Children and Youth (infants - 19 years)
Ethnic/Racial Minorities -- General
Infants/Babies (under age 5)
Over twenty years ago, two Jefferson County School Nurses (Karen Pramenko and Karen Connor) found that many of the students they cared for in Arvada had no health insurance, and no access to health care. They submitted a proposal to the City of Arvada and collaborated with various community entities to create a unique clinic to serve children without health insurance: Carin' Clinic. Carin' (short for caring) Clinic first opened in September 1993 and became a 501 (c) (3) tax-exempt clinic in 1997. For the first 16 years, the clinic operated in donated space at Arvada Middle School. Since 2010, Carin' Clinic has been located at 51st and Allison, behind the Jeffco Head Start Center. In 2013, Jefferson County Human Services gave ownership of the building to Carin' Clinic, and the clinic now leases the underlying property from Jefferson County.
Carin' Clinic was founded to provide health care to children who had no health insurance or access to health care. Carin' Clinic has evolved to also serve children who qualify for Medicaid and Child Health Plan Plus state programs after the passing of the Affordable Care Act. Although Carin' Clinic does not have residency restrictions for children to receive health care, of the 2,411 visits made to the clinic in 2018, over 60% of them were made by residents of Arvada. These Arvadans are the most vulnerable among us, and Carin' Clinic has been their "Safety Net Clinic" for more than 20 years. 79% of the Arvada residents that use the Carin' Clinic earn less than 142% of the Federal Poverty Level (i.e., less than $36,565/year for a family of four) and have Medicaid. About 10% of the Arvada families at our clinic do not have Medicaid or other insurance, and a small co-pay is requested, based on their income. Although a co-pay is requested, no one is ever turned away if unable to pay.
Thanks to increased coverage by the Affordable Care Act, there are lower numbers of uninsured people. The 2017 Colorado Health Access Survey completed by the Colorado Health Institute (https://www.coloradohealthinstitute.org/research/colorado-health-access-
survey) found that Jefferson County has a rate of only 4% of uninsured people. However, even as Colorado holds on to its historically low uninsured rate, 350,000 people still don't have health insurance. Who are they? The state's most vulnerable residents tend to be disproportionately represented in this group. Low-income and Hispanic Coloradans, as well as non-citizens. Hispanics account for 34% of the uninsured but just 21.2% of the total population of Colorado. Even with expanded number of children covered by Medicaid, low-income children in the City of Arvada need a medical home to provide primary health care. Nearly 23 percent of Medicaid clients report not getting care because the doctor's office wasn't taking their insurance, a rate that has stayed consistently higher than employer-sponsored and private insurance. The private pediatric clinics located nearest to the clinic are referring patients with Medicaid to Carin' Clinic. In the zip codes near where the clinic is located (80002 and 80003), 16.5% of families with children under the age of 18 are living in poverty. There are three large Section 8 subsidized apartment buildings (Allison Village, Allison Point, and Columbine Village) located within walking distance from the clinic, and at least 19 other complexes within 3.5 miles from the clinic.
Our families are dealing with multiple stressors, struggling to keep the children in our community healthy and well fed. Recently, a new family came to the clinic. A mom with two young boys who were staying in a shelter for women and families due to domestic violence. Her sons were enrolling at Head Start next door to us, and that is how she found out about the clinic. Not only were we able to give the boys physicals and immunizations so that they could attend Head Start, but we were able to take the time to find out what her needs were. She had almost no clothes for herself or the boys and no pull-up diapers, and no job. We were able to give her King Soopers gift cards and tell her about the King Soopers near the clinic that also sells clothes, and refer her to a Medicaid social worker (luckily her boys had Medicaid). She was so thankful, and we couldn't do it without your generosity.
The Board of Directors and executive team used our Strategic Plan to help strengthen our internal organization, achieve goals and objectives based on our mission and input from the community, and to assess how our goals and objectives are being met. We are currently evaluating how we met our goals and objectives, and will begin to create another Strategic Plan with goals for the next five to ten years.
The continual increase in number of visits to the clinic demonstrates that Carin' Clinic is fulfilling a need in the community. The Executive Director evaluates and reports clinic utilization to the Board of Directors at least quarterly.
The clinical staff meets at least bi-monthly to review charts and evaluate patient quality care measures and objectives such as immunization rates, asthma care and depression screening. Carin' Clinic is participating in demonstrating Meaningful Use with its Electronic Health Records; to obtain federal incentive monies quality care measures must be evaluated and met. Having received funds each fiscal year demonstrates success in meeting quality care measures that we are working on.
The clinic is also working with CCHA (Colorado Community Health Alliance) to meet Key Performance measures such as decreasing Emergency Room visits, increasing percentage of children with annual Well Child Checks and participating in Quality Assurance activities. We are also working on decreasing the "no-show" rate by evaluating the effectiveness of various pre-appointment reminders.