Hackley Community Care Center

1. Hackley Community Care Center 2008 Annual Quality Report Our mission is to share our respect, compassion, quality and time with the residents of our community to promote and support their total health.

4. Clinical Services: Preventative health care services - medical & dental Acute and chronic health care services - medical & dental NowCARE Medical Walk-in Clinic Minor office surgeries (to include colposcopy and leep procedures) OB services and Family Planning Maternal and Infant Health Program EPSDT well child exams, hearing & vision testing Behavioral Health and Substance Abuse Laboratory services Nurse case management services Pharmacy

6. 2008 Patients: 13,235 By Race: African American 5,442 41% White 5,758 44% Hispanic 1,531 12% American Indian 92 1% Other 412 2% By Age: 0-10 3,523 27% 11-18 2,260 17% 19-39 3,866 29% 40-64 3,144 24% 65+ 442 3% By Gender: Female 8,041 61% Male 5,194 39%

7. 2008 Visits: 68,694 Medical � 42,393 Dental � 15,792 OB � 5,847 Behavioral Health � 2,190 Maternal Infant Health Program � 2,472

8. Community Care Pharmacy: HCCC opened the Community Care Pharmacy in January 2008. Prior to that, Hackley Pharmacy offered on site services to our patients, staff, and community. 4,563 total patients served in 2008 52,767 prescriptions 207 average daily prescriptions

9. Performance Improvement/Quality Assurance: Joint Commission Accreditation since 2001 Performance Improvement Committee Workgroups: Health Literacy and Forms EHR and E-Prescribing Depression Collaborative Diabetes Collaborative Infection Control Program Employee Illness Reportable Diseases Antibiotic Susceptibility Prevalent Pathogens Pap Smear Summary Post Procedural Infections Annual Failure Mode Effectiveness Analysis (FMEA) Medical Report Follow-up Dental Front Office Patient Privacy Emergency Response Committee

10. Pharmacy & Therapeutics Committee Medication Management e prescribing Provider PEER Reviews 305 medical, 100 dental Billing Process Reviews 144 encounters, 20 EOB�s Medical Coding and Documentation Reviews 104 medical charts Patient Satisfaction Surveys 1,036 surveys 97.7% were satisfactory or higher Employee Satisfaction Surveys 89% satisfactory or higher Technology EHR for medical and dental Patient Centered Medical Home Pay For Performance Measures Clinical Measure Outcome Audits

11. 2008 Clinical Measure Outcomes

12. Perinatal Lifecycle: HCCC staff participate on the FIMR Collaborative & Maternal Smoking reduction task force. Our OB BSW case manager meets with OB patients to provide risk assessments, depression screening, and education. Newborn follow-up in 1 month: 81% First Trimester Into Care: 81% Dental Exams During Pregnancy: 73% Smoking Reduction During Pregnancy: 43% Post Partum: 70% Post Partum Depression Ed. Documentation: 89% Third Trimester Into Care: 3% Post Partum Depression Screen by BH: 95% Pediatric Lifecycle: HCCC hired a Pediatrician in November 2007. Wellchild exams and immunizations continue to be a priority of HCCC. Our medical and Behavioral Health providers work together to provide the best care to children diagnosed with ADHD. We provide on-site CPT Conners Screening and counseling to children and parents. Immunizations (19 to 35 months): 93% Growth/Development: 88% Dental � Baby Bottle: 98% Dental � Fluoride Suppl.: 99% ADD/ADHD School Checklist annual school year (2007-2008): 70% Parent Evaluation Forms at least two times per school year (2007-2008): 93% Visit at least 2 times per school year (2007-2008): 45%

13. Adolescent Lifecycle: Adolescents fill out a RAAPS/CRAFT risk screening and are referred to HCCC Behavioral Health staff as indicated. Behavioral Risk Assessments: 48% Family Planning: 95% Immunizations: 92% Screening for Smoking: 80% Geriatric Lifecycle: Two HCCC physicians give of their time and expertise to write monthly articles for the Senior Resources Magazine. Immunization (Flu & Pneumonia): 40% Functional Assessment: 40% Td: 59%

