The Power of
Connection
ANNUAL REPORT
ONEWORLD COMMUNITY HEALTH CENTERS, INC.
1 ANNUAL REPORT 2022
FROM OUR CEO
At OneWorld, we see adversity as an opportunity. Our goal of providing quality care for all people pushes us to look for ways to grow our impact. When we see a need within our community, we work to address that need. We are continually expanding our services and clinical locations to ensure that our patients have access to quality care. The foundation of everything we do is based on human connection. Connection is at the core of what makes us feel seen and valued. Our connections are built on trust. The connections we create with our patients allow them to feel comfortable knowing they are receiving quality care, leading to a healthier future. There is power within connection. Our staff connection empowers our patients to take control of their health. Thousands of lives are changed every year through their connections to the OneWorld community. Thank you to our staff, donors and community, whose connections allow us to grow. Embracing our connections lead us to personal growth and drives the entire community to new opportunities. Embracing our connections
Connection is our golden thread.
Andrea Skolkin Chief Executive Officer
Our Mission
To partner with the community to provide access to quality health care services for all people.
Our Vision
To be a respected, trusted and inclusive organization, providing care and promoting well-being in the communities we serve.
Our Values
Inclusion We are intentionally inclusive of all people . Compassion We act with kindness. Access We believe in caring for all people. Relationships We are committed to building trustworthy relationships. Excellence We are dedicated to providing superior quality services.
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50,067 Unique Patients
Etian Ives
3 ANNUAL REPORT 2022
74 Zip Codes Unique Patients from over in Nebraska and Iowa
FREMONT
LINCOLN
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OMAHA
COUNCIL BLUFFS
PLATTSMOUTH
NEBRASKA CITY
44 Distinct Languages Providing Quality Services in
5 ANNUAL REPORT 2022
Demographics Patient
Kubra Haidari
Nadira Jafari
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ANNUAL REPORT 2022
2.7%
Patients by PAYER
18.1%
42.1%
Medicare or dual eligible Private insurance Medicaid None/uninsured
37.2%
5.2%
Patients by AGE
38.4%
56.4%
0-19 20-64 65+
Patients by % FEDERAL POVERTY LEVEL
4.8%
11.1%
with known income
27.2%
Over 200% 151-200% 101-150% 100% & Below
56.9%
7 ANNUAL REPORT 2022
178,842 Visits
9,888 Behavioral Health Visits
Uninsured Children 3,665
121,657 Medical Visits
1,675 Prenatal Patients
1,067 Babies Born
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23,315 Patient Support Visits
149,698 Prescriptions Filled
23,982 Dental Visits
85,199 Vaccine Doses Given
9 ANNUAL REPORT 2022
Why we Care for All People
Quality Care
& Advocacy
Without OneWorld’s sliding fee scale, 3,665 uninsured children would have gone without medical and dental care in 2022. In 2022, 33% of OneWorld dental patients were uninsured and relied on the dental sliding fee scale to afford dental care.
In 2022, over 680 patients suffering from depression or anxiety symptoms sought care
Alex Dworak, MD, Associate Medical Director – Family Practice Nebraska Medical Association, Physician Advocate of the Year
at OneWorld every month.
32% of adolescents and young adults served by OneWorld reported having
risk factors for mental health or substance abuse related problems in 2022.
In 2022, 514 OneWorld Pharmacy patients were able to afford prescriptions
Mariela Munoz, RN, Nurse Care Manager Health Center Association of Nebraska, Exceptional Patient Care
because of the Medication Assistance Program, a total of nearly $5 million in savings.
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As a national health center quality leader, OneWorld is recognized for excellence in providing medical, dental, behavioral health, pharmacy and support services. In addition to continuously improving patient care, OneWorld is known for increasing access to care in the Greater Omaha area and advancing health equity at the state and national level. Each year, OneWorld participates in community events, testifies for legislation to support our community and invests in community partnerships to enhance health equity. As a testament to this work, several OneWorld leaders and employees earned awards for their efforts in fighting for health equity, inspiring the medical community and providing top quality health care in 2022.
