A Demonstrated Return on Investment

2016 MISSISSIPPI QUALIFIED HEALTH CENTER PROGRAM REPORT A Demonstrated Return on Investment Mississippi s Health Centers Provide Quality Care at Lower Cost

MISSISSIPPI QUALIFIED HEALTH CENTER PROGRAM 2 About the Mississippi Qualified Health Center Program The Mississippi Qualified Health Center (MQHC) Program emerged from the need to address the immense disparities and access barriers between primary health care for uninsured or medically indigent patients and the insured population. The MQHC Program was established under House Bill 403 during the 1999 Legislative session and funded through the Health Care Expendable Fund. The Legislature allocated funding for a five year, $20 million program to be distributed at the rate of $4 million per year for SFYs 2000-2004, with no MQHC receiving more than $200,000 annually. MQHCs or Community Health Centers (CHCs) are public or nonprofit 501(c)(3) entities that provide comprehensive primary care services and meet the following criteria. 1) Have a community board of directors, the majority of which are users of such centers; 2) Accept all patients that present themselves despite their ability to pay and also utilize a sliding-fee-schedule for payments; and 3) Serve a designated medically underserved area or population, as provided in Section 330 of the Public Health Services Act. During SFY2014, twenty-one Community Health Centers operating 191 delivery sites located across the state received annual grant awards ranging from $119,866 to $142,793 under the MQHC Program. (See page 3 for a complete listing of funds awarded). These CHCs have used their grant awards to provide increased access to preventive and primary care services for uninsured or medically indigent patients and to augment existing services. Many CHCs have new services that were made possible solely through the funding provided by the MQHC Program. (See complete listing of services on page 3). Since the MQHC Program s inception, utilization of Mississippi s Community Health Centers has increased significantly. This increase demonstrates the success of the program in reaching more of Mississippi s most vulnerable populations, the uninsured and medically indigent. A Letter to the Mississippi Legislators Dear Legislators: We are pleased to report success this year as the MQHC program support offers you a significant return on your investment of $3,000,000 in FY 2016. Given that the Community Health Centers saw 115,427 underserved Mississippians during this reporting period, this would yield an ROI of $25 to every $1 of the state s investment. This is in line with a landmark study referenced in this year s report produced by the American Journal of Public Health in 2016, entitled Healthcare Use and Spending in FQHCs vs. other Primary Care Settings. MPHCA as an organization has remained steadfast in its mission for 30 years, which is, To serve as a member organization, which supports its {Community Health Center} members in their collaborative efforts and advocates for the provision of equal access to quality, comprehensive health care services and the elimination of health disparities in the state. Community Health Centers in Mississippi continue to expand access to healthcare for an average of 300,000 patients annually. At the core, each health center mission is the goal to provide comprehensive and quality services of primary care, behavioral and oral health care as well as many enabling services. In 2016, expansions occurred by health centers which will increase capacity to serve an additional estimate of 18,000 citizens, provide new opportunities for employment and result in exponential economic impact. As we approach the 30th year of the work of MPHCA in 2017, health centers are poised as never before to impact the quality of life for Mississippi s underserved residents on a statewide basis. The environment of value-based care puts health centers in our state right at the center of a movement regarding Accountable Care, which seeks pay for value and not simply volume. It affords opportunity for highlighting the ongoing improvements in health outcomes that CHCs provide to those who are disproportionately impacted by chronic health conditions. We remain committed to driving improvements in population health through critical data mining and the effective use of technology. Future generations of Mississippians will be afforded an even broader benefit as primary care is transformed to be more and more patient-centric. To-date, eighty percent of health centers have met rigorous data standards through the National Center for Quality Assurance and the Joint Commission for achieving Patient Centered Medical Homes. Others are well on their way to achieving this same goal. In addition to our sincere appreciation to the legislative body, we appreciate the ongoing work with our partners to improve the health of Mississippians at the absolute best cost. Community Health Centers offer a significant return on your investment in offering the Best Cost of Care for Quality Care. Sincerely, Rashad Ali, MD, JD Mississippi Primary Health Care Association Janice Sherman, CEO Mississippi Primary Health Care Association THE MQHC PROGRAM HAS BEEN SUCCESSFUL IN PROVIDING COMPREHENSIVE HEALTH CARE TO MANY UNINSURED, UNDERINSURED AND MEDICALLY INDIGENT MISSISSIPPIANS; HOWEVER, ACCESS TO HEALTH CARE REMAINS A VITAL ISSUE FOR THE STATE. SUSTAINING EQUAL OR GREATER FUNDING WILL YIELD EVEN GREATER PROGRESS FOR THE FUTURE IN SUPPORT OF A COST EFFECTIVE METHOD FOR PROVIDING CRITICALLY NEEDED HEALTH SERVICES TO MISSISSIPPI S MOST VULNERABLE, UNDERINSURED & UNINSURED CITIZENS.

