February 2011

Volume 7 Issue 1

www.mo-pca.org

Featured Articles:• MPCA 2012 Priorities: the

Health Home Model

• MOQuIN Utilizes IT to Improve Quality Care

• The MO SEARCH Program

• Health Center Highlights

• Missouri’s Health Centers FACT SHEET

• MPCA Statement on the House Appropriations Committee Proposal to cut $1.3 Billion from Funding for CHCs

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Our Mission:

Community Health Center (FQHC) Priorities:FY 2012 Budget and Policy Issues

he MPCA supports Governor Nixon’s recommendation of

$4,020,000 in state General Revenue and an estimated $9 million New Decision Item of federal funding for FQHCs and other qualifi ed primary care providers to implement health homes for MO HealthNet Patients with chronic conditions. The health home project will provide the State with enhanced federal funding to establish health care homes to bett er coordinate the care of MO HealthNet participants with chronic illnesses. The enhanced federal match provides the State the opportunity to enhance the integration and coordination of primary, acute and behavioral health services. The program will operate under a ‘whole-person’ philosophy of care with the goal of expanding the traditional medical home model to build linkages to community and social supports in keeping with the needs of participants with multiple chronic conditions. This health care home model could drive down MO HealthNet costs through lower rates of emergency room use, reductions in hospital admissions and less reliance on long-term care facilities and improve the experience of care and quality outcomes for patients. The health home model could produce a longer and sustainable decrease in health care costs and will bring clarity to the way comprehensive care management is impacting patients. Based on the goals of the Medicaid Health Home initiative

To be Missouri’s leader in shaping

policies and programs that improve access

to high quality, community based, and

aff ordable primary health services.

T and the MPCA’s organizational goals, the MPCA has identifi ed the following conditions to target through the health home model: Diabetes, Heart Disease, Asthma, Obesity, and Chronic Pain.To accomplish the MPCA’s goal, each health home will have care coordination and case management functions staff ed by appropriate professionals, as determined by the FQHC or primary care practice. Six Key Services off ered through the Health Home Model

Comprehensive care management•

Care coordination and health •promotionComprehensive transitional care •from inpatient to other sett ingsPatient and family support•

Referral to community and social •support servicesUse of Health Information •Technology to link services

MPCA is committ ed to providing a health care home to all patients throughout the State and is leading Missouri’s Community Health Centers through transformation of traditional care delivery processes, improving patient access and experience, increasing the percentage of patients receiving evidence-based care, improving patient self-management knowledge and skills, and reducing costs through decreased avoidable inpatient admissions and ER utilization.

We’re Back! Aft er a hiatus, we’re excited to re-launch the MPCA newslett er!

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Offi cers

Robert Massie, PresidentFamily Care Health Centers

Alan Stevens, Vice PresidentCommunity Health Center

of Central Missouri

Dwayne Butler, TreasurerBett y Jean Kerr People’s Health Center, Inc.

Christine Stewart, SecretaryKaty Trail Community Health

Board of DirectorsJennifer Buehler

Jordan Valley Community Health Center

Sherilyn ClarkMissouri Highlands Health Care

Gloria CrullFamily Health Center

T.R. DudleyGreat Mines Health Center, Inc.

Ben ErnstNorthwest Health Services, Inc.

Alan FreemanGrace Hill Neighborhood Health Centers,

Inc.

