2015 Year in Review - Indiana Primary Health Care Association

Making a Difference
Indiana Primary Health Care Association, Inc.
429 North Pennsylvania Street, Suite 333, Indianapolis, IN 46204
Phone: 317.630.0845 - Fax: 317.630.0849
www.indianapca.org
This project is 100% supported by the Health Resources and Services Administration (HRSA) of the U.S.
Department of Health and Human Services (HHS) under cooperative agreement number U58CS06826,
State and Regional Primary Care Associations, award amount $789,671. This information or content
and conclusions are those of the author and should not be construed as the official position or policy
of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.
2015-16 Year in Review
What IPHCA Does
Organized in 1982, the Indiana Primary Health Care Association (IPHCA) is a statewide not-for-profit organization
that promotes the provision of primary health care services in areas of need throughout the state and works to
ensure the development and growth of Community, Migrant, Homeless, and Public Housing Health Centers in
Indiana.
IPHCA’s Mission
To champion the development and delivery of accessible, community-driven quality health care.
IPHCA’s Vision
A barrier-free, high quality health care system that is affordable, available, accessible, appropriate, and acceptable.
IPHCA’s Beliefs and Values
1. Health care is a right, not a privilege.
2. Grassroots advocates are crucial to community-supported health care.
3. Comprehensive, integrated, and coordinated primary health care encompasses medical, dental, behavioral
health, and enabling services.
4. The Community Health Center (CHC) model, to which the consumer’s voice is integral, provides for an
outcome-based and patient-focused health care home.
5. IPHCA equips leaders to advance health care goals and objectives.
FQHC Sites with Congressional Districts
INDIANA’S
COMMUNITY
LOCATIONS
INDIANA’S
COMMUNITY
HEALTHHEALTH
CENTERCENTER
LOCATIONS
MAP LEGEND
MAP LEGEND
Regional
Health Clinic
Regional Health
Clinic
HealthLinc HealthLinc
CommunityCommunity
HealthNet HealthNet
NorthShoreNorthShore
Porter-Starke
Porter-Starke
Services Services
Indiana
Health Centers
Indiana Health
Centers
Heart City
Health Center
Heart City Health
Center
Maple City Maple
Health City
CareHealth
CenterCare Center
Knox
Winimac
Knox Winimac
(FQHC
Look(FQHC
Alike) Look Alike)
Neighborhood
Health Clinics
Neighborhood
Health Clinics
Meridian
Health Services
Meridian Health
Services
Purdue
North
Central
Nursing Clinics
Purdue North
Central
Nursing
Clinics
Riggs Community
Health
Center (Lafayette)
Riggs Community
Health Center
(Lafayette)
Valley Professionals
Health Center
Valley Professionals
CommunityCommunity
Health Center
Madison
County Community
Health Center
Madison County
Community
Health Center
Health Services
Open Door Open
HealthDoor
Services
Pauley Community
Health Center
Jane PauleyJane
Community
Health Center
WindRose
Health Network
WindRose Health
Network
“Open Door Health Services has been a member of IPHCA almost from the beginning of its formation. We recognized the
importance of membership even as a very small, grass-roots health center receiving only community dollars to support the
operation of two staff and moonlighting residents from the local hospital residency program. The services we received from
IPHCA in all those years helped us to become a Federally Qualified Health Center in 2000, now serving almost 21,000 patients
annually. In 2015 we received PCMH Level 3 recognition and the assistance from the IPHCA staff, Carla Chance, played a huge
role in making sure that our application was “point on” when we submitted it! IPHCA serves not only as a source for valuable
training, but also as a connection to new and innovative services that will assist us to provide top quality health care to the
communities we serve.
In the past year the quality of training opportunities has been phenomenal! Members of our staff have returned from
trainings ranging from the Prospective Payment System, 340B, CHC Management, ICD-10, and too many more to mention,
with rave reviews! The Annual IPHCA meeting, while providing great speakers, is also a terrific opportunity for our staff to
network with peers and share stories and best practices. It is wonderful to have at our fingertips the myriad of high caliber
training opportunities with minimal traveling and cost.” Quote from: Toni R. Estep, CEO, Open Door Health Services
FQHC
SITESCONGRESSIONAL
WITH CONGRESSIONAL
DISTRICTS
FQHC SITES
WITH
DISTRICTS
HealthNet (Indianapolis)
HealthNet (Indianapolis)
Eskenazi
Health Centers
Eskenazi Health
Centers
Raphael Community
Health Clinic
Raphael Community
Health Clinic
Shalom
Shalom Health
CareHealth
CenterCare Center
Wabash
Valley Community
Health Center
Wabash Valley
Community
Health Center
ECHO Community
ECHO Community
Health CareHealth Care
Family
Health
Centers ofIndiana
Southern Indiana
Family Health
Centers
of Southern
Wayne
County
Health Department
Wayne County
Health
Department
LifeSpring Community
Medical Services
LifeSpring Community
Medical Services
Table of Contents
What IPHCA DoesInside Front Cover
Table of Contents1
Letter from the CEO
2-3
The Primary Health Care Association
4
Board of Directors and Committees
5
IPHCA Staff
6
IPHCA Members
7
Community Development
8
Oral Health Initiatives
9
Outreach & Enrollment
10-11
CHC Program Services
12
Training Opportunities
13
Data Analytics Initiative
14
CHC Finance and Operations Technical Assistance
15
The STAR Initiative
16-17
Policy Accomplishments
18-19
Shortage Areas
20
Indiana FQHC User Demographics 2015
21-23
National Health Center Week 2015
24
Financial Statement
25
Much to Celebrate
26-28
1
Letter from IPHCA CEO
May 2, 20016
Dear Members and Friends,
We are pleased to provide this report of IPHCA’s Year in Review. As your primary care association, it
is essential that we think and act strategically in order to ensure that our vision of a barrier-free, high
quality health care system that is affordable, available, accessible, appropriate, and acceptable can
and will be met. There are three key elements in building a strategic organization that can successfully
pursue its vision: Strategic planning, strategic relationships, and strategic vision.
STRATEGIC PLANNING: IPHCA’s board and staff have long been engaged in a process of strategic
planning and execution. We understand that there is truth in the statement “if you don’t know where
you’re going, any road will get you there.” IPHCA’s current plan entails five strategic priorities aimed
at addressing work force needs, developing and maintaining a strong membership, board, and staff,
financial strength, increasing the market power of the membership, and addressing training needs of
community health centers. Work is ongoing to carve out significant progress in all five priorities, while at
the same time identifying additional areas of opportunity in which IPHCA can play a positive role.
We are well aware of the evolution of the very concept of strategy, a critical role for any board of
directors. A rapidly evolving future will require regular updating and revision of strategic plans. IPHCA’s
board will consider this new environment, seeking new approaches to establishing timely, responsive
strategies that anticipate and address needs and issues as they emerge. As board and staff work
together in this critical area, we urge the members to share your thinking with us regarding areas of
need and opportunity. IPHCA is pleased to present its 2015-16 edition of the “Year in Review.” Indiana’s
community health centers will experience dramatic changes over the next few years. Your Primary Care
Association is supporting our community health centers as they transition to survive and prosper in a
new world.
STRATEGIC PARTNERSHIPS: IPHCA does not exist in a vacuum. We cannot achieve our objectives alone.
With this understanding, we have maintained a long-term effort to establish and build relationships with
individuals and organizations that share our objectives and help us make progress in the right direction.
IPHCA staff, board, and member relationships with legislators, government officials, state associations,
and other key entities are essential to positive outcomes in legislative and regulatory endeavors, funding
initiatives, workforce-related programs, training and technical assistance, and outreach and enrollment.