3 MQHC Grant Program 2016 SFY Closeout Data Grantee Award Amount Total # of Patients Served by MQHC Funds # of Uninsured Patients Assisted with MQHC Grant Funds # of Indigent Patients Assisted with MQHC Grant Funds CHC 1 $ 122,458 14,152 6,520 3,816 3,816 # of Patients Receiving Additional Services through the MQHC Grant Program Additional notes Provided enhanced access to care through discounted prescription medications to 3,816 patients and operation of a centralized call center that averaged more than 38,000 calls per month. CHC 2 $ 142,793 2,326 1,164 1,072 90 CHC 3 $ 142,793 1,096 198 198 700 CHC 4 $ 134,912 3,963 391 1,324 2,248 Hired RN that serves as a quality improvement nurse & patient educator. Increased visits by extending clinic hours. Renovated and upgraded mobile care unit; expanded to an additional county and added 3 additional clients to coverage area. Provided primary care medical services to 2,048 additional patients. Enrolled 74 patients in patient pharmaceutical assistance programs. Provided enrollment assistance for 2,819 individuals. Provided diagnostic services to 60 patients. CHC 5 $ 142,793 3,741 1,101 2,500 140 CHC 6 $ 129,167 14,745 2,219 804 11,722 CHC 7 $ 129,167 5,258 3,262 1,202 794 CHC 8 $ 129,167 2,301 972 553 776 Direct patient care from physician has increased from 16 hours to 24 hours per week, thereby increasing access to care. 60 patients received specialty care including digital retinal exams, digestive disorder treatment, nephrology, pulmonology, urology, mommograms, dermatology, diagnostic images, cardiology, orthopedic, surgery consult, and wound care. Improved level of preventive and primary care services and visit volume for uninsured and medically indigent patients. Maintained chronic disease management model at all sites. Increased total patients by 5.6%; acquired additional staffing (3.75 FTE); increased pediatric patients by 8.9%; received American Association of Diabetic Educators accreditation as diabetic education site. CHC 9 $ 142,793 5,144 1,286 1,286 2,572 Marketing campaigns were developed to make the community aware that dental and medical services were available at all clinic locations, including school-based and mobile units. Mobile units were utilized for medical and dental screenings at school-based clinics and other schools.

MQHC Grant Program 2016 SFY Closeout Data 4 Grantee Award Amount Total # of Patients Served by MQHC Funds # of Uninsured Patients Assisted with MQHC Grant Funds # of Indigent Patients Assisted with MQHC Grant Funds CHC 10 $ 119,866 1,982 219 772 991 # of Patients Receiving Additional Services through the MQHC Grant Program Additional notes Provided enhanced care to students, faculty, and staff of county school district. CHC 11 $ 134,912 2,582 1,156 1,156 270 CHC 12 $ 119,866 1,852 537 1,315 0 CHC 13 $ 129,167 8,278 2,789 2,306 3,183 CHC 14 $ 125,218 23,446 5,714 14,966 2,766 CHC 15 $ 142,793 6,664 3,308 3,356 0 CHC 16 $ 134,912 1,737 1,044 693 0 CHC 17 $ 134,912 8,840 1,251 4,725 2,864 CHC 18 $ 129,167 1,285 365 447 473 CHC 19 $ 134,912 854 351 503 0 Provided dental services, affordable pharmaceuticals, and health education. Maintained dental services (provided oral health care to 1,405 patients). Provided foot care to 210, eye exams to 45, eye glasses to 46, and lab testing to 394 diabetic patients. Expanded primary and preventive dental services. Continued medication assistance program. MQHC Grant provided funding for staff so that additional hours of access could be offered. Provided primary care medical services to 1,877 patients. Increased access to health care services by 10%. Provided prenatal services to 399 low income and indigent mothers; improved percentage of pregnant patients whose first prenatal visit was in the 1st trimester. Without the MQHC grant, there would be no dental services in the county of operation. CHC 20 $ 134,912 3,278 672 672 1,934 CHC 21 $ 142,793 1,903 1,060 765 78 TOTAL $ 2,799,473 115,427 35,579 44,431 35,417 Maintained school-based clinics providing medical and dental services to students grades K-12 (1,911 patients and 6,063 encounters). Transportation services were provided to 10 patients. Medications were purchased for 153 patients. Lab services were provided to 457 patients. Mammograms were provided for 62 women. 72.8% of diabetics had at least 2 HbA1c tests (and their average was 8.0% or lower), 91% of diabetics had foot exams, 82.6% of diabetics had a self mgt. plan of action, and 63.6% of diabetics had an eye exam. Also provided 70 pairs of shoes, 130 glucometers, 421 strips, and 237 lancets to diabetic patients.

