Michigan Primary Care
Association’s Role in Developing
  Access to Care in Michigan

  Detroit Central City’s Annual Meeting
           December 11, 2012



         Kim E. Sibilsky, Executive Director
         Michigan Primary Care Association
         www.mpca.net
Health Centers
  are                              uniq
                                   ue
The fundamental principles on which they were
  established over 45 years ago set them apart
           from other providers of health care:


Located in or serve medically
underserved areas or populations

                Provide comprehensive primary health care
                services as well as support services that
                promote access to health care

  Provide services available to all with fees
  adjusted based on ability to pay

                 Governed by a community board composed of
                 51 percent or more of Health Center patients
                 who represent the population served


  Meet strict performance and accountability
  requirements regarding administrative,
  clinical, and financial operations as
  established by the federal government
35 Health Centers
provide care for nearly
600,000 residents
at over 220 delivery
sites across Michigan
Health
Increased Access
to


         care
         Today nearly 600,000 Michigan residents rely on a Health
         Center as their health care home—including individuals who
         are low
         income, uninsured, underinsured, elderly, minority, migrant
         and seasonal farmworkers, homeless, and those living with
         HIV/AIDS.
Michigan Health Center Patients
        550,000
                                                  546,245



        525,000




        500,000




        475,000




        450,000
                    2007   2008   2009   2010   2011

Michigan UDS 2011
Patients by Insurance Status - Statewide
Actual Values                                       Percentage of Total

      240,545                                        Medicaid/CHIP                              44.0%




                178,903                                  Uninsured                      32.8%




                                                            Private             14.0%

                          76,473

                                   48,765
                                                         Medicare            8.9%

                                            1,559

                                                       Other Public   0.3%




 Michigan UDS 2011
Patients by Income Level - Statewide

Actual Values                                             Percentage of Total


                          505,906                         100% FPL and
                                                                                 68.1%
                                                             Below



     372,000



                                                          200% FPL and
                                                                                         92.6%
                                                             Below




                                             40,339       Over 200% FPL   7.4%




100% FPL and Below   200% FPL and Below   Over 200% FPL




Michigan UDS 2011
MPCA and Detroit Central City
   MPCA promotes, supports and develops
    CHCs through
    ◦ Strategic communications and collective
      advocacy
    ◦ Providing technical assistance, program
      support, education and training
    ◦ Assisting communities in determining best
      approach to providing access
MPCA and Detroit Central City:
Discussion Questions
 Health Centers under Affordable Care Act
  especially as to relations with behavioral
  health organizations?
 MPCA’s vision of care for the vulnerable
  population served by Detroit Central City
  (severely and persistently mentally ill with
  complicating physical disorders)?
 Examples of successful improvement
  processes that have been used in Michigan
  to address behavioral health in integration
  into primary care?
Health Center Growth Strategy

   New Access Points: Grants for new health
  centers and satellites of current centers
 Expanded Medical Capacity: Grants for
  existing health centers to start or expand oral
  health, behavioral health, and pharmaceutical
  services
 Service Expansion: Grants for existing centers
  to start or expand oral health, behavioral
  health, and pharmaceutical services
Health Center Growth Strategy

   Change in Scope: Noncompetitive process
    whereby center applies to HRSA to add a new
    site or service
   Facility Expansion: Investments to expand
    physical capacity to increase new patients
   Enabling Services: Grants for existing sites
    that serve special populations to enable access
    to primary health care services and improve
    health outcomes.
Efforts to Improve Health Center
Quality and Integration
 Since their inception, CHCs have had
  Quality Assurance Programs and have
  done periodic reporting to the Fed
 From ‘98 to ‘08 the majority of CHCs
  participated in Institute for Healthcare
  Improvement Health Disparities
  Collaboratives
 Michigan had over 88% of CHCs
  accredited through accrediting agencies
Efforts to Improve Health Center
Quality and Integration
 MPCA worked with the MACMHB in
  NHSC/SAMHSA integration efforts
 Co-sponsored Learning Communities with
  MACMHB and MDCH
 Have jointly sponsored Statewide
  Behavioral Health Primary Care
  Integration Conferences
THE END


 Questions?

