directions_coverWhen she was 16 years old, Nellie Lazar was a candy striper, wearing the red-and-white striped uniform that resembled peppermint candy, working as a volunteer in the emergency room of her local hospital. Now her uniform, a crisp white coat, bears her name and her degree: Nellie Lazar, CRNP, Congreso Health Center.

Lazar is a certified registered nurse practitioner (CRNP), having earned her master's degree in nursing at University of California, San Francisco. She heads up Congreso Health Center, the newest health center managed by PHMC. Her staff consists of a combination of Congreso de Latinos Unidos (Congreso) and PHMC staff: a second CRNP, a nurse, a social worker and two medical assistants. “We have a fabulous team. We all worked very hard together to get where we are today. We make decisions together on how we are to serve our patients,” Lazar says.

Lazar’s background was always in community health. She spent two years in the Peace Corps in Guatemala, teaching health and hygiene in primary school and helping to run a health clinic. She went back to San Francisco to work as a school nurse in a Latino high school. Lazar then moved to Philadelphia and got a job at The Children’s Hospital of Philadelphia in adolescent medicine, providing primary care. She was hired in August 2009 by PHMC and worked as a CRNP at two health clinics managed by PHMC, Rising Sun and Health Connection. With the opening of the Congreso Health Center on December 2, 2011, Lazar came aboard to direct the clinic, which is located in Congreso’s headquarters at 215 West Somerset Street, in eastern North Philadelphia.

Congreso had already provided behavioral health, HIV counseling and testing, education, workforce, family and housing services to more than 15,000 people per year. Now, partnering with PHMC, it is able to offer a much needed service to the community: primary care.

“It is a very exciting partnership with Congreso to provide primary care to their existing clients who are already seeing robust social services from Congreso. The clinic is a great benefit to the community, to Congreso’s clients, to PHMC, and to Congreso,” says Melissa Fox, managing director of health, PHMC.

Planning for the clinic was extensive. A needs assessment conducted by Congreso and PHMC affiliate National Nursing Centers Consortium (NNCC) revealed that 51% of the children served by Congreso did not have access to timely healthcare services, 60% of clients had chronic conditions, and more than one-third of adults accessed care in the emergency room, if anywhere.1

Nearly 14% of adult residents in eastern North Philadelphia have no regular source of health care, compared with 10.3% of the city’s adult population and 12.3% in all of Southeastern Pennsylvania. What’s more, this number has risen from 9.8% in 2000.2

After establishing the needs, Congreso, NNCC and PHMC worked with the community to put together an application for a fifth Federally Qualified Health Center (FQHC) in PHMC’s network. FQHCs, funded by the US Department of Health and Human Services' Health Resources and Services Administration, are community-based health centers that provide comprehensive primary care and preventive care to persons of all ages, regardless of their ability to pay or their health insurance status.

On August 9, 2011, Congreso received the news that PHMC had been awarded one of two New Access Point grants in Pennsylvania. The health center at Congreso was one of 67 projects funded across the country and one of very few nurse-managed health centers included in that cohort.3

Four of the five health centers that PHMC operates are nurse-run. “One of the benefits of seeing a nurse is that we focus a lot more on health promotion and disease prevention, versus just screening and treatment. We spend more time on the visit itself and we are linked to other programs such as nutrition, smoking cessation and diabetes management. We help you to be healthy and to learn how to avoid disease,” says Lazar.

The first health clinic that PHMC managed, Mary Howard Health Center, was up and running in 1997. Located in Jewelers’ Row in Center City, it continues to serve the homeless population, providing comprehensive health care, including free vision care and eyeglasses in collaboration with Davis Vision.

PHMC Care Clinic at 1200 Callowhill Street serves a diverse population, provides HIV counseling and testing, hepatitis C clinics to patients co-infected with HIV/AIDS and hepatitis C, and social services that include housing application assistance, food bank referrals and vouchers, and employment training referrals.

Serving mostly women and children, Rising Sun Health Center at 500 Adams Avenue, and PHMC Health Connection at 11th and Berks Streets near the Temple University campus, are located within or in close proximity to public housing developments. Services include primary care, prenatal services, immunizations and family planning. PHMC Health Connection recently received a $1.1 million grant from the US Department of Health and Human Services' Health Resources and Services Administration to more than double its capacity and to add behavioral health services.

“We have a wonderful mixture within our network. We can help anyone, any need or any situation. We are truly addressing the needs of our community,” says Fox, who manages primary care clinics, homeless services and Program of All-inclusive Care for the Elderly (PACE) services.

The 2010 Census showed that 12.1% of Philadelphians are 65 years and older. That number is projected to more than double between now and the year 2050. “We currently serve more than 13,000 people and are expecting a 5-10% growth next year. The PHMC Health Network providers are poised and ready for the increased care expectations from our community as a result of changes in healthcare legislation and the aging population. We look forward to providing preventive care to populations that until now have not received it,” explained Fox.

1 Jennifer Atlas and Waleska Maldonado, “Healthcare Access and Utilization Survey 2010,” Congreso de Latinos Unidos: Establishing Primary Care Services in Eastern North Philadelphia (September 2011).

2 PHMC Community Health Data Base’s Southeastern Pennsylvania Household Health Survey, 2010 and 2000.

3 Jennifer Atlas and Waleska Maldonado, Congreso de Latinos Unidos: Establishing Primary Care Services in Eastern North Philadelphia (September 2011).