Creating and Maintaining a Successful Health Clinic under the Affordable Care Act What the Affordable Care Act means for health clinics and how to plan.

Creating and Maintaining a Successful Health Clinic under the Affordable Care

Act What the Affordable Care Act means for health clinics and how to plan for their

success through financial and legal considerations.

Aamer Hayat CEO AWC Management, Inc

COO Avecinia Wellness Center

Wasif Ali Khan, JD, LLM (Health Law)

LaDonna Waugh, MD, JD FACS

MAY 9, 2015 (CHICAGO, IL)

FINANCIAL CONSIDERATIONS AND BUSINESS PLANNING

Financial Considerations/Business Planning

1) Understand your market• Who are you serving?• What resources are currently available to that

population?• What is your clinics value proposition?

2) Understand your resources• Will you be using grants? Fundraising? Medicaid?• Which community groups can be partners?

3) Understand your costs• What will be your most significant costs:

• Salary (Administrative, Professional Fees)• Rent• Supplies

Financial Considerations/Business Planning

1) Understand your market• Who are you serving?

• Medicaid Population• Indigent – Uninsured• Immigrant - Uninsured

• What resources are currently available to that population?• Local Health Clinics• Homeless Shelters• Islamic Centers/Churches/Synagogues

• What is your clinics value proposition?• What difference are you try to make?• What are alternatives to creating a clinic?

Financial Considerations/Business Planning

1) Understand your resources• Will you be using grants? Fundraising? Medicaid?

• Medicaid or other federal health resources may be restrictive in who can be

• Grants • Which community groups/businesses can be

partners?• Can pooling you resources achieve better

results?• Can local businesses or resources provide for

costs?

Financial Considerations/Business Planning

1) Understand your costs• What will be your most significant costs:

• Salary (Administrative, Professional Fees)• Hire a good lawyer (Asbahi Law)

• Not For Profit Status, Etc• Hire a good accountant

• Cash Flow & Income Statement • Hire a good “manager”

• Organizational management• Rent

• What are your most cost efficient options• Free spaces• Shared spaces

• Insurance• Malpractice – Volunteer programs

• Supplies• Administrative/Medical Supplies• Medicines

LEGAL ELEMENTS OF NON-PROFIT CLINIC OPERATIONS

Legal Elements of Non-profit Clinic Operations

1) Forming the Legal Entity• Formation of Entity (Not for Profit Corporation)• Internal Documents (Bylaws, Policies &

Procedures)• Form 1023-Application for Tax Exemption• State Registrations

• Registration with Attorney General• State Solicitation Statutes• Tax and Employment Security Offices

2) Business Contracts and Agreements• Vendor Agreement• Commercial Leases• Employment/Independent Contractor

Agreements

Legal Elements of Non-profit Clinic Operations

3) Relationships w/ Health Professionals• Prohibition on corporate practice of medicine

• If you will be paying for staff physicians/dentist must be independent contractor & maintain independent judgment

• Preference for volunteers• Volunteer Protection Act• State Protections for Physicians and Dentists

4) Insurance• Malpractice concerns for Physicians/Dentists• General Business Liability Insurance• Directors & Officers Insurance

Legal Elements of Non-profit Clinic Operations

5) Compliance with Health Care Laws and Regulations• Some compliance efforts dependent on

equipment (use of X-Rays, MRI’s, etc.) • HIPAA & Privacy Laws

• Personal Information Protection Act• Medical Patient Rights Act• HIPAA-generally not applicable to non-profit

clinics6) General Recommendations

• Well-thought out and proper documentation at the start prevents headaches

• Operate the free-clinic like a clinic, not like a “free” clinic

• Maintain proper board governance as you grow (transition from operation to governing board)

• Fiduciary obligations for Board of Directors• Duties of Care, Loyalty and Obedience

The Future of ACA: What We Still Don’t Know about Healthcare Reform in

America in Twenty Minutes or Less

LaDonna Waugh, MD, JD, FACSAmerican Muslim Healthcare Conference

9 May 2015

2.5-2.9 x 107

Will the Affordable Care Act Survive 2015?

Congress, the Supreme Court and Political Reality

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