health center expansion in michigan
DESCRIPTION
Provides an overview of expansion of Michigan Health Centers and how it is increasing access to health care for the underinsured and medically underserved in Michigan,TRANSCRIPT
Health Center Expansion in Michigan
Michigan Primary Care AssociationMichigan Health Center Capital Development Program
With funding from the Kresge Foundation
Neal ColburnDirector of Capital Development
Michigan Primary Care Association
www.mpca.net
What is a Health Center?Federally Qualified Health Centers
◦ Established 45 years ago◦ Serve designated medically underserved areas; populations◦ Governed by volunteer nonprofit boards (501c3)
51%+ HC patients representing those being served
◦ Provide comprehensive, integrated primary care Medical, dental, behavioral health, preventive and referral services
◦ Provide ‘enabling services’ enabling access effective use of services Translation, health education, case management & benefit assistance etc.
◦ Provide services to all; adjusting fees to ability to pay ◦ Meet strict federal performance & accountability requirements
Clinical quality, administrative, financial
Increased Access to Health CareNearly 600,000 Michigan residents rely on health
centers as their health care home◦ 32 Michigan health center organizations; 190 clinic sites ◦ Nationally, over 20 million health center patients receive health
center services annuallyThe MPCA/MDCH Strategic Plan
◦ MI access goal: 1.1 million patients; 40% of <200% FPL◦ Five year growth estimate: +240,000 patients
SE MI area: 8 health centers with 29 clinic sites◦ Provide services to 100,000 patients annually and expanding◦ 8 FQHCs receive annual grant funds; (2 recently funded)◦ 1 FQHC Look-Alike (3 sites) & 1 Indian Health Service Clinic (These
are eligible to apply for FQHC funding )
32 Health Centersprovide care for nearly
600,000 residents
at over 190 delivery sites across Michigan
3 additional Health Centerorganizations funded in 2012
6 new delivery sites
Michigan’s Health ChallengeHigh rates of obesity (32%); diabetes; asthma…High infant mortality/low birth weight rates
◦ 7.1/1,000 infant mortality; 8.5% low birth weight rateShortage of primary care doctors, LPNs, PAs etc. 1/4 of children live in families with incomes below poverty level
◦ Detroit: over 1/3 live in families with incomes below poverty & over 1/2 below 200% of poverty level
39% of Michigan’s population is below 200% of poverty level In Michigan, over 60% of health center patients are uninsured
or covered by Medicaid, Medicare or other public programs In Detroit, over 90% of health center patients are uninsured or
covered by Medicaid, Medicare or other public programs
FQHC Expansion Initiative Collaborative efforts to expand access; ACA
◦ MI Primary Care Association & MDCH ◦ Detroit Wayne County Health Authority & FQHC Council of SE MI◦ Foundations◦ Kresge Foundation funding of MPCA MI Health Center Capital Development
Program
Foundation grant funding (grant writing; training; TA) Potential FQHC grant applicants identified & encouraged Training & technical assistance (TA) provided Nine (9) planning grants awarded (Two [2] in Detroit area)
Eleven (11) community development construction & renovation grants awarded (Five [5] in Detroit area)
Six (6) New Access Point (NAP) awards (Three [3] in Detroit area)
◦ Over an additional $3.6 million annual HRSA funding
Full range of FQHC services provided at 3 new sites Annual FQHC NAP award: $3.6M annually, plus:
◦ 6 health centers received$3,663,021 in federal grant funds (@16.65% of typical budget; +$22M in annual FQHC operational budgets)
◦ Eligible for special Medicaid/Medicare bundled rates◦ Eligible for future funding: service expansion; capital funding◦ Eligible for National Health Services Corps doctors, LPNs etc.◦ Eligible for FTCA malpractice coverage (like military coverage)◦ Well positioned to apply for additional programs; HIV, PCMH, IT
FQHCs save money ◦ 24% of global healthcare cost reduction
Over $100 million, 2010 Michigan Medicaid savings Michigan FQHC economic benefit $½ Billion (NACHC 2009)
Program Value Opportunity
Michigan Health Center Capital Development Program
Established by Michigan Primary Care Association (MPCA) with funding from the Kresge Foundation
Provides technical assistance, consultation, financing and fund raising to FQHCs
27 MI FQHC capital projects: over $50 million◦ Eleven (11) MI FQHC projects awarded $19,600,806
(5 construction projects; 6 renovation projects; )
◦ Four (4) awards in the Greater Detroit area: $3,257,000 (1 construction project; 3 renovation projects - 2 in Detroit)
Additional projects continue in developmentPublic and private grant funding and finance options
are being actively sought
HRSA Building Capacity Awards
(May 1, 2012)
Downriver Community
Services$1,887,000
Family Health Center of
Battle Creek$3,000,000
Family Medical Center of Michigan
$5,000,000
Cassopolis Family Care$4,400,000
East Jordan Family Health Center
$2,480,050
HRSA Immediate Facility Improvement
Awards(May 1, 2012)
Downriver Community
Services$490,000
Baldwin Family Health Care, Inc.
$500,000
Covenant Community Care
$500,000
Detroit Community Health
Connection$473,756
Cherry Street Health Services
$500,000
Western Wayne Family Health
Centers$370,000
HRSA New Access Point Grant Awards
(June 2012)
Covenant Community Care
$868,750
Genesee County Community Mental
Health$608,333
Cherry Street Health Services$566,667
MidMichigan Community Health
Services$319,271
Wayne County Health & Human Services
$650,000
The Wellness Plan Medical Centers
$650,000
Program Value Opportunity Affordable Care Act (ACA)
◦ Upheld by the Supreme Court◦ Medicaid expansion is optional by state; federally funded
ACA reduction in uninsured = potential for FQHC expansion◦ MI: potential $50M additional annual FQHC operational revenue◦ Wayne County: potential $10 million additional annual revenue
Massachusetts expansion - primary care overwhelmed◦ Resulted in reduced access to appropriate care; delayed care◦ Inappropriate use of hospital emergency departments and other
hospital services◦ Diminished population health benefit; increased cost to all parties
MI expansion needed; increase in FQHCs desperately needed
Emerging Needs Primary Care Medical Facilities; PCMH (2013 project starts)
◦ New; expanded; renovated◦ Pre-development (Construction & renovation projects)
Project planning: architects, site selection; space planning; builders, developers, project management etc.
Financial planning: financial analysis, finance plan, financing & fundraising
◦ Construction; renovation and completion Interim initial & operational funding (2014 Medicaid expansion)
◦ Expansion of medical staff to expand capacity Recruitment needed in 2013 (July & August end of residency) Recruitment expenses
◦ Expansion of benefit assistance personnel Medicaid enrollment assistance Conversion assistance of auto-assigned to appropriate providers & plans
◦ Expansion of outreach staff Identify, approach and encourage eligible populations Work with community organizations; churches etc.
Questions?
For further information, please contact:
Neal ColburnDirector of Capital Development
Michigan Primary Care Association(517) 827-0472
Our mission is to promote, support and develop comprehensive, accessible and affordable community-based primary health care
services to everyone in Michigan.