1. Mauda Monger, MPH Delta Region AIDS Education Training Center 2012 Faculty Development Conference LPS Coordinator- Mississippi

2. History of CHCs in the United States Community Health Center defined and types of CHCS Building collaborations and trainings with Community Health Centers

3. First clinics opened in 1965, Boston and 1967 in Mount Bayou, MS (neighborhood clinics) Were developed to provide health and social services access points in poor and medically underserved communities and to promote community empowerment Health Centers Consolidation Act of 1996 – Public Service Act (330 funds)

4. Health centers are community-based and patient-directed organizations that serve populations with limited access to health care.

5. Located in or serve a high need community (designated Medically Underserved Area or Population). Governed by a community board composed of a majority (51% or more) of health center patients who represent the population served. Provide comprehensive primary health care services as well as supportive services (education, translation and transportation, etc.) that promote access to health care. Provide services available to all with fees adjusted based on ability to pay. Meet other performance and accountability requirements regarding administrative, clinical, and financial operations.

6. Community Health Center or Health Center: An outpatient clinic that receives grant funds from the federal government through §330 of the Public Health Service Act (PHSA). Look-alike: An outpatient clinic that meets all requirements to receive §330 grant funds but does not actually receive a grant.

7. Rural Health Clinic: An outpatient clinic that may be for profit, is located in a rural HPSA or MUA, and uses nurse practitioners and physician assistants to provide the majority of care. Tribal or Urban Indian FQHC: An outpatient clinic or program operated by a tribe or tribal organization or by an urban Indian organization.

8. Low income Minorities Elderly Young people (16-25) Children

10. Growth in Uninsured: Continue to be Largest Group of Health Center Patients Decline in Charity Care: Cutbacks by Private Providers Squeezed by Managed Care Loss of Medicaid and Other Public Funding: Severe Deficit Reduction Cuts by States & now Congress Changing Nature of Insurance Coverage: Growing Shift to Catastrophic/High-Deductible Plans that Cover Little or no Preventive/Primary Care Shortage of Primary Care Physicians:Growing Demand and Lack of Appeal to U.S. Medical Students is Already Causing Physician Vacancy Rates in Health Centers

11. Need 1,843 primary care providers, inclusive of physicians, nurse practitioners, physician assistants, and certified nurse midwives. 1,384 nurses short. To reach 30 million patients by 2015, health centers need at least an additional 15,585 primary care providers Health centers also will need another 11,553 to 14,397 nurses. Health Center Workforce ShortagesSource: NACHC, Robert Graham Center, and The George Washington University School of Public Health and Health Services, Access Transformed: Building A Primary Care Workforce For The 21stCentury, August 2008, www.nachc.com/research.

12. Starting Points Develop a plan What is it we want from the CHCs? How are we willing to support them in their efforts? Learn the role and history of CHCs in your state Make a connections within the health care organizations that support and or govern the community health centers in your state

13. Establishing relationship with governing bodies (MPHCA) May take a long period of time Attend all functions( meetings, trainings, & conferences) Understand the dynamics Connect with the board, medical directors and lead persons of clinics

14. Get educated about HIV/AIDS epi in the state Provide a safe environment for their community to get information on HIV/AIDS Offer HIV screening as a part of routine care Provide information on HIV/AIDS prevention and modes of transmission ULTIMATELY..provide primary HIV care

15. Provide training (onsite and offsite) Provide resources and links to resources Provide effective and efficient consultation options Be a source of technical assistance

16. Number of Organizations 21 Number of Delivery Sites 188 Total Patients 314,612 Number Seasonal Farmworker Patients 999 Number Homeless Patients 7,455

17. Health Center Population At or Below 100% of Poverty 72% Under 200% of Poverty 94% Uninsured 43% Medicaid 30% Medicare 9% Hispanic/Latino 3% African American 65% Asian/Pacific Islander 1% White 34% Rural 71%

18. Should be done in person Should be direct and concise Use the background data to have a realistic conversation Demonstrate the true capability of your AETC, dont oversale what you are able to do

19. Specialized for community health centers Timing Information Culturally competent Patients Providers Informative, but not overwhelming Should be flexible May be after your normal hrs

20. Make them a priority Assign someone to be their liaison Continued offering of new trainings and information for all levels of staff Annual needs assessments

21. Finding connections Answering the push-back Ensuring that we have the resources they will need once we get them onboard Specialized attention

22. Long process Requires a plan before the first meeting Expect difficulty in getting changes/updates in place They will have a major role in the Affordable Care Act,