October 2018 Volunteer Highlight: Edenton Street United Methodist Church

Fall is in full swing, which means our garden is being prepared for the colder months! Forty members of Edenton Street United Methodist Church joined us on Saturday, October 20th for their Great Day of Service.

The group spent the morning working in the garden, including prepping the garden beds inside the newly-constructed hoop house, and laying irrigation lines. Volunteers shaped the beds and added compost and fertilizer.

Volunteers cleared out weeds and planted annual rye grass was added to cover crop and keep soil in place and prevent future weeds. The group trimmed hedges and bushes around the building to have Alliance looking great!

Thank you ESUMC for spending your Great Day of Service with us!

Interested in having your group volunteer in thegarden? Contact garden@alliancemedicalministry.org for more information.

'Cue for a Cause raises $4,000 for AMM

The Alliance Young Professionals sponsored the fourth annual ‘Cue for a Cause at Alliance Medical Ministry on Sunday, Oct. 7th in the Alliance Community Garden.

The event raised $4,000 to support AMM, and welcomed over 100 attendees for clinic tours and family-friendly activities.

‘Cue attendees enjoyed delicious barbecue prepared by our friends at Glen Cove Farm (Ed Coleman and Bo Walker), Trophy Brewing beer, and sides from The Pit.

Children of all ages enjoyed a bounce house, games and face painting, supported by members of National Charity League, Dogwood Chapter.

Special thanks to Enloe High School Jazz band students for the incredible live tunes!

And, thanks to our volunteers who made it possible! Enloe MBSA and BlueCross BlueShield NC Foundation helped set up, man tables, and clean up.

Thank you to our Host Committee:

Beth & Paul McCain

Louise & Steve McCoy

Charita Murphy

Elizabeth Outten & Isaac King

Katie Patterson

Megg Rader

Mary Allison & Locke Raper

Kristin & Scott Stroud

Jena & Chris Taft

Harriet & David Wilson

Elaine & Fred Wood

Jennifer & Paxton Badham

Amelia & Andrew Bernstein

Carrie McMillan & David Boaz

Greta & Webb Bostic

Lori & Phillip Cowan

Irene Duncan & Cal Cunningham

Eleanor Scott & Hill Davis

Becca & George Edwards

Kelly Holcombe

Kathryn & Will Holding

Anna & Robert Hosea

This event was presented by Alliance Young Professionals

Interested in joining or learning more?

A Farewell Letter from Megg Rader, Executive Director

Friends,

As many of you know, I am retiring as Executive Director of Alliance Medical Ministry. Since my announcement at the end of April, the months have flown by. It hardly seems possible, but I will be leaving the end of October! 

It has been my sincere privilege and honor to lead Alliance over the last 6 years. I feel such gratitude at having been given the opportunity to meet, work and partner with so many amazing people in our community. We truly could not do the work at Alliance without you, and I thank you with all my heart!

I have been focused on the transition by supporting the board, staff and volunteers, as well as the search committee, moss+ross. Alliance is a phenomenal organization with great staff, board, donors, community partners and volunteers; it is poised to continue to do meaningful work to care for the under-served in our community, and I am confident that our next leader will be the right person to lead us the next exciting chapter. I look forward to supporting him/her and introducing him/her to you and others!

Alliance has always intentionally focused on excellent and compassionate patient care from the first day we saw patients in January 2003.  Every board member, staff and volunteer has contributed to our success and helped us live into our mission of providing comprehensive, compassionate quality medical care to a vulnerable population. 

Kudos to ALL of you for your support and commitment to AMM!

With gratitude,

AMM named one of two NC clinics for Patient-Centered Medical Home Transformation

Alliance has been selected as one of two clinics in North Carolina to pilot a Patient-Centered Medical Home (PCMH) Transformation Initiative administered by the North Carolina Association of Free and Charitable Clinics (NCAFCC).

NCAFCC has partnered with the Community Care of North Carolina network to assist with and The Blue Cross Blue Shield of North Carolina Foundation to fund the initiative, which provides technical support and a two-year grant of up to $50,000 per year!

NCAFCC evaluated 34 eligible member clinics for capability and interest in adopting PCMH transformation. After on-site visits and interviews with four of those clinics, only two were selected to move forward -- Alliance and Cape Fear Clinic in Wilmington.

The initiative provides technical support and a two-year grant of up to $50,000 year. As a pilot clinic, Alliance is committed to PCMH transformation and in obtaining PCMH Recognition by the National Committee for Quality Assurance (NCQA).

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What does it mean to be a Patient-Centered Medical Home?

