Healthy Communities Access Program Public Health Institutes: A New Way of Doing Business May 20-21, 2004 Presented By Susan Lumsden Cephas Goldman, D.D.S.,

Healthy Communities Access Program

Public Health Institutes: A New Way of Doing Business

May 20-21, 2004Presented By Susan Lumsden

Cephas Goldman, D.D.S., M.B.A.U.S. Department of Health and Human ServicesHealth Resources and Services Administration

Bureau of Primary Health Care

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Overview Bureau of Primary Health Care

President’s Initiative

Healthy Communities Access Program

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Office of the Bureau Director

Bureau of Primary Health CareBureau of Primary Health Care

Office of Policy, Evaluation& Data

Division of Immigration Health Services

Division of Health CenterDevelopment

Division of State andCommunity Assistance

Division ofClinical Quality

Division of Health CenterManagement

Office of Minority and Special Populations

Division of National

Hansen’s DiseaseProgram

-Expand: Increase the # primary care access points, people served, and services provided-Strengthen: Increase clinical, managerial and financial efficiency -Improve Quality: Improve quality of care for patients and families

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The President’s Health Center The President’s Health Center InitiativeInitiative

Goal:To strengthen the health care safety

net for those most in need (FY 2002-2006)

Performance Measures:• 1200 new/expanded health center

access points• Serve an additional 6 million people• Maintain commitment to community-

based programs

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Three Essential AreasThree Essential Areas

• Managing quality improvement

• Strengthening existing health centers

• Managing the growth of new and expanded health centers

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President’s Initiative to Expand Health Centers

President’s Initiative to Expand Health Centers

130 130

9080

61 63

176

156

145

125

0

20

40

60

80

100

120

140

160

180

200

NAP EMC NAP EMC NAP EMC NAP EMC NAP EMC

FY 2002 FY 2003 FY 2004 FY 2005 FY 2006

Projected Actual171

131

10087

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New Users Projected Within InitiativeNew Users Projected Within Initiative

1.04M

1.18M

0.74M

1.59M 1.56M

4,560,000

2,970,000

2,230,000

1,040,000

6,100,000

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

FY 2002 FY 2003 FY 2004 FY 2005 FY 2006

0

1

2

3

4

5

6

7

Add'l Patients

Cum. # of Patients

+

Healthy Communities Access Program (HCAP)

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Healthy Communities Access Healthy Communities Access Program (HCAP)Program (HCAP)

Provides assistance to communities and consortia of health care providers and others, to develop or strengthen integrated community health care delivery systems

Coordinates health care services for individuals who are uninsured or underinsured

Develops or strengthens activities related to providing coordinated care for individuals with chronic conditions who are uninsured or underinsured

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Basic Eligibility RequirementsBasic Eligibility Requirements 

For an entity to be eligible to receive an HCAP award, the following requirements must be met:

 1. The applicant entity must represent a

consortium whose principal purpose is to provide a broad range of coordinated health care services to their defined community’s uninsured and underinsured populations.

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Basic Eligibility Requirements(Continued)

2. The community-wide consortium represented by the applicant entity must include at least one of each of the following providers that serve the stated community, unless such provider does not exist, declines or refuses to participate, or places unreasonable conditions on its participation:

 • A Federally qualified health center• A hospital with a low-income utilization rate, that is greater than 25

percent• A public health department• An interested public or private sector health care provider or an

organization that has traditionally served the medically uninsured and underserved

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HCAP ExpectationsHCAP Expectations

The coordination of services through the HCAP grant will allow the uninsured and underinsured to gain entry into and receive services from a more efficient, comprehensive and higher quality system of care, regardless of ability to pay.

The infrastructure development supported by HCAP will result in a health care delivery system characterized by effective collaboration, information sharing, and clinical and financial coordination among providers and organizations in the community.  HCAP funds should not supplant or replace existing Federal categorical programs that support entities providing services to low-income populations in the community, but instead build on these resources in an effort to expand and improve the quality of services for more individuals at a lower cost.

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HCAP: Outcomes

Community assets and HRSA programs are integrated at the community level

Capacity of existing safety net providers is coordinated and enhanced

Collaboration and community linkages are strengthened

Gaps or duplication in services for the uninsured and underinsured are eliminated

Resources are leveraged

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HCAP: Outcomes (Continued)

FY 2000: $25 Million to support the first 23 CAP communities

To date, Communities Access Program & HCAP have supported 193 grantee communities in 44 states and the District of Columbia

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HCAP Grantees

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Service Area Type Reported by FY 03 HCAP Grantees:

40% urban

31% rural

29% serving blended rural, urban, tribal and other communities

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Consortia Represent a Broad Array of Community Stakeholders

73% are Federally Qualified Health Centers72% are Local Health Departments59% are Community Based Social Service

Organizations57% are Private Hospitals54% are Local Government51% are Other Community Health Centers53% are Public Hospitals40% are Faith Based Organizations39% are Mental Health Programs35% are Private Providers & Group Practices

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HCAP GRANT FUNDSHCAP GRANT FUNDS 

Grant funds may support justified direct expenses associated with achieving the greater integration of and/or to fill identified or documented gaps in the health care delivery system.

Some examples of what costs grant funds may support are:• Project staff salaries• Management Information Systems (e.g.,hardware and software)• Project-related travel and training• Other direct expenses necessary for the integration of administrative,

clinical, information system, or financial functions• Program evaluation activities• Case management and disease management activities that are not

reimbursable services• Outreach and health education activities

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HCAP: Leveraging Other Funding Sources

Source % of Grantees

Local Foundations 21%State Government 19%National Foundations 14%Other Federal Sources 13%Hospital Organizations 12%County Government 11%

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HCAP: Leveraging In-Kind

Contributions

Source % of GranteesPrivate Hospitals 30%Federally Qualified Health Centers 25%Local Health Departments 24%Various Other sources 20%Public Hospitals 19%Private Provider/Group Practices 18%

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For More Information

Bureau of Primary Health CareDivision of State and Community Assistance

4350 East West Highway, 9th FloorBethesda, Maryland 20814

301-594-4488301-480-7833 (FAX)

[email protected]

[email protected]