How does a University meet its obligations to the surrounding community? Drexel University has asked and answered that question in a long-term initiative focused on improving access to health care for the residents of four public housing developments in North Philadelphia.The Eleventh Street Family Health Services Center of Drexel University began in North Philadelphia in 1996 when Patricia Gerrity, Ph.D.,RN, associate dean for community programs and Robert Wood Johnson Nurse Executive Fellow, asked leaders of the public housing tenants’ councils how the faculty and staff of Drexel’s College of Nursing and Health Professions might work with the community on health-related issues.The council leaders were skeptical about a university’s involvement in their community. They doubted the level of long-term commitment and were tired of being the subjects of assessments and surveys that led to nothing tangible. “We need services,” they said, “a place in our own neighborhood where we can get good health care.”

A Partnership for Community-Based Care
For the past 10 years,we have worked with the residents of North Philadelphia on building a community-based health center into a clinic and a place to promote healthy living by addressing the needs of the sick and worried as well as those struggling to stay well. Two years into the community-university partnership, a federal grant was awarded to Dr. Gerrity with the purpose of offering primary-care services in North Philadelphia.A community advisory board was formed and found modest space in a community recreation center, where Drexel’s nurse practitioner faculty and staff delivered primary-care services for four years in anticipation of some day opening their own health center.

A State-of-the-Art Health Center Rises on 11th Street
Health Resources and Services Administration (HRSA), a federal agency, awarded $3.3 million to Drexel University to build a freestanding, 17,000-square-foot, state-of-the-art facility in North Philadelphia in partnership with the Philadelphia Housing Authority.The Eleventh Street Family Health Services Center of Drexel University, named by the community advisory board, opened its doors in September 2002 in a location accessible to the residents of four public housing developments. Our mission is “to provide quality, comprehensive health services to all served with special attention to vulnerable people and residents of public housing communities.”Ours is the most comprehensive nurse-managed health center operated by a university in the Commonwealth of Pennsylvania. The number of patients grew from 885 in 2003 to more than 2,000 in 2005, and the growth continues. From 2003 to 2005 the number of visits to primary care grew from 2,200 to 6,800. About 85 percent of our primary care patients are African Americans. During the same period the number of visits to behavioral health grew from 210 to 3,200.The center takes full advantage of the academic and technological resources that Drexel offers.The facility is wireless, and its security system is linked to the University. Drexel’s technological expertise was instrumental in the development of the Electronic Medical Record, which integrates all aspects of patient care, including primary care, behavioral health care and dental care.

A Healthy-Living Center with No Wrong Door
From the beginning, the community advisory board wanted Drexel to provide “more than just a clinic.” So in addition to seven primary-care examination rooms, the board designed a kitchen where nutrition classes and healthy cooking take place, as well as a gymnasium with state-of-the-art exercise equipment to address the problems of obesity-related conditions, hypertension and diabetes.We have a behavioral-health suite where psychotherapists and psychiatrists meet with adults and children for depression and other mental-healthissues. In fall 2004, four dental suites were built and equipped.The project was funded by a private gift and a matching grant from the Pennsylvania Department of Health.

Two years ago, the center changed from an appointment-based system to one allowing open
access, guaranteeing that clients who walk in will be seen.That decision was made to accommodate the needs of individuals whose life circumstances and level of illness require a flexible approach to accessing care. The shift to open access has dramatically increased the number of clients.

In addition to clinical services, a variety of health-promotion programs are offered both on-site and in community settings such as schools and churches.“We say that ours is a healthy-living center with no wrong door,”according to Dr.Gerrity. “Our goal is to be the hub of healthrelated activity, where patients can be treated for a variety of illnesses and also learn about healthy living, participate in physical-fitness activities and more.” For example, all adult patients treated by dental or primary-care providers also are screened for depression so that referrals can be made to behavioral health when indicated. And the center has partnered with a Philadelphia food bank, PhilAbundance, to provide fresh fruit and vegetables for local families each week in a farmers’ market atmosphere in the parking lot of the building.

