2011 Annual ReportM I C H I G A N

A S S O C I A T I O N

Care

Connecting Communities with Quality, Affordable Health Care

M I C H I G A N

A S S O C I A T I O N

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As the statewide association for Michigan Health Centers, Michigan Primary Care Association is impacting the health of Michigan by promoting, supporting, and developing comprehensive, accessible, and affordable community-based health care services for all residents. Our vision is to build a healthy society in which all residents have convenient and affordable access to health care that ensures excellent health outcomes and quality of life.

Health Centers are a key strategic tool in assuring that underserved areas and populations have access to health care. Today nearly 600,000 Michigan residents rely on a Health Center as their health care home—including individuals who are low income, uninsured, underinsured, elderly, minority, migrant and seasonal farmworkers, homeless, and those living with HIV. If it weren’t for Health Centers, many of these individuals would remain isolated from health care due to lack of insurance, inability to pay for services, and transportation, language, and cultural barriers. Health Centers overcome these barriers by providing coordinated, comprehensive, community based health care to anyone who walks through their doors.

www.mpca.net

Michigan Health Center Patients by Income

Michigan Health Center Patients by Insurance Status

41.9%

34.4%

14.1%

9.1%

0.5%

Medicaid/CHIP

Uninsured

Private

Medicare

Other Public

92.2%

69%

200% FPL*and Below

100% FPL*and Below

*Federal Poverty Level

CONTENTSM I C H I G A N

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4 Executive Director’s Message

5 Access

8 Quality

10 Operations

12 Partnerships

15 Board of Directors

16 Staff

17 Financial Statement

18 Revenue Diversification

Executive Director’s Message

Michigan Primary Care Association (MPCA) is very proud to present to you our 2011 annual report. This report not only gives you MPCA’s year in review, it also places before you the many and rich opportunities for partnership, growth, transformation, and improved quality that accrue benefit to Michigan communities and their medically underserved populations through the work of Health Centers. MPCA’s member Health Centers, their staff and boards, and MPCA’s highly skilled associates are here to support and lead Michigan communities into a healthier 2012 and beyond.

As the economy in Michigan has started to take a turn for the better, Michigan Health Center grantees and FQHC Look-Alikes have helped to lead the way. Health Centers are building new facilities, creating jobs that make communities healthier, and expanding access to care that makes families healthier. Michigan Health Centers are also reaching out to community partners, linking resources that result in a more integrated system of care. This allows individuals to be the center of their care plan and helps create a more continuous and connected set of supports that extend from your health care home to where you live “24/7”.

As with every year, 2011 offered its set of challenges. Twenty-five New Access Point (NAP) applications were submitted from Michigan, but none were funded in the first round. This challenge resulted in a binding together of Michigan’s communities and their leadership in a call for support for expanded access in the state. Communities, Congress, the Administration, foundations, and other partners expressed their concern and support for new access to health care for underserved populations in Michigan, and they were heard. There has never been a time in my 32 years working with Health Centers that I’ve seen so much support for communities in need of care. That is power and should give impetus to our next steps.

Moving into 2012, transformation is our mantra, using the support we’ve gained, the leadership within our Health Centers, and the credibility we’ve accrued nationally. MPCA and its members are moving to high performing comprehensive care providers. There is a renewed focus on clinical leadership. Systems improvement processes are being implemented that will drive redesign at the point of care. Data will be transformed into information that is readily available to teams for rapid redesign. Community resources and communications systems will be aligned—all to improve the health and wellbeing of people living in the communities we serve.

Thank you for a great 2011! Join us for a dynamic and transformational 2012. We welcome you as partners in this ground breaking work. n

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Kim E. SibilskyExecutive Director

ACCESSM I C H I G A N

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One of MPCA’s strategic goals is for all people to have access to primary care, regardless of where they live, the language they speak, their income level, or whether they have health insurance. In 2011 MPCA continued to work toward that goal by....