MPCA's Role in Developing Access to Care in Michigan

  • 1.
    Michigan Primary Care Association’sRole in Developing Access to Care in Michigan Detroit Central City’s Annual Meeting December 11, 2012 Kim E. Sibilsky, Executive Director Michigan Primary Care Association www.mpca.net
  • 2.
    Health Centers are uniq ue The fundamental principles on which they were established over 45 years ago set them apart from other providers of health care: Located in or serve medically underserved areas or populations Provide comprehensive primary health care services as well as support services that promote access to health care Provide services available to all with fees adjusted based on ability to pay Governed by a community board composed of 51 percent or more of Health Center patients who represent the population served Meet strict performance and accountability requirements regarding administrative, clinical, and financial operations as established by the federal government
  • 3.
    35 Health Centers providecare for nearly 600,000 residents at over 220 delivery sites across Michigan
  • 4.
    Health Increased Access to care Today nearly 600,000 Michigan residents rely on a Health Center as their health care home—including individuals who are low income, uninsured, underinsured, elderly, minority, migrant and seasonal farmworkers, homeless, and those living with HIV/AIDS.
  • 5.
    Michigan Health CenterPatients 550,000 546,245 525,000 500,000 475,000 450,000 2007 2008 2009 2010 2011 Michigan UDS 2011
  • 6.
    Patients by InsuranceStatus - Statewide Actual Values Percentage of Total 240,545 Medicaid/CHIP 44.0% 178,903 Uninsured 32.8% Private 14.0% 76,473 48,765 Medicare 8.9% 1,559 Other Public 0.3% Michigan UDS 2011
  • 7.
    Patients by IncomeLevel - Statewide Actual Values Percentage of Total 505,906 100% FPL and 68.1% Below 372,000 200% FPL and 92.6% Below 40,339 Over 200% FPL 7.4% 100% FPL and Below 200% FPL and Below Over 200% FPL Michigan UDS 2011
  • 10.
    MPCA and DetroitCentral City  MPCA promotes, supports and develops CHCs through ◦ Strategic communications and collective advocacy ◦ Providing technical assistance, program support, education and training ◦ Assisting communities in determining best approach to providing access
  • 11.
    MPCA and DetroitCentral City: Discussion Questions  Health Centers under Affordable Care Act especially as to relations with behavioral health organizations?  MPCA’s vision of care for the vulnerable population served by Detroit Central City (severely and persistently mentally ill with complicating physical disorders)?  Examples of successful improvement processes that have been used in Michigan to address behavioral health in integration into primary care?
  • 12.
    Health Center GrowthStrategy  New Access Points: Grants for new health centers and satellites of current centers  Expanded Medical Capacity: Grants for existing health centers to start or expand oral health, behavioral health, and pharmaceutical services  Service Expansion: Grants for existing centers to start or expand oral health, behavioral health, and pharmaceutical services
  • 13.
    Health Center GrowthStrategy  Change in Scope: Noncompetitive process whereby center applies to HRSA to add a new site or service  Facility Expansion: Investments to expand physical capacity to increase new patients  Enabling Services: Grants for existing sites that serve special populations to enable access to primary health care services and improve health outcomes.
  • 14.
    Efforts to ImproveHealth Center Quality and Integration  Since their inception, CHCs have had Quality Assurance Programs and have done periodic reporting to the Fed  From ‘98 to ‘08 the majority of CHCs participated in Institute for Healthcare Improvement Health Disparities Collaboratives  Michigan had over 88% of CHCs accredited through accrediting agencies
  • 15.
    Efforts to ImproveHealth Center Quality and Integration  MPCA worked with the MACMHB in NHSC/SAMHSA integration efforts  Co-sponsored Learning Communities with MACMHB and MDCH  Have jointly sponsored Statewide Behavioral Health Primary Care Integration Conferences
  • 16.

Editor's Notes

  • #13 Clarity and Agreement
  • #14 Clarity and Agreement