Our key partners include the Great Lakes Practice Transformation Network, Purdue Healthcare
Associates, Covering Kids and Families, AHEC, The Health Foundation of Greater Indianapolis, The
Indiana Hospital Association, The Indiana Dental Association, The Regenstrief Institute, IHIE, MHIN, and
many others; our relationships with these organizations have contributed greatly to our success. The
U.S. Health Resources and Services Administration (HRSA), U.S. Centers for Medicare and Medicaid
Services (CMS), Indiana State Department of Health (ISDH), and the Family and Social Services
Administration (FSSA) play ongoing central roles as regulators, funders, and purchasers of primary
care services provided by our member organizations, as well as direct funding of activities carried out
by IPHCA. Colleges and universities engaged in training and educating our work force include Indiana
University, Marian University, Butler University, and many others are essential to our members’ ability to
continue to meet the primary care needs of patients throughout the state.
Strategic relationships don’t happen by accident. IPHCA works consistently and intentionally to establish
and maintain relationships that will strengthen our efforts to serve the needs of the membership, and,
indeed, health centers throughout the state.
2
STRATEGIC VISION: It is the responsibility of the PCA to envision a future state of being through which
we can support the achievement of desired outcomes by health centers. Over the past few years, in
addition to responding to needs identified by funders and health centers alike, IPHCA anticipated and
acted on future needs, not yet identified by others. For example, we have provided leadership in areas
such as the use of scribes, establishment of a health center-controlled network (HCCN), and the need for
a more effective means for extracting reports from EHR products (Azara DRVS).
Our vision of the future includes a fully engaged membership, the availability of real-time process and
outcomes data for all sites and all patients, an unrestricted ability to meet all training and technical
assistance needs throughout the state, a workforce and recruitment effort that meets all needs
throughout the state, and a highly functioning team comprising an effective staff and board of directors.
Our vision of the future includes an understanding that health centers will soon experience an as-yet
undetermined measure of payment reform. Some of our health centers will certainly move to a system
of assumed risk. Within a matter of a few years, all will be paid through systems based more on value
than volume. Integrated, team-based care, patient engagement, expansion of oral and behavioral health
services, and understanding and addressing the social determinants of health will all be essential as
health centers move into a world in which population health is central to our way of being.
CONCLUSION: Your continued support of IPHCA is essential to our collective ability to fulfill our
mission and our vision of a better future for all. The board and staff of IPHCA will continue to work
for the benefit of all. To do our very best, and to ensure that we continue to be an organization that is
strategically positioned to achieve that better future, we need your wisdom, advice, and foresight, and
we seek the active engagement of your organization in IPHCA’s activities.
Sincerely,
Philip L. Morphew
Chief Executive Officer
Indiana Primary Health Care Association
“As CEO/CFO of Boone County Community Clinic it has been a pleasure and an honor to have had the opportunity
to work with the IPHCA Staff as a Board Director for the past two years. Our clinic has been an IPHCA member for
the past 7 years and utilizes IPHCA for comprehensive training, education, and networking assistance whenever
required. Phil Morphew, IPHCA CEO, should be proud of the staff he has assembled and the professional manner
in which they conduct business.”
Quote from Todd Jones,CEO/CFO,Boone County Community Clinic
3
The Primary Health Care Association
The Indiana Primary Health Care Association (IPHCA) is the primary care association (PCA) in Indiana. Every state in the
U.S. is supported by a PCA. The PCA serves as the membership association for Community Health Centers and receives
funding from the Health Resources and Services Administration, Bureau of Primary Health Care, to monitor the degree of
access to primary care services for state residents, to provide technical assistance for Federally Qualified Health Centers
(FQHCs), Federally Qualified Health Center Look-Alikes, and organizations applying for status as an FQHC or Look-Alike,
and to support outreach and enrollment assistance activities at health centers.
In Fiscal Year 2014-15, IPHCA received funding from the following partners:
• Health Resources and Services Administration, Bureau of Primary Health Care for primary care association services
as described above
•
Indiana State Department of Health to provide deliverables related to the National Health Service Corps Program
•
Indiana State Department of Health to provide technical assistance deliverables for the Community Health Centers
receiving state funding from the Indiana State Department of Health
•
The DentaQuest Foundation for participation in a PCA learning collaborative working to learn more about what it
takes to develop the capacity to support oral health improvement in safety net settings.
•
The Kresge Foundation STAR (Strengthen Transform Adapt Replicate) Initiative
•
The Health Foundation of Greater Indianapolis for additional outreach and enrollment support needs and to provide
training and resources in response to the HIV/AIDS outbreak in Southern Indiana
IPHCA is also supported by Community Health Center membership dues, state and federal funding, and by individuals or
corporate sponsoring organizations that support IPHCA’s mission.
“The Indiana Primary Health Care Association has been a great support system for me and Neighborhood Health Clinics for
the last 20 years. The issues have changed in many ways, but some of the basics remain the same. Today we are dealing with
Patient Centered Medical Home, Affordable Care Act, HIP 2.0, shortage of primary care providers, and gridlock in the Indiana and
National legislatures. The consultation and training from IPHCA and its members has always been important to our success and
will be a great support to NHCI as I retire and a new CEO is in place.”
Quote from Mary Haupert, CEO, Neighborhood Health Clinics, Inc.
4
Board Members and Committees
BOARD OF DIRECTORS 2015-16
FINANCE Committee
HEALTH POLICY Committee
Mike Kolenda, Acting CHAIR *
CEO
WindRose Health Network, Inc.
Edinburgh, IN
Marc Hackett, CHAIR, Executive Director
The Jane Pauley Community Health Center
Beth Wrobel, CHAIR, CEO
HealthLinc, Inc.
Hoagland Elliott, Retired Executive Director
Raphael Health Center
Mike Kolenda, CEO
WindRose Health Network
Terry (TJ) Warren, Jr., Executive Director
Valley Professionals Community Health Center
Dr. Leonardo Ortega, Executive Director/CEO
Shalom Health Care Center, Inc.
J. Cornelius (Jimmy) Brown, President/CEO
HealthNet, Inc.
Toni Estep, CEO
Open Door Health Services
Dr. James Gingerich, Executive & Project Dir.
Maple City Health Care Center, Inc.
Dr. Janet Seabrook, CEO
Community HealthNet
Todd Jones, CEO/CFO
Boone County Community Clinic
Brooke Lockhart, COO
Wabash Valley Health Center
Dr. Leonardo Ortega, Executive Director/CEO
Shalom Health Care Center, Inc.
Elvin Plank, CEO
Indiana Health Centers, Inc.
MEMBERSHIP Committee
Todd Van Buskirk, Director-Integrated Care
Porter-Starke Services, Inc.
J. Cornelius Brown, Acting VICE CHAIR *
President/CEO
HealthNet, Inc.
Indianapolis, IN
Vacant, IMMEDIATE PAST CHAIR *
Jose Perez, SECRETARY *
COO
Indiana Health Centers, Inc.
Indianapolis, IN
Marc Hackett, TREASURER *
Executive Director
The Jane Pauley Community Health Center
Indianapolis, IN
Eric Coulter, AT LARGE *
Executive Director
Wayne County Community Health Center
Richmond, IN
Dr. Mark Bustamante, AT LARGE *
CEO
Eskenazi Health Center
Indianapolis, IN
Toni Estep, CEO
Open Door Health Services
Muncie, IN
Dr. James Gingerich, Executive Director
Maple City Health Care Center, Inc.
Goshen, IN
Todd Jones, CEO/CFO
Boone County Community Clinic
Lebanon, IN
Daniel J. (Jim) Layman, Executive Director
North Central Nursing Clinics
Delphi, IN
Brooke Lockhart, COO
Wabash Valley Health Center
Terre Haute, IN
Dr. Leonardo Ortega, Executive Director/CEO
Shalom Health Care Center, Inc.
Indianapolis, IN
Dr. Janet Seabrook, CEO
Community HealthNet
Gary, IN
Sandee Strader-McMillen, CEO
ECHO Community Health Center
Evansville, IN
Toni Estep, CHAIR, CEO
Open Door Health Services
Beth Wrobel, CEO
HealthLinc, Inc.
