organization; most notably, green-lighting our fresh food efforts. In the past two years alone these efforts brought forth a vegetable garden on the roof of our medical clinic – the largest urban agricultural project in the DC Metro area, and City Orchard, the first ever orchard operated by a food pantry that will provide 40,000 pounds of produce annually for our clients. As they say, an apple a day keeps the doctor away.

Today, Jeannine’s fingerprints can be felt throughout Bread for the City—in both our organizational structure and physical environment. I fondly recall once passing by her desk and seeing her surrounded by doorknobs. When asked what she was doing, she responded that she was contemplating which doorknob would best suit the various needs (for both staff and clients alike) of our new facility. Doorknobs. It’s just one of thousands of decisions that someone has to make in order for an organization to grow to a size like ours. And somehow, Jeannine finds the time each day to make those decisions in addition to overseeing many staff and programs.

I consider it a privilege just to witness Jeannine in action. I’m proud to call her both a colleague and a friend. And I am delighted to see her tireless efforts on behalf of Bread for the City’s clients and staff acknowledged publicly — recognition that is long overdue. Warmest congratulations, Jeannine!

The District of Columbia Historic Preservation Office/Office of Planning presented Bread for the City with a Design and Construction Award for our expanded 7th Street Center at the Ninth Annual Awards for Excellence in Historic Preservation on June 21st. Obviously, we didn’t do this alone. Awarded along with us were Weibenson and Dorman Architects PC, S3E Kilngemann, Inc., JGK Structural Engineers, Heller & Metzger, PC, and Turner Construction Company.

 
Bread for the City moved into 1525 7th Street in 1994. Before then the building was a former lumber warehouse. How cool is that? Quite cool according to the DC Historic Preservation Office who landmarked the building a few years back. This distinction did make expanding the facility by 11,000-square-feet back in 2010 a bit tricky, but apparently the DC Office of Planning liked how it all turned out. We’d have to agree.

We are pleased as punch to receive this award; however, we knew we nailed the project when a client exclaimed: “This new building takes the breath away. Folks always knew that they had a friend in Bread for the City. Now, they have a home.”

View photos of the Ninth Annual Preservation Awards and our new Northwest Center on our flickr feed. Want your own personal tour? Email info@breadforthecity.org and we’ll get in on the books.

Bread for the City’s new 7th Street facility was the first major completed project of the DC Primary Care Association’s Medical Homes DC Capital Projects initiative, which is funded by the Government of the District of Columbia through grants from the DC Department of Health (DOH); the DOH grants provided 75% of the financing for the new facility.

Disclaimer: This is an acronym-laden zone. Please proceed with care.

Sometimes we aren’t very good about celebrating our successes. That feels especially true right now in the sad story of the DC Regional Health Information Organization, which only just recently launched and is now, suddenly, suspended. (See this reporting in the Washington Business Journal to learn more.)

The DC Primary Care Association’s ambitious plan was to use the DC RHIO to coordinate the provision of health care services across the regional network of hospitals and specialists and community health clinics like Bread for the City. The goal was to achieve — through established channels of shared information — better patient-centered medical care with fewer errors, greater cost-savings, and protection for the most vulnerable people in our community.

It is a beautiful and exciting vision. In our unfortunate current reality, there are many separate data systems across the city, even within a single organization (like a hospital for example), that all track different pieces of care, without the ability to talk to one another. That makes for seeing a whole health picture very difficult. Think of it this way: in the 21st century, we can access all the world’s information from gadgets in our palm, but when we go to a neurologist or the ER, our doctors don’t have access to our primary doctor’s most recent labs and notes. James Turner of the HealthIT Now Coalition draws a parallel, “It’s as if we live in a time when someone with a Verizon phone can’t talk to someone with AT&T service. But this is healthcare!”