Hilda FuentesSamuel U. Rodgers Health Center

Archie Griffi nMyrtle Hilliard Davis Comprehensive Health

Centers

Andy GrimmNortheast Missouri Health Council

Don McBrideAccess Family Care

Pat RichardsSouthern Missouri Community Health

Center

Verneda Bachus RobinsonSwope Health Services

Richard SimsMissouri Ozarks Community Health

Robert WaltersCentral Ozarks Medical Center

Mona WellsCross Trails Medical Center

Cheryl WhiteSoutheast Missouri Health Network

Karl Wilson, P.h.D.Crider Health Center

Joseph Pierle, CEOMissouri Primary Care Association

Missouri Quality Improvement Network Leverages Health Information Technology to Improve Primary Care

The Missouri Primary Care Association (MPCA) proudly launched the Mis-souri Quality Improvement Network (MOQuIN) in January 2011. MOQuIN is a Health Center-Controlled Network with three stated goals: a data warehouse with a clinical quality measures reporting system, an organized state-wide quality improvement initiative, and the qualifi cation of all Community Health Centers to receive incentives available through Medicaid for the meaningful use of Health Information Technology (HIT). The network is governed by Community Health Center representatives and managed by MPCA’s Center for Primary Care Quality and Excellence staff .

Missouri’s Community Health Centers, also known as Federally-Qualifi ed Health Centers, or FQHCs, began their journey toward using Health Information Technology to improve patient care in the 1990’s when the federal Bureau of Primary Health Care’s Health Disparities Collaboratives program was instituted. National learning sessions with expert speakers provided the FQHCs with knowledge of evidence-based practices and tools to achieve rapid improvements in care delivery. FQHCs used electronic patient registries to track patients with chronic illnesses such as diabetes, asthma, cardiovascular disease and depression. Reports from the registries enabled the FQHC care teams to assure that appropriate services and tests were provided during planned patient visits.

Electronic health record systems (EHRs) were the next step. With some help from the Missouri General Assembly in 2007, every FQHC in Missouri acquired and implemented an EHR. At the same time, MPCA began work on a data repository to provide clinical quality measures reporting from the patient data in the FQHCs’ EHRs.

With the assistance of federal funding in 2010, Arcadia Solutions was engaged to complete the MOQuIN data warehouse and reporting system. As a result, data extraction and analysis for seventeen measures has been performed at seven FQHCs. Seven core HIT Meaningful Use measures, three Meaningful Use clinical measures, and three chronic care measures are included in the present data set. Preliminary analysis indicates that Missouri FQHCs’ quality measures exceed national target levels, and that they are well-positioned to qualify for HIT Meaningful Use incentive payments.

Beginning April 1, 2011, the MO HealthNet Medical Electronic Health Record (EHR) Incentive Program will open enrollment in anticipation of federal approval of the State Medicaid Health Information Technology Plan. Under the program, professionals and hospitals may receive up to $63,750 in adoption incentives over a period of six years. Those interested in participating in the Medicaid program may begin registration at the CMS site: http://www.cms.gov/EHRIncentivePrograms.

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The entire fact sheet is available at:www.nachc.com/client/documents/20090929_Rising_Patient_Demand.pdf

he Missouri Student/Resident Experiences and Rotations in Community Health (MO SEARCH) Program off ers training for health professional students and residents in Community Health Center (CHC) sett ings in rural and urban underserved areas of the state. The MO SEARCH Program provides students and residents with the opportunity to experience fi rst-hand what it is like to live and practice in rural and/or underserved areas of Missouri. Students/residents gain an understanding of how CHC multidisciplinary teams function and work effi ciently to meet the needs of the populations and communities they serve. The program not only meets specifi c health professional training goals but also guarantees a community-oriented and culturally

diverse experience for the students and residents by emphasizing the important of compassion and service to your community. While students/residents are participating in the program, they are required to complete a community project that focuses and addresses particular health issues of the CHC’s patients. Examples of community projects that have been completed by MO SEARCH participants are: community health assessments, patient screenings, development of education materials, and working with communities to promote and increase physical activity and encourage literacy and reading.

The MO SEARCH Program strives to increase recruitment and retention of health professionals in Missouri’s underserved areas. Clinical rotations and experiences in CHC sett ings have been proven to help drive the decision making process for health professionals to practice in the same type of sett ings and communities in which they were trained and exposed to while obtaining their education. Currently there are

37 approved sites throughout the state that participate in the program. The 37 sites consist of 12 Missouri CHCs and 1 Private Non-Profi t Free Health Clinic. The program’s Sites and Preceptors, health care providers who serve as teachers and mentors, provide exceptional hands-on training to students and residents during their rotation.