Assisting in the development of new or expanded sites and services where needed

l Michigan organizations submitted 25 applications to the U.S. Department of Health and Human Services in 2011 for establishing new access points. Unfortunately, due to federal budget constraints, just 67 of the 800 applications submitted nationwide were funded. Although no Michigan organizations received funding, Michigan Health Centers and friends banded together to voice concern for the funding selection process. This gave us new energy in our advocacy, both with Washington and Michigan. Senator Debbie Stabenow and other members of the Michigan Congressional Delegation, and Governor Rick Snyder and his Community Health Director worked in concert to support the need for more Health Centers in Michigan. It is estimated that 1.7 million state residents lack access to primary health care. MPCA continues to provide technical assistance to Health Centers with particular focus on increasing the number of new access points and expanding Health Center services in Michigan. The Greater Detroit area was one of the priorities in 2011. MPCA worked collaboratively with the Detroit Wayne County Health Authority, Voices of

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Detroit Initiative, members of the Detroit Area FQHC Council of Southeast Michigan, and other organizations interested in expanding Health Center services.

l In August 2011, nine Michigan organizations received grant funding from the U.S. Health Resources and Services Administration to help them plan for developing into future Health Centers. Becoming a Health Center would enable them to extend comprehensive primary and preventive health services to populations currently lacking access to such services and improve their health status. MPCA continues to provide support and technical assistance to these organizations.

l In 2011 MPCA developed a Capital Development Program to assist Michigan Health Centers in capital development efforts by identifying capital development opportunities, potential sources of funding, financing, and other assistance; providing planning and development information; and identifying potential financial consultants and experienced developers. This information is available on the MPCA website.

l MPCA received a three-year grant from The Kresge Foundation to provide Michigan Health Centers with technical assistance in developing innovative, signature capital development projects, and to seek and develop additional sources of funding for these types of projects. In 2011 MPCA launched the design of collateral materials promoting Michigan Health Center capital projects.

l MPCA provided information and technical assistance to 20 Michigan Health Centers in submitting Capital Improvement grant applications to the U.S. Health Resources and Services Administration in 2011 for building, expanding, and improving Health Centers.

Supporting Health Centers in developing creative partnerships to expand capacity

l The health care community in Michigan continues to strive to meet the ever growing health care needs of the population, and MPCA and its member Health Centers continue to work with partners at the community, state, and national level to ensure the health care needs of Michigan are addressed.

l In 2011, 32 individuals served with the MPCA Community HealthCorps program: 18 served in Health Centers or with local health organizations, 13 served with MPCA’s CHIPRA program, 1 served with MPCA’s Special Populations programs. Members focused their service activities on the Corporation for National and Community Services’ Healthy Futures Priority, which emphasizes access to health care, disease prevention, health promotion initiatives, health literacy, childhood obesity, other unmet health needs, and volunteer development. Collectively, AmeriCorps members leveraged 140 volunteers for approximately 560 hours of volunteer service, provided direct assistance to 8,521 individuals, provided assessment support to 12,987 individuals, referred 998 individuals to additional services, and provided interpretative support to 442 individuals.

Assisting with enrollment in coverage programs

l During 2011, the second year of MPCA’s children’s health insurance outreach and enrollment program, MPCA assisted 1,562 children in applying for health insurance in 68 of 83 Michigan counties: 1,084 were enrolled in Medicaid and 145 were

ACCESST he following Michigan Health Centers opened

new or expanded sites in 2011: Baldwin Family Health Care, Center for Family Health, Cherry Street Health Services, Covenant Community Care, Family Health Center Inc., Family Health Center of Battle Creek, Hamilton Community Health Network, Health Delivery Inc., InterCare Community Health Network, Muskegon Family Care.

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enrolled in MIChild through nearly 10,000 outreach, enrollment, and follow-up encounters. MPCA also enrolled children in Medicaid Emergency Services, pregnant women in Medicaid and MOMS, and mothers in Plan First. MPCA launched a substantial new back-to-school enrollment campaign called Enroll Michigan in partnership with the Michigan Health and Hospital Association. The campaign resulted in a 20% increase statewide in the number of online applications for coverage during August-September 2011. MPCA also received a one-year, no-cost extension to the grant, which will allow us to continue outreach and enrollment efforts for a third year.

l MPCA received competitive funding from the U.S. Department of Health and Human Services through the Children’s Health Insurance Program Reauthorization Act (CHIPRA) for a two-year project to assist children insured through public coverage programs in retaining Medicaid or MIChild coverage. MPCA is using the funding to launch an innovative voice and text message reminder system and support increased local retention assistance to reach nearly 90,000 children across Michigan served by eight member Health Centers.

l During 2011 MPCA worked as a key partner in the Michigan Benefits Access Initiative (MBAI), a public-private partnership between community non-profit organizations and the Department of Human Services. MBAI focuses on “bundling” public benefit programs, including Medicaid, into one online, accessible system for clients to use in enrolling, renewing, and reporting status changes. The new system, called MiBridges, debuted in December 2011. MPCA also served as a technical assistant to MBAI pilot efforts underway in Southeast Michigan, which provided grant funding to community, faith-based, and health care organizations—including two Michigan Health Centers—to expand the level of benefit assistance provided to clients in their facilities.

