The Health Center Program and the NHAS and VHAP
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The Health Center Program and the NHAS and VHAP

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Seiji Hayashi, MD, MPH, FAAFP...

Seiji Hayashi, MD, MPH, FAAFP
Chief Medical Officer
U.S. Department of Health and Human Services
Health Resources and Services Administration
Bureau of Primary Health Care

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  • For the next 10-15 minutes, I’d like to convey the importance of integrating HIV and Hepatitis care into primary care, and then partner with HIV and other specialists
  • Through initiatives under our Quality Improvement Strategy, such as the meaningful use of electronic health records and the establishment of patient centered medical homes, we are working to improve coordination of care and quality of care for PLWHWe don’t expect all health centers to become HIV specialty care provider, but to establish formal referrals with an array of service providers to increase the accessibility of a comprehensive array of services We want to see all health centers move along a spectrum of service delivery with a goal of becoming an innovative and effective service delivery model. Involves Health information exchange is key to care coordinationUses co-case management models can be cost effective and improve coordinationOffers patients options for obtaining services from different types of providers and in different settings through establishment of a strong networkRequires formal written referral agreements to add clarity and structure to provider roles

The Health Center Program and the NHAS and VHAP The Health Center Program and the NHAS and VHAP Presentation Transcript

  • The Health Center Program and the NHAS and VHAP SYNChronicity (SYNC 2012) April 20, 2012Seiji Hayashi, MD, MPH, FAAFPChief Medical OfficerU.S. Department of Health and Human ServicesHealth Resources and Services AdministrationBureau of Primary Health Care
  • Overview• Health Center Program Update• Health Centers, HIV, STDs and Hepatitis• QI Strategy• Partnerships
  • Primary Health Care MissionImprove the health of theNation’s underservedcommunities andvulnerable populationsby assuring access tocomprehensive,culturally competent,quality primary healthcare services 3
  • Health Center ProgramNational Presence – October 2011 4
  • Health Center Program Overview Calendar Year 2010 19.5 Million Patients  93% Below 200% poverty  38% Uninsured  62% Racial/Ethnic Minorities  1,052,000 Homeless Individuals  863,000 Farmworkers  173,000 Residents of Public Housing 77 Million Patient Visits  1,124 Grantees  8,100+ Service Sites Over 131,000 Staff  9,592 Physicians  6,362 NPs, PA, & CNMs 5Source: Uniform Data System, 2010, Service Sites: HRSA Electronic Handbooks Scope Repository 12/31/2010
  • Health Center Program Growth: National Impact 2008-201020,000,000 Patients Jobs Sites 135,000 8,40019,500,000 130,000 8,20019,000,00018,500,000 125,000 8,00018,000,000 120,000 7,80017,500,000 115,000 7,60017,000,000 110,000 7,40016,500,00016,000,000 105,000 7,20015,500,000 100,000 7,000 2008 2009 2010 2008 2009 2010 2008 2009 2010 Year Year Year 2008 2009 2010 Growth from 2008- 2010 (% Increase) Patients 17,122,535 18,753,858 19,469,467 2,346,932 (13.7%) Sites 7,518 7,892 8,156 638 (8.5%) Jobs 113,059 123,012 131,660 18,601 (16.5%)
  • HCs and HIV, STDs, Hepatitis• HIV & STD Care and Services – 781,750 Patients receiving HIV Testing – 90,559 Patients living with HIV/AIDS – 59,158 Patients with Syphilis/other STDs• Preventive Health & Screening – 1,808,992 Pap Tests Conducted – 1,096,615 Patients for Contraceptive Management
