HomeMy WebLinkAbout03112013 City Council Work Session Notes - CHC Priorities • -
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WORK SESSION NOTES ON
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• 3/11/2013
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2"iSEWARD
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. !, COMMUNITY HEALTH CENTER
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11111
" j l City Council W-orkaesaion
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i March 11,2013,5:30 pin
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COMMON ACRONYMS
OHRSA
•Health Resource and Services Administration I.t
•Division(DHHS)of the Department of Health and Human Services
OBPHC E`
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•Bureau of Primary Health Care(the Bureau) S'
t,
•Division of HRSA
OCHC
• Community Health Center
• Program of the BPHC !'l
•Also known as Section 330 or FQHC �:E
COMMON ACRONYMS(corrPD)
OFQHC
• Federally Qualified Health Center
• An organization that receives enhanced reimbursement
from Medicare and Medicaid(CHC,LAL,Tribal)
OLAL
• Look-ALike-entities that do not receive funding under I.
section 330 of the Public Health Service(PHS)Act,but
received enhanced reimbursement and operate I provide (�
services consistent with grant-fimded programs.
ONAP
• New Access Point !'
• An organization or site seeking CHC grant funding OF
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i 3/11/2013
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DESIRED OUTCOMES OF THIS WORIiSESSIO\
o Better understanding of the CHC model
o Identify questions/concerns to be
addressed
o Support of the CHC program by City
Council members
o Identification of action needed by the City
1 Council
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DISCUSSION POINTS �.
o Why a CHC?
o Seward CHC Accomplishments
o New Access Point Application
o Next Steps
o4ppendixInformation: Proggram
Requirements;Clinical &Financial
Measures ®i "
WHY A CHC?
o A need for increased access to healthcare has
been identified
o The CHC public-entity model allows the City to
exercise a level of oversight of the
program(consistent with home-rule
city obligations).
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• 3/11/2013
WHY A CHC?(coNTD)
o Expand Access to Primary Care,
especially to uninsured and underserved
o Improve efficiency
o Reduce cost to patients
o Increase collaboration of community providers
•
I F.
WHY A CHC? (corrrD)
o Ensure community involvement in governance �.
fF
o Bring$$into the community to assist in
meeting identified needs 'F
•Annual base grant funding >
• Future opportunities for dental and
behavioral health funding
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WHY NOW AND WHY US?
o Community Need!
o Planning Grant
o Application Cycle
o Public-Entity Model
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3/11/2013 '
BENEFITS OF A CHC
o Program has been in place since 1965
o Program has bi-p artisan support !`�
o Community Health Centers have been
identified as major players in the"Obama
Care"model14
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BENEFITS OF A CHC (CONTD) •(`
o Ongoing Grant funding "-\
• Up to$650,000 annually
• Steady funding source(program>45 years)
o Enhanced Medicaid/Medicare payments
o Medicare deductible costs waived
o Medical malpractice coverage through the
federal government
BENEFITS OF A CHC (coNTD)
o Voice thru consumer majority Board
o Provider loan repayment
o Educational scholarship programs for
providers
o Prescription drug discount of 20%-50%
• 3/11/2013
BENEFITS OF A CHC (cONTD)
o Grant pays for enabling services
(transportation,case management,etc.)
o Eligible for Federal funding and/or loan
opportunities
•Facility improvements
•Capital construction
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CHC LIMITATIONS
o Limitation on construction or major
capital expenditures
•Able to use up to$150,000 for
equipment or renovation during the 18L
year of funding
o CHC funds cannot be used for hospital
equipment or operations
•
SENVARD CHC ACCOMPLISHMENTS
o Board established and functioning
• Bylaws,policies&procedures
• Monthly meetings
• Board member training
• Mission/vision 1111X
o 501(c)3 statusr.die
o Professional.Memberships
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3/11/2013 -
SCHC ACCOMPLISHMENTS(cowl's)
o Provider outreach meetings held(3)
o Community education articles published
o Financial feasibility of"look-alike"
completed
o Clinical efficiency study/space assessment
in progress
GO
SCHC ACCOMPLISHMENTS(cowl's)
o Using outcomes of Providence-directed
Community Needs Assessment
•Validated need in the Community
• Identified priority Health Care needs
that can be addressed through the
CHC program
JJ
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SCHC ACCOMPLISHMENTS OnNTD)
o Providence Seward Medical Center has
made incremental changes in support ui
the CHC requirements. (i.e.)