Assessing the need for improved access to care statewide

l In May 2011 MPCA was granted access to the federal Application Submission and Processing System (ASAPS). As a result, MPCA has been able to further support the State Primary Care Office (PCO) and expedite the Health Professional Shortage Area (HPSA) designation process. MPCA worked with the State PCO to redesignate 27 primary care and 26 mental health HPSAs across the state in 2011.

l MPCA completed the first report of a five-year statewide assessment of need and targeted growth areas to project patient growth, new services, required resources, and geographic locations of development. From the 26 organizations that participated in the assessment, 93 planned projects were documented with new access points accounting for nearly 75% of planned expansion.

Increasing awareness of Health Center services

l MPCA assisted Michigan Health Centers in planning National Health Center Week 2011 events to highlight how Health Centers are “Serving Locally, Leading Nationally.” Governor Snyder declared August 7-13, 2011, as National Health Center Week in Michigan.

l MPCA continued to increase awareness of Health Center services through its weekly MPCA eUpdate, website, blog, social media sites, and outreach to media outlets across the state.

l MPCA assisted Michigan Health Centers in participating in the Campaign for America’s Health Centers’ National Petition and Letter Drive. Michigan Health Centers have collected over 6,770 petition signatures and advocacy letters, showing tremendous support for Health Centers across the state and the nation.

l To help strengthen the recognition of Health Centers as a unified and nationwide network of quality providers, MPCA joined the National Association of Community Health Centers’ Community of Community Health Centers branding initiative by adopting the FQHC brand identity mark.

ACCESS

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MPCA assists Michigan Health Centers in ensuring they are the very best at delivering quality, comprehensive, community responsive health care. In 2011 MPCA continued to work toward that goal by....

Assisting Michigan Health Centers in becoming Patient-Centered Medical Homes

l In 2011, two Michigan Health Centers achieved Patient-Centered Medical Home (PCMH) certification from the National Committee on Quality Assurance, and five received Blue Cross Blue Shield of Michigan PCMH certification. PCMH is being championed as the transformative model of care that will build primary care infrastructure, improve quality of health care delivery, and bend the cost curve to contain escalating health care costs. Introduced in pediatrics more than 40 years ago to address the complex care of special needs children, the PCMH model is designed to place the patient at the center of accessible, continuous, comprehensive, and coordinated care.

l MPCA completed an assessment of Michigan Health Centers’ clinical quality, PCMH, and Meaningful Use needs. The results provided the necessary information to create a Health Center focused approach to guide the strategic work of the MPCA Clinical Services Team.

l MPCA developed and began work on the Patient-Centered Medical Home Learning Community for Michigan Health Centers, a 12-month technical assistance initiative to assist participating

Health Centers in becoming positioned to receive National Committee on Quality Assurance Level 3 PCMH designation and Meaningful Use achievement. The Learning Community launched March 1, 2012.

l In response to needs expressed by Michigan Health Centers for assistance in the PCMH designation process, Meaningful Use achievement, practice transformation, and new staffing models for patient-centered care, MPCA held a day-long pre-conference session for clinicians at the 2011 MPCA Annual Conference.

l Twenty-five Michigan Health Centers were among 900 organizations across the country to receive Health Center Quality Improvement and PCMH Supplemental Funding in September 2011 to enhance the quality and coordination of health care, including primary and behavioral health services.

Promoting effective change to support evidence-based clinical and quality improvement across a wide variety of health care settings

l MPCA launched the Pharmacy Network to facilitate the exchange of information and collaboration among 340B pharmacy staff and those managing contract pharmacies. Nineteen pharmacists and pharmacy staff from 12 Michigan Health Centers participated in the Network’s inaugural face-to-face meeting held in November 2011.

l MPCA continues to maintain and nurture key federal and state partnerships to benefit migrant health and homeless health activities. Five Migrant Health Centers in Michigan serve about

QUALITYM I C H I G A N

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18% of the state’s migrant and seasonal population. Eight Health Care for the Homeless programs in Michigan serve over 15,650 homeless individuals, either through the direct provision of care or established links with other community agencies.

l MPCA built a strong relationship with Tribal Health Centers, mainly in the area of immunization.

l MPCA developed partnerships with HIV providers, care coordinators, case managers, and key leadership to set the path for increased HIV testing and care in Michigan Health Centers.

l MPCA successfully completed a pilot project with Delta Dental to assess the impact of dental providers screening for high blood pressure when patients present for routine dental appointments. About one in three adults in the U.S. has high blood pressure, but many aren’t aware until it has reached advanced stages. Taking advantage of regular dental appointments as screening opportunities and referring patients who need further evaluation or treatment can improve health outcomes.

