1. PLAYING IN THE SANDBOX NICELY COLLABORATION STRATEGIES WITHIN THE SAFETY-NET

2. IT’S A PHILOSOPHY, THAT LEADS TO A STRATEGY, WHICH PRODUCES RESULTS! Davidson Medical Ministries Clinic just finished 20 years of service to our community by being the only safety net organization in our county. Our mission statement is : To minister to the needs of those in our communities who lack access to quality health care. Our vision is : To lead in maintaining and enhancing a collaborative network to improve access to health care for the uninsured and underinsured people of Davidson County. Our value: In everything we do we will conduct ourselves with care and compassion to improve the health of those we serve.

3. DMMC PRIOR RELATIONSHIP WITH DCHD Co-existed peacefully through 2 other Health Directors Each doing their own thing Then in 1998 we formed a partnership to be the host site for the Children’s Medicaid Dental Clinic.

4. THE RELATIONSHIP BETWEEN THE HEALTH DIRECTOR AND THE CLINIC DIRECTOR IS ESSENTIAL. It helped that Davidson Medical Ministries had grown to the point of being able to add additional staff and the director had more flexibility to get involved in activities, meetings, etc. outside of the clinic and become more involved in community networking opportunities.

5. DMMC seeks to provide access to as many uninsured individuals as possible with the resources at hand; however, the need for increased access to care is NOT a clinic problem, but a community problem. DMMC cannot tackle this problem alone. The Health Director would rather assist with increased access to care through existing efforts than be forced into adult primary care at the health department level. OUR PHILOSOPHIES MERGED:

6. DAVIDSON COUNTY ACCESS TO CARE COMMITTEE The DCA2CC was the counties “Healthy Carolinians” group. It was the first opportunity for multiple county agencies to gather to discuss health issues. Provided increased opportunities for DMMC and the Health Department to network.

7. IN 2006……. Davidson Medical Ministries Clinic was looking at expanding our services in the Thomasville area, by opening a satellite clinic inside Thomasville Medical Center. It was because of that previous existing relationship with the Health Department and the collaboration and networking opportunities that we were able to investigate the possibility of the Board of Health and subsequently the County Commissioners approval of and support of this endeavor. The result was the Health Department agreeing to partially fund the Nurse Practitioner position for the Thomasville Clinic.

8. CURRENTLY THE CLINIC AND THE HEALTH DEPARTMENT PARTNER IN THE FOLLOWING AREAS. Children’s Dental Medicaid Clinic BCCCP Komen Grant Education Classes ACHIEVE Grant Community Health Assessment Davidson County Healthy Communities Coalition NP grant

9. IN 2009 YET ANOTHER OPPORTUNITY AROSE. A Community Stakeholders meeting, called by the Health Director, to address the need for increased access to care for the uninsured in Davidson County Led to the creation of a County Leadership Team. For the purpose of writing a business plan to “Improve Access to Care for the Uninsured and underinsured of Davidson County.” Led to application and acceptance into the Management Academy of Public Health to help write the business plan.

10. OUR VISION: Partner with an existing FQHC to write a Section 330 grant. Become a Hybrid organization as a FQHC/Free and Charitable Clinic

11. THE RESULT: A Hybrid FQHC/FCC Gaston Family Health Services became our “parent” organization. Davidson Medical Ministries Clinic operating as a dual entity :Davidson Health Services and Davidson Medical Ministries.

12. Provide quality health care to as many uninsured / underinsured residents as possible. Partner and Collaborate with as many resources as you can to ensure that the services needed are provided. The Philosophy The Strategy The needs of the community are met, by the people best equipped to provide the necessary services. The Result

13. Caring for the future of the communities we serve Robert E. Spencer Executive Director rspencer@gfhs.info

14. GASTON FAMILY HEALTH SERVICES Developed as a “child” of the local health department Coordinated Services and Non-Duplication Filling Gaps in Safety-Net Leveraging Local Support

15. GASTON FAMILY HEALTH SERVICES Created a successful model GFHS Board elected to “share” the successes Expansion to other Counties (by invitation) Leveraging Local Support Filling Gaps in Safety-Net – individualized by County

16. WHAT DOES A “HYBRID” LOOK LIKE? Operational Details: Appearances Count…….And appearances change based on your perceptive Patients Community - Supporters funders (e.g. hospitals) - Referral points Staff

17. CHALLENGES Different Cultures Turf Who gets credit/blame It is never 50/50 Negative Nancy Trust Communication Rumors

18. LESSONS LEARNED Collaboration takes time Baby steps – Build from Small Successes I’m not good at that, can you help? If you’re uncomfortable, you’re probably doing it right! Reframe the message “Carving up the deficit pie” Perfect is in the eye of the beholder You win some, You Lose some…Get over it Top Down “Loud and Out There” Support

19. LESSONS LEARNED Forgive and forget Importance of Face to Face time Build from small successes Give away credit Look for opportunities to do favors Nip staff misbehavior in the bud Walk a mile Remember you share the same mission

20. CONTACTS Sandy Motley, RN Davidson Medical Ministries Clinic 336-243-3205 sandym@medicalministries.org www.davidsonmedicalministries.org Robert E. Spencer, CEO Gaston Family Health Services 704-874-1902 rspencer@gfhs.info www.gfhs.info