  • HCs and HIV, STDs, Hepatitis• Hepatitis B & C Care and Services – 58,594 Patients with Hepatitis C – 12,333 Patients with Hepatitis B – 256,133 Patients receiving Hepatitis B testing – 162, 320 Patients receiving Hepatitis C testing
  • HCs and HIV, STDs, Hepatitis• Mental Health Care & Services – 726,779 Patients for depression/mood disorder – 397,541 patients with anxiety/PTSD• Substance Use Care & Services – 110,031 Patients for tobacco use – 97,913 Patients for substance use (excluding tobacco) – 73,082 Patients for alcohol abuse
  • Overarching Approach• Improve coordination of care and quality of care for people living with HIV• Encourage HIV service delivery both directly and through formal referrals• Move health centers along the spectrum of HIV service delivery HIV Primary HIV Primary Care, Specialty Innovative Model Prevention & Case Care, & Support Services & Mentor Management
  • BPHC QI Strategy Medical “neighborhoods”INTEGRATED HEALTH Integration of patient information and SYSTEM need between HCs and community services INTEGRATED Coordination and monitoring of SERVICES services within a health center Provision of full scope of primary health COMPREHENSIVE services, including dental, behavioral SERVICES health, and enabling services Ability of patients to be seen in a ACCESS timely, affordable and culturally competent manner
  • BPHC QI StrategyINTEGRATED HEALTH SYSTEM Strategy Implementation 1. Programs/Policies INTEGRATED SERVICES 2. Funding COMPREHENSIVE 3. Technical Assistance SERVICES 4. Data/Information ACCESS
  • BPHC QI StrategyINTEGRATED HEALTH SYSTEM Strategy Implementation Programs/Policies INTEGRATED SERVICES • Alignment with NHAS • Alignment with HHS VHAP • Program Guidance on Testing andCOMPREHENSIVE SERVICES Treatment • PCMH and behavioral health integration ACCESS
  • BPHC QI StrategyINTEGRATED HEALTH SYSTEM Strategy Implementation Funding INTEGRATED SERVICES •$150 Million for Health Center New Access Points •$15 Million for ExpandedCOMPREHENSIVE SERVICES Services, including Expanded HIV Services and Support for Health Center Recruitment and Retention Strategies ACCESS •$20 million for Health Center Controlled Networks
  • BPHC QI Strategy Strategy ImplementationINTEGRATED HEALTH SYSTEM Technical Assistance (National) INTEGRATED •National Association of Community SERVICES Health Centers (NACHC) •National Training and Technical Assistance Center for LGBT HealthCOMPREHENSIVE SERVICES •Association of Asian Pacific Community Health Organizations (AAPCHO) •SAMHSA/HRSA Center for Integrated ACCESS Health Solutions (CIHS)
  • BPHC QI Strategy Strategy ImplementationINTEGRATED HEALTH SYSTEM Technical Assistance INTEGRATED (Regional/State) SERVICES •AETC (Regional-National) •Primary Care Association (PCA)COMPREHENSIVE •Primary Care Offices (PCO) •Area Health Education Centers (AHEC) SERVICES ACCESS
  • BPHC QI StrategyINTEGRATED HEALTH SYSTEM Strategy Implementation Data/Information INTEGRATED SERVICES •UDS Reporting on HIV, Hepatitis •Health Center Patient SurveyCOMPREHENSIVE •Research: Community Health Applied SERVICES Research Network (CHARN) ACCESS
  • Partnerships/Collaborations• National Partners – Federal: White House, HHS, Other Federal agencies – Non-Governmental Partners: NASTAD, NACHC, NCCBH, others• State Partners – Primary Care Associations – State HIV/AIDS Directors – State Hepatitis Coordinators• Local Partners – Health Centers, CBHC, HIV/Hepatology specialists, Hospitals, CBOs
  • Thank You! 19
  • Seiji Hayashi, MD, MPH, FAAFP Chief Medical OfficerU.S. Department of Health and Human ServicesHealth Resources and Services Administration Bureau of Primary Health Care 5600 Fishers Lane Rm. 17-105 Rockville, MD 20857 Telephone: 301.594-4110 Email: SHayashi@hrsa.gov 20