Sally Watlington, Board Chair emeritus
Riggs Community Health Center
Sandee Strader-McMillen, CEO
ECHO Community Health Center
Daniel J. (Jim) Layman, Executive Director
North Central Nursing Clinics
Dr. Leonardo Ortega, Executive Director/CEO
Shalom Health Care Center, Inc.
J. Cornelius (Jimmy) Brown, President/CEO
HealthNet, Inc.
NOMINATING Committee
Jose Perez, CHAIR, COO
Indiana Health Centers, Inc.
Marc Hackett, Executive Director
The Jane Pauley Community Health Center
Daniel J. (Jim) Layman, Executive Director
North Central Nursing Clinics
Toni Estep, CEO
Open Door Health Services
Mary Haupert, (Past Chair), CEO
Neighborhood Health Clinics, Inc.
Terry (T.J.) Warren, Jr., Executive Director
Valley Professionals Community Health Center
Clinton, IN
Beth Wrobel, CEO
HealthLinc, Inc.
Valparaiso, IN
*Indicates EXECUTIVE COMMITTEE
5
Joseph (Joe) Biggs, Executive Director
Richard G. Lugar Center for Rural Health/
Clay City Center – Family Medicine
PERSONNEL Committee
Eric Coulter, CHAIR, Executive Director
Wayne County Community Health Center
Todd Jones, CEO/CFO
Boone County Community Clinic
Terri Hutchison, Chief HR Officer
Open Door Health Services
Angie Zaegel, VP/COO
Neighborhood Health Clinics, Inc.
Lori Harris, CEO
Family Health Centers of Southern Indiana
Amelia Clark, VP, Community Health
Meridian Health Services
Veronique LeBlanc, (Past Chair), Retired CEO
Riggs Community Health Center
IPHCA Staff: Making a Difference
JASON BUNDY
Education & Membership
Program Director
EMILY DAW
Data Marketing
Enrollment Specialist
PHILIP L. MORPHEW
Chief Executive Officer
DREW THOMAS
MARIE BUTZ, BME, MS
Executive Assistant
JESSICA ELLIS
Outreach and Enrollment
Program Director
CARLA CHANCE, BSN, PCMH CCE
Community Health Centers
Programs Manager
MICHELLE GRANAT, BS, BA
Finance and Benefits Administrator
NATALIE MORRISON, MPH
Shortage Designation and
National Health Service Corp Program Director
Finance and Operations Program Director
ELAINE WILLIAMS
JASMINE PAGE, MPH
Health Care Data Specialist
Oral Health Program Director
6
JING XU
NANCY CURD
Outreach & Enrollment
Administrative Coordinator
LISA MANGIFICO
Policy Analyst
NANCY STASSEN
Director of Operations
Resource Development Program Director
IPHCA Members
SECTION 330 HEALTH CENTER GRANTEES
Community HealthNet, Inc.
ECHO Community Health Care
Eskenazi Health Centers
Family Health Centers of Southern Indiana
HealthLinc, Inc. HealthNet, Inc.
Heart City Health Center, Inc.
Indiana Health Centers, Inc.
Jane Pauley Community Health Center
LifeSpring Health Systems
Madison County Community Health Centers, Inc.
Maple City Health Care Center
Marram Health Center
Meridian Health Services
Neighborhood Health Clinics, Inc.
North Central Nursing Clinics/Purdue University
NorthShore Health Centers
Open Door Health Services
Raphael Health Center
Regional Health Clinic
Riggs Community Health Center, Inc.
Shalom Health Care Center, Inc.
Valley Professionals Community Health Center
Wabash Valley Health Center
Wayne County Community Health Center
WindRose Health Network, Inc.
STATE FUNDED COMMUNITY HEALTH CENTER PRIMARY CARE PROVIDERS
Boone County Community Clinic
Centerstone
Community Health and Wellness Center
Daviess Community Hospital Clinic
IU Health LaPorte Community Health and Dental Center
Richard G. Lugar Center for Rural Health/Clay City Family Medicine
Rising Sun Medical Center, Inc.
St. Francis Neighborhood Health Center
Tulip Tree Health Services of Gibson County, Inc.
AFFILIATES
Adult and Child Center
ASPIRE Indiana
Community Health Clinic
Community Mental Health Center, Inc.
I.U. Dept. of Family Medicine/AHEC Program
CORPORATE PARTNERS
“The Indiana Primary Care Association is a great resource for training and
technical assistance. As the Founder and CEO of Community HealthNet, I can
Anthem
attest that our organization has benefitted from membership in IPHCA. The
MDwise, Inc.
staff at IPHCA has a wealth of knowledge and all are true advocates for the
INDIVIDUALS
Indiana Community Health Centers. Phil Morphew and the IPHCA staff are
greatly appreciated.”
Hoagland Elliott
Quote from Dr. Janet Seabrook, CEO, Community HealthNet, Inc.
Veronique LeBlanc
Sally Watlington
7
Community Development: IPHCA’s Mission in Action
Increasing Access to Health Care
Educating:
Federally Qualified Health Centers (FQHCs) are amazing organizations that meet the health care needs of thousands
of Hoosiers. Yet many Hoosiers still do not know they exist. Part of the community development work of the Indiana
Primary Health Care Association is to educate community leaders, health care professionals, academicians, and economic
development staff on what FQHCs are and how they impact the health and well-being of communities across the state.
To this end, IPHCA provides educational services listed below to interested communities/professional organizations/
non-profit and faith-based groups:
Speakers for meetings on what FQHCs are and how they meet the health care needs
of the underserved
Individual group meetings with hospital administrations, critical access hospitals,
county commissions, health departments, community groups
Educational materials to all who make requests
Working with Communities to further our Goal of Creating Health Care Access to all Hoosiers:
IPHCA works with communities, bringing together health care professionals, community business leaders, political
leaders, social services professionals, and communities of faith as well as concerned residents in order to develop
additional access to health care. Working with communities provides us opportunities to help create new Federally
Qualified Health Centers or new sites of existing health centers.
Our centers have been proven to produce cost effective patient-centered quality care. They have been created by people
with a passion for serving. It is important to continue to pass along this combination of passion, purpose, and proven
effectiveness through our community development efforts.
Health Center Controlled Network (HCCN)
Beginning in July, 2015, the HCCN Advisory Committee and IPHCA staff held discussions and preparations for creating an
HCCN in Indiana to assist health centers with health IT issues, population health management, and quality improvement.
With HRSA’s HCCN Funding Opportunity Announcement released on December 2, 2015, IPHCA coordinated and drafted
the Indiana Quality Improvement Network (IQIN) HCCN project proposal. With full approval from members of the HCCN
Advisory Group, IPHCA submitted the final HCCN grant application on February 29, 2016.
During the HCCN grant application process, IPHCA staff reached mutual understandings with multiple stakeholders from
professional organizations, Health Information Exchanges (HIEs), Institutes of Higher Learning, and a HRSA National
Cooperative Agreement Recipient. All stakeholders have provided Letters of Support and agreed to continue working
with IPHCA on health IT, population health, and quality improvement issues identified across health centers.
HCCN Grant Application:
Throughout the HCCN grant application process, IPHCA staff has identified a wide range of health IT and workforce
related challenges concerning health centers. IPHCA is committed to address these challenges with ongoing training and
technical assistance programs. With the creation of IQIN, additional resources will focus on assisting Participating Health
Centers with needs specified in individual work plans. Development of an HCCN for Indiana represents a major step
forward in collaboration and cooperation among participating health centers.
“As HealthLinc’s CEO, I have been involved with IPHCA for over fourteen years and am amazed at the growth in the
depth and breathe of their organizational team. From my first interaction with IPHCA in 2002, when HealthLinc was
just becoming a state-funded health center, until today, as HealthLinc has grown to a federally qualified health center
with eight locations, the multi-talented IPHCA staff continues to be right by our side to support and guide us. Their
professional services continue to broaden, especially in the areas of outreach and enrollment, financial sustainability,
advocacy, quality and compliance. On our journey toward improving the health of the communities we serve, we
consider IPHCA a valuable partner in our mission.”