Improving Health Centers’ clinical performance using data to generate information to drive change

l Offering assistance to Michigan Health Centers regarding their immunization program continues to be a vital MPCA service. This includes assessing each Health Center’s immunization program and coverage levels; providing education about new vaccines and recommendations, as well as ways to improve coverage levels; and providing technical assistance around specific problem areas. Overall coverage levels in the Michigan Care Improvement Registry (MCIR) for 2-year old children served by Michigan Health Centers in 2011 was 77%, which is 4.5% higher than the national average. The coverage level for migrant children was 80%.

l MPCA continued to use findings from the Emergency Preparedness Survey to assist Michigan Health Centers in

mitigating identified gaps in readiness and response plans. We held a full-day workshop for Michigan Health Center staff in 2011 to increase knowledge and build a network.

l The MPCA Health Information Technology Network continues to support electronic health record (EHR) implementation in Michigan Health Centers. Michigan Health Centers have an 87.5% EHR adoption rate. In 2011 the Network continued progress on creating a data repository that would enable MPCA to utilize our information technology capacity in collecting member data and converting it to information to drive change. Members will have the capability of producing reports such as National Committee on Quality Assurance Patient-Centered Medical Home reporting, clinical data quality validation, lost revenue reports, chronic disease management, clinical process improvement tracking, and detailed aging and productivity trending.

l MPCA’s technology service, VirtualCHC, provided Health Information Technology (HIT) support to 60 Health Centers in 15 states through online hosting of software applications including practice management systems, electronic health records, accounting systems, HIT consulting, and HIT equipment purchasing services. VirtualCHC also hosted online clinical registries, a data warehouse, and data management and reporting solutions for quality data.

QUALITY

In 2011 MPCA established the position of Director of Quality and Clinical Services to lead MPCA’s internal

clinical services team, collaborate with Health Center clinical leadership, and strengthen external partnerships. The team also restructured communication delivery strategies to more effectively and efficiently communicate with Michigan Health Center clinicians, and it recruited new clinical representation on the MPCA Board of Directors.

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MPCA assists Michigan Health Centers in operating as stable, innovative, and highly efficient organizations by...

Assembling and maintaining an infrastructure to support Health Centers in continuous improvement and innovation

l MPCA established the position of Manager of Health Center Operations in 2011 and formed a Health Center Operations team.

l MPCA began work on and piloted a new online repository for educational content, resources, and best practices that will be formally launched in 2012. This new platform will utilize advanced technology to deliver engaging audio, video, and module-based learning experiences for Health Centers to improve organizational processes and explore innovative practices.

l To promote information, educational opportunities, and peer-to-peer networking among Michigan Health Center staff, MPCA continues to facilitate Communication Networks focused on behavioral health, billing, clinical services, communications, finance, grassroots advocacy, Health Center board member governance, human resources, operations, outreach and enrollment, and pharmacy.

Assisting Health Centers in maintaining financial stability

l MPCA provided financial analysis and advocacy on two advanced primary care demonstration opportunities from the U.S. Health Resources and Services Administration and the Centers for Medicare and Medicaid Services.

l MPCA resolved numerous reimbursement policy issues in 2011, including modifications to when a Health Center begins to receive payment from Medicaid as Federally Qualified Health Center (FQHC). This resulted in securing several million dollars in revenue for Michigan Health Centers. (The term FQHC is defined in Medicare and Medicaid statues, and it is used by the Centers for Medicare and Medicaid Services to indicate that an organization is approved to be reimbursed under Medicare and Medicaid using specific methodologies for FQHCs.)

l MPCA enhanced its support to Michigan Health Centers in the area of billing by expanding the MPCA Billing Network, hosting a billing and coding conference, and delivering online trainings.