Kristine McVea, MD, MPH, Chief Medical Officer Omaha World Herald Inspire Awards, Excellence in Healthcare
Tania Murrell, RN, Associate Nursing Director Midlands Business Journal, 2022 40 Under 40
Jeremy Howe, MD, MPH, Associate Medical Director – Satellite Clinics Health Center Association of Nebraska, Exceptional Patient Care
11 ANNUAL REPORT 2022
Crossing paths for good
Jessica Garcia Lara and Pat O’Hanlon discuss outreach information at Generation Diamond, a nonprofit in Omaha.
OneWorld Covid-19 Outreach team members reflect on the power of connection
When Jessica Garcia Lara, Community Health Worker, was 10 years old, she stepped into a OneWorld clinic for the first time. Having recently immigrated to the United States from Mexico along with her parents and
younger brother, she was in process of enrolling into the Omaha Public School District. “I had to get a lot of my vaccines again so I could go to school because a lot of the shots I had in Mexico weren’t validated
in the U.S.,” said Garcia Lara. “Our neighbor told us we should go to the ‘Chicano Center’ for our vaccines, and that’s how I met Pat O.” Pat O’Hanlon, or “Pat O.” as many people know him by, was at
12 ANNUAL REPORT 2022
the beginning of his career as an outreach nurse at the time. “The center was small, so you could always hear Pat O.,” said Garcia Lara. “Even though he gave me shots that day, he made me feel so welcome and he gave me a lollipop.” Throughout Garcia Lara’s childhood and early adolescence, she and O’Hanlon continued to cross paths during her school field trips to OneWorld and for O’Hanlon’s sexually transmitted infections presentations at Omaha South High School. “Jessica reminded me that I gave her vaccines when she first came to the U.S., and it was really very emotional for me to
Jessica Garcia Lara works on her computer.
recall,” said O’Hanlon. “I’m not Hispanic and my Spanish isn’t that good, but I was still able to leave a positive impression with her, which is such a testament of
the power of connection.” Twenty years later, Garcia Lara and O’Hanlon’s connection has come full circle through their work on OneWorld’s Covid-19 Outreach team. Along with other members of the team, they provide education and Covid-19 and flu vaccines at organizations and in homes in the South Omaha area. Since 2020, the team has connected with thousands of individuals through outreach events and home visits. “Jessica has become a pillar of our team, and it’s incredible to see her work because her passion is nearly tangible,” said O’Hanlon. “She meets people where they are
“
Jessica has become a pillar of our team, and it’s incredible to see her work because her passion is nearly tangible. She meets people where they are at, and she takes time to not only explain but also to listen, and that is an immense talent.”
- Pat O’Hanlon, Outreach Nurse
13 ANNUAL REPORT 2022
Jessica Garcia Lara and Pat O’Hanlon arrive at a patient’s home for a visit.
at, and she takes time to not only explain but also to listen, and that is an immense talent.” Before Garcia Lara joined OneWorld, her work focused on the social aspects of care by completing patient barrier assessments for insurance, transportation, financial needs and food insecurities. Garcia Lara said her job experience combined with her own personal experiences help her understand people’s situations and gain their trust. “I know how scary it can be to ask a question,” said Garcia Lara. “In many other countries, there is
only one doctor for every medical need. The U.S. medical system is much different, and for someone who grew up with having one person for all of your medical needs, that can be stressful and frustrating and wear you down, especially emotionally. I recognize those emotions and try to build a connection with everyone I talk to so they feel comfortable. Knowing that I can contribute more and that I can be a person like Pat and OneWorld, who once supported my family, is very fulfilling.” Garcia Lara and O’Hanlon agreed it is humbling
In 2022:
220 Outreach Events
1,675 People Served through Outreach Efforts
Home Visits Vaccines at Home Visits 124 995 630 Vaccines at Outreach Events
14 ANNUAL REPORT 2022
Jessica Garcia Lara and Pat O’Hanlon meet with a patient for their home visit.
