Michigan Primary CareAssociation’s Role in Developing Access to Care in Michigan Detroit Central City’s Annual Meeting December 11, 2012 Kim E. Sibilsky, Executive Director Michigan Primary Care Association www.mpca.net
Health Centers are uniq ueThe fundamental principles on which they were established over 45 years ago set them apart from other providers of health care:Located in or serve medicallyunderserved areas or populations Provide comprehensive primary health care services as well as support services that promote access to health care Provide services available to all with fees adjusted based on ability to pay Governed by a community board composed of 51 percent or more of Health Center patients who represent the population served Meet strict performance and accountability requirements regarding administrative, clinical, and financial operations as established by the federal government
35 Health Centersprovide care for nearly600,000 residentsat over 220 deliverysites across Michigan
HealthIncreased Accessto care Today nearly 600,000 Michigan residents rely on a Health Center as their health care home—including individuals who are low income, uninsured, underinsured, elderly, minority, migrant and seasonal farmworkers, homeless, and those living with HIV/AIDS.
Michigan Health Center Patients 550,000 546,245 525,000 500,000 475,000 450,000 2007 2008 2009 2010 2011Michigan UDS 2011
Patients by Insurance Status - StatewideActual Values Percentage of Total 240,545 Medicaid/CHIP 44.0% 178,903 Uninsured 32.8% Private 14.0% 76,473 48,765 Medicare 8.9% 1,559 Other Public 0.3% Michigan UDS 2011
Patients by Income Level - StatewideActual Values Percentage of Total 505,906 100% FPL and 68.1% Below 372,000 200% FPL and 92.6% Below 40,339 Over 200% FPL 7.4%100% FPL and Below 200% FPL and Below Over 200% FPLMichigan UDS 2011
MPCA and Detroit Central City MPCA promotes, supports and develops CHCs through ◦ Strategic communications and collective advocacy ◦ Providing technical assistance, program support, education and training ◦ Assisting communities in determining best approach to providing access
MPCA and Detroit Central City:Discussion Questions Health Centers under Affordable Care Act especially as to relations with behavioral health organizations? MPCA’s vision of care for the vulnerable population served by Detroit Central City (severely and persistently mentally ill with complicating physical disorders)? Examples of successful improvement processes that have been used in Michigan to address behavioral health in integration into primary care?
Health Center Growth Strategy New Access Points: Grants for new health centers and satellites of current centers Expanded Medical Capacity: Grants for existing health centers to start or expand oral health, behavioral health, and pharmaceutical services Service Expansion: Grants for existing centers to start or expand oral health, behavioral health, and pharmaceutical services
Health Center Growth Strategy Change in Scope: Noncompetitive process whereby center applies to HRSA to add a new site or service Facility Expansion: Investments to expand physical capacity to increase new patients Enabling Services: Grants for existing sites that serve special populations to enable access to primary health care services and improve health outcomes.
Efforts to Improve Health CenterQuality and Integration Since their inception, CHCs have had Quality Assurance Programs and have done periodic reporting to the Fed From ‘98 to ‘08 the majority of CHCs participated in Institute for Healthcare Improvement Health Disparities Collaboratives Michigan had over 88% of CHCs accredited through accrediting agencies
Efforts to Improve Health CenterQuality and Integration MPCA worked with the MACMHB in NHSC/SAMHSA integration efforts Co-sponsored Learning Communities with MACMHB and MDCH Have jointly sponsored Statewide Behavioral Health Primary Care Integration Conferences