TACHC ANNUAL CONFERENCE

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• TACHC ANNUAL CONFERENCE
• Clinical Educational SessionOctober 23, 2004

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Welcome and Introduction

• Sandy Benavides-Vaello, RN, BSN, MPAff.
• Texas Association of
• Community Health Centers

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Community Health Centers

• What are we?
• What is our role in the current health care
  environment?

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What Are CHCs?

• Administratively
• Philosophically

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Administratively

• What is an FQHC?
• FQHC versus CHC
• Safety net providers

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What is an FQHC?

• A provider type
• Bundle of services
• Reimbursement methodology

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What is An FQHC? (Cont.)

• Community based non-profit, or public primary
  health care clinics
• Must be located in or serving a designated MUA or
  MUP
• Consumer board governance requirement (51
  consumers)
• Provide comprehensive primary health, oral, and
  behavioral/substance abuse services to all
  persons in all stages of the life cycle

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What is An FQHC? (Cont.)

• Provide services to all persons regardless of
  ability to pay
• Charge for services on a sliding fee scale
• Comply with 330 program expectations/requirements
  and all applicable state and federal regulations

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Philosophically

• We are safety net providers
• We ensure that the underserved receive quality
  health care
• We meet the health care needs of our communities
• We aim to improve outcomes and reduce health
  disparities among all, including the underserved
• We meet the health care needs of our communities

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What is Our Role in the Current Health
Environment?

• To provide comprehensive health and social
  services
• To meet the health care needs of the increasing
  numbers of underserved
• To be the model for how health care is delivered

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Provision of Comprehensive Health and Social
Services

• FQHCs/CHCs Provide
• Primary Care
• Behavioral Health
• Transportation
• Social Services
• Outreach
• Translation
• Advocates for the communities in which we serve

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Meeting the Health Care Needs of the Underserved

• The number of uninsured increased by 5.4 million
  between 2001 and 2003
• Texas has one of the highest rates of uninsured
  populations in the nation
• Texas also has some of the highest chronic
  disease rates
• Dismantling of mental health services

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Model for Health Care Delivery

• Initiatives in Place
• CPI Program
• FTCA
• Health Disparities Collaboratives
• Leadership Initiative
• E-Learning
• JCAHO
• Access Redesign

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Health Disparities Collaboratives

• Probably the greatest and most challenging effort
  taken on by CHCs
• Forced CHCs to examine how care was being
  provided and used evidence-based guidelines and
  outcomes
• As we enter the 6th year of the collaboratives,
  we have collected a body of knowledge, including
  more effective approaches

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Planned Care Model

• Chronic Care Model Here

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Can You Hear Me Now?
Current Clinical Management Approach
Patient Presentation
Depression
Depression
Diabetes
Economical Issues
Diabetes
Family
Self Care
Asthma
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Care Model

• Unanticipated Model

Asthma
Diabetes
Depression
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Care Model

• Patient Context

Physical Pain
Family Issues
Depression
Economic Issues
Disability
Emotional Pain
Culture
Diabetes
Overwhelmed
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Importance of Integration of Behavioral Health
and Primary Care

• Co-morbidity of behavioral and physical disorders
• Dismantling of mental health system
• Cannot continue to provide care in silos, it
  doesnt work
• Behavioral health in primary care is not going
  away
• We need to be prepared

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Preparation for Integration

• Need to establish a solid foundation
• Training of all staff (clinicians, support
  administrative staff, etc.)
• Developing efficient, effective, and holistic
  system of care
• Access Redesign

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• HMMMMMM.

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• BOISTEROUS LAUGHTER!!

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APPLAUSE!

• BRAVO!! BRAVO!!