What is ECHO?

ECHO (Empowering Church Health Outreach) is a non-profit organization dedicated to helping charitable clinics open, grow, and sustain their operations. The organization uses Church Health – a 30 year old charitable clinic in Memphis, TN that sees more than 58,000 patients per year – as a flagship that helps model success and define sustainability for new clinics we call ECHO Community Clinics.

How does ECHO help and support charitable clinics?

ECHO provides ECHO Community Clinics with operational, recruiting, financial (when appropriate), usage, and marketing support. Operational support comes from access (through a clinic liaison) to the launch team – a group of experts from Church Health who will consult clinics on their establishment and day-to-day operations.

ECHO will assign an experienced consultant to work with your project and give you access to our planning guide, benchmarking tools, start-up files, and other tools only available to those clinics with aspirations to become a Church Health Community clinic. ECHO also offers periodic conference calls for training and networking with operational clinics and projects under development.

Our Director of Clinic Sponsor Recruitment will match clinic founders with support from the churches in their community. Church Health became what it is today in large part because of the support it has received from St. John’s United Methodist Church during its 30-year relationship. ECHO hopes to help all ECHO Community Clinics cultivate fruitful relationships with the churches in their area.

ECHO offers templates, branding, guides, and purchased media to provide ECHO Community Clinics with usage and marketing support. Our goal is to support viable, sustainable clinics that are committed to providing quality healthcare to those in need.

What ongoing help does ECHO provide once our clinic is operational?

As a Church Health Community clinic, you will have access to ECHO’s knowledge center, one-on-one consulting with an ECHO clinic liaison, experts from Church Health, and opportunities to network with and learn from other ECHO Community Clinics.

The ongoing help ECHO provides to clinics is designed to help you maintain and grow your clinic.

Services include strategic planning, executive coaching, program development, board training, and facilitation of community discussions to determine need, environmental scans, and more.

About the New Clinic

How long does it take to start an ECHO supported clinic?

With support from ECHO, ECHO Community Clinics generally open within 18 months. There are many variables that influence a new clinic’s opening and our consultants will help you navigate those, while capturing and maintaining the momentum and energy of a group of people excited about opening a clinic. Our deliberate process will help you build a sustainable clinic of great value to your community.

How much money does it take to start a clinic?

The financial needs of your clinic will be based on many things, but most importantly your ambition for the clinic. ECHO provides the Church Health Community clinic template which is a proven model for charitable clinics. With this model, we will coach you on fundraising, help you find a church partner that will provide support to your clinic, and – when appropriate – help you raise money.

Your ECHO consultant will help your team determine what is realistic for your situation.

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While we believe your vision and ambition should drive the offerings of your clinic, ECHO does hold ECHO Community Clinics to minimum standards of operation (at least 1 FT employee, open 5 days/week). Because of our relationship with Church Health and our collective understanding of the factors in their success, we work to position ECHO Community Clinics to succeed based on a proven model.

Your ECHO consultant will help your team determine the needs in your community and the resources available to address those needs and identify where gaps exist. We will provide you with a Church Health Community clinic model and it is then up to your team to determine how your clinic will address these gaps.

An initial phone call with ECHO staff will help to clarify your vision, community need, and how ECHO’s mission can be of service to you and your community.

What are the expectations and obligations of the clinic to ECHO once we open?

At this point, we intend to work with six charter clinics to establish best practices for ECHO Community Clinics. In turn, we will offer an opportunity for interaction with other ECHO supported clinics nationwide and services to help you continuously improve.

The ongoing dialogue about your clinic operation and services greatly enhance ECHO’s mission and services. As with any nonprofit, we are accountable to our founders, funders and supporters, and we are earnest about collecting data and stories that support the accomplishment of our goals.

To this end, ECHO will request, on an annual basis, some fundamental data that clinics typically collect for their own program development, program evaluation, and for funders. In addition, we are grateful to learn of clinic experiences and other indicators of your growth and development that can help us tell the story of the importance of free and charitable clinics across the country. ECHO also looks to inform the field of safety net clinics through research, requiring specific data (potentially quantitative and qualitative) and will expect the Community Health Community clinics participation.

Concerning Churches

What is a Clinic Sponsor? Why is it needed?

Starting a clinic is no small undertaking. It takes a visionary leader along with a team of other motivated and skilled individuals to get the job done and the doors open. Based on the 30-year experience of Church Health, ECHO has found that it is best to begin with a sponsor for this needed manpower and energy. Churches serve as sponsors that cultivate community interest and expand manpower to develop a project that reflects community need and interest.

Community Need and the Affordable Care Act

I thought Healthcare Reform solved this problem!

ECHO will respond to changes in healthcare legislation as appropriate.

The passage of the Affordable Care Act (ACA) in March 2010 created a perception in the minds of many Americans that this legislative action solved our nation’s healthcare problems. As the subsequent history and current circumstances demonstrate, the reality is that coverage is not synonymous with access, and large gaps in available, affordable coverage and services continue to be a major issue for millions of people. In fact, the Congressional Budget Office (CBO) projects that if the ACA is fully implemented nationally, nearly 30 million Americans would remain without access to affordable healthcare.[1] The cost-sharing provisions of the new health exchange plans are already creating challenges for low-income people who choose to purchase health insurance coverage.[2] In these first years of full implementation there is a growing population of newly insured people who are unable to afford their deductibles and co-pays, resulting in a larger underinsured population[3] and an equally substantial number of individuals who are electing to remain uninsured and accept the financial penalty, aware that the affordable coverage available to them remains beyond their means. Large gaps in coverage and services will continue to be a major issue that will require safety net providers of free and charitable clinics.

