The Mission of the National Center for Health in Public Housing (NCHPH) is to strengthen the capacity of federally funded Public Housing Primary Care (PHPC) health centers and other health center grantees by providing training and a range of technical assistance.
NCHPH, a project of North American Management, receives funding through a cooperative agreement grant awarded by the U.S. Department of Health and Human Services Administration.
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What is a Health Center?
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According to the Health Resources and Services Administration (HRSA), health centers are community-based and patient-directed organizations that serve populations with limited access to health care. In 2011, there were a total of 1,128 health center grantees reporting having served over 20 million patients. Health center programs must:
- Be located in or serve a high need community
- Be governed by a community board
- Provide comprehensive primary care
- Provide services available to all
- Meet other performance and accountability requirements.
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Some health centers also receive specific funding to focus on certain special populations:
- migrant and seasonal farmworkers
- individuals and families experiencing homelessness
- those living in public housing
- Native Hawaiians
In 2011, public housing primary care (PHPC) health centers served 187,992 patients. You can find out more information about these and other health centers serving special populations here.
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19 Program Requirements
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There are 19 key program requirements that health centers must follow.
Need
1. Needs Assessment: Health Center Programs (HCP) conduct needs assessments to determine the needs of the target population.
Services
2. Required and Additional Services: HCPs provide or make arrangements for patients to obtain appropriate services.
3. Staffing Requirement: HCPs have core staff at the health center to provide services to patients.
4: Accessible Hours of Operation/Locations: HCPs exercise flexibility in order to provide necessary services to patients.
5: After Hours Coverage: HCPs arrange for patients to access emergency services during off hours.
6. Hospital Admitting Privileges and Continuum of Care: HCPs' physicians have authorization at admitting hospitals to provide continuous care to patients.
7. Sliding Fee Discounts: HCPs organize an adjusted payment scale for patients to pay for services based on their income.
8. Quality Improvement/Assurance Plan: HCPs continuously evaluate performance through Quality Indicators and Quality Assurance measures.
Management and Finance
9. Contractual/Affiliation Agreements: HCPs have regular, full-staffed management teams.
10. Collaborative Relationships: HCP management is responsible for all contractors that work with the HCP and all contractors must be complaint with HCP guidelines.
11. Financial Management and Control Policies: HCPs maintain relationships with professionals in the field and other health centers.
12. Billing and Collections: HCPs manage financial and accounting systems to assure continued standard of operations.
13. Budget: HCPs have a billing and collection system in place to manage patient accounts.
14. Program Data Reporting System: HCPs create a budget that includes the operating costs, all expenses, and all forms of revenue.
15. Program Data Reporting System: HCPs establish reporting systems to organize and collect data.
16. Scope of Project: HCPs continue to provide services that the health center was funded to provide to target population.
Governance
17. Board Authority: HCPs establish a governing body that provides leadership and guidance.
18. Board Composition: An HCPs governing body should have a diverse member base.
19. Conflict of Interest: HCPs' policies and procedures should not conflict with the individual interest of board members.
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Additionally, health center programs have a reporting requirement. The Uniform Data System (UDS) tracks a variety of information, including patient demographics, services provided, staffing, clinical indicators, utilization rates, costs, and revenues. Information is collected from each grantee and is reported on the grantee, state and national level. Data is due annually each year by the end of the first quarter (March 31st). New health center program grantees that are operational by October of the reporting year are required to submit UDS data.
Please click here for more information and resources on UDS reporting requirements.
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2013 Changes to UDS
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The changes include: (1) two revised clinical measures; (2) and reporting patients by zip codes, insurance source, and age categories. The 2013 changes the UDS are:
- Clinical Performance Measures
- Childhood Immunization
- Remove Hepatitis A, Retrovirus, and Influenza immunizations from the immunization test battery
- Revise the time frame for shot completion from age 2 to by age 3.
The reason for the change as indicated by HRSA is to align this measure with the current Healthy People 2020 goals and to be consistent with previous years' reporting on this measure. Click here for more information on the upcoming changes.
The 2012 Uniform Data System (UDS) Manual is now available on the HRSA webpage.
