Health Center Program Update Alabama Primary Health Care Association Annual Conference

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1 Health Center Program Update Alabama Primary Health Care Association Annual Conference October 6, 2017 Angela R. Powell, MPH Director, Office of Southern Health Services Bureau of Primary Health Care Health Resources and Services Administration U.S. Department of Health and Human Services

2 Agenda BPHC s Strategic Goals Department s Priorities Compliance is Fundamental Updates on the Compliance Manual Q&A 2

3 Increasing Access to Primary Health Care 3

4 Bureau of Primary Health Care: Strategic Goals Increase Access to Primary Health Care Advance Health Center Quality and Impact Optimize Bureau of Primary Health Care Operations Mission: Improve the health of the nation s underserved communities and vulnerable populations by assuring access to comprehensive, culturally competent, quality primary health care services 4

Strategic Goal 1: Increase Access to Primary Health Care Objectives Increase the number of underserved communities and vulnerable populations with access to primary health care Expand access to

5 Strategic Goal 1: Increase Access to Primary Health Care Objectives Increase the number of underserved communities and vulnerable populations with access to primary health care Expand access to comprehensive services Primary Medical Oral Health Mental Health Substance Abuse/Opioid Treatment Vision Services Enabling Services (case management, transportation, patient education) Clinician education and training Strengthen health center capacity to respond to urgent and emergent issues 5

6 Strategic Goal 2: Advance Health Center Quality & Impact Objectives Promote and advance quality of care Improve performance management and operations Build a Learning Health Center System 6

7 Clinical Quality Measures Alabama Health Centers (%) 2015 (%) 2016 (%) Δ (%) Depression Screening Tobacco Use Screening Hypertension Control (less than 140/90 mm Hg) Diabetes Control (HbA1c <9%) Coronary Artery: Lipid Therapy Source: Uniform Data System,

8 Quality Improvement (QI) Awards Total Funding to Alabama: 14 awards totaling $1,225,902 Type of Award # of Awards Total Amount EHR Reporter Awards 10 $105,000 Clinical Quality Improver Awards 13 $258,249 Health Center Quality Leader Awards 2 $45,153 Access Enhancers Awards 3 $21,000 PCMH Recognition Awards 12 $765,000 Addressing Health Disparities Awards 1 $31,500 8

9 Strategic Goal 3: Optimize Bureau of Primary Health Care Operations Objectives Maximize human capital Enhance communications and knowledge management Promote data-driven, evidence-based practices and innovation 9

HHS Priority: Diabetes Healthy People 2020 Goals Chronic Disease Management: Patients with controlled diabetes 100% 80% 60% 54% 70% 67% 40% 20% Diabetes Controlled 0% National

10 HHS Priority: Diabetes Healthy People 2020 Goals Chronic Disease Management: Patients with controlled diabetes 100% 80% 60% 54% 70% 67% 40% 20% Diabetes Controlled 0% National Average Health Centers Alabama Source: National Average Sources: National Committee for Quality Assurance. The State of Health Care Quality Report Uniform Data System,

11 Diabetes Quality Improvement Initiative - Goals Increase Diabetes Prevention Efforts Increase the percentage of adults who receive weight screenings & counseling Increase the percentage of children who receive weight screenings & counseling Improve Diabetes Treatment And Management Reduce the proportion of persons with diabetes with an HbA1c value greater than 9 percent Increase the proportion of health centers that meet the Healthy People 2020 goal for uncontrolled diabetes for each racial/ethnic group 10% 8% 6% 4% 2% 0% 6.8% 8.8% 8.5% 6.5% % of HRSA Health Centers that Met the HP 2020 Goal for Uncontrolled Diabetes 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% 37.9% American Indian/ Alaska Native 22.5% Asian 34.4% 33.4% Black/ African American Hispanic or Latino % of Uncontrolled Diabetes Patients by Race/Ethnicity for % Native Hawaiian 42.6% Other Pacific Islander 29.6% White (NonHispanic/ Latino) 11