• Hiring of Mid-Level Providers(NP /PA)
• Patient Centered Medical Home Model
• Discount Schedule
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3/11/2013
SCHC ACCOMPLISHMENTS(coNT'D)
o HRSA Planning grant awarded and
activities complete
o City funds($50,000)remain for start-up
o Ready to submit New Access Point grant
application no later than April 3,2013
THE MISSION OF SEWARD CHC
To identify and serve the
healthcare needs of our
community by providing
quality, affordable
services and promoting
wellness,prevention and
partnerships.
41111POTENTIAL AREAS OF COLLABORATION
IDENTIFIED BY COMMUNITY PROVIDERS
• Case management • Mental health
• Chronic illness • Obesity
management • Independent living
(Diabetes, partnership
Hypertension,etc) • Pain management
• Dental • Post-partum depression
• Enrollment Assistance screeningsdnterventions
for Medicare& • Resources and referrals
Medicaid
• Integrated charts/ • School-based services
Electronic Records • Stress management
• Health Education • Transportation
• Lab services
3/11/2013 '
NEXT STEPS
! o CHC/City of Seward infrastructure
• City Council recommendation on Finance and
Personnel—need to know model for the grant
• Co-Applicant Agreement in place prior to grant
application
o Affiliation Agreements with providers
(i.e.dental,mental health,ancillary services,tribal,hospital)
o Submit New Access Point grant application
NEXT STEPS (Couto)
{ o Completion of clinic efficiency and space
utilization analysis .
o Provider outreach and education
o Meetings with PSMC staff
NEXT STEPS (conro) • 0
o Town hall meetings/education 1i
{
o Continued Board development&Strategic
Planning
o City,CHC&Providence meetings re:staffing,
cost comparisons,efficiency issues
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• 3/11/2013
NEXT STEPS(CONT D)
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o Prepare for funding announcement
• Expected September 2013
• 120 days to be operational
• CEO Recruitment
• Transition Plan development
•Visit other Alaska CHCs
o Consider Look-Alike application
NEW ACCESS POINT APPLICATION
o Deadline for submission: April 3
o Anticipated announcement of awards:
September 2013
o Nationwide,competitive process
oCurrent funding for approx.25 new health
centers=$19 million dollars
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PROPOSED OSED MODEL
Responable EE
for
Retves
H.. opts-tone HRSA
Exec.Ivo ofclinic funding
Enrectce Rm.
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Seward CFI(
Board ...n2c., City of Seward
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3/11/2013
CITY COUNCIL INPUT NEEDED
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o March 18,2013
Recommendations needed for grant application:
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• Does the City want to retain Finance and/or Personnel
oversight and responsibility?
• Who will employ staff of the Center?City or CHC?
• Is the City willing to process financial transactions for the I
CHC (i.e.payroll and accounts payable)?
• Can the City cover startup costs? ®,
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CITY COUNCIL INPUT NI:l:D i•:u nr:r r)
o March 31,2013
Action Needed:
• The CHC application needs to include documentation
that clinic space will be available.
• Is the City able to offer the CHC a lease?
At a nominal rate?
• Can a draft agreement be in place by the end of this
month?
