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National Association of Community Health Centers, Inc.

National Association of Community Health Centers, Inc. 1. America’s Voice for Community Health Care. The NACHC Mission

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National Association of Community Health Centers, Inc.

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  1. National Association of Community Health Centers, Inc. 1

  2. America’s Voice for Community Health Care The NACHC Mission To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved people. National Association of Community Health Centers, Inc. 2

  3. DEVELOPING EFFECTIVE FQHC PROGRAMS AND APPLICATIONS National Association of Community Health Centers, Inc. 3

  4. DEVELOPING EFFECTIVE FQHC PROGRAMS AND APPLICATIONS: SERVICE PACKAGE & DELIVERY STRATEGY National Association of Community Health Centers, Inc.

  5. The Program/Proposal Logic Model STRONG HEALTH CENTER PROGRAMS STRATEGIC PLANNING NEEDS ASSESSMENTS National Association of Community Health Centers, Inc.

  6. The Program/Proposal Logic Model The Needs Assessment Informs the Strategic Planning Process Which Forms the Basis for the Health Care Plan and the Service Package, Staffing Profile and Delivery Strategy Lays Out a Rational and Logical Approach to Implementing that Plan and Strategy Which is Supported by a Reasonable, Realistic and Cost Effective Budget National Association of Community Health Centers, Inc.

  7. Ensuring Legal Compliance • All FQHCs must comply with applicable Section 330-related statutory and regulatory requirements, guidelines and policies • Community Health Centers: Section 330(e) • Migrant Health Centers: Section 330(e) and Section 330(g) • Health Care for the Homeless: Section 330(e) and Section 330(h) • Public Housing Primary Care: Section 330(e) and Section 330(i) • New Access Point Applicant: compliance at time of submission or within 120 days of grant award • FQHC Look-Alike Applicant: compliance at time of submission National Association of Community Health Centers, Inc.

  8. Need = 30 POINTS • USE THE NARRATIVE SECTION TO TELL A STORY - DRAW A PICTURE • FOCUS ON THE TARGET POPULATION • COMPARED TO…….. National Association of Community Health Centers, Inc.

  9. Program/Proposal Logic Model The Needs Assessment Informs the Strategic Planning Process Which Forms the Basis for the Health Care Plan and Service Delivery Model Lays Out a Rational and Logical Approach to the Implementing that Plan Which is Supported by a Reasonable, Realistic and Cost Effective Budget National Association of Community Health Centers, Inc. 9

  10. Building Strong FQHC Programs Board Member Constituencies Partners in the Community Input from staff Input from PCA Identified Need Input from Patients Environmental Analysis Short and Long Term Strategic Goals Evaluation of Options Which Patients What Services How Provided How Implemented How Supported National Association of Community Health Centers, Inc. 10

  11. IDENTIFYING NEED National Association of Community Health Centers, Inc. 11

  12. RULE #1A IDENTIFIED NEEDS HAVE TO RELATE TO PROGRAM HEALTH DISPARITIES = SERVICE PACKAGE ACCESS PROBLEMS = STAFFING PROFILE BARRIER PROBLEMS = DELIVERY STRATEGY National Association of Community Health Centers, Inc. 12

  13. RULE #1B IDENTIFIED NEEDS HAVE TO RELATE TO PROGRAM IDENTIFYING SCORES OF PROBLEMS WITHOUT CORRESPONDING PROGRAM IS NOT A WINNING STRATEGY National Association of Community Health Centers, Inc. 13

  14. From the SAC FY09 Guidance: “Information provided on need should serve as the basis for, and align with, the proposed activities and goals described in the health care and business plans and throughout the application.” National Association of Community Health Centers, Inc. 14

  15. IDENTIFYING NEED Health Disparities Health outcome data demonstrating that the target population experiences disparities in health outcomes compared to the general population in the Service Area or other benchmarks National Association of Community Health Centers, Inc. 15

  16. IDENTIFYING NEED Access to Care Data demonstrating that there is not an adequate quantity of accessible primary health care providers for the Target Population National Association of Community Health Centers, Inc. 16

  17. IDENTIFYING NEED Barriers to Care – Even if there are health care resources why is it that the target population cannot use them fully? Cultural and/or linguistic Geographic/transportation Insurance/available income Other factors creating barriers Unique health care needs National Association of Community Health Centers, Inc. 17

  18. IDENTIFYING NEED ATTENTION EVERYBODY!!!! LOOK FOR REQUIRED NEEDS DATA!!!! BUT DO NOT LIMIT YOUR ANALYSIS TO THOSE INDICATORS!!!! National Association of Community Health Centers, Inc. 18

  19. IDENTIFYING NEED Community Based Needs Assessment National Association of Community Health Centers, Inc. 19

  20. LEVELS OF DESCRIPTION PATIENTS TARGET POPULATION SERVICE AREA National Association of Community Health Centers, Inc. 20

  21. LEVELS OF DESCRIPTION SERVICE AREA National Association of Community Health Centers, Inc. 21

  22. Service Area Define Service Area – A geographic area from which your target population will be drawn (census tracts, counties, MUAs, HPSAs, etc.) A logical and rational area for providing health care services That relates to your target population and their accessibility and barrier issues This is the character of the area Environmental/geographic characteristics Housing Economy – types of economic activity National Association of Community Health Centers, Inc. 22

  23. Service Area This is how the people here live Education Income Livelihood Transportation Socio-demographic information And all of these things relate to potential health risks and barriers to care National Association of Community Health Centers, Inc. 23

  24. Service Area And all of these things relate to: Potential health risks Decreased access Barriers to care National Association of Community Health Centers, Inc. 24

