Pre-Application Technical Assistance to Community-Based Primary Care Clinics February 26, 2007 Barbara Gibson, Director State Primary Care Office Kansas Department of Health and Environment February 26, 2007 KDHE Primary Care Office Slide 1
Mission To establish primary care clinics in high need areas throughout Kansas where poverty, lack of insurance, or inability to retain a private medical provider is a barrier to accessing continuous health care. February 26, 2007 KDHE Primary Care Office Slide 2
Vision Primary care clinics helping communities to ensure that individuals and families have access to primary care and preventive services that support optimal health status February 26, 2007 KDHE Primary Care Office Slide 3
Approach Programs vary widely in terms of specific mission, service area, range of services, client eligibility, and local project goals and objectives. Each clinic is community-based and governed by a local board. Clinic services, staffing and target areas are determined by locally-defined community needs, direction and resources which vary from clinic site to clinic site. February 26, 2007 KDHE Primary Care Office Slide 4
Key Concept #1 Primary care clinics are accessible for the target population they serve. Client eligibility is determined by each community, clearly documented, visibly posted, and includes clients at or below 200% of federal poverty level guidelines. Clients will not be turned away from services because of inability to pay. Staff and clinic hours are appropriate for the clinic size and type of clients served. February 26, 2007 KDHE Primary Care Office Slide 5
Logic Model for Access February 26, 2007 KDHE Primary Care Office Slide 6
Logic Model for Access February 26, 2007 KDHE Primary Care Office Slide 7
Key Concept #2 Primary care clinic services are comprehensive. Clinic health services provided and/or referred include: Diagnosis, treatment and management of acute and chronic diseases Disease prevention -health promotion Laboratory, x-ray, and other diagnostic services Pharmaceuticals, Dental, mental and behavioral health services. February 26, 2007 KDHE Primary Care Office Slide 8
Key Concept #3 Primary care clinic services are coordinated. The services are coordinated within the local system of care. Formal and informal agreements are present to refer clinic clients to local community public and private resources and services. February 26, 2007 KDHE Primary Care Office Slide 9
Key Concept #4 Primary care clinic services are continuous The clinics assure access to a medical home, or a health care base, for the targeted population within a community. The clinics maintain a follow-up system for clients with special needs and chronic conditions. February 26, 2007 KDHE Primary Care Office Slide 10
Key Concept #5 Primary care clinics assure accountability Clinics assures quality of care through a permanent organized medical record system. Clinics maintain a management information system for data entry and retrieval of client information. Clinics maintain a financial accounting system. Clinic have an ongoing quality assurance program. February 26, 2007 KDHE Primary Care Office Slide 11
Eligibility Applicants must be communitybased, not-for-profit or publiclyfunded primary care clinics. This includes federally qualified community health centers (FQHC) and FQHC look-alikes February 26, 2007 KDHE Primary Care Office Slide 12
Eligibility Clinics must provide comprehensive primary health care services, offer sliding fee discounts based upon household income and serve any person regardless of ability to pay. February 26, 2007 KDHE Primary Care Office Slide 13
Management Factors to Consider in Seeking State Funds Standard accounting methods must be used for all grant-supported activities reflecting all receipts, obligations, and revenue, including non-cash contributions and disbursement of grant and local funds. February 26, 2007 KDHE Primary Care Office Slide 14
DEFINITIONS Non-cash contributions may be used to meet the required local match. In-kind, non-cash support may include: Personnel time, space, commodities, or services Contributions must be given a fair market value and documented in the local health agency accounting records. Costs associated with inpatient care are non-allowable. February 26, 2007 KDHE Primary Care Office Slide 15
Prescription Drug Assistance Program (PDAP) In 2005, the Kansas Legislature added $750,000 to the budget of the Kansas Department of Health and Environment (KDHE) and established an account for prescription support for communitybased primary care clinics. At that time, the Legislature authorized three forms of financial assistance to community-based primary care clinics. February 26, 2007 KDHE Primary Care Office Slide 16
Prescription Drug Assistance Strategy #1 Participate in the federal discount drug pricing program (Section 340B pharmaceutical discount purchasing program), eligibility restricted to qualifying Community Health Centers, also referred to as Federally Qualified Health Centers (FQHC) and FQHC Look-Alikes. inventory acquisition or formulary expansion, and/or prescription subsidy for sliding fee discounts to qualified clients February 26, 2007 KDHE Primary Care Office Slide 17
Prescription Drug Assistance Strategy #2 FQHCs may employ professional staff. CHCs participating in the 340B program are eligible, for example, to hire pharmacy staff or other qualified health care providers to disburse drugs. February 26, 2007 KDHE Primary Care Office Slide 18
Prescription Drug Assistance Strategy #3 Non-FQHCs employ staff to manage medication resources acquired through participation in pharmaceutical manufacturers prescription drug assistance programs, also known as indigent drug programs or patient assistance programs. February 26, 2007 KDHE Primary Care Office Slide 19
