C a r i n g F o r o u r C o m m u n i t y

l5annualreport

Gaston FamilyHealth Services

Dear Friends,

This past year has been one of change and growth for Gaston Family Health Services (GFHS). The paradigm for healthcare delivery is changing, transitioning from a traditional episode based model to a value-based model of care. Through dedication to our mission and values, GFHS successfully expanded services in 2015 to reach more patients, and made significant strides positioning ourselves for success in this new healthcare landscape.

Several accomplishments throughout 2015 reinforce our commitment to provide integrated services to our patients. The planned growth in our behavioral health program now allows us to offer counseling services at all medical sites. The recent co-location of pediatric healthcare and dentistry services in Statesville provides patients a full continuum of medical and dental care at one site.

At the same time, we expanded several important programs and services in 2015; such as the opening of Catawba Family Dentistry in Hickory, the expansion of dental services in Davidson County and the opioid overdose prevention and reversal program. We also introduced our new Patient Portal, which gives GFHS patients online access to medical records, appointments and providers. Through our existing and expanded programs, GFHS served over 44,000 patients through more than 120,000 visits in five counties in 2015: Gaston, Lincoln, Iredell, Catawba, and Davidson.

All 10 GFHS medical sites are now recognized as a Patient Centered Medical Home, demonstrating our commitment to using evidence-based patient-centered processes that focus on highly coordinated care and long-term participative relationships.

GFHS has also taken the lead this year in educating community residents about their best options for healthcare coverage. The 58% increase in insurance enrollments in our service area (Open Enrollment 1 to Open Enrollment 2) is attributable in part to our Affordable Care Act team’s outreach efforts. They successfully enrolled nearly 2,000 consumers and provided individual assistance to over 10,000 residents.

Along with these achievements, we are strategically positioning our organization for the future. GFHS appointed its first Chief Information Officer and launched programs for improved asset management, disaster recovery and systems security. A dedicated resource directing communications and marketing activities will help build community relationships and increase the visibility of our role in the communities we serve. We have also invested in an internal staff Wellness Program, which provides employees with encouragement, education and incentives for healthy living. Looking ahead, we are excited to continue our transition to more integrated and value-based care. GFHS’ participation in the Medicare Shared Saving /ACO Program will help us deliver better quality care at lower cost. The adoption of a Team Based Model of Care will allow the medical team and our patients to truly work together to maximize and personalize the health care we deliver.

The need for our services only increases. We look forward to continuing the momentum of the past year, and planning the best next steps to ensure quality health care services for GFHS patients, present and future.

On behalf of the GFHS Board of Directors, staff and patients, I thank you for your trust and confidence in our organization, your past and future financial contributions and your shared commitment to our mission as we work in Caring for Our Community.

Robert E. SpencerChief Executive Officer

Grew The Behavioral Health Program continued expansion in 2015. Behavioral health services are now offered at all 10 GFHS Medical locations. The IT/Informatics team added staff and launched a robust program for Asset Management, Disaster Recovery and improved operational efficiencies.

AddedGFHS began operations at Catawba Family Dentistry and opened new doors for Statesville Children’s Clinic and Statesville Family Dentistry. Dental services were also expanded in Davidson County.

developedGFHS is proud of new programs developed in FY 2015 for employees. Through GFHS’ Leadership Development Program, 100+ staff members now participate in web-based Management and Leadership training specific to their roles.

GFHS’ new Medical Assistant Career Ladder Program offers growth, mentoring and reward opportunities for achieving levels of skills proficiency and leadership. Six Medical Assistants are currently enrolled in the program. Staff participating in the Roadmap to Wellness Program receive structured encouragement and social support for a healthy lifestyle. Staff can earn extra time-off by achieving exercise and healthy eating goals. Currently GFHS has 75 employees enrolled in the program, and 54 have earned a day off.

