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COMMUNITY HEALTH CENTER ASSOCIATION OF CONNECTICUT
FQHC 101Connecticut Public Health Association
Health Education Committee
June 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 network
facebook.com/CHCACTtwitter.com/CTHealthCenters
youtube.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 [email protected]