to work on such an intimate level with the community because it demonstrates that OneWorld’s foundation is built on trust and understanding. While the outreach team spends their days knocking on doors, the business owners, employees
and community members welcome them inside. Looking to the future, Garcia Lara and O’Hanlon
better access to health care for all people. While the number of outreach events, presentations and vaccines given stand out, Garcia Lara said that the biggest difference the team has made is simply being there for the community. “Pat has always been the person to not only connect people, but to simply be there for someone when they need it, and that’s what our community needs more than anything,” said Garcia Lara. “Pat made me feel like I belonged when I was brand new to the U.S., and it just goes to show that what matters the most is treating people how you want to be treated. That is the golden thread that connects all of us together.”
hope to continue to develop close relationships with the South Omaha community and transform their connections into
Pat made me feel like I belonged when I was brand new to the U.S., and it just goes to show that what matters the most is treating people how you want to be treated. That is the golden thread that connects all of us together.” “
- Jessica Garcia Lara, Community Health Worker
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16 ANNUAL REPORT 2022
Brandon Thelen, OneWorld patient
Happy to help
OneWorld patient builds connections as part of recovery journey
Brandon Thelen, OneWorld patient, spent his teenage years and early adulthood in and out of hospitals and doctor’s offices, largely in part to Chron’s disease and injuries resulting in broken bones. Eventually, he became dependent on pain medication and began to struggle with substance use disorder. While Thelen sought help at substance use disorder services clinics, the medications cost nearly $500 a month, so he was unable to continue treatment. “I learned that OneWorld offers Medication Assisted Treatment, and since that program, my quality of life has really changed,” said Thelen. “I’m the most stable I’ve ever been, I have energy and have connected with new people who bring so much joy to my life.” OneWorld’s Medication Assisted
Treatment (MAT) program combines behavioral health therapy with medications to treat substance use disorders. For 12 weeks, patients attend weekly group therapy sessions led by Behavioral Health Therapist, Longfellow Marquez, LIMHP, LMHP, LADC, and receive one week’s worth of Suboxone. After patients complete the 12 weeks of treatment, they continue to see their primary care clinician monthly to maintain their Suboxone prescription. Thelen graduated from the MAT program in 2020, and began to reclaim his life. “While in the program, Brandon moved to a better living environment and reconnected with his family,” said Family Medicine Physician Assistant, Bethany Levy, MPAS, PA-C. “His family’s support benefitted him. He also grew independently and became
I learned that OneWorld offers Medication Assisted Treatment, and since that program, my quality of life has really changed. I’m the most stable I’ve ever been, I have energy and I have connected with new people who bring so much joy to my life.” “ - Brandon Thelen, OneWorld patient
17 ANNUAL REPORT 2022
Brandon Thelen discusses his care plan with Bethany Levy, MPAS, PA-C, and Longfellow Marquez, LIMHP, LMHP, LADC.
a leader in his MAT group.” After settling into his new apartment, Thelen connected with several neighbors in his complex. He began to spend his time helping two of his new friends, a disabled veteran and an elderly woman, with grocery shopping, going to medical appointments and other daily tasks. “I realized that if I never took the time to get to know the people around me that my life wouldn’t be very satisfying,” said Thelen. “I really enjoy helping people, so I made the decision that I was going to grow friendships with the people around me and do what I can to positively impact their lives.” In 2021, Thelen had to renew his social security benefits. He was still seeing Levy monthly, but he began experiencing anxiety because he was unsure if his benefits would be renewed. Levy mentioned to Thelen that OneWorld was participating in the University of Washington’s CHAMP study (Collaborating to Heal Opioid Addiction with Mental Health in Primary Care). Patients who completed the study participated in a collaborative care model that combined behavioral
health therapy with regular primary care. After confirming Thelen qualified for the study, he reintegrated behavioral health treatment into his care plan. From August 2021 to April 2022, Thelen met one-on-one with Longfellow Marquez. “Brandon has remained committed to his treatment and his recovery ever since coming to
Brandon Thelen meets with Longfellow Marquez for a behavioral health appointment.
18 ANNUAL REPORT 2022
Brandon Thelen meets with his family friend, Dolores, at her assisted living facility.
