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Community Health Partnership and Health Care Reform An Overview of Working Together May 25, 2011 Slide 2 Presentation Overview Health Care Reform- Getting Familiar with Landmark Legislation Role of Community Health Centers (CHCs) Carrying out the Promise of Health Care Reform in Santa Clara County Our Call to Action! Slide 3 Circle of Health Care Reform Slide 4 Henry J. Kaiser Family Foundation Pop Quiz on Health Care Reform Slide 5 Slide 6 Slide 7 Slide 8 Slide 9 Slide 10 Slide 11 Slide 12 Slide 13 Slide 14 Slide 15 Whats in the health care reform legislation? Patient Protection and Affordable Care Act, 2009 Slide 16 Health Care Reform Hits Main Street by the Kaiser Family Foundation Slide 17 Pop Quiz Self-Scoring! Slide 18 How did the public do? Slide 19 Grading the Public 1/4 got 7-10 answers correct 1/3 got 0-4 answers correct 2/3 got 5 or more answers correct Most people got 4-6 questions correct Less than 1% responded to all 10 questions correctly Slide 20 What does the health care reform law do? The health care reform law: Expands, promotes, and improves health care insurance coverage Requires delivery system changes Promotes primary and preventative care Improves health care quality Slide 21 How does health care reform impact medically underserved communities? Health care reform makes an $11 Billion investment in Community Health Centers Expands Medicaid/Medi-Cal Improves quality and coordination of care Funds prevention and wellness initiatives Funds workforce development initiatives Slide 22 Community Health Centers The idea for health centers was inspired by a model of community care in South Africa. Created in 1965 as part of the Office of Economic Opportunity to provide health and social service access points in poor and medically underserved communities. Incorporated the community empowerment philosophy. Slide 23 Community Health Centers Community Health Centers (CHCs) play a vital role as the safety net for our countrys health delivery system. Do not turn anyone away for lack of insurance or ability to pay. CHCs are community driven; at least 51% of the health center board must be patients. Slide 24 Community Health Centers Improve access to primary and preventative care Facilitate access to specialty care Provide quality care and produce cost savings Slide 25 Administration of CHCs U.S. Department of Health and Human Services HRSA-Health Resources and Services Administration BPHC- Bureau of Primary Health Care Slide 26 What does this mean locally? Slide 27 1115 Waiver Bridge to HealthCare Reform Slide 28 Medi-Cal Waiver The Medi-Cal 1115 Waiver 1115 Waiver Relationship to Health Care Reform 1115 Waiver Components Slide 29 The 1115 Waiver Agreement: Federal Government & State of California Allows the State to waive national Medicaid regulations Savings from the program will go back into the waiver program created A mechanism for funding to public hospitals for Medi-Cal services and indigent care Previous waiver programs in Santa Clara County: A low- income health initiative called Valley Care and funding for hospital to care for indigent patients. Slide 30 Health Care Reform 1115 Waiver Components Medi-Cal Coverage Expansion Seniors & People with Disabilities DSRIP-Delivery System Reform Incentive Pool Improve infrastructure Innovation System Redesign Population-Focused Improvement Urgent improvement in Care (access,quality, etc.) 20,000-30,000 New Patients in Santa Clara County Slide 31 Health Care Reform Promising New Coverage MediCaid $43,320 4 People >$88,200 Slide 32 The Role of Community Health Partnership Slide 33 Community Health Center Advocacy NACHC-National Association of Community Health Centers CPCA-California Primary Care Association Consortia (are) state-wide Regional Associations of Safety-net Clinics or Community Health Centers Community Health Partnership (is) a Consortium of safety-net, community health centers in Santa Clara and San Mateo County Asian Americans for Community Involvement, Foothill Health Centers, Gardner Family Health Network, Indian Health Center of Santa Clara Valley, Planned Parenthood Mar Monte, Mar Monte Community Clinic, MayView Community Health Center, North East Medical Services, Ravenswood Family Health Center, RotaCare Bay Area, School Health Clinics of Santa Clara Valley Slide 34 OUR ROLE Policy and Advocacy To ADVOCATE on behalf of CHCs To ensure that the CHCs role as a VITAL component of the countywide System of Care To represent CHCs at local, state, and federal government levels (in concert with CPCAs strategic plan) Slide 35 OUR ROLE Preparing CHCs for Health Reform Assessing CHC capacity for expansion Testing and implementing payment reform initiatives Helping build systems that will quantify QI and DSRIP measures Supporting and increasing enrollment & retention in qualifying health plans Slide 36 OUR ROLE Providing technical assistance to CHCs in these areas: Patient Centered Medical Home Achieving Meaningful Use of Electronic Health Record Systems Building operational infrastructure that improves: Cost management Resource management Data collection and reporting Patient care coordination Quality management Slide 37 Call to Action! Be part of an Historic Era in Healthcare! Be part of a TEAM with a strategic direction! Be part of a something BIGGER than the sum! Witness the transformation of CHCs into Medical Homes! Slide 38 Be part of a MOVEMENT in health care by: Participating in legislative events and advocacy activities Educating yourself about the Santa Clara Health and Hospital System Determining linkages and opportunities between your program and health care reform (enrollment, medical home, etc.) Slide 39 Questions/ Discussion Slide 40 References Jorge De Luna, MPH California Primary Care Association (CPCA) Families USA Kaiser Family Foundation National Association of Community Health Centers (NACHC) Slide 41 Thank You!