National Association of Community Health Centers (NACHC)

National Association of Community Health Centers (NACHC)

Jason Patnosh, Associate Vice President/National Director, Community HealthCorps

[email protected] / www.nachc.com / www.communityhealthcorps.org Twitter: @nachc / @commhealthcorps

mailto:[email protected]

http://www.nachc.com/

http://www.communityhealthcorps.org/

America’s Voice for Community Health Care

The NACHC MissionTo promote the provision of high quality,

comprehensive and affordable health care that is coordinated, culturally and

linguistically competent, and community directed for all medically underserved

people.

Outline• Federally qualified health centers (FQHCs)• Patient centered medical home (PCMH)• Allied health professions in FQHCs• Identification and pipeline programs

Federally qualified health centers (FQHCs)

• Federally qualified health centers (FQHCs) were founded over 40 years ago in Boston and Mt. Bayou, MS by Drs. Jack Geiger and Count Gibson in collaboration with the Office of Economic Opportunity.

• FQHCs are consumer oriented and directed, located in medically underserved areas, provide primary and preventive heath care, and open to all regardless of ability to pay.

• Today, FQHCs see nearly 22 million patients annually across 1200 grantees and over 8000 locations.

• NACHC was founded a few years later to serve as the voice for health centers, provide technical assistance and support, and develop programs for FQHCs.

Health Center Funding in ACA

•The Affordable Care Act (ACA) provides $11 billion in dedicated funding for health center operations and capital for FY2011-FY2015.–$9.5 billion to support health center operations.–$1.5 billion for capital needs

•Expanded Services at Existing Health Centers–Serve additional patients by expanding current service capacity, including adding providers/staff and increasing hours of operation–New or expanded oral health, behavioral health, pharmacy, and enabling services Funding Award Announcements were scheduled

The Current Environment• The view from Congress is turbulent, with the

parties taking very different approaches on many big issues. The nation’s fiscal situation is a considered a serious issue to future prosperity by members of both parties, and will continue to grow.• Funding for FQHCs was reduced by $600M in the

FY11 budget deal. This essentially stunts the ability to see up to 5M more patients and grow, potentially reducing growth in the ACA estimates.

Patient Centered Medical Home (PCMH)

From Health Affairs Blog by Holly Koda (April 26, 2011)• The PCMH is not a one-size-fits-all, and neither are the patients or

providers who live, work and play within its walls…Ideally, the PCMH helps to empower patients who can participate fully in their care — and places the patient at the center as part of the care team.

• What new skills are needed, and how can we prepare competent patients in the PCMH? Patients do have responsibilities: meeting appointments and follow up visits, filling and refilling prescriptions, communicating frankly about health concerns, and more. Notably, many will fall short, and disparities will advantage or disadvantage specific patient groups. Low income, culturally diverse and other special populations will likely require enabling support to meet their patient responsibilities in the PCMH.

• Experience shows that health care professionals can play better with others on collaborative, inter-professional teams when they understand and appreciate the shifting roles and how they fit together in a patient-centered medical home.

Allied Health Professions in FQHCs

• Dental hygienists• Medical or dental assistants• Health information technologists• Some health care administrators• Medical coders• Pharmacist/pharmacy technicians• Phlebotomists• Community health workers

Identification and Pipeline Programs

World Academy for Total Community Health (Brownsville, NY): Mission: To prepare our students to make healthy choices, lead healthy lives and advocate for the total health of their families, their communities, their nation and ultimately, their world; to expose students to all aspects of the health care field and variety of career options the industry offers; to create a socially supportive learning environment; to offer an academically rigorous curriculum that prepares students for higher education.

Lead partners: Brownsville Multi-Service Family Health Center (an FQHC), Long Island University School of Nursing, and Sophie Davis School of Biomedical Education.

Identification and Pipeline Programs

Central Valley Health Network (Sacramento, CA)

• Hold an annual conference for 400-500 young people annually highlighting leadership and careers in health care

Area Health Education Centers• Nationwide, are creating programs for youth as

early as 1st graders to teach healthy lifestyles and become interested in health careers

High School Drop Out Rates MATTER!

