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

1. The Health Center Program
and the NHAS and VHAP
SYNChronicity (SYNC 2012)
April 20, 2012
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

2. Overview
• Health Center Program Update
• Health Centers, HIV, STDs and
Hepatitis
• QI Strategy
• Partnerships

3. Primary Health Care Mission
Improve the health of the
Nation’s underserved
communities and
vulnerable populations
by assuring access to
comprehensive,
culturally competent,
quality primary health
care services
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4. Health Center Program
National Presence – October 2011
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5. 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
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Source: Uniform Data System, 2010, Service Sites: HRSA Electronic Handbooks Scope Repository 12/31/2010

6. Health Center Program Growth:
National Impact 2008-2010
20,000,000
Patients Jobs Sites
135,000 8,400
19,500,000
130,000 8,200
19,000,000
18,500,000 125,000 8,000
18,000,000 120,000 7,800
17,500,000
115,000 7,600
17,000,000
110,000 7,400
16,500,000
16,000,000 105,000 7,200
15,500,000 100,000 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%)

7. 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

8. 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

9. 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

10. 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

11. 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

12. BPHC QI Strategy
INTEGRATED HEALTH
SYSTEM Strategy Implementation
1. Programs/Policies
INTEGRATED
SERVICES
2. Funding
COMPREHENSIVE 3. Technical Assistance
SERVICES
4. Data/Information
ACCESS

13. BPHC QI Strategy
INTEGRATED HEALTH
SYSTEM
Strategy Implementation
Programs/Policies
INTEGRATED
SERVICES
• Alignment with NHAS
• Alignment with HHS VHAP
• Program Guidance on Testing and
COMPREHENSIVE
SERVICES
Treatment
• PCMH and behavioral health
integration
ACCESS

14. BPHC QI Strategy
INTEGRATED HEALTH
SYSTEM
Strategy Implementation
Funding
INTEGRATED
SERVICES
•$150 Million for Health Center New
Access Points
•$15 Million for Expanded
COMPREHENSIVE
SERVICES Services, including Expanded HIV
Services and Support for Health Center
Recruitment and Retention Strategies
ACCESS •$20 million for Health Center Controlled
Networks

15. BPHC QI Strategy
Strategy Implementation
INTEGRATED HEALTH
SYSTEM
Technical Assistance
(National)
INTEGRATED •National Association of Community
SERVICES
Health Centers (NACHC)
•National Training and Technical
Assistance Center for LGBT Health
COMPREHENSIVE
SERVICES •Association of Asian Pacific Community
Health Organizations (AAPCHO)
•SAMHSA/HRSA Center for Integrated
ACCESS Health Solutions (CIHS)

16. BPHC QI Strategy
Strategy Implementation
INTEGRATED 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

17. BPHC QI Strategy
INTEGRATED HEALTH
SYSTEM
Strategy Implementation
Data/Information
INTEGRATED
SERVICES
•UDS Reporting on HIV, Hepatitis
•Health Center Patient Survey
COMPREHENSIVE
•Research: Community Health Applied
SERVICES
Research Network (CHARN)
ACCESS

18. 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

19. Thank You!
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20. 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
5600 Fishers Lane Rm. 17-105
Rockville, MD 20857
Telephone: 301.594-4110
Email: SHayashi@hrsa.gov
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