City of Frederick Board of Aldermen Meeting October 27, 2010 FCAA/City of Frederick FQHC Planning Project

Agenda Mission / Purpose of 330 Community Health Center (FQHC) Program FQHC Eligibility Requirements Benefits of FQHC Status Elements of Strong Application Summary/Preliminary Review of Proposed Health Center

Mission / Purpose of 330 (FQHC) Program Provide comprehensive primary care services to low income, uninsured, underserved, and otherwise vulnerable populations Conduct outreach and education in service area Facilitate access to full range of needed medical (inc. OB), behavioral health, and dental services Provide case management services that link target population to needed social services

Federally Qualified Health Center (330 - Eligibility Requirements) New Access Point applications must: –Demonstrate that target population will have access to required primary, preventive, enabling, and supplemental services without regard to ability to pay –Demonstrate program will be operational and meet section 330 requirements within 120 days (e.g., governance, services provided, etc.) –Demonstrate how 330 funds will expand services and increase the number of people served

General primary medical care Diagnostic services (e.g., lab and x-ray) Prevention and screening services (e.g., cancer screening, chronic disease mgmt, immunizations, well child services) Voluntary family planning Gynecological care Prenatal, perinatal, and obstetrical services Preventive dental services Referrals to mental health, substance abuse, and medical specialty care Case management services Health education and outreach Other enabling services that help to ensure access (e.g., transportation and translation) Federally Qualified Health Center (Required Services)

Urgent medical care Dental services (e.g., restorative, emergency services) Mental health services (e.g., treatment/counseling, dev. Screening, crisis services) Substance abuse services Environmental health Occupational health Recuperative care Occupational and physical therapy HIV testing TB Therapy Podiatry Federally Qualified Health Center (Optional Services)

Benefits of FQHCs Enhanced Medicaid and Medicare reimbursement $650,000 base funding annually to offset service to the uninsured/under-insured Eligible for 340B Drug pricing program Eligible to apply for malpractice coverage under FTCA (Federal Tort Claim Act – Malpractice Insurance.) Covered by the anti-kickback safe harbor Eligible to apply for expansion grants to provide dental and behavioral health services Eligible for other special funding (e.g. HIT, stimulus capital funds)

Profile of Typical NAP-FQHC Patients and Encounters –4,000 – 4,500 new patients after two years –Encounters per year per patient (3-5 medical, 2-3 dental) Typical Payer Mix (major variation) – % Uninsured –30 – 50% Medicaid –7-10% Medicare –15-20% Private Revenue (major variation) –30% Grant and private support –70% Patient revenue

Elements of a Strong Application Service Area and Target Population –Must serve an MUA/MUP* and should serve a HPSA(s) –Need to serve large low income pop. Needs Assessment and Barriers to Access –Need to show major disease burden / health disparities –Need to articulate barriers to access and/or service gaps Community Collaboration and Planning –Must show good community collaboration and support –Must show major planning and assessment effort –Must show how proposed plan leverages community resources Governance and Readiness –Must be a 501(c)3 entity with an independent board made up of at least 51% consumers of care –Can be co-applicant with government entity –Must be ready within 90 days of award

Summary Description of Proposed Health Center SEE HANDOUT