PDAP Proposal Details Define your target population. How is your target population currently obtaining needed prescription medication? Is this working well for your clients? Will this grant enable you to implement a new project or expand a current one? What are the desired outcomes of your project? How will you achieve your desired outcomes? How will you track, measure, evaluate and report your activities (outputs) and your outcomes? February 26, 2007 KDHE Primary Care Office Slide 20
ESTIMATE OF TOTAL FUNDING AVAILABLE Community Based Primary Care Clinics $2,520,840 Prescription Drug Assistance to Primary Care Clinics $ 750,000 February 26, 2007 KDHE Primary Care Office Slide 21
Factors to Consider Requesting State Funds Applicants are required to provide local support which meets the local match requirement of one dollar for each one dollar of funding awarded through this program. Funding for continuation requires Legislative authorization and is not assured. February 26, 2007 KDHE Primary Care Office Slide 22
Factors to Consider Requesting State Funds The applicant will be fully responsible for providing workers compensation, unemployment insurance and social security coverage. February 26, 2007 KDHE Primary Care Office Slide 23
Factors to Consider Requesting State Funds The local clinic or health center is responsible for income tax deductions, and for providing any benefits required by law for those employees who are employed on behalf of the grant program. February 26, 2007 KDHE Primary Care Office Slide 24
UNIVERSAL CONTRACT KDHE AID TO LOCAL PROGRAM Disclose personal health information (PHI) to the State Agency as requested or as required by law [45 C.F.R 165.512(b)] unless disclosure is prohibited by the Health Insurance Portability and Accountability Act (HIPAA). Comply with all relevant federal requirements Comply with statutes, rules and regulations pertaining to public health, including but not exclusively K.S.A. 65-101 et seq. The Local Agency, its agents or subcontractors, shall provide services which have meaningful access to persons with Limited English Proficiency (LEP) pursuant to Title VI of the Civil Rights Act [(42 U.S.C. 2000d et seq.) and 45 C.F.R. 80.3(b)]. Meaningful access is to ensure that the Provider, its agents or subcontractors, and LEP person(s) can communicate effectively when services are being provided to LEP persons. February 26, 2007 KDHE Primary Care Office Slide 25
Awarding Funds The key criteria for funding consideration will be proposals that focus on new or expanded service to vulnerable populations, strengthen an organization s capacity to fulfill its mission and/ or enhance its ability to operate efficiently and effectively. February 26, 2007 KDHE Primary Care Office Slide 26
Awarding Funds Funding will be provided to clinics and health centers that: demonstrate a high level of need in their community, present a sound proposal to meet this need, demonstrate responsiveness to the health care environment of the service area, and have collaborative and coordinated delivery systems for the provision of health care to the underserved to the extent funding is available. http://www.kdheks.gov/doc_lib/index.html February 26, 2007 KDHE Primary Care Office Slide 27
Narrative 1. Description of Community Needs: Patients to be Served 2. Response to Fulfill Needs 3. Program Evaluation 4. Expected Impact 5. Governance 6. Health Care Plan (optional) 7. Business Plan (optional) February 26, 2007 KDHE Primary Care Office Slide 28
Application Process Funds may be requested for one program alone or both programs with a single application. February 26, 2007 KDHE Primary Care Office Slide 29
Application Instructions: and Forms Face Page: APPLICATION FOR GRANT (Form #1) Budget Forms: Primary Care Clinic and Pharmacy Assistance Program (Form #4) February 26, 2007 KDHE Primary Care Office Slide 30
Application Documents Personnel Allocation by Program (Attachment #14) Program Narrative Written agreements Letters of Support (new projects) February 26, 2007 KDHE Primary Care Office Slide 31
NOTICE OF GRANT AWARD AMOUNT & SUMMARY OF PROGRAM OBJECTIVES Grantee will be asked to submit a revised final budget for the amount awarded. February 26, 2007 KDHE Primary Care Office Slide 32
Reporting Instructions Table of Contents (p 27) General Instructions Primary Care Clinic and PDAP Instructions (p 30) Quarterly Fiscal Report Form Fiscal Reporting Instructions (p 24) February 26, 2007 KDHE Primary Care Office Slide 33
Web based Reporting Clinics must report annually by logging on to: http://www.datacounts.net/kamu/. The data requested is based upon reporting requirements for federally funded clinics. The Reporting Manual may also be found at that website. Recipients of the Pharmacy Assistance grants shall also be responsible for data specific to that program. February 26, 2007 KDHE Primary Care Office Slide 34
Quarterly Financial Reporting REPORTING SCHEDULE 1st Quarter 7/1 to 9/30 REPORT DUE October 15 th 2nd Quarter 10/1 to 12/31 REPORT DUE January 15 th 3rd Quarter 1/1 to 3/31 REPORT DUE April 15 th 4th Quarter 4/1 to 6/30 REPORT DUE July 15 th February 26, 2007 KDHE Primary Care Office Slide 35
Submission Instructions Three (3) complete copies of each of the grant applications, postmarked not later than Monday, March 15, 2007, should be mailed to: Kansas Department of Health & Environment Office of Local & Rural Health Curtis State Office Building 1000 SW Jackson Ave, Suite 340 Topeka, KS 66612-1365 February 26, 2007 KDHE Primary Care Office Slide 36
Program Contact: Barbara J. Gibson, Primary Care Office Kansas Department of Health & Environment Office of Local and Rural Health Curtis State Office Building 1000 SW Jackson, Suite 340 Topeka KS 66612-1365 785 296-1200 (voice) 785 296-1231 (fax) E-mail: bgibson@kdhe.state.ks.us UPDATE WEBSITE: http://www.kdheks.gov/olrh February 26, 2007 KDHE Primary Care Office Slide 37