ETSU COLLEGE OF NURSING NURSE-MANAGED CLINICS January 2015

Community-Based Clinics Hancock County Elementary School CHC Johnson City Community Health Center Mountain City Extended Hours Health Center Johnson City Day Center Hancock County Middle High CHC Johnson City Partners for Health

School-Based Clinics Jonesboro Elementary School Northeast State Community College University School Daniel Boone HS David Crockett High School ETSU Student/University Health

Mission ” To optimize health and reduce health disparities through the provision of innovative and high quality care and services in partnership with our patients, communities, and regional health and services agencies." ETSU College of Nursing

Vision “Our vision is two-fold: To deliver world-class quality health care that is accessible, affordable, and outcome driven and to provide students with the best interprofessional clinical experience that is nationally renowned.”

VALUES STATEMENTS East Tennessee State University pursues its mission through a student-centered community of learning reflecting high standards and promoting a balance of liberal arts and professional preparation, continuous improvement, and based upon core values. The College of Nursing faculty and staff will support and exhibit the university’s core values as follows: PEOPLE come first, are treated with dignity and respect, and are encouraged to achieve their full potential; RELATIONSHIPS are built on honesty, integrity and trust; DIVERSITY of people and thought is respected; EXCELLENCE is achieved through teamwork, leadership, creativity, and a strong work ethic; EFFICIENCY is achieved through wise use of human and financial resources; and COMMITMENT to intellectual achievement is embraced.

ETSU College of Nursing Nurse-Managed Clinics – Johnson City Downtown Clinic (Designated Community Health Center) Johnson City Day Center Johnson City Downtown Clinic/Johnson City Public Housing Authority Clinic (JCDC/JCHA Clinic) – Hancock County School-Based Clinics-Sneedville, TN (Designated Community Health Center) Elementary Middle/High Combined School – Mountain City Extended Hours Health Center, Mountain City, TN (Designated Rural Health Center) – Washington County School-Based Clinics Jonesborough Elementary David Crockett High School Daniel Boone High School – ETSU Student/University Health ETSU College of Nursing

In the beginning…

History Initial mission – Service for the homeless-basement of Salvation Army (Johnson City)-1990 – Service for those who lost health care providers and hospital (Mountain City)-1990 Expansion-Underserved – Washington County School Contract-1992 Expansion of services to 6 schools in 2014 – Service as a collaborative in Hancock County-1992 – ETSU Student Health – Johnson City Public Housing January 2011 – University School 2014 – Northeast State Community College 2014 ETSU College of Nursing

CO-APPLICANT AGREEMENT The Governing Board (herein known as the "Board”) of the ETSU College of Nursing Community Health Centers and the College of Nursing (CON) at East Tennessee State University (ETSU) herewith agree to provide for comprehensive primary care services to be delivered through the ETSU College of Nursing Community Health Centers and do make co- application that the associated clinics be operated as Federally Qualified Health Centers under the provisions of the Public Health Services Act Section 330.

HRSA Key requirements There are 19 key requirements, with # 18 - Board Composition: The health center governing board is composed of individuals, a majority of whom are being served by the center and, who as a group, represent the individuals being served by the center.

Johnson County Community Health Center (Includes Johnson City Partners for Health Clinic)

Day Center Visits

Hancock County School-Based Health Centers Encounters FY 05-FY 08 inclusive of nursing and NP visits

Mountain City Extended Hours Health Center Encounters

Washington County School-Based Health Centers Encounters

Student Health Clinic Visits

Total Encounters per Clinic

291,562 Total Clinic Encounters FY

Community health center funding 15 years of continued support from Health Services and Resource Administration, Bureau of Primary Health Care

Community Health Center Funding

CHC Poverty Status

CHC Insurance Status

PAP Smears

Hypertension Control B/P <140/90

Diabetic Management Hemoglobin A1C <9 mg/dl

Immunization 2 yr Olds *2012 measurement indicator changed

Prenatal Care First Trimester RN Case manager left

Quality of Care: Low & Very Low Birth Weight Babies 31 * Very Low Birth Weight-Measure Changed 2009 to include very low and low combined

FY Accomplishments Finished FY in the black across all clinics Dr. Lisa Ousley published dermatology handbook Quality indicators from the United Data System report that continue to be better than the state and the nation across most measures (low birth weight babies, B/P control, immunizations, and cost of care) Transitioned of Dispensary of Hope to JCCHC-ETSU Charity Pharmacy 9 Interprofessional collaboration in practice, research, and grant applications. 1 Approved but not funded. 1 not funded and 2 pending 2 poster presentations-Dr. Vanhook; 90 minute podium presentation-Dr. Ousley Practice network grew by 2 clinic sites 11 Practice research/capstone projects completed or in progress at our clinics Clinical coordinator for students established for each site

FY Grants Grant Applications: 1/24/2014 HRSA NEPQR, $1,499,856 (Nurse Education, Practice, Quality, & Retention-approved but not funded) 2/05/2014 HRSA H80CS00840 $1,226,018 (Community Health Center) Funded 6/22/2014 HRSA Expanded Medical Capacity $203,305 (NP, LCSW, RN) Funded 4/30/2014 HRSA Facilities Improvement Grant $250,000 (Mammography equipment/patient portal) Funded 4/10/2014 HRSA Behavioral Health Integration Grant $250,000/yr. for 2 yrs. Not funded 9/22/2014 Walgreens/American Cancer Society Colorectal Cancer Screening Grant $50,000 11/2014 for 1 year Funded 10/06/2014 HRSA New Access Point-School-Based Health (submitted) 11/14/2014 HRSA Rural Healthcare Services Outreach (submitted) 11/24/2014 National Nursing Centers Consortium Medical-Legal Partnership Foundation grant $50, months Funded

Goals Level 3 Patient-Centered Medical Home Increase NP productivity across all clinics Develop new programs to generate revenue to support the mission- health care for female inmates, Develop infrastructure for comparative effectiveness research Quality outcome core measures at or better than state metrics Publications from each clinic type Interprofessional research Integrate technology in patient care and interprofessional education Excellence in patient outcomes and student success!

Contacts for Each Site Johnson City Community Health Center/Day Center & Public Housing Clinic – Gina Flack Mountain City Extended Hours Health Center – Shelia Cooke Hancock County School-Based Health Centers – Nancy Seal Student/University Health & Washington Co. School-Based Health Centers – Pam Williams