Quote from Beth Wrobel, CEO of HealthLinc, Inc.
8
Promoting Oral Health Initiatives in Community Health Centers
In 2015, IPHCA was selected by the DentaQuest Foundation to become a partner in the National Oral Health Innovation
and Integration Network (NOHIIN). Through this partnership, IPHCA has been able to dedicate a part-time position to
oral health education, training, and technical assistance. As a result of our partnership with DentaQuest, IPHCA has been
able to provide, through a competitive grant application, oral health programming technical assistance from Safety-net
Solutions. This assistance has a monetary value of $67,000+ per participant. It is anticipated additional awards can be
made in 2016, as the IPHCA grant has been renewed for the 2016-17 year. Through this support, IPHCA’s oral health staff
member and CEO have participated in national oral health conferences, the Midwest Regional Convenings, and monthly
webinars. These venues have provided invaluable training and led to new partnerships that serve to enhance IPHCA’s
ability to provide oral health programming assistance to community health centers in Indiana.
Oral Health Initiatives
Mission: IPHCA works with safety-net providers to unify and empower a network of champions of oral health as a part
of overall health.
Vision: We envision an innovative, equitable safety net health care system where:
• Oral health is an integrated, critical component of person-centered, comprehensive health care and
wellbeing.
• Health outcomes are improved for all.
• IPHCA and CHC dental professionals are part of a network and have access to the tools and resources needed
to elevate oral health programs in Indiana.
Partnering for Oral Health
Since implementing our expansion of oral health trainings, we have developed working partnerships with:
1. DentaQuest Foundation: Participating in all NOHIIN programming, working with Midwest region PCAs and
dental associations, starting CHC Dental Professionals/CEO quarterly conference calls, and participating in Safety
Net Solutions technical assistance summary meetings.
2. Indiana Dental Association: We are presently working on a joint grant that will support the good efforts of
private dentists as well as dental professionals in CHCs.
3. American Dental Association: The ADA was instrumental in recruiting IPHCA to participate in the DentaQuest
Foundation’s programming, presenting data on the oral health needs of Medicaid recipients to the Social
Determinants of Health Data Users group, and ongoing assistance as questions arise.
4. Indiana School of Dentistry: IPHCA is promoting the rotation program the School of Dentistry has available for
CHCs. Though this program senior dental students are placed in CHCs to assist dental staffs. These students are
able to provide basic oral health care.
5. Indiana Oral Health Coalition: IPHCA has been an active member of this organization for a number of years. We
recently provided an educational presentation to coalition members on the FQHC model.
6. FSSA: IPHCA provides information to FSSA on oral health issues that impact Medicaid enrollees in Indiana, while
advocating for expansion and improvement of services for oral outcomes of Medicaid patients.
9
Closing Gaps and Covering the Uninsured: Outreach and Enrollment 2015
In September 2015, IPHCA was awarded a three-year Cooperative Agreement to Support Navigators in Federallyfacilitated and State Partnership Marketplaces from the Centers for
Medicare and Medicaid Services (CMS) to expand the federal Navigator
footprint in Indiana’s most underserved and vulnerable areas. This
IPHCA Outreach & Enrollment
funding added 8.6 full-time equivalent (FTE) federal Navigators in
2015 Accomplishments
nine Community Health Centers (CHCs) serving 48 of Indiana’s highest
• Procured nearly $2 million in O/E
uninsured counties. IPHCA also opened a storefront office in Indianapolis
for its 2.8 FTE Navigators to assist central Indiana’s uninsured Hoosiers.
funding
This three-year award totaling $1,777,998 will continue to be utilized for
• Created www.enrollindiana.org and
reducing the state’s uninsured rate and alleviating barriers to affordable
statewide multimedia compaign
health care until September 2018.
• Developed and hosted 20 unique
webinars
Continued financial support from
• Organized 8 free regional luncheons for
The Health Foundation of Greater
approximately 220 O/E specialists
Indianapolis (THFGI) has also
• Wrote and distributed over 300
provided IPHCA’s O/E department
“Reference Guides for Navigators”
the opportunity to grow immensely
and increase resource development,
technical assistance and education
for members. Since December 2013, IPHCA has received $377,376 from THFGI
to provide specialized leadership in educating and strengthening the statewide
network of Navigators and in promoting health coverage enrollment. Combined
with funding from the Health Resources and Services Administration (HRSA) and the
Indiana State Department of Health (ISDH), IPHCA’s internal O/E department has
grown from one staff member in 2013 to 5.2 FTEs in late 2015.
Near the end of the second open enrollment period (OEP), Indiana’s Section 1115 Medicaid Demonstration Waiver,
the Healthy Indiana Plan (HIP) 2.0, was approved in January 2015
and has since transformed the landscape of health care in Indiana.
IPHCA O/E staff assisted with bridging knowledge gaps by hosting a
HIP 2.0 four-part webinar series just six days after the official approval,
developing an online “HIP 2.0 Hub” of resources and providing
presentations across the state. Matt Cesnik, former Office of Medicaid
Policy and Planning (OMPP) Eligibility Director for the Family and
Social Services Administration (FSSA), stated in February 2015, “You
(IPHCA) are the most proactive group in getting coverage and asking
all of the right questions.” During the first year of HIP 2.0, enrollment
increased from roughly 60,000 to over 370,000 Hoosiers, many of
whom were previously stuck in the “coverage gap” without affordable
health insurance options. IPHCA helped Navigators across the state
troubleshoot
complex issues and improve the application and eligibility process
during this pivotal year of Indiana health care innovation. One year
into HIP 2.0, nearly 64% of enrollees elect to pay a monthly POWER
Account contribution for more comprehensive coverage including
dental and vision benefits. Additionally, more than 5,300 new
providers have joined the Indiana Health Coverage Programs (IHCP)
network to improve access to care and provider selection for HIP
enrollees.
“Communication is key. From what we communicate with them (IPHCA), they will help us find solutions, talk to government
agencies to find answers to our barriers, and they celebrate our successes with us.”
Lauren Lamb, Outreach & Enrollment Manager, HealthLinc, Inc.
10
“The Indiana Primary Health Care
Association’s Outreach & Enrollment
Department continues to be the #1
resource for myself and my entire
O/E Department. The high-level of
communication from this team amazes
me. They offer several avenues to keep
me informed of the most up-to-date
information including conference calls,
in-person education, and webinars.
My staff particularly loves the many
networking opportunities we are
presented with. As the Outreach and
Enrollment landscape continues to
change for FQHCs, I remain confident
that with IPHCA’s O/E support, myself,
my staff, and my organization will
continue to serve many Hoosiers.”
Bradley Denton, Outreach &
Enrollment Manager, Jane Pauley
Community Health Centers
Prior to the OEP3, IPHCA launched a multimedia campaign called “Enroll Indiana”
to promote the services of Indiana Navigators and CHCs across the state. The O/E
department developed www.EnrollIndiana.
org and procured a toll-free telephone
number to serve as the platform for social
media and outdoor advertising throughout
the state. The goal of Enroll Indiana is
to connect Hoosiers with free education
and enrollment assistance by promoting
the value of Indiana’s Navigators and the
unbiased services they offer.
At the end of OEP3 in January 2016,
national statistics revealed that approximately 12.7 million Americans have
enrolled in a Marketplace plan and 14 million more have enrolled in Medicaid
since 2013. The national uninsured rate has dropped from 20.3% to just 11.5%
in less than three years thanks to the diligence and determination of O/E
professionals across the country. In Indiana, approximately 196,242 Hoosiers
enrolled in a Marketplace plan during OEP3; 81% of enrollees selected a Qualified
Health Plan (QHP) with an average premium tax credit of $259 per month. In
addition to Marketplace enrollment, Indiana Health Coverage Programs (IHCP)
now covers over 1.3 million
Hoosiers with free or low-cost
health coverage. Tremendous
progress has been made since
the Patient Protection and
Affordable Care Act was signed
into law; however, there are
still hundreds of thousands of
Hoosiers that remain uninsured.