Consider the following scenario that our Dr. Randi lays out: “Say a patient of ours had a heart attack or a stroke. They have just been released from the ER, and they are confused and distressed. They might have no idea what doctors they saw, what tests were performed, or even the outcome of the visit. With a Health Information Exchange, we [providers] can look that patient up in the system, see lab results, medications prescribed, pathology reports, discharge summaries, and we can begin to piece the picture together for the patient. When we can help in that way, the patient is relieved and more informed and we can give them better care with less redundancy and run-around.”

And perhaps the best reassurance that we were doing the right thing with the RHIO: patients were behind it. When we would tell Bread for the City patients that we would be sharing their information with other providers in the RHIO, the response was often “Aren’t you doing that already?!” After all, that’s what quality healthcare and meaningful use of technology is all about, right?

While small at first – six early-adopter clinics and a few hospitals – the big vision for the RHIO entailed the interconnection of every point of contact in the whole system of care in the Washington DC for all the city’s patients.

So why then, if the project was underway, did the District halt the development of its Health Information Exchange? I don’t really know for sure, but I think it’s safe to say that it involves politics and money.

If the RHIO is not saved, a considerable amount of investment will go to waste — and the potential value will be lost. The District has announced the pursuit of a bare bones Direct Project model, instead of a more robust HIE – but this feels a little like salt in the wounds. This Direct Project is essentially just a protected email service — while it serves a function that could be integrated into a bigger HIE system, it falls far short of the comprehensive data sharing necessary to improve care.

Now what? Rather than lose years of progress and millions of dollars which put DC at the cutting edge of health information  technology, we think DC should reconsider this new direction. The DC RHIO is an investment worth protecting. Let’s ensure the effective implementation of the health information technology initiatives that we need to modernize our healthcare system. The State Health Information Exchange is really a valuable public utility — so the Mayor and City Council should be committed to identifying budgetary solutions for next year and beyond. We need $3,086,000 to be funded to DCPCA through the Office of the Chief Technology Officer to save DC RHIO. Please contact the Mayor and your Councilmember today and ask them to invest in our city’s health.

SAVE THE DC RHIO!

>The DC Fiscal Policy Institute reported yesterday that, given the passage of national healthcare legislation, the District is taking an early advantage by opting-in to a major expansion of Medicaid.

DC has already become a nationwide leader in the push for healthcare reform: our locally-funded DC Health Care Alliance helps ensure that almost 95% of our residents are insured, the second-highest percentage in the nation.

This expansion will therefore be especially beneficial for us: with Medicaid newly available to residents with incomes below 133 percent of the federal poverty line (including childless adults), DCFPI cites estimates that 35,000 to 40,000 DC residents will transfer out of the locally-funded Alliance and into Medicaid next year.

With the passage of reform, the District can cut costs of their coverage by almost one half. The potential benefits of this development were also reported last week by the Washington Post. (But the Post article was misleading in one important respect. Tim Craig’s reporting suggested that the Alliance only covers childless adults and undocumented immigrants. In fact, the Alliance also covers many immigrants who legally reside in the U.S. but are ineligible for Medicaid due to a 1996 federal law that drastically restricts the Medicaid eligibility of lawfully residing immigrants.)

With the significant savings that DC stands to yield from Medicaid expansion, our city has a great reinvestment opportunity. The city could expand Alliance benefits for prescription drugs and specialty care to match those available through Medicaid. (As DCFPI notes, the Alliance does not currently provide strong mental health coverage.) And we could further expand eligibility for still more low- and moderate-income District residents.

This reinvestment would ensure that in the midst of sweeping healthcare reform, DC will remain at the forefront of the national trend towards universal health coverage.

>~Sharon Feuer Gruber, our blogging Nutrition Initiative Adviser, has been on a spring holiday at the Sustainable Food blog at change.org, producing all sorts of discussions over the Series of Tubes. The subject of her posts are Bread for the City’s Nutrition Initiative–an ongoing effort to improve the health of our community.  One of our major efforts has been providing healthy food including fresh produce to all the low-income residents who utilize our food pantry. A series of cooking classes called Fit for Fun, a Health Peer Education Program, gleaning trips to local farms, and much more have come out of this initiative, as well.