Click here for archived webinars and other training and technical assistance
If you have any questions, please contact the BPHC Help Line at bphchelpline@hrsa.gov or 1-877-974-BPHC (2742).
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UDS Mapper
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Not only is UDS data an invaluable tool available to current and potential health center grantees, the data is even more valuable when combined with other data such as census data and federal poverty level indicators. UDS Mapper (shown to the right) is a free website which contains UDS data as well as other data which assists health centers and others with evaluating the geographic reach, penetration, and growth of the Section 330-funded Health Center Program and its relationship to other federally-linked health resources. These data are presented in an interactive map.
Click here to learn more and register for free access.
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Partnerships and Outreach
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PHPC health centers have an established history of creating strong partnerships with public, government, social, community-based, non-profit and educational institutions to augment primary care and social services provided to patients. Please click the following links to learn more about how health centers can partner with other organizations, perform outreach to public housing residents, and implement innovative models of care.
PHPC health centers can no longer solely rely on traditional and existing funding sources to meet their needs, and therefore must focus on diversifying their funding streams. Everything from special events to individual donor cultivation should be considered.
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Grantee Corner
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Feature: Redwood Community Health Coalition
RCHC based in California, is a coalition of community health partners, nine of which are health center programs (HCPs).
RCHC was recently featured in a news article that congratulated them for using innovative ways to enroll patients in public assistance programs. Through technology, specifically One-e-App, health providers are able to enroll patients into multiple assistance programs from one application.
The program makes it easier for case managers and patients to keep track of paper work and for health centers to better address the social needs of their patients.The HCPs that are a part of the coalition are listed below:
Alliance Medical
Coastal Health Alliance
CommuniCare Health Centers
Community Health Clinic Ole
Marin Community Clinics
Petaluma Health Center
Sonoma Valley CHC
West County Health Centers, Inc.
Winters Healthcare Foundation, Inc.
Contact RCHC for more information on One-e-App or their community health members:
RCHC Office
1310 Redwood Way
Suite135
Petaluma, CA 94954
707-792-7900
email - support@rchc.net or pr@rchc.net
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Accreditation and Patient-Centered Medical Home (PCMH)
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Accreditation
According to the American Psychological Association (APA), accreditation "provides public notification that an institution or program meets standards of quality set forth by an accrediting agency" (APA, n.d.). There are many benefits of attaining accreditation. Because of increased demands, health plans are looking to show their value to employers with a stamp of quality. One source of accreditation is the National Committee for Quality Assurance (NCQA). The NCQA monitors health care quality through a comprehensive review and reporting process that utilizes the insight of large employers, policymakers, doctors, patients and health plans (NCQA, n.d.). NCQA accreditation scores are based on actual results achieved on a set of clinical measures and consumer experience measures. Other sources of accreditation include the Joint Commission, URAC (formerly the Utilization Review Accreditation Committee) and the Accreditation Association for Ambulatory Health Care (AAAHC). Accredited plans have a competitive advantage over nonaccredited plans that includes respected, third-party validation of their quality and a detailed roadmap for continuous improvement that drives value" (NCQA, n.d.).
Please visit the Joint Commission, URAC, the Accreditation Association for Ambulatory Health Care, the National Committee for Quality Assurance, and the HRSA Health Center Accreditation websites for more information.
Different types of accreditation may include:
- Accountable Care Organizations (ACO)
- Health Plan Accreditation (HPA)
- Wellness & Health Promotion (WHP)
- Case Management Accreditation
- Managed Behavioral Healthcare Organizations (MBHO)
- New Health Plans (NHP)
- Disease Management (DM)
- Accreditation Users Group (AUG).
Patient Centered Medical Homes (PCMH)
According to the Agency for Healthcare Research and Quality (AHRQ), a Patient Centered Medical Home (PCMH) is a "model of the organization of primary care that delivers the core functions of primary health care" (AHRQ, n.d.). As defined by the AHRQ, the five attributes of the PCMH include comprehensive care, being patient-centered, coordinated care, accessible services, and quality and safety (AHRQ, n.d.). Patient-centered coordination of care is a transformative process that is accredited by the following Medical Home Joint Principles (NCQA, n.d.):
- Personal physician: Each patient has an ongoing relationship with a personal physician who is trained to provide first contact, continuous and comprehensive care.
