Journey from Free Clinic to FQHC Monica Medina McCurdy, PA-C VP, Healthcare Services Project HOME James Plumb, MD, MPH Vice Chair – Community Medicine Director, Center for Urban Health, Thomas Jefferson Univ. Hospital

Who’s in the room? Free clinic staff? Free clinics who already decided to pursue FQHC or Look-Alike? Patients of free clinics? Any hospital representatives present? Any behavioral health providers present? Dental providers? Charitable foundations? Health insurers? Health professions students?

The “M” in Project HOME: The First 18 Years Jefferson Family Medicine starts formal resident continuity clinic @ St. E’s Services at St. Elizabeth’s start in partnership with Jefferson Family Medicine. Two Jefferson MDs with students see patients weekly. Continues to present time. Philanthropist Steve Klein steps forward with interest in making major contribution to “wellness” initiative. Project HOME is founded by Sister Mary Scullion (Exec. Director) and Joan Dawson McConnon (CFO) 1992 1997 2002 2006-2008 1989 2009-2010 JeffHOPE medical students from Thomas Jefferson University volunteer at a Project HOME shelter for chronically homeless men (1992-2000) RN hired as Health Services Coordinator from 2002-2008. Physician Assistant and Office Manager hired. Site acquisition begins for future Stephen Klein Wellness Center Original Home: St. Elizabeth’s Wellness Center: 1845 N. 23rd Street, Philadelphia 19121 Current Home: Stephen Klein Wellness Center, 2100 Cecil B. Moore Ave., Philadelphia 19121

Strategic Growth of the “M” in Project HOME: 2011-2013* VP position approved in March to oversee growth of health care services (position filled Oct) Architect selected; design of 28,000 sq ft Stephen Klein Wellness Center begins Project HOME is awarded HRSA Health Center Planning Grant. St. Elizabeth’s renovation completed (1 to 4 exam rooms) 2011 2012 2013 Keystone First 2-Yr Pilot Study initiated; part-time Nurse added; Behavioral health partners form City-funded coalition with Project HOME and Jefferson to provide on-site BH services. Wellness Center Community Advisory Board, 1st Meeting; 3rd Jefferson Physician added Full-time Director of Clinical Services (Physician Assistant) added; New Access Point Application submitted NEW ACCESS POINT GRANT AWARDED FROM HRSA! FQHC STATUS OBTAINED! *Also in 2013: Nurse increased to full time; Physician Assistant added; EHR system purchased; 100% design completed on new Stephen Klein Wellness Center; Financial Assistance Specialist, Receptionist, Medical Assistant, Community Health Worker, Healing Touch Practitioner added

*Between 2009 to now, when from 1 employee to over 40 employees Strategic Growth of the “M” in Project HOME: 2014-2017 First Patient Satisfaction Survey Opening of 340b Pharmacy SKWC Ground-breaking First HRSA Operational Site Visit Expansion at Pathways, Center of Excellence 2014 2015 2017 2016 2018-20 NextGen goes live; first time billing First Medical Director hired; started service site at Pathways to Housing SKWC OPENS! December 23, 2014 w/ Primary care & behavioral health Opening of Dental Practice Future growth, addition of new sites 2nd HRSA Operational Site Visit *Between 2009 to now, when from 1 employee to over 40 employees

Where to start? Read Visit Partner

Important websites Mechanics of Starting an FQHC HRSA Bureau of Primary Health Care Pennsylvania Association of Community Health Centers Health Federation of Philadelphia FQHC Finance National Association of Community Health Centers Integrated Healthcare / Social Determinants of Health SAMHSA-HRSA Center for Integrated Health Solutions Kaiser Family Foundation Robert Wood Johnson Foundation Professional Liability

Definitions, Acronyms FQHC vs. FQHC Look-Alike 330 Grant Community Health Center vs. Special Populations Health Center (board requirements) PPS Rate (Prospective Payment System) Medicaid, Medicare, Dual-Eligibles Medically Underserved Areas and Medically Underserved Populations HPSA (Health Professional Shortage Area) FTCA (Federal Tort Claim Act) 340B Drug Pricing Program Uniform Data Systems

Develop Partnerships Hospitals, Residency Programs, and Academic Health Centers Behavioral health providers Pharmacies Health education Affordable Housing Legal Volunteers Emergency Food Pantries

Project HOME Jefferson Partnership

Thomas Jefferson University, located in Philadelphia, is dedicated to the health sciences and community health via education, research, and health services to improve the health of the populations we serve.

Department of Family and Community Medicine Vision: The Department of Family and Community Medicine will transform healthcare to eliminate health inequities. Mission: The Department will be a leader at Jefferson Health, nationally and globally in reducing health inequities by: providing exemplary patient- and family-centered clinical care; nurturing health professional students and physicians to be excellent clinicians, leaders, teachers and advocates; promoting health and wellness through community based-care, partnerships and education; generating new knowledge that impacts the delivery of comprehensive population and evidence-based care focusing on prevention and chronic disease management.

COMMUNITY MEDICINE/HEALTH Care to vulnerable populations Health promotion through programs and community engagement and partnerships Epidemiology Biostatistics Environmental Health Health Services Research Social/Behavioral Determinants Center for Urban Health Community Medicine/Health Public Health DFCM/TJU/TJUH Primary Care Center City, North and South Philadelphia Project Home, Nationalities Services Center, Churches, YMCA, Senior Centers, Norris Square Civic Association, SHARE, PHS, Food Trust, Dixon House, South East Philadelphia Collaborative, United Communities, SEAMAAC, Refugee Mental Health Collaborative, Schools, YMCA, Federation of Neighborhood Centers, Welcoming Center, Maternity Care Coalition, PCA, PDPH Mazzoni, Jeff HOPE, Refugee Health Center, YES, PATHWAYS, Steven Klein Wellness Center

Wellness Center – P R O J E C T H M Wellness Center Director Housing Education Job Training D and A Treatment INTERDISCIPLINARY STREET CLINIC RESPITE CARE HOME VISIT PRG JEFFERSON PRIMARY CARE DENTAL CARE adults, children acute care, preventive screening, oral health education INTEGRATION SERVICES Wellness Center Director Reception & Central Scheduling Patient Navigator / Care Coordination Targeted Case Management Community Health Workers & Peer Specialists Nutrition Education & Consultation Child Care COMMUNITY-BASED MENTAL HEALTH CARE Counseling/Prevention programs/Case Management: D&A, mental health, IPV, Child maltreatment YMCA Referrals from PH sites, Jeff Primary Care, JFMA, Mental Health Services, Physical Therapy PHARMACY & LAB SERVICES PHYSICAL THERAPY NORTH PHILLY “WALKING NEIGHBORHOOD” PROJECT Medical Legal Clinic Center for Urban Health

Q&A about FQHCs or Look-Alikes? about partnerships with Academic Health Centers? other issues we did not cover?