For clinics already in operation, the ACA has brought about the need to determine how to respond to this shift in the healthcare landscape. Will your clinic change its service delivery model? Will your clinic change its eligibility requirement for the patients it treats? Will it continue providing the services it has historically offered? ECHO has many services available to help you during this time of change. Through our Support Services, our consultants can walk your clinic through the process of determining how it would like to respond to these changes. For those clinics that see the need to increase capacity to serve, our Expansion program can assist you in laying the foundation to build a strong and more robust clinic. For ECHO Community Clinics, we work hard to provide timely information on the impact of these changes in the healthcare system and provide tools to assist you in moving forward.

The Affordable Care Act has undercut our traditional patient population and the future changes, while yet unknown, may redefine again those who need access to quality health care. Will safety net clinics still be needed?

While the ACA expanded the number of individuals who were able to access affordable insurance, it did not cover all individuals in need. When states were given the authority to determine their own eligibility for Medicaid, there were dramatic differences in available coverage state to state. The new administration has promised sweeping changes to the ACA as it is currently configured. We cannot predict the exact nature of this alternative at this point. What we can be certain of is that universal access to affordable healthcare will NOT be in our near future. Until such a time comes, safety net clinics will be needed to care for those who do not fit whatever model federal and/or states may implement. For this reason, ECHO remains confident that our work will remain relevant for the foreseeable future. Changing patient populations may require updated needs assessments to determine these newly created gaps in access to care. ECHO can assist in this process and help guide your clinic into a newly defined essential role in your community.

For Existing Clinics

I’m a clinic already in operation. How can ECHO help me?

ECHO is able to assist clinics in operation in a number of ways.

First, the network of ECHO Community Clinics is an opportunity for safety net clinics to network, grow, and learn from each other. Visit our ECHO Community Clinics page for more information.

Secondly, our Expansion Program is available to existing clinics interested in growing their capacity to serve more patients, develop more comprehensive service and to assume a more integral part of their community healthcare safety net. An ECHO Consultant will walk you through the process of exploring whether or not expanding capacity is right for your clinic and community, then they will develop the necessary plans with your staff and Board of Directors to extend your reach. For more information visit our Expand A Clinic page.

Lastly, ECHO is proud of its team and of the experts who come from our partnership with Church Health. Their combined experience with the safety net system makes them an excellent resource to help you with any needs you might have such as strategic planning, fundraising, board development, executive coaching, program development and more. If you are interested in strengthening your clinic offerings or broadening your community impact, please visit Support Services to learn more about our service offerings and contact us so we can develop a plan to best fit your needs.

How do we stay relevant in our community given the changes in health care and the perception that clinics are no longer needed due to the ACA and subsequent changes in healthcare delivery?

ECHO has developed approaches and tools that will benefit a clinic on the cusp of change. Most revolve around a strategic planning process. If you anticipate change in your future, contact ECHO to help assure that it’s a productive, pro-active process.

Can ECHO help us strengthen our clinic to better serve our patients?

Yes. The ECHO services are all designed to strengthen safety net clinics in a variety of ways. From building your board resources to improving your service delivery to attaining recognition as a Patient Centered Medical Home, the ECHO staff will work with you to improve and expand service to your clients.

Miscellaneous

How can ECHO provide these services at low cost or no cost?

ECHO is a private nonprofit organization that was founded by the Nancy and John Snyder Foundation. This foundation generously provided the seed money to start ECHO and continues to support our work. Outside of the Nancy and John Snyder Foundation, ECHO also seeks private support from other foundations and private and corporate donors, which allows the organization to subsidize our work with engaged clinics and startup initiatives.

I am not affiliated with a community of faith or an existing organization but I want to start a clinic. Can ECHO help me?

Yes. ECHO will help your clinic find a church sponsor and work within your community to find other appropriate partners and support. An initial phone call with ECHO staff will help clarify what your clinic needs from a sponsor. Please fill out the Initial Interest Questionnaire and one of our consultants will contact you.

Will ECHO consultants keep religion out of the conversation if we are not a faith-based group?

Yes. ECHO is a faith-based organization that does not proselytize. Your ECHO consultant will honor your group’s cultural and organizational identity and practices.

However, ECHO Community Clinics do have relationships with church sponsors.

Will ECHO allow for our practice of faith in the operation of our clinic?

Yes. ECHO does not prescribe how or if your clinic incorporates a spiritual component to its operation. If intended eligibility requirements include that patients profess a particular spiritual belief or must attend a religious service or participate in prayer as a condition of their medical care, please discuss this in your first phone call with an ECHO consultant.

[1] Congressional Budget Office. (2012, July). Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decisionhttp://cbo.gov/sites/default/files/cbofiles/attachments/43472-07-24-2012-CoverageEstimates.pdf, pg 20

[2] McGuire, Leslie, Meehan, Kate. (2014, March). The Role of Free Clinics in the Era of Health Reformhttp://www.safetynetcenter.org/sites/default/files/images/The%20Role%20of%20Free%20Clinics%20in%20the%20Era%20of%20Health%20Reform.pdf, pg 3

2 Ibid., pg 3