Healthy Communities Access Program

1
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., M.B.A.
• U.S. Department of Health and Human Services
• Health Resources and Services Administration
• Bureau of Primary Health Care

2
Overview

• Bureau of Primary Health Care
• Presidents Initiative
• Healthy Communities Access Program

3
Bureau of Primary Health Care
Office of the Bureau Director
Division of Immigration Health Services

Division of National Hansens Disease Program

Office of Policy, Evaluation Data
Office of Minority and Special Populations
Division of Health Center Development
Division of Health Center Management
Division of State and Community Assistance
Division of Clinical Quality

• 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

4
The Presidents Health Center Initiative

• 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

5
Three Essential Areas

• Managing quality improvement
• Strengthening existing health centers
• Managing the growth of new and
• expanded health centers

6
Presidents Initiative to Expand Health Centers
200
171
180
Projected
Actual
160
131
140
176
145
130
130
120
156
125
100
100
87
90
80
80
60
63
61
40
20
0
NAP
EMC
NAP
EMC
NAP
EMC
NAP
EMC
NAP
EMC
FY 2002
FY 2003
FY 2004
FY 2005
FY 2006
7
New Users Projected Within
Initiative
8
Healthy Communities Access Program
(HCAP)
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Healthy Communities Access 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

10
Basic Eligibility Requirements

•  
• For an entity to be eligible to receive an HCAP
  award, the following requirements must be met
•  
• The applicant entity must represent a consortium
  whose principal purpose is to provide a broad
  range of coordinated health care services to
  their defined communitys uninsured and
  underinsured populations.

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Basic Eligibility Requirements(Continued)

• 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 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.
13
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

14
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

15
HCAP Grantees
16
Service Area Type Reported by FY 03
HCAP Grantees

• 40 urban
• 31 rural
• 29 serving blended rural, urban, tribal and
  other communities

17
Consortia Represent a Broad Array
of Community Stakeholders

• 73 are Federally Qualified Health Centers
• 72 are Local Health Departments
• 59 are Community Based Social Service
  Organizations
• 57 are Private Hospitals
• 54 are Local Government
• 51 are Other Community Health Centers
• 53 are Public Hospitals
• 40 are Faith Based Organizations
• 39 are Mental Health Programs
• 35 are Private Providers Group Practices

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HCAP 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

20
HCAP Leveraging
In-Kind Contributions

• Source of Grantees
• Private 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 Care
• Division of State and Community Assistance
• 4350 East West Highway, 9th Floor
• Bethesda, Maryland 20814
• 301-594-4488
• 301-480-7833 (FAX)
• BBailey_at_hrsa.gov
• Capcentraloffice_at_hrsa.gov