citymatch january 17 2008
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CityMatCH January 17, 2008. Collaboration between Community Health Centers and Local Health Departments. Disclosure.

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citymatch january 17 2008

CityMatCHJanuary 17, 2008

Collaboration between

Community Health Centers

and

Local Health Departments

disclosure
Disclosure

CDC, our planners, and our presenters wish to disclose they have no financial interest or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. Presentations will not include any discussion of the unlabeled use of a product or a product under investigational use

lyon county health department dba flint hills community health center lchd fhchc
Lyon County Health DepartmentdbaFlint Hills Community Health Center(LCHD/FHCHC)

The ultimate collaboration

demographics
Demographics

Population of Lyon County: 35,560

Principal city population (Emporia): 26,780

Population of 4-county catchment area for community health center: 63,627

Majority of services provided to Lyon County residents, and maximum distance would not exceed 20 miles.

Outlying counties: maximum travel distance, 50 miles

responding to community need
Responding to community need

As Lyon County Health Department meeting two essential services: community assessment and assurance led the organization to pursue community health center funding.

community needs
Community Needs

Lack of access to personal health care services was a significant unmet need leading to the initiative to secure funding and resulting in the collaboration. Local hospital was a key partner in the process.

Lack of access to oral health services resulted in addition of dental clinic in 2000

Capacity shortage for mental health services resulted in addition of behavioral health services in 2002

historical context
Historical Context
  • Great unmet need for primary health care both for uninsured and Medicaid recipients in Lyon and surrounding counties
  • County hospital provided funding to establish a small primary care clinic staffed by Advanced Registered Nurse Practitioner
  • County health department secured Federally Qualified Health Center Look-alike status
  • Community Health Center funding (Section 330) secured in 1997
organizational structure
Organizational structure
  • Lyon County Health Department was the grantee and thus the CHC functioned as a public entity
  • 501(c)3 corporation established with a consumer majority board
  • Organization continued as a unit of county government until December 31, 2003
august 2001 the question
August, 2001: The Question

Can LCHD/FHCHC be a totally independent entity?

july 2002 the answer
July, 2002: The Answer

NO

Must maintain a connection to Lyon County as an instrumentality of government. This became a key issue. Instrumentality is a legal construct under Kansas law.

the charge
The Charge

Lyon County Commission authorized Flint Hills Community Health Center Board of Directors to move forward with an implementation plan to begin functioning as an instrumentality of government

the administrative challenges of functioning as a public entity
The Administrative Challenges of Functioning as a Public Entity

Dual governance: County Board of commissioners and Community Health Center Board

Duplication of work efforts in human resource and financial responsibilities

More limited ability to be responsive to work force needs in the health care environment

a new model for governance
A new model for governance

LCHD/FHCHC began functioning as an instrumentality of government effective January 1, 2004

Employees were transferred from Lyon County government to FHCHC

Lyon County Health Department remains the grantee for Section 330 funds

FHCHC Board of Directors has a contract with Lyon County Commission by which grants and their requisite responsibilities are assigned to FHCHC

Contract also includes assignment of responsibility for public health functions

challenges
Challenges
  • Maintaining level funding from county to sustain public health functions
  • Some loss of revenue for public health functions as state Medicaid agency does not allow the agency to bill both as a local health department and an FQHC
benefits
Benefits
  • Collaboration with public health at its best
  • CHC has been easily incorporated into Public Health Preparedness Planning
  • One-stop for health care for low-income, underserved residents of catchment area (population-based health services, primary care, dental, and behavioral health
  • Cost effective with shared administration and infrastructure
  • Administrative challenges and duplication of work effort reduced or eliminated
  • Organization able to be more responsive to changes in health care environment
questions comments
Questions/Comments?

For more information, contact:

Lougene Marsh, MPA

Executive Director

420 W. 15th Avenue

Emporia, KS 66801

620-342-4864, x261

[email protected]

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