RECAP OF DESIRED OUTCONIES
OF THIS WORKSESSION:
o Better understanding of the CHC model
o Identify questions/concerns to be I
addressed
o Support of the CHC program by City I
Council members
o Identific4p of action needed by the City
Council
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3/11/2013
END
SEWARD CHC BOARD MEMBERS
o Patty Beals,President o Lois Daubney
o Maya Moriarty,VP o Kris Erchinger
o Marianna Keil,Sec o Shane Hand
o Dick Cruse,Treasurer o Stacy Lane
o Jean Bardarson o Dave Norcross
o Keith Campbell o Dave Paperman
o Mike Craytor
RESOURCES
o Health Resources&Services Administration:
http://bphc.hrsa.gov/
i o National Assoc.of Community Health Centers:
www.nachc.org
o Alaska Primary Care Association
www.alaskapca.org
o NorthWest Regional Primary Care Association
www.nwrpca.org
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3/11/2013
19 CORE PROGRAM REQUIREMENTS
1. Needs assessment
2. Primary,preventive,enabling health services
provided directly or through written
arrangements
s. Core staff licensed,credentialed,and privileged
Accessible hours of operation/locations
5 After hours coverage
Hospital admit privileges and continuum of care
Sliding fee discount
s Quality improvement/assurance plan
19 CORE PROGRAM REQUIREMENTS
9. Key management staff
io. Contractual/affiliation agreements
ii. Collaborative relationships
12 Financial management and control policies
13. Billing and collections
14. Budget
15 Program data reporting systems
e. CHC maintains its funded Scope of project
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19 CORE PROGRAM REQUIREMENTS
17 Board authority
(monthly meetings,approval of budget,CEO
hire/fire,services and hours of operations,
measure and evaluate progress,policies)
ia. Board composition
(9-25 members;representative of community;
more than 50%consumers of CHC services;
expertise;represent demographic diversity)
19 Conflict of interest policy
(no board member shall be employee or
immediate family member of employee of411.
health center)
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3/11/2013
SEWARD CHC ACCOUNTABILITY— `{a
CLINICAL MEASURES f'Ei
E1
o Clinical Measures:
eq
•Prenatal care in first trimester ii
• Childhood immunizations i's1
• Cervical cancer screening(pap)for women I E
• Body mass index(screening,counseling) ,i
•Tobacco use screening&follow-up 4'`
•Asthma control ,4
•Lipid therapy for coronary artery disease
i
•Aspirin therapy for ischemic vascular
1 disease IP ,,
• Colorectal cancer screening Es
1
SEWARD CHC ACCOUNTABILITY—
CLINICAL MEASURES
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o Clinical Measures-Health Outcomes/Disparities
•Diabetic patients HbAlc levels
•Blood pressure control for patients with
hypertension
•Percentage low weight births to health center
patients
o Additional measures:
ol behavioral health
ol oral health
41)
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SEWARD CHC ACCOUNTABILITY—
FINANCIAL MEASURES
o Financial Viability/Costs
•Total cost per patient
•Medical cost per medical visit
• Change in net assets to expense ratio
• Working capital to monthly expense ratio
• Long term debt to equity ratio
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3/11/2013
ALASKA CHC ORGANIZATIONS
o Alaska Island o Bristol Bay Area
Community Health Health Corporation
Services(Wrangell) o Bristol Bay Borough
o Aleutian/Pribilof (Naknek)
Islands Assoc o Council of Athabascan
o Anchorage Tribal Governments
Neighborhood Health (Ft.Yukon)
Center o Crossroads Medical
o Bethel Family Clinic Center(Glenallen)
S
ALASKA CHC ORGANIZATIONS
o Eastern Aleutian o Manillaq Association
Tribes (Kotzebue)
o Iliuliuk Family& o Mat-Su Health
Health Services Services
(Unalaska/Dutch o Native Village of Eyak
Harbor) (Cordova)
o Interior Community o Norton Sound Health
Health Center Corporation
(Fairbanks&Healy) o Peninsula Community
o Kodiak Community Health Centers
Health Center (Soldotna)
ALASKA CHC ORGANIZATIONS
o Seldovia Village o Sunshine Community
Tribes(Homer) Health Center
o City of Skagway (Talkeetna)
o SouthCentral o Tanana Chiefs
Foundation Conference
o Southeast Alaska o Yakutat Tlinglit Tribe
Regional Health o Yukon Kuskokwim
Consortium Health Corporation
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2102-2103 MID-YEAR BUDGET POLICY WORK SESSIONs,
DRAFT SCHEDULE
Infrastructure replacement/Infrastructure replacement plan: Capital requirements and Funding
Strategies
• WORK SESSION 1
o Electrical
■ Lines and poles
o Electric Rates
• WORK SESSION 2
o Water and Sewer Infrastructure
o Water and Sewer rates
Admin will provide previous critical, high risk, and moderate capital project lists, rate studies or
projections, and depreciation schedules
• WORK SESSION 3
o General Fund Long range financial planning
o SCLM bond repayment strategy
• WORK SESSION 4
o FEED (Front End Engineering and Development) strategies for extending utilities to
undeveloped lots/subdivisions
• WORK SESSION 5
o Animal Control Service Area
• Main Office(907)224-4050
CITY OF SEWARD t Police(907)224-3338
• Harbor(907)224-3138
P.O. Box 167 • Fire(907)224-3445
410 Adams Street y • City Clerk (907)224-4046
Seward,Alaska 996640167 • Community Development(907) 224-4049
• • Utilities (907)224-4050
• Fax (907) 224-4038
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March
March 11,2013
Honorable Representatives Seaton,Kawasaki and Thompson, and Members of the Finance Committee,
2013 is shaping up to be a record year for the Pick-Click-Give program.Nearly 20,000 Alaskans have
contributed almost$2 million for food and shelter for fellow Alaskans,aided families affected by
domestic violence,rescued animals and many other causes.The program truly does make small gifts
large,yet some small organizations that can provide meaningful local services are at present ineligible.
