Behavioral Health
Locating affordable and accessible behavioral health services that do not have long wait lists can be difficult. Below is a list of organizations that offer a multitude of services from psychiatry and counseling to substance abuse and other supportive programs. If you are a provider and would like to add your services or would like to volunteer to offer services at one of the Arizona Safety Net Clinics please contact us.
Breast Cancer Resources
There are a number of resources available screenings. If your clinic does not offer screening than you can refer your patients to one of the clinics that are contracted as Well Woman Health Check providers and they will be able to access services for free. If your clinic screens women but does not have resources for follow up testing these patients can also be referred to Well Woman Health Check contracted clinics.
Well Woman Health Check
The Well woman health check offers free breast and cervical cancer screenings to uninsured women for free and includes most of the diagnostic tests if the screenings is abnormal.
Current clinics that are contracted as Well Woman providers are Adelante, MIHS, Mountain Park, and Wesley.
https://directorsblog.health.azdhs.gov/well-woman-healthcheck-program/
Breast Cancer Awareness month
October is breast cancer awareness month and most imaging facilities offer free screening for the uninsured. Usually you have to put “uninsured patient, give mammogram promo” in the order or call the facility to see what they specifically require.
Cancer
If a woman has biopsy confirmed cancer and received services through one of the Well Women Health Check contracted clinics they have services for case management, referral to treatment, transportation, etc.
USPSTF link
https://www.uspreventiveservicestaskforce.org/BrowseRec/Index
(PDFs are for a Prevention poster for providers, a Prevention poster for patients, a factsheet for the Well Women Health Program)
Cervical Cancer Resources
There are a number of resources available for screenings. If your clinic does not offer screening than you can refer your patients to one of the clinics that are contracted as Well Woman Health Check providers and they will be able to access services for free. If your clinic screens women but does not have resources for follow up testing these patients can also be referred to Well Woman Health Check contracted clinics or to St. Vincent de Paul for follow up colposcopy or endometrial biopsies.
Well Woman Health Check
The Well woman health check offers free breast and cervical cancer screenings to uninsured women for free and includes most of the diagnostic tests if the screenings is abnormal.
Current clinics that are contracted as Well Woman providers are Adelante, MIHS, Mountain Park, and Wesley.
https://directorsblog.health.azdhs.gov/well-woman-healthcheck-program/
Colposcopy
All clinics that are contracted as Well Woman Health Check providers will be able to provide colposcopy. St. Vincent de Paul offers free colposcopies for women who meet the criteria. Send the referral with cytology/HPV report to 602-261-6816.
LEEP
Most of the FQHCs that are contracted providers through the Well Woman Healthcheck program have the capabilities to perform LEEPs free of charge.
Cancer
If a woman has biopsy confirmed cancer and received services through one of the Well Women Health Check contracted clinics they have services for case management, referral to treatment, transportation, etc.
USPSTF link
https://www.uspreventiveservicestaskforce.org/BrowseRec/Index
ASCCP link
http://www.asccp.org/management-guidelines
(PDFs are for a Prevention poster for providers, a Prevention poster for patients, a factsheet for the Well Women Health Program)
Diabetes resources
Diabetes is a complex chronic disease that is difficult for providers to fully understand which makes it that much more difficult for patients. A patient plan of care has been provided to act as a provider checklist and to help your patients understand and take control of their diabetes. Also available are educational posters for providers and patients.
Point of care labs
The current prevalence of diabetes has made point of care testing essential for diagnosis, management and monitoring of patients. No all point of care testing is the same. There are two validated machines for A1c, the DCA Vantage and Afinion meet the ADA requirements. The cost of each test is around $7.
The National Association of Free Clinics has multiple partners each year to sponsor establishing point of care labs in clinics that include but are not limited to A1c, istat, lipids and microalbumin which would cover all of the laboratory based quality metrics for treating patients with diabetes.
Medications
Medications for diabetes can be costly and usually the $4 list and resources like GoodRx are not helpful when looking for medications other than metformin. You do not have to resort to using sulfonylureas and 70/30. Each drug company (i.e. Sanofi, Novo Nordisk, Eli Lily) has a patient assistance program that can provide free or discounted medications to patients who are uninsured or whose insurance will not cover insulins, GLP-1, DPP4 inhibitors and SGLT2 inhibitors. A simple internet search for the “drug name patient assistance program” should take you to the website and application. Once approved patient will receive a years worth of medication. The prescription needs to be for 3 months with 3 refills. If you are having trouble with the process email the St. Vincent de Paul clinic at medical@svdpaz.org and they will be happy to help you trouble shoot the problem.
DMEMany pharmacies are now carrying low cost diabetes DME. If your patient needs to monitor their glucose levels at home there are a number of meters that are cheap, the key is to make sure the strips are cheap as well. Patients should not have to pay more than $10 for their meter and $10 for a box of 50 strips. The Walmart Relion brand has always been a cheap reliable brand and now there are a number of other pharmacies and online vendors that have similar products. Lancing devices and a box of 100 lancets can be purchased at any pharmacy for under $5 as well as sharps containers. The Relion brand syringes and pen needles can also be purchased for under $10 as well at Walmart, and like the other DME is likely available at a number of other pharmacies and online vendors that have similar products.
Diabetic Retinopathy Screening
If you do not have a resource available to provide diabetic eye exams for your patients they can be referred to St. Vincent de Paul’s medical clinic. The clinic has an Eidon retinal scanner that does not require the patient to be dilated and takes clear photos that can be imported to your EHR. They also have volunteer optometrists, ophthalmologists and retinal specialists. If you work for an FQHC or a local charity clinic see if your organization has the process set up with St. Vincent de Paul, otherwise feel free to contact the clinic at medical@svdpaz.org to inquire about setting up these services for your patients.
ADA Standards of Care Link
https://care.diabetesjournals.org/content/42/Supplement_1/S1
AACE Algorithm
https://www.aace.com/pdfs/diabetes/AACE_2019_Diabetes_Algorithm_FINAL_ES.pdf
(pdfs are for a Provider Diabetes Poster, Patient Diabetes Poster, Patient Diabetes Plan of Care, Diabetic Retinopathy flyer)
Hepatitis C
Hepatitis C virus is the most common chronic blood borne pathogen in the United States and a leading cause of complications from chronic liver disease. The prevalence of the anti-HCV antibody in the United States is approximately 1.6% in noninstitutionalized persons. According to data from 1999 to 2008, about three fourths of patients in the United States living with HCV infection were born between 1945 and 1965, with a peak prevalence of 4.3% in persons aged 40 to 49 years from 1999 to 2002. The most important risk factor for HCV infection is past or current injection drug use, with most studies reporting a prevalence of 50% or more.
The USPSTF found no direct evidence on the benefit of screening for HCV infection in asymptomatic adults in reducing morbidity and mortality. However, the USPSTF found adequate evidence that antiviral regimens result in sustained virologic response (SVR) and improved clinical outcomes. The USPSTF concludes that screening is of moderate benefit for populations at high risk for infection. The USPSTF concludes that 1-time screening in all adults in the United States born between 1945 and 1965 is also of moderate benefit.
Historically treatment for Hepatitis C was arduous and needed to be carried out by a specialist. Now this disease can be treated by primary care providers and the largest barrier has become the cost of the medications.
The medications are extremely expensive and are available through the pharmaceutical companies Patient Assistance Program (see medications).
There are links to the full guidelines for screening, treating and monitoring patients with Hepatitis C. There is also a quick cheat sheet to get a birds eye view of the management.
https://www.hcvguidelines.org/
https://www.cdc.gov/hepatitis/resources/professionals/trainingresources.htm