Piedmont Health Services, Inc Piedmont Health Services, Inc. Intern/Trainee/Research Associate On-Line Orientation Instructions Thank you for your interest in collaborating with Piedmont Health Services. We ask that you please review the entire Ppt. presentation that follows, then complete the following forms, and bring them with you to your first day of work and give them to the Health Center Manager, or at Corporate Office, to Betty Melanson*: Print out and complete the Application Print out the PHS Orientation Overview Test and complete it Print and Sign the Drug-Free and Patient Confidentiality forms Please print and fill out the top two lines of the Employee Health Record form and bring up-to-date copies of all immunization records/student/occupational health records with you on your first day. (Note: Current health professional students/residents at Duke or UNC Schools of Medicine, Nursing, and Pharmacy are assumed compliant and do not need to bring records). *Failure to bring forms on your first day of work may postpone or prevent the start of your rotation.

Piedmont Health Services, Inc. An Overview

What is a Federally Qualified Health Center (FQHC)? FQHCs are grantees of the Bureau of Primary Health Care of the US Department of Health and Human Services and include community and migrant health centers, health care for the homeless sites, and school-based centers. FQHCs are overseen by community boards and provide primary health care access to underserved groups. All offer care of a siding-fee scale tied to the Federal poverty level. There are 1150 FQHC grantees nationally with thousands of clinical sites, including 23 FQHCs with 104 sites in North Carolina. Nationally: 17 million Americans receive care each year from FQHCs 38% of FQHC patients are uninsured 70% of FQHC patients live in poverty It is estimated that FQHCs save the national health care system between $9.6 billion and $17.6 billion a year by helping patients avoid emergency rooms and making better use of preventive services.

Our Mission “Our mission is to improve the health and well-being of the community by providing high quality, affordable, and comprehensive primary health care.”

Our Historical Timeline March 1970 – First incorporated as Orange-Chatham Comprehensive Health Services, a joint venture of the UNC Division of Health Affairs and a Local Community Action Program Late 1970 – Opened Prospect Hill – Carrboro – Moncure CHC’s May 1995 - Name changed to Piedmont Health Services, Inc. 1996 – Opened Charles Drew CHC July 2001 – Acquired the Scott Clinic December 2002 – Opened Siler City CHC February 2006 – Opened a new facility to house Siler City CHC August 2007 – Began conversion to Electronic Health Records October 2008 – PHS Senior Care opens in Burlington

What we do: Health Centers: Primary Health Care Physician and Midlevel Provider medical care Dental Services with diagnostic XRAY Pharmacy Services onsite Lab Services – both in-house and Reference Social Work/Care Management Services for any patient Women Infants and Children (WIC) and nutritional services Referrals for Specialty Services Program of All-Inclusive Care for the Elderly All-inclusive care for nursing home-eligible residents of Alamance and Caswell Counties who wish to remain independent in their communities.

Total CHC Medical & Dental Visits PHS Center Locations 7 centers in 4 counties, providing health care to more than 39,000 unduplicated people each year Location County Total CHC Medical & Dental Visits 2012 CARRBORO CHC CHARLES DREW MONCURE CHC PROSPECT HILL SCOTT CHC SILER CITY CHC SYLVAN CHC (School based) Piedmont Health Senior Care ORANGE ALAMANCE CHATHAM CASWELL 120,534

Pharmacy locations at the following sites: Carrboro Charles Drew Moncure Prospect Hill Siler City Scott Total prescriptions filled in 2007: Over 195,000

PHS Patients Ethnic Profile * Calendar year 2007

Encounters by Payment Source 50% 30% 11% 7%

Sources of Revenue 70% of our health center revenue comes from patients, with the following payer mix: Sliding Scale* (Self-pay) – 51% Medicare – 10% Medicaid/S-CHIP – 27% Private Insurance – 12% The remainder of our health center revenue comes from other sources including our Federal Health Center Grant (about 20% of our revenue) and other State, local grants and contracts.

The Joint Commission Joint Commission for Accreditation of Healthcare Organizations JCACHO is an external evaluator of the quality of our clinical and fiscal policies. PHS is one of only 25% of all health centers in the country that are JCAHO accredited, and we were one of the first to receive this accreditation. April 2001 - PHS became Joint Commission accredited June 2013 – Completed 5th survey Triennial Accreditation Cycle Periodic Performance Review (performed annually) Unannounced Surveys Self-assessment mid-cycle - PPR 150+ Standards (totaling over 350 pages) for Ambulatory Care, alone

PHS Performance Improvement The Performance Improvement program: Incorporates quality improvement planning throughout the organization Provides a systematic monitoring of critical elements or dimensions of care Identifies and prioritizes risks, inefficiencies or strategic threats to PHS Establishes and follows up on activities to address quality of care issues Reassesses the organization’s improvement plan on a periodic basis

Performance Improvement (cont’d) To accomplish these goals and objectives, the following structure has been established: Board of Directors: Ultimate responsibility and oversight for the PHS Performance Improvement Program. Composed of >50% Health Center Patients. Senior Management Committee: Delegated the overall responsibility for implementing and maintaining the Performance Improvement Program Five standing committees will monitor, problem-solve and follow-up on critical aspects of the organization. These committees are 1. Safety and Facilities Committee 2. Clinical Steering Committee 3. Center Management Committee 4. Human Resource/Credentialing Committee 5. Pharmacy and Therapeutics Committee

HIPAA Regulations If you have already been instructed on HIPAA, please take time to review the next few slides to refresh your knowledge of HIPAA. If you have not been instructed on HIPAA, the following information will be useful in your understanding of this important law and the importance we place on HIPAA at PHS.