5 MISSISSIPPI QUALIFIED HEALTH CENTER PROGRAM "#$$#$$#%%#&'&$%()*#+,-).$#+,(/01,0,.,2#3$3)34,,.3#(,$3/3,34/3#.-15+,$50$3/.3#/1,-).)6#-0,.,2#3$/$7,11/$34, %()*#$#).)285/1#394,/134$,(*#-,$" Economic/Employment :-).)6#-;:6%1)96,.3<6%/-3 Impact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otal ($94,255) Medicaid/CHIP Patients seen by CHCs, 2015 94,255 * $2,371=$216,786,500 in total savings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tatewide K3/3,7#+,&'&:6%1)96,.3=)3/1$/.+L..5/1M/3#,.3N#$#3$BOEP CHC Employment Totals and Annual Patient Visits 2015 Q#$-#%1#.,;M()2,$$#). R=:$ M/3#,.3N#$#3$ Q56%*0*1.% ]K"8] 8]]<;K: R+)1.0,+Q'102*2*(.,'%ZCQ<QR<#C?[ :;:";9 M98<F_] C='%,% 8L:"_: :]<;:M N,.2*%2% FK":L _:<98] N,.21A$6-*,.*%2% ::"KF :9<MK:?,.21A`a,51)*('1A$,1A25 8F";K ::<_8L Q51'>106 8K"KM C`R b&2(>,2'*%2`p*%*(. _"98 K<;F_ B(21AY.14A*.-O21// :;M";8 MK<F]M b25,'o21// ]K8"9M C`R =)3/1 Health ',/134K,(*#-,<6%/-3 Service Impact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

7 CHC/MQHC SITES & COUNTIES SERVED Mississippi Community Health Centers and Counties of Operation 1. Aaron E. Henry Community Health Services Center 2. ACCESS Family Health Services 3. Amite County Medical Services 4. Central Mississippi Health Services 5. Claiborne County Family Health Center 6. Coastal Family Health Center 7. Delta Health Center 8. East Central MS Health Care 9. Family Health Care Clinic 10. Family Health Center 11.G.A. Carmichael Family Health Center 12. Greater Meridian Health Clinic 13. Jackson-Hinds Comprehensive Health Center 14. Jefferson Comprehensive Health Center 15. Mallory Community Health Center 16. Mantachie Rural Health Care 17. North Mississippi Primary Health Care 18. Northeast Mississippi Health Care 19. Outreach Health Services 20. Southeast Mississippi Rural Health Initiative 20 CHCs and approximately 190 Clinic Sites

MPHCA COMMUNITY HEALTH CENTER MEMBERS Aaron E. Henry Community Health Services Center CEO: Ms. Aurelia Jones-Taylor 662-624-4292 ataylor@aehcommunityhealth.org Access Family Health Services Executive Director: Ms. Marilyn Sumerford 662-651-4686 msumerford@accessfamilyhealth.com Amite County Medical Services Executive Director: Ms. Pam T. Poole 601-657-4326 acmsinc@bellsouth.net Central MS Health Services Director: Dr. Robert Smith 601-948-5572 robertsmithmd@comcast.net Claiborne County Family Health Center CEO: Mr. James Oliver 601-437-3050 jeo0705@yahoo.com Coastal Family Health Center CEO: Ms. Angel Greer 228-374-2494 agreer@coastalfamilyhealth.org Delta Health Center Executive Director: Mr. John A. Fairman 662-741-8880 ceo1deltahealthcenter.org East Central MS Health Care CEO: Ms. Jill Bishop 601-625-7140 jbishop@ecmhci.com Family Health Care Clinic President/CEO: Margaret A. Gray, PhD 601-825-7280 drmgray@bellsouth.net Family Health Center CEO: Rashad N. Ali, MD, JD 601-425-3033 fhcadmin@laurelfhc-ms.com Greater Meridian Health Clinic CEO: Mr. Wilbert L Jones 601-693-0151 wjones@gmhcinc.org Greene Area Medical Extenders CEO: Ms. Angel Greer 601-394-5714 angel_greer@coastalfamilyhealth.org Jackson-Hinds Comprehensive Health Center CEO: Jasmin Chapman, DDS 601-362-5321 jhchc@comcast.net Jefferson Comprehensive Health Center Executive Director: Ms. Shirley Ellis-Stampley 601-786-3475 Sellis2020@aol.com Mallory (Arenia C.) Community Health Center CEO: C. Rozell Chapman, MD 662-834-1857 cchapman@mallorychc.org Mantachie Rural Health Care CEO: Ms. Marjorie McKinney 662-282-4226 mckinney.mrhc@yahoo.com North MS Primary Health Care Executive Director: Mr. James D. Nunnally 662-224-8951 james.nunnally@nmphc.org Northeast MS Health Care Executive Director: Dr. Clifton Rodgers 662-838-2163 crodgersnemhc@yahoo.com Outreach Health Services CEO: Ms. Sabrina Howze 601-687-5859 S_howze@hotmail.com Southeast MS Rural Health Initiative CEO: Geroldean Dyse, Ph.D 601-545-8700 geroldean@semrhi.com G.A. Carmichael Family Health Center CEO: James Coleman, Ed D 601-859-5213 jcoleman@gacfhc.org MISSION STATEMENT Mississippi Primary Health Care Association (MPHCA) is a member organization which supports its members in their collaborative efforts and advocates for the provision of equal access to quality, comprehensive health care services and the elimination of health disparities in the state. FOR MORE INFORMATION CONTACT MPCHA Janice Sherman, MPA Chief Executive Officer jsherman@mphca.com 6400 Lakeover Road, Suite A Jackson, Mississippi 39213 Phone: (601) 981-1817 Fax: (601) 981-1217 www.mphca.com

