Patient Flow Enewsletter
Volume 1, Issue 5
Thursday, April 29, 2004
Resources in this article:
When long and sometimes anguished discussions among city officials ended in the sale of the city-owned hospital in Lincoln, Nebraska, in 1997, community residents were justifiably concerned about the future of the community's health care safety net. So local health care leaders and city officials used proceeds from the hospital's sale to establish the Community Health Endowment of Lincoln, a non-governmental entity that provides money and oversight to help improve health services throughout the Lincoln area.
Determining what the community's needs are has been the result of a unique project that involved residents and leaders. The 'Blueprint Project,' first initiated in late 2001, was designed to involve the community in identifying specific actions that would improve the health of Lincoln's most vulnerable populations, guided by findings revealed through Census tracts.
During a yearlong planning process, the Blueprint Project sponsored 51 focus groups, nearly 2,000 surveys, 21 community meetings and 83 interviews to develop neighborhood-based solutions. Funded by the Endowment, the process has resulted in a clear roadmap of actions that private organizations and city administrators use to make health improvements throughout the city. It has also improved collaboration among safety net providers and helped focus priorities. In the 18 months since the Blueprint's findings were unveiled, several high profile, high-yield projects have been implemented, all outlined in the Blueprint.
Mayor Coleen Seng, elected to office one year ago after serving 16 years on the Lincoln City Council, has long advocated for improved health care services in the community. Through the Blueprint, Mayor Seng feels the city has a firm handle on what needs to be done immediately, as well as a clear vision for the future.
Click here to download the findings of the 'Blueprint' project.
Interview with Mayor Coleen Seng
Q. What first got you interested in health care?
For more than 20 years I worked as a local United Methodist Church lay employee in community ministry, so I had worked in the community and saw first-hand what was happening to people and saw that many of our neighbors had no where to go for their health care. I was also on the City Council for many years before becoming mayor, and had been involved in a lot of decisions involving health services, including the decision to sell the hospital. That was one of the hardest decisions I've ever made in public office and it upset many people. I felt then, and now, that we had a promise to keep to the people of Lincoln to make sure that they had appropriate health services and a place to go to in order to receive needed care. I've also always been interested in funding questions, too, which is how most people who work in city government get to understand health care issues.
Q. Tell us about the Blueprint Project and how it started.
We learned from Census information that certain neighborhoods in Lincoln exceeded the community average in terms of poverty, death rate, poor housing stock, infant mortality and ethnic and minority populations. So when we became aware of this, we worked with the Community Health Endowment of Lincoln to help provide direction on how to use limited resources wisely to address some of these issues. The Endowment funded the Blueprint Project to develop neighborhood-based services and improve the health of people who live in these areas. That's where the name came from - to get a blueprint of what we needed to do.
Q. How did the process begin and how did you involve the community?
We learned from Census information that certain neighborhoods in Lincoln exceeded the community average in terms of poverty, death rate, poor housing stock, infant mortality and ethnic and minority populations. So when we became aware of this, we worked with the Community Health Endowment of Lincoln to help provide direction on how to use limited resources wisely to address some of these issues. The Endowment funded the Blueprint Project to develop neighborhood-based services and improve the health of people who live in these areas. That's where the name came from - to get a blueprint of what we needed to do.
Q. What did you learn through the data collection phase that surprised you?
Probably what surprised me most was that we could even compile all of this information - really an enormous amount of feedback - and put it together so quickly into something that made such good sense! I'm also surprised by how quickly and fully the Blueprint has become institutionalized in Lincoln. It really has become a project that people feel very personally attached to. It has done more than just help all of us better understand our priorities - it's really become part of the community. The organizations across the city that worked on it took all of this information - and they did this as part of their volunteer service and commitment to the community - and did their work with diligence and did it right. Every single recommendation in the Blueprint is needed, reasonable and achievable.
Q. What results have come out of the Blueprint so far?
One of the most important things to come out of the Blueprint Project has been the need for community health clinics in Lincoln that are located near the people who most need them. Because of the Blueprint and a lot of people working together, a new community health center, the People's Clinic has been opened, which is a much-needed resource for primary care and dental services for uninsured and low-income residents.
There are many other examples. Right now, for example, we're working on meeting the vision needs among homeless individuals, which may sound very specialized but is something that people don't think about. One of the solutions was to create a program to identify and treat vision needs among homeless, funded by the Endowment. Local opticians provided low-cost screenings and optometrists provided surgical care. Some corporate sponsors donated eyeglasses. The project is truly collaborative and meets a need that probably would never have surfaced or been addressed without the Blueprint Project.
Q. How do you evaluate the Blueprint's effectiveness and keep it updated?
Working through the Endowment, the groups and people who worked on the Blueprint reconvened this past January to assess progress. It had been a little over a year since the Blueprint was released and we wanted to revisit where we are, review progress and select where we want to go. We all agreed that we have made great accomplishments in a short period of time and credit the Blueprint and the process that led to it as being instrumental in our success. About half of the recommendations have already been acted on. Some of them have changed or sparked new issues, but we all came out of meeting with many new ideas to build on.
Q. What are the next steps?
There's always something being planned. For example, we know that in Lincoln, Nebraska, we have to work on translation issues in our health care system because we have so many new Americans as members of our community. The Blueprint also identified a number of issues around homelessness. As a community we're still learning about this issue, so we formed a Mayor's Task Force on Health Care for the Homeless. They're meeting now and have taken information originally compiled for the Blueprint Project and brought together people from the frontlines of community groups as well as city departments, including police and medical response teams. They are addressing several issues and will make very specific recommendations.
We also need to do an inventory of all case management services to make sure that there is not duplication among agencies and that we're making appropriate referrals to health care providers and taking advantage of resources. We're also trying to work on medical transportation so that people who need health services can get to them.
Q. The Urgent Matters project recently completed an assessment in Lincoln. How will that affect your work?
Urgent Matters assessed our community and now everyone is thinking and talking about what we could and should be doing, so it was great for stimulating thinking and giving us something fresh to respond to. We were very pleased that many of the Urgent Matters' recommendations were similar to projects we're undertaking, so we feel that we're on a good path. Urgent Matters suggested that our hospital emergency departments could implement procedures to help make sure that people who leave the ED have a better understanding of their appropriate 'medical home.' As a result, people in the community are already at the table and talking about it. That's going to be very important for our community and help close the gap between clinical services and ED services. We're all grateful that Urgent Matters chose Lincoln as a site to look at, and hope that our experience can help other similarly situated cities.
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Coleen Seng
Mayor
Lincoln, NE
