Sentara Healthcare and Optima Health Donate $5.5 Million for Medicaid Expansion

Sentara Healthcare and Optima Health donated $5.5 million to four non-profit organizations supporting community health clinics and food banks across the Commonwealth of Virginia. The grants will support needs stemming from Medicaid expansion and address social determinants affecting the health and well-being of low-income Virginians, including access to care, behavioral health, opioid addiction and food insecurity. Recipient organizations are the Virginia Community Healthcare Association, Virginia Association of Free and Charitable Clinics, Virginia Health Care Foundation and the Federation of Virginia Food Banks. These four organizations will oversee distribution of the donations across 28 Federally Qualified Health Clinics (FQHCs), several charity and community clinics to provide medical homes for Medicaid expansion enrollees and new behavioral health services, and numerous food banks and pantries across the Commonwealth.

"The organizations we are supporting are focused on the most fundamental issues in population health," stated Howard P. Kern, president and CEO of Sentara Healthcare. "Social determinants such as access to care, behavioral health and food insecurity, are identified in our Community Health Needs Assessments. We hope our contributions help these organizations continue to bring meaningful solutions to Virginia communities."

"The Sentara mission – we improve health every day – means our support of our communities does not start or end with this donation," said Dian Calderone, chair, Sentara Healthcare Board of Directors. "These grants are in addition to the more than $2 million in donations made by Sentara and Optima throughout 2018, as well as $390 million provided in charity care. As a private, not-for-profit health system, we not only care about the communities we live in, we also take action to make them healthier."

Supporting Medicaid Expansion

With an estimated 400,000 Virginians eligible, the expanded Medicaid enrolled population is 225,000 according to the Virginia Department of Medical Assistance Services (DMAS). Many health providers and community clinics are scrambling to prepare for Medicaid expansion by growing clinical and support staffs and enhancing administrative structures. While the approval of Medicaid in Virginia provides health insurance for many residents previously without coverage, the need to ensure access to and continuity of care is immediate and vital. Sentara medical groups will also be increasing access to serve more Medicaid expansion patients.

Social Determinants of Health

Research has shown that numerous social determinants matter beyond traditional health care. According to a 2014 study by the Institute for Clinical Systems Improvement and Robert Wood Johnson Foundation, while health services account for 20 percent of an individual's health, socioeconomic factors equate to 40 percent and health behaviors comprise 30 percent. Behavioral health ranks at the top of critical service gaps among community health needs assessments conducted by Virginia's nonprofit hospitals and local health departments. It is one of the top three issues with which patients present at health safety net practices and is tied closely to physical health. Opioid addiction falls under the behavioral health category and with the marked increase in opioid-related health problems plaguing Virginia, it will be considered a priority issue to be tackled through these donations.

Access to healthy food is another key social determinant. Food insecurity – meaning people are not sure where their food will come from and have little to no access to nutritious food – affects more than 10% of Virginia families according to the Federation of Virginia Food Banks.

"Our support of the Sentara Healthcare mission goes beyond covering sick visits and hospital stays," says Dennis Matheis, president of Optima Health. "By addressing access to medical homes and healthy food, we're investing in solutions to improve wellness and quality of life for thousands of Virginians."

A 2014 Virginia Tech study found that Virginia's low food-access rate of 17.8 percent exceeds the national low-access rate of 7.3 percent. On any given day, more than 890,000 Virginians may be uncertain about their next meal. Children in particular are at risk, especially in Virginia where 13.3 percent of children are food-insecure compared to the overall rate of 10.6 percent, according to Feeding America 2016. The Tufts University School of Nutrition Science and Policy conducted research indicating even mild undernutrition experienced by young children during critical periods of growth impacts their behavior, school performance and overall cognitive development. Food banks and related hunger programs are often at the forefront of getting healthy food to residents who may lack physical and economic access.

"Health starts in our homes, schools, workplaces, neighborhoods, and communities," said Virginia Secretary of Health and Human Resources Daniel Carey, M.D. "I applaud Sentara and Optima for recognizing the need to invest in social determinants of health, especially food security. While access to health care is key to healthy communities, addressing hunger among children and families is equally important if our communities are to thrive."

Donation Details

The organizations receiving support from Sentara and Optima and details for how the donation will be distributed are as follows:

1. $2 million to the Virginia Community Healthcare Association for distribution to 28 Federally Qualified Health Clinics (FQHC) across the Commonwealth. These clinics need additional staffing to serve the larger Medicaid population. This donation will help clinics provide ready access for new Medicaid patients and offer a focus on behavioral health and addiction services.
2. $1.5 million to the Virginia Association of Free and Charitable Clinics for distribution to 12 free clinics with signed Medicaid participation agreements with Optima Health. This will assist the clinics in developing a billing system for Medicaid patients and increase staffing needed to manage that work. Historically, free and charity clinics' patients have been uninsured and billing was not part of their structures. Many current patients will be eligible for Medicaid and this donation will help ensure they continue to have medical homes.
3. $1 million to the Virginia Health Care Foundation to increase access to behavioral health services, primarily in state localities that are federally designated mental health professional shortage areas. Telemedicine and integrating the delivery of those behavioral health services with primary medical care will be related focus areas. Efforts will include availability of care to both Medicaid and non-Medicaid populations.
4. $1 million to the Federation of Virginia Food Banks for distribution to food banks across Virginia recognized by Feeding America. In turn, those food banks will support dozens of church and community-based food pantries.

Recipient organizations will report demographics of patients served in 2019 to help ensure that Virginians of every race, age, gender and background receive timely and appropriate services.

These grants are in addition to a Sentara Healthcare donation in December of $535,000 to 17 health-related programs in the communities Sentara serves in Virginia and North Carolina. The recipient organizations focus on behavioral health and substance abuse programs, food insecurity and healthy diets, education, workforce readiness, transportation, EMS services and prevention of hospital readmissions.

They are also in addition to a $250,000 donation from Optima Health to the Virginia Health Care Foundation last fall to help promote expanded Medicaid eligibility criteria and ensure enrollment by newly eligible adults.