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OPERATIONSM I C H I G A N

A S S O C I A T I O N

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Assisting Health Centers in growing the expertise and resources needed to operate high-performing, efficient organizations

l MPCA supports workforce recruitment and retention efforts for all safety net facilities by generating prospective employment leads and assisting Health Centers in recruiting suitable candidates. A major focus of MPCA’s Workforce Development Program is to increase the number of Health Centers participating in provider retention programs such as the National Health Service Corps, Michigan State Loan Repayment Program, and J-1 Visa Waiver.

l MPCA hosted 13 in-person and 27 online training and education events attended by hundreds of individuals from Michigan Health Centers and other organizations. Topics ranged from Health Center billing, to emergency management, to combatting childhood obesity. Attendance at the 2011 MPCA Annual Conference was a record high.

l MPCA conducted an in-depth assessment of Health Center operations, finance, and billing/reimbursement training and technical assistance needs to inform strategic planning, workplan development, pursuit of funding opportunities, and member offerings.

l MPCA negotiated a group purchase of the Optimizing Comprehensive Clinical Care (OC³) Compliance and Performance Improvement (CPI) Manual. The manual provides Health Centers with a solid foundation for achieving compliance with legal requirements, meeting accreditation standards such as those from the Joint Commission and the National Committee on Quality Assurance Patient-Centered Medical Home Recognition Program, and implementing best practices in the field.

l MPCA actively monitored funding opportunities, alerted Health Centers of potential funding partnerships, and coordinated funding applications on behalf of Health Center groups.

l MPCA formed a state-based, Health Center specific user group for organizations using NextGen Electronic Health Record and Practice Management systems.

OPERATIONS

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MPCA represents Michigan Health Centers in its work with partners at the community, state, and national level to ensure Health Centers are leaders in health systems change by...

Developing relationships with policymakers and assisting them in developing policy that impacts accessibility, capacity, quality, and delivery of care

l Governor Rick Snyder included reforming Michigan’s health care system in his Top 10 Plan for the state. He specifically named Health Centers as a strategy to help ensure that every resident has access to affordable and quality health care; placing value on prevention and wellness; and moving Michigan to a more patient-centered model to achieve large cost savings, promote wellness, and improve overall service quality. The Governor delivered a special message on health and wellness in 2011 from the Heart of the City Health Center in Grand Rapids.

l Under the leadership of Governor Snyder, the Michigan Legislature maintained the integrity of Medicaid in the fiscal year 2012 budget (October 1, 2011, through September 30, 2012) by preserving current eligibility categories, benefits, and provider rates. This ensures Michigan’s 1.9 million Medicaid beneficiaries have access to essential primary and preventive care. This included maintaining dental benefits for adult Medicaid beneficiaries; these were eliminated and then reinstated twice in the recent past.

l With support from MPCA, Michigan Health Centers hosted visits with state legislators and members of the Michigan Congressional delegation so they could experience, first-hand, how Health Centers benefit Michigan residents and communities.

l MPCA hosted its annual Legislative Forum in March 2011 to build and nurture relationships with state legislators and discuss issues impacting Michigan Health Centers.

l Michigan Health Center advocates joined with advocates from across the country to meet with Congressional staff during more than 380 visits to Capitol Hill in March 2011.

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Congressman Fred Upton visited InterCare Community Health Network’s new site in Benton Harbor in celebration of National Health Center Week 2011.

l Senator Debbie Stabenow once again co-sponsored the Health Centers Dear Colleague Letter in the U.S. Senate, a key step in the annual federal appropriations process in determining the level of federal funding for the Health Centers Program.

l MPCA mobilized Michigan Health Center advocates to educate the Michigan Congressional delegation about the critical importance of the Medicaid program for Health Centers and patients through a national call-in day, state call-in day, and media outreach efforts.

l MPCA launched the Grassroots Advocacy Network to facilitate Michigan Health Centers’ advocacy efforts and streamline the sharing of information.

Participating and influencing health care reform development and concurrent system changes at the state and federal level

l In anticipation of the Centers for Medicare and Medicaid Services’ release of the interim rule for Accountable Care Organizations (ACOs), MPCA established an ACO workgroup and drafted a proposal for establishing a statewide Independent Practice Association (IPA) for MPCA members.

l MPCA supported state legislation (S 693) that Senator Jim Marleau introduced in 2011 for creating a health insurance marketplace in Michigan, called the MiHealth Marketplace, and successfully advocated for Senate passage of the bill. The House has yet to take action on the bill.

l In collaboration with its partners of the Michigan Consumers for Healthcare, MPCA celebrated the Affordable Care Act’s first birthday in March 2011 by co-hosting birthday parties in communities across the state and providing information on the ACA to educate state residents about its benefits.

