Albany Area Primary Health Care, Inc. Implementation and Financial Sustainability of a

School Based Health Center

Clifton BushChief Operating Officer

Georgia House of Representatives SBHC Study CommitteeAtlanta, GeorgiaOctober 27, 2015

AAPHC History

• Corporation initially established in 1978 and current institution was incorporated in 1979.

• Grant to develop clinic in Lee County was based on thesis project regarding lack of care for women and babies in the community, particularly prenatal care. AAPHC did not implement OB services until 2009…thirty years later.

• AAPHC had three locations in 1982 and has grown to include 13 clinical locations, 2 adjunct locations, 1 laboratory, and 1 administrative site

AAPHC Growth

• AAPHC has seen significant growth since 2008, opening and/or expanding 7 locations during this time; including the addition of three new service models (OB/GYN, Dentistry, & Podiatry)

• To facilitate this growth, AAPHC has a well defined implementation model to help ensure successful launches.

• AAPHC opened the doors to it’s inaugural School-Based Health Center in March 2013.

Turner Elementary SBHC

• Approximately 500 students• Approximately 50 Faculty & Staff• Grades K-5• 99% free and reduced lunch• Over 90% African American• Less than 5% utilize

English as a Second Language

Why an FQHC as a Sponsoring Agent?

• Prospective Payment System• Community Involvement• Federal Grants- NAPS, HRSA, etc.• Sliding Fee Scale Program• Medication Programs• FTCA- Providers Malpractice

SBHC Sustainability• Student/Staff Enrollment

– Consent forms distributed prior to start-up– Poster Contests & Prizes for Students– School Activity Involvement (PTO, etc.)– Relationship with School Administrators

• Wellness Campaigns (Flu Vaccinations)• Focus on Well Child Exams for all engaged students• Annual Health Fair Event • Faculty/Staff Engagement

– Promotional activities (i.e. Adult Health Month)

SBHC Sustainability (Financials)

• Medicaid and CMO Enrollment• Sliding Fee Scale and the SBHC• Collections- How Do We Make It Happen?• Inactive Medicaid - What Do We Do?• Faculty and Staff- How Do We Handle Insurance?• Billing Assignments - SBHC• Communication• Chart Auditing and Peer

Review• Credentialing

SBHC Quality and Sustainability

• Establishing Health Outcomes Benchmarks– Asthma

• Asthma Severity• Asthma Assessment• Asthma Action Plan• Pharmacological Therapy• Annual Flu Vaccine

– Obesity• BMI• Blood Pressure• Lipid Profile• Hemoglobin A1c

– Health Maintenance• # Health Checks• Screenings for Behavioral Health/Development• Immunizations

SBHC – User & Encounter Data 2014-2015

August September October November December January February March April0

50

100

150

200

250

300

350

400

233

197

284

199

157

188 182 179

212

270251

392

238

200

237 237 242

286

9 9 318

917

6 515

Total number of Pa-tients/Individual Users

Total Number of Encounters

Number of Adult users (>18 years)

Asthma Quality Data 2014-2015

August September October November December January February March April0

10

20

30

40

50

60

70

80

90

75

34

79

40 40

71

48

54

68

51

29

75

3937

69

45

49

65

20 1 0

20 0 0 0

Number of Pts w/ Asthma

Number of pts. w/ Influenza Vaccine

Number of pts. w/ ER Visits in past 30 days

Asthma Quality Data 2014-2015

August September October November December January February March April0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100% 96% 97% 99% 100% 100% 99% 100% 100% 100%

Percentage of patients on Asthma Pharm Therapy

SBHC Health Maintenance Data 2014-2015

Number of students en-rolled in the

health center

Number of Health Checks

Number of patients fully immunized

Number with Menactra, 1

dose

Number with Menactra, 2

doses

Number with HPV, 1 dose

Number with HPV, 2 doses

Number with HPV, 3 doses

Number with T-DAP

0

50

100

150

200

250

300

350

400

450

500

409

255

6479

9

7651

20

79

424

116

1738

2

3724

1338

445

150

3249

2

49 3925

49

1st Quarter 2014-15 (Aug, Sept, Oct) Albany 2nd Quarter 2014-15 (Nov, Dec, Jan) Albany

3rd Quarter 2014-15 (Feb, March, April) Albany

SBHC Program Expansion

• New Site(s)

– Elementary School- Medical– Middle School- Dental

• New Services–Dental–Behavioral Health

THANK YOU!