OneWorld,” said Marquez. “I think having access to health care and treatment options has been very helpful for him, and his dedication to his recovery has helped him learn new coping skills to work through stressors like the social security benefits renewal.” During Thelen’s time in the CHAMP program, he began to spend time with a family friend, Dolores. Together they went to her hair appointments, doctor appointments, completed shopping trips and went out to eat. Dolores moved to an assisted living facility in 2022. Thelen continues to visit with her and help her get around town as she needs. Steak nights are a favorite between the two. “I’ve made awesome connections with my neighbors and Dolores,” said Thelen. “I like to be known as a guy who will show up and who you can count on. I’m so glad I was able to make these connections, because they are such a positive part of my life.” Thelen continues to see Levy on a regular basis to maintain his recovery treatment, and the
Just like my community, I’ve made so many great connections at OneWorld. I’m grateful for my clinicians and OneWorld as a whole for caring about my health and well-being so much.” “
- Brandon Thelen, OneWorld patient
OneWorld Pharmacy for his medications. “Just like with my community, I’ve made so many great connections at OneWorld,” said Thelen. “I trust Bethany and feel like I can be myself. I’m grateful for my clinicians and OneWorld as a whole for caring about my health and well-being so much.”
19 ANNUAL REPORT 2022
Molding barriers
into bridges
Mariela Munoz, RN and Michele Labs discuss their work on the case management team.
OneWorld Case Management team supports patients in need
In the world of case management, connection molds barriers into bridges that lead to empowerment, education and better health for all people. At the core of OneWorld’s Case Management team are two passionate and dedicated individuals, Mariela Munoz, RN, Nurse Care Manager, and Michele Labs, Value Based Care Nurse Manager. Every day, Munoz reaches out to patients who are identified by managed care organizations in Nebraska and OneWorld clinicians as high utilizers of the medical system and/or have multiple chronic illnesses. Munoz helps patients set personal goals and, with support from Labs, works directly with clinicians, insurance, pharmacy and
other entities each patient uses for their care to help patients reach their goals. She also offers education to ensure patients are aware of their benefits. On average, Munoz works with patients for around 9-12 months so they have the support they need to make a meaningful and sustainable life change. “We help our patients navigate all of the red tape that comes with health care because we truly care about them,” said Labs. “Having someone to help fill the gaps is so important, especially for patients who have gone through many trials and tribulations. We want our OneWorld family to be supported, and our patients are a big part of our family.”
20 ANNUAL REPORT 2022
Holding on to hope In February 2022, Munoz met *Manuel, a 57-year-old OneWorld patient who had lost his home and moved to Missouri to live with his son. Manuel had chronic abdominal pain and a hypertensive crisis that led to multiple emergency room visits. “He was depressed, anxious and frustrated, and hesitant to believe that I could help him because he had tried to reach out to the state beforehand but never heard anything back,” said Munoz. “I told him that I’m in case management because I want to help make sure that if I’m connecting him to someone, that they actually help him. And if they don’t help, I will find someone who will.” Munoz asked Manuel what his goal was, and with his voice breaking, he said, “I don’t want to be here, I want to be in Omaha. But I don’t see a way for me to get there.” After Manuel agreed to work with Munoz, she reached out to Nebraska Total Care (NTC). Right away, NTC sent Manuel a cell phone so they could get ahold of him. They began looking into housing options in Omaha and identifying other
areas where he was in need of support. Munoz regularly checked in with Manuel to ensure he was getting support from NTC and other community resources and to see how he was feeling, physically and mentally. She learned Manuel was running low on his medication, so she arranged a virtual health care appointment with Sam Balk, PA-C, Family Medicine Physician Assistant, so Manuel could get his necessary medication refills. Manuel also began taking an anti-depressant to help with his depression. By November 2022, he was able to move into an apartment in Omaha. NTC helped Manuel apply for furniture assistance, connected him to transportation assistance for his medical appointments and is currently helping Manuel look for a job. “There were a lot of ups and downs, but he continued regardless,” said Munoz. “He saw a little piece of hope and he held on and I’m so proud of him for accepting our help and choosing to move forward.” *Name has been changed to protect the patient’s privacy.
Mariela Munoz and Michele Labs talk with their patient on the phone.