Creating or identifying opportunities for participating in new models of service delivery and reimbursement that integrates care or expands service delivery and demonstrates effective reimbursement mechanisms

l In an effort to improve health outcomes, decrease health care costs, and improve the experience of care among Medicaid beneficiaries with behavioral health or selected chronic physical conditions, MPCA collaborated with the Michigan Association of Community Mental Health Boards in developing a Michigan Medicaid Health Homes proposal that was submitted to the Michigan Department of Community Health for consideration.

l Eighteen Michigan Health Center sites were among 500 Health Centers across the country selected to participate in the Centers for Medicare and Medicaid Services’ three-year Federally Qualified Health Center Advanced Primary Care Practice demonstration project. The intent of the demonstration is to show how the PCMH model can coordinate and improve quality of care, promote better health, and lower costs of care delivered to Medicare beneficiaries and other patients.

l MPCA served on two workgroups charged with drafting the state’s Medicare/Medicaid dual integration planning project. Michigan was one of 15 states to receive a CMS contract to develop ways to improve care and services for individuals who are dually eligible for Medicare and Medicaid. Michigan Health Centers are the health care home for 23,000 individuals who are dually eligible for Medicare and Medicaid.

PARTNERSHIPS

Michigan Primary Care Association continuously collaborates with partners at the local, state, and national

level—governmental agencies, elected officials, community organizations, educational institutions, foundations, and more.

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l At both the state and national level, MPCA has been a critical player in efforts to integrate behavioral health care into the primary care setting, and comprehensive primary care into the behavioral health setting. MPCA worked closely with the Michigan Association of Community Health Boards and the National Council for Community Behavioral Healthcare, U.S. Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, and Michigan Medicaid to create meaningful and sustainable integration of mental health, substance use, and primary care services. In November 2011, MPCA hosted a Behavioral Health/Primary Care Integration Conference, attended by over 300 primary care and mental health advocates, and we launched a year-long series of monthly webinars that began in December 2011.

l MPCA began a comprehensive analysis of existing/evolving behavioral health integration projects of Michigan safety net providers. These projects will be showcased on the MPCA website to increase awareness of the projects, provide guidance and resources for Health Centers in choosing an integration model, and to serve as an advocacy and policy planning tool.

l MPCA AmeriCorps program staff helped the Michigan Association of United Ways develop their AmeriCorps Community Resource Navigator program by providing direct program oversight through December 2011 when a program director was selected to oversee the United Way program. This program has added an additional 33 members to Michigan’s AmeriCorps Program, providing direct support to Michigan Benefits Access Initiative and regional 2-1-1 Call Centers.

PARTNERSHIPS

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32 Michigan Health Centers serve

nearly 600,000 residents at over

190 delivery sites across Michigan.

MPCA Executive Committee

Anthony V. King, FACHE, MHSAPresidentThe Wellness Plan Medical Centers

Joseph W. Ferguson, MHA, FACHEPresident-ElectAdvantage Health Centers

Donald Simila, MSW, FACHETreasurer Upper Great Lakes Family Health Center

Mary MiddletonSecretaryCassopolis Family Clinic

Adrienne GloverChair, Health Center Board Member CommitteeCassopolis Family Clinic

BOARD of DIRECTORS M I C H I G A N

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MPCA Board of Directors

Linda AtkinsWestern Wayne Family Health Centers Christine BaumgardnerAlcona Health CentersWayne W. Bradley, Sr.Detroit Community Health ConnectionArlene Brennan, RN, MSN, MHSA Traverse Health ClinicSheila Bridges, MBAMuskegon Family CareDeb Brinson, MPAIngham County Health DepartmentBrenda Coughlin, MDHealth Delivery, Inc.Denise Crawford, MSW, MBAFamily Health Center, Inc.Dale ErnstCenter for Family HealthLisa GalonskaHealth Delivery, Inc.Marcia GibbardEast Jordan Family Health CenterRicardo Guzman, LMSW, MPHCommunity Health & Social Services (CHASS) Center

Velma HendershottInterCare Community Health NetworkDonna JaksicUpper Peninsula Association of Rural Health ServicesAJ Jones, NDFamily Health Center of Battle CreekLinda Juarez, MPHHackley Community Care CenterMolly KaserCenter for Family HealthLaurel KeenanBay Mills Health CenterEd LarkinsFamily Medical Center of MichiganBradford Mathis Saint Mary’s Health Care Community Health CentersDan McKinnonEast Jordan Family Health CenterDarrell E. Milner, MPHMidMichigan Health ServicesClarence Pierce, MSHamilton Community Health Network

