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Home My WebLink About07242018 City Council Work Session Laydown SCHC PresentationSeward Community Health Center Seward City Council Work Session July 24, 2018, 5:00 pm Our Mission 7/24/2018 l/� S awvl SC�G • • • • °COMMUNITY HEALTH CLi ENTER To identify and serve the healthcare needs of our community by providing quality, affordable services and promoting wellness, prevention, and partnerships • oCOMMUNITI <HEALTH LU CENTER 1 Dick Cruse,' Shane Chair Hand, Vice Chair Margaret Maranda Anderson I McManus Susie Martha Urbach, Fleming, Treasurer I Secretary Maya I Juliana Kim Moriarty Board of Directors Kathy Kloster Amy Micheley Komarek Kowalski Steve Pautz Non -Board Committee Members Skip Reierson John Melvin Mary Tougas Sharon Smith Joe Fong (Ex-Officio) Valarie Kingsland Pam Jarosz Tara Riemer Lois Daubney Nan Jean Thompson I Bardarson 7/24/2018 • Federally Qualified Health Center • An organization that receives enhanced reimbursement from Medicare and Medicaid • Community Health Center • Also known as Section 330 or FQHC • Service Area Competition • A request for federal financial assistance to continue support of an area served by a Health Center Program award recipient onight's Outline KENTER History &current status of SCHC Driving Decision Point - HRSA grant renewal due August l5 (SAC) Big questions to move us forward 3 7/24/2018 SCHC History QDec. 2010 Seward residents approve an ordinance establishing the Seward Community Health Center (SC C) board of directors. SCHC is created a non-profit CHC; initial board membqfs appointed by City. • • • • °COMMUNITY HEALTH CENTER CENTER May 2013 SCHC Board submits second application seeking federal funding for a new FQHC. SCHC Board of Directors submits an application for federal funding to establish an FQHC. The application failed to achieve funding by only one ranking point. Dec. 2010 SCHC History (con't) QNov. 2013 SCHC receives notice of federal funding! HRSA gives 120 days to get the clinic up and running in the hospita pace currently occupied by Providen e Family Medicine Clinic. • • • COMMUNITY ;HEALTH CENTER Jan. 2014 New clinic sets timeline. The clinic as operated by providence will close on February 14. The space will be renovated and SCHC tentatively expects to be open and treating patients by February 28, 2014. City Council makes provisions for new SCHC employees to be hired as City employees, in part to meet federal deadlines for getting the clinic open. Dec. 2013 4 7/24/2018 SCHC History (con't) Feb. 2014 Providence closes doors to its clinic in preparation for SCHC to step in. Mar. 2014 SCHC opens to the public with a total of six staff. Most positions are filled with temporary staff/locum tenens providers. For federal funding purposes, the City of Seward and SCHC enter into a co - applicant agreement. Feb. 2014 SCHC History (con't) QOct. 2014 SCHC staff go live with NextGen, an electronic health record system. Dec. 2014 •OCOMMUNITY ,,HEALTH KENTER A team of federal reviewers conducts a 3-day site visit to assess compliance with 19 program requirements. Noted deficiencies are remedied in the required timeline. Sep. 2014 Six employees move into a prefabricated mobile office trailer to accommodate growing medical staff in the main building. Clinic hours expanded to cover Monday -Friday, 8:00 am-6:00 pm Dec. 2014 • 000MMUNITv 'HEALTH .CENTER SCHC hires Drs. Van Camp and Allen as its first two permanent physicians. Mar. 2015 5 7/24/2018 SCHC History (con't) 9 May 2015 The SCHC staff has now grown to a total of 20 employees. Sep. 2015 Jeanette Nienaber, PA-C, starts seeing patients as our first permanent female provider. SCHC is granted access to the City's AccuFund accounting system. 6 June 2015 SCHC History (con't) QOct. 2016 SCHC goes live with new EHR, which allows seamless communication w/ • °COMMUNITY 3HEALTH CENTER 0 Apr. 2016 SCHC lobby/waiting room receives a much -needed facelift. SCHC receives a supplemental federal grant, allowing the organization to hire a fourth provider. Sep. 2015 May 2017 SCHC receives FTCA deeming, which provides federal medical malpractice coverage to providers. Craig Ambrosiani steps into the Executive Director position; Patrick Linton retires. May 2017 • °COMMUNITY 'HEALTH CENTER Clinic hours expanded to include Saturdays during the summer, 9:00 am - 5:00 pm. 6June 2017 7/24/2018 SCHC History (con't) QAug. 2017 3-day site visit by HRSA to assess compliance with 19 program requirennents. Scores are within the top 10%of all CRCs. h ( Oct. 2017 SCHC is formally recognized as a Patient -Centered Medical Home, demonstrating our commitment to a higher level of care that places the patient at the heart of all we do. SCHC receives supplemental grant to start integrating behavioral health with primary care. Sep. 2017 SCHC History (con't) Q Feb. 2018 SCHC begins cutting its own payroll checks. F f • °COMMUNITY <HEALTH CENTER Dr. Carolyn Roloff begins seeing pediatric patients twice a month. Jan. 2018 May 2018 SCHC staff take over all patient billing, drastically improving AR & patient