Team-Based Care

• Practice leadership

• Care Team

• Orientation & education of patient/family

Patient-Centered Access

• Patient access to practice

• Care continuity

Knowing & Managing your Patients

• Data collection

• Medication reconciliation

• Evidence-based clinical decision support

Care Coordination

• Managing labs

• Tracking, managing pt. referrals

• Care transitions

Care Management & Support

• Identifying pts. for care management

• Person- centered care plan built

QI & Performance Measures

• Collecting & analyzing data

• Setting goals

• Improving practice performance

• Sharing data

“Alliance has always intentionally focused on excellent and compassionate patient care from the first day we saw patients in January 2003. I believe strongly that this opportunity has been 15 years in the making. Every board member, staff and volunteer has contributed to our success and helped us live into our mission of providing comprehensive, compassionate quality medical care to a vulnerable population. 

Kudos to ALL of you for your support and commitment to AMM!”

— Megg Rader, Executive Director

September: National Cholesterol Education Month

Our bodies need cholesterol to function properly, but too much can lead to an increased risk of heart disease.

The American Heart Association recommends adults have their cholesterol checked every 4-6 years, and yearly if diagnosed with high cholesterol, diabetes, or heart disease.

Here’s what you should aim for:

HDL, "Good Cholesterol":

• Men > 40

• Women > 50

• Need to raise your HDL? Exercise!

• Adults should aim to get 150 minute of moderate physical activity weekly

LDL, "Bad Cholesterol":

• Less than 130

• Need to lower your LDL?  Diet change!  

• More fruits and vegetables, whole grains and lean meats

Ideal Foods:

• Omega 3 fatty acids, such as salmon, walnuts, and flax seeds

• Soluble Fiber, such as oatmeal, kidney beans, Brussels sprouts, apples, pears, eggplant, okra and barley

Addressing Social Determinants of Health: Megg Rader, Executive Director

Transportation is often a hurdle individuals face that negatively impact their healthcare. A partnership with Wheels4Hope allows qualifying patients to receive a vehicle.

Providing comprehensive primary care to working uninsured adults is the core of what we do at Alliance Medical Ministry. 

However, we know that providing medical care and medication is not enough. A deep connection exists between physical heath and mental health, and between social issues and health outcomes.

Alliance has a strong history of addressing mental health and social barriers.

Over the years, Alliance has built a robust Pastoral Care and Counseling Program, providing prayer, psychotherapy, marriage and family therapy, and counseling for individuals and families. As the program grew, we began connecting patients to community resources for issues like substance abuse, addiction, and intimate partner violence. 

While addressing immediate health concerns is paramount to improving health outcomes, Alliance places an emphasis on prevention and healthy behaviors. In 2009 and 2010, we conducted patient surveys to identify patient needs and concerns, and heard loud and clear that patients wanted access to fresh, healthy food, and educational opportunities that would lead to improved eating and lifestyles. 

With the support of Inter-Faith Food Shuttle, we built our Community Garden in 2010, and began addressing food insecurity by offering fresh produce to patients in the clinic. Over time, we have developed a thriving wellness program, engaging patients and their families in on-site cooking and nutrition education, gardening, and exercise opportunities to prevent and manage chronic illnesses. Our garden now grows more than 2,000 pounds of produce for patients.

We are strengthening our partnership with southeast Raleigh non-profit Passage Home, also working alongside Fertile Ground Food Cooperative, and Wake County Department of Health & Human Services to address race fairness around our shared work with food insecurity, healthcare and workforce development.

Alliance patient and StepUp Ministry graduate James Ivey discusses how our partnership changed his life.

Economic stability has been identified by Alliance patients as one of their biggest concerns and greatest cause of stress. Although patients are required to be working or living in a working household to be eligible for care at Alliance, they struggle to make ends meet.  Many patients work in part-time, seasonal or contract jobs and do not have steady, consistent income.

Alliance has partnered with StepUp Ministry for many years, working together to cross refer patients and clients to each other's programming.

Building upon this partnership, we helped initiate The Family Table, a collaborative funded by United Way of the Greater Triangle. Together with Catholic Parrish Outreach, StepUp Ministry, Dress for Success, NC Works, Boys & Girls Club, and Childcare Resource and Referral Services, we have hired a Care Coordinator to identify and case manage families, place them in job training programs and assist with job placement, navigating food access, and enrolling in healthcare at AMM. Once Family Table clients become employed, they have access to childcare resources and after-school care.  

Via Healthy People 2020

Today, the practice of addressing social issues is called "working upstream" to address "Social Determinants of Health" (SDOH). SDOH include non-medical barriers to health, including food insecurity, housing, transportation, employment, childcare and intimate partner violence. 

Clinical care contributes to only 20% of overall health outcomes; the remaining 80% is impacted by social and economic factors, health behaviors, and your physical environment. The fewer resources and social support an individual has, the greater the barriers to optimal health outcomes.

