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Federally Qualified Health Centers

Federally Qualified Health Centers. Presented by Vicki M. Young, PhD October 19, 2010. Community Health Centers (CHCs) are community owned and operated, non-profit businesses that provide access to quality primary and preventive health care that is affordable to everyone.

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Federally Qualified Health Centers

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  1. Federally Qualified Health Centers Presented by Vicki M. Young, PhD October 19, 2010

  2. Community Health Centers (CHCs) are community owned and operated, non-profit businesses that provide access to quality primary and preventive health care that is affordable to everyone. What Are Community Health Centers?

  3. Three Elements of the Health Center Model • Community Health Services • Community Economic Development • Community Participation

  4. Federal Requirements • Must be non-profit organization • Must have Governing Board dominated by health center patients • Must provide services based on community need (5 life cycles: perinatal, pediatric, adolescent, adult, geriatric) • Must see all patients regardless of their inability to pay • Must be located in an MUA or serve an MUP

  5. Federal Requirements • Must employ at a minimum, an Executive Director, Medical Director and a Finance Officer • May charge a nominal fee for patients who are <100% of federal poverty level (FPL) and must charge 100% for patients >200% of FPL • Must have a sliding fee scale for services for patients between 100% and 200% of FPL • Must address linguistic needs • Must be accessible

  6. Core Health Care Services • Primary Care • Family Practice • Internal Medicine • OB/GYN • Pediatrics • Other Health Care Services • Dental • Pharmacy • Mental Health • Diagnostic • Lab and X-ray • Ancillary/ Support Services • Outreach • Transportation • Communication Assistance • Case Management • Social Services • Nutrition • Podiatry

  7. Cancer Related Services • Primary Care Core Services • Screenings • Treatment • Referral • Supportive Care • Patient Education/ Self Management

  8. Other Facts • Physicians are covered under FTCA • Several of the CHCs have partnered/merged with private physician practices • Hospital affiliations may include residency training • Must have annual independent audits; also reviewed routinely by the federal government

  9. Other Facts • Must have 24-hour call arrangements • Support for the integration of mental health, oral health, pharmacy services

  10. South Carolina Community Health Centers • 19 CHC Corporate Grantees • 163 service sites • Served 300,000 + medical patients in 2009 • 275 provider FTEs

  11. Community Health Center Program • http://www.hrsa.gov/data-statistics/health-center-data/NationalData/index.html

  12. South Carolina Primary Health Care Association (SCPHCA) • THE MISSION • The mission of the South Carolina Primary Health Care Association is to provide a coordinating structure to assure access to community based primary, behavioral and other health care services to every community in South Carolina. • Direct Services through Migrant Health

  13. SCPHCA Functions Primary Care Association (all centers are members) Programs/Initiatives/Services Program/CommunityDevelopment Advocacy Research TA/Training HealthPolicy Partnerships

  14. SCPHCA Departments • Operations and Administration • Programs and Health Policy • Finance and Information Technology (IT) • Clinical Quality Improvement

  15. Clinical Quality Improvement Department • Focus on providing assistance to centers in the area of quality improvement • Provided through different mechanisms • Technical Assistance in the area of clinical practice and quality management (e.g., FTCA, Risk Management, Accreditation, Credentialing, Emergency Preparedness, Planned Care Models, CPR Training, etc.) • Training • Quarterly Clinical Network Meetings • Annual Clinical Retreat • Other ways we assist with quality improvement • Management/Coordination of Programs • Liaison Role between partners and member organizations • Research

  16. Current Challenges/Opportunities • Adequate Access to Care • Coordination of Care for Patients • Access to specialists due to • Uninsured numbers • No specialists in the area • Resources • Financial • Compensation for care • Timeliness of compensation • Human • Workforce • Facility

  17. Future Challenges/Opportunities • Dedicated funding to decrease the burden of the challenges • Workforce • Facility • Patient access to services • Preventive • Increased access to primary care services • Specialty and enhancing services • Some of current challenges will decrease but won’t be eliminated (e.g., workforce, coordinated care issues, etc.) • Establishing strategic partnerships

  18. Programmatic Areas of Interest • Meaningful Use • Patient Centered Medical Homes • Population Health • Data Assisted/Driven Decision Making • Integration of Enhancing Services

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