21 ANNUAL REPORT 2022
Munoz talks with her patients over the phone about case management support.
Sylvia, a 63-year-old OneWorld patient, has multiple chronic conditions that affect her day- to-day life. From 2018-2021, she was going to the ER six times each month on average, so her name was given to OneWorld’s Case Management team. Munoz reached out to Sylvia in June of 2021 to see if she would be interested in receiving case management support. Initially, Sylvia said she did not need case management because she had her primary care physician. Munoz reached out to Sylvia’s Family Medicine Physician, Jeremy Howe, MD, MPH, to gain a better understanding of how she could help Sylvia. Dr. Howe emphasized that Sylvia could benefit from having a personal advocate outside of the clinic setting. After consulting Dr. Howe, Sylvia agreed to try case management. Finding the missing links
“Sylvia needed to see a lung specialist because there was concern that her symptoms were driven by her lungs,” said Munoz. “She had previously seen a pulmonologist, but he left, so she felt abandoned and didn’t trust
“
This was a huge victory not only because it made accessibility much easier, but also because she realized that I was committed to helping her and that she could trust me.”
- Mariela Munoz, RN, Nurse Case Manager
22 ANNUAL REPORT 2022
anyone else. I was able to convince her to try it out again. She had many tests done, but refused to listen to their recommendations. She claimed the specialist was out to get her and made it very personal.” Munoz said she was at a loss with how she could help Sylvia, but refusing to give up, she reached out to Dr. Howe again. “He gave me some talking points, so when I called Sylvia back she said, ‘Okay fine, you convinced me,’” said Munoz. “She went to her specialist appointments and agreed to begin pulmonary rehab, which had been recommended for a long time.” Sylvia uses oxygen as part of her Chronic Obstructive Pulmonary Disease treatment, but she revealed to Munoz that insurance would not cover a portable oxygen concentrator, so she had to take an oxygen tank with her everywhere. Munoz reached out to Nebraska Total Care (NTC) to learn about Sylvia’s coverage options. After nearly six months and countless calls to pharmacies and NTC, she located a portable concentrator at a pharmacy that Sylvia could rent. “This was a huge victory not only because it made accessibility to her oxygen much easier, but also because she realized that I was committed to helping her and that she could trust me,” said Munoz. Over time, Munoz said Sylvia became more open with her. Through their conversations, Munoz listened to Sylvia’s concerns about her chest pain and other symptoms and offered education about the ER medical
Mariela Munoz and Jeremy Howe, MD, MPH discuss Sylvia’s care plan.
team’s suggestions for her care. “Eventually, Sylvia told me that she realized some of her symptoms were brought on by situational stressors,” said Munoz. “She didn’t want to go to therapy to discuss these stressors, so I suggested she reach out to someone in her community she trusted. She reached out to her pastor and set up regular visits with them and that helped her a lot.” By June 2022, Sylvia’s ER visits were reduced by nearly 50 percent. From June to December, she only went to the ER one time. “I continue to visit with Sylvia to ensure she has support,” said Munoz. “Her care has certainly benefitted from connections. We found the missing links, and I’m so grateful she was willing to trust me because now she is invested in her health.”