The MO SEARCH Program is now accepting applications for upcoming Spring and Summer rotations. To become a Participant, Site, Preceptor or to learn more about the MO SEARCH Program, please contact the Missouri Primary Care Association at 573.636.4222. Funding for the MO SEARCH Program is sponsored by U.S. Department of Health and Human Services, Health Resources and Services Administration.

T

“My MO SEARCH experience inspired me to

seek employment in an underserved area” (Family

Nurse Practitioner Student)

“ MO SEARCH is a wonderful program; all health professional

students should be required to complete a rotation in an

underserved area” (SEARCH Program Preceptor)

“My SEARCH Preceptor taught me new approaches to patient management that positively impacted my clinical skills”

(Fourth Year Dental Student)

Health CenterHealth CenterHealth Center4

Cross Trails Medical Center, Cape GirardeauCross Trails Medical Center has received Recognition from the Physician Practice Connections – Patient-Centered Medical Home (PPC-PCMH) program for using evidence-based, patient-centered processes that focus on highly coordinated care and long-term participative relationships. Cross Trails Medical Center received Recognition for their Advance, Missouri, clinic and expect to achieve Recognition for their remaining two clinics in 2011, once they have been “live” on their electronic records for over a year. Five staff members formed a committ ee to tackle the Recognition project, and aft er a great deal of planning, organization, and teamwork, achieved the goal of being Recognized as a Patient-Centered Medical Home.Family Health Center, ColumbiaFHC Dental programs were busy in 2010. Family Dental Center of Salisbury welcomed Cindy Hawkey as its hygienist this year. FHC now has sixteen operatories, four dentists, two hygienists, and of course, lots to do. Both of our dental volunteers have been accepted to UMKC-SOD. One dental assistant has been accepted to State Fair Community College dental hygiene program. We are so proud of them and looking forward to having them as future colleagues. The Family Dental Center was proud to receive an award of recognition from Central Missouri Community Action as 2010 Business Partner of the Year.Fordland ClinicFordland Clinic is directing Healthy Roots Along Route 60, a project funded by Community Foundation of the Ozarks and Missouri Foundation for Health. The goal of the project is to decrease obesity through gardening. Classes teach kids to garden, cook, and preserve food. Achievement of these skills promotes healthy eating and an active lifestyle, and bolsters the integration of local food production. So far, there are school gardens in Fordland (a berry garden), Rogersville (salad greens) and Mansfi eld (grand prize green beans). Seymour youth helped build eleven raised beds and a greenhouse at the YMCA, and four churches have started community gardens. Jordan Valley Community Health Center, Springfi eldJordan Valley Community Health Center (whose offi ces are located in Springfi eld and Marshfi eld) unveiled its new website in December, www.jordanvalley.org. Its current theme is Moms and Kids: The Heart of Jordan Valley. Visitors to the site can view stories from mothers who have utilized the many services at Jordan Valley. Also featured are entertaining videos of Springfi eld-area children talking about their own experiences at Jordan Valley and their many hopes and dreams for the future. The new website is part of an eff ort to re-brand Jordan Valley in Southwest Missouri and increase awareness of our services.

