1. Healthy Communities Access Program Public Health Institutes: A New Way of Doing Business May 20-21, 2004 Presented By Susan Lumsden Cephas Goldman, D.D.S., M.B.A. U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Primary Health Care

2. 2 Overview Bureau of Primary Health Care President’s Initiative Healthy Communities Access Program

3. 3 Office of the Bureau Director Bureau of Primary Health Care Office of Policy, Evaluation& Data Division of Immigration Health Services Division of Health Center Development Division of State and Community Assistance Division of Clinical Quality Division of Health Center Management Office of Minority and Special Populations Division of National Hansen’s Disease Program -Expand: Increase the # primary care access points, people served, and services provided -Strengthen: Increase clinical, managerial and financial efficiency -Improve Quality: Improve quality of care for patients and families

4. 4 The President’s Health Center Initiative Goal: To strengthen the health care safety net for those most in need (FY 2002-2006) Performance Measures: 1200 new/expanded health center access points Serve an additional 6 million people Maintain commitment to community-based programs

5. 5 Three Essential Areas Managing quality improvement Strengthening existing health centers Managing the growth of new and expanded health centers

6. 6 President’s Initiative to Expand Health Centers President’s Initiative to Expand Health Centers 130 90 80 61 63 176 156 145 125 0 20 40 60 80 100 120 140 160 180 200 NAPEMCNAPEMCNAPEMCNAPEMCNAPEMC FY 2002FY 2003FY 2004FY 2005FY 2006 ProjectedActual 171 131 100 87

7. 7 New Users Projected Within Initiative

8. Healthy Communities Access Program (HCAP)

9. 9 Provides assistance to communities and consortia of health care providers and others, to develop or strengthen integrated community health care delivery systems Coordinates health care services for individuals who are uninsured or underinsured Develops or strengthens activities related to providing coordinated care for individuals with chronic conditions who are uninsured or underinsured

10. 10 Basic Eligibility Requirements For an entity to be eligible to receive an HCAP award, the following requirements must be met: 1.The applicant entity must represent a consortium whose principal purpose is to provide a broad range of coordinated health care services to their defined community’s uninsured and underinsured populations.

11. 11 Basic Eligibility Requirements (Continued) 2.The community-wide consortium represented by the applicant entity must include at least one of each of the following providers that serve the stated community, unless such provider does not exist, declines or refuses to participate, or places unreasonable conditions on its participation: A Federally qualified health center A hospital with a low-income utilization rate, that is greater than 25 percent A public health department An interested public or private sector health care provider or an organization that has traditionally served the medically uninsured and underserved

12. 12 HCAP Expectations The coordination of services through the HCAP grant will allow the uninsured and underinsured to gain entry into and receive services from a more efficient, comprehensive and higher quality system of care, regardless of ability to pay. The infrastructure development supported by HCAP will result in a health care delivery system characterized by effective collaboration, information sharing, and clinical and financial coordination among providers and organizations in the community. HCAP funds should not supplant or replace existing Federal categorical programs that support entities providing services to low-income populations in the community, but instead build on these resources in an effort to expand and improve the quality of services for more individuals at a lower cost.

13. 13 HCAP: Outcomes Community assets and HRSA programs are integrated at the community level Capacity of existing safety net providers is coordinated and enhanced Collaboration and community linkages are strengthened Gaps or duplication in services for the uninsured and underinsured are eliminated Resources are leveraged

14. 14 HCAP: Outcomes (Continued) FY 2000: $25 Million to support the first 23 CAP communities To date, Communities Access Program & HCAP have supported 193 grantee communities in 44 states and the District of Columbia

15. 15 HCAP Grantees

16. 16 Service Area Type Reported by FY 03 HCAP Grantees: 40% urban 31% rural 29% serving blended rural, urban, tribal and other communities

17. 17 Consortia Represent a Broad Array of Community Stakeholders 73% are Federally Qualified Health Centers 72% are Local Health Departments 59% are Community Based Social Service Organizations 57% are Private Hospitals 54% are Local Government 51% are Other Community Health Centers 53% are Public Hospitals 40% are Faith Based Organizations 39% are Mental Health Programs 35% are Private Providers & Group Practices

18. 18 HCAP GRANT FUNDS Grant funds may support justified direct expenses associated with achieving the greater integration of and/or to fill identified or documented gaps in the health care delivery system. Some examples of what costs grant funds may support are: Project staff salaries Management Information Systems (e.g.,hardware and software) Project-related travel and training Other direct expenses necessary for the integration of administrative, clinical, information system, or financial functions Program evaluation activities Case management and disease management activities that are not reimbursable services Outreach and health education activities

19. 19 HCAP: Leveraging Other Funding Sources Source % of Grantees Local Foundations21% State Government19% National Foundations14% Other Federal Sources13% Hospital Organizations12% County Government11%

20. 20 HCAP: Leveraging In-Kind Contributions Source% of Grantees Private Hospitals30% Federally Qualified Health Centers25% Local Health Departments24% Various Other sources20% Public Hospitals19% Private Provider/Group Practices 18%

21. 21 For More Information Bureau of Primary Health Care Division of State and Community Assistance 4350 East West Highway, 9 th Floor Bethesda, Maryland 20814 301-594-4488 301-480-7833 (FAX) BBailey@hrsa.gov Capcentraloffice@hrsa.gov