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Community Health Centers Spotlight

Community Health Center Spotlight
 

Community Health Centers

Updated April 2013

NCSL highlights innovative health centers and state and federal action that impacts community health centers.

 

St. Louis CHCs Play Leading Role in Missouri Demonstration Project

The Centers for Medicare and Medicaid has allowed states to apply for transitional or “bridge”  dollars to cover  uninsured adults until the ACA is fully implemented.  California, Washington and Missouri implemented this type of Section 1115 Demonstration early on.  Now Missouri has extended their project to December 2014 because of its success in St. Louis City and County. 
Gateway to Better Health, a partnership between St. Louis’s Grace Hill Health Centers, Myrtle Hilliard Davis Comprehensive Health Centers and the ambulatory facility ConnectCare was originally launched in 2002.  Now funded as a Section 1115 “bridge” project,  these community health centers are central to the demonstration’s goal of providing low-cost healthcare coverage to uninsured adults.  The project is administered through the St. Louis Regional Health Commission and has five primary purposes:
 

  1. Preserve the St. Louis City and County safety net until coverage under the ACA is available;
  2. Achieve financial sustainability of the partners: ConnectCare, Myrtle Hilliard Davis Comprehensive Health Centers, Grace Hill Health Centers;
  3. Connect the uninsured and Medicaid populations to a medical home which will enhance coordination, quality, and efficiency of health care through patient and provider involvement;
  4. Maintain and enhance quality service delivery strategies to reduce health disparities;
  5. For the first two years, ensure that there is a 2% increase in the number of uninsured persons receiving services.

 
Eligible adults who are uninsured can receive reduced rates medical and dental services and prescription drugs.  No enrollment fees or monthly premiums are required and patients will be charged visit co-pays as low as $0.50 to $3.00. Proof of income and residency is required; enrollees must have to have been a legal U.S. resident for at least five years and/or meet applicable legal status requirements; and meet the annual income eligibility. For a family of four, income eligibility is less than $30,658 a year.

  

Health Center Spotlight Archive

 

Grand-Aides: Reducing Unnecessary Visits and Lowering Costs at Legacy Community Health Centers

At Legacy Community Health Center in Houston, Texas, a pilot of the innovative “Grand-Aides” program shows promise. Although initially based on the notion that “grandparents have been doing simple primary care for centuries,” anyone who completes the required training may become a Grand-Aide.  In contrast to community health workers, promotoras, or navigators, who generally provide health translation, advocacy and other social services, Grand-Aides undergo training to provide primary health care and education under the direct supervision of a nurse. They essentially serve as extenders for medical providers, conducting primary care home visits or phone consultations with patients who otherwise might be treated in the emergency department. Grand-Aides are required to complete 180 hours of program-specific curriculum and must also receive state certification as a nursing assistant, medical assistant or community health worker.  According to a study in Health Affairs, Grand-Aides could reduce drop-in visits at Legacy Community’s pediatric clinic by more than 60 percent and generate significant cost savings, reducing the cost of each clinic visit by more than $180.  By educating patients, providing primary care in the home, and reducing unnecessary primary care and emergency department visits, programs such as the Grand-Aides have the potential to help decongest community health centers, improve access to health care, and reduce costs. 



Community Health Centers Addressing Childhood Asthma: The CHAMPS Partnership 

Five community health centers—in Tucson, Arizona, Gran Rapids, Michigan and Rincon, Puerto Rico—have been selected to implement new asthma management programs for children. According to a report by the George Washington University, as many as 20 percent of low-income children with asthma receive care at community health centers. The program, Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS), partners asthma control specialists with the health centers to implement strategies that have proven to effectively manage childhood asthma in controlled trials. CHAMPS is funded by the nonprofit Merck Childhood Asthma Network, Inc. (MCAN) and will receive more than $4 million over four years.

El Rio Community Health Center in Tucson, which was selected to participate in the CHAMPS program, is one of nation’s largest health centers. This integrated health care system currently serves over 70,000 patients annually, including more than 4,000 children with asthma. El Rio’s Inner-City Asthma Intervention Program already provides free care, medication and preventive education for asthmatic children from low-income families. The program model relies on comprehensive evaluations of environmental triggers for each child and develops tailored, individual treatment plans. El Rios’ asthma program has contributed to an 80 percent reduction of emergency room visits at two local hospitals.

