Access CHC Cornerstones of Care


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Access Community Health Centers CEO Ken Loving Describes the organization's mission and goals

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  • Example of federal government providing local funding that bypassed state government. First health centers: Boston and MS
  • What does this mean. It means communities apply for CHC status to the federal government; and that CHCs are run by the community; BOD make up over ½ users of the center. To ensure the relevance and continuation of the CHC movement There is a central professional organization called NACHC.
  • National Association of Community Health Centers
  • Cost effective, Accessible, Quality Services
  • LIMITED DIRECT FUNDING: 7% of our revenue from feds; if we grow, doesn’t mean we have commensurate growth of our grant.
  • Importance of “horizontal” growth; development of community collaborations (ie. Specialty care, Wingra affiliation); can’t provide care at our community standard without the full complement of primary care services.
  • So, we try to face these challenges at the local level by building relationships with our health care partners.
  • Patient Protection and Affordable Care Act AKA Health Care Reform Legislation, in follow up to one time appropriation of American Recovery and Reinvestment Act (ARRA) Funding Opportunities: New Access Points; Expanded Medical Capacity; Service Expansion (ie. Substance abuse services). From NEJM 4/10 Data from U Washington that CHCs are understaffed, so that more $ support and growth must come with workforce development
  • Complicated marriage of federally funded agency with a UW (state) entity. Extend FQHC benefits that were highlighted earlier: Behavioral Health, pharmacy, dental Demonstrate to residents that with proper support, viable career path WashAlaskaMontanaIdaho residency showed 3 fold increase in residents choosing CHC if they trained there. One year into affiliation, we are all part of this experiment, and it extends beyond our organizations and demonstrates the exceptional community support we all receive.
  • Thank you, Questions.
  • Access CHC Cornerstones of Care

    1. 2. July 20, 2010 Ken Loving, M.D. Interim Chief Executive Officer Chief Medical Officer Community Health Centers: The Cornerstone of Care for the Underserved
    2. 3. <ul><li>Proud History </li></ul><ul><li>42 years of improving health in underserved communities and providing local ownership and control of delivery system </li></ul><ul><li>Large national network </li></ul><ul><li>nearly 18 million people served: 40% uninsured; 37% Medicaid/SCHIP; 63% people of color; 92% low-income individuals </li></ul><ul><li>Record of Achievement </li></ul><ul><li>cited by IOM, OMB, and GAO for excellence in care, disparities reduction, cost-effectiveness, and community benefit </li></ul><ul><li>Bipartisan support </li></ul><ul><li>Congressional majority and key Presidential candidates praise work, mission of health centers, call for continuation & growth </li></ul>Community Health Centers Today
    3. 4. Brief History of Health Centers <ul><li>Unique Public-Private Partnership : resources directly to community-owned organizations </li></ul><ul><li>Health Centers’ two-fold purpose : </li></ul><ul><ul><li>be agents of care in communities with specific need </li></ul></ul><ul><ul><li>be agents of change , giving communities control of their health care system </li></ul></ul>
    4. 5. NACHC <ul><li>National Association of Community Health Centers </li></ul><ul><li>Provides research-based advocacy for health centers and their patients. </li></ul><ul><li>Educates the public about the mission and value of health centers.  </li></ul><ul><li>Develops alliances with private partners and key stakeholders for delivery of primary health care services to communities in need. </li></ul>
    5. 6. NACHC’s Vision for the Future <ul><li>Grow health centers </li></ul><ul><li>to become the health care home for 51 million medically disenfranchised Americans </li></ul><ul><li>Reform health professions training programs </li></ul><ul><li>to promote primary care careers, diversity, and service in underserved areas via health centers </li></ul><ul><li>Preserve the Medicaid guarantee of coverage </li></ul><ul><li>for low-income, elderly & disabled Americans </li></ul>
    6. 7. <ul><li>Wire every health center </li></ul><ul><li>for complete health information technology (HIT) </li></ul><ul><li>Lead the way </li></ul><ul><li>to a high-performing health system, grounded in primary care </li></ul><ul><li>Play a central role in emergency preparedness </li></ul><ul><li>at the local & national levels </li></ul>NACHC’s Vision for the Future (cont.)
    7. 8. Why is Health Center Growth Needed? 56 Million People Are Medically Disenfranchised
    8. 9. Why Health Centers? <ul><li>Costs: </li></ul><ul><li>– Total patient care costs 41% lower than those </li></ul><ul><li>served in other settings* </li></ul><ul><li>– Save up to $18 billion annually for taxpayers and </li></ul><ul><li>society* </li></ul><ul><li>Access: </li></ul><ul><li>– Serve people & communities not served by others </li></ul><ul><li>– Open to all regardless of ability to pay </li></ul><ul><li>Quality: </li></ul><ul><li>– Quality is equal or superior to other providers** </li></ul>* Robert Graham Center ** George Washington University, August, 2006.
    9. 10. Why Health Centers? <ul><li>Full-cost reimbursement from Medicaid </li></ul><ul><li>FTCA Coverage </li></ul><ul><li>Unique Health Care Home Model </li></ul><ul><li>Pharmacy Services (340B) </li></ul><ul><li>Sliding Fee Scale </li></ul>
    10. 11. Who Will Staff Future Health Centers? <ul><li>A.T. Still Medical & Dental Schools </li></ul><ul><li>now training future CHC clinicians </li></ul><ul><li>National Health Service Corps </li></ul><ul><li>revisions to give preference to CHCs for NHSC placements </li></ul><ul><li>Teaching health centers </li></ul><ul><li>building on existing models to expand CHC-based teaching & training of future clinicians </li></ul><ul><li>Linkages with training programs </li></ul><ul><li>expanding use of CHCs as training sites across country </li></ul>
    11. 12. Also Needed: Partnerships with Other Safety Net/Community Providers <ul><li>Organize continuum of care for uninsured locally </li></ul><ul><li>Streamline and simplify eligibility rules and enrollment procedures </li></ul><ul><li>Allocate responsibilities for various care levels to maximize effectiveness </li></ul><ul><li>Ensure that uninsured get the care they need within available resources </li></ul>
    12. 13. What Are The Biggest Challenges We Face? <ul><li>Growth in Uninsured </li></ul><ul><li>Now 47M, +2.2M in 2006, many more coming to health centers daily </li></ul><ul><li>Decline in Charity Care </li></ul><ul><li>Cutbacks by private providers squeezed by declining income </li></ul><ul><li>Loss of Medicaid/SCHIP Coverage </li></ul><ul><li>Citizenship documentation, threat to SCHIP funding </li></ul><ul><li>Changing Nature of Insurance Coverage </li></ul><ul><li>Growing shift to high-deductible/HSA plans that cover little or no preventive/primary care, causing huge losses for CHCs </li></ul>
    13. 14. Opportunities: Patient Protection and Affordable Care Act (PPACA) <ul><li>11 billion dollars over 5 years </li></ul><ul><li>20 million more patients </li></ul><ul><li>15,000 more providers </li></ul><ul><li>300 million dollars for NHSC </li></ul><ul><li>Almost 50 million dollars to support primary care residencies </li></ul>
    14. 15. Local Initiative-AFFILIATION <ul><li>Improve patient care </li></ul><ul><li>Enhance educational opportunities </li></ul><ul><li>Serve more patients </li></ul><ul><li>Develop primary care workforce of the future </li></ul>
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