1. OneAthens Health Initiative Team James Shrum* - Chair, ARMC Virginia Day* - St. Mary’s Healthcare System Monica Knight* - Clarke County School District Terry Tellefson* - Advantage Behavioral Health Diane Dunston* or Jennifer Richardson - Neighborhood Health Tracy Thompson - Mercy Clinic Deb Williams - Nurses Clinic Claude Burnett - Athens-Clarke County Health Department Bob Galen - School of Public Health, UGA Farris Johnson - Family Practice Pamela Robinson - Wellcare Kathy Hoard - Athens-Clarke County Commission Karen Schlanger - UGA Cooperative Extension John Culpepper - Athens-Clarke County Finance Dept Mark Ebell - Professor, Family Practice Sherrie Ford - Power Partners Lisa Caine - Daily Bread * Indicates PPA Steering Committee Member Support Staff: Delene Porter Fanning Institute Adam Gobin – Intern, School of Public Health

2. Partners for a Prosperous Athens: http://prosperousathens.org/ OneAthens OneAthens Health Initiative Team

3. The Problem Georgia is: – 45 th in the nation in overall health status – Last in Public Health Spending – Last in Per Capita Health Spending – Tied for 6 th as the Most Obese State – 4 th worst in Infectious Disease – Tied for 8 th worst in Premature Death – Tied for 7 th highest in Infant Mortality – Tied for 10 th worst in Cardiovascular Deaths OneAthens Health Initiative Team Georgia Health Policy Center Georgia State University

4. The Problem Employer-sponsored insurance coverage is eroding: – 3% decline in firms offering between 2002 and 2004 – Most decline in coverage at firms with 25 to 99 employees Most firms that do not offer coverage say it costs too much. OneAthens Health Initiative Team Georgia Health Policy Center Georgia State University

5. The Problem The uninsured are: more likely to delay seeking care. less likely to get needed medications for chronic diseases. more likely to seek emergency care. sicker when they are admitted to the hospital. more likely to be re-admitted for the same illness. OneAthens Health Initiative Team Georgia Health Policy Center Georgia State University

6. The Problem A family of three with a household income of $50,000 pays about $800 annually toward the cost of the uninsured. OneAthens Health Initiative Team Georgia Health Policy Center Georgia State University

7. The Problem Georgia ranks 37 th in ratio of physicians to population (Banner-Herald, 5/20/07) Average county in Georgia 108:1 physician ratio (GA County Guide, 2005-2006) ACC 310:1 physician ratio (GA County Guide, 2005-2006) OneAthens Health Initiative Team

8. The Problem 26,000 (28.3%) people in ACC live in poverty (Bishop, 2006) 19,843 (19%) people in ACC are uninsured (Georgia Health Policy Center/Georgia State University) (GA County Guide; 2005 Census Estimate) OneAthens Health Initiative Team

9. PPA Findings Growing number of uninsured and increasing demand for health services. Much of the demand is being handled by the emergency rooms. Continued reductions in payments by Medicare, Medicaid, and health insurance. Increasing operating costs. Clinics for uninsured and underinsured are at capacity. Growing Hispanic population in need of care. OneAthens Health Initiative Team

10. PPA Findings Difficult to access affordable specialty care such as dental, mental health pharmacy, and physical/occupational therapy. Reductions in funding for clinics serving uninsured and underinsured. Collaboration among providers is lacking. OneAthens Health Initiative Team

11. PPA Findings There seems to be one underlying challenge. This challenge is our “culture of fragmented response” to poverty and our community’s “focus on process and talk” without follow-through. Each committee’s story calls for a “culture of comprehensive, collaborative action and accountability for community results”. OneAthens Health Initiative Team

12. The message is clear – we must change the status quo. While every community institution can justify the programs they operate, the negative indicators for the community stay constant. Our biggest challenge is to lead this community into a “culture of collaboration”, working together towards a greater vision. We must demonstrate our willingness to embrace new ideas, share power, become involved, demand excellence and, where necessary, consider the appropriateness of new ways. OneAthens Health Initiative Team

13. Product A community health foundation with an approved plan to coordinate and fund basic health services for those in poverty and near poverty by January 2008. OneAthens Health Initiative Team

14. Product Components: Phase One Primary Care Medications Specialty Care Prevention OneAthens Health Initiative Team

15. Product Components: Phase Two Community Health Foundation OneAthens Health Initiative Team

16. Timeline OneAthens — Define product by mid-June. Report to the community in July or August. Health Team — Phase One Demand & Capacity – 1 to 2 meetings. Brainstorm models & ideas – 2 meetings. Develop strategic plan – 4 meetings. If we meet every two weeks – finish August 31. OneAthens Health Initiative Team

17. Ground Rules 1.Start on Time and End on Time. 2.Keep an open mind. 3.Discussion must remain on the initiative being discussed. 4.Be respectful of one another, which includes not talking over each other. 5.No personal attacks – no personal agendas. 6.Our meetings are open to the public; everyone is welcome to attend. 7.Only team members will be allowed to participate in the discussion during the meeting. 8.Public comments and input related to items on the agenda will be welcome during the last 15 minutes of the meeting. OneAthens Health Initiative Team