Community HealthCorpsmission : improve health care access and

enhance workforce development for community health centers through national

service programs

Community HealthCorps A Standardized Program Design that Works

Process:Members apply directly to program sites for Fall startProgram Coordinators screen and select applicants

Criteria:High school diploma, GED or working toward GED; interest in health care; attitude; good work ethic of helping the community

Initial:Pre-service Orientation includes Introduction to AmeriCorps/ HealthCorps, health center, basic first aid training

On-going:Program Coordinators and Site Supervisors continue to develop and train members for skills needed to perform day-to-day service duties

Each program hosts 5-25 members who meet as a team for training and peer support (avg. size around 12 members) and perform various activities, including but not limited to: health outreach on health center services, education (i.e., tobacco cessation and flu vaccinations), enrolling kids and families in public health insurance, coordinating pediatric obesity intervention programs, and providing translations for limited English proficient patients

Members are supervised on-site by Site Supervisors, staff employed by the health center

Members are also supported by Program Coordinators who source the positions, facilitate team interactions and serve as liaison between the members and sites

During Service:Members learn goal setting, job search, resume writing, interview preparation to support their transition to future employment and higher education

After Service:Some stay with HealthCorps for second year, others are hired by CHC or others to work in a health care field, pursue more schooling or employment

Recruit Train ServeServe

TransitionTeams and Roles Supervision

Benefit to Health Centers and AmeriCorps Members

Community Health Centers Benefit from Hosting

-Increased skilled workforce -Increased engagement of community volunteers

-Greater advocacy for community residents and community health issues

-Increased third-party health insurance and other revenues

-Increased funding diversification

AmeriCorps Members Benefit from Serving

-Improved understanding of community health delivery

-Improved interest in high need health careers

-Obtained job skills and workplace experience that lead to living wage career opportunities

-Reduced debt burden from past education and encourage pursuit of further education

- Increased self-efficacy

A Program Model That Gets Results

• Thanks to Community HealthCorps (2009-2010)…–Approximately 1.2 million people who lacked access

and inadequately used health services–123,096 enrollment applications for health insurance

(including children’s health insurance), health education workshops and other health center services–159,932 people in need used preventive and primary

health care services two or more times within the last program year–12,754 community volunteers provided over 25K

hours of service (valued at $532,586)

Return on Investment

• An estimated $11 million was invested in the program during program year 2009-2010 ($6 million from federal and $5 million from matching resources).• Community HealthCorps members provided

689,870 hours of service valued at $14.4 million and leveraged over $1.9 million in educational scholarships for the members…this is 145% return on investment in dollars alone and longer term ROI with healthier children and families, and HealthCorps members seeking further careers and education in primary and preventive health.

Contact

Jason [email protected] / 301-347-0400

mailto:[email protected]

EBNHC Education and Training Institute

East Boston Neighborhood Health Center

Caring for the Community

• The East Boston Neighborhood Health Center has been a vital part of the community for 40 years. We provide easily accessible, high-quality health care to all who live and work in East Boston and the surrounding communities, without regard to age, income, insurance status, language, culture, or social circumstances. Our doors are always open.


EBNHC: Overview• Over 800 Employees• Over 250,000 Patient Visits per year• Full Array of Primary and Specialty

Services• 24/7 Emergency Department• Onsite Pharmacy• Elderly Service Plan – PACE Program• Transportation Services• Education and Training Institute


Education & Training Institute

Established in 2005.Grow and retain your own!


Challenge: To provide high quality healthcare to a linguistically and

culturally diverse community.

