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SCHC Annual Report
Seward Community Health Center
2020 Annual report to City Council
(Thank God it's over)
January 25, 2021
The Seward Community Health Center (SCHC) is a 501 C3 organization that is a co -applicant with the City of
Seward for a Federal grant from HRSA — the Health Resources and Services Administration — that allows us to
operate our community's health center. The City and SCHC have a co -applicant agreement that requires us to
meet with the city coordinating committee on a quarterly basis. The Coordinating Committee includes the city
manager, council healthcare representative, Sharyl Seese, the SCHC board chair, and the SCHC Executive
Director.
This presentation is our presentation to the City Council per our co -applicant agreement.
Review of the year 2020:
0
?0
M
M
M
0
6/13/2020
Seward COVID cases a id 14day count
7/13/2020 8/13/2020 _`_- 2c:1 11/13/202-�
MIIIIN Z,:SiT'. e. _Ae1..;= _1 — 14-,!34. c-11
This does not include local cannery outbreaks.
12/1312020
M
EE
IE
IE
M
0
1/13/2021
2020 was a heck of a year and it proved challenging for our community and our local healthcare providers. SCHC
provided over 2,400 COVID tests and made over 1,300 follow-up calls to approximately 450 positive and
symptomatic patients. Our community had two major COVID spikes in 2020, but they are spikes, not plateaus,
because our community reacted and brought the number of active cases down quickly. We were able to recover
quickly because of the responsible actions taken by our community with voluntary closing of local businesses
over the busiest week of the summer, the masking mandates enacted by our City Council, the active reminders
from the Chamber, the testing support from the state, masks made by Spring creek and the Senior center and
testing supplies from the Sea -Life Center. This pooling of resources and cooperation of our local private
businesses, non-profit organizations, governmental agencies, and amazing individuals strengthened our
community which prevented a catastrophe in Seward, that many other small communities were unable to avoid.
One of the good things that came out of this pandemic is that we were able to clearly see that a strong
community that works together is a critical component to positive community health.
Financial:
SCHC YTD Total Provider Encounters and Unduplicated
Encounters
. M
5,000
Ln
v
= 4,000
0
LIJ
C
3,000
0
v
E 2,000
z
1,000
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
t2019 YTD Total
398
773
1,135
1,570
1,985
2,446
2,952
3,466
3,841
4,257
4,559
4,970
-0-2019 YTD Unduplicated
348
601
791
934
1,180
1,305
1,539
1,758
1,878
1,968
2,048
2,160
t2020 YTD Total
405
753
1,088
1,354
1,688
2,133
2,535
2,990
3,411
3,780
4,112
4,435
2020 YTD Unduplicated
380
540
709
823
951
1,187
1,268
1426
1,545
1,668
1,739
1,818
Volume: Our number of provider visits decreased by about 11% or 535 visits less than 2019. Our unduplicated
number of patients seeing providers decreased by 16% or 342 less patients than 2019, which is close to the
number on non-resident patients from prior years. We did see a 6% increase in the frequency of patient visits.
Revenues: Our YTD unaudited net patient revenues were 10% or 120,000 less than 2019. Due to reduced
patient visit volumes. Our total revenues are over 2019 total revenues by 11% or $620,000, due to increased
Federal COVID grants of $743,000.
Expenses: Year to date expenses were 15% or $462,379 higher than 2019 expenses, due to increased personnel
expenses.
Net Income: Our unaudited annual net Income for 2020 is a positive $273,000, compared to a 2019 profit of
$116,000. This is mostly due to the use of HRSA grants for COVID related salary and operating costs.
Cash: As of 12/31/2020 our cash balance was $634,000 in unrestricted cash or approximately 60 days of
available cash.
Patient Accounts Receivables: Patient receivables are in line with expectations at $244,000 or 45-days' worth of
revenue.
Net Assets: Net assets are approximately $1,186,000 compared to $912,000 in 2019. The current ratio which is a
measure of an organizations net worth is 2.8 with an expectation of at least 1.5.
3 .'_ 00
33.5'___'Z`00
33.... ,_00
5 2. 5 v,v00
s2.v v.v00
$1,50X,v00
$1,000,000
$500,000
SCHC Revenue by Sou~ce
2014 2015 2016 2017 2018 2019
■ City ■ Federal ■ Wet Pa^err' Reve-Le ■ 01er
HRSA — Health Resources and Services Administration: We are extremely grateful to HRSA for their ability to
provide our CHC with significant and flexible grant funding with directives to maintain staff and assist our
community in health -related needs through this pandemic, testing, mask purchases, on -going communication
about recommendations, and updates regarding pandemic issues.
Operational Site Visit — OSV — In order to stay compliant with HRSA we are subject to a once every three years
site visit. Of course, 2020 was our year for this review and it was conducted virtually in November, while our
COVID count was escalating. HRSA had three reviewers work with us virtually for three days, where they
review 93 areas of compliance, including interviewing our board members. We were found to be compliant in all
areas and were actually recommended to other CHC's as a resource.
