1. Health Center Program National Brownfields Conference Philadelphia, PA April 5, 2011 Scott Otterbein Senior Advisor, Office of Training and Technical Assistance U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Primary Health Care

2. What is a “Health Center”? Located in or serve a high need community (designated Medically Underserved Area or Population). Governed by a community board composed of a majority (51% or more) of health center patients who represent the population served. Provide comprehensive primary health care services as well as supportive services (education, translation and transportation, etc.) that promote access to health care. Provide services available to all with fees adjusted based on ability to pay. Meet other performance and accountability requirements regarding administrative, clinical, and financial operations Synonyms: Federally Qualified Health Centers (FQHC), Community Health Centers

3. Health Center Background Beginning: 1965 under President Johnson’s War on Poverty. The Health Center Program includes: –Community Health Center Program – section 330(e) –Migrant Health Center Program – section 330(g) –Health Care for the Homeless Program – section 330(h) –Public Housing Primary Care Program – section 330(i)

4. Health centers are non-profit private or public entities that serve designated medically underserved populations/areas or special medically underserved populations comprised of migrant and seasonal farmworkers, the homeless or residents of public housing. There are 19 key Health Center Program Requirements based in the program’s statute and related regulations. 19 Requirements are divided into four categories:  Need  Services  Management & Finance  Governance For more on Program Requirements visit: http://www.bphc.hrsa.gov/about/requirements.htm http://www.bphc.hrsa.gov/about/requirements.htm Health Center Program Requirements 4

5. Primary Health Care Mission Improve the health of the Nation’s underserved communities and vulnerable populations by assuring access to comprehensive, culturally competent, quality primary health care services 5

6. Technical Assistance Resources National and state-based support for training and technical assistance: o Primary Care Associations o Primary Care Offices o National Cooperative Agreements Federal TA Support: Project Officer TA Calls Onsite Consultant Support BPHC TA Website For more information visit the NEW BPHC TA Website: http://bphc.hrsa.gov/ta/default.aspx http://bphc.hrsa.gov/ta/default.aspx 6

7. Questions?

8. FY 2011 HRSA Strategic Priorities Improve Access to Quality Health Care and Services –Community/new site development –Expansion planning –Patient-centered medical/health home development –Meaningful use adoption Strengthen the Health Workforce –Workforce recruitment and retention Build Healthy Communities and Improve Health Equity 8

9. Health Center Program Overview Calendar Year 2009 73.8 Million Patient Visits  1,131 Grantees – half rural  7,900+ Service Sites Over 123,000 Staff  9,100+ Physicians  5,700+ NPs, PA, & CNMs Source: Uniform Data System, 2009 18.8 Million Patients  92% At or Below 200% Poverty  38% Uninsured  63% Racial/Ethnic Minorities  Over 1 Million Homeless Individuals  865,000 Migrant/Seasonal Farmworkers  165,000 Residents of Public Housing 9

10. Health Center Performance Calendar Year 2009 Among Health Center Patients: 67.3% entered prenatal care in the first trimester Rate of low birth weight babies (7.3%) continues to be lower than national estimates (8.2%) 68.8% of children received all recommended immunizations by 2 nd birthday 63.1% Hypertensive Patients with Blood Pressure<= 140/90 70.7% Diabetic Patients with HbA1c <= 9 $600 Total Cost per Patient $131 per Medical Visit For more information: http://www.bphc.hrsa.gov/about/performancemeasures.htmhttp://www.bphc.hrsa.gov/about/performancemeasures.htm Source: Uniform Data System, 2009 10

11. o Over 80% reported the overall quality of services received at the health center were “excellent” or “very good.” o Over 80% reported that they were “very likely” to refer friends and relatives to the health center. o Over 75% reported the main reason for “going to the health center for healthcare instead of someplace else” was because it was convenient (28%), affordable (25%), and provided quality healthcare (22%). Health Center Patient Survey Calendar Year 2009 11

12. Health Centers: Affordable Care Act The Affordable Care Act provides $11 billion in funding over the next 5 years for the operation, expansion, and construction of health centers throughout the Nation. $9.5 billion is targeted to: –Create new health center sites in medically underserved areas. –Expand preventive and primary health care services, including oral health, behavioral health, pharmacy, and/or enabling services, at existing health center sites. $1.5 billion will support major construction and renovation projects at community health centers nationwide. This increased funding will enable health centers to nearly double the number of patients seen. 12

13. FY 2011 Funding Opportunities o $727 Million in Capital Development grants o $250 million to continue New Access Points and Increased Demand for Services funding initiated under the Recovery Act (President’s FY 2011 Budget Request) o $250 million for Health Center New Access Points o New Health Centers o Satellite Sites 13

14. FY 2011 Funding Opportunities  $270 - $335 Million for Expanded Services –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, vision, and enabling services (outreach and enrollment, case management, patient and community health education, transportation and translation services)  $25 million for Behavioral Health Service Expansion (President’s FY 2011 Budget Request) 14

15. FY 2011 Funding Opportunities  Planning Grants  National/Regional/State Training and Technical Assistance –Community/site development –Expansion planning –Shortage Designation –Primary care medical/health home development –Meaningful use adoption –Workforce recruitment and retention Leadership/management Providers/staff Board members –Outreach and enrollment 15

16. Affordable Care Act: Other Key Health Center Provisions o National Health Service Corps and Workforce Programs o Teaching Health Centers o School-Based Health Centers o Negotiated Rulemaking for Shortage Designation o Community-Based Collaborative Care Networks 16

17. Primary Health Care Divisions

18. Expected Benefits Build on current structure but prepare for program growth Promote the integration of BPHC’s service delivery programs Improve the coordination of internal and external technical assistance and training activities Provide increased administrative service and support for grantees and staff

19. Health Center Program National Presence 19

20. Questions?

21. Scott A. Otterbein, Senior Advisor Department of Health and Human Services Health Resources and Services Administration Bureau of Primary Health Care Office of Training and Technical Assistance Coordination 150 S. Independence Mall West, Suite 1172 Philadelphia, PA 19106-3499 215.861.4414 sotterbein@hrsa.gov 21