Health Center HighlightsAccess Family Care, NeoshoAccess Family Care (ACCESS), serving southwest Missouri, is proud to announce the successful implementation of its Electronic Medical Record System. The four medical clinics, though separated by 40-60 miles, are now connected electronically. Improving the program for Meaningful Use is the next step in mastering the EMR. In a few weeks, ACCESS looks forward to breaking ground for a new Medical/Dental clinic to serve Barry County patients in Cassville. Staff will move from a 1,300 sq. ft . facility to 6,800 sq. ft . to increase capacity to serve more patients. The community is especially excited about the new dental facility and are cheering ACCESS on! BJK People’s Health Center, St. LouisBett y Jean Kerr People’s Health Centers (PHC) will honor Black History Month with a Free Tax Preparation Day on February 2nd from 11:30 am – 5:30 pm. Former employees of the IRS volunteer their services for this event each year. FMI, call (314) 460-3648. PHC also honored Healthy Weight Week this year, January 18th – 21st. Programs provided a sampling of healthy, fresh, foods, informative handouts, weigh-ins and BMI readings, 2-month realistic goal plans, a smoothie cooking demonstration , and a 14-day free fi tness pass to enthusiastic participants. This exciting event will be held every other month. FMI call (314) 367-7848 ext. 1221.Central Ozark Medical Center, RichlandCOMC is a professional medical practice providing high quality primary and preventive health care services in modern facilities, to individuals and families in Pulaski, Miller, Laclede, and Camden Counties in Central Missouri. COMC has been providing care to Missourians for over thirty years. COMC is delivering second generation babies! COMC has two primary medical care sites and a dental practice site. COMC is pleased to announce the addition of behavioral health services through COMC’s full-time Clinical Psychologist. COMC looks forward to continuing providing quality care to Missourians and the opportunity to deliver and care for third generation babies and families.Crider Health Center, WentzvilleIn 2010, Crider celebrated the grand opening of its newly expanded health care facility located in Wentzville. The 45,000 sq. ft . expansion allowed Crider to broaden its services to include mental health care and counseling, primary health care, pediatrics, lab services, immunizations, pharmacy, dental services, gynecology, and mammography. Currently, Crider is preparing to begin renovation on its former medical clinic in Wentzville to house seven state-of-the-art dental suites. Crider is also planning to begin construction of a new 15,000 sq. ft . health care facility in Warrenton. The Warrenton facility will off er primary and behavioral health care, pediatrics, and dental services.

Health Center5

H e a l t h C e n t e rH e a l t h C e n t e r

Katy Trail Community Health, SedaliaKaty Trail Community Health Center’s (KTCH) case management program is blazing new trails for community health. In 2007, KTCH hired its fi rst bilingual case manager. By 2010, we employed fi ve case managers, four of whom are bilingual. Spanish-speaking patients are now assisted with medication instructions, chronic disease self-management, and healthy lifestyle changes. In addition to these bilingual services, our case management team assists with enrollment for the Medicaid/MC+ program. Between 2009 and 2010, our team assisted more than 850 enrollees in att aining eligibility. Patient social needs, such as housing, food, clothing, and transportation, are also assessed, and local partners are identifi ed to provide assistance. Northeast Missouri Health Council, KirksvilleNortheast Missouri Health Council recently completed a two-year “Health Literacy and Diabetes Communication Initiative” research project performed in partnership with Northwestern University and the American College of Physicians Foundation (ACPF). The study built on ACPF’s eff orts to respond to the call for strategies to support diabetic patients with limited health literacy skills through chronic disease self-management. The study’s objective was to evaluate the effi cacy of ACPF’s low literacy guide, Living with Diabetes: An Everyday Guide for You and Your Family, to improve diabetes self-management. NMHC had 103 diabetic patients participate in the study that implemented and tested two intervention strategies.Northwest Health Services, St. JosephNorthwest Health Services (NHS) opened a new dental clinic in Mound City during August, 2010, eliminating the great distance many patients had to travel for dental care. In addition, NHS is proud to introduce a new dentist, Dr. Aaron Hiegert. Dr. Heigert is living in the community and making his presence known! NHS has also added three providers to our Hamilton, Savannah, and St. Joseph Medical Clinics. All providers have received positive community feedback and are busy building their practices. NHS continues to expand outreach hoping to do our part in educating people on the roles of community health centers.