• 45% of patients are best served in a language other than English

• 25 Professional Interpreters• Over 80,000 encounters per year• External Language Line $75,000

– 54,397 minutes• Increasing demand for language

assistance


Jobs to Careers: Pathways for Frontline Workers

A project of the East Boston Neighborhood Health Center’s

Education and Training Institute

in collaboration with

Bunker Hill Community CollegeJewish Vocational Service

World Educationmade possible with generous support from The Robert Wood Johnson Foundation,

the Hitachi Foundation and the Department of Labor


Jobs to Careers (J2C)Source:http://www.jobs2careers.org/pdf/J2CNewsMarch08.pdf

• Jobs to Careers seeks to advance and reward the skill and career development of the low-wage incumbent (health care) workers.

• Jobs to Careers supports partnerships of employers and educational institutions to expand and redesign systems which test new models of education and training that incorporate work-based learning.


Target Employees

»Medical Assistants»Administrative Practice Support Staff

»ESP (Elder Service Plan) Nurse’s Aides

EBNHC employs over 300 FLWs!


Partner RolesEast Boston Neighborhood Health Center:• Promote J2C to internal staff,

especially Managers and Supervisors

• Recruit potential participants• Assist employees to access

necessary supports, including financial and academic


Partner RolesJVS:• Developed and delivered college prep

courses (Reading Comprehension, Writing, ESOL, and Math)

• Prepared employees for college placement exam (CPT);

• Provided Career Coaching services;• Developed and delivered a preceptor

training course for Medical Interpreters.


School in the Summer!

…for people who FEAR math!

When: Mondays from 5-7 p.m.

(Begins Monday June 8th)Where: 155 Addison Street,

East Boston


Partner Roles, cont.Bunker Hill Community College:• Developed a 3 credit Medical

Interpreting course, based on the EBNHC Certified Auxiliary Interpreter (CAI) training, incorporating Work-Based Learning methodologies;

• Developed a Communications course: designed to strengthen employees’ customer service skills and cultural competency


Certified Aux Interpreters (CAI)

• Response to the exponential growth in demand for interpreter services

• Train bilingual frontline staff to serve as culturally competent medical interpreters

• Developed to improve quality and maintain standards of interpreter practice


Medical InterpretingMedical Interpreting 1

COURSE DESCRIPTION: This course is designed for bilingual students interested in becoming integral members of the health care team in bridging the language and cultural gap between patients and providers. Students will examine issues related to interpreter ethics and the role of the interpreter in a variety of clinical settings. Topics include anatomy and physiology, pathophysiology, diagnoses, medical treatments, medical terminology and abbreviations. (3 Credits)


Employees’ Perspective

What are the barriers that prohibit (EBNHC) employees from advancing in their careers? (Based on the results of a 2007 ETI employee focus

group)

• Family responsibilities; lack of time• Limited financial resources• Basic academic skills’ deficits• Lack of information regarding career

paths


Addressing Staff Barriers to Career Advancement

Family responsibilities/Lack of time ↓

On-site BHCC Classes at ETI and Work-Based Learning!

Limited financial resources↓

Tuition Reimbursement, Financial Aid, and Back to School Incentive!

Basic academic skills deficits↓

JVS College Prep Classes!

Lack of information regarding career paths ↓

Career Coaching!


How do we accomplish all this?

Through Work-Based Learning! • Curriculum is work-place driven,

developed in conjunction with employer

• Less time in the classroom• Work process itself is source of

learning• Structured assessments• Rewards for achievements (e.g.,

college credits, bi-annual bonus)


J2C: Outcomes• Over 70 EBNHC employees

participated in at least one service component of J2C

• CAIs: 28 EBNHC employees completed Medical Interpreting 1 (receiving 3 college credits in the process)

• 15 EBNHC employees are working toward an 18-credit Certificate in Medical Interpreting through BHCC


Where are we, post-J2C?

• Currently ETI offers 15 BHCC courses over three evenings;

• ETI sponsors courses such as Medical Spanish, Medical Terminology and Basic Computer Skills for employees;

• Exploring options to provide healthcare training to members of the community


Questions?

National Association of Community Health Centers (NACHC)

Documents

Transcript of National Association of Community Health Centers (NACHC)