Other community health centers selected to participate in the CHAMPS program include:

Community Health Center, Inc., Connecticut
As a leading health care provider to Connecticut’s underserved population since 1972, Community Health Center Inc. knows what it takes to convert to electronic health records. In 2006, it became one of the first safety-net providers to make the change, and, according to CEO Mark Masselli, it’s been a great success. “We are committed to transforming the way health care is delivered,” he says, by focusing on what works best to improve patients’ health, “which ultimately helps contain costs.” He believes using electronic health records helps providers respond to patients’ needs like never before. The advantages include:

  • A patient’s complete medical record is available to an entire care team, regardless of where he or she is.
  • Safety improves because every prescribed medication is automatically checked for potentially harmful interactions.
  • New tools are available for providers to remind them when patients are due for important screenings.
  • Trends can be tracked to evaluate what works, allowing changes to be made often, when necessary.

Although the benefits are clear, adopting an electronic system is not always easy. “It takes commitment from the entire agency,” says Margaret Flinter, senior vice president of the Connecticut provider. Difficulties include:

  • The upfront costs.
  • Maintaining the privacy of medical information.
  • Giving health care providers support as they change their practice habits.
  • Understanding the current workflow in order to create procedures that work in the exam rooms.   

Despite these challenges, Masselli believes “There is no doubt that EHR technology improves the quality of care at our center. Never before have we had access to data across our entire system that we can use to drive improvements.” For more information, click here.

 

Peak Vista Community Health Centers, Colorado Springs
In response to health care providers limiting Medicare services, Peak Vista Community Health Centers opened the Colorado Springs Senior Health Center in April 2010.  Established in 1971, Peak Vista is a nonprofit organization that provides primary medical, dental and behavioral health care to more than 60,000 residents of the Pikes Peak region.

The new Senior Health Center offers geriatric-specific services for seniors, emphasizing primary care, medical and behavioral health care for a healthy lifestyle. Geriatric-trained providers deliver one-on-one attention to support senior health issues and help manage chronic diseases.  Peak Vista provides patients with their own personal primary care provider and coordinates referrals to community specialists.   The center encourages healthy lifestyle behaviors through health education classes, providing counseling on diabetes management, cholesterol control and heart healthy habits.  Peak Vista’s new Senior Health Center caters to patients 60 years and older, including the uninsured, and those who have Medicare.

Health outcomes improve when barriers to access are removed.  Not only do studies show that community health centers – like Peak Vista –  are a cost effective way to deliver services, they demonstrate improved health outcomes for individuals they serve, relative to comparable populations not served by health centers.   For more information, click here.

 

Cherokee Health Systems, Tennessee
Cherokee Health Systems is a unique health center that integrates behavioral services into primary care (adult, family practice, pediatric) with the goal of improving health outcomes and reducing cost. Founded in 1960, the organization currently has 22 locations, serving over 58,000 individuals in Tennessee.
Moving beyond the services received from co-located primary and mental health facilities, where mental health services are ancillary to primary care and require written referrals and scheduled appointments—Cherokee Health Systems utilizes a licensed psychologist as a part of the primary care team. Patients are able to see an on-site behavior health consultant immediately for assessment or intervention. The integrated approach to care allows for the psychosocial aspects of chronic and acute diseases to be addressed.  By combining primary care with mental and behavioral care, Cherokee Health Systems is able to provide more comprehensive care that addresses lifestyle and health risk issues in order to encourage personal responsibility for health.
Health outcomes improve when the health care model addresses both physical and emotional factors together.  Preliminary evaluation of integrated care programs- like Cherokee- show both reduced overall cost of care and higher levels of patient satisfaction.  Cherokee’s experience has demonstrated that blending behavioral health experts into the primary care team has the promise of being both efficient and effective.   For more information, click here.

 

Illinois General Assembly Appropriations
The Illinois General Assembly appropriated $50 million for the construction and renovation of health centers as part of a statewide capital bill designed to stimulate the economy. “With the passage of the capital funding, Illinois health centers will not only be expanding the number of sites and services available to new patients, but will also have the benefit of creating both construction jobs and health professional positions in underserved communities throughout the state. Community health centers have a responsibility to meet the increased needs of their communities … the Community Health Center Construction Program gets them one step closer to meeting those needs,” says Jill Hayden, the director of state government affairs at the Illinois Primary Care Association.  For more information on the Community Health Center Construction Program, click here.

 

The American Recovery and Reinvestment Act
The American Recovery and Reinvestment Act (ARRA) contains $1.5 billion in funding for health center infrastructure and $500 million for health center operational costs, to be dispersed by the Health Resources and Services Administration (HRSA). The Act's significant funding for Medicaid and Health IT, distributed by CMS, is also expected to have a benefit for health centers.
HRSA is one of the first federal agencies to begin awarding ARRA funds.   President Obama announced the release of $155 million to fund 126 health center New Access Points (NAPs).  For more information about the Community Health Center grants by state, click here.  For more information regarding the program, click here.

 

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