1. WIDESCREEN PRESENTATION Tips and tools for creating and presenting wide format slides COMMUNITY HEALTH CENTERS IN HAWAI‘I Legislative Briefing – April 7, 2010 BETH GIESTING, HAWAI‘I PRIMARY CARE ASSOCIATION

2.  Federally-recognized  Non-profit  Underserved communities  Vulnerable populations  Community governed OVERVIEW

3. DEMOGRAPHICS MEDICAID (47%) UNINSURED (24%) PRIVATE (22%) MEDICARE (7%) Coverage

4. DEMOGRAPHICS RURAL (71%) URBAN (29%) Location

5. DEMOGRAPHICS NATIVE HAWAIIAN (27%) CAUCASIAN (25%) ASIAN (18%) PACIFIC ISLANDER (17%) OTHER (13%) Ethnicity

6. DEMOGRAPHICS 84 % 200% Federal Poverty Level

7. DEMOGRAPHICS 84% Poverty NATIVE HAWAIIAN (27%) CAUCASIAN (25%) ASIAN (18%) PACIFIC ISLANDER (17%) OTHER (13%) RURAL (71%) URBAN (29%) MEDICAID (47%) UNINSURED (24%) PRIVATE (22%) MEDICARE (7%)

8. TRENDS Patients +10%

9. TRENDS Medicaid Patients +26%

10. TRENDS Mental Health +46%

11. TRENDS Homeless +7% Rural Oahu: +29%

12. TRENDS Homeless +7% Rural Oahu: +29% Mental Health +46% Medicaid +26 %

13.  Poor Economy  Uninsured Population  Increased Demand for Services  Fragmented System  Potential Medicaid Surge (HCR) ENVIRONMENT

14.  AMHD decimated  COFA benefit reduction  Eligibility worker cuts  Payment lag  Proposed Cuts to Med-QUEST Benefits  Mass DHS Layoffs STATE RESPONSE

15. SYSTEM IN CRISIS Need Support

16.  Focus on Quality, Cost, Information Technology  CHCs as Medical Homes  Medicaid Modernization & Health Care Reform TRANSFORMATION

17.  Principles  Cost Effectiveness  Quality Dividends PATIENT-CENTERED MEDICAL HOME

18.  National priority  Improved outcomes  Legislative initiatives PCMH IN PRACTICE

19.  Quality Culture  Evidence-Based Care  Comprehensive, Integrated Services  Partnerships CHCs AS MEDICAL HOMES

20. HAWAI‘I MEDICAL HOME PILOTS AlohaCare Hawai‘i Primary Care Association Kalihi-Palama Health Center Waimanalo Health Center West Hawai‘i Community Health Center Waianae Coast Comprehensive Health Center HMSA UHA

21.  Essential to meet future demand  Innovation to transform safety net  Proving ground for entire system LONG TERM SOLUTIONS

22. MEDICAID  CHCs are proven innovators  Savings from CHCs: $64.5 million  Proposed cuts disproportionately affect health centers

23. MED-QUEST MODERNIZATION  Projected deficit: $160m  Innovation versus Cuts  Medical home incentives (90% FMAP)

24.  CHCs are essential  System transformation  Partnerships  Policy support SUMMARY

25. WIDESCREEN PRESENTATION Tips and tools for creating and presenting wide format slides COMMUNITY HEALTH CENTERS IN HAWAI‘I Legislative Briefing – April 7, 2010 BETH GIESTING, HAWAI‘I PRIMARY CARE ASSOCIATION