Across the board nationally, statewide, and locally, healthcare organizations are embracing opportunities to address SDOH. Locally, Alliance serves on the Steering Committee of the Wake County Medical Society Community Health Foundation (WCMSCHF), which seeks to create a formalized approach to addressing SDOH by linking clinical and social services organizations.

Hasana Wooding, MPH Candidate, and Meaghan Henry, LCSW candidate, have worked this summer to draft the social screening questionnaire and help implement roll-out.

A priority of the WCMSCHF is to roll-out a social needs questionnaire in the medical setting, and implement a purposeful referral process to link clinical and social services.

A report prepared for John Rex Endowment by the North Carolina Institute for Public Health echoes this need: "[Key informants] would like to contribute data into centralized, well-coordinated systems that could benefit others outside their organizations. . . . High quality, coordinated referral systems that would allow them to track the people they serve as they access other services."

Likewise, the John Rex Endowment report concluded that "key informants need access to up-to-date, relevant and reliable data that could better inform their work."  The Wake Network of Care is a hub for social resources, and Alliance has expanded social resource information on our website for easy review by patients.

This summer, Alliance will roll out a social screening to new patients through our Patient Services Team. At enrollment, questions around transportation, food access, housing, employment, and childcare will be posed to new patients, with resources identified for them immediately, referrals made, a plan built, and a note made in their medical record. 

How Alliance first defined "comprehensive care" may have evolved over 15 years, but the way we intentionally embrace addressing the needs of each individual patient has remained the same. 

We remain committed to leaning in to opportunities that can positively impact our patients’ health, and to being a leader in innovative initiates and working with other organizations to find ways to address barriers to improved health. 

Are you interested in learning more about the SDOH?  Check out these resources:

• Wake County Medical Society Community Health Foundation: Community Wide Action Plan 2017-2019

• Exploring the Social Determinants of Health in Wake County, North Carolina Institute for Public Health, January 2018

• Healthy People 2020, Social Determinants of Health

Patient Spotlight: Manuel

After moving to the United States from El Salvador, Manuel Ramos-Sifontes, like many others, struggled with finding stable medical care. At the time, his mother-in-law was struggling with managing her diabetes, and soon found care at Alliance Medical Ministry. Once Manuel saw how Alliance was able to help his family, he felt encouraged to seek medical care of his own.

As a father to four, husband, and employee, Manuel recognized the need and importance of preventative healthcare. 

When he first came for care at Alliance seven years ago, Manuel was suffering from psoriasis, a chronic skin disease. “It was all over, my skin was cracking, it was very painful.”  Alliance's Referral Coordinator referred him with Blue Ridge Dermatology, and later Duke Dermatology through Project Access, for medication and treatment. The doctors at Blue Ridge Dermatology and Duke Dermatology were able to provide Manuel with a specific medicine that helped reduce his symptoms. With their support, Manuel has been able to control the disease.

"Coming here made me feel much better about [my psoriasis]. It helped reduce a lot of stress, and build my confidence."

Yoga

After receiving care, Manuel decided to get involved with some of the wellness programs. “I was nervous about going to yoga, but it helps support my mental state. It is an amazing program!” Manuel has been attending yoga weekly for over one year.  "For your life, you need to keep focused on what you’re doing. Yoga has helped me a lot with deep breathing and focus."

Seed to Supper

Manuel was first introduced to Garden & Wellness Coordinator Jesse Crouch during a yoga class. Jesse introduced Manuel to Seed to Supper, the garden education program offered twice a year in the Alliance Community Garden in partnership with Inter-Faith Food Shuttle.

Manuel Ramos-Sifontes (L) with Jesse Crouch, Flor Lopez, and other students of the Seed to Supper spring class.

Teacher and Master Gardener Rich Woynicz taught Seed to Supper students about soil quality, rotation, and natural pesticides.

Manuel participated in the spring Seed to Supper program, and at the class conclusion built his own backyard garden!  "Jesse gave me some compost to help me start the garden. The garden is a help to me because I’m exercising, moving around and eating differently!”

Cooking Matters & Diabetes Prevention Program

This summer, Manuel enrolled in the one-year Diabetes Prevention Program, offered in partnership with the Wake County Department of Health & Human Services. As part of that program, he has the goal of exercising 150 minutes a week and losing 7% of his body fat.

To continue his nutrition education and support his health goals, Manuel is taking Cooking Matters this summer, learning how to better incorporate the foods from his garden into his everyday meals. 

“I am going to start eating differently, and make sure I get exercise by working in the garden!” Manuel continues to work hard to create a healthier lifestyle for his family and himself, and enjoys every part of it!

“I’m very happy with AMM, it’s incredible how it changes your life if you need help.”