Transcript Slide 1

From Research to Policy:
Building the Evidence for
Community Oriented
Primary Health Care
September 27, 2013
Vicki M.Young, Chief Operating Officer
South Carolina Primary Health Care Association
3 Technology Circle, Columbia, SC 29203
(Phone) 803-788-2778 / (Fax) 803-788-8233 / www.scphca.org
Access to Quality Health Care for All South Carolina
The
US CHC Story
◦ Background
◦ Where we are, where we’re
headed
Parallel
Stories: Canadian
CHCs and US CHCs
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“The Movement”
The Beginning
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The health center movement began in
apartheid South Africa
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In the 1950s, Dr. Sidney Kark created
the first health center in South Africa
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“The Movement”
The Beginning
•
In 1964, the American version was formed
by Dr. Jack Geiger and Count Gibson
• occurred when War on Poverty and Civil
Rights Movement were major social issues
• funded through the Office of Economic
Opportunity
•
Included the social and environmental
factors that affect health in communities
and by communities
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“The Movement”
The Beginning
•
First Two Community Health Centers in US
• Columbia Point- Massachusetts
• Mount Bayou- Mississippi
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Focus was to Stimulate Change in Family
and Community Knowledge and Behavior
• prevention of disease
• informed use of available health resources
• improvement of environmental, economic and
educational factors related to health
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“The Movement”
The Beginning
•
Two-Fold Purpose
• Agents of Care
• Agents of Change
•
Three Elements of the Health Center
Model
• Community health services
• Community economic development
• Community participation
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“The test of our progress is not whether
we add more to the abundance of
those who have much; It is whether
we provide enough for those who
have too little.
- Franklin Delano Roosevelt
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Federal Requirements
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Must be a non-profit organization, accessible
to all
Community Governance representative of
health center patients
Comprehensive, patient- and communitycentered across the life cycle
Broad definition of “health”
Located in federally-designated medically
underserved areas or serving medically
underserved populations
Ongoing needs assessment and quality
improvement (QI)
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Federal Requirements
Bureau of Primary Health Care
(BPHC) requires community health
centers to meet 19 Key Health Center
Program Requirements
 Health Center Program Requirements
are divided into four categories:
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Need
Services
Management & Finance
Governance
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“Where We Are Today”
Health Center Funding Sources
 Medicaid
 Medicare
 Private Insurance
 Federal Grants (DHHS, HRSA,
BPHC)
 Patient Fees
 Other
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“Where We Are Today”
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2012 Demographics- US Community Health
Center
1,198 Health Centers Grantees
21,102,391 Medical Patients Served
92.6% of Patients ≤ 200% of Poverty; 71.9%
≤100% of Poverty
36% Uninsured; 40.8% Medicaid; 8% Medicare
13.9% Special Populations Grantees
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Homeless
Migrant/Seasonal Farm Workers
Public Housing
School- based
Veterans
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“We are only as strong as we are united
as weak as we are divided”
- J.K. Rowling
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How Did We Get Here?
Advocacy Strategy and Quality Care
 Qualitative Data/Evidence
 Quantitative Data/Evidence
◦ Cost effectiveness
◦ Quality evidence-based health care
◦ Access
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Data Sources
◦ UDS
◦ Health Disparities Collaboratives data
◦ Individual health center
stories
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How Did We Get Here?
Commitment to working collaboratively at
the national, regional/state, and local levels
to make the case with available data
 Commitment to “Tell Our Story”
 Recognition of the importance of research
and data in “Telling Our Story”
 Recognition that the “right” partnerships
with academia and other community
partners is key to success
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How Did We Get Here?
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Commitment by health centers with
capacity and interest to engage in health
services and outcomes research
◦ Comparative Effectiveness
◦ Translational/Dissemination
◦ Clinical Outcomes
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Commitment to explore building capacity
for research in the community health
center setting
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Where Are We Headed?
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Assess Health Center Research Activities and
Needs through National Survey
◦ Diverse partnership- Clinical and Translational Science
Institute-CN, National Association of Community Health
Centers, George Washington University, SC Primary Health
Care Association, University of SC
◦ Results
 386 respondents (health centers); 35.3% response rate
 55% of respondents indicated that the health center conducted
or participated in research
 54% of respondents indicated
interest in participating in research
activities
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Where Are We Headed?
National Research Agenda
(health center policy)
 Patient Complexity and Risk Adjustment
 Document Health Center Value
◦ Model addresses access, quality, and cost
◦ Comprehensiveness- enabling services
Inform Health Center Growth Strategy
 Support Transformation and Health
Reform Implementation
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Where Are We Headed?
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Continue to Focus on and Expand
Participation in Health Services and
Outcomes Research
◦ Comparative Effectiveness
◦ Translational/Dissemination
◦ Clinical Outcomes
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Impact of Non-medical Services and
Evidence-based Practices/Programs
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Parallel Stories – Canada and US
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Services
◦ Primary Care
◦ Enabling

Health Care Service Delivery System
◦ Comprehensive- Integrated Services
◦ Patient-centered
Federal Government Involvement/Assistance
 Populations Served
 Data and Research agendas
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“I am a strong individualist by personal
habit, inheritance and conviction; but
it is a mere matter of common sense
to recognize that the State, the
community, the citizens acting
together, can do a number of things
better than if they were left to
individual action”
- Theodore Roosevelt
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