Samuel U. Rodgers Health Center, Kansas CitySamuel U. Rodgers Health Center is launching a new scheduling system to improve healthcare access to our patients. Modifi ed Open Access Scheduling will provide bett er quality care and decreased wait times. New patient appointments currently range from 21-47 days out. Under this new plan, we will off er appointments within 24-48 hours of the patient's phone call. The program is being piloted, beginning February 1, 2011, in our Adult Medicine clinic (downtown location only). This new system is just one of the ways the Health Center is staying true to its mission of providing high, quality, compassionate and aff ordable healthcare for all. Southeast Missouri Health Network, New MadridIn December, 2010, The American Cancer Society, High Plains Division, was pleased to present SEMO Health Network with the Harold P. Freeman Service Award. This honor is awarded to individuals, groups, organizations, or companies who demonstrate exemplary cancer services in underserved, at-risk communities. Areas of achievement that are considered include: saving lives, diminishing suff ering, and improving quality for cancer patients. The Harold P. Freeman Service Award was developed by the Society to recognize outstanding eff orts in cancer control activities. Only one award is available per state in the High Plains Division.Southern Missouri Community Health Center, West PlainsSouthern Missouri Community Health Center (SMCHC) is proud to announce that patients and staff are now enjoying the benefi ts of completed remodeling projects funded by ARRA. In other news, medical providers, nursing and billing staff have recently completed “Asthma Ready” training and have passed competency exams. Among the expected benefi ts are a more focused approach to asthma treatment and bett er education for patients. Looking ahead, SMCHC is anticipating the approval of a HRSA expanded medical capacity grant that will enable the Thayer clinic to expand its medical schedule to full-time.Swope Health Services, Kansas CitySwope Health Services has partnered with Comprehensive Mental Health Services to integrate medical services with behavioral health services. Comprehensive is the primary mental health provider in the Northeast Jackson County, and serves over 6,000 patients who require appropriate and timely primary medical care. Historically, persons with chronic mental illness tend to die 26 years earlier than the general population due to lack of primary health care access, prevention, and ongoing treatment. This integrated health care model will provide the link between behavioral health management and psychological support, connecting the value of psychiatric consultation with the primary health care system.

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Missouri Health Centers

FACT SHEETWHAT ARE HEALTH CENTERS?Community health centers are local, non-profi t, community-owned health care providers serving low income and medically underserved communities. For over 40 years, Missouri’s health centers have provided high-quality, aff ordable primary care and preventive services, and oft en provide on-site dental, pharmaceutical, and mental health and substance abuse services. Also known as Federally-Qualifi ed Health Centers (FQHCs), they are located in areas where care is needed but scarce, and improve access to care for thousands of Missourians regardless of their insurance status or ability to pay. Their costs of care rank among the lowest, and they reduce the need for more expensive in-patient and specialty care, saving taxpayers millions of dollars. In 2009, Missouri’s 21 health centers provided services through 180 delivery sites in both rural and urban communities, which is a 57% increase in site locations since 2004.

WHO DO HEALTH CENTERS SERVE?Health centers serve as the medical home to 374,855 Missourians through nearly 1.4 million encounters each year – numbers that are quickly growing. Dental encounters alone have increased 63% since 2004. Health center patients are among Missouri’s most vulnerable populations – people who even if insured would nonetheless remain isolated from traditional forms of medical care because of where they live, who they are, the language they speak, and their higher levels of complex health care needs. About 50% of health center patients reside in rural areas, while the other half live in urban communities. As Figure 1 demonstrates, 75.6% of health center patients have family incomes at or below 100% of poverty ($18,310 annual income for a family of three in 2009). Moreover, as shown in Figure 2, 36.5% of health center patients are uninsured and another 40.9% depend on Medicaid, much higher than the national rates of 11% and 13%, respectively (not shown). Slightly under half of health center patients are members of racial and ethnic minorities, as shown in Figure 3.