Achieved10 Medical GFHS clinical sites received national PCMH recognition. GFHS’ Workplace Wellness program won the NC Community Health Center Association’s 2015 Dr. Evelyn Schmidt Outstanding Service Award

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Iredell CountyStatesville Children’s ClinicStatesville Family DentistryStatesville Family Medicine

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1 Gaston CountyBessemer City Health Care CenterCherryville Health CenterGaston Family Counseling CenterGaston Family Health ServicesGaston Family Medical CenterGFHS General DentistryGFHS Pediatric DentistryGFHS PediatricsHighland Health Center

2 lInColn CountyHelping Hands Health Center

3 Catawba CountyCatawba Family CareCatawba Family Dentistry

5 davIdson CountyDavidson Health Services - LexingtonDavidson Health Services - Thomasville

Gaston Family health Services is a community-sponsored,family-centered provider of health care, health education and preventive care services without regard for the ability to pay.

2015a year of achievement

our mission

Behavioral Health Integration

Over the past decade, professionals in both the mental health and physical health communities have developed a strong interest in the integration of behavioral health services into the primary care medical system. Integrated Primary care settings have become a gateway to the behavioral health system with 25-30% of office visits involving a mental health or psychosocial issue as part of the presenting concern (Gunn and Blount, 2009).

Recognizing the fragile nature and multiple needs of its under-served patient population, in 2014 GFHS began moving towards a fully integrated care model in order to provide supportive services beyond the scope of traditional primary care. GFHS’ integrated care model allows both primary care and behavioral health to work in a shared system.

Under the direction of the GFHS Behavioral Health Director and Integration Program Manager, a reorganization of the department in 2015 allowed for even greater changes, increasing capacity to see more patients. GFHS’ Behavioral Health team of 10 now includes a licensed Psychologist, an MD and 8 LCSWs. A behavioral health care team now serves at each primary care location, taking the team’s on-site presence from 18% in 2014 to 64% in 2015. GFHS’ goal is to reach 80% in 2016.

In 2015 the behavioral health team served 3,031patients through 9,462 visits; 6% of the total patient population; more than doubling the numbers served in previous years.

GFHS has embraced the expansion of integrated care, and continues work to close the gap.

Expansion of Dental Services

GFHS’ dental clinics maintain a goal of treating patients regardless of ability to pay. In addition to providing a full range of adult dental services, GFHS’ pediatric dentists provide comprehensive preventative care and treatment to children and adolescents. This past year was one of continued investment in and expansion of GFHS’ dental services.

In July 2015, Open Door Dentistry in Statesville changed its name to Statesville Family Dentistry and moved to modern, larger facilities conveniently co-located with Statesville Children’s Clinic. The co-location has enabled GFHS to offer truly integrated and convenient pediatric medical and dental care. The six operatory rooms and the addition of a second provider in 2015 expanded capacity to see an additional 3000 patients per year.

The School Dental Outreach Program served 537 school-aged children in Iredell County elementary schools and summer programs in 2015. Using portable equipment, the program now takes dental care directly to the schools, enabling more children to be seen with less disruption to school time. In Gaston County, where children are bussed to clinics, the Dental Access Program program continues to grow, having seen 1,198 children in 2015.

Catawba Family Dentistry (CFD) opened its doors in October 2015, located in the dental clinic formerly operated by Catawba County Public Health. Starting with one provider in 2015, CFD will add a second provider in early 2016 and expand services to adults.

Davidson Health Services (DHS) expanded dental services in its Lexington location, adding a full time provider in 2015. DHS Lexington now offers a full complement of medical and dental care for its patients.

Pediatric Hospital-Based Operatory Services (full-mouth rehabilitation services provided by GFHS dentists at local hospitals) continue to grow in Iredell and Gaston Counties, and expansion into Davidson and Catawba Counties is planned for 2016.

GFHS is proud to offer expanded dental services in our communities and looks forward to working towards the goal of offering comprehensive and fully integrated care across the organization.

All GFHS dental practices accept patients with Medicaid, private insurance or sliding fee.

AcA outreach & enrollmentThe Affordable Care Act (ACA) Outreach and Enrollment team works with community partners to provide the public with information about health insurance requirements and assists consumers in applying for insurance coverage during open enrollment and special enrollment periods.