Our staff does not sit and wait for clients to appear for services. Community outreach workers canvass their neighborhoods to explain the services and special programs offered. At the Eleventh Street Family Health Services Center of Drexel University, a monthly newsletter provides a calendar of events such as important screenings, health-promotion programs and tips to manage physical and behavioral-health problems.The Drexel dragon logo is proudly displayed on the health center’s van, which is used to drive patients to referral appointments and to take groups food shopping because no supermarket is located in the neighborhood.We believe that health is not just the absence of illness; it is a part of every aspect of life.The health center reflects that belief.

A Safety Net for Care
Drexel’s health center is a safety-net provider, extending care to almost exclusively low income
and uninsured clients. More than half the patients seen receive Medicaid and 33 percent are uninsured.The community served has one of the lowest median family incomes in the city—$13,000 annually—and almost 80 percent of the patients we serve fall below 200 percent of the poverty level. Our special focus is on vulnerable adults with chronic illness, given that 40 percent of the residents served have a chronic condition needing regular care.The provision of care in our facility reduces the burden the underinsured place on emergency room services, improving care and reducing costs for every healthcare consumer. Furthermore, the center treats a large group of adults with multiple medical and behavioral chronic illnesses who struggle with day-to-day survival. Anxiety, stress and depression often compromise their ability to be actively
involved in the management of their own illnesses. The Pew Foundation recently
awarded the center three years of funding to address the complex needs of patients with
chronic illness who live in North Philadelphia.

A Business Model for Safety-Net Care
The Eleventh Street Family Health Services Center of Drexel University is also part of the Family Practice and Counseling Network, which consists of four federally qualified health centers located in Philadelphia neighborhoods where a pressing need for access to quality health care exists. HRSA guided the linking of Drexel’s center to the network, to facilitate the center’s financial sustainability. Federally qualified status provides two funding streams to Drexel’s health center, an annual grant that underwrites care for the uninsured and cost-based reimbursement through all patients covered by Medical Assistance. The health center also has a contract with the Philadelphia Department of Health to provide prenatal care to first-time mothers at risk.The health center’s funding comprises 54 percent Medical Assistance, 16 percent Philadelphia Department of Health funds, 13 percent U.S. Department of Health and Human Services funds, 10 percent grants and donations and 7 percent from other sources including patients’ fees, reimbursement from health insurers and Medicare. Because the health center resides in the midst of four Philadelphia public housing developments, the Philadelphia Housing Authority is involved in the maintenance of the building, grounds and other infrastructure. Linking with a network of federally
qualified nurse-managed health centers has put Drexel’s center on strong financial footing, ensuring that quality care will continue for the residents of North Philadelphia.

A Place to Learn
Our health center also serves Drexel University faculty and students. Nursing, health professions and other students practice side-by-side with the center’s staff, learning how to deliver culturally competent, community-based care. Interior design majors from our College of Media Arts & Design competed in a project to design the dental suites. Students and faculty from our School of Public Health conduct a variety of community- based projects focused on the broad determinants of health. Students from Drexel’s LeBow College of Business worked with a group of residents interested in starting their own businesses. Faculty from the Rehabilitation Sciences, Nursing and Couple and Family Therapy programs practice at the health center with their students. There is nothing quite like learning how to deliver health care from those on the receiving end, and every aspect of student learning conducted at the health center includes community participation and feedback.

Living the Mission
The mission of Drexel University is “To serve its students and society through comprehensive,
integrated academic offerings enhanced by technology, cooperative education and clinical practice in an urban setting.” At the Eleventh Street Family Health Services Center of Drexel University, the University does live its mission, serving a community in a partnership and educating students who learn through service. Students and faculty of Drexel’s College of Nursing and Health Professions are proud to work with the residents of North Philadelphia on improving their health and strengthening their community.

For more information, please contact:
Gloria Donnelly, Ph.D., R.N., F.A.A.N.
Dean, College of Nursing and Health Professions
Drexel University
245 N. 15th Street
Mail Stop 501
Philadelphia, PA 19102
215-762-3845
gloria.donnelly@drexel.edu

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