Community Health Center Association of Connecticut

COMMUNITY HEALTH CENTER ASSOCIATION OF CONNECTICUT

FQHC 101Connecticut Public Health Association

Health Education CommitteeJune 8, 2011

Presented byJennifer Granger, MPHChief Operating Officer

Community Health Center Association of Connecticut (CHCACT)

June 8, 2011

Federally Qualified Health Center 101

Of the Community

By the Community

For the Community

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Terminology

CHC – Community Health Center FQHC – Federally Qualified Health Center FQHC Look-Alike

FQHC Introduction

Located in a high-need area (defined as MUA, MUP, HPSA)

Provide comprehensive primary care, provision or formal linkage to specialty, oral health and mental health services and supportive services (transportation, etc.)

Services available to all with charges based on ability to pay

Governance by community Board whose majority are users of FQHC

Meet all federal requirements regarding how they set up and run their practices

The FQHC Movement 1965:

First neighborhood health centers (NHCs) funded

Medicaid Program enacted (Title XIX) 1970’s:

150 health centers established 1980”s:

Under 1981 Omnibus Budget Reconciliation Act (OBRA), 186 health centers defunded

Omnibus Budget Reconciliation Act of 1989 Made Federally Qualified Health Center (FQHC)

services mandatory under Medicaid and Medicare Programs

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Small beginnings… 1996: CHC Federal grant program

authorized under Section 330 of the Health Centers Consolidation Act of 1996

1998:100% Access/0 Health Disparities 2001: President Bush’s Initiative to

Expand Health Centers by providing 1,200 communities with new or expanded health centers by end of FY 2006 to: Assure access for an additional 6 million people 630 new access points (new and existing grantees) 570 existing sites significantly expanded

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Grow into great things! 2009 Nationally

~1200+ grant-funded FQHC entities ~8000 Delivery sites >8440 physicians >5000 nurse practitioners/physician assistants ~7500 dentists and ~900 dental hygienists Served 20 million people of whom 38% were

uninsured

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The Opportunity Key “Safety Net” providers Provide comprehensive primary and

preventive care and related services Serve nation’s most vulnerable, low-

income, and uninsured persons living in medically underserved areas

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FQHC RequirementsMission & Strategy

Public or nonprofit private entity Organized and operated to provide comprehensive

primary care services Serves a “medically underserved population”

Population of an urban or rural area with a shortage of personal health services (MUA) or

Population group having a shortage of personal health services (MUP)

Serves low income, uninsured, minority and elderly persons

Ongoing quality assurance program

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Sliding fee does not mean no fee

Services available to individuals regardless of ability to pay

Fee schedule and schedule of discounts

Government Program Provider: Medicaid, Medicare, Charter Oak, State Administered General Assistance (SAGA), Children’s Health Insurance Program (CHIP)

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FQHC RequirementsGovernance

Governing board Size = Minimum 9, Maximum 25 51% Majority users Represents individuals and communities being served by

center No more than ½ of remaining members derive more than

10% of their annual income from health care industry Remaining members representative of community and

expertise in community affairs, local government, finance and banking, legal affairs, trade unions, other commercial and industrial concerns, social service agencies

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FQHC RequirementsGovernance

Authority and oversight responsibility for health center

Establishes FQHC’s general policies (except public centers)

Selects services provided Schedules service hours Approves FQHC’s annual budget Approves selection of FQHC’s director Approves 330 grant application Meets at least once/month

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FQHC RequirementsClinical Program

Required primary health services: Basic health services Referrals for medical and other health-related services

(including MH/SA and Dental) Patient case management services and other assistive

services Enabling services Patient and community education Diagnostic laboratory and x-ray services, preventive

health services Needed pharmacy services either on-site or through

firm arrangement

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FQHC RequirementsClinical Program

Provision of services through: Staff and supporting resources of center Contracts or cooperative arrangements

Firm arrangements for after-hours clinical coverage

At least ½ of FTE primary care providers full-time members of staff

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FQHC Benefits Malpractice insurance through Federal Tort

Claims Act Recruitment and retention assistance

National Health Service Corps Program Section 340b discount drug pricing

program Enhanced Medicaid and Medicare

reimbursement Joint Commission Accreditation Initiative

Accreditation survey at no direct cost to FQHCHC

NCQA Patient Centered Medical Home Recognition PCMH Application at no direct cost to FQHC

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FQHC Evolution in Connecticut

2011: 13 FQHCs and 1 FQHC Look-Alike Charter Oak Health Center CIFC Community Health Center of Greater Danbury Community Health Center Community Health and Wellness Center of Greater Torrington Cornell Scott - Hill Health Center Community Health Services East Hartford Community HealthCare Fair Haven Community Health Center Generations Family Health Center Norwalk Community Health Center Optimus Health Care Southwest Community Health Center StayWell Health Center United Community and Family Services [FQHC Look-Alike]

Growth of FQHCs in Connecticut FY 2010 Federal CHC Program:

13 grant-funded FQHC entities and 1 FQHC Look Alike

>140 Delivery sites >152 physicians >145 nurse practitioners/physician

assistants/CNMs ~63 dentists and ~149 dental

hygienists/assistants Served 310,999 people of whom nearly 25%

were uninsured and 57% are Medicaid

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Community Health CenterAssociation of Connecticut Established in 1989 501(c) 3 Provide training and technical assistance

to all FQHCs in CT regardless of member status

13 members 13 staff who oversee a wide variety of

grants and programs: Clinical Quality, PCMH, HIT, Workforce Development, Outreach, Finance & Administration

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Mission Statement

CHCACT exists to enable Connecticut’s federally qualified health centers (FQHCs) to provide access to the highest quality health care and social services to Connecticut’s underserved populations.

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Vision

CHCACT will be recognized as the organization most qualified by its leadership, expertise and experience in addressing the issues of significance to all FQHCs and populations needing comprehensive health care.

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Values Collaboration: teamwork within the

organization; productive partnerships; willingness to participate

Expertise: integration across programs and people; demonstrates breadth of knowledge; willingness to gain new knowledge

Integrity: demonstrates accuracy, consistency, honesty, and accountability

Responsiveness: internal and external communication that is timely and relevant to the need or demand

Social Equality: actions that promote social justice, further the mission of the FQHCs and advance cultural competency

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Serving Many Masters Federal funders

Health Resources and Services Administration (HRSA)

Bureau of Primary Health Care (BPHC) HIV/AIDS Bureau (HAB) Bureau of Health Professions/National Health

Service Corps Centers for Medicaid and Medicare (CMS) Agency for Healthcare Research and Quality

State funders Department of Public Health (DPH) Department of Social Services (DSS)

Private foundations Robert Wood Johnson Foundation Connecticut Health Foundation The Donaghue Foundation Universal Health Care Foundation

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Community Health Care Alliance The 13 members of CHCACT have joined

together to form the Community Health Care Alliance

The Alliance is constitutes the largest provider of health care in Connecticut

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Social Networking Find the Community Health Care Alliance

on your favorite social networkfacebook.com/CHCACT

twitter.com/CTHealthCentersyoutube.com/CHCACT

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Contact Information

Jennifer Granger, MPH, Chief Operating OfficerCHCACT375 Willard Ave.Newington, CT 06111P 860.667.7820F 860.667.7835E jgranger@chcact.orgwww.chcact.org