According to Kaiser Family Foundation, 310,000 Indiana residents
are eligible for IHCP coverage, and another 128,000 are eligible for
Marketplace coverage with premium tax credits. IPHCA believes the
continuation of Outreach and Enrollment services in CHCs is critical to
reaching these individuals and improving the quality and accessibility of
health care in Indiana.
“Working with the IPHCA O/E team has been very beneficial to our health center, patients, and our Navigators. They have provided
educational materials, webinars, regional luncheons, and networking phone calls where we could share ideas, ask questions and get
feedback from other outreach and enrollment teams throughout the state. The IPHCA O/E team leaves no questions unanswered. They
will reach out to their contacts to get correct information so we can best assist our consumers accurately and efficiently.”
Marla Asberry, Lead Enrollment Specialist/Navigator, Open Door Health Services
11
CHC Program Services
April 2015 – March 2016 has seen many initiatives/services being offered by IPHCA. Patient-Centered Medical Home
(PCMH) application and process assistance remains a top priority for IPHCA. IPHCA staff has maintained the certification
of PCMH Certified Content Expert through the National Committee for Quality Assurance (NCQA). IPHCA has a contract
with BizMed for five health centers seeking to use a web-based tool with resources that health centers can use to meet
each of the factors. BizMed also allows for multiple users to add documents and for IPHCA staff to review content
without having to email each document. It provides scoring of each element so the health center can track progress and,
when ready to submit, the document goes straight into NCQA’s ISS system with no need for a second upload of files.
IPHCA offered 100 subscriptions to any health center staff interested in taking courses through the Institute for
Healthcare Improvement’s Open School. Sixty-three people have signed up to take advantage of the on-line courses
on Patient Safety, Improvement Capability, Quality Cost and Value, Person- and Family-Centered Care, Triple Aim for
Populations, and Leadership.
The ICD-10 Coding Review and Consultation has been another initiative offered by IPHCA to five health centers. A
nationally recognized expert in ICD-10 coding and training, Shellie Sulzberger, LPN, CPC, ICDCT-CM, conducted the
reviews, provided on-site technical assistance and conducted a state-wide educational training session on the gaps that
were noted from the reviews, proper use of ICD-10 codes and documentation requirements. (see photo below)
The Quality Plan Review Initiative was started and will continue into 2016-2017 for eight health centers. Participants
will receive technical assistance from Candace Chitty, RN, MBA, CPHQ, PCMH CCE. Ms. Chitty also serves as an
operational site reviewer for the Bureau of Primary Health Care.
Building upon the successful Federal Tort Claims Act (FTCA) sessions offered at the IPHCA Annual Conference in May
2015, IPHCA applied to the Health Resources and Services Administration (HRSA) to host the FTCA University. IPHCA was
one of four honored recipients awarded the unique opportunity and has scheduled the two-day university training for
July 21 and 22, 2016.
The CHC Digest is published monthly. Articles under the various sections of News and Notices, Outreach and Enrollment,
NHSC/J-1, and Finance and Operations Trainings have been selected from other newsworthy sources, condensed to a
“bite-size” format, and provided to health center staff with information that may be useful to them in one convenient
document.
IPHCA staff has also provided information or connection to experts on specific topics to health centers such as: definition
of visits as it relates to UDS reporting; malpractice wrap-around insurance; medical student/resident run clinics; and
homeless shelter medical services.
12
IPHCA Training Opportunities
IPHCA Training Opportunities In order for community health centers to continue to provide high quality services, it is important for staff to have opportunities to receive additional training. IPHCA provided the following training opportunities in FY 2015‐16. Date 4/14/2015 4/15/2015 4/21/2015 5/4/2015 5/4/2015 5/20/2015 6/16/2015 6/17/2015 6/25/2015 7/15/2015 7/22/2015 7/23/2015 7/27/2015 7/29/2015 8/18/2015 8/19/2015 9/16/2015 10/20/2015 10/21/2015 10/22/2015 10/23/2015 11/3/2015 11/4/2015 11/9/2015 12/15/2015 1/19/2016 2/9/2016 2/16/2016 2/25/2016 3/3/2016 3/3/2016 3/8/2016 3/8/2016 3/9/2016 3/11/2016 3/15/2016 3/16/2016 3/17/2016 Name Webinar: Effective Utilization of Nurse Practitioners and Physician Assistants in CHCs and FQHCs Social Determinants of Health Data Users Webinar FORUM: MDwise Quality Incentives / HIP 2.0 Update Annual Conference May 4‐5 2015 Indiana Navigator Continuing Education Social Determinants of Health Data Users Webinar Forum: Meaningful Use / Indiana HIV Update Social Determinants of Health Data Users Webinar Topic: HIV – What Health Care Providers Need to Know Social Determinants of Health Data Users Webinar Porter County Outreach & Enrollment Regional Lunch Marion County Outreach & Enrollment Regional Lunch Dubois County Outreach & Enrollment Regional Lunch Delaware County Outreach & Enrollment Regional Lunch FORUM: Oral Health Integration Social Determinants of Health Data Users Webinar Social Determinants of Health Data Users Webinar FORUM: Great Lakes Practice Transformation Network Social Determinants of Health Data Users Webinar CFO Intensive Training South Bend CFO Intensive Training Indianapolis UDS Training 2015 eClinical Works Training Corporate Compliance Training 2015 FORUM: CHC Employee Engagement Outreach & Enrollment Webinar: Best Practices for Assisting Individuals Experiencing Homelessness Outreach & Enrollment Webinar: HIP Redeterminations IPHCA LEGISLATIVE FORUM PPS/ Change in Scope Maximization Health Center Management O/E Webinar: Assisting the Criminal Justice Population 340B From A to Z Dubois County O/E Regional Lunch Social Determinants of Health Data Users Group Meeting Delaware County O/E Regional Lunch Elkhart County O/E Regional Lunch Marion County O/E Regional Lunch Population Health Management Webinar: Steps for Creating a Platform for Managing High Cost/Risk Patients 13
Registrations 22 19 9 164 113 19 34 16 10 18 58 89 21 50 42 9 1 32 4 8 18 78 7 21 45 25 83 37 22 36 45 34 42 28 51 66 94 22 2015-2016 Data Analytics Initiatives
Community Need Profiles and Maps
IPHCA uses data analytics in health centers
as a tool for supporting quality and health
outcome improvements. Specifically, we have
been creating community needs index maps
for each federally-qualified health center. The
Community Needs Index (CNI) was developed
by Dignity Health and Truven Health Analytics
to indicate community health care needs based
on socio-economic factors. The CNI generates a
score to determine areas with the highest need
with a scale ranging from 1.0 to 5.0. A score
of 1.0 indicates a zip code with the least need
while a score of 5.0 represents a zip code with
the most need. The CNI score is derived by
taking an average of the five barrier scores. The
components of the index score include: income
barriers, cultural barriers, education barriers,
insurance barriers, and housing barriers.
Using UDS Mapper, IPHCA staff has been able
to overlay the CNI scores with the health
centers service areas and for the entire county
in which they are located. In addition to the
CNI score, maps have been made to show race/ethnicity and low income areas by zip code level. Above is an example
map of low income for an Indiana health center which was prepared using UDS Mapper.
Health Data Repository
IPHCA has recently formed a data repository with those health centers using Azara DRVS that allows members to access
aggregate and patient level health information. There are currently six health centers participating in the data repository
and more to come. Moving forward, this group of data repository participants will strengthen quality improvement
initiatives by having reliable data access and working together to set targets for specific measures.
