C. W. Williams Community Center: Phase 3

Phase 1: Research Introduction

Phase 2: External and Internal Analysis

Team Phase Three: HCO Organizational Operations & Strategies

Overview:   In this phase

Phase I: Research Introduction

Group One

Palm Beach State College

January 31, 2021

 

 

 

 

 

 

 

 

 

 

 

 

Introduction

Background

Organization Leaders. True heroes do not wear capes. Their outfit is simple, a face mask, a white coat, and surgical gloves. They are ready to help those who are in need without anything in return. That squad of true believers that the world can be changed to a better place were Dr. Charles Warren, Dr. John Murphy, Bob Ellis, Rowe Motley, and Peggy Beckwith who in 1980 started a health facility that helped hundreds of thousands of low-income and underserved people get access to quality care for over 38 years now (C.W. Williams Community Health Center, 2020).

Michelle Marrs started her job at C. W. Williams Health Center in the fall of 1994 as the new CEO. Thanks to her 15 years of prior supervising experience at various health facilities and her excellent education at Harvard School of Public Health, the C. W. Williams Health Center started rapidly transform in a positive way (StudyDaddy, 2020). Her powerful knowledge and rich experience right from the start have been recognized not only by the board of directors but most importantly by patients of the health center.

The current Chief Executive Officer of C.W Williams Community Health Center, Inc. is Debra Weeks who started her duty as CEO in March of 2015 (Linkedin, 2020). Before taking that position, Debra Weeks held the position of CEO at Bond Community Health Center. As well since 2016, she is the active board member of the North Carolina Community Health Center Association. (ZoomInfo, 2020). Debra Weeks carefully preserving the strong foundation created by Michelle Marrs and proudly continues to further develop C.W Williams Community Health Center with the focus on core values set by founder Dr. Charles Warren “C. W.” Williams.

 

Essential Events and Critical Incidents. At the beginning of 1980, the United States Department of Health and Human Service provided a start-up grant of $25,000 to Dr. Charles Warren to create the first nonprofit federally qualified community health center in West Charlotte, North Carolina. (C.W. Williams Community Health Center, 2020). In 1980, Charlotte’s population was over 314,000 residents making it the 47th most populated city in the United States (BiggestUsCities, 2020). Approximately 50 percent of those residents did not have private health insurance or were not eligible for government-supported health insurance such as Medicare or Medicaid.

In 1981, Dr. Charles Warren “C. W.” Williams together with his colleagues’ received the official corporate status (501 (c) (3) status) for their brand new health facility under name of “Metrolina Comprehensive Health Center” (Idealist, 2021). Unfortunately, Dr. Charles Warren “C. W.” Williams who served as the first medical director died in 1982 just months after opening the health center. However, his tremendous vision to provide quality healthcare to economically and medically disadvantaged residents of Mecklenburg County continued to live and was carried by his ambitious followers in Metrolina Comprehensive Health Center. In memory of Dr. Warren “C. W.” Williams, the health center was renamed to C. W. Williams Community Health Center, Inc.,

Along Michelle Marrs way at C. W. Williams Health Center, been many difficult challenges that extensively tested her management, long-term planning, and administrative skills. Decisions she had to make were crucial to the future of the health center. In 1996, Mrs. Marrs had to choose if it would be the right decision to expand the C. W. Williams Health Center and purchase a necessary but unaffordably expensive building to allow the necessary growth of the health center.

During 1993-1996, healthcare facilities in North Carolina started to rapidly implement digital technology systems (StudyDaddy, 2020). Due to the limited funds of non-profit C. W. Williams Health Center, it was difficult to keep up with its competitors in the industry. However, once again Mrs.Marrs strategic planning skills allowed the health center to find and allocate in the most efficient way funds necessary for the purchase of such systems.

One of the most significant challenges that C. W. Williams Health Center has faced during 1993-1996 was the healthcare shift from a fee-for-service to a managed care that resulted in a shortage of staff and great difficulties in finding volunteers and part-time physicians.

In 2014, non-profit C. W. Williams Health Center which was receiving county funding since 2007 had to lay off about 50 percent of its workers due to financial difficulties (Perlmutt, 2015).

Historical (Initial) Products/Services, Current Products/Services. Federally qualified C. W. Williams Health Center since its opening in 1981, offered a wide variety of medical and non-medical services with a focus on assisting every patient that is in need regardless of their race, financial or social status. Preventive health services included health education and community outreach. Primary services were consisting of medical, pharmacy, radiology, and lab. Non-emergency transportation to the facility and back was also offered for special needs patients. In 1995, over 3000 patient bed days were provided by C. W. Williams to local partner medical centers. C. W. Williams pharmacy was working at its full capacity filling over 20,000 prescriptions a year. Health Center constantly evolved and was adding more and more services for its patients.

