Health Centers in Trenton and Newark: Building New Jersey’s Primary Care Safety Net Feasibility Study of Newark, New Jersey Submitted by: Nurse Practitioner Healthcare Foundation and New Jersey Health Care Quality Institute February 29, 2016 The Nurse Practitioner Healthcare Foundation and the New Jersey Health Care Quality Institute express their appreciation to The Nicholson Foundation for its generous support of this Feasibility Study. Special thanks to Maureen Deevey and Michelle Fouks for their encouragement and guidance. Project Team Co-Directors Phyllis Arn Zimmer, MN, FNP, FAANP, FAAN President Nurse Practitioner Healthcare Foundation David L. Knowlton, BA, MA Past President and CEO New Jersey Health Care Quality Institute Team Members Patricia Kappas-Larson, DNP, ANP, FAAN President Transformative Solutions, LLC Jeffrey A. Warren, MPA Principal JR Market Strategies, LLC Kevin J. O’Brien, BA, MBA Founder and CEO Strategic Business Alternatives, LLC Christina Strong, J.D. Law Office of Christina Strong, Esq. Patricia Kelmar, J.D. PDKelmar Associates, LLC Judith L. Formalarie JL Formalarie Consulting, LLC Special Thanks Special thanks to the New Jersey Collaborating Center for Nursing for its support and collaboration on this Project. Gratitude is also expressed to: The APN Network of NJ, LLC Forum of Nurses in Advanced Practice-New Jersey Society of Psychiatric Advanced Practice Nurses The New Jersey Nurses Association New Jersey Board of Nursing Acknowledgements The Project Team wishes to thank the many individuals who supported this Project by participating in interviews, surveys, focus groups, or reviewing content. We appreciate their thoughtful comments, suggestions, and insights. We recognize and value their passion for moving healthcare forward in the State of New Jersey. Mary Aikins, RN, BA, CCM, Manager of Care Management Operations, Horizon Healthcare Innovations, Horizon Blue Cross Blue Shield of New Jersey Roland Anglin, PhD, Director, The Joseph Cornwall Center for Metropolitan Studies, The State University of New Jersey-Rutgers Marsha Atkind, Executive Director, The Healthcare Foundation of New Jersey Robert Atkins, PhD, RN, FAAN, National Program Director, New Jersey Health Initiatives Vivian Baker, Assistant Director, New Jersey Transit (and Leader of Community Planning, Together North Jersey) Carolyn Beauchamp, ACSW, MSW, President/CEO, Mental Health Association in New Jersey, Inc. Dana Berry, President, Starting Points for Children (and Board Member, State Employment & Training Commission) Jeffrey Brenner, MD, Executive Director, Camden Coalition of Healthcare Providers Jeff Brown, Former Executive Director, QI Collaborative, New Jersey Health Care Quality Institute Edna Cadmus, PhD, RN, NEA-BC, FAAN, Executive Director, New Jersey Collaborating Center for Nursing Richard Cammarieri, Director of Special Projects, New Community Corporation Service Bureau of Newark Karen L. Clark, Vice President, Medicaid, Horizon Blue Cross Blue Shield of New Jersey Pamela Clarke, PhD, President, CEO, Newark Community Health Centers (FQHC) Tai Cooper, Chief Policy Advisor, Office of the Mayor Andrew Crighton, MD, Chief Medical Officer, Prudential Financial Robert N. Davison, MA, LPC, Executive Director, Mental Health Association of Essex County Pat Dennehy, DNP, RN, FNP-BC, FAAN, Principal, Health Management Associates Mary DiGiulio, DNP, APN, Specialty Director, Adult Gerontology Primary Care Nurse Practitioner Program, The State University of New Jersey-Rutgers Ashley Donecker, Director, Junior Achievement of New Jersey Judy Donlen, DNSc, RN, JD, Executive Director, Southern NJ Perinatal Cooperative and President/CEO of Family Health Initiatives Marie Foley, PhD, RN, CNL, Dean & Professor, Seton Hall University College of Nursing Doug Forrester, Chairman & CEO, Integrity Health Kelly Fulton, RN, Vice President, Barnabas Health Medical Group Kathleen M. Gialanella, Esq., P.C. Brendan Gill, Essex County Freeholder Jennifer Gillooly, HRINJ Advocate Manager, Health Republic Insurance of New Jersey Nicholas S. Guittari, MD (Geriatrician), Center for Geriatric Healthcare, Newark Beth Israel Medical Center Chip Hallock, President, Newark Regional Business Partnership Hanaa A. Hamdi, Ph.D, Director, Department of Health and Community Wellness, City of Newark Rabbi Yitzchock Halberstam - Principal, Seton Services Valerie Harr, Chief of Operations, NJ Medicaid Program William L. Holzemer, PhD, RN, FAAN, Dean & Distinguished Professor, The State University of New Jersey, Rutgers School of Nursing Dr. M. William Howard, Pastor, Bethany Baptist Church Jillian Hudspeth, President and CEO, New Jersey Primary Care Association Theresa Jacks, Deputy Director, Council of New Jersey Grantmakers Kathleen