Social Determinants of Health Data Users Group
The Social Determinants of Health Data Users Group has continued to meet on a quarterly basis for 2015-16. The
purpose of the group is to provide a space for community organizations interested in addressing the social determinants
of health to come together to share information and ideas, gain knowledge of community programs currently addressing
SDH, and engage with partners to generate synergy. Members represent community health center leaders, academia
professionals, managed health plan leaders, and other nonprofit organizations with an interest in addressing social
determinants of health. Past meeting topics include:
• Mapping data to identify areas of need
• Mapping social determinants of health
• Dental issues and disparities in Indiana
• Progress on integrating social determinants of health data into the Michiana Health Network
• Pregnancy centering programs at a Northwest Indiana health center
• Nurse Family Partnership’s nurse home visiting program
14
CHC Finance & Operations Technical Assistance Initiatives
CFO/COO Peer-to-Peer Conference Calls
In 2015 IPHCA held four (4) peer-to-peer calls for CFOs/COOs of Community Health Centers (CHCs) around the state.
These calls are intended to develop a relationship between centers, strengthen the overall knowledge base, and provide
a safe place for discussion of challenges facing CHCs. While the CFOs/COOs of health centers are specifically invited, they
often share the calls with other staff as well. Topics for 2015 included:
• Credentialing, Licensing and Reimbursing: Peers working to Support BH (Webinar)
• Peer-to-Peer Call - HIP 2.0 (conference call)
• HIP Debit Card (conference call)
• Sliding Fee Schedule (conference call)
Sliding Fee Scale
In December 2015, IPHCA hosted a state-wide discussion focusing on the sliding fee scale. The need for technical
assistance was based on findings from site reviews. Discussion reviewed several aspects of this requirement, using PIN
201402 to structure the discussion.
The fee schedule was discussed to ensure clinics were using sustainable and accurate pricing for their services. The
discount is not in the fee schedule itself but in the three (or more) tiers within the federal poverty guidelines (FPG). One
clinic representative shared experiences on using Optum, a company specializing in providing fee schedule pricing based
on regional or geographic information.
Participants reviewed eligibility tiers per FPG. Clinics were reminded not to include any programing above 200% FPG on
sliding scales for Ryan White or other “special populations.” HRSA is only interested in verifying that 330 funding is used
for 200% of FPG or lower. The policy may note details about “special populations” but the sliding scale and policy and
procedures must be explicitly referring to 330 funding. Participants also discussed language within the PIN referring to
services provided off site. Per 201402 PIN, page 12: “For services the health center provides only via a formal written
referral arrangement (Form 5A: Service provided, Column III within the federally approved scope of project), the health
center is responsible for ensuring that the referral provider’s discounts for health center patients meet the criteria
above.”
One clinic discussed the difficulty writing policy and procedures concerning nominal fees and patients unable to pay.
According to Feldsman & Tucker, procedures must clearly state how “unable to pay” and “refusal to pay” members are
handled, even including the number of letters sent prior to changing from “unable to pay” to “refusal to pay.” Clinics
were reminded that “everyone needs to know they will be seen regardless of their ability to pay.” The location of the
signage and the sliding fee scale signage itself must be clear to all who may be potentially eligible.
Capital Link Economic Impact Analysis and Performance Evaluation Profiles
IPHCA reached out to Capital Link to assist in providing Indiana FQHCs valuable financial data. Health Centers were given
the choice in receiving the Economic Impact Analysis (EIA) or both the EIA and the Performance Evaluation Profile (PEP).
The 16 FQHCs who chose to participate in the PEP reports not only received the report (individual and state aggregate),
but also were invited to a webinar hosted by Capital Link to review the findings and advise how the measures were
compiled. Participants were also invited to schedule one on one time with Capital Link to discuss individual findings.
The EIA reports focused on each center’s economic impact within its local community proving the value of Indiana
health centers. In 2014, these nineteen health centers saw 393,111 patients, bringing in a total economic impact of
$365,695,527, and employed 3,356 FTEs, producing $47,536,164 in total tax revenue.
“The data and succinct presentation provided to us through Capital Link and the Indiana Primary Health Care Association was
very timely to assist us in “telling our story.” As community engagement is a core value of Purdue University, we can readily
demonstrate how we are: providing affordable and quality healthcare, educating future healthcare professionals and impacting
the economic health of the communities we serve during our presentation to the School of Nursing Advisory Council next month.”
Quote from Suzan Overholzer, North Central Nursing Clinics
15
The STAR Initiative™
Strengthen  Transform  Adapt  Replicate (STAR) Community Health Centers
STAR Initiative Project Progress Report – Year Three
Year three has been both exciting and challenging. There have been face-to-face trainings, webinars, dashboard tools,
free LEAN training, grants to meet work plan goals, and money invested in revenue cycle/charge master review. Teams
continued into year three, when it was expected that teams would take greater ownership of work plans and team
development, with IPHCA staff providing technical assistance as requested.
What made STAR successful were the personnel and high level of dedication at both the PCA and FQHC level. The
general experience between Wisconsin and Indiana was developed into a STAR toolkit known as the Implementation
Guide for Health Care Associations and Organizations. The Implementation Guide is available not only to primary
care associations, but also to other organizations that have interest in strengthening members, such as Rural Health
Associations. To date, Indiana has distributed the Implementation Guide to fifteen state primary care associations.
IPHCA was challenged in year three to continue to work with IFF on capacity building. All Indiana and Wisconsin STAR
participants were polled regarding capacity building, after which IFF held a webinar on that topic in September. IFF
reviewed various aspects including capital projects, expansion projects, and utilization of current capacity.
The STAR Initiative continued to provide technical assistance and training to its participants. In year three, IPHCA
challenged the participants to take responsibility for their work projects and follow through on tasks. IPHCA sent email
updates and provided opportunities for training. Participants were encouraged to request assistance and face-to-face
meetings throughout the year.
One team, Madison County CHC, completed its work plan, implanted STAR-provided tools in all departments, and
created a second work plan. In addition, they gave a presentation to both Indiana and Wisconsin teams in February of
2015 covering staff resistance, self-monitoring, work plan review, and various other topics.
In December 2014, teams were offered the opportunity to request funding to assist with achieving their work plan. Of
STAR’s twelve participating teams, three submitted requests for funding. All three were approved for a total of $22,500.
One request was to hire a consultant focused on team decision making and building, a second was to fund a consultant
to assist with dental clinic expansion, and the third request was to train and develop a marketing plan to increase
community awareness with an underlying need to build the revenue cycle via increasing patient population.
STAR participants were also offered the opportunity to have an outside accounting firm that specializes in health care
(specifically in FQHCs) to visit and review the entire revenue cycle, including the charge master, policies, and billing
practices. Four teams accepted that offer, two of which had also participated in the grant funding request in December,
therefore 50% of the teams participated in the two combined projects.
Training opportunities were offered throughout the year. The first training offered in year three was the Certified
Nonprofit Accounting Professional (CNAP) course by FMA, held in Chicago. All of the Indiana attendees completed the
course and passed its corresponding exam. Also, due to concerns expressed during the year-end evaluation, Koehler
& Partners were engaged to create two webinars focused on dashboards as well as to create a tool that could easily be
adapted by the teams to create dashboards. The webinars, entitled Driving by Dashboard, were held in October 2014,
and the final tool was distributed in March 2015.
One team’s request for training was on change management. A consultant was hired to host a face-to-face one-day
seminar, Staying Sane in Stress and Change, held in October 2014 in Fort Wayne, Indiana. Four teams participated.
Another team’s request focused on time management and team building. A consultant was hired and presented a faceto-face one-day seminar in Valparaiso, Indiana in July 2014. Four teams participated in that training.