satisfaction. SCHC begins cutting its own checks for accounts payable. May 2018 • • OCOMMUNITY 'HEALTH CENTER SCHC divests itself from the City's healthcare plan to administer its own plan, offering more benefits to employees at a lower rate. Aug. 2018 7 Full-time Staff = Full-time Staff M Part -Time Staff • Dr. Lance Allen •Craig Ambrosiani •Tiffany Anderson, CMA • Frances Azzad-Smith •Jilian Chapman •Julie Crites, FNP •Stephanie Higgins • Eric Gardner, CNA •Stephanie Kaiser, RN • Katie Lunsford, MA • Katlin Lynch • Courtney Moore •Jeanette Nienaber, PA-C •Adrienne Roy, CNA •Albi Tatum, RN •Andra Woodard, LBSW • Wannah Zacher •Jodi Kurtz • Lori Landstrom, PA-C •Chet Rall, FNP •Stephanie Ray •Annette Shearer • Dr. Ross Van Camp 7/24/2018 SCHC Gross Accounts Receivable January 2017 - June 2018 400k 350k 3pOk 250k 0 O 0 150k 100k 50k Ok I C:iuss A/R 318k 321k 324k 329k 353k 269k 280k 272k 281k 288k 218k 222k 199k 195k 210k 17b� 150k I44k F AN over 120 days 137k 149k 16Oc 171k 163k 75k 75k 80k 93k IO7k 76k 92k 71k 65k 771, 44k 33k 22k Gross A/R days 109 118 101 97 94 71 67 62 64 72 64 72 63 62 66 57 50 4� foss A/R days GOAL 45 45 45 45 45 45 45 45 45 45 45 45 45 45 45 45 45 4:. 6.000 I 5.000 4,000 C N d a W a U a V C 2,0 00 i 1 1.000 1 Jan 17 YTD provider encounters: 284 YTD provider encounters: 370 YID unduplicated 225 8 D undupficated 351 SCHC YTD provider encounters and unduplicated encounters 2017-2018 as of 6/30/2018 Fet- March Apr May Jun Jul Aug Sep Oct Nov Dec 606 1,027 1,401 1,851 2.300 2,814 3,369 3.807 4.189 4,524 4,860 687 1.050 1.380 1,709 2.054 429 652 816 1,020 1,254 1.506 1.757 1,883 1,995 2062 2,136 467 699 867 968 1.154 f J 7/24/2018 SCHC MTD Net income/(loss) 350.000 2017-2018 as of 6/30/2018 300,000 250,000 200.U00 1so.000 77 )00,000 0 0 a 0 (50.000) i (100,000) LT r (I50.000) 1 r } 1200.000) j Jan Feb March Apr May Jun Jul Aug Sep Oct Nov Dec -2017 Total Revenues 92.420 174,899 276,610 223,288 246,826 215,086 240,212 246,451 222,394 218,775 209,462 223,951 } - 2017 Totoi Ezpenses 227,477 217.406 304,439 255,498 232,088 219,245 195,798 224,670 191,931 200.776 198,480 211.613 F -2017Ne11n-jl,oss) 1135.057) 142.508) (27,829) (32,210) 14,738 (4,159) 44,414 23,781 30,463 17.999 10.982 12,338 2018 Total Revenues 217,552 215,521 227,033 209,540 166,292 204,592 {; i. 2018 Total Expenses 203,438 183.850 203.666 222.719 190,638 195.611 2018 Net Income (Loss) I4, 114 31,671 23.367 (13,179) (24,3451 8,981 t: Big Question #1 What would you like to see our healthcare system look like in the future? • oCOMMUNIT' 3HEALTH CENTER 10 7/24/2018 OCOMMUNITY Big Question #2 RENTER Would City Council support renewal of the co-applicant61 agreement or SCHCX] moving forward as a single entity? Key Provisions of Co -Applicant Agreement 1 City receives federal grant funding from HRSA }, • City finance staff manage grant k F • SCHC invoices City for reimbursement • City is authorizing official of HRSA grant 11 7/24/2018 Key Provisions of Co -Applicant Agreement SCHC must meet SCHC must make Allows SCHC w/ City Admin public report to employees to and Council reps City Council on also be City on quarterly basis quarterly basis employees Key Provisions of Co -Applicant Agreement City employees & their immediate family cannot serve on the SCHC Board L0 0 Requires City Council to approve SCHC annual budget Provides SCHC with access to a portion of the 1 % sales tax revenue dedicated to healthcare V 12 7/24/2018 Key Provisions of Co -Applicant Agreement Requires SCHC to collaborate rather than compete with other Seward healthcare providers E Y 0 Requires SCHC to avoid duplication of healthcare services LJ Provides the City with means to ensure that SCHC meets grant requirements and overall best interests of the community V Co -Applicant Model Clinic operations Hires Receives Executive Finance HRSA $$ Director and funding Personnel Administration Grant Owns reporting hospital/ F CHC Governs, facility k Sets Patient policies Billing SCHC Board City of Seward pia 13 7/24/2018 Single -Entity Model Clinic operations Hires Receives Executive Finance HRSA $$ Director and funding Caktanaletn Admir-titration accountability ag em nt EMU Owns L.reporting hospital/ CHC Governs, facility P Sets Patient } policies Billing Y SCHC Board City of Seward W�00C �O !MM �UN I T Y KENTER Would City Council support renewal of the co -applicant agreement or SCHC e moving forward as a single entity? 14 7/24/2018 �.MUMM Big Question #3 • <HEALTH CENTER tinanciai conauit between the City and our local healthcare organizations for the remaining 1%sales 1 +rry vim%i/-Nv�i i/-� .J/-%rit-4v�rr+r-%A f/-Nv i • • I - KENTER SCHC is currently operating under amonth-to-month lease of clinic space within the City -owned hospital. Can we extend this to a 5-year lease? 15 The SCHC is moving forward with a building plan. We would like to stay close to the hospital service areas and build closely or add on to the hospital. How best do we achieve this? 1 Revise co -applicant agreement 2 City provides SCHC with letter of support for SAC Establish new collaborative agreement & related City ordinance