Community Health Centers Presentation to Allegan County Health Department July 12, 2012 Andrea Charlton, MPH, MSW Community Health Planning Manager Michigan Primary Care Association
Introduction to Community Health Centers FQHC and FQHC Look-Alike Program Requirements (Summary) Role of Governing Board Role of MPCA and Assistance
FQHC Grantee and FQHC Look-Alike Program Requirements
Michigan s Health Centers 30 Health Center Program Grantees 2 FQHC Look-Alikes 2 are a Health Center Program grantee and an FQHC Look-Alike 200+ Service Sites Located in 51 Counties Over 600,00 Patients Served Annually
Program Requirements To qualify for Section 330 funding or to be a Look-Alike: Must be a private nonprofit entity or a public entity with compliant co-applicant board, including tribal, faith-based and community based organizations CHC must provide care to either a federally designated Medically Underserved Area (MUA) or Medically Underserved Population (MUP)
Medically Underserved Areas & Populations Designation Type Governor s Exceptional MUP Medically Underserved Area (MUA) Medically Underserved Population (MUP) Source: Michigan Department of Community Health Planning & Access to Care Section, 6/14/12
Program Requirements Governance Accessible: extended hours, and arrangements for off hour coverage (24/7) Sliding fee scale to adjust fees to a patient s ability to pay (<200% FPL; nominal for <100% FPL) Accept Medicare & Medicaid Culturally competent services
Program Requirements Comprehensive system of care (either directly or by contract) Care available and accessible promptly and in a manner that assures continuity of care Required services: Basic primary and preventive services Referrals to other providers (specialists when medically indicated) and health related services and agencies (substance abuse; mental health)
Program Requirements Case management services (counseling; referral & follow-up) and services to assist patients establishing eligibility for financial assistance programs Enabling services: outreach, transportation and translation Health Education: availability & proper use of health services Additional health services as appropriate Comprehensive oral health Linguistic and cultural competence Special populations services (migrant, homeless, public housing etc.)
Grantee and FQHC-LA Benefits
Grantee and FQHC Look-Alike Requirement/Benefit Meet all FQHC requirements, including governance Provide care to Federally designated Medically Underserved Area/Population FQHC Grantee FQHC Look- Alike Enhanced Medicaid Payment Access to favorable drug pricing under section 340B of the PHSA Access to providers through the National Health Service Corps Receive Grant Money Federal Tort Claims Act Coverage Federal Loan Guarantee Program Eligible to apply for additional grant funds Application Competitive Designation
Role of Governing Board
Board Authority Health center governing board maintains appropriate authority to oversee the operations of the center, including: Monthly meetings Approval of health center grant application and budget Selection/dismissal and performance evaluation of the health center CEO Selection of services and hours of operations; Measuring and evaluating the organization s progress in meeting its annual and long-term programmatic and financial goals and developing plans for the long-range viability of the organization by engaging in strategic planning, ongoing review of the organization s mission and bylaws, evaluating patient satisfaction, and monitoring organizational assets and performance Establishment of general policies for the health center
Board Composition Governing board composed of individuals, a majority of whom are being served by the center and, who as a group, represent the individuals being served by the center in terms of demographic factors such as race, ethnicity, and sex. 9 25 members Non-consumer members of the board representative of community and selected for expertise in community affairs, local government, finance and banking, legal affairs, trade unions, and other commercial and industrial concerns, or social service agencies within the community. No more than one half (50%) of the non-consumer board members may derive more than 10% of their annual income from the health care industry.
Public Centers (Public Entities) Most health centers are private, non-profit corporations. Public entities operating health center programs may meet the governance requirement in either of two ways: 1. The public entity's board meets health center board composition requirements including having a consumer majority. In this case, no special considerations are needed. http://bphc.hrsa.gov/policiesregulations/policies/pin199812.html
Public Centers (Public Entities) 2. When the public entity's board does not meet health center composition requirements, a separate health center governing board may be established. Must meet all the membership requirements and perform all the responsibilities expected of governing boards (public entity may retain the responsibility of establishing fiscal and personnel policies) Can be a formally incorporated entity and it and the public entity board are co-applicants for the health center program When there are two boards, each board's responsibilities must be specified in writing so responsibilities for carrying out governance functions are clearly understood. http://bphc.hrsa.gov/policiesregulations/policies/pin199812.html
Role of MPCA and Assistance
Additional Resources Health Center program requirements summary http://bit.ly/healthcenterpr CMS FQHC Fact Sheet http://go.cms.gov/fqhcfs Implementation of the Section 330 Governance Requirements, HSRA Policy Information Notice 1999-12 http://bit.ly/pin1998-12 Contact nearby FQHCs Cherry Street Health Services and InterCare Community Health Network
Questions? For further information, please contact: Andrea Charlton, MPH, MSW, CHCEF acharlton@mpca.net 517.827.0475 www.mpca.net
Speaker Biographies for FQHC Presentation July 12 th, 2012 Greg Bonk, President HMS Consultants President, HMS Associates, Founded in 1990, supporting innovation through balanced coalitions of communities and health care service providers informed by data driven decision-making processes. Clients in 18 states coast-to-coast. Broad range of clientele ranging from modest not-for-profits with operating budgets under $500K to county, state and the federal government and charitable foundations. 90% of projects involve rural or underserved communities and multiple provider networks or alliances Major citations include: Principles of Rural Health Network Development and Management, January 2000, Academy of Health, Washington, DC through support from Robert Wood Johnson Foundation Evaluator, US Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy, Delta States Rural Network Development Program, 2006 through 2010 Special Report, Emergency Department Use in Arizona, #1 Result on Goggle Search Engine, 2008 Pike and Wayne County Pennsylvania Health and Human Services Needs Assessment, Community Service Award, 2009 A Manual on Successful Collaboration between Critical Access Hospitals and Federally Qualified Health Centers, US Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy, April 2010. Andrea Carlton, Community Health Planning Manager Michigan Primary Care Association Community Health Planning Manager January 2010 - present Michigan Primary Care Association Lansing, MI As the Community Health Planning Manager, Andrea assists communities in identifying areas of unmet need and in designing programs to address the need. She provides ongoing technical assistance to new and
developing community health centers, including maintaining a web based repository of resources to assist in the development of health centers and coordinating on-going training for health center board members. Andrea has several years of experience working in the United Kingdom with the National Health Service in an out-patient clinic. She provided oneon-one counseling to patients presenting at the clinic. Andrea is a Community Health Center Executive Fellow from the University of Kansas. She also holds two master s degrees, one in public health and one in social work, both from the University of Michigan. John Barnas, Executive Director, Michigan Center for Rural Health John is employed as the Executive Director of the Michigan Center for Rural Health; a non-profit affiliate of Michigan State University. He has been the Executive Director since February 2000. Prior to arriving at the MCRH, John was employed at a federally qualified health center in Battle Creek, Michigan as the Director of Program Development. He worked closely with the Kellogg Foundation and the hospital system, wrote grants, recruited health professionals, and supervised the staff of marketing, building and grounds, and community outreach. John received his bachelor s degree from Central Michigan University and after graduation was employed in various social service jobs. He went back to CMU and received his Elementary Education Teaching Certificate and taught for a couple of years. John resides in Lansing and is married to Patty. His family includes Caleb who is a gemologist in the Denver area, Sarah who is a senior at the University of Colorado - Boulder, Laura who works at SC Johnson in Racine, Wisconsin, and Julia who is a senior at Spring Hill College in Mobile, Alabama. In his free time John enjoys reading history, brewing wine, gardening, jogging, and vacationing near water.