President Obama has been saying that reforming inefficient healthcare technology will save time, money, and (ultimately) lives. Recently, a number of people have been trying to refute the point, saying the projected savings are overblown.

DC’s safety net has become one of the first in the country to try and strategically bring all the different community clinics over to a standardized system, eClinicalWorks. Bread for the City is one of six clinics to switch to eCW, and the reports are just coming in. So do electronic medical records live up to the hype? The short answer is yes.

One of the most notable savings revolves around our volunteers. In the past we relied on a lot of volunteers consistently coming through the Medical Clinic to wade through the endless administrative tasks (creating/finding/filing charts). If a volunteer didn’t show up one day, we were suddenly in a pickle. Though our volunteers are the lifeblood of our organization, relying on an inconsistent workforce to catalogue sensitive data means that there are elements of inefficiency and human error. Since transitioning to eCW, our efficiency has gone through the roof. With our two dedicated administrative volunteers coming in one day a week, we’re able to keep up, and if one of our patients goes to a participating hospital or community clinic, their information can be instantly sent over, saving precious time if there’s an emergency. It’s a miracle!

That savings of time is also a savings of money. The volunteers who used to file charts are now helping with nutrition outreach to medical clinic patients, allowing our healthcare providers to disseminate nutrition information to more patients more quickly. Since our files are more accurate and easily archived, we are able to receive accurate Medicaid reimbursement rates for all of the patients we see—a welcome (albeit small) revenue stream in this tough economic climate.

That’s not to say it wasn’t a huge pain during the transition. For months, our providers’ desks were almost walled off behind massive stacks of paper records labeled “TO BE SCANNED.” On many different occasions I thought Lisa Johnson, who runs the administrative side of our clinic and did a great deal of the work for the transition, was simply going to die. And every new system has kinks. But now that the transition is complete, the benefits are remarkable. Though I can’t speak for the healthcare system in the macro, Bread for the City has undeniably benefited from the switch to electronic records.

Many thanks go out to the DC Primary Care Association for funding this step forward, and to our many generous donors who make all of our work possible.

–Matt Siemer

>http://www.flickr.com/apps/slideshow/show.swf?v=71649

Between our blog’s launch and our birthday, Bread for the City saw a number of major institutional changes which were covered on our blog. The biggest, of course, was our recent decision to temporarily move off of Fridays, have staff take a 10% pay cut, and managers take a 12% pay cut. Those changes went through this past April 1st.

But let’s not forget the other monumental steps we’ve taken. Last year, Bread for the City started partnering with Claggett Farm to provide nutritious, fresh produce to the many people who come through our two food pantries. That partnership was so successful that it grew into a massive nutrition commitment on the part of our food staff. Starting September 1st, we vowed that we would provide fresh produce in every bag that went out our door. Working with a number of sources, we continue that commitment. Even more exciting, we’re currently ramping up to start sending volunteers out to local farms to bring back whole tons of fresh produce. Also in the mix, a group of donors combined their efforts in March to buy us eggs every month that we distribute through both our pantries.

Maybe you’ve also heard of our upcoming expansion! Due to a generous grant from the DCPCA and the DC Government, Bread for the City is going to be doubling the size of our medical clinic!! Our groundbreaking was on March 25th, and we had a pretty great turnout.

Our Holiday Helpings program, through which we distributed a complete Thanksgiving meal to 12,214 families in need (our goal was 10,000, so we beat it by 20%!), was our most successful to date.

We also spoke with a number of our patrons, asking their opinions on certain issues, archiving their recollections of days past, and providing an insight into why we care so much about healthcare, teaching good nutrition, and a comprehensive approach to poverty issues.

Partner organizations helped us raise over $20,000 through the Help the Homeless Walk this past year–you can see some of those partners walking with us in our slideshow.