At present time C. W. Williams Health Center became a modern, fully advanced medical facility with a broad range of services and 24 full-time employees (ZoomInfo, 2020). Women’s health services including gynecology health education, pediatric services, dental care, immunization, basic needs assistance, behavioral healthcare, case management, family planning, nutrition counseling, parenting education, and even translation assistance for non-English speaking patients are available now in addition to previously offered services. C. W. Williams Health Center went beyond that and also provides homeless services with access to the food pantry. Most of the healthcare services at C. W. Williams Health Center provided through a sliding fee discount scale or free of charge depending on the particular situation (C.W. Williams Community Health Center, 2020).

Industry Competitors. C. W. Williams Health Center’s top competitors are the three local hospitals, nearby Charlotte Memorial hospital, Novant Health Presbyterian Medical Center and within half an hour away Atrium Health’s Carolinas HealthCare System NorthEast.

Charlotte Memorial hospital that is located 3.5 miles East of C. W. Williams Health Center is not only the largest hospital in Charlotte city but also the largest in North Carolina with its 959 licensed beds and 49,960 inpatient visits in 2017 (Jane Little, 2017). Charlotte Memorial hospital was renamed Carolinas Medical Center (CMC) in 1984 and now is the flagship hospital of a nonprofit health system called “Atrium Health”. CMC operates at two locations with a little over a mile between them. Carolinas Medical Center is designated at the Trauma 1 level by the NC state healthcare department, currently employing over 1100 physicians (Atrium Health CMC, 2021). CMC certified and able to provide transplantation for heart, kidney, pancreas, and liver. In comparison to C. W. Williams, the CMC offers a significantly wider amount of services at an incomparably larger scale. However, C. W. Williams Health Center has a long history of collaboration with CMC, providing it with over 3,000 patient bed days in 1995. CMC is a teaching hospital giving training and education to 200 physicians annually.

Novant Health Presbyterian Medical Center is the second-largest healthcare facility in Charlotte, NC, located about 4 miles East of C. W. Williams Health Center (Jane Little, 2017). A wide variety of emergency services, maternity care, specialized care to cancer and heart disease patients is the key elements that outstand Novant Health Presbyterian Medical Center from other local hospitals. Novant Health Presbyterian Medical Center received an excellence award for being the best Maternity Hospital in the nation for 2020 (Novant Health, 2021).

Atrium Health’s Carolinas HealthCare System NorthEast is a regional 457-bed, not-for-profit, acute-care, teaching hospital located 21 miles NorthEast of C. W. Williams Health Center. 4,200 hospital employees provide world-class medical care through an extensive inpatient and outpatient network (Atrium Health Cabarrus, 2021).

Statement of the Problem

C.W Williams Health Center mission is to advance a better future for our local area by reliably giving incredible, open wellbeing care with satisfaction, empathy, and respect. The Health Care System, like any other system, is subject to changes over some time. Changes come with requirements for all key players within a system to adapt and suit the new system. Among the notable changes are reforms in the regulation governing health centers. One example is the Affordable Care Act, which stipulates that programs be implemented across the country for Medicare and Medicaid patients (Salmond and Echevarria, 2017). The Act’s proposal came due to growing concern over the increase in patients with chronic health conditions and who lacked access to health services (Salmond and Echevarria, 2017). the Act came into force to ensure a universal health care system that is of quality and affordable.

Further, the Act required the coordination of health care providers across the nation (Salmond and Echevarria, 2017). Medical professions and nurses take steps to ensure the coordination between health care centers is smooth. In C. W Williams Health Center, the only patients the institution handles are fee-for-service patients and not managed-care patients. The Centre does not have the technology required to ensure a smooth transition into handling managed care patients. There is a need to identify how C. W. Williams can create the technological capacity to handle managed care services since its current machinery is inadequate.

