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
The health center movement began in
apartheid South Africa
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
•
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
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”
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
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?
Commitment by health centers with
capacity and interest to engage in health
services and outcomes research
◦ Comparative Effectiveness
◦ Translational/Dissemination
◦ Clinical Outcomes
Commitment to explore building capacity
for research in the community health
center setting
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Where Are We Headed?
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?
Continue to Focus on and Expand
Participation in Health Services and
Outcomes Research
◦ Comparative Effectiveness
◦ Translational/Dissemination
◦ Clinical Outcomes
Impact of Non-medical Services and
Evidence-based Practices/Programs
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Parallel Stories – Canada and US
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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