Executives in healthcare and other social service fields like to talk about "reaching out to the community." One gets the feeling that Anthony Munroe, chief executive officer of the Miami-based Economic Opportunity Family Health Center, talks about it in his sleep.
"It's not sufficient just to open a facility and expect your patients to come to you. Sometimes you have to go to your patients," says Munroe,
38, whose achievements in that regard have helped
earn him the American College of Healthcare Executives' 2003 Robert S. Hudgens Memorial Award for healthcare executives under age 40. Munroe, previously recognized as one of Modern Healthcare's 2002 "Up and Comers" and honored with the ACHE's Regent's Award in 2001, will receive the Hudgens Award on March 17 in Chicago during the ACHE's 46th Congress on Healthcare Management.
"I'm not sure if I've had a moment for this to have sunk in. It's marinating," Munroe says of receiving the award, named after the ACHE's first vice president and established by the Alumni Association at Virginia Commonwealth University, Richmond, where Hudgens served as director of the health administration program. "I think it will hit me the day the award is actually presented; I only hope I can hold my composure."
Munroe previously worked as director of community health promotion for the DeKalb County Board of Health in suburban Atlanta from 1996 to 1998 and as executive director of family health services for the New York City Department of Health from 1994 to 1996. He has a master's degree in business administration from Northwestern University, Evanston, Ill., and a master's in public health from Columbia University, New York. He also is working toward a doctorate in health systems management from Tulane University, New Orleans.
Munroe has led the not-for-profit Economic Opportunity center since 1998. The 501(c)(3) primary-care organization has a $20 million annual budget that's about 30% federally funded. Since Munroe's arrival he has worked to improve access for the underserved and move them toward higher quality care by:
* Expanding the center's permanent locations from 13 to 17, with newer facilities in underserved areas, which has helped lead to a 35.4% annual patient increase, from 96,000 to 130,000.
* Sending mobile outreach and screening units into community facilities ranging from faith-based institutions to shopping malls.
* Placing nurses and other healthcare services in eight elementary and middle schools.
* Forging partnerships with local educational institutions to train the organization's staff.
Economic Opportunity officials began the expansion after asking some key questions, Munroe says. "Why are we in business? What is it that we're charged to do?" he says. "The simple answer was: to provide the highest quality healthcare regardless of immigration status, ability to pay, race, ethnicity, etc." With that in mind, more questions followed: "Do we have the best business practices in place so that we truly meet the needs of our customers? What are some of the demographic shifts in the community? What are some of the top diagnoses?"
Among the results of this process were the establishment of new locations and the additional outreach provided by mobile units, which travel to lower-income, culturally diverse communities throughout northern Miami-Dade County to screen for diabetes, HIV/AIDS and other life-threatening illnesses.
"You name it, we screen for it," Munroe says, and the screeners then offer referral assistance to those who test positive. "We develop a schedule whereby we will have the vehicle available at a particular location for a number of days, so there is a degree of continuity. The following week, we move to another location."
Potential patients gravitate to the screening units-and Economic Opportunity-partly because of Munroe's focus on "cultural congruency," says Patti Rose, the center's vice president of behavioral health services. That includes paying attention to both language and other "cultural nuances" that make diverse populations feel welcome, from the waiting room to the bedside, she says. "Many leaders are not quite at the point of embracing that concept," Rose says.
Munroe will make a follow-up presentation on the "cultural proficiency model" during the ACHE's congress. Last year, he offered a session that focused on a general description of the model and how to replicate it; this year, Munroe will discuss how such an approach affects finances.
Other forms of outreach have included eight school-based health centers and services at the Scott Homes public housing project, where an on-site primary-care center serves residents as well as the surrounding neighborhood.
"We're in the community, not only in terms of medical efforts but also in terms of supporting other community agencies," says Alvin Moore, the center's board chairman and self-sufficiency program coordinator for the U.S. Department of Housing and Urban Development's Miami-Dade County office.
To keep his staff fresh, Munroe has created tuition-reimbursement partnerships with Miami-Dade Community College, through which medical assistants and other personnel can take "refresher" training courses, and with the University of South Florida, which provides courses toward a master's degree in public health at the center's main administrative offices in Miami.
Although all healthcare organizations provide continuing education for doctors, Munroe says, "What about the front line? This is so that we can ensure all of our employees are competent in providing the care they're required to do.