16
On March 26th IPHCA joined with WPHCA in hosting a webinar entitled Increasing Efficiencies: A Basic Approach to
Workflow Analysis presented by Jay Arthur of KnowWare International. KnowWare International’s website had been
suggested previously to teams as it offers free online LEAN training for all levels of staff. This webinar had seventeen
registered attendees.
Two half-day training sessions were scheduled for May and July 2015. These trainings also included individualized
coaching between sessions. The first, Coaching: A Leader’s Best Tool for Greater Engagement, was hosted in Indianapolis
on May 13th with nineteen registered attendees. This face-to-face training was designed to help staff understand that
more engagement equals greater productivity and greater patient satisfaction. The second was held in Indianapolis on
July 8th with thirteen registered attendees, entitled Energy: Your Only Renewable Resource and the Key to your Life and
designated to help participants experience the importance of balance in their work and personal life.
During the summer of 2015, IPHCA and WPHCA held a “Summer Sharing Series” where each PCA asked a STAR
participant to present on what impact STAR had on their FQHC. The first was held on July 29th, with topics covering goal
setting and leadership. The second webinar was held on September 2nd on the topics of leadership and finance. July’s
presentation had ten health centers participating and September’s had twelve.
It is difficult to definitively quantify the impact of The STAR Initiative. The evaluation and surveys show that during the
period of STAR, knowledge was gained by STAR participants on the improvement of financial sustainability, operation
performance, and loan readiness. Based on survey responses, it was clear that STAR was a strong contributing factor in
gaining key knowledge in finance and operations. Throughout activities during The STAR Initiative, IPHCA learned that providing an abundance of training opportunities
was imperative for strengthening the health centers’ infrastructure. Although the STAR program name may no longer be
used, training opportunities will continue at a much higher-sustainable level than prior to the implementation of STAR.
In addition, all training materials on STAR’s website will be made available on IPHCA’s website. Tools developed over the
previous three years will no longer be exclusive and will be released throughout year four to build capacity, strengthen
CHC revenue cycles, and promote team decision making.
Funded by:
Collaborative Partners:
17
Policy Accomplishments
Funding
• State CHC funding remained level at $14,453,000 annually for FY 2015-2016 and FY 2016-2017
• Federal Funding
o H.R. 2 - MACRA (Medicare Access and CHIP Reauthorization Act of 2015) extended Health Centers’
mandatory funding for an additional two years at FY 2015 levels—$3.6 billion annually
o The bill also included two additional years of funding for the National Health Service Corps and Teaching
Health Centers Program
State Legislative Forum
IPHCA coordinated a legislative day during the 2016 state legislative session. On Tuesday, February 16, thirty-seven
community health center advocates gathered in Indianapolis to meet face-to-face with state law makers. This time
was valuable for building and maintaining relationships and communicating local health center issues and needs.
Representative Denny Zent, Vice Chair of the House Public Health Committee, addressed the group highlighting the
significance of hearing from those at the front lines.
IPHCA continues to show public support for the program. Lisa Mangifico, Policy Analyst, testified before the House Public
Health Committee during the 2016 state legislative session regarding Senate Bill 165 which codified HIP 2.0. Governor
Mike Pence signed the bill into law on March 21, 2016.
Capitol Hill Visits during 2016 Policy & Issues Forum
IPHCA representatives, health center staff, board members, and consumers took to Capital Hill for meetings with all
eleven Indiana Congressional offices and both Senate offices. During these meetings, attendees discussed keeping
funding whole during the Appropriations process, health center workforce issues, and health center innovations—
creative ways that health centers are going above and beyond to meet many of the unique needs of their patients.
Consumers from two of the health centers represented were also given time to tell their personal stories.
Congressmen André Carson and Todd Rokita, along with Congresswoman Susan Brooks, took action to sign the Bilirakis
Green Appropriations letter in support of continued funding of the community health centers program. Senator Joe
Donnelly signed a similar letter of support in the Senate.
18
Congresswoman Jacki Walorski (seated right) met with Indiana
Delegates from HealthLinc, Indiana Health Centers, Maple City
Health Care Center, Heart City Health Center, Riggs Community
Health Center and IPHCA, 3/17/16.
Congressman André Carson was presented a NACHC
Distinguished Community Health Advocate award by
Indiana delegates representing Jane Pauley Community
Health Center, Shalom Health Care Center, Raphael Health
Center, Indiana Health Centers and IPHCA.
Jimmy Brown, HealthNet, with
Senator Donnelly
Elvin Plank, IHC, with Casey Murphy, Health Policy Director for
Senator Coats
“Thank you Marie for the prompt reply and the valuable information. I know Lisa and the IPHCA staff have
worked very hard to compile these (P&I) materials and I’m glad that we can promote Indiana’s Health Centers
from a variety of angles. ….Thank you for all you do to represent our efforts. Jim”
Quote from David J. (Jim) Layman, Executive Director, North Central Nursing Clinics/Purdue University
19
PRIMARY HEALTH CARE SHORTAGE AREAS
Underserved Areas
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LaGran ge
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LaPorte
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INDIANA
MEDICALLY
UNDERSERVED
AREAS AND
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Fountain
Huntington
Wabash
Miami
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!
DESIGNATION TYPE
Warren
Cass
!
!
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DeKalb
Newton
Benton
!
Marshall
Pulaski
March, 2016
!
Noble
!
Jasper
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Grant
Howard
Adams
Wells
Blackford
Jay
Tipton
Clinton
Delaware
Randolph
Madison
Hamilton
Boon e
Montgomery
Henry
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Geographic Area
Vermillion
Medically Underserved Areas/
Populations are geographic
areas determined to be
medically underserved. This
determination is based on the
ratio of primary medical care
physicians per 1,000 population,
infant mortality rate, percentage
of the population with incomes
below the poverty level, and
percentage of the population
age 65 or over. Population
groups requested for MUP
designations should be those
with economic barriers (lowincome or Medicaid-eligible
populations), or cultural and/
or linguistic access barriers to
primary medical care services.
A new designation program,
SDMS, was implemented
by the federal government
in 2015. The Indiana State
Department of Health (ISDH)
then verified and uploaded all
provider data into the system
to streamline the application
process. Late in 2015, this
process was completed and
work began on analyzing new
areas for designation. All HPSAs
that are currently designated
will be updated automatically
by a process that will be
implemented by HRSA in the
near future. As always, per the
federal regulations, all MUA/P
designations will stay designated
without any updates required.
Low-Income Population
Governor (Low-Inc Pop)
!
Hendricks
Parke
Putnam
Bold county names denote counties
having any type of MUA designation
Vigo
Sulliva n
0
10
Knox
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Posey
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Rush
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Morgan
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Monroe
Greene
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Brown
Decatur
Bartholomew
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Jackson
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Washington
Orange
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Gibson
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20
Miles
Wayne
Marion
Clark
Floyd
Harrison
Source: Shortage Designation Branch, HRSA,
U.S. Department of Health and Human Services
Map Author: ISDH ERC PHG - 10.30.2015
Conrad 30 Program
The Conrad 30 Program continues to serve as a great resource for Indiana, especially regarding Primary Care physicians.
Indiana received 30 J-1 Visa Waiver Applications between October 2014 and February 2015, all of which received waiver
recommendations to the Department of State (DOS) from the Indiana State Department of Health (ISDH). This year
Indiana had ten primary care applications, two less than the 2014 Cycle, despite allowing primary care three months
of priority processing. Two of the primary care applications were from Community Health Centers. Including this year,
Indiana has filled all thirty slots for six consecutive years. This is a crucial resource to sites that have challenges recruiting
Primary Care physicians, especially when considering the continual decline of U.S. candidates graduating and entering
into Primary Care annually. The Conrad 30 Program has the potential to be a very beneficial program for Community
Health Centers, Rural Health Clinics, and Critical Access Hospitals located in areas with underserved populations who
desperately need these capable physicians.
