Critical Expansion of Care—Albany Area Primary Health Care Opens Vision Care Centers
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Background
According to a 2020 report entitled "Integrating Eye Health and Vision Care for Underserved Populations into Primary Care Settings" by the American Optometric Association and the Association of Clinicians for the Underserved, community health centers are uniquely positioned to improve access to eye health and vision care due to their reach in underserved communities and their emphasis on providing integrated, whole-person care to underserved populations. In a National Academies Health and Medicine Division report, Making Eye Health a Population Health Imperative: Vision for Tomorrow, the authors state that "for many underserved and low-income communities, federally funded community and rural health centers may be the only source of eye and vision care services." Yet, most health centers are not equipped to provide comprehensive eye health and vision care.1
Despite this national need for vision care—one that is even greater for the underserved—a dearth of workforce negatively affects access to services. According to the organization Prevent Blindness, as of 2020, 721 out of 3,006 counties in the United States had no ophthalmologist or optometrist. Out of the 29 million people who visited community health centers in 2019, only 2.76% received eye care services, far below service delivery for medical, oral health, and behavioral health services.2
Vision care affects the entire lifespan. Children from under-resourced urban areas, many of whom are considered members of racial or ethnic minority groups, experience more than twice the normal incidence rate of vision problems but are also less likely to be referred to and receive examination by an eye doctor.3 Concerning the elderly population—a segment of the country that is expected to grow rapidly in the future—data show that nearly half (46.7%) of adults aged 65 and older with severe vision impairment or blindness have experienced a fall, compared with 27.7% of adults [End Page xi] over age 65 without severe vision impairment or blindness who have experienced a fall.4 There are clear public and community health implications that underlie the need for vision care access.
Intervention
The need to expand to vision care services has long been a palpable reality for many health centers. One of these health centers, located in rural Georgia—Albany Area Primary Health Care (AAPHC)—started to address the need for expanded vision care organizationally in 2016. Shelley Spires, AAPHC Chief Executive Officer, met with Clifton Bush, AAPHC Chief Operating Officer, to plan what services should be added to their community health center in southwest Georgia. With so much on their wish list, they knew for certain that one service needed to be added as quickly as possible—vision care.
Albany Area Primary Health Care (AAPHC) serves the uninsured and underinsured across nine counties in rural Georgia. As one of Georgia's largest community health centers, and one of southwest Georgia's largest medical groups, the organization cares for the most vulnerable in their communities.
As a community health center, the organization can provide a sliding fee scale program and prescription saving plan to their patients to offset the costs of health care and prescriptions. Both Spires and Bush quickly realized they could expand the costsavings to vision care, too. "We knew that we could open this new service and ensure eye exams and glasses were affordable for our patients," says Spires. "We were closing a critical care gap in this area of rural Georgia."
It did not take long for expanded vision care centers to become operational. On November 1, 2017, AAPHC opened their first vision care center in Albany, Georgia. AAPHC then opened their vision care center at Alice Coachman Elementary School-Based Health Center on February 1, 2018.
By adding vision care centers in Albany, Georgia, plus expanding vision care centers into the local schools, they were adding a much-needed service to their community health center. "Our vision care centers provide important eye exams and care for our patients," says Spires. "We follow-up with our diabetic patients to ensure they are receiving their annual diabetic eye exams, as well...