  25. LEVELS OF DESCRIPTION TARGET POPULATION SERVICE AREA National Association of Community Health Centers, Inc. 25

  26. Target Population These are the people in the Service Area that I am focusing on serving: Socio-demographic indicators Race Ethnicity Income Language/culture Education Insurance status Age Free/reduced lunch Employment/unemployment National Association of Community Health Centers, Inc. 26

  27. Target Population Health Status Indicators/Health Disparities Maternal child health indicators Infant mortality Low birth weight Prenatal care Teen pregnancy Immunizations Lead paint exposure/poisoning Others National Association of Community Health Centers, Inc. 27

  28. Target Population Health Status Indicators/Health Disparities Chronic Diseases Cancer Diabetes Asthma Coronary Heart Disease Hypertension Others National Association of Community Health Centers, Inc. 28

  29. Target Population Health Status Indicators/Health Disparities Mental Health Problems Depression Suicide Substance abuse Serious mental health conditions Add/ADHD Oral Health Problems Caries Other? National Association of Community Health Centers, Inc. 29

  30. Target Population Health Status Indicators/Health Disparities HIV/AIDS Nutrition/hunger Obesity Conditions Specific to Special Populations Environmental Exposure Pesticide exposure Skin disorders Accidents National Association of Community Health Centers, Inc. 30

  31. IDENTIFYING NEED Define Special Populations specific health problems and health care needs significant changes in the past year impacting specific special populations National Association of Community Health Centers, Inc. 31

  32. IDENTIFYING NEED Special Populations Additional Descriptions: MCH – agricultural environment/crops; growing seasons; special circumstances impacting demand HCH – availability of housing and other factors that impact demand for services PHPC – recent changes in availability of public housing and impact on demand National Association of Community Health Centers, Inc. 32

  33. LEVELS OF DESCRIPTION PATIENTS TARGET POPULATION SERVICE AREA National Association of Community Health Centers, Inc. 33

  34. Patients Community Based Needs Assessment National Association of Community Health Centers, Inc. 34

  35. Patients – Just the Tip of the Iceberg Health Status Access to Care Barriers to Health Care Patient surveys Focus groups Chart audits Anecdotal information National Association of Community Health Centers, Inc. 35

  36. IDENTIFYING NEED For those already providing health care to the target population (existing grantees-Service Area Competition and Expansion Applications–and other operational applicants) Who are you serving now…how many? For everyone How many will be served and how many projected encounters throughout the proposed project Give data for end of each project year and at full capacity! Make sure the data is consistent National Association of Community Health Centers, Inc. 36

  37. IDENTIFYING NEED Remember: Patient Derived Data and Information is Not Population-Based Data! Always Use the Correct Data for the Question Being Asked National Association of Community Health Centers, Inc. 37

  38. Patients Other Area Providers Community Based Needs Assessment National Association of Community Health Centers, Inc. 38

  39. ACCESS TO CARE – HOW MANY PROVIDERS ARE THERE? Access to Care – Are health care resources available to the Target Population? Data demonstrating that the Target Population has restricted access to primary health care: Numbers of providers available Others providing resources/services to the target population Other FQHCs/Section 330 grantees, rural health clinics, public health services, etc National Association of Community Health Centers, Inc. 39

  40. ACCESS TO CARE – HOW MANY PROVIDERS ARE THERE? Access to Care Discussion of the adequacy and effectiveness of the existing network of care for the Target Population Absolute shortage of primary, oral, behavioral care providers Shortage specifically for Target Population Numbers of providers accepting Medicaid, SCHIP, sliding fee scale Waiting times to get appointments, etc. National Association of Community Health Centers, Inc. 40

  41. Community Based Needs Assessment Patients Other Area Providers Barriers to Care National Association of Community Health Centers, Inc. 41

  42. BARRIERS TO CARE Barriers to Care – Even if there are health care resources why is it that the target population cannot use them fully? Cultural and/or linguistic Geographic/transportation Insurance/available income Other factors creating barriers Unique health care needs National Association of Community Health Centers, Inc. 42

  43. Community Based Needs Assessment Patients Other Area Providers Barriers to Care Environmental Context National Association of Community Health Centers, Inc. 43

  44. HEALTH CARE ENVIRONMENT Health Care Environment – What is happening in the state, region, local area that impacts the health care status and access to care for the target population? Federal, state, county, local Medicaid, welfare, other health care reforms Implementation of 1115 and 1915(b) waivers, Medicaid PPS, SCHIP, others Direction that state environment and health policy is going including trends in state budgets, unemployment, etc. National Association of Community Health Centers, Inc. 44

  45. HEALTH CARE ENVIRONMENT Health Care Environment How do these trends and policies impact the future fiscal well being of the proposed program and applicant organization? National Association of Community Health Centers, Inc. 45

  46. ENVIRONMENT-NOT JUST HEALTH CARE • What other environmental – policy – politics – will impact the proposed program? • Immigration laws • Changing economic structure • Employment trends • others???? National Association of Community Health Centers, Inc. 46

  47. Community Based Needs Assessment Patients Other Area Providers Barriers to Care State Priorities Environmental Issues National Association of Community Health Centers, Inc. 47

  48. STATE PRIORITIES How does the proposed new site fit into the state priorities regarding health care for the underserved? Market Place Analysis Statewide Strategic Plan Other analyses of health care access National Association of Community Health Centers, Inc. 48

  49. LET’S DIG DEEPER INTO DATA:Understanding and Describing Your Target Population

  50. Data is Your Friend Finding and Generating Relevant Data National Association of Community Health Centers, Inc. 50

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