November 6, 2000

uring hearings before the General Assembly last winter it became clear that many legislative leaders were unaware of the vital work the Health Center does in communities across the state. This realization led to the creation of the Connecticut Health initiative, one of four signature programs in the Health Center's Strategic Plan.

Of the signature programs, Connecticut Health is the only one that does not promote the translation of advanced research to innovations in clinical care. Instead, it embodies an inherent aspect of the Health Center's role as an academic medical center: improving the health of all Connecticut citizens.

Connecticut Health is charged with supporting and helping facilitate a wide range of community-based initiatives in which Health Center faculty, students or staff play pivotal roles.

"This represents a new way of focusing on areas of need and sharing our resources with other state agencies, non-profit groups and local communities. It's a new focus on public health and community service," says Charles Huntington, who is providing administrative support for the project. He also is associate director of the Connecticut Area Health Education Center.

Since July, a committee has been meeting regularly to establish goals for the initiative's first year. Connecticut Health is being led by Howard Bailit, director of Health Policy and Primary Care Research, and Robert Trestman, vice chair of clinical affairs for the Department of Psychiatry.

Each of the initial projects will require significant administrative and clinical resources, creativity and hard work, Bailit stresses. In addition, some of the initiatives will require additional funding from state agencies. Bailit also expects further goals to develop.

One of the first tasks has been to create an inventory of current Health Center projects that fall under the Connecticut Health umbrella. The database will be able to generate reports according to state legislative districts, offering legislators and the public easy access to timely information about the Health Center's contributions to local communities. The database, which is still under construction, will be accessible through the Health Center's Web site. It is expected to be on-line by early 2001.

"This will catalogue descriptions of all the efforts where the Health Center adds value to communities and reaches out to underserved populations," Bailit says. Examples include dental care for people with mental retardation and other special needs; outreach initiatives to promote health in schools; delivering care to people in prisons; and providing free treatment for people with drug addictions, alcoholism or gambling problems.

All these efforts provide direct benefits to populations with specific needs and, at the same time, offer opportunities for faculty and students to provide public education services, deliver care and conduct research.

"The database will organize information about the ways the Health Center is working with community organizations to provide care and improve services," Huntington adds. "Ultimately, it will help to tell an important but little known story about the Health Center."

The new projects Connecticut Health is supporting include:

Expanded services for pregnant women at high risk: Working with community hospitals in northern Connecticut, this program would improve ways to screen and triage women at risk of delivering low or very low birth weight babies and is expected to result in healthier pregnancies, healthier babies, and ultimately less strain on health care resources. It will use existing Health Center strengths in highly specialized areas including the maternal and infant transport system and the Neonatal Intensive Care Unit.

The program is scheduled to begin in March 2001. Faculty participants include Winston Campbell, perinatology; Marilyn Sanders of the NICU; and Julian Ford of the Department of Psychiatry. The effort is expected to result in 25 to 50 additional high-risk mothers and infants using the advanced services of the Health Center during the next 12 months.

Expanded services for the Department of Mental Retardation: The Health Center is already the primary provider of dental and psychiatric services to adults and children with mental retardation in the North Central region of the state. Now, the Health Center and DMR will expand the programs through a variety of initiatives coordinated by Leighton Huey, chairman of the Department of Psychiatry. These will include:

• Collaborating with DMR to develop a community mental health resource team providing crisis support and clinical outreach services to clients in DMR residential and day care programs;
  
  
• Developing a comprehensive medical and dental care system for DMR clients in the North Central region;
  
  
• Developing a Behavioral Intervention Resource Center to provide behavioral and psychiatric consulting services and staff training to the providers caring for young adults with severe emotional, mental and developmental disabilities.
  
  

Support for local public health services: This initiative will bring Health Center resources to the 106 health directors who serve Connecticut cities and towns. It will be coordinated by Huntington, and will build on existing relationships between health directors, the state Department of Public Health and various Health Center departments. Areas in which the Health Center can provide assistance include:

• Access to electronic databases available through the Health Center library;
  
  
• Epidemiological and economic analysis of community-level data and public health programs;
  
  
• Involving students in the Master's of Public Health program in local proj-ects as part of their training.
  
  

More formal relationships with state health agencies: The Health Center currently has a contractual relationship to provide medical, dental and mental health services for the Department of Correction. Also, the Health Center's Department of Community Medicine and the state Department of Public Health recently signed a memorandum of understanding. Connecticut Health will now look for new ways to bring the expertise and resources of the Health Center to other state agencies, with special emphasis on the public health department.

Trestman says the Health Center's work with the Department of Correction can be used as a model of the positive ways an academic medical center can improve care for certain populations. He notes that a recently secured $750,000 grant from the National Institute for Justice will help improve screening and triage tools to treat people with mental illness in the correctional system.

Establish a grant application process for small research projects: During the coming months, Connecticut Health will consider the establishment of a small grants program, that would be internally funded, to support pilot studies so that faculty, residents and students can collect the preliminary data needed to compete for externally funded community health projects.

Maureen McGuire