THE LARIMER-COUNTY-CHILDRENS-CLINIC - A PUBLIC-PRIVATE PARTNERSHIP TOPROVIDE MEDICAL-CARE TO INDIGENT CHILDREN

Objective: To describe a unique collaboration between private and publ ic entities to provide comprehensive health care to medically indigent children in rural Larimer County, Cole. Setting: The Children's Clini c, Fort Collins, Cole. Study Participants: Uninsured children and thos e eligible for Medicaid, living in families with incomes below 150% of the federal poverty level. Selection Procedures: Eligible patients ha ve been enrolled in the Children's Clinic on a first-come, first-serve d basis. Interventions: A community collaboration involving an interac tive system with the Children's Clinic staff, the Larimer County Depar tment of Health and Environment, private primary care and subspecialty physicians, ancillary health providers, and the family practice resid ency program at Poudre Valley Hospital, Fort Collins. Funding for this endeavor has been composed of city and county funds, public and priva te grants, community business support, and local fund-raising efforts, as well as Medicaid reimbursements. Measurements/Main Results: Since 1989, comprehensive pediatric care has been provided to a growing numb er of eligible children. At present, 3619 children, aged birth to 18 y ears, from 2230 families are being served. From this population, there were 8945 office visits to the Children's Clinic, 1392 patient contac ts by the clinic social workers, 1287 visits to the Larimer County Dep artment of Health and Environment for well-child care, 543 referrals t o subspecialists and other community health care providers, and 615 af ter-hours visits to the Poudre Valley Hospital emergency department be tween July 1, 1992, and June 30, 1993. The clinic's professional staff consists of full-time pediatric care providers, one nurse, one medica l social worker, one receptionist, and one administrator, with an expe nditure of $356 471. Conclusions: The Children's Clinic collaboration has provided comprehensive pediatric health care to a population that previously received only fragmented care. The next step is to assess t he impact of this program on the frequency of emergency department vis its for these patients.