Board Membership: Currently our board has 13 out of 15 seats filled. We also have 9 community members on
our various operating committees.
Building project — We have preliminary drawings, with a site plan and space requirements. Our next steps are to
complete the feasibility study and our fundraising plan. We expect to have a public presentation with an
opportunity for input after the feasibility study is completed. Our next milestone is to raise approximately
$1,200,000 to get to a shovel ready status.
Mobile Clinic Van project: SCHC has raised $145,000 for a mobile clinic. We are currently working on
specifications, a request for proposal and additional funding.
Staffing: Through 2020 we had three of our full time 19 positions turn -over, two were employed less than three
months and one had been with us for three years. We did not have any provider turnover, so we still have, Dr.
Allen, Dr. Roloff, Pediatrics, Dr. Schellinger, Osteopathic physician doing OMT, Jeanette Nienaber PA, Julie Crites
ANP. Mike Craytor, LPC, doing behavioral health assessments, brief interventions, and referrals. Our providers
with bio's can be found on our website and Facebook page.
Quality indicators: Our quality indicators are tracked monthly and reported annually to HRSA. They are used to
determine if we qualify for Federal annual quality awards based on improvement and scores. We received
$64,000 in 2020 for our 2019 quality improvements. Attached are our year-to-date quality indicators, that show
our current score, the change from last year, the arrow shows green if we improved over last year. The target
column is long term goals that relate to the 2030 healthy person goals.
2020 UDS Measures YTD vs. 2019 year-end
UDS 2020 CQMs Run on 1/20/2021 2:51:34 PM
MEASURE
Cervical Cancer Screerurrg (CMS 124v8)
Breas' G.inrer Srr;�,erimg Ages 50,74 (CMS 125v8)
Tobac.-ri !c� ;,rPning and Cessation (CMS 138v8)
ChIdn. Imiriunrzatton Status (CMS 117v8)
- leenng i BMI , Nutrrttonal Phi -iI Activity Counsehrg (CMS 15M)
-'. wrong and FoNow-Up 18+ Yearn,
,rape tnr th, -ion and Trca: , r (Ardrovascular Disease (CM S347v3)
N aspirin -- • . I.' . • I AV7)
1rectal Cancer Screening (CMS 130A)
HIV Screenng (CMS 3490)
Screening for Depression and Fohow-lip flan tCMS 2v9i
Depression Remission at Twelve Montfss (L:MS I 1h0` )
Hvpertension Controlling High Bbod Pressure (CM S16M)
Diabetes A1c , 9 or Unrested (CMS 122v8)
HIV and Pregnant (UDS 2020)
F+..I SLILY
CHANGE
TARGET
44 7%
+ 4 6% a
50 0%
449%
+81% a
811%
95 9°'a
+ 1 5% a
100 0%
40 7Qo
- 3.3% v
55.0%
57 1110
+ 10.9% a
55 0%
72 7%
- 0 9% +
70 0%
59 3%
0 0%
80 0%
74.5%
+ 4 3% a
95 0%
27.6%
+9.3% a
31 0`!v
15.0%
+ 2 0% a
15.0%
87 1%
+ 13 5% a
85 0%
0 0%
0 0%
12 0%
82.7%
- 11 4% v
55 0` a
29 3%
1 7% ►
23 0%
0 0%
0 0%
B.N" 1' �` T-"
Clinical operations: Patient Centered Medical Home (PCMH) accreditation: Another area of mandatory
compliance for CHC's is the PCMH accreditation. Of course, our three-year accreditation is up this year in April
and requires a transformation to a collaborative patient care model where case management and health
maintenance concerns are reviewed along with each patient's care plan before their visit. This transformation
will result in excellent care for our patients, but we will be putting more emphasis on prompt arrival for
appointment check in's. If patients come in after their scheduled check in time, they may have to re -schedule
their appointment.
COVID vaccinations: Through January 215Y, we have administered 330 first doses of the COVID vaccine to front
line healthcare workers and people over 65 years old, with needed additional staff from Providence. We are
following the State guidelines for vaccine distribution. SCHC has continued to see regular patients and COVID
patients through the pandemic, and we continue to utilize tele-med services for about 5% to 10% of our patient
visits. COVID patients with symptoms are evaluated and tested outside of the facility. Drive thru testing
continues thanks to Providence allowing us to utilize their staff and their van along with our recently purchased
ice fishing tent to give our staff a place to warm up.
Outreach: Our outreach and enrollment staff signed up 126 people for our sliding fee scale in 2020, compared to
156 in 2019. We are currently the only fee agent in Seward and are aiding 15 to 30 people per month, we are
also handing out shower tokens and laundry vouchers for the homeless connection. We are not sure how, but
we will be celebrating our 7 anniversary on or around March 10th 2021
Collaboration — We continue to work closely with various groups within our community to distribute
information, assist in preparedness and problem solve community issues involving COVIDI9.
We appreciate everyone's hard work and patience during this pandemic, we would just like to remind folks to
be nice. We are all doing the best we can with what we have.
Craig Ambrosiani
Executive Director
Seward Community Health Center