- Physician-directed medical practice: The personal physician leads a team of individuals at the practice level who collectively take responsibility for ongoing patient care.
- Whole-person orientation: The personal physician is responsible for providing all of the patient's health care needs or for arranging care with other qualified professionals.
- Care is coordinated and integrated across all elements of the complex health care system and the patient's community.
- Quality and safety are hallmarks of the medical home.
- Enhanced access to care is available through open scheduling, expanded hours and other innovative options for communication between patients, their personal physician and practice staff.
- Payment appropriately recognizes the added value provided to patients who have a patient-centered medical home.
According to NCQA, Patient-Centered Medical Home (PPC-PCMH) Recognition is based on meeting the following nine standards:
1. Access and Communication
2. Patient Tracking and Registry Functions
3. Care Management
4. Patient Self-Management and Support
5. Electronic Prescribing
6. Test Tracking
7. Referral Tracking
8. Performance Reporting and Improvement
9. Advanced Electronic Communication
Resources:
Federal facilities seeking PCMH Recognition must meet the same high standards as medical homes in the private sector. Application and regulations are different, though, and the following include specific requirements for the Government Recognition Initiative Program (GRIP):
PCMH 2011 Content and Scoring Summary
PCMH 2011 Overview
Pricing and Fee Schedule for PCMH 2011
Additional Medical Home Resources
PCMH 2011 Recognition Process
PCMH and PPC-PCMH FAQs
Upgrades and Renewal Requirements to PCMH 2011
All PCMH materials can be obtained from the following sites: NCQA, URAC, the Joint Commission, and the AAHC.
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Chronic Disease Self-Management into a Patient-Centered Medical Home
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Implementing CDSMP into a PCMH is a new offering at the Consortium for Older Adult Wellness in Colorado. Join them January 12-13 for an in-depth look at the nuts and bolts of embedding and sustaining the Chronic Disease Self-Management Program. Attendees will see successful models working within the Health Centers Program and Patient Centered Medical Homes then learn how to master the details of messaging, recruiting, physician referrals, documentation for PCMH, running the classes in conjunction with health systems, paperwork, pitfalls and partnerships. You'll leave with a national perspective on the importance of connecting community based-organizations to health systems, templates for your use, and action plans specifically geared toward making implementation a reality in your organization.
Join presenters from the National Council on Aging, Colorado Community Health Network, and the Consortium for Older Adult Wellness for a lively and informative workshop. Seeking detailed information on how to make it happen at your organization? Then this workshop is for you! Call COAW at 888-900-2629 and see the details and register on-line at http://coaw.org/home.aspx.
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December Health Observance: Safe Toys
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Unsafe toys can increase emergency room visits in children under age 15. In 2010 over 250,000 children were treated in emergency rooms for toy-related injuries. Prevent Blindness America has designated December, a month where gifts are most often given to children, as Safe Toys and Gifts Awareness Month.
Unfortunately minority children experience toy-related injuries more often than nonminority children. The U.S. Government Accountability Office (GAO) was required to assess the disparity of minority children suffering more injuries from unsafe toys than nonminority children. The health outcomes that were included in the study were "preventable injuries and deaths for suffocation, poisoning, and drowning." Click here to access that report. It is possible to keep children safe from toy-related injury and death with the help of a few simple tips. One of the most important things to remember is gifts for children should always be age appropriate. |
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The National Center for Health in Public Housing (NCHPH), a project of North American Management, is supported in part by a cooperative agreement grant awarded by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA).
This publication was made possible by grant number U30CS09734 from the Health Resources and Services Administration, Bureau of Primary Health Care and its contents are solely the responsibility of the authors and do not necessarily represent the official views of HRSA.
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Upcoming Events
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for a list of December webinars
January 12-13, 2013 Lakewood, CO
February 7-9, 2012 Kansas City, MO
May 7-10, 2013 San Diego, CA
June 4-6, 2013 Denver, CO |
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