J. Jackson, DNP, APN, BC-ADM, Assistant Professor, The State University of New Jersey-Rutgers School of Nursing Mary L. Johansen, PhD, NE-BC, RN, Associate Director, New Jersey Collaborating Center for Nursing Arti D. Kakkar, EdS, LMFT, AAMFT Approved Supervisor, Executive Director, Family Service Bureau of Newark Ellen Lambert, Chief Development Officer & Corporate Citizenship, PSE&G Monsignor William Lindner, Chairman, New Community Corporation Keri Logosso Misurell, J.D., Executive Director, Healthy Greater Newark ACO Filomena Machleder, Program Officer, Corporate Social Responsibility Department, Horizon Foundation for New Jersey Jim Martin, Former CEO, Health Republic Elizabeth Mbakaya, Chief Financial Officer, New Community Corporation Wendy McWeeny, Amelior Foundation Kenneth D. Merin, President/CEO, Charles Hayden Foundation Gina Miranda-Diaz, Director & Health Officer, West New York Health Department Dr. Thomas Ortiz, Founder, Forest Hill Medical Associates; Chair, PCP Committee, Greater Newark Health Care Coalition Melissa Parker, Chief Operating Officer, United Family Medicine, St. Paul, Minnesota Tray Parris-Benjamin, LMSW, Transformation Coach, Horizon Healthcare Innovations, Horizon Blue Cross Blue Shield of New Jersey Steven Peskin, MD, Senior Medical Director, Clinical Innovations, Horizon Blue Cross Blue Shield of New Jersey Bonita A. Pilon, PhD, NE-A, FAAN, Professor, Vanderbilt University School of Nursing Sharon Pleasant-Jones, BSN, RN, Director, Health & Social Services, New Community Corporation Erhardt H.L. Preitauer, President, Horizon New Jersey Health & Sr. Vice President Government Programs, Horizon Blue Cross Blue Shield of New Jersey Joanne M. Pohl, PhD, ANP-BC, FAAN, FAANP, Professor Emerita, University of Michigan School of Nursing Darcel Reyes, PhD(c), MS, ANP-BC, Clinical Instructor/Associate Director, HIV Care Specialization Doctoral Program, The State University of New Jersey-Rutgers Mary Ellen Roberts, DNP, RN, APN, FAANP, FAAN, Assistant Professor, Graduate Department, College of Nursing, Seton Hall University Richard Rohrman, Chief Executive Officer, New Community Corporation, Newark, New Jersey Susan Salmond, EdD, RN, ANEF, FAAN, Executive Vice Dean and Professor, The State University of New Jersey-Rutgers John Sarno, President, Employers Association of New Jersey Catherine Ann Sauner, Chief Operations Officer, Health Republic Insurance of New Jersey Donna Scheel, Director of Veterans Services, US Department of Labor Linda Schwimmer, JD, President and CEO, New Jersey Health Care Quality Institute Cindy Sickora, DNP, RN, Associate Professor, Director of Community Programs, The State University of New Jersey, Rutgers School of Nursing Kathy L. Spivey, Chief of Staff, New Community Corporation June Stanley, MSN, FNP, Senior Director of Clinical Operations, Government Programs, Horizon Blue Cross Blue Shield of New Jersey Peter G. Stewart, Partner (retired), Carella, Byrne, Cecchi, Olstein, Brody & Agnello, P.C. Robert Strausberg, Rehabilitation Counselor, Jewish Vocational Service John Tedeschi, MD, Advocare LLC, Continuum Health Alliance Rick Thigpen, Vice President State Government Affairs, PSE&G Jennifer Velez, Senior Vice President for Community and Behavioral Health, Barnabas Health Jennifer Valverde, Clinical Professor of Law and Clinical Director of H.E.A.L., Rutgers School of Law-Newark Patricia M. Vanhook, Ph.D, RN, FNP-BC, FAAN, Professor and Associate Dean of Practice, East Tennessee State University Nadine Venezia, Associate Executive Director, Mental Health Association of Essex County Susan VonNessen-Scanlin, MSN, CPNP, MBA, Chief Transformation Officer, Robert Wood Johnson Medical School Kathy Weaver, Vice President of Programs, Newark Alliance Industrial Development Colleen Woods, Interim Executive Director, Healthy Greater Newark AC Executive Summary Newark is a racially and culturally diverse city with significant challenges including high poverty rates, significant under- and unemployment, and rampant crime. These social factors negatively impact the ability of the city’s residents to access quality healthcare. As a result of poor access, the City has a large number of medically complex individuals, straining the capacity of on Newark’s healthcare facilities to provide care. Low reimbursement rates from government payers and provision of uncompensated care to undocumented individuals challenge the fiscal strength of both the city’s hospitals and primary care facilities. Adding to this problem is the lack of a diverse payer mix, especially the more generous commercial payers. The City of Newark continues to display some of the worst health outcomes of any city in the United States. Despite important efforts in the last decade to increase access to care through a variety of local