Loading...
HomeMy WebLinkAboutRes2010-109 Sponsored by: Oates CITY OF SEWARD, ALASKA RESOLUTION 2010 -109 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, GRANTING APPROVAL TO THE CITY MANAGER TO SUBMIT AN APPLICATION FOR FEDERAL FUNDING TO ESTABLISH A COMMUNITY HEALTH CENTER TO SERVE THE SEWARD COMMUNITY WHEREAS, a Seward Community Needs Assessment in 2008 provided a comprehensive view of health issues and a Seward Primary Care Feasibility Analysis in 2010 substantiated the need to make affordable primary health care available to the medically uninsured and underinsured population, and WHEREAS, the City must improve the efficiency of primary health care delivery and management; and WHEREAS, a Federally Qualified Health Center (FQHC) is also known as a Community Health Center; and WHEREAS, the Health Center Program is authorized by Section 330 of the Public Health Services Act and makes grants to private non -profit and public agencies to subsidize the cost of providing primary health services to the medically underserved: and WHEREAS, a Community Health Center supports implementation of the best practices from the Patient Centered Medical Home Model and better integration of the City health care delivery system; and WHEREAS, a Community Health Center allows higher reimbursement rates for Medicare and Medicaid patients; and WHEREAS, a Community Health Center makes medical school tuition reimbursement available to attract doctors; and WHEREAS, a Community Health Center is eligible for Federal Tort Claims Act medical malpractice coverage for health centers' officers, governing board members, employees, and certain practitioner contractors; and WHEREAS, HRSA encourages a Community Health Center to collaborate and contract with other community health providers to expand access to health care and reduce costs; and WHEREAS, a Community Health Center could operate, initially, from the site of the current City owned Family Care Clinic; and CITY OF SEWARD, ALASKA RESOLUTION 2010 -109 Page 2 of 3 ore WHEREAS, a Public Entity such as the City of Seward may establish a Community Health Center and receive Federal funding and grants for that Center: and WHEREAS, a Public Entity may meet the governance requirements with a "co- applicant board" if its own governing body does not meet the federal requirements: and WHEREAS, it is a core value of the health center program that service delivery be governed by service recipients; and WHEREAS, the Community Health Center would be governed by a "co- applicant" board of directors that is composed of individuals, a majority of whom are being served by the Center and who, as a group represent the Community of Seward; and WHEREAS, HRSA strongly prefers that the "co- applicant" board be incorporated as a separate non - profit entity; and WHEREAS, the Community Health Center would be owned and operated by the City of Seward and the "co- applicant" board; and WHEREAS, the City must delegate appropriate powers and authorities to the "co- applicant board; and WHEREAS, the "co- applicant" board's span of authority is limited to the approved scope of the center; and WHEREAS, the city and the "co- applicant" board will share a common focus on serving the patient population; and WHEREAS, the City would be responsible for assuring the Community Health Center operates in compliance with applicable Federal, State and Local laws and regulations; and WHEREAS, the City would retain responsibilities for financial management policy to include accountability for Center resources and developing the annual budget in concert with the "co- applicant" board of the Center; and WHEREAS, the City has significant operational and financial inefficiencies that preclude expanding primary care services and addressing health care deficiencies identified in the 2008 community needs assessment; and WHEREAS, the current system of primary health care in Seward is not sustainable and the inefficiencies threaten the sustainability of primary health care delivery; and CITY OF SEWARD, ALASKA RESOLUTION 2010 -109 Page 3 of 3 WHEREAS, a Community Health Center will help achieve improvement in the financial sustainability of the City's critical access hospital and make it possible to improve access to primary health care for the medically underserved population through Federal funding and grants; and WHEREAS, the Community Health Center program has been in existence and funded for nearly forty years by the Federal Government; and WHEREAS, passage of this resolution occurs through a public process. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, that: Section 1. The City Manager shall submit an application for Federal Funding to establish a Federally Qualified Community Health Center (Community Health Center). Section 2. The application to establish a Community Health Center shall be submitted to meet the phase I application deadline of November 15, 2010. Section 3. This resolution shall take effect immediately upon its adoption. PASSED AND APPROVED by the City Council of the City of Seward, Alaska, this 8 day of November, 2010. THE CIT . • SEWARD, ALASKA Willard E. 1 unham, Mayor AYES: Valdatta, Bardarson, Smith, Shafer, Keil, Casagranda, Dunham NOES: None ABSENT: None ABSTAIN: None ATTEST: /1 ) 4b 4 4 4 OF Sett:'. �9fi0 py :, Je Lewis, CM : : 6 e • 6/4,e��J� �,,. °? ;•, Ci Clerk `� •, • (City Seal) —�— L ® sEAL j • '•.,F OF AVr .` a Aaaaau 11 Council Agenda Statement V oF sew Meeting Date: November 8, 2010 .1 From: Phillip Oates, City Manager qCASKP Agenda Item: Application for Federal Funding of a Community Health Center BACKGROUND & JUSTIFICATION: In recent years the City of Seward has been active in evaluating and improving our City owned health system, including our community hospital, nursing home, and primary care clinic. In 2004 our hospital applied for and was designated a Critical Access Hospital. This change proved to be seamless to the public yet greatly improved the hospital's fmancial reimbursement rate. Another change included the transition from caring for our most vulnerable elders in an old institutional care center to our new Seward Mountain Haven Long Term Care Facility. It is the first "Green House" model of long term care in the State of Alaska. As expected with change, some adjustments have been difficult. In the end, however, the changes have made and continue to make our health care system more responsive and fmancially sustainable while improving the delivery of compassionate health care. More changes are necessary to continue this progress. In a City Council Work Session on October 27, 2010, a presentation and discussion portrayed the results of changes in the City owned health system and highlights of