Paul PropsonCovenant Community CareCynthia RoushDownriver Community ServicesRoger RushlowSterling Area Health CenterKathy Sather, BSN, MBABaldwin Family Health CareChris SheaCherry Street Health ServicesLinda Shively, MPA, HCAOakland Primary Health ServicesHerb Smitherman, MD, MPHHealth Centers Detroit Medical GroupMarilyn Stolberg, DDSBaldwin Family Health CareMichelle StymaThunder Bay Community Health Service, Inc.Cynthia TauegSt. John Providence Health SystemAshley TuomiAmerican Indian Health & Family Services of Southeastern Michigan, Inc.Judith Williams, MPH, MSWNorthwest Michigan Health Services, Inc.

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www.mpca.net

STAFF M I C H I G A N

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Kim SibilskyExecutive Director

Dustin BarberInformation Technology Assistant

Brittany BeardHealth Access Coordinator

Kimberly A. Benjamin, PHR Workforce Development Specialist

Phillip J. BergquistManager of Health Center Operations, CHIPRA Program Director

Carolee Besteman, RN, MSClinical Consultant

Patrick BurkeDirector of Finance & Operations

John Cahill, CHPInformation Systems Manager

Andrea Charlton, MPH, MSWCommunity Health Planning Manager

Rebecca Cienki, MPHDirector of Strategic Growth

Neal Colburn, CPHIT, CPEHR, CPHIEDirector of Capital Development

Bill Collin, MBA, CPMEProject Manager

Michael GleasonNetwork Administrator

Matt Herwaldt, CMAAccounting Manager

Dana LawrenceDirector of Communications & Grassroots Advocacy

Barbara LincolnConference & Events Coordinator

Kevin McGheeAmeriCorps Program Specialist

Lynda Meade, MPAProgram Manager

Katie Nearpass Accounting Assistant

Douglas M. Paterson, MPADirector of State Policy

Rob PazdanManager of Network Operations

Natasha RobinsonCHIPRA Program Specialist

Erin RogersOffice Administrator

Kristin SeyfertReceptionist

Mazhar Shaik, MD, MBADirector of Quality & Clinical Services

Cindy Shaw, CHRS, CERPCertified Human Resources Specialist

Erin Sloan-TurnerCHIPRA Program Specialist

John TaylorAmeriCorps Program Director

Jon Villasurda, MPHData & Policy Specialist

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FINANCIAL STATEMENTM I C H I G A N

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Statements of MPCA Financial Position

Year ended September 30ASSETS 2010 2011Cash and cash equivalents $16,751,564 $9,504,699Prepaid expenses 6,092 1,642Accounts receivable 784,362 739,770Land and buildings - net 837,127 860,075Other property, equipment - net

106,723 70,217

Total assets 18,485,868 11,176,403 LIABILITIES & NET ASSETSLiabilitiesAccounts payable 3,511,756 3,271,901Accrued expenses 122,406 107,158Loans payable 651,695 667,357Deferred revenues 13,637,634 6,687,248Total liabilities 17,923,491 10,733,644Net assets - unrestricted 562,377 442,739Total liabilities and net assets

18,485,868 11,176,403

Statements of MPCA Financial Activities

Year ended September 30REVENUE & SUPPORT 2010 2011Member dues and assessments $687,811 $510,978Training and education 195,033 131,537Business services 1,116,618 757,715Grant income 2,808,223 4,062,993Contract income 14,920,281 13,144,079Other income 381,060 193,727Total revenue and support 20,109,026 18,801,029EXPENSESFederal grant programs 1,704,780 2,453,651State and other grant programs 1,225,843 1,435,354Contracts 15,125,184 13,214,588Member services 283,283 290,028Business services 922,513 757,019Training and education 231,962 175,889Management and general 495,823 476,328Total expenses 19,989,388 18,802,857Change in net assets 119,638 (1,828)Net assets - beginning of period 442,739 444,567Net assets - end of period 562,377 442,739

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l In 2011 MPCA provided Administrative Services support for several organizations. The support work included contract administration, invoicing, cash receipts, bill payment, financial reporting, and financial oversight. In return for providing these services, MPCA received service fees. The programs and organizations that MPCA supported include the Child and Adolescent Health Center program through the Michigan Department of Community Health, various school health programs through the Michigan Department of Education, and the Michigan Primary Care Consortium.