23 ANNUAL REPORT 2022
When As inflation raises cost of living, community health centers play a vital role in keeping care accessible and affordable do not add up DOLLARS
From June 2021 to June 2022, the Consumer Price Index for All Urban Consumers increased 9.1 percent, the highest 12-month increase since 1981. With food costs increasing by 10.4 percent, energy costs increasing by 41.6 percent and other costs also increasing, many people in the United States continue to face financial hardship. 1 Within the state of Nebraska, the average household spent $481 more a month in July 2022 to buy the same goods and services as they did in July 2021. 2 The U.S. Census Bureau reported the median household income in Douglas County, Nebraska, in 2021 dollars, is $70,683. 3 This
places many Douglas county families in a deficit based on the Economic Policy Institute’s Family Budget Calculator that states a family of four needs $90,008 annually to attain a modest yet adequate standard of living. 4 Combining this deficit with the rapid inflation increase, families were left with no choice but to make cuts to their budgets. One of the affected areas was delays in medical treatment. A recent Gallup survey reported that 38% of Americans reported they or a family member postponed medical treatment in 2022 due to cost, a 12 percent increase from 2021. Families with an annual household income under $40,000 were nearly twice as likely as those with an income of $100,000 or more to report someone in their family delayed medical care for a serious condition. 5 Nearly 57 percent of OneWorld patients who reported their income in 2022 belong in the 0-100% U.S. Federal Poverty Guidelines slide that provides a maximum monthly gross income of $2,500 for a family of four. Based on the Economic Policy Institute’s Family Budget Calculator for Douglas County, this places these families at -$4,994 each month, or -$59,928 each year, and only covers housing and food costs before going into negatives. With costs continuing to rise and families making difficult budget decisions when dollars do not add up, community health centers continue to play a vital role in providing access to affordable, quality care for all populations. At OneWorld, we believe no one should have to choose between medication or food, newborn check-ups or rent. We are committed to overcoming barriers to access such as cost and empowering the people we serve with information, resources and support.
MONTHLY COSTS 2 adults and 2 children Douglas County, NE
HOUSING FOOD CHILD CARE TRANSPORTATION HEALTH CARE OTHER NECESSITIES
$992.00 $757.00 $1,755.00 $1,108.00 $1,392.00 $634.00
TAXES
$864.00
MONTHLY TOTAL
$7,501.00
ANNUAL TOTAL
$90,008.00
24 ANNUAL REPORT 2022
The above estimations are from the Economic Policy Institute’s Family Budget Calculator.
Filling the gaps: Care as it should be
Nearly half of U.S. adults, insured and uninsured, report they have difficulty affording health care costs. 6a
OneWorld’s sliding fee scale provides affordable options for patients without insurance, high deductibles or copays.
OneWorld offers a percentage discount through the sliding fee scale, based on the patient’s slide discount level.
35% of U.S. adults say they have put off dental care because of the cost. 6b
Nearly one in four U.S. adults say they or a family member in the household have not filled a prescription, cut pills in half, or skipped doses of medicine because of the cost. 6c
OneWorld Pharmacy participates in the 340B program that saves patients 20-50% per prescription, and offers Medication Assistance Programs for uninsured patients.
1 U.S. Bureau of Labor Statistics: Consumer prices up 9.1 percent over the year ended June 2022, largest increase in 40 years 2 United States Congress Joint Economic Committee: Nebraska’s Monthly Inflation Costs 3 United States Census Bureau Quick Facts: Douglas County, Nebraska 4Economic Policy Institute: Family Budget Calculator – Douglas County, Nebraska, 2 adults and 2 children
5 Gallup: Record High in U.S. Put Off Medical Care Due to Cost in 2022 6a,b,c Kaiser Family Foundation: American’s Challenges with Health Care Costs
25 ANNUAL REPORT 2022
Financials OneWorld 2022
1%
23%
20.2%
2023-2024 BUDGET 68M
19.2%
Patient Billing Federal Grants
State & Local Govt. Grants Philanthropy & Contributions Other
45.6%
2022-2023 REVENUES & EXPENSES
REVENUES $74,178,646
EXPENSES $68,828,561
Patient BIlling
Salaries
$32.2M
$32.2M
Grants & Contracts
Benefits
$6.7M
$21.2M
Fees & Services
$5.8M
Contributions
$14.3M
Supplies
$21.5M
Other
$6.5M
Rent
$1.0M
Depreciation
$1.6M
26 ANNUAL REPORT 2022
Your support is life changing
As we reflect on the power of connection, we are grateful for our community’s support. Through connection, we are able to build trust, increase access and pursue excellence every day. This foundation is the result of countless individuals and organizations acting with compassion, creating ripples of positive change. We are committed to providing quality health care for our patients and the Greater Omaha community. We look forward to continuing to build a community where everyone has the opportunity to thrive.
Through the power of connection, we can Care for All People.
Luis Vasquez
27 ANNUAL REPORT 2022
oneworldomaha.org | (402) 734-4110
28 ANNUAL REPORT 2022
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