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Although no commonly accepted definition of the safety net exists, in mid-1990's the Institute of Medicine (IOM) appointed a committee with the purpose to: "examine the impact of Medicaid managed care and other changes in health care coverage on the future integrity and viability of safety net providers operating primarily in ambulatory and primary care settings."
This IOM committee defined the "health care safety net" as follows (Source: Institute of Medicine. 2000. America's Health Care Safety Net: Intact but Endangered. Washington, DC: National Academy Press, p.3-4):
"Those providers that organize and deliver a significant level of health care and other related services to uninsured, Medicaid, and other vulnerable patients."
According to the Committee's report,
"In most communities there is a subset of the safety net that the committee described as 'core safety net providers:'
These providers have two distinguishing characteristics: (1) either by legal mandate or explicitly adopted mission they maintain an 'open door,' offering access to services for patients regardless of their ability to pay; (2) a substantial share of their case mix is uninsured, Medicaid, and other vulnerable patients."
Furthermore, according to the Committee's report,
"Core safety net providers typically include public hospital systems; federal, state and locally supported community health centers (CHCs) or clinics (of which federally qualified health centers [FQHCs] are an important subset); and local health departments. In most communities several smaller special service providers (e.g., family planning clinics, school-based health programs, and Ryan White AIDS programs also are considered a part of the core safety net. In some communities teaching and community hospitals, private physicians, and ambulatory care sites with demonstrated commitment to serving the poor and uninsured fulfill the role of core safety net providers."
In Wyandotte County, on November 6, 2001 a coalition of safety net providers established the following qualifications for membership:
- Must have a 501 C designation or be publicly funded;
- Must provide health care regardless of ability to pay;
- Must have a sliding fee scale or reduced scale for payment;
- Must provide primary health care; The Mission Statement must emphasize "access to care" for medically underserved;
- Must be located in Wyandotte County and primarily serve Wyandotte County residents.
These providers currently consist of: Duchesne Clinic, Silver City Health Center, Southwest Boulevard Family Health Care, Swope Health Wyandotte (Douglas Clinic), Swope Health Quindaro (Brown Clinic), and Turner House Clinic, plus the Unified Government Health Department
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