l The MPC Insurance Agency was quiet in 2011 as all work was focused on establishing a new program for health insurance (see next bullet). The MPC Insurance Agency is looking to get back on track in 2012. Insurance products offered through the agency are Long-Term Disability, Short-Term Disability, and Life Insurance. The Agency is working exclusively with Lincoln Financial Group to provide these policies. The Lincoln products provide excellent coverage and a competitive price. Other products available through the Agency are Directors and Officers Liability, and “GAP” liability. The GAP policy is designed to provide coverage where the Federal Tort Claims Act (FTCA) will not.

l In 2011, a new non-profit corporation was established to administer the health insurance program—the Michigan Community Health Centers Employee Benefit Program, Inc. The Employee Benefit Program (EBP) is supported by a committed Board of Directors and an attorney with expertise in EBP. An

experienced third party administrator has been secured to handle insurance claims. The EBP is ready to enroll Health Centers in 2012. MPCA will contract with the EBP to provide support services to participating Health Centers.

l Membership dues in 2011 were a vital source of revenue for MPCA activities. Projects funded through member dues include Legislative Advocacy, Shareholder Partnerships, and Clinical Services. All three of these projects were priorities of the MPCA Strategic Plan for 2011.

l 2011 MPCA funding partners included the U.S. Department of Health and Human Services-Health Resources and Services Administration, U.S. Department of Health and Human Services-Centers for Medicare and Medicaid Services, Michigan Health Centers, Michigan Department of Human Services, Michigan Department of Community Health, Michigan Community Service Commission, Michigan Department of Education, Michigan Oral Health Coalition, Michigan Public Health Institute, Michigan Primary Care Consortium, MidWest Clinicians’ Network, Detroit Wayne County Health Authority, University of Michigan, Kresge Foundation, and Community Health Ventures, Inc.

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REVENUE DIVERSIFICATIONM I C H I G A N

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Michigan Health Center Program Grantees

These organizations receive section 330E (Community Health Center), section 330G (Migrant Health Center), and/or section 330H (Health Care for the Homeless Health Center) funding under the Public Health Service Act, as amended.

Advantage Health Centers Detroit | 330E, 330HAlcona Health Centers Lincoln | 330EBaldwin Family Health Care Baldwin | 330EBay Mills Health Center Brimley | 330ECassopolis Family Clinic Cassopolis | 330ECenter for Family Health Jackson | 330ECherry Street Health Services Grand Rapids | 330E, 330G, 330HCommunity Health & Social Services Center Detroit | 330ECovenant Community Care Detroit | 330EDetroit Community Health Connection Detroit | 330E Downriver Community Services Algonac | 330E, 330HEast Jordan Family Health Center East Jordan | 330EFamily Health Center, Inc. Kalamazoo | 330E, 330HFamily Health Center of Battle Creek Battle Creek | 330E, 330HFamily Medical Center of Michigan Temperance | 330EHackley Community Care Center Muskegon | 330EHamilton Community Health Network Flint | 330E, 330H*Health Delivery, Inc. Saginaw | 330E, 330G*Ingham County Health Department Lansing | 330E, 330HInterCare Community Health Network Bangor | 330E, 330GMidMichigan Health Services Houghton Lake | 330EMuskegon Family Care Muskegon | 330ENorthwest Michigan Health Services, Inc. Traverse City | 330GOakland Primary Health Services Pontiac | 330ESaint Mary’s Health Care Community Health Centers Grand Rapids | 330H Sterling Area Health Center Sterling | 330EThunder Bay Community Health Service, Inc. Hillman | 330EUpper Peninsula Association of Rural Health Services, Inc. Marquette | 330EWestern Wayne Family Health Centers Inskter | 330E

Michigan FQHC Look-Alikes

These organizations have been certified by the Centers for Medicare and Medicaid Services (CMS), based on recommendations provided by the U.S. Health Resources and Services Administration/Bureau of Primary Health Care, as meeting all Health Center Program requirements. They do not receive funding under the Health Center Program.

Health Centers Detroit Medical Group Detroit*Health Delivery, Inc. Owosso*Ingham County Health Department LansingUpper Great Lakes Family Health Center GwinnThe Wellness Plan Medical Centers Detroit

*These organizations are both Health Center Program Grantees and FQHC Look-Alikes.

Other Community-Based Providers Represented by Michigan Primary Care Association

American Indian Health & Family Services of Southeastern Michigan, Inc. DetroitSt. John Providence Health System Warren

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