12 12 Diabetes Quality Improvement Initiative Implementation Strategies 1. Quality Improvement Priority Alignment Focus on Diabetes Quality Measures during Oversight Activities Quality Improvement Investments and Activities focus on Diabetes 2. Using Data and Evidence to Drive Improvement 3. Developing and Implementing Technical Assistance Resources 4. Establishing and Leveraging Partnerships/Collaborations

13 Strategic Partners Technical Assistance Strategies to Prevent and Manage Diabetes Improving Health Systems & Infrastructure Optimizing Provider & Multidisciplinary Teams Facilitating Behavior Change in Patients EHRs with Diabetes Modules Diabetes Informatics Health Information Exchange (HIE) & Telemedicine Patient Centered Medical Home (PCMH) Use Patient Portals Team Based Care Promote National Standards New Techniques for Early Detection Screening Case Management Sharing of Diabetes Management Promising Practices Eye, Foot, Dental, & Kidney Screening Provider Counseling of Patients CHW Directed Patient Education Lifestyle/Self- Management Promote Physical Activity and Healthy Diets Address Childhood & Adult Obesity Increase Patient Health Literacy 13

14 HHS Priority: Substance Abuse & Mental Health Substance Abuse and Opioid Treatment and Recovery Services $195 million for Access Increases in Mental Health and Substance Abuse Services (AIMS) 13 Alabama grantees received AIMS funding: Total of $2,193,600 Key performance measures include number of: Mental health/substance abuse providers Providers with Drug Addiction Treatment Act of 2000 (DATA) waivers Patients receiving mental health/substance abuse services Patients receiving Screening, Brief Intervention, and Referral to Treatment (SBIRT) Patients receiving Medication-Assisted Treatment (MAT) 14

15 Compliance is Fundamental 15

16 Compliance is Fundamental Compliance Manual is Released! Replaces most PINs and PALs creating a one-stop, consolidated, and streamlined guidance document Compliance assessment-related tools, resources, and processes will be updated and aligned with the new Compliance Manual Program Assistance Letters (PALs) Program Requirement Summaries Policy Information Notices (PINs) Compliance Manual 16

17 Compliance Manual: Goals Centralize, Streamline & Clarify Increase Transparency Consistent Compliance Determinations Reduce Burden Strengthen Stewardship 17

18 Compliance Manual: Streamline 18

19 Compliance Manual: Streamline 19

20 Compliance Manual: Streamline Federal Tort Claims Act (FTCA) Deeming Service Area Competition and Operational Site Visit Quality Improvement/ Quality Assurance Risk Management FTCA Application + Operational Site Visit Supplement Credentialing and Privileging FTCA Deeming Claims Management 20

21 Compliance Manual: Clarify Clinical and operational excellence Effective implementation of program requirements Compliance Compliance with Program Requirements Musts per statute and regulation Compliance Manual 21

22 Compliance Assessment Before Submission of Compliance Data (SAC application/ OSV/Response to Condition) Foundation for Compliance Determination: 1. Policy Information Notices (PINs) 2. Program Assistance Letters (PALs) 3. Program requirement descriptors Technical Assistance HRSA Compliance Determination Condition(s) on Award 22

23 Compliance Assessment After Submission of Compliance Data (SAC application/ OSV/Response to Condition) Foundation for Compliance Determination: 1. Compliance Manual Technical Assistance HRSA Compliance Determination Condition(s) on Award 23

24 Aligning Oversight with the Compliance Manual 24 Compliance Manual release Site visit protocol pilot test Final site visit protocol posted to HRSA website Site visit protocol replaces site visit guide SAC NOFO and FTCA application alignment Compliance assessment and progressive action aligns with the Compliance Manual demonstrating compliance elements

25 QUESTIONS 25

26 Thank You! Angela Powell, MPH, CPH Director, Office of Southern Health Services Bureau of Primary Health Care (BPHC) Health Resources and Services Administration (HRSA) facebook.com/hhs.hrsa 26

Integration of Oral Health and Primary Care Practice. Candace Owen, RDH, MS, MPH NNOHA Education Director Wyoming PCA Meeting September 19, 2018

Integration of Oral Health and Primary Care Practice Candace Owen, RDH, MS, MPH NNOHA Education Director Wyoming PCA Meeting September 19, 2018 Objectives Explain the 5 oral health core clinical competency