Health Center Expansion in Michigan Michigan Primary Care AssociationMichigan Health Center Capital Development Program With funding from the Kresge Foundation Neal Colburn Director of Capital Development Michigan Primary Care Association www.mpca.net
What is a Health Center? Federally Qualified Health Centers ◦ Established 45 years ago ◦ Serve designated medically underserved areas; populations ◦ Governed by volunteer nonprofit boards (501c3) 51%+ HC patients representing those being served ◦ Provide comprehensive, integrated primary care Medical, dental, behavioral health, preventive and referral services ◦ Provide ‘enabling services’ enabling access effective use of services Translation, health education, case management & benefit assistance etc. ◦ Provide services to all; adjusting fees to ability to pay ◦ Meet strict federal performance & accountability requirements Clinical quality, administrative, financial
Increased Access to Health Care Nearly 600,000 Michigan residents rely on health centers as their health care home ◦ 32 Michigan health center organizations; 190 clinic sites ◦ Nationally, over 20 million health center patients receive health center services annually The MPCA/MDCH Strategic Plan ◦ MI access goal: 1.1 million patients; 40% of <200% FPL ◦ Five year growth estimate: +240,000 patients SE MI area: 8 health centers with 29 clinic sites ◦ Provide services to 100,000 patients annually and expanding ◦ 8 FQHCs receive annual grant funds; (2 recently funded) ◦ 1 FQHC Look-Alike (3 sites) & 1 Indian Health Service Clinic (These are eligible to apply for FQHC funding )
32 Health Centersprovide care for nearly600,000 residentsat over 190 deliverysites across Michigan3 additional Health Centerorganizations funded in 20126 new delivery sites
Michigan’s Health Challenge High rates of obesity (32%); diabetes; asthma… High infant mortality/low birth weight rates ◦ 7.1/1,000 infant mortality; 8.5% low birth weight rate Shortage of primary care doctors, LPNs, PAs etc. 1/4 of children live in families with incomes below poverty level ◦ Detroit: over 1/3 live in families with incomes below poverty & over 1/2 below 200% of poverty level 39% of Michigan’s population is below 200% of poverty level In Michigan, over 60% of health center patients are uninsured or covered by Medicaid, Medicare or other public programs In Detroit, over 90% of health center patients are uninsured or covered by Medicaid, Medicare or other public programs
Complex health needsUninsured,Underinsured Poverty
FQHC Expansion Initiative Collaborative efforts to expand access; ACA ◦ MI Primary Care Association & MDCH ◦ Detroit Wayne County Health Authority & FQHC Council of SE MI ◦ Foundations ◦ Kresge Foundation funding of MPCA MI Health Center Capital Development Program Foundation grant funding (grant writing; training; TA) Potential FQHC grant applicants identified & encouraged Training & technical assistance (TA) provided Nine (9) planning grants awarded (Two  in Detroit area) Eleven (11) community development construction & renovation grants awarded (Five  in Detroit area) Six (6) New Access Point (NAP) awards (Three  in Detroit area) ◦ Over an additional $3.6 million annual HRSA funding
Program Value Opportunity Full range of FQHC services provided at 3 new sites Annual FQHC NAP award: $3.6M annually, plus: ◦ 6 health centers received$3,663,021 in federal grant funds (@16.65% of typical budget; +$22M in annual FQHC operational budgets) ◦ Eligible for special Medicaid/Medicare bundled rates ◦ Eligible for future funding: service expansion; capital funding ◦ Eligible for National Health Services Corps doctors, LPNs etc. ◦ Eligible for FTCA malpractice coverage (like military coverage) ◦ Well positioned to apply for additional programs; HIV, PCMH, IT FQHCs save money ◦ 24% of global healthcare cost reduction Over $100 million, 2010 Michigan Medicaid savings Michigan FQHC economic benefit $½ Billion (NACHC 2009)
Increase Reduce GenerateAccess to Health Economic Care Care Costs Benefits
Michigan Health Center Capital Development Program Established by Michigan Primary Care Association (MPCA) with funding from the Kresge Foundation Provides technical assistance, consultation, financing and fund raising to FQHCs 27 MI FQHC capital projects: over $50 million ◦ Eleven (11) MI FQHC projects awarded $19,600,806 (5 construction projects; 6 renovation projects; ) ◦ Four (4) awards in the Greater Detroit area: $3,257,000 (1 construction project; 3 renovation projects - 2 in Detroit) Additional projects continue in development Public and private grant funding and finance options are being actively sought
HRSA Immediate HRSA New Access PointHRSA Building Capacity Facility Improvement Grant Awards Awards (May 1, 2012) Awards (June 2012) (May 1, 2012) Downriver Downriver Covenant Community Community Community Care Services Services $868,750 $1,887,000 $490,000 Family Health Center of Baldwin Family Genesee County Battle Creek Health Care, Inc. Community Mental $3,000,000 $500,000 Health $608,333 Family Medical Covenant Center of Michigan Cherry Street Health Community Care $5,000,000 Services $500,000 $566,667 Detroit Cassopolis MidMichigan Community Health Family Care Community Health Connection $4,400,000 Services $473,756 $319,271 East Jordan Family Cherry Street Health Center Health Services $2,480,050 $500,000 Wayne County Health & Human Services $650,000 Western Wayne Family Health Centers The Wellness Plan $370,000 Medical Centers $650,000
Program Value Opportunity Affordable Care Act (ACA) ◦ Upheld by the Supreme Court ◦ Medicaid expansion is optional by state; federally funded ACA reduction in uninsured = potential for FQHC expansion ◦ MI: potential $50M additional annual FQHC operational revenue ◦ Wayne County: potential $10 million additional annual revenue Massachusetts expansion - primary care overwhelmed ◦ Resulted in reduced access to appropriate care; delayed care ◦ Inappropriate use of hospital emergency departments and other hospital services ◦ Diminished population health benefit; increased cost to all parties MI expansion needed; increase in FQHCs desperately needed
Emerging Needs Primary Care Medical Facilities; PCMH (2013 project starts) ◦ New; expanded; renovated ◦ Pre-development (Construction & renovation projects) Project planning: architects, site selection; space planning; builders, developers, project management etc. Financial planning: financial analysis, finance plan, financing & fundraising ◦ Construction; renovation and completion Interim initial & operational funding (2014 Medicaid expansion) ◦ Expansion of medical staff to expand capacity Recruitment needed in 2013 (July & August end of residency) Recruitment expenses ◦ Expansion of benefit assistance personnel Medicaid enrollment assistance Conversion assistance of auto-assigned to appropriate providers & plans ◦ Expansion of outreach staff Identify, approach and encourage eligible populations Work with community organizations; churches etc.
Questions?For further information, please contact: Neal Colburn Director of Capital Development Michigan Primary Care Association (517) 827-0472 firstname.lastname@example.org www.mpca.net Our mission is to promote, support and develop comprehensive, accessible and affordable community-based primary health care services to everyone in Michigan.