Changes in the health sector that have affected C. W. Williams go beyond the technological aspect. Michelle Marrs, the health center’s Chief Executive Officer, indicates that there is a challenge of the available workforce (Swayne, Duncan, and Ginter, 2006). Precisely, the number of physicians who can handle managed care patients are few. Lack of adequate physicians at C. W. Williams Health Center can be attributed to many of them being engaged in permanent contracts, thus lacking time to volunteer at the facility (Swayne et al., 2008). Likewise, there is a rigorous rotational schedule, which makes the opportunity unattractive no matter the compensation package offered (Swayne et al., 2008). Additionally, the problem of inadequate human resources does not end with physician recruitment and retention challenges. C. W. Williams is a small health facility that requires integration with another medical facility to handle managed care patients. This involves additional costs. Additional costs associated with integration are acquisition costs (Staňková, Papadaki, & Dvorský, 2019). Michelle indicates that a place has been found to purchase and expand the Health facility (Swayne et al., 2008). However, the cost of expansion may be a challenge since there is a need for a director of finance to oversee the project’s acquisition and implementation.

The lack of a director of finance adds to the labor shortage C. W. Williams is facing. Further, Michelle opens about how the health care industry is undergoing difficult times (Swayne et al., 2008). In challenging economic times, another facility’s purchase would pose significant risks of financial collapse for C. W. Williams. C.W. Williams plays a substantial role in the pilot program for offering health care to Medicaid patients in Mecklenberg County (Swayne et al., 2008). Moreover, C.W. Williams is approved to serve Medicaid patients yet, it is not a Health Maintenance Organization (Swayne et al., 2008). Despite these milestones, C.W. Williams faces technological and human labor challenges in the new health care system. Considering these challenges, there is a need to examine the effect of health care changes on the labor structure at C.W. Williams.

Research Significance

C.W Williams Healthcare would benefit from further research to enlighten and guide the company in the right direction from the issues they face today. Research and development (R and D) are utilized in multiple aspects of any business such as, examining the market, how to attract and retain customers, and also for improvement of products and services((Zarah, 2010). This community-based center is suffering from inadequate space which leaves the company with limited services provided, underproduction of human resources creating low retention and recruitment rates and also, lack of guidance from financial directors leaving the company vulnerable to financial ruins.

To start, C.W Williams could benefit by looking further into local properties for sale, ensuring that this investment would not leave the business in financial destruction. Finding adequate and affordable space will promote the increases of services they are able to provide and/or offer for the community. Expanding the company will also assist in taking on the managed care patients, providing them with the quality care they deserve. Allowing continued research will provide directors with a better image of how to increase their productivity and integrate new technological advances to help sustain the team.

Identifying a new director of finance will exponentially support the company in staffing issues such as recruitment and retention and the financial crisis they stand to face. The new director will be able to allocate funds and delegate task to oversee the new changes brought forth to elevate the business.

Strategic research and planning will offer the company an enhanced opportunity to continue the growth of the company and exceptional work they deliver to the community. Change is essential, yet necessary and for a business to stay relevant and continue to run effectively and flourish.(Ginter et al., 2018)

Purpose

C W Williams Community Center, a community facility, will be assessed to determine its problems in providing adequate health care to the community. Action will later be undertaken to solve the issues based on the results of the study. Therefore, the research will have two purposes:

· To examine the problems that bedevil the health care system at the community level.

· To propose interventions that should be undertaken in addressing the healthcare system’s problems at the community level.

This paper will address issues that affect C W Williams Community Center and other community-based health centers and then propose ways to address the problems.

Health is not equal to all people in the United States. Some receive the best care, but some lack it. Community health center will provide health care to medically underserved populations within society. This research will seek to determine the underserved people and state their locations to improve the region’s facility. It will then recommend the activities that should be undertaken to uplift the facility’s standards by providing medical equipment and drugs.

Many of the community health centers serve the poor within society (Lazar & Davenport, 2018). This makes them charge less because people are unable to afford high-end medication. They are, therefore, popular with the poverty-stricken communities. The purpose of this research is to determine the poverty levels within the regions with community health facilities. It will then propose mechanisms such as subsidized health care or insurance-based health care to the patients.

To effectively provide healthcare to patients, most facilities offer managed care to patients. This is a method used by the state to organize or manage the cost of medication, operation, and quality of care (Cook et al., 2007). The research will assess how the government will intervene in providing health care to its citizens by contracting with MCOs to offer Medicaid programs to beneficiaries. This will significantly reduce the cost and provide better manage utilization of health services.

The research will also look at the challenges experienced by moving from the primarily fee-for-service to a managed care environment. Physicians will be barred from working with C W Williams Community Center after the transfer because they will enter the hospitals under the managed care. This will affect the facility’s quality of care by denying it the best doctors to treat patients. Therefore, this research aims to provide a solution to see such facilities to get the best doctors. Strategies will be improvised to see community facilities contract medical facilities without breaching their former employers’ agreement.

