1. "The Performance of an FQHC and Its Impact on the Public's Health" PALOMA HERNANDEZ Planning Committee State Hospital Review and Planning Council JUNE 18, 2010

2. Overview - Urban Health Plan Founded in 1974 by Dr. Richard Izquierdo Became FQHC in 1999 4 practice sites in the South Bronx and Queens 5 School Sites 4 Off Sites 2 Administrative Sites Fully implemented EHR System since 2006 Largest Employer in our Zip Code: 480 2007 National Exemplary Award, US EPA 2009 Selected as one of the top performing Health Centers in the US by HRSA 2009 Nicholas E. Davies Award by HIMSS 2009 PCMH Level 3 Certification 2009 Actual Volume: 231,000 Users: 38,000 2010 Volume Projections: 260,000 Projected Users: 45,000

3. Community Profile – South Bronx Source: NYCDOHMH Community Health Profiles 2005 * per 100,000 MORBIDITY/MORTALITY HUNTS POINT/ MOTT HAVEN BRONXNYC Diabetes – (% of Adults)17% 12%9% Obesity – (% of Adults)25% 20% Asthma - (5 of Adults) 9%7%5% Child Asthma Hospitalization* 12%10%7% Heart Disease Hospitalization* 2,7732,2011,856 Death Rate Due to HIV*613918 People Living w/ HIV/AIDS*3,1492,0171419 Hospitalization Mental Illness* 1051949831 Teenage Mothers, 15-19 Year* 15512045

4. Community Profile – 16 th Congressional District Source: US Census Bureau 2006-2008 American Community Survey 3-Year Estimates 59 percent of people 25 years and over have at least graduated from high school and 10 percent had a bachelor's degree or higher. 41 percent were dropouts; they were not enrolled in school and had not graduated from high school. The median income of households was $23,270. 19 percent of the households received Social Security. The average income from Social Security was $10,116. 40 percent of people live in poverty. 53 percent of children under 18 live in poverty. 37 percent of people 65 years old and over live in poverty.

5. URBAN HEALTH PLAN’S PERFORMANCE

6. Percent of Patients Ages 18+ with Smoking History Documented Source: NYCDOHMH PCIP

7. Percent of Patients ages 18+ screened for Alcohol Use Source: NYCDOHMH PCIP

8. Percent of Patients Ages 18+ with a Documented BMI within the past 24 months

9. CHILDHOOD OBESITY Source: NYCDOHMH New York City South Bronx Dr. Ally 3 to 4 y/o Underweight5% 4% Healthy Weight53%49%64% Overweight15%16%6% Obese27%31%26% Total percentage Overweight/Obese42%47%32%

10. Percent of Patients Ages 18+ with Sexual History Documented Source: NYCDOHMH PCIP

11. Percent of Sexually Active Patients Ages 16-26 tested for Chlamydia Source: NYCDOHMH PCIP

12. Percent of Patients Ages 50+ with an Influenza Vaccine

13. Percent of Patients Ages 18+ Screened for Depression Source: NYCDOHMH PCIP

14. Percent of CSD Patients with a 50% Reduction in PHQ Score Source: HRSA Health Disparities Reporting Website

15. Percent of Depression Patients with a 6 month Reassessment Source: HRSA Health Disparities Reporting Website

16. Percent of Diabetic Patients Ages 18-75 with a Documented A1c Source: NYCDOHMH PCIP

17. Percent of Diabetic Patients Ages 40 + on Statins Source: HRSA Health Disparities Reporting Website

18. Percent of Diabetic Patients 40+ on Aspirin Source: HRSA Health Disparities Reporting Website

19. UHP Asthma Registry Size

20. Average Symptom Free Days (out of last 14)

21. Percent of Asthma Patients with a Severity Assessment Source: HRSA Health Disparities Reporting Website

22. Percent of Persistent Patients on Anti- Inflammatory Medication Source: HRSA Health Disparities Reporting Website

23. Percent of Asthmatic Patients with a Documented Self Management Goal Source: HRSA Health Disparities Reporting Website

24. Hunts Point/Mott Haven Comparison of Asthma Hospitalization Rates in Children Aged 0-14, 1997 to 2005 Source: NYCDOHMH 19972005 58% Decrease HP 2010 goal 2.25/1,000

25. Hunts Point-Mott Haven NYC Comparison of Asthma Emergency Room Visits 2003 to 2008 Source: NYCDOHMH PCIP 20032008 55% Decrease

26. Business Case Affinity Health Plan PMPM Comparative Data of UHP v. All Affinity Network 2006-2007 Non-UHP Providers UHP Network % Difference Pediatrics $81.11$49.18-39% Adults $280.62$219.96-22%

27. Geriatric Comparative Outcomes

28. Percent of Patients with an Influenza Vaccine

29. Percent of Geriatric Patients with a Physical in the past 18 months

30. Percent of Geriatric Patients with a Pneumoccal Vaccine

31. Percent of Geriatric Female Patients with a Mammogram within the past 2 years

32. URBAN HEALTH PLAN’S HEALTH CARE DELIVERY SYSTEM Culture of Performance Management and Improvement –Supported by a Learning Center for Professional Development –Supported by Use of Data Fully implemented Electronic Health Record System - Supported by a Provider Incentive Program Care Coordination - Supported by Health Education and Care Managers Innovative Programs - Project HOPE - Health and Wellness Program in collaboration with the Canyon Ranch Institute

33. Potential Impact on Emergency Room Growth Realistic goal of increasing FQHCs in NYS …..remembering that a DTC is not an FQHC Upgraded Diagnostic and Treatment Center Utilize FQHCs HPSA scores to open sites near ERs Mandate linkages between ERs and FQHCs (RWJ – Urgent Matters Project) Encourage change in Reimbursement Models so that we are properly compensated for the level of service that we provide

34. CONTACT INFORMATION Paloma Hernandez Urban Health Plan 1065 Southern Boulevard Bronx, New York 10459 (718) 991-4833 paloma.hernandez@urbanhealthplan.org