From Open Enrollment 1 to Open Enrollment 2, GFHS saw a 58% increase in insurance enrollment in its service area – far surpassing the national (40% increase) and state (56% increase) averages. This increase in uptake is attributable in part to the ACA team’s outreach efforts -- they successfully enrolled nearly 2,000 consumers during OE2 and provided individual assistance and information to over 10,000 consumers in Gaston, Lincoln, Iredell, Catawba and Davidson Counties.

community health partners

CHP serves as the Community Care of NC Medicaid Care Management Progam for Gaston and Lincoln counties. In 2015, CHP:

• received NCQA accreditation for complex care management with each of the local 14 networks, and Community Care of North Carolina (CCNC). • worked directly with 60 primary care practices in Gaston and Lincoln Counties.• implemented a pharmacy enhanced services program with three local pharmacies.• added two patient educators to work directly with patients• expanded behavioral health-focused case management

diabetes Management GFHS Gaston Diabetes Center has been an American Diabetes Association Recognized Program since 1998. In Gaston County, eligible patients can attend group and individual counseling sessions led by Certified Diabetes Educators (CDE) at two GFHS locations. In FY 2015, embracing the GFHS strategy of providing integrated care, the program expanded services to offer diabetes education to patients as part of their primary care visit.

healthNet In 2015, HNG served 1,737 total adult patients, providing 6,569 primary and specialty care provider visits and healthcare services valued at $11,893,537, including provider visits, hospitalizations, emergency department visits, labs, diagnostics, physical therapy and home health. HNG patients live in Gaston County, have incomes at or below 100% Federal Poverty Level and have a chronic medical condition.

In Iredell County, HealthNet Iredell provide access to primary care, limited specialty care (endocrinology, nephrology, asthma and allergy), labs, care coordination, healthy living classes, diabetes education and medication assistance In Catawba County, HealthNet Catawba provides primary care, labs and medication assistance. HealthNet Iredell and Catawba County patients have incomes at/below 200% Federal Poverty. In 2015, HealthNet Iredell and HealthNet Catawba provided services to over 1,000 people.

hiv program

In FY2015, 364 HIV positive patients were served via GFHS medical and dental locations. Of those, 238 patients received assistance through the Ryan White Program, which provides funding to serve the uninsured or underinsured HIV/AIDS population who meet program guidelines. Clients are assigned to a case manager who connects them to care needed, while identifying available resources. GFHS is committed to providing a coordinated and comprehensive system of care and treatment to people living with HIV/AIDS. This ensures that patients are retained in care and helps reduce the risk of HIV transmission to others while helping patients live longer, healthier lives.

MAp

The Medication Assistance Program (MAP) helps qualified uninsured patients gain access to medications through various pharmaceutical manufacturer’s indigent patient assistant programs. In 2015, GFHS’ MAP program helped 2261 patients with 8642 prescriptions valued at over $8,900,000.

School dental outreach program

Through the School Outreach program, the GFHS dental clinics served 1,735 children in Gaston and Iredell Schools.

Staff wellness program

Staff participating in the Wellness Program receive structured encouragement and social support for a healthy lifestyle. In 2015, the Program launced a reward system for achieving exercise and healthy eating goals. All GFHS campuses are tobacco free.

workplace wellness

The Workplace Wellness program’s utilization had a slight decrease in onsite visits to 3,269 in FY15 but an increase in off-site visits to 1,333.

The average cost per visit for onsite was $70.88 and $82.75 for offsite. The WW pharmacy program had an 11% increase in prescriptions dispensed in FY15 with a total of 3,693. Several partners continued to rely on GFHS’ WW program for flu shot clinics and prostate cancer screenings held at their locations.

vision center

The GFHS Vision Center is open to uninsured patients with household incomes at or below 100% federal poverty. HealthNet Gaston staff began coordinating the Vision Center and recruiting additional volunteer providers in June 2015. With the volunteer leadership of Dr. James Mason, provider participation increased by 63% over the previous fiscal year.

For FY 2015, 247 patients were seen by 24 volunteer optometrists and ophthalmologists who provided 24 exam days. Glasses were dispensed to 173 patients, 51 of whom were diabetic patients.