PHS Health Information Privacy Practices Notice of Information Privacy Practices All Patients Offered Notice of our privacy policy at Registration This policy lists how PHS can disclose Patient Health Information The policy also lists patient rights Record Release Restriction Request Limits PHS use of PHI

PHS Privacy Health Information (PHI) Practices (cont’d) PHS Privacy Officer – Becky Cicale PHS Trains 100% Employees on HIPAA PHS Confidentiality Policy PHI will not be discussed outside work, when not related to patient care, or in areas audible to other patients/staff

Important Information to Remember about Patient Privacy The Golden Rule applies here! If you see a patient out in public, you cannot acknowledge them unless they acknowledge you first. Access to patient medical records by anyone at PHS is only authorized on a need-to-know basis involving the care of a patient. You cannot give out any patient information over the phone (even if the person is the patient). Do not view patient information on screens when at others’ desks. All conversations with or about patients should be done in private, not public areas. Records can only be released by authorized staff and you are not authorized to release records.

Cultural & Ethnic Diversity At PHS we recognize diversity of values, interactional styles and cultures in our work environment. We ask that our employees and trainees respect the many ethnic and culturally diverse customs and beliefs of our vast patient population.   We ask that you be mindful of the following situations: Religious beliefs may affect a patient’s willingness to be treated or tested in a clinical setting Some patients may be gender-sensitive about physical exams Occasionally, you may find cultural customs that may seem vastly different from those you may be accustomed to; we ask that you remain respectful of others’ beliefs and customs at all times

Safety We make safety of our staff, visitors and patients paramount at all times in our clinics. We ask that you strictly observe all PHS safety rules and procedures. The following codes are utilized by PHS to alert employees to emergency situations: Code Yellow: Tornado (move to interior room without windows) Code Red: Fire (use RACE protocol – see next slide) Code Blue: Medical Emergency Code Green: Potentially violent situation (immediately report to your supervisor or your community health center leadership and remove yourself from the situation)

Safety (cont’d) In case of fire, PHS uses the word, RACE to help remember what to do: R: Rescue those in immediate danger A: Alert (Page overhead Code Red with location of fire) and dial 911 C: Contain (Close doors and windows to room where fire is located) E: Evacuate and extinguish fire (if small in size).

Fire Safety (cont’d) Remember the PASS method when using a fire extinguisher to put out a small, contained fire. P: Pull Pin on extinguisher A: Aim at base of fire S: Squeeze handle S: Use sweeping motion to extinguish fire

Safety (cont’d) It is the responsibility of every employee and trainee to know where the fire extinguishers and fire exits are located in the site in which they are working. The Center Manager at your site will review the center’s fire protocol with you on your first day in clinic.

OSHA OSHA Occupational Safety and Health Administration Employees, including part-time, temporary, or “per diem,” who are potentially exposed to Bloodborne pathogens (BBP) or other potentially infectious material (OPIM) must receive education about practicing universal precautions, and the epidemiology, modes of transmission and prevention for HIV, HBV and HCV. Employees trained in first aid and identified by PHS as responsible for rendering medical assistance as part of job duties must also receive training. All employees who may be potentially exposed to BBP or OPIM will be trained at their specific sties on issues having to do with their specific jobs Every clinic has an employee health provider responsible for a needle stick injury. To protect yourself, please report any needle stick immediately, so we can: Obtain source information before the involved patient leaves the premises Treat you promptly when indicated

PHS Abuse and Neglect Policy Any staff/trainee witnessing potential abuse or neglect should report it to their supervisor or lead provider PHS has policies in the following areas: Child abuse Elder abuse Domestic Partner Abuse If you see or suspect signs of abuse, report it to your supervisor and refer to the abuse and neglect policy in the clinical manual.

Dress Code At Piedmont Health Services, we want all people to be treated with respect and dignity. Part of this process is how we present ourselves to the public we serve. We ask that you respect our patients by following the PHS dress code dressing appropriately Please refer to the HR policy manual or check with your supervisor if you have any questions regarding our dress code. The following items may not be worn at any time Jeans, T-shirts, Sweat shirts, Tank tops, Shorts, Sheer clothing with undergarments visible, Sweat pants, Low-cut shirt or dresses (either front or back), Flip flops, Visible tattoos or body piercing (earrings are an exception), Clothing that displays bare midriffs.

Congratulations! You have completed the PHS orientation training. You are now ready to take your test. Please remember to Follow the instructions on page one of this PowerPoint presentation. Good luck! We look forward to welcoming you to PHS!