20
Indiana FQHC User Demographics 2015
FQHC Patients & Encounters
21
Indiana FQHC User Demographics 2015
22
Indiana FQHC User Demographics 2015
Patient Income (By % of Federal Poverty Level)
2016 Federal Poverty
Level for Family of 4
Percent of
FPL
0-100%
Poverty
Guideline
$0 through
$24,300
$24,543
through
101%-150% $36,450
$36,693
through
151%-200% $48,600
201% or
more
23
$48,843 and
above
National Health Center Week - August 9-15, 2015
Communities across the state celebrated both the National Health Center Week 2015 and the 50th Anniversary of the
Community Health Center Program at 34 separate events. Many health centers planned multiple events during the week
and received attention from local news, elected officials, and community leaders. Community health centers hosted a
variety of events including health fairs and free health screenings, open houses, staff appreciation days, live music, food,
games, prizes, school supplies and other giveaways.
“This week, as we recognize the 50-year anniversary of the first community health centers being established in
America, let us remember that health care is not a privilege for the few among us who can afford it, but a right for all
Americans -- and let us recognize the vital role health centers across our country play in carrying us toward greater
health for our people. I encourage all Americans to celebrate this week by visiting their local health center, meeting
health center providers, and exploring the programs they offer to help keep families healthy.”
Quote by U.S. President Barack Obama, August 7, 2015
24
Financial Statement and A-133 Audits
Fiscal Year 2014-2015
Gauthier & Kimmerling, LLC audited the financial statements of the Indiana Primary Health Care Association, Inc. for the
year ended March 31, 2015, in accordance with auditing standards generally accepted in the United States of America
and the standards applicable to financial audits contained in Government Auditing Standards, issued by the Comptroller
of the United States. A final report was issued for the year ended March 31, 2015 which included:
Independent Auditor’s Report
Statements of Financial Position
Statement of Activities
Statement of Cash Flows
Statement of Functional Expenses
Notes to Financial Statements
Gauthier & Kimmerling issued an unmodified opinion on the statement of financial position and on compliance
requirements under OMB Circular A-133. There were no findings issued on the final audit report.
Indiana Primary Health Care Association reported total revenues of $1,813,981 and total expenses of $1,676,124 for the
2014-2015 fiscal year. Unrestricted net assets increased by $137,857.
25
Much to Celebrate
Phil Morphew and Vernita Todd
HealthNet Northwest Groundbreaking Celebration
Jane Pauley CHC Staff during NHCW
Facility Expansion at Tulip Tree
Tent event at FHCCC during NHCW
26
Much to Celebrate
Rep. Rokita at FHC Carroll County
(North Central Nursing Clinics)
Shalom HCC Grand Opening March 31
Congressman Carson and other dignitaries at
HealthNet Grand Opening
State Delegation Meeting/Dinner at P&I
ECHO Community Health Care at NHCW event
IN Delegates gathering at P&I
27
Much to Celebrate
Hoagland Elliott receiving Lifetime Service Award
Jessica Ellis, IPHCA’s O&E Program Director
receiving NACHC Emerging Leadership Award
during P&I 2016
Open Door Health Service NHCW Runner-Up Picture Contest 2015
MCCHC balloon fun at NHCW event
28
What IPHCA Does
Organized in 1982, the Indiana Primary Health Care Association (IPHCA) is a statewide not-for-profit organization
that promotes the provision of primary health care services in areas of need throughout the state and works to
ensure the development and growth of Community, Migrant, Homeless, and Public Housing Health Centers in
Indiana.
IPHCA’s Mission
To champion the development and delivery of accessible, community-driven quality health care.
IPHCA’s Vision
A barrier-free, high quality health care system that is affordable, available, accessible, appropriate, and acceptable.
IPHCA’s Beliefs and Values
1. Health care is a right, not a privilege.
2. Grassroots advocates are crucial to community-supported health care.
3. Comprehensive, integrated, and coordinated primary health care encompasses medical, dental, behavioral
health, and enabling services.
4. The Community Health Center (CHC) model, to which the consumer’s voice is integral, provides for an
outcome-based and patient-focused health care home.
5. IPHCA equips leaders to advance health care goals and objectives.
FQHC Sites with Congressional Districts
INDIANA’S
COMMUNITY
LOCATIONS
INDIANA’S
COMMUNITY
HEALTHHEALTH
CENTERCENTER
LOCATIONS
MAP LEGEND
MAP LEGEND
Regional
Health Clinic
Regional Health
Clinic
HealthLinc HealthLinc
CommunityCommunity
HealthNet HealthNet
NorthShoreNorthShore
Porter-Starke
Porter-Starke
Services Services
Indiana
Health Centers
Indiana Health
Centers
Heart City
Health Center
Heart City Health
Center
Maple City Maple
Health City
CareHealth
CenterCare Center
Knox
Winimac
Knox Winimac
(FQHC
Look(FQHC
Alike) Look Alike)
Neighborhood
Health Clinics
Neighborhood
Health Clinics
Meridian
Health Services
Meridian Health
Services
Purdue
North
Central
Nursing Clinics
Purdue North
Central
Nursing
Clinics
Riggs Community
Health
Center (Lafayette)
Riggs Community
Health Center
(Lafayette)
Valley Professionals
Health Center
Valley Professionals
CommunityCommunity
Health Center
Madison
County Community
Health Center
Madison County
Community
Health Center
Health Services
Open Door Open
HealthDoor
Services
Pauley Community
Health Center
Jane PauleyJane
Community
Health Center
WindRose
Health Network
WindRose Health
Network
“Open Door Health Services has been a member of IPHCA almost from the beginning of its formation. We recognized the
importance of membership even as a very small, grass-roots health center receiving only community dollars to support the
operation of two staff and moonlighting residents from the local hospital residency program. The services we received from
IPHCA in all those years helped us to become a Federally Qualified Health Center in 2000, now serving almost 21,000 patients
annually. In 2015 we received PCMH Level 3 recognition and the assistance from the IPHCA staff, Carla Chance, played a huge
role in making sure that our application was “point on” when we submitted it! IPHCA serves not only as a source for valuable
training, but also as a connection to new and innovative services that will assist us to provide top quality health care to the
communities we serve.
In the past year the quality of training opportunities has been phenomenal! Members of our staff have returned from
trainings ranging from the Prospective Payment System, 340B, CHC Management, ICD-10, and too many more to mention,
with rave reviews! The Annual IPHCA meeting, while providing great speakers, is also a terrific opportunity for our staff to
network with peers and share stories and best practices. It is wonderful to have at our fingertips the myriad of high caliber
training opportunities with minimal traveling and cost.” Quote from: Toni R. Estep, CEO, Open Door Health Services
FQHC
SITESCONGRESSIONAL
WITH CONGRESSIONAL
DISTRICTS
FQHC SITES
WITH
DISTRICTS
HealthNet (Indianapolis)
HealthNet (Indianapolis)
Eskenazi
Health Centers
Eskenazi Health
Centers
Raphael Community
Health Clinic
Raphael Community
Health Clinic
Shalom
Shalom Health
CareHealth
CenterCare Center
Wabash
Valley Community
Health Center
Wabash Valley
Community
Health Center
ECHO Community
ECHO Community
Health CareHealth Care
Family
Health
Centers ofIndiana
Southern Indiana
Family Health
Centers
of Southern
Wayne
County
Health Department
Wayne County
Health
Department
LifeSpring Community
Medical Services
LifeSpring Community
Medical Services
Making a Difference
Indiana Primary Health Care Association, Inc.
429 North Pennsylvania Street, Suite 333, Indianapolis, IN 46204
Phone: 317.630.0845 - Fax: 317.630.0849
www.indianapca.org
This project is 100% supported by the Health Resources and Services Administration (HRSA) of the U.S.
Department of Health and Human Services (HHS) under cooperative agreement number U58CS06826,
State and Regional Primary Care Associations, award amount $789,671. This information or content
and conclusions are those of the author and should not be construed as the official position or policy
of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.
2015-16 Year in Review