The Northern Manhattan Community Voices Collaborative does not wait for patients in the emergency room. The Community Health Outreach Workers at the Alianza Dominicana Center for Health Promotion and Education are stopping problems at their source by providing information, education, training, and referrals to meet the health needs of the uninsured and underinsured population largely Dominican/Latino and African American in Central Harlem and Washington Heights-Inwood. The first of its kind, the Center for Health Promotion and Education links community-based organizations with health care providers, increasing access to health care in this severely underserved community. The Center is also facilitating the delivery of health care by referring local residents to health resources and relaying important public health needs to providers. Together, institutions and community groups are shifting health perceptions from emergency treatment to preventative care.
The Northern Manhattan Community Voices Collaborative is a partnership of 35 community-based organizations and local health care providers working to improve the overall health of the Northern Manhattan community. This unique collaborative, led by Columbia University School of Dental and Oral Surgery, Harlem Hospital Center, and Alianza Dominicana, addresses the barriers that contribute to poor health, such as lack of insurance, language barriers, and cultural perceptions.
Northern Manhattan houses less than one-third of the Manhattan population, yet accounts for nearly 60 percent of the Medicaid-eligible persons with disabilities, elderly, or families living under the federal poverty requirement residents in the borough.
In the 1980s, Northern Manhattan received the largest influx of legal immigrants of any New York City neighborhood. Studies indicate that a large number of foreign-born U.S. residents are not covered by health insurance. Northern Manhattan immigrants, who make up a significant portion of the working poor, experience high levels of underemployment and unemployment and a significant lack of health insurance. Language barriers and cultural practices also affect the level and quality of care in this community.
Hospital closings have also had a significant impact on access to health care and the economic health in Northern Manhattan. Between 1967 and 1987, eight neighborhood or nearby hospitals closed. These closings greatly decreased the number of available doctors and deprived the community of thousands of essential jobs.
The entire community struggles to keep up with the rules for government-funded health insurance, such as Medicaid or Child Health Plus (CHP), the state's Child Health Insurance Program (CHIP). Welfare reform in 1996 ended or amended benefits for many and created fear of deportation among the immigrant population. Even today, many people still do not understand their eligibility for benefits.
Language, transportation, and a difficult application process further contribute to the lack of coverage for those who may be eligible for government-funded health care. The problem is so widespread that more than two-thirds of children without insurance are eligible for CHP insurance, but their parents fail or are reluctant to apply.
To address the needs of the uninsured and underinsured in the community, the Northern Manhattan Community Voices Collaborative is:
Using the Community Health Outreach Worker Training Program to promote access to health care services and enrollment in Medicaid and Child Health Plus
Developing low-cost, high-quality health coverage for uninsured Northern Manhattan residents
Developing health and wellness education programs through hospitals, churches, and community groups
Expanding service availability for primary care through expanded office hours and the availability of nurses or physicians for phone consultations
Offering training to help providers develop stronger partnerships with patients
Revising Medicaid and CHP outreach materials to make them linguistically and culturally appropriate
Developing a system for preventing interruptions to Medicaid coverage
Training dental assistants through the Dental Assistant Training Program. The one-year program is open to high school graduates or those who have passed GED exams. There is no cost to students thanks to a grant from Empowerment Zone.
One important undertaking is the Mannie L. Wilson Senior Citizen project, a $2.8 million construction project located at 124th Street and Manhattan Avenue in the heart of Harlem. The Collaborative is working with a coalition of Harlem Senior Centers, Harlem Hospital, and the Harlem Congregations for Community Improvement on an access plan to ease the path for seniors to get care. This includes a transportation component and other ways to make it easier for the elderly to get comprehensive rather than merely acute care, including much-needed oral health services, to manage chronic conditions instead of just acute care.
Another important project is the Asthma Initiative. The Fund for the City of New York and the Beldon Fund have expressed interest in funding this project. The Fund for the City of New York is interested in assisting the Northern Manhattan Community Voices in coordinating a web-based initiative for community based organizations and residents. The Beldon Fund has expressed interest in helping with the environmental aspects of asthma management so that the Collaborative can work with the Housing Authorities and others to take care of some of the environmental factors contributing to the high prevalence of asthma.
The Northern Manhattan Community Voices Collaborative increases access to health services for the uninsured and underinsured in the Central Harlem and Washington Heights-Inwood community. The collaborative addresses community health needs with the following strategies:
Enrollment in Medicaid and CHP. The Northern Manhattan site enrolls uninsured persons who are eligible for Medicaid, Child Health Plus, WIC, and other coverage options
Affordable primary health care coverage. The Northern Manhattan site is developing low-cost, high-quality health coverage for uninsured Northern Manhattan residents
Health education and disease prevention programs. The Northern Manhattan site offers training and education on important health promotion and disease prevention strategies
Access to important health resources. The Northern Manhattan site facilitates access to dental and mental health services that may not be covered by insurance.
Community Voices Northern Manhattan partner agencies also include; the Joseph L. Mailman School of Public Health, Community Premier Plus, Harlem Congregations for Community Improvement, Inc., Isabella Geriatric Center, New York Presbyterian Hospital, Renaissance Health Care Network, West Harlem Environmental Action, Inc (WHE ACT), Arthur Eugene & Thelma Adair Community Life Center, Inc., Inwood Community Services, New York Task Force on Immigrant Health, and the Start Right Coalition.
Columbia University, School of Dental & Oral Surgery
Columbia University is the oldest institution of higher learning in the state of New York and the fifth oldest in the United States. Its School of Dental & Oral Surgery is committed to preparing students for careers that emphasize biomedical sciences and allow them to practice general dentistry or to pursue advanced training in hospitals and dental schools. Its mission focuses on three areas education, patient care, and research. This is the only major institution providing health services in the Washington Heights/Inwood community of Manhattan.
Project Director, Northern Manhattan Community Voices Collaborative
100 Haven Avenue, Suite 27C
New York, NY 10032
Phone: (212) 304-7030
Fax: (212) 544-1905