To work well and provide quality care to patients, the community-based facilities should partner with other hospitals to offer additional services that are not provided by them (Lazar & Davenport, 2018). Therefore, this study will identify facilities that are well equipped and can provide extra care to the patients at a reduced price.

Community care facilities are also touted to be working on losses. This is because they are in poor neighborhoods, and most clients cannot pay for high-end medication (Lazar & Davenport, 2018). The research will look at C W Williams Community Center’s financial records and assess the profits or losses that the hospital makes. The study will then suggest ways to enable the hospital and other community facilities to make more profits even as they offer affordable health care to the economically poor populations. Partnership with insurance companies can assist in addressing the problem of frequent losses incurred by community hospitals. Therefore, the research will assess the problems that affect community hospitals and suggest ways of improving the situation to provide affordable and quality care to patients.

Data Collection/Research Methods

Data collection about C.W. Williams Health Center helps us to understand the medical facility as a whole, its functions, and what can be done to better provide exceptional service to patients. Interviews played an imperative role in the health center because they questioned why patients were pleased with the community health center and how it has changed their life. In a recent YouTube video, a middle-aged Latin woman spoke in Spanish, next to a translator and stated that “her neighborhood is saturated with their own kind; to have a managed care service like that right under her nose is the reason she is here at the facility” she was very grateful, nevertheless (Padilla, 2018).

A survey is another tool used for collecting data from groups of people that give their insights on different topics. It can also be a questionnaire, given online. On the C.W. William Center website, survey questions ask, “please select how well you think we are doing in the following areas” (C.W. Williams, 2020). Another related question would be about their waiting time, was it a long wait or not, and were they pleased with their providers on the type of care. Surveys at the C.W. Williams Center tie back to patient satisfaction, which is an important factor in collecting information.

The research method will be qualitative, and it will mainly be secondary data analysis. The importance of using qualitative research is that it helps analyze the scenario to have a more in-depth understanding of both the capabilities and limitations of achieving the solution as well as the organization itself. Existing texts and documents from educational databases along with other researchers will contribute to research analysis and further understanding of the C.W. Williams Health Center case.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Atrium Health’s Carolinas Medical Center: Hospital in Charlotte, NC. (2021).

Charlotte, North Carolina Population History 1940 – 2019. (2020, November 18). Retrieved from https://www.biggestuscities.com/city/charlotte-north-carolina .

Clinical Services in NC: C.W. Williams Community Health Center. (2020, April 08).

Cook, N. L., Hicks, L. S., O’Malley, A. J., Keegan, T., Guadagnoli, E., & Landon, B. E. (2007). Access to speciality care and medical services in community health centres. Health Affairs, 26(5), 1459-1468.

C.W.Williams, I. (2020, March 03). Trusted Community Health Center and Urgent Care Charlotte NC : FQHC., from https://www.cwwilliams.org/

Ginter , P. M., & Swayne , L. E. (2018). Chapter 1 Why the Nature of Strategic Management is Important . In W. J. Duncan (Ed.), Strategic Management of Health Care Organizations (Eighth, p. 1). John Wiley and Sons, Inc.

Lazar, M., & Davenport, L. (2018). Barriers to health care access for low-income families: a review of the literature. Journal of community health nursing, 35(1), 28-37.

Metrics, L. (n.d.). C W Williams Community Health Center: Charlotte, NC: Cause IQ profile. from https://www.causeiq.com/organizations/c-w-williams-community-health-center,561262478/

Retrieved from https://atriumhealth.org/locations/detail/carolinas-medical-center .

Retrieved from https://www.cwwilliams.org/services/other-services .

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12.https://doi.org/10.1097/NOR.0000000000000308

Staňková, P., Papadaki, Š., & Dvorský, J. (2019). Reducing Hospital Costs through Horizontal Integration. Iranian journal of public health, 48(11), 2016–2024.

Swayne, L. E., Duncan, W. J., & Ginter, P. M. (2006). Strategic Management of Health Care Organizations. Fifth ed. Massachusetts: Blackwell Publishing.

Zarah, L. (2010, December 20). 7 Reasons Why Research Is Important – Owlcation – Education. Owlcation. https://owlcation.com/academia/Why-Research-is-Important-Within-and-Beyond-the-Academe .

you will explore the organization’s operations to help in identifying one or more areas exhibiting weakness or threats for further analysis (consistent with situational analysis in Phase 2).

The tasks I chose to write about in this phase is the “Marketing Issues, and Human Resource Aspects” of the C. W. Williams Community Center: A Community Asset Case Study.

Requirements:

• 1 page on “Marketing Issues”
• 1 page on “Human Resource Aspects”
• Include references