>Bread for the City’s longtime medical clinic director, Dr. Randi Abramson, is on a roll: last year, she was honored as the DC Primary Care Association’s “Caregiver of the Year,” and this year the American Medical Association presented her with an “Excellence in Medicine” Award for her dedication to community health.

Thanks to the AMA, we can now share the video that was featured at the awards ceremony in March; the clip shares some insight into Randi’s long history here at Bread for the City, and features some pretty adorable old-school pictures. Note the shot of her with a pregnant woman: back in the day when Bread for the City’s clinic was in a basement without, like, actual doors! The distance from those humble beginnings to our in-the-works expanded medical center speaks to a great vision and commitment.

What’s the Oscar for doctors? Whatever it is, one can safely assume she’ll get that next. Though it should be noted that Dr. Randi was unaware that she’d been nominated for any of these awards, and really was only convinced to receive them because these were good opportunities for her to draw attention to the work of Bread for the City itself. Because who has time for awards ceremonies when there are patients to treat?

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This guy means business.

It just occurred to me today that, though he posted yesterday, we never introduced one of our newest staff members—Jeffrey Wankel! This blog has covered one of Jeffrey’s jobs before: launching a new initiative through which we will send volunteers out to the fields of local farms and distribute that fresh produce for free to low-income residents through our two food pantries.

His official title, and a brand new one for BFC, is Health Education & Farm Outreach Coordinator. He is currently working with Sharon (our Nutrition Initiative Adviser), Ted (our Food & Clothing Director), and me (Volunteer Coordinator) to build relationships with local farms and coordinate volunteer groups that will go pick fresh produce at the farms. Right now we’re lining up dates with farms, and then we’ll start recruiting volunteers to join us on the days the farmers give us permission to come.

And because no one at Bread for the City has only one job, he’s also in charge of our new peer education program (which we posted about yesterday). When wearing his Health Educator hat, Jeffrey works in the Medical Clinic to promote one health topic each month (like heart health, stress reduction, and overcoming situational depression associated with job loss). He meets with patients of the medical clinic who express an interest in taking health education information out into their communities and trains them to be Peer Educators that can coach their own group on healthy living.

Jeff comes to us by way of an Americorps partnership with the DCPCA. Other things about Jeff: he’s 22 years old; originally from Bloomer, Wisconsin; he likes to stay active with sports, especially basketball; his favorite style of food is Italian; he just moved to Eckington; and he’s excited about working here. Both of these programs have a lot of moving parts, so we’ll be posting updates on the progress of both on your favorite blog—Beyond Bread!

>~Bread for the City had a groundbreaking ceremony on Wednesday!!! All of the specifics of the new, bigger facility are on this old internet here along with some of the remarks from our friends. DCist was kind enough to cover the event, as well as the Washington Post. Thank you to all of our readers who moseyed over, and especially those who flagged me down to say hello. It was nice to see so many people come out to support us. Michael Blue, a long-time patient of Dr. Randi, gave a speech about the need for a bigger clinic that is now up on this blog.

~Kathy Kretman, Director of Georgetown University’s Center for Public and Nonprofit Leadership, praised our Executive Director George Jones in the Washington Post this week. Kathy says that, “George Jones and the Bread for the City staff set an example of how to handle this economic crisis with grace and dignity. They are true leaders.” Thank you, Kathy. That’s a really nice thing to say.

~MPNnow, the leading news source for suburban Rochester and the Finger Lakes, picked up a story about one of our volunteer groups!! The group, which was down from Rochester on a mission trip, came through the Youth Service Opportunities Project, a non-profit organization that warms my heart by linking us over 200 volunteers per year. Thank you to our friends in Rochester—you’re welcome back anytime!

~The number of homeless residents in DC jumped by 3 percent this past year to 6,228 residents. Of that, 2,294 people are in homeless families—a sharp 25% increase over last year.