a comprehensive community health needs assessment. The assessment was an initiative in 2008 by Providence Health Systems Alaska (PHSA). Community input and data from the assessment highlighted areas of health needs in the community. As a result of that assessment, a Seward Primary Care Feasibility Analysis was conducted. The funding for the analysis came from a PHSA Community Benefit Strategic Investment (CBSI) grant from United Way Funding. Based on these many initiatives and other stakeholder input, the City of Seward has another opportunity to again make improvements to our health care delivery system. Proposed changes are necessary that would help accomplish the following objectives: (1) Reducing recurring annual Family Care Clinic losses (primary care); (2) Improving the efficiency of primary care delivery and management; (3) Enabling implementation of best practices from the Patient Centered Medical Home Model; (4) Allowing progression to a more integrated community health care delivery system; and (5) Implementation of HRSA recommended Critical Access Hospital and Community Health Center collaborative strategies which result in operational and fiscal benefits. Ensuring access to care is the right thing. In addition, it is also the best decision fiscally. Studies strongly document that when people receive appropriate and timely primary care, overall system and personal medical costs are significantly reduced. This resolution will allow the City Manager to apply for Health Center Funding to establish a Federally Qualified Health Center (FQHC). Such a Center is also known as a Community Health 4 5 Center. This initiative is necessary because the current model of primary health care in Seward is financially unsustainable, significant barriers exist to access care, and the needs of the uninsured or underinsured are not being met. There are many fmancial and other incentives for establishing a Community Health Center that include the following possibilities: (1) Making affordable primary health care available to a larger percentage of individuals who do not have health insurance or are under insured; (2) Achieving improvement in financial sustainability (compared to the Seward health care system losses of $2.5 million in 2009) and receiving additional Federal grants; (3) Obtaining higher reimbursement rates for Medicare and Medicaid patients; (4) Obtaining repayment of medical school tuition to attract doctors; (5) Obtaining Federal protection for malpractice exposure that would reduce the cost of malpractice insurance; and (6) Collaboration and contracting with other community health providers to expand access to health care and reduce costs. If the City of Seward establishes a Community Health Center, the primary care would be delivered from the location of the current Family Care Clinic. The Community Health Center would replace our existing health clinic. Greater access to health care would become possible by adding health care providers and making some appointments available on weekends and evenings. These changes would become possible as a result of greater profitability and Federal subsidies. Although Federal funding would also be available for constructing a new health center building, the City of Seward does not intend to pursue that option at this time. The Community Health Center would be governed by a "co- applicant" Board of Directors made up primarily of representative community members who use the Center for their primary care. The initial board members would be appointed by the City Council. The City would be responsible for assuring the Center operates in compliance with applicable Federal, State and Local laws and regulations. The City would also retain responsibilities for financial management policy to include accountability for Center resources and developing the annual budget in concert with the Chief Financial Officer of the Center. Subsequently the Community Health Center Board of Directors would approve the budget. In other words, there would be budget cooperation and collaboration between the two governing entities. If the City of Seward applies and is successful, the Community Health Center would be owned and operated by the City of Seward and the "co- applicant" board. Management of the clinic would be by the "co- applicant" board and the clinic director. If the City does not apply to become a Community Health Center a similar Center could be established by the Kenai Peninsula Borough, 501(c)(3) nonprofit organizations, or tribal organization. If an organization other than the City established a Community Health Center the community Critical Access Hospital could be put in the position of competing with an independent, potentially competitive Community Health Center.. The City hospital system could see a decline in patients and the loss of business in areas (such as lab and radiological services). The public entity and "co- applicant' arrangement best ensures a collaborative health care system that best serves the overall health care needs of the community. The Community Health Center program has been in existence and funded for nearly forty years by the Federal Government. Currently 72 Alaskan communities have Community Health Centers. For example, the communities of Soldotna, Kenai, Homer, and Valdez all have 4 Community Health Centers. The program has broad bi- partisan support. This year the Congress and President have approved 9.5 billion dollars to expand or establish Community Health Centers throughout the nation. A City Community Health Center will bring in up to $650,000 per year of recurring funding and greatly increase Federal/State reimbursement rates. It will also open a plethora of other medical care, provider and system opportunities. Most importantly, many more individuals in the greater Seward area will, for the first time, have ready access to good quality primary care regardless of their insurance status. Just as with the transition to a Critical Access Hospital, this change should appear seamless to the general public. INTENT: The intent of this resolution is to grant approval for the City Manger to submit an application for Federal funding to establish a City Community Health Center. CONSISTENCY CHECKLIST Where applicable, this resolution is consistent with guidance and directives in the Seward City Code, City Charter, Comprehensive Plans, Land Use Plans, Strategic Plan, and the City Council Rules of Procedures. FISCAL NOTE: Approved by Finance Department: ,960 44.eitt -� ATTORNEY REVIEW: Yes No X RECOMMENDATION Council approve Resolution 2010-05 granting approval for the City Manager to submit an application for Federal funding to establish a City Community Health Center 47