1. 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.

2. Piedmont Health Services, Inc.
An Overview

3. 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.

4. 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.”

5. 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 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

6. 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.

7. 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

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

9. PHS Patients Ethnic Profile
* Calendar year 2007

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

11. 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.

12. 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 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

13. 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

14. 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

15. 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.

16. 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

17. 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

18. 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.

19. 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

20. 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)

21. 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).

22. 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

23. 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.

24. 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

25. 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.

26. 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.

27. 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!