JPS Health Network is launching GT-55, the first geriatric trauma program in Tarrant County, adding a team of advanced practitioners and instituting new protocols to get patients 55 and older to surgery more quickly, assigning them priority access to operating rooms.
Many people don’t consider 55 geriatric. But trauma statistics do. A 55-year-old accident victim is more likely to die or suffer debilitating complications than a younger adult with similar injuries. The increase is so well documented that the American College of Surgeons now recommends that patients 55-plus be considered for transport to a Trauma Center, rather than the nearest hospital, without regard to the severity of their injuries.
"No one would treat a child the same way that they would treat an adult. Likewise, adults in their 50s are not simply older adults. There are physiological differences,” said Raj Gandhi, MD, chief of trauma surgery at JPS, home of Tarrant County’s only Level I Trauma Center. “As the population ages, most traumatologists recognize that this program is the next evolution in trauma care."
GT-55 will begin in January. It will be the only comprehensive geriatric trauma program in Tarrant County and one of just two programs serving all of North Texas. The other geriatric trauma program in the region is Methodist Dallas Medical Center’s G-60 service.
Healthcare Expansion Targets Infant Mortality
JPS has launched a sweeping new initiative aimed at Tarrant County’s high infant mortality rate, which chronically falls well above the state and national averages. One out of every 119 babies born in Fort Worth fails to reach the age of 1. Among babies born to African American mothers, 1 in 70 will succumb to infant mortality.
Research has found infant mortality closely tied to prenatal care. Premature birth is among the leading contributors, and is more likely to occur in women who received late or no prenatal care. The Tarrant County Fetal Infant Mortality Review found that 48 percent of babies are born to women who got late or no prenatal care. For many of those women, the first encounter with a healthcare provider comes in the OB Triage unit in the Emergency Department at JPS, a 10-bed unit with more than 1,200 patient encounters each month.
JPS has committed to an ambitious effort to make prenatal care more accessible and affordable, and to work with community agencies and organizations, including Catholic Charities, Rising Star Baptist Church, Tarrant County Public Health and area school districts, to identify women eligible for assistance and help them navigate the social services and healthcare safety nets.
New models of prenatal care currently in place at a single JPS clinic will be expanded to all four JPS Health Centers for Women, which will begin providing an initial prenatal appointment in concert with pregnancy testing. Clinic staff will help women identify sources of financial assistance that they qualify for, and will assist with applications for Medicaid and CHIP Medicaid, preventing delays in prenatal care while applications are being processed.
JPS will begin providing dental care for low-income pregnant women at six clinics throughout the county. Community health workers will be hired to work in area neighborhoods, educating women about prenatal care and the financial assistance available to them. A doula will be hired to provide support for pregnant women without a support network of their own. And lactation consultants will be hired to encourage breastfeeding.
The new initiatives are funded largely with federal money available under a Medicaid 1115 Waiver approved for the state of Texas last year. Medicaid waivers provide incentive funds for innovative projects designed to improve efficiency and ultimately lower healthcare costs while improving health outcomes. Additional federal funding is being provided by Primary Health Center Expansion Grants awarded to JPS.
Demystifying Federal Healthcare Policy
JPS took up the challenge of educating providers and industry executives on the complexities of the Texas Medicaid 1115 Waiver, hosting a two-day Waiver Symposium in September that drew 350 healthcare executives from across Texas. Speakers included some of the nation’s key players in national healthcare financing.
The 1115 Waiver will serve to transform healthcare delivery in Texas in unique ways that will impact everyone involved in the business of healthcare. The 1115 Waiver is changing the landscape for accountants, bond underwriters, rating agencies, investment bankers, lawyers, insurers and politicians — everyone involved in healthcare financing or promoting business with healthcare organizations, including private hospitals, public hospital districts and large practitioner groups.
Medicaid Waivers are a federal government mechanism for engineering change in healthcare delivery, aiming for greater efficiency. No two waivers are alike. Each represents a different approach to bringing healthcare inflation under control and improving population health. The 1115 Waiver granted Texas last year is large in its scope and potential impact, and will fund dozens of delivery system innovations known as DSRIP projects, with the acronym reflecting their funding source, Delivery System Reform Incentive Payments.
Tarrant County Hospital District, as the anchor entity for Region 10 of the Texas Medicaid 1115 Waiver, will oversee $1.1 billion in federal spending over five years for authorized system delivery improvement projects at JPS and healthcare providers throughout Region 10, which includes Tarrant, Ellis, Erath, Hood, Johnson, Navarro, Parker, Somervell and Wise counties.
Knocking Down Barriers
Patients who once waited months for access to affordable medical care are now waiting less than 24 hours following a top-to-bottom overhaul of the application process for the Connection charity care program at JPS.
"What for many people was the single biggest barrier to accessing Connection has practically been eliminated for the majority of our patients," said David Salsberry, chief financial officer.
JPS provides discounted care for uninsured Tarrant County residents, as well as those with insurance but unable to afford their plan’s deductibles and co-pays. Income determines which of six JPS Connection programs a patient joins.
Using the new streamlined application process, a majority of applicants now have an answer the same day — within an hour in many cases.
Dr. Huda Al-Hafidh, director of Dental Services at JPS, has won the Hispanic Health Care Heroes Award for her dedication to the children of Tarrant County.
The Heroes Award is presented by the Hispanic Wellness Coalition, the Fort Worth Hispanic Chamber of Commerce and United Healthcare to recognize “distinguished individuals and organizations that provide healthcare and education to the Latino community.”
Al-Hafidh, widely known as Dr. Huda, has spent the last two decades at JPS improving the dental health of a generation of school children. She initiated community partnerships with Title I schools in Fort Worth, taking dentistry into the classroom to provide preventive care and identify children in need of affordable treatment for decay or infection. The program grew to include school districts HEB, Grapevine-Colleyville, White Settlement, Everman, Birdville, Keller and Crowley. The effort is in its fifteenth year and provides services to more than 20,000 children annually.
Archived Foundation News
Giving homeless patients a place to call their own
500 Books donated from Primrose School of Bedford
Annual Giving Campaign
Owning a Piece of History
Trauma Center Tours
A Shower of Love for the newest JPS patients
Annual Trauma Conference: Great Saves Over the Decades
AT&T Partners with Centering Pregnancy
JPS Foundation Receives Komen Grant to Fight Breast Cancer
JPS pays homage to Fort Worth’s oldest hospital
Meet the JPS Foundation Board of Directors
Meeting the Need: Expanding Behavioral Health Services
Shower of Love Recap