p acific i slands h ealth o rganization a ssociation pacific basin primary care office angela...

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Pacific Islands Health Organization Association

Pacific Basin Primary Care Office

Angela Techur-Pedro, MO/PhD

PB-PCO Coordinator

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Pacific Basin PCO Program

Background• HRSA funded, Bureau of Health Workforce (BHW) and

Office of Shortage Designation (OSD)• The PIHOA PBPCO is in its year 7 • New grant: FY2• Supports PIHOA Secretariat Staff: 1 100% FTE; 1 20%

FTE; 1 10% FTE and 10% Administrative cost and deliverable related expenses—Travel, equipments/supplies, communications, etc.,

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Goal of the PCO program

• Improve Access to Primary Care• Access to primary care is “the timely use of personal

health services to achieve the best health outcomes” (HP 2020)

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To operationalize “Access to PC” based on the definition:

• Coverage• Services• Timeliness• Workforce

Note: Limited resources restrict needs assessment specific for HPSA and MUA health indicators

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Generally, the PCO program has 3 core deliverables:

1. Statewide Primary Care Needs Assessment (SPCNA) Services

2. NHSC site certification/recertification3. NHSC provider recruitment, placement, and

retention

To assess, describe, and meet the identified primary care needs

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First core deliverable:

1. Statewide Primary Care Needs Assessment (SPCNA) Services (Pacific Basin Regional SPCNA Data Book) endorsed by 57th PIHOA Executive Board during the last PIHOA meeting in Palaua. Coverage (insurance; accessible – within 30 minutes;

affordable; acceptable;)b. Services (primary care, dental and mental health)

c. Timeliness (appointments are <=2 weeks; clinic visits are within 2 hours after arrival

d. Workforce—qualified provider (culturally sensitive)

To assess, describe, and meet the identified primary care needs

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2nd Core Deliverable: HPSA and MUAP Designations (New or Update)

HPSA: Health Professional Shortage Areas (HPSAs)1. 3 Types:

a. Primary care (Highest score=25)b. Dental Health (Highest score=26)c. Mental Health (Highest score=25)

2. May be geographic (county or service area), population (low income—at or below 100% Federal Poverty Level) or facilities (FQHCs, State or Federal facilities)

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Data Sources:

1. Census for Population and SES indicators2. MCH Annual Reports from MCHB and USAPIJ’s3. CMS National Provider List based on National

Provider Index (NPI)4. Provider Survey (Physicians, Dentists, Psychiatrists

and NHSC providers including PA, NP, Nurse Corp)1. Primary Care Providers (PC Provider Survey)2. Dental Health Providers (Dental Provider Survey)3. Mental Health (Mental Health Provider Survey)

Note: Slight change to the Pacific Basin Regional SPCNA Data Book will be an expanded Health Workforce (Physicians, Dentists, and Psychiatrist) Inventory

https://docs.google.com/a/pihoa.org/forms/d/1N_lzYDOjc6f2beU3v5EiE5-XMyd3sQK2uZimXu0di1g/edit

https://docs.google.com/a/pihoa.org/forms/d/12OFopOYlu0ittSyDsycS4JC1NpMhXORCByjiuIbRv2E/edit

https://docs.google.com/a/pihoa.org/forms/d/1huvledtCgNP-nM2UD03pytLffbU01gSA1BL19ZUVF_o/edit

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Current Status:

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MUAP Designations (New or Update)

MUAP: Medically Underserved Area/Population1. 1 types:

a. Primary care (Eligible score is <62 out of 100)

2. May be geographic (county or service area), population (low income—at or below 100% Federal Poverty Level)

3. Qualified Designation is based on an Index of Medical Underservice (IMU) score <62

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MUAP Designations (New or Update)

MUAP: Medically Underserved Area/Population1. Qualifying for Designation is based on 4 indicator

values weighted values based on prescriptive criteria and added up to yield an IMU scorea. Ratio of primary medical care physicians per 1,000

population,b. Infant mortality rate (IMR)c. Percentage of the population with incomes at or below

100%FPLd. Percentage of the population aged 65 or over

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Example of MUAP Designation Application

Qualifying CNMI as a MUA: Medically Underserved Area a. Ratio of primary medical care physicians per 1,000 population12.5 provider FTE to 62,392 population1/4991*1000=0.2, weight value~ 2.8

b. Infant mortality rate (IMR): <8.0 per 1000 LB ~ weighted value =26.0

c. Percentage of the population with incomes at or below 100%FPL: >50% ~weight value=0

d. Percentage of the population aged 65 or over: <7%, weighted value = 20.2

e. Together, these values total ~ 49 although OSDIMU=46.7

Note: Access to the methodology “demystifies” the process and allows us an opportunity to try to create Service areas that gets the best scores!!

