2001 Report

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Agape/Community Care Activities Summary: 2001

In 2001 we provided care in the community as shown below. The value column is based on the community standard cost of care. See end of document* for a discussion of community standards of costs.

Activity	# Patients Served	Value*	Totals
Medical care for illness or physical exam	4623	55.00	254,265.00
Medications provided	4200	25.00	105,000.00
Immunizations	1906	55.00	104,830.00
Follow-up & home visits	440	50.00	22,000
Social work or chaplain care	319	-	-

Conservatively calculated year-end total value of care given at the Agape Clinic with expenses less than $25,000 is $486,095.00. This is the first time we have looked at value in terms of money. Always before, we looked at what we do in terms of mercy, quality of care, outcomes of care, and the like. We still hold Agape and mercy as central values; and we continue to look at quality and outcomes of care. But the money perspective is very interesting. In more than 20 years of volunteer work, this is by far the best value for money spent I have seen.

Comments

We provided community education, e.g., weekly classes at the Brady Center throughout the spring and classes in the Agape waiting room in the fall. The City of Dallas provided ongoing classes on family violence for our patients and families.
Health screening through Agape included screening at an elementary school, a health fair at a very large Cambodian New Year celebration, and developmental screening for children less than two years of age. All screenings included referral and assistance into the health system for positive findings.
A comprehensive guide to registering at Parkland was produced and translated into Spanish. The guide is available at the clinic and on-line at http://www.baylor.edu/~Charles_Kemp/primary_care.htm
There were significant amounts of undocumented work done at Agape, e.g., screening for hypertension and other health problems, work on referrals, pregnancy tests, vast amounts of teaching, and so on.
34 nursing students were trained in community health and primary health care in a setting in which they also practiced Agape and mercy. The students provided much of the nursing and community health care at Agape/Community Care.
Patients contributed both assistance to staff and money.
Several grants were received, as were many donations of medications. Grants included:
- Communities Foundation - $12,800 for equipment and supplies (grant is for nursing education activities at Agape Clinic)
- Open Ring Class @ First Presbyterian - $4000 for medications
- First Presbyterian Church Foundation - $13,000 for lay health promoter - 2001; and $8,000 in 2002
- Bob Smith, MD Foundation - $5,000 for lay health promoter salary - 2002
- Highland Park Presbyterian Church - $2,000 for lay health promoter - 2002
- Presbyterian Church (U.S.A.) national denomination - $2,000 for lay health promoter - 2002
Common Grace Ministries is supporting a women's mission and spiritual formation group, which is separate from clinic operations.
Social work and chaplain care were difficult to quantify. There were a few cases/ situations that required more than a full week of work and many interventions that were not documented.
We put in a new floor in the waiting room. What a wonderful improvement! The children's area is carpeted and there are some new (used) interactive toys + a good supply of books.

Priorities for 2002 (More may be determined by the clinic committee)

The top priority remains funding for an RN coordinator (50% time). We have pushed this all-volunteer model well past what I have seen in the past and we simply have no reserves. The $486,000 worth of services was delivered on expenses of < $25,000! Everyone is pushing hard, and we need help on this. We can put a ½ time R.N. and ½ time lay health promoter in place for around $50,000/year.

The grant from Communities will allow students to conduct some serious asthma screening. Through the grant we are purchasing a pulmonary function machine, which will allow students to monitor pulmonary status and physicians and nurse practitioners to provide improved care for patients with asthma and other pulmonary diseases.

Health promotion and disease prevention activities should increase somewhat; and if the RN coordinator is funded, these activities will increase to a greater extent.

Increasing volunteer involvement and resources are ongoing priorities. Our focus is on increased professional volunteers (especially physicians and nurses), lay volunteers from Grace and other churches, and especially volunteers from the community served by the clinic.

* Community standard costs of health care: To avoid criticism, I have estimated on the low side in all cases. The cost of care for illness or physical assessments is based on what patients would pay if they went to a neighborhood clinic such as the clinic on Columbia across the street from the Cost Plus Supermarket. Of course this does not accurately reflect what patients would pay for care from some of our volunteer physicians! For medications, I simply (under) estimated. The cost of immunizations is also based on what patients would pay if they went to a neighborhood clinic such as the clinic across from Cost Plus. For follow-up/home visits I assigned a number significantly lower than that charged Medicare for home health visits. Social work and chaplain care costs are not estimated, nor is the value of the many volunteer hours given by physicians, nurses, and other volunteers.

Report by Charles Kemp

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