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Federal

Private

StateLocal

Health Care 18,655,235 15,790,395

General and Administrative 5,391,342 4,520,319

Total health care, general & admin. expenses 24,046,577 20,310,714

Increase in restricted net assets $656,512 $72,830

Changes in temporarily restricted net assets

Federal grants 6,316,039 5,756,224

State grants 44,625 96,405

Private grants 1,474,809 1,123,645

Net assets released from restrictions (7,631,680) (6,889,050)

Increase in temporarily restricted $203,793 $87,224

Increase in net assets 860,305 160,054

Net assets at beginning of year 5,412,221 5,252,167

Net assets at end of year $6,272,526 $5,412,221

Health Care, General & administrative expenses

Community Benefit

Dental Locations

Net Patient Service Revenue- Gastonia 2,373,005 2,373,005

Net Patient Service Revenue - Statesville 422,347 422,347

Net Patient Service Revenue - Davidson 9,263 ---

Total unrestricted revenues & other support $24,703,089 $20,383,544

2015 2014Health Department Location

Net Patient Service Revenue $2,395,446 $2,480,949

Contributions:

Gaston County 653,872 743,375

Gaston Memorial Hospital Foundation 225,000 300,000

Pharmacy Income 4,000,727 2,591,775

Other Income 1,234,246 918,701

Bessemer City Location

Net Patient Service Revenue 392,246 412,100

Other Income 100 -

Highland Medical Location

Net Patient Service Revenue 376,808 318,260

Other Income 13,051 -

Behavorial Health

Net Patient Service Revenue 527,682 2,704

Statesville Location

Net Patient Service Revenue 1,189,964 1,125,449

Other Income 259 194

Pharmacy Income 472,657 438,344

Lincolnton Location

Net Patient Service Revenue 237,987 218,827

Contributions: 30,000 30,000

Pharmacy Income 253,771 232,587

Cherryville Location

Net Patient Service Revenue 199,101 207,944

Lexington Location

Net Patient Service Revenue 296,901 185,180

Pharmacy Income 362,506 151,743

Thomasville Location

Net Patient Service Revenue 28,480 23,249

Pharmacy Income 16,384 10,917

REvEnuES anD OtHER SuppORt

Net Assets released from restriction 7,631,680 6,889,050

$21,633,221 $17,588,192

FederalPHS 330 Grant - Federal FundingRyan White FundingMeaningful Use - Federal Funding

StateORH - MAPORH - CHGORH - HNI

LocalGaston County GovernmentLincoln County Government

PrivateDavidson Medical MinistriesCaroMont FoundationCannon Foundation - SCC/SFDCHPSTLCHNGDuke Foundation Foundation of the CarolinasRichard J & Marie M Reynolds FoundationLavine FoundationKate B ReynoldsParish Nurse Area ChurchesCatawba Valley Medical CenterUnited Way of Lincoln CountyFoundation of the CarolinasBCBS Action Learning GratnntHeart Society of Gaston CountyCommunity Foundation of the CarolinasFirst Gaston FoundationAdolescent Pregnany Prevention CampaignIn-kind

Gifts & Grants

Medical Services FY 2015 FY 2014

total value of Care $42,902,362 $40,440,419

Dental Services

Active Providers 34 34Employees 337 306Total Patient Encounters 96,832 79,608Total Prescriptions 189,053 192,256

Total Revenue $21,633,221 $17,588,192

Active Dentists 14 7Employees 63 32Total Patient Encounters 23,737 21,269Total Surgery Visits 291 292

Total Revenue $3,069,868 $2,795,352

IT DevelopmentAssuring Support, Security and Business Continuity

In 2015, GFHS appointed its first Chief Information Officer, increased Information Technology staff and launched a long-term expansion and development plan for its IT infrastructure. Several initiatives set in motion during the year form an integral part of GFHS’ IT strategy.

GFHS’ new Asset Management Program includes ongoing refresh plan for desktops, laptops and network devices. The proactive replacement and lifecycle management of equipment will improve operating efficiencies through standardization and improved capabilities, and will mitigate risks of downtime, outages and obsolescence.