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2 Core Benefits of HPSA and MUAP Designation

1. Qualifies USAPIJ to apply for $ Funding for Community Health Centers (MUAP) among other funding opportunities

2. Qualifies USAPIJ sites for provider placements and other funding opportunities (CAH), Rural Health Clinics

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Application Process

1. HRSA BHW online application software system –SDMS (Shortage Designation Management System)

2. SDMS rolled out in December 15, 20143. Many technical and non-technical issues4. Pacific Basin sites

1. Only Guam has an account2. BHW has not completely developed the application for

the USAPI3. Proposed solution: Paper application yet to be

approved

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3nd core deliverable:

1. NHSC site certification and recertification a. Certification (4/1-6/2); Recertification (Aug 1-9/30)

b. Bureau of Health Workforce (BHW) Program Portal (https://programportal.hrsa.gov/)

• Each USAPIJ can create accounts for advertisements, recruitments, and profile sharing of sites information

Note: CAH

https://programportal.hrsa.gov/

https://programportal.hrsa.gov/

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3rd core deliverable (cont):

2. NHSC provider recruitment, placement, and retentiona. Rationale: short-term gap solution for HPS in the region

1) Feasible for AS, CNMI, Guam2) Currently not as feasible in the FAS

b. PCO Annual Meeting: 6/22-6/25/2015 in Rockville, MD1) ASTHO sponsored PCO Director Peer Mentoring Program (Danielle Garrett

(ASTHO) and Lynnette Araki (HRSA)2) 2-days Meetings with NHSC, ASTHO, BPHC, HIV, STI, MCH, COINN etc., 3) Potential Solution – SLRP4) Requires non-federal matching dollars5) New Application cycle opens in 9/2016

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Updates:

1. PCO Annual Meeting: 6/22-6/25/2015 in Rockville, MD1. Address many of the SDMS technical issues face to face/one-on-one so

that the system’s technical team can see on the computer screen what I encounter with the SDMS system for the USAPIs

2. ASTHO sponsored PCO Director Peer Mentoring Program (Danielle Garrett (ASTHO) and Lynnette Araki (HRSA)1) 2-days Meetings with NHSC, ASTHO, BPHC, HIV, STI, MCH, COINN etc., 2) Potential Solution – SLRP3) Requires non-federal matching dollars4) New Application cycle opens in 9/2016

2. Upcoming Site visits: 9/6-10/5a. PBMA in Palau (Face-to-face provider interview)b. Site visits across—Guam, CNMI, Chuuk, Pohnpei, Kosrae, Ebeye,

Majuro

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• Comments?• Questions?

• Recommendations?

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Acknowledgements

Executive Board Members• Palau Board Members & Partners• Guam Board Members & Partners

• CNMI Board Members & Partners

• FSM Board Members & Partners

• RMI Board Members & Partners

• American Samoa Board Members and Partners

Associate and Affiliate Members

Pacific Basin Dental Association Board

Pacific Basin Medical Association

Pacific Basin Mental Health Association

Pacific Islands Primary Care Association

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Contact & Helpful

• US HRSA Health Professional Shortage Designation• http://bhpr.hrsa.gov/shortage

• HPSA or MUA/P Designation Scores• http://hpsafind.hrsa.gov/• http://muafind.hrsa.gov/

• Primary Health designated Areas or Facilities in the Pacific Basin• http://

datawarehouse.hrsa.gov/DataDownload/FRN/D_BCD_HPSA_H1_FederalRegister.pdf (pg. 224 – 234)

• Dental Health designated Areas or Facilities in the Pacific Basin• http://

datawarehouse.hrsa.gov/DataDownload/FRN/E_BCD_HPSA_H6_FederalRegister.pdf (pg. 192-200)

• Mental Health designated Areas or Facilities in the Pacific Basin• http://

datawarehouse.hrsa.gov/DataDownload/FRN/F_BCD_HPSA_H7_FederalRegister.pdf (pg. 205-213)

• (PIHOA & PB-PCO)• Web: http://www.pihoa.org/initiatives/pco.php• Web: www.pihoa.org• Angela Techur-Pedro (HPSA/MUAP/SPCNA)

• [email protected]• Dr. Greg Dever (HRH & TA for Workforce Dev.)

• [email protected]• Emi Chutaro (PIHOA Ex. Director)

• [email protected]• Regie Tolentino (Honolulu Office Manager)

• [email protected]• PIHOA/PB-PCO Office in Honolulu, HI

Pacific Guardian CenterSuite #2075, Mauka Tower737 Bishop StreetHonolulu, Hawaii 96813Office: (808) 537-3131 I Fax: (808) 537-6868

http://bhpr.hrsa.gov/shortage

http://bhpr.hrsa.gov/shortage

http://hpsafind.hrsa.gov/

http://hpsafind.hrsa.gov/

http://muafind.hrsa.gov/

http://muafind.hrsa.gov/

http://datawarehouse.hrsa.gov/DataDownload/FRN/D_BCD_HPSA_H1_FederalRegister.pdf



http://datawarehouse.hrsa.gov/DataDownload/FRN/E_BCD_HPSA_H6_FederalRegister.pdf



http://datawarehouse.hrsa.gov/DataDownload/FRN/F_BCD_HPSA_H7_FederalRegister.pdf



http://www.pihoa.org/initiatives/pco.php



http://www.pihoa.org/

mailto:[email protected]




tel:(808)%20537-3131

tel:(808)%20537-3131

tel:(808)%20537-6868

tel:(808)%20537-6868

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