Currently, organizations with a total budget of$250,000 or more are required to file an audited financial
statement to be eligible,which in many cases would cost more than the donations they might receive
through the Pick-Click-Give program.
Accountability can be maintained,and a broader choice of organizations to support can be presented to
Permanent Fund recipients by adopting HB-75.This bill would allow smaller organizations: those with
more than$250,000 total budget but receiving less than$500,000 in Federal finding,to substitute the
already required IRS Form-990 for the audit requirement.This is a form anyone can access to determine
if the organization meets not only the Federal requirements for non-profits,but their own personal
standards as well.
The City of Seward supports the goal of enabling the Pick-Click-Give program to allow smaller deserving
organizations providing important services at the local level to participate.We appreciate your bringing
this bill forward,believe it to be in the best interests of the State, and urge adoption by the Legislature.
Sincerely,
Day'0,
Ma o
• J
/.41kes
(Aid b/rj
—"ilDENCE
Seward
Medical&Care Center
Providence Seward Medical and Care Center
2012 Year End Report
City of Seward - City Council
March 11,2013
•,. r x-ate >c �.
-`/IDENCE
Table of Contents Medical&Care Center
• Executive Summary
• Community Health Needs Assessment Survey
• Quality Measures
• Patient Experience
• Financial Performance / Census
• Employee Engagement
• Community Benefit
• 2013 - 2015 Priorities
1
C"IDENCE
Executive "'IKSeward
Dear Seward City Council Members,Mayor and City Manager:
Medical&Care Center
Summary I am proud to report that Providence Seward Medical and Care Center(PSMCC)
had a strong operating year in 2012. Dedicated PSMCC staff and providers
worked hard to provide exceptional care and service to individuals and families
in our community.There have been many successes this year around Quality,
Patient/Elder Experience and Financial Performance.
Within our successes,we have identified areas for continued improvement to
ensure we provide excellent care and experience every day,for every patient/
elder we serve.Furthermore,changes in regulatory standards and
reimbursement rates will challenge us to look for ways to strategize,and
collaborate with others to ensure long term sustainability of healthcare services
in the community.
As we move forward in 2013,improving our internal processes,ensuring staff
and physicians have the training and resources to provide the best service and
patient/elder experience and strengthening our partnerships withinthe
community will be key to our success.
Contained in this report is a summary of some of our successes,challenges and
strategies to ensure we carry on the heritage of the Sisters of Providence and
our continued partnership with the City of Seward to ensure we serve our
community to the best of our ability,always seeking dinical,service and
operational excellence.
On behalf of the PSMCC Team,thank you for your continued support and we
look forward to continuing our service to you and the community.