14. Adult Lifecycle: Flu Vaccine: 47% Cardiovascular Risk Screening & Management Plan: 42% Blood Pressure less than 140/90: 69% Substance Abuse Management Plan: 77% Asthma Education: 65% Abnormal Pap F/U: 100% Td: 55% Screening for Smoking: 94% Cancer Screening: HCCC participates in the BCCCP and WISEWOMAN programs. Cervical Cancer Screening: 69% Breast Cancer Screening: 69% Prostate Screening Education: 42% Dental: Oral Cancer Education: 100% Completed Treatment Plans w/in 12 months: 75 % Pain Management: HCCC is one of few clinics that has integrated a pain management program in a primary care setting. Pain Assessment: 98% Decrease Pain Score 6 Months After Initial Visit: 43% At Least One Functional Goal Within 6 Months of Initial Visit: 70%

15. Diabetes: HCCC participates in the national Diabetes Collaborative. Two R.N. Case Managers provide education to patients and we also offer Chronic Disease Self Management Classes. 878 Diabetic Patients as of December 2008 blood pressure less than 130/80: 28% fasting LDL less than 100: 44% ACE inhibitors or ARB medication: 76% self management goal: 25% Avg HbA1c: 7.7 HbA1c less than or equal to 7: 43% HbA1c less than or equal to 9: 70% two HbA1c within twelve months: 56% eye exams: 33% dental exams: 27% Depression: In 2001 HCCC was one of the first to integrate Behavioral Health and primary care. HCCC participates in the national Depression Collaborative. 736 Depression Patients as of December 2008 CSD PHQ 50% reduction: 23% PHQ 4 week reassessment: 35% documented PHQ with in 6 months: 50% documented SMG�s in 12 months: 75% Number of patients on an antidepressant/psychotherapy within 1 month of New Episode PHQ: 234 new episode PHQ on psychotherapy medications: 85%

16. Special Programs & Services

17. # of Childhood Immunizations: 9,523 HCCC was one of the first clinics to utilize the State MCIR registry. Our motto: Never Miss An Opportunity.

18. Referrals: The referral staff facilitate tests and referrals between HCCC, the patient, the specialty provider, the hospital, and insurance companies. Medical: 12,313 (7,528 Tests; 4,785 Specialists)

19. Technology: 1.5 FTE IT Staff HCCC Website, Outlook Email, Internet Access Medical EHR A4 Healthmatics Implemented April 2003. Lab Interface (Quest & Hackley Labs) E Prescribing Computers/ePocrates in exam rooms Dental Dentrix � partial EHR Digital X-Ray (December 2008) Full EHR (2009) Pharmacy SRS software HCCC staff participate in local, regional, and State networks regarding the use of technology in a medical setting.

20. Sliding Fee Scale: A sliding fee scale is offered to patients based on their financial status. 1,816 active SFS patients as of December 2008 Dept. Human Services: HCCC was one of the first in the State of Michigan to have an on-site DHS worker available to patients and staff. 295 family applications submitted in 2008

21. Community Outreach Events: HCCC staff are committed to reaching out to the community at health fairs, festivals, back to school programs, church events, and other community outreaches. Number of patient contacts: 7,639 Number of community events: 40

22. Patient Assistance Program: Patients: 1,112 Number of Prescriptions: 56,728

23. Chronic Disease Classes: A 6-week, 2 � hour once per week workshop that builds confidence for managing health, staying active and enjoying life. 5 classes 35 participants

24. Breast & Cervical Cancer Program: This service provides eligible women clinical breast & pelvic exams, pap smears and mammograms free of charge. HCCC also participates in the WISEWOMAN program, which identifies risk factors for chronic diseases and encourages healthy lifestyle choices. 204 women seen

25. School Based Health Program: Over 8,670 Kids Served HCCC staff are located in Steele, Bunker and Muskegon Heights Middle schools. Services offered include: health, fitness, and nutrition education health screenings case management services after school programs

26. Physician Assistants: 5 Medical Assistants: 3 R.N. Nursing Students: 8 U of M Dental Students: 11 Students for 36 weeks

27. Casual For A Cause: HCCC staff pay $2.00 to wear jeans on Friday. Money collected is donated to community agencies (Love Inc, Rescue Mission, MAP, Meals on Wheels, etc.). $2,411 donated to the community in 2008 $22,281 since 1997