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2017 HRSA NCC Progress Report

This report provides updates on the progress of the Health Center Program grantees, including information on the healthcare environment, organizational capacity, patient capacity, clinical/financial performance measures, and budget. It also highlights the challenges faced and progress made in 2017.

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2017 HRSA NCC Progress Report

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  1. 2017 HRSA NCC Progress Report August 2018

  2. HRSA Health Center Program • As a Federally Qualified Health Center: • Federal grant period of 3 years • Every 3 years we apply via the Service Area Competitive grant process • Federally mandated to provide updates on the progress of grant activities • Non-Competing Continuation Progress Report

  3. Overview of Progress Report • HRSA Non-Competing Continuation Report • Provides an update on the progress of Health Center Program grantees • Includes updates on: • Healthcare environment • Organizational capacity • Patient Capacity • Clinical / Financial Performance Measures • Budget information and narrative • Completed every year, except during renewal year

  4. 2017 Healthcare Environment • Policy • Continued uncertainty of ACA / Covered CA • Immigration / social policy • Avoided fiscal cliff… for now! • Delivery System • Competition for patients and workforce • Payment reform in CA • Local (Service Area) • Patient demos staying constant / aging population • Increase in uninsured / decrease in Medi-Cal • Continued demand for services / limited capacity

  5. 2017 Organizational Capacity • Staffing • Provider and support staff shortages • Competitive market; provider cost to recruit increasing • Staff / provider recruitment a challenge • Operations • New health center and facility expansions • 19 additional providers hired in 2017 • Expanded services, cross utilization • Centralized care coordination for certain populations

  6. 2017 Organizational Capacity • Systems • Rightsized and stabilized technology systems • Addition of various layers of security • Implementation of disaster recovery and BC plans • Implementation of Single Sign On • Clinical workflow enhancement through BI • Telehealth • New section regarding use of telehealth • Began telepsychiatry services at NCHS Ramona • Received HRSA AIMS grant to expand to all primary care locations

  7. Patient & Visit Counts 2017

  8. Clinical Performance Measures

  9. Clinical Performance Measures

  10. Clinical Performance Measures

  11. Clinical Performance Measures

  12. Clinical Performance Measures

  13. Childhood Immunization Status Measure in 2015 (88%) Measure in 2017 (58%) Percentage of children age 3 years who were fully immunized before their third birthday. • 4 DTP/DTaP, • 3 polio IPV, • 1 MMR, • 3 H influenza type b (Hib), • 3 Hepatitis B (HepB), • 1 chicken pox VZV (Varicella), • 4 Pneumococcal conjugate Percentage of children age 2 years who were fully immunized by their second birthday. • 4 (DTP/DTaP), • 3 polio (IPV), • 1 MMR, • 3 H influenza type b (Hib), • 3 Hepatitis B (Hep B), • 1 chicken pox VZV (Varicella), • 4 Pneumococcal conjugate • 1 Hepatitis A (Hep A), • 2 or 3 rotavirus (RV), and • 2 influenza (flu) vaccines.

  14. Any Questions?

  15. 2019 Federal Noncompeting Continuation (NCC)/Budget Period Renewal August 2018 By: Kathy Martinez

  16. HRSA Federal Budget 2019 • The August BOD packet included an internal federal budget narrative and a one page budget summary. (pgs. 5 & 6) • The 2019 non-competing grant submission is year 3 of a 3 year award. • The total budget is up 8.65% from 2018 for an increase of $6M. • 2019 Funding is $8,992,747, an increase of $85,200 from the 2018 submission. • The actual federal award will be higher with cross period carry over awards & potential additional awards. The budget forms provided to the BOD are internal documents only. The actual grant application includes a CHC/MHC narrative, line item budget justification, Income analysis & staffing profile for federally funded positions. All Federal forms are available upon request.

  17. 2019 Federal Budget Revenues Expenses The 2019 Federal Funds are 11.92% of the total $75,425,240 federal budget.

  18. The Federal budget is the starting point of our annual budgeting cycle. It provides us the foundation in which we begin to build our annual operating budget from. Key differences between the Federal & Operational Budget: • Revenue-when compiling the federal budget it is imperative that patient revenue is not overstated. If we do not meet our projected patient revenue it could lead to an unobligated balance and the possibility of returning a portion of the federal award. • Expenses-are reported on historical trend and represent our personnel cost at the time of the budget preparation. We do not include vacancies as this would increase our costs and would force us to increase the projected revenue to cover the costs to achieve a neutral bottom line. • The federal budget does not allow depreciation expenses. The costs reported as depreciation on our operational budget are reported as Capital Equipment & Building Renovations. • The federal budget only includes sites and services in our HRSA approved scope of service at the time of the grant submission. New or additional sites and services require a separate application and budget submission to be added to our HRSA scope of service. • The federal budget bottom line must equal ZERO, bottom line neutral. Federal vs. Operational Budget

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