Sincerely,
Joseph Fong
Administrator
2
t PRO"IDENCE
Community Health Seward
Medical&Care Center
Needs Assessment Survey
• Community Health Needs Assessment
completed
— Over 750 participants (300 in 2008)
• Prioritized top 4 priorities
— Preventative Care
— Overweight / lack of physical activity
— Alcohol / substance abuse
— Lack of access to care
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2
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4 -"'"IDENCE
Quality Measures Seward
Medical&Care Center
Seward Mountain Haven
Falls/1000 elder days
Jan-Dec 2012
14.00
12.00
10.00
8.00
6.00
A
4.00 /
2.00
0.00
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec
4
EPP "-""IDENCE
Quality Measures Seward
Medical&Care Center
Hospital Acquired Infections
Jan - Dec 2012
L
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Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
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"'-"'`'IDENCE
Patient Experience Mdaical&Care Center
Overall Patient Experience 96% 94.2% 92.0
Likelihood to Recommend 91.1% 88.0%
• Positive comments:
— "The clinic provides a vital service to our community. The kindness of
staff is a comfort when a person is ill."
— "Dr. was great-funny,friendly, put me at ease, listened to my
concerns. Thank you!"
• Opportunities:
- "It would nice if there was another option besides the ER on weekends
or after hours."
— "Less time waiting... more communication why running late."
6
"-"" IDENCE
Seward
Medical&Care Center
Financial Performance / Census
2012 2012 2011
Actual Budget Actual
Total Revenue $18.11 $17.12 $17.2M
Total Expense $16.34 $15.36 $17.7M
Net Income $2.38M $2.33M $0.15M
Charity Care / Bad Debt $0.92M $1 .42M $1 .34M
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4
--'1,IDENCE
Seward
Medical&Care Center
Financial Performance / Census
2012 2012 2011
Actual Budget Actual
Inpatient Days 247 245 239
Swing bed days 499 450 569
LTC days 12,444 13,176 11 ,723
(ADC=Average Daily Census) (34.0 ADC) (36.0 ADC) (32.1 ADC)
ER visits 2,457 2,664 2,614
Clinic visits 4,580 5,819 5,986
Outpatient visits 23,163 23,126 23,348
Therapy visits 12,440 12,212 12,516
8
.L IDENCE
Employee Engagement Seward
Medical&Care Center
Employee Satisfaction Survey
IVO.
70%
60'i•
50'x.
2010
2011
•2012
za•:.
10%
Recommend Supervisor t.ty Work I get the limning I
Providence as a Responds to Supports the need to do my
Creat Place to Feedback from Mission work
Work Employees 9
5
;' "IDENCE
Community Benefit rd
M dical&Care Center
• Over 1800 community volunteer hours
• "Table of the King" event
— Over 301bs of non-perishable food and over $90
donated to He Will Provide Food Bank
• Angel Tree
— Staff provided almost $800 in gifts for adopted
families
• Mount Marathon Race
— Approx 50 volunteer hours
10
11. "IDENCE
Community Benefit Seward
Medical&Care Center
• Seward Wellness For All
— Approx $62,000 in-kind services and labor
• On Demand Labs
— Over $11 ,000
• Over $300K in Charity Care
— Includes Sliding Fee Schedule benefits
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6
E PP "'"`"1DENCE
2013 - 2015 Priorities Seward
Medical&Care Center
• Improve Clinic performance
— Greater access (walk-in appointments, extended and
weekend hours)
— Optimize staffing and scheduling
— Adopt best practice to achieve excellent outcomes
and patient experience / satisfaction
12
E PP --"IDENCE
2013 - 2015 Priorities Seward
Medical&Care Center
• Distinguish Seward Mountain Haven as LTC
facility of choice for Alaskan Elders
— Perfect Green Home care model
— Further develop referral network throughout Alaska
13
7
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.P "IDENCE
2013 2015 Priorities rd
M dical&Care Center
• Further develop emergency preparedness
— Formalize partnerships to ensure business continuity
in the event of a natural disaster
— Further develop staff preparedness to respond to a
variety of situations
14
* nan`"IDENCE
2013 - 2015 Priorities Mdacal&Care Center
• Continue partnerships and support of:
— Seward Wellness for All — promotion of community
health and wellness
— Seward Prevention Coalition — to decrease under
aged alcohol and substance abuse
— Seward CHC Board — to further serve under and un
insured through a Federally Qualified Health Center
15
8
4
J^ *"1DENCE
Thank you
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