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Seiji Hayashi, MD, MPH, FAAFPChief Medical OfficerU.S. Department of Health and Human ServicesHealth Resources and Services AdministrationBureau of Primary Health Care
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The Health Center Program and the NHAS
and VHAP
Seiji Hayashi, MD, MPH, FAAFPChief Medical OfficerU.S. Department of Health and Human ServicesHealth Resources and Services AdministrationBureau of Primary Health Care
April 20, 2012
SYNChronicity (SYNC 2012)
Overview
• Health Center Program Update
• Health Centers, HIV, STDs and Hepatitis
• QI Strategy• Partnerships
Primary Health Care 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
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Health Center Program National Presence –
October 2011
4
Health Center Program Overview
Calendar Year 2010
77 Million Patient Visits 1,124 Grantees 8,100+ Service Sites
Over 131,000 Staff 9,592 Physicians 6,362 NPs, PA, & CNMs
Source: Uniform Data System, 2010, Service Sites: HRSA Electronic Handbooks Scope Repository 12/31/2010
19.5 Million Patients 93% Below 200% poverty 38% Uninsured 62% Racial/Ethnic Minorities 1,052,000 Homeless Individuals 863,000 Farmworkers 173,000 Residents of Public Housing
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Health Center Program Growth:
National Impact 2008-2010
2008 2009 201015,500,000
16,000,000
16,500,000
17,000,000
17,500,000
18,000,000
18,500,000
19,000,000
19,500,000
20,000,000Patients
Year
2008 2009 20107,000
7,200
7,400
7,600
7,800
8,000
8,200
8,400
Sites
Year
2008 2009 2010100,000
105,000
110,000
115,000
120,000
125,000
130,000
135,000Jobs
Year
2008 2009 2010 Growth from 2008-2010 (% Increase)
Patients 17,122,535 18,753,858 19,469,467 2,346,932 (13.7%)Sites 7,518 7,892 8,156 638 (8.5%)Jobs 113,059 123,012 131,660 18,601 (16.5%)
HCs and HIV, STDs, Hepatitis
• HIV & STD Care and Services– 781,750 Patients receiving HIV
Testing– 90,559 Patients living with HIV/AIDS– 59,158 Patients with Syphilis/other
STDs• Preventive Health & Screening
– 1,808,992 Pap Tests Conducted– 1,096,615 Patients for Contraceptive
Management
HCs and HIV, STDs, Hepatitis
• Hepatitis B & C Care and Services– 58,594 Patients with Hepatitis C– 12,333 Patients with Hepatitis B– 256,133 Patients receiving Hepatitis
B testing– 162, 320 Patients receiving
Hepatitis C testing
• Mental Health Care & Services– 726,779 Patients for depression/mood
disorder– 397,541 patients with anxiety/PTSD
• Substance Use Care & Services– 110,031 Patients for tobacco use– 97,913 Patients for substance use
(excluding tobacco)– 73,082 Patients for alcohol abuse
HCs and HIV, STDs, Hepatitis
Overarching Approach
• Improve coordination of care and quality of care for people living with HIV
• Encourage HIV service delivery both directly and through formal referrals
• Move health centers along the spectrum of HIV service delivery
HIV Primary Prevention & Case
Management
HIV Primary Care, Specialty Care, & Support Services
Innovative Model & Mentor
ACCESS
COMPREHENSIVE SERVICES
INTEGRATED SERVICES
INTEGRATED HEALTH SYSTEM
Ability of patients to be seen in atimely, affordable and culturallycompetent manner
Provision of full scope of primary health services, including dental, behavioral health, and enabling services
Coordination and monitoring of services within a health center
Medical “neighborhoods”Integration of patient information and need between HCs and community services
BPHC QI Strategy
ACCESS
COMPREHENSIVE SERVICES
INTEGRATED SERVICES
INTEGRATED HEALTH SYSTEM
BPHC QI Strategy
1.Programs/Policies
2.Funding
3.Technical Assistance
4.Data/Information
Strategy Implementation
ACCESS
COMPREHENSIVE
SERVICES
INTEGRATED
SERVICES
INTEGRATED HEALTH SYSTEM
BPHC QI Strategy
Programs/Policies
• Alignment with NHAS• Alignment with HHS VHAP• Program Guidance on Testing
and Treatment• PCMH and behavioral health
integration
Strategy Implementation
ACCESS
COMPREHENSIVE
SERVICES
INTEGRATED
SERVICES
INTEGRATED HEALTH SYSTEM
BPHC QI Strategy
Funding
• $150 Million for Health Center New Access Points
• $15 Million for Expanded Services, including Expanded HIV Services and Support for Health Center Recruitment and Retention Strategies
• $20 million for Health Center Controlled Networks
Strategy Implementation
ACCESS
COMPREHENSIVE
SERVICES
INTEGRATED
SERVICES
INTEGRATED HEALTH SYSTEM
BPHC QI Strategy
Technical Assistance (National)
• National Association of Community Health Centers (NACHC)
• National Training and Technical Assistance Center for LGBT Health
•Association of Asian Pacific Community Health Organizations (AAPCHO)•SAMHSA/HRSA Center for Integrated Health Solutions (CIHS)
Strategy Implementation
ACCESS
COMPREHENSIVE
SERVICES
INTEGRATED
SERVICES
INTEGRATED HEALTH SYSTEM
BPHC QI Strategy
Technical Assistance(Regional/State)
• AETC (Regional-National)• Primary Care Association (PCA)• Primary Care Offices (PCO)• Area Health Education Centers
(AHEC)
Strategy Implementation
ACCESS
COMPREHENSIVE
SERVICES
INTEGRATED
SERVICES
INTEGRATED HEALTH SYSTEM
BPHC QI Strategy
Data/Information
• UDS Reporting on HIV, Hepatitis• Health Center Patient Survey• Research: Community Health
Applied Research Network (CHARN)
Strategy Implementation
Partnerships/Collaborations
• National Partners– Federal: White House, HHS, Other
Federal agencies– Non-Governmental Partners:
NASTAD, NACHC, NCCBH, others• State Partners
– Primary Care Associations– State HIV/AIDS Directors– State Hepatitis Coordinators
• Local Partners– Health Centers, CBHC,
HIV/Hepatology specialists, Hospitals, CBOs
Thank You!
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Seiji Hayashi, MD, MPH, FAAFPChief Medical Officer
U.S. Department of Health and Human ServicesHealth Resources and Services Administration
Bureau of Primary Health Care 5600 Fishers Lane Rm. 17-105
Rockville, MD 20857Telephone: 301.594-4110
Email: SHayashi@hrsa.gov
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