PROFILE OF MISSISSIPPI CHC PATIENTS 6 "##"##"$$"%&'&#%$()*"+,%-".-%/012"34%51(,%3)%6,1(24%7889888%"6+"*"+012#9%(,+05"6.%-,123-%+"#$1("3",#%16+%":$()*"6.%$13",63%)035):,#;%%&'&#%1(,% 2)513,+%"6%-".-<6,,+%1(,1#%"+,63"=",+%1#%-1*"6.%,2,*13,+%$)*,(349%-".-,(%3-16%1*,(1.,%"6=163%:)(312"349%16+%>-,(,%=,>%$-4#"5"16#%$(153"5,;%%&'&#%1(,% )$,6% 3)% 122% (,#"+,63#9% (,.1(+2,##% )=% "6#0(165,% #3130#% )(% 1?"2"34% 3)% $149% 16+% #,(*"5,#% 1(,% 31"2)(,+% 3)% ="3% 3-,% #$,5"12% 6,,+#% 16+% $(")("3",#% )=% 3-,"(% 5)::06"3",#;% % K)-#),-).)6#-K3/35$KE5,)1%291^('*26ZNM"HL[(/5,1:250,.2,'&12*,.2%/1::12('4,:(3 @AAL(/25,/,+,'1:&(),'26:,),:;35*:,MML1',4,:(3>AAL7Sc"H 4 In 2015, Mississippi CHCs provided over $34 million in sliding fee discounts to medically indigent patients. U/-,;:34.#-#39I?*%%*%%*&&*#$#%%,'),1+*%&'(&('2*(.12,A6A1'-,&,'0,.21-,(/>*.('*26',%*+,.2%"b),';9J(/#$#&12*,.2%1', R/'*01.R>,'*01.<0(>&1',+2((.A6:FJ(/25,dO-,.,'1A&(&=A12*(."F 4, 5 <.$5(/.-,K3/35$I?*%%*%%*&&*#$#%&'()*+,100,%%2(01',/('1AA',%*+,.2%<',-1'+A,%%(/14*A*262(&16"O&,0*1A,>&51%*%*%&A10,+(. 25,%212,T%>,+*01AA6+*%1+)1.21-,+&(&=A12*(."7.89:KFFJ(/1AA#$#&12*,.2%3,',=.*.%=',+<1.+FFJ1',0(),',+46%212, 4, 6?,+*01*+`#$7Q&'(-'1>%" Sources/Citations 1. Rust George, et al. (2003) Presence of a Community Health Center and Uninsured Emergency Department Visit Rates in Rural Counties. Journal of Rural Health 25(1):8-16. Cunningham P. (200P) What Accounts for Differences in the Use of Hospital Emergency Departments Across U.S. Communities? Health Affairs 25: W324-W336. 2. Study was conducted by researchers from the University of Chicago, Johns Hopkins University, the University of California at Irvin, the Agency for healthcare Research and Quality and the Health Resources and Services Administration. 3. The Economic Impact of Physicians in Mississippi. IMS Health. Prepared for the American Medical Association (2014) 4. HRSA Bureau of Primary Health Care, Health Center Data & Reporting. http://bphc.hrsa.gov/datareporting/index.html 5. United States Census Bureau, QuickFacts. https://www.census.gov/quickfacts/ 6. The Henry J. Kaiser Family Foundation, State Health Facts. http://statehealthfacts.org