In partnership with the University of Arizona, El Rio Community Health Center developed an innovative, comprehensive approach to helping get pediatric asthma under control for those children and families that need it the very most – the Inner City Asthma Intervention Program. The program began in 2001 and includes free of charge 1) Intake and individual health assessment for the child, including allergen skin testing; 2) In-home environmental assessment; 3) Extensive individual and group education on controlling asthma triggers and managing the disease for patients and their families; 4) Supplies, including necessary medical equipment and supplies to control allergens (i.e. peak flow meters, HEPA vacuum cleaners, mattress/pillow covers); 5) Medications 6) Development of an individualized asthma action plan for each child.

What sets El Rio’s Inner City Asthma Intervention Program apart is our bi-lingual /bi-cultural program staff, who actively partner with the patient’s family to identify asthma triggers and deal with the environmental causes of the disease. We have expanded the program from serving children ages 6-12 to ages 3-18. In the past five years, close to 600 children and their families have been served. As a result, these children have experienced fewer trips to the emergency room and their school attendance has improved dramatically.

The El Rio immunization program was started to help the many parents we serve have their children immunized in a timely manner - especially low-income families who are often holding down multiple jobs with little flexibility. We are successful because 1) we run free weekly walk-in immunization clinics at multiple sites regardless of whether or not children have appointments and 2) we use the power of technology to track patients and have a bi-lingual LPN recall them at recommended intervals to come in and complete the schedule of vaccinations. El Rio has moved from a 45% to a 90% immunization rate with our pediatric patients over the past 6 years. In 2006, El Rio started a new program with Food City grocery stores to offer three free back-to-school immunization days for kids ages 5-18. The first day, El Rio had 15 LPN’s, RN’s and support staff ready to go for the 100 kids waiting in line when the door opened! More than 400 kids were immunized at three outreach events.

Thanks to El Rio’s Reach Out and Read Literacy Program, children ages 0-6 continue to receive a brand new book at every well-child check-up and their parents receive guidelines for reading aloud with their children. In the past 18 months we 1) created comfortable reading areas in 4 of our pediatric waiting areas, 2) hired a part-time volunteer coordinator; 3) recruited 5 regular volunteers who spent 85 hours reading in our pediatric lobbies and 4) distributed 9,000 books in English and Spanish.

In 2000, a law passed by the Arizona Legislature authorized pharmacists to enter into collaborative practice agreements with physicians to manage patient’s drug therapy - including diagnostic and prescription privileges. This legal change provided El Rio the opportunity to implement our award-winning Pharmacy-based Diabetes Management Program in August 2001 − using a residency trained, bilingual Pharm. D. as the provider for patients referred by staff physicians. The program has clearly revealed statistically significant improvement in all clinical parameters monitored, including: blood pressure, cholesterol, blood glucose and A1C.

With the success of the original project, a collaborative agreement was developed between El Rio Community Health Center and the Pascua Yaqui Tribal Council to add a second pharmacist to the team in order to replicate the program at the Pascua Yaqui Clinic. The program continues to expand to accommodate new patients. Community and family referrals among the Yaquis are increasing, suggesting that patients find value in the services provided by the diabetes clinic. Community outreach and education remain a big focus.

El Rio is committed to working on public-private partnerships that reduce health disparities and expand access to medicines and services for underserved populations. Given the demonstrated effectiveness of promotora programs in border health communities, we were excited to have the opportunity to expand our current promotora program through a new partnership with Pfizer, Inc.

Pfizer’s support has helped us provide critical outreach and follow up services for El Rio’s existing diabetes prevention and wellness initiatives. El Rio promotoras are working in conjunction with our Physicians, Clinical Pharmacists, Certified Diabetes Educator (CDE) and Women’s Wellness staff to identify at-risk families on Tucson’s south and west sides. The Promotoras facilitate risk assessments, health screenings, education (including ongoing classes in diabetes prevention), referrals to clinic-based services, and support activities.

Of the estimated 12,000 homeless individuals in Tucson last year, over 8,500 received primary health care, case management, advocacy, and behavioral health services through El Rio Community Health Center. Through The Health Education Project (THE Project) El Rio coordinates with 25 other non-profit and government entities to deliver workforce development and health education classes at shelters and prison sites throughout our community. In addition to developing curricula and recruiting volunteer instructors, THE Project provides class site coordination as well as materials and training to the volunteers. We currently have curriculum developed for 40 topics, and have 55 volunteers who in turn conduct over 75 health education classes per month. Last year over 3,400 homeless and at-risk persons living in transitional housing or prison participated in the training classes. Thanks to grants from corporations, foundations and individuals El Rio is able to provide eyeglasses and transportation (bus passes) to Tucson’s homeless population.

The women who directly benefit from El Rio’s Women’s Wellness Programs are low-income Hispanic women (ages 20-69) living on Tucson’s Southside, who often face serious barriers to adopting more healthy behaviors. For example, 58% of the participants surveyed had no health insurance. In addition, over half of Southside mothers with children less than six years old work full-time, and 26% of households are headed by Hispanic women. Environmental and economic barriers can make access to healthcare, exercise and fitness services very difficult. The program employs an exciting social change strategy that starts with the individual woman. The program is designed to impact the woman’s physical health, her sense of self-esteem and personal power, through providing the tools and information that allow her to make new choices – empowering choices. Through the program, women start to feel better about themselves, which reinforces their sense of personal value.

The El Rio TeenAge Parent Program is currently serving 110 pregnant and parenting teens at 7 different Sunnyside schools as well as the El Rio Teen Clinic. Services offered include education, health care, and child care for pregnant and parenting teens (fathers) in order to minimize the impact of pregnancy and parenting on success in school, improve pregnancy outcomes and parenting skills, and prevent repeat pregnancies. Education is also provided regarding pregnancy prevention. The program is available to all middle school and high school students in the district.

El Rio school based clinics continue to service low-income families in the Sunnyside Unified School District. In October 2006, a young girl’s life was saved when our school-based clinic nurse noticed bruises all over the patient’s legs. After a thorough exam by an El Rio physician, the student was rushed to University Medical Center to see a specialist, who later determined (based on a bone marrow biopsy) that the patient had Idiopathic Thrombocytopenia – a rare and potentially deadly blood disorder. We continue to monitor the child’s progress, and her mother is extremely grateful for the loving, expert care her daughter continues to receive at El Rio. In 2006 2,200 kids were served through these two sites.

El Rio operates the largest non-profit dental clinic in the State of Arizona, with 34,000 treatment visits per year. According to the Arizona Department of Oral Health, 36% of children, 44% of adults and 67% of seniors in our state have no dental coverage. To assist patients that do not have the resources available for preventive dental care, El Rio established the Dental Partnership Program, which offers free dental services to qualified patients most in need. The program also educates the community at large about the importance of good oral health.

In addition, El Rio’s “Right From the Start” program addresses the problem of early childhood caries by educating pregnant and postpartum women on the importance of oral hygiene for both mother and child.