As part of a comprehensive Disaster Recovery Plan developed this year, critical systems are being moved to a data center, where newer technologies and daily backups will enhance security and ensure business continuity. 2015 was also a year of improved internal communications. The IT Service Helpdesk, manned by three full time staff, provides a central contact point for employees seeking IT assistance. The company interactive intranet portal, StaffConnect, launched in June, keeps employees up to date with GFHS news and announcements.

The Informatics team improved operational efficiencies with the delivery of several web-based data management platforms. These platforms enabled the move from paper to electronic management and reporting processes in key areas such as medical records, risk management, provider peer review UDS, PCMH and Meaningful Use. GFHS is committed to the ongoing development of its IT infrastructure to meet the demands of this growing company in a changing healthcare arena.

National Recognition for Patient-Centered Care

NCQA patient-Centered Medical Home ™ standards emphasize enhanced care through patient-clinician partnership

The NCQA Patient-Centered Medical Home (PCMH) certification recognizes the use of evidence-based, patient-centered processes that focus on highly coordinated care and long-term, participative relationships.

GFHS is proud to have ten medical centers receive PCMH recognition:

Gaston CountyBessemer City Health CenterCherryville Health CenterGaston Family Health Services – MainGaston Family Medical CenterHighland Health Center

Catawba CountyCatawba Family Care

Lincoln CountyHelping Hands Health Center

Iredell CountyStatesville Family MedicineStatesville Children’s Clinic

Davidson CountyDavidson Health Services - Lexington

Medical Dental

Self Pay 46% 16%Medicaid 27% 66%Private Insurance 14% 18%Medicare 13% -

payor Mix

“We are what we repeatedly do. excellence, then, is not an act, but a habit.” -Aristotle

17practice locations

5counties served

23years providing healthcare

18patients serve on GFHS Board of Directors

400total staff

120,000+patient visits in 2015

59medical, dental and behavioral health providers

42million dollars in overall value of care

189thousand prescriptions dispensed in 2015

1,735elementary school children served through the School Outreach Program in Gaston & Iredell County

10 tHInGS you should know about GFHS

Gaston Pediatrics Location

Net Patient Service Revenue 765,885 194,837

Other Income 765 -

Catawba Family Care Location

Net Patient Service Revenue 327,703 112,007

www.gfhs.info

When the call for care is received, we are able to respond positively thanks to the compassion and generosity of many people.

GFHS appreciates all of our donors, volunteers and board members who help make health care affordable and available, ensuring that no one in need is turned away.

2015 Board of DirectorsDonyel Barber Peggy Blackburn Darrell Current, DDS Viggo Doddo Louise Grigg Anne Heilig John Herrera Phil Hinley James Hodges, SecretaryOmodele Masha, MD Theresa Matthews Joetta McQueen Alex Mullineaux Melvin Parent, ChairMickey Price Gordon Quarles, TreasurerDonald Sebastian Mark Skillestad, Past ChairJohn Snow Shirley Stowe Bob Tull, Vice ChairPatti West

2015 volunteers

“Gaston Family health Services has provided a positive

change for many citizens throughout North carolina.

i am proud and honored to serve on its board.”

Melvin ParentChair, GFHs board of directors

tHank YOu

Dr. Richard AkersMrs. Stephanie AllredMrs. Karen AmireshaniDr. Todd BrownDr. Fred CloningerDr. Mark Cowan (DDS)Mr. Charles CraverDr. Mark Davis (DDS) Dr. Melanie EubanksDr. Sandra FarnhamDr. John FosterDr. Rey GarridoDr. Thomas HawkinsDr. Kevin Hoover (DDS) Dr. Timothy Hughes (DDS) Dr. Kashyap KansupadaDr. David KirlinDr. Karen Lanier (DDS) Dr. John LoweryDr. Michael LundDr. James MasonMs. Jessica MasonMs. Amy McLaurinDr. Wilbur Meredith IVDr. Robert OlsonMs. Dionne RobertsDr. Robert SaltzmannDr. Wagner SantiagoDr. Daniel Siceloff (DDS)Dr. Sim Siceloff (DDS)Dr. James Slyman (DDS)Mrs. Maureen TullDr. Willie WhitakerMs. Jean WilliamsDr. Benjamin WilsonDr. Bradley WrubleDr. Rachael Wruble