Partnering for Healthy Communities Since 1973

1. NC SCHOOL COMMUNITY HEALTH ALLIANCE Annual Meeting December 4, 2012 Partnering for Healthy Communities Since 1973

2. Early 70’s *Photo Courtesy of Cecil G. Sheps Center for Health Services Research

3. Early 70’s “State government could not merely issue edicts or dangle money; it had to engage in meaningful partnerships, be prepared to make long-term investments in communities, and nurture the leadership needed to deliver the desired improvements.” ~Jim Bernstein Clingman Medical Center, Wilkes County

4. OFFICE OVERVIEW 2012 The North Carolina Office of Rural Health and Community Care assists underserved communities and populations to develop innovative strategies for equal access, quality, and cost-effectiveness of health care for all. PURPOSE • Work with communities to meet the health needs of all underserved residents • Foster state and local partnerships with ownership vested in communities • Provide in-depth technical assistance on an on-going basis • Assure clear and measurable accountability • Seek to eliminate health disparities PRINCIPLES

5. Founded in 1973 40 Employees Budget (July 1, 2012) - $37,632,240 Appropriation (SFY 2013) - $16,244,397 Other Support (SFY 2013): • Federal (Grants and Medicaid) - $11,291,070 • Other Grants and Provider Match - $10,096,773 Office of Rural Health & Community CareSnapshot – Size and Budget

6. Technical Assistance • Key Elements: • Market analysis • Organizational analysis • Practice development • Practice management • Architectural • Graphic design Those supported through Technical Assistance: • Rural Health Centers • Community Health Centers • Hospitals • Health Departments • Other Safety-Net Providers

7. Programs & Resources Rural Health Centers Program Medical and Dental Placement Services NC HealthNet Program Prescription Assistance Program Community Health Grants Rural Hospital Assistance Program Farmworker Health Program

8. Placement Services Medical, Dental, and Psychiatric Placement Services Provides comprehensive recruitment assistance to communities and practices that serve underserved residents

9. Recruit primary medical, dental, and psychiatric providers Secure candidate pool from in- state residencies, nationwide mailings, and national clinical meetings Provide personal contact with providers and communities toassure quality matches Provide travel assistance to sites for provider and spouse Offer incentives to providers locating in areas of greatest need(loan repayment or service bonus) Make optimal use of National Health Service Corps resources Medical, Dental, and Psychiatric Placement Services

11. Medical, Dental, and Psychiatric Placement ServicesPlacement Statistics • Average placements per year over the past 6 FYs: 149 • Placements to rural and underserved communities SFY 2011 and SFY 2012 • Physicians 33 41 • Physician Assistants 28 26 • Nurse Practitioners 24 24 • Certified Nurse Midwife 1 1 • Dentists 29 20 • Dental Hygienists 2 0 • Psychiatrists 12 12 • Licensed Clinical Social Workers 1 1 • Totals..................................................................... 130 ………. 125 • Number of active PC, Dental, and/or Psychiatric recruitment opportunities as of 10/01/12: … 467 • Primary care …………………… 434 • Dental ……….……………………. 33 • Number of active candidates in recruitment pool as of 10/01/2012: … 431 • Primary care ……………… 363 • Dental ..…………………… 68 • Number of incentive contracts issued SFY 2012: … 86 • Average incentive contract SFY 2012: … $23,367

13. NC HealthNet Program Links safety net organizations and indigent care programs providing free and low-cost health care services for uninsured adults with Community Care of NC’s administrative infrastructure and networks of physicians and care managers.

14. State appropriation ($4,800,000 recurring) to sustain existing HealthNet networks and develop new programs Grants support local efforts to increase access and quality of care through a coordinated delivery system Share and conserve limited resources through collaborative partnerships Office provides on-site technical assistance and monitoring NC HealthNet Program Summary

15. Funding 34 networks providing services for the uninsured in 71 counties • 96,000+ individuals have a primary care medical home • 56,000+ individuals have access to needed prescription medications • 37,000+ individuals with chronic medical conditions have a care coordinator NC HealthNet Program Status

16. Prescription Assistance Program Provides prescription assistance software and technical assistance to community practices assisting uninsured and low-income residents in obtaining prescription drugs.

17. Prescription Assistance • Key Elements: • Assists community organizations in establishing a Prescription Assistance Program for indigent patients • Distributes and supports Prescription Assistance software that accesses pharmaceutical companies’ free and low-cost medication assistance programs • Provides technical assistance through training sessions, on-site visits, and software support • ChecKmeds NC is designed to help seniors enrolled in a Medicare Prescription Drug Plan manage their medications through one-on-one consultations with pharmacists. • Program Statistics SFY 2012: • MARP sites: 133 • Number of patients served: 48,245 • Value of medications received: $157,035,352 • Medications Received: 249,146

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19. Community Health Grants Improves access to healthcare services for north Carolina's underserved residents through grant funding for safety-Net provider organizations

20. Community Health Grants Program • Improve access to health care services for NC’s uninsured and indigent residents through a RFP • Non-profit primary care safety-net organizations, such as community health centers, rural health centers, local non-profit health centers, free clinics, public health departments, and school-based health centers, are eligible to apply • $4,407,473 received in appropriations • 43 program grants and amendments awarded in SFY 12 • ~ 44,100 uninsured and indigent users accessed health care through this grant process • 39 counties benefiting from these grants

21. Other Programs & Resources Economic Impact of Health Care on NC Study Health Professional Shortage Analysis Children’s Health Insurance Program Reauthorization Act (CHIPRA) State Health Access Plan (SHAP) – Community Care of NC for Uninsured Parents (CCNC-UP) Multi-Payer Medical Home Demonstration

23. Contact Information John Price, Director Anne braswell, healthnet manager NC Office of Rural Health and Community Care 2009 Mail Service Center Raleigh, NC 27699-2009 Telephone: (919) 733-2040 Email: john.price@dhhs.nc.gov Anne.braswell@dhhs.nc.gov Website: www.ncdhhs.gov/orhcc/