Additionally, DOH's newly established Community Health Access Teams (CHAT) are placing community member outreach teams in neighborhoods to provide residents with the tools and information they need to become better health care consumers. CHAT trains residents to educate their neighbors about healthy lifestyles and accessing early preventive health services. CHAT will also work with community members in gathering quality management data about the Alliance services. CHAT, a public/community partnership, teams DOH outreach staff with community–based organizations including the East Capitol Community Center for Change, Brookland Community Center, and Mary's Center. CHAT currently encompasses three teams of six persons, and is targeting residents in Wards 5, 7, and 8 and the District's Latino/Hispanic community.

Challenges still exist in defining and quantifying inpatient care needs. Low utilization and anecdotal hospital reports indicate that many Alliance–eligible patients seek care at non–Alliance hospitals. However, the strength of the "commitment to care" shines through in the actions of all of our District hospitals. Though some of these hospitals have chosen to decline membership in the DC Healthcare Alliance, we are working to provide some level of reimbursement for the services they have provided to some of the most vulnerable members of our community.

DOH has made several efforts to gather data on the use of non–Alliance facilities including holding several meetings with hospital leaders and written requests for data including letters sent out on May 17, 2001, June 7, 2001, and August 15, 2001. To date, only GWUH has been consistently responsive in its efforts to provide DOH with the data necessary to track utilization of hospital care and develop strategies to address this issue. We have recently received some information from Providence Hospital and have exchanged correspondence with the Washington Hospital Center. In order to establish a baseline for the need for hospital services for the uninsured, DOH will continue its efforts to gather this data.

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