National Association of Community Health Centers (NACHC)

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2 National Association of Community Health Centers (NACHC) Workshop on Allied Health Workforce and Services May 9, 2011 Jason Patnosh, Associate Vice President/National Director, Community HealthCorps / /

3 America s Voice for Community Health Care The NACHC Mission To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved people.

4 Outline Federally qualified health centers (FQHCs) Patient centered medical home (PCMH) Allied health professions in FQHCs Identification and pipeline programs PCMH and future

5 Federally qualified health centers (FQHCs) Federally qualified health centers (FQHCs) were founded over 40 years ago in Boston and Mt. Bayou, MS by Drs. Jack Craddock and Count Gibson in collaboration with the Office of Economic Opportunity. FQHCs are consumer oriented and directed, located in medically underserved areas, provide primary and preventive heath care, and open to all regardless of ability to pay. Today, FQHCs see nearly 22 million patients annually across 1200 grantees and over 8000 locations. NACHC was founded a few years later to serve as the voice for health centers, provide technical assistance and support, and develop programs for FQHCs.

6 Health Center Funding in ACA The Affordable Care Act (ACA) provides $11 billion in dedicated funding for health center operations and capital for FY2011- FY2015. $9.5 billion to support health center operations. $1.5 billion for capital needs Expanded Services at Existing Health Centers Serve additional patients by expanding current service capacity, including adding providers/staff and increasing hours of operation New or expanded oral health, behavioral health, pharmacy, and enabling services Funding Award Announcements were scheduled

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8 The Current Environment The view from Congress is turbulent, with the parties taking very different approaches on many big issues. The nation s fiscal situation is a considered a serious issue to future prosperity by members of both parties, and will continue to grow. Funding for FQHCs was reduced by $600M in the FY11 budget deal. This essentially stunts the ability to see up to 5M more patients and grow, potentially reducing growth in the ACA estimates.

9 Patient Centered Medical Home (PCMH) From Health Affairs Blog by Holly Koda (April 26, 2011) The PCMH is not a one-size-fits-all, and neither are the patients or providers who live, work and play within its walls Ideally, the PCMH helps to empower patients who can participate fully in their care and places the patient at the center as part of the care team. What new skills are needed, and how can we prepare competent patients in the PCMH? Patients do have responsibilities: meeting appointments and follow up visits, filling and refilling prescriptions, communicating frankly about health concerns, and more. Notably, many will fall short, and disparities will advantage or disadvantage specific patient groups. Low income, culturally diverse and other special populations will likely require enabling support to meet their patient responsibilities in the PCMH. Experience shows that health care professionals can play better with others on collaborative, inter-professional teams when they understand and appreciate the shifting roles and how they fit together in a patient-centered medical home.

10 Allied Health Professions in FQHCs Dental hygienists Medical or dental assistants Health information technologists Some health care administrators Medical coders Pharmacist/pharmacy technicians Phlebotomists Community health workers

11 Identification and Pipeline Programs World Academy for Total Community Health (Brownsville, NY): Mission: To prepare our students to make healthy choices, lead healthy lives and advocate for the total health of their families, their communities, their nation and ultimately, their world; to expose students to all aspects of the health care field and variety of career options the industry offers; to create a socially supportive learning environment; to offer an academically rigorous curriculum that prepares students for higher education. Lead partners: Brownsville Multi-Service Family Health Center (an FQHC), Long Island University School of Nursing, and Sophie Davis School of Biomedical Education.

12 Identification and Pipeline Programs Central Valley Health Network (Sacramento, CA) Hold an annual conference for young people annually highlighting leadership and careers in health care Area Health Education Centers Nationwide, are creating programs for youth as early as 1 st graders to teach healthy lifestyles and become interested in health careers High School Drop Out Rates MATTER!

13 Community HealthCorps mission : improve health care access and enhance workforce development for community health centers through national service programs

14 Community HealthCorps A Standardized Program Design that Works Recruit Train Serve Serve Teams and Roles Supervision Transition Process: Members apply directly to program sites for Fall start Program Coordinators screen and select applicants Criteria: High school diploma, GED or working toward GED; interest in health care; attitude; good work ethic of helping the community Initial: Pre-service Orientation includes Introduction to AmeriCorps/ HealthCorps, health center, basic first aid training On-going: Program Coordinators and Site Supervisors continue to develop and train members for skills needed to perform day-to-day service duties Each program hosts 5-25 members who meet as a team for training and peer support (avg. size around 12 members) and perform various activities, including but not limited to: health outreach on health center services, education (i.e., tobacco cessation and flu vaccinations), enrolling kids and families in public health insurance, coordinating pediatric obesity intervention programs, and providing translations for limited English proficient patients Members are supervised onsite by Site Supervisors, staff employed by the health center Members are also supported by Program Coordinators who source the positions, facilitate team interactions and serve as liaison between the members and sites During Service: Members learn goal setting, job search, resume writing, interview preparation to support their transition to future employment and higher education After Service: Some stay with HealthCorps for second year, others are hired by CHC or others to work in a health care field, pursue more schooling or employment

15 Benefit to Health Centers and AmeriCorps Members Community Health Centers Benefit from Hosting -Increased skilled workforce -Increased engagement of community volunteers -Greater advocacy for community residents and community health issues -Increased third-party health insurance and other revenues -Increased funding diversification AmeriCorps Members Benefit from Serving -Improved understanding of community health delivery -Improved interest in high need health careers -Obtained job skills and workplace experience that lead to living wage career opportunities -Reduced debt burden from past education and encourage pursuit of further education -Increased self-efficacy

16 A Program Model That Gets Results Thanks to Community HealthCorps ( ) Approximately 1.2 million people who lacked access and inadequately used health services 123,096 enrollment applications for health insurance (including children s health insurance), health education workshops and other health center services 159,932 people in need used preventive and primary health care services two or more times within the last program year 12,754 community volunteers provided over 25K hours of service (valued at $532,586)

17 Return on Investment An estimated $11 million was invested in the program during program year ($6 million from federal and $5 million from matching resources). Community HealthCorps members provided 689,870 hours of service valued at $14.4 million and leveraged over $1.9 million in educational scholarships for the members this is 145% return on investment in dollars alone and longer term ROI with healthier children and families, and HealthCorps members seeking further careers and education in primary and preventive health.

18 Contact Jason Patnosh /