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HOW DO HEALTH CENTERS OVERCOME BARRIERS TO CARE?Health centers remove common barriers to care by serving communities that otherwise confront fi nancial, geographic, language/cultural and other barriers, making them diff erent from most private, offi ce-based practices. They• are located in high-need

areas identifi ed by the federal and state government as having elevated poverty, higher than average infant mortality, and where few providers practice;

• are open to all residents, regardless of insurance status, and provide reduced cost care based on ability to pay;

• serve residents from all 114 Missouri counties as well as the City of St. Louis;

• tailor their services to fi t the special needs and priorities of their local communities, and provide services based on the advice of local residents, businesses, churches, and other organizations; and

• off er services that help their patients access health care, such as transportation, translation, case management, health education, and chronic disease management.

For many patients, the health center may be the only source of health care services available. In fact, the number of uninsured patients at Missouri’s health centers has grown by 41% since 2004, while the number of Medicaid patients has grown 32% since 2004.

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KHOW DO HEALTH CENTERS MAKE A DIFFERENCE?

mortality, prenatal care, tuberculosis case rates, and death rates. Another major study found that disparities in health status do not exist among health center users, even after controlling for socio-demographic factors, and that the absence of disparities at health centers may be related to their culturally sensitive practices and community involvement – features that other primary care settings may lack.

• Cost-Effective Care. Care received at health centers is ranked among the most cost-effective. Several studies have found that health centers save the Medicaid program around 30% in annual spending for health center Medicaid beneficiaries due to reduced specialty care referrals and fewer hospital admissions, thereby producing significant savings in combined federal and state Medicaid expenditures. If avoidable visits to emergency rooms were redirected to health centers, over $24 billion in annual health care costs could be saved nationally.

• High Quality of Care. Studies have found that the quality of care provided at health centers is equal to or greater than the quality of care provided elsewhere. Moreover, 99% of surveyed patients report that they were satisfied with the care they receive at health centers.

• Fewer Infant Deaths. Several studies have found that communities served by health centers have infant mortality rates between 10 and 40% lower than communities not served by health centers. Health centers are also linked to improvements in accessing early prenatal care and reductions in low birth weight.

• Create Jobs and Stimulate Economic Growth. Health centers support 3,613 jobs, including the employment of many local residents. They bolster local business and stabilize neighborhoods by stimulating community development and economic growth, which resulted in an overall economic impact of nearly $324 million in 2007.

ey to health centers’ accomplishments is patient involvement in service delivery. Governing boards – the majority of which must be patients according to grant requirements – oversee health center operations. Board members serve as community representatives and make decisions on services provided. Active patient management of health centers assures responsiveness to local needs, and helps guarantee that health centers improve the quality of life for thousands of patients in the following ways.• Improve Access to Primary and Preventive

Care. Health centers provide preventive services to vulnerable populations that would otherwise not have access to certain services, such as immunizations, health education, mammograms, pap smears, and other screenings. Health centers have also made significant strides in preventing anemia and lead poisoning. Low income, uninsured health center users are also much more likely to have a usual source of care than the uninsured nationally.

• Effective Management of Chronic Illness. Health centers meet or exceed nationally accepted practice standards for treatment of chronic conditions. In fact, the Institute of Medicine (IOM) and the General Accounting Office (GAO) have recognized health centers as models for screening, diagnosing, and managing chronic conditions such as diabetes, cardiovascular disease, asthma, depression, cancer, and HIV. Health centers’ efforts have led to improved health outcomes for their patients, as well as lowered the cost of treating patients with chronic illness.

• Reduction of Health Disparities. Because of their success in removing barriers to care, the IOM and GAO recognized health centers for reducing or even eliminating the health gaps for racial and ethnic minorities, as well as for the poor in the U.S. A recent landmark study found that health centers are associated with reducing racial and ethnic disparities in such key areas as infant

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WHY IS INVESTING IN HEALTH CENTERS IMPORTANT?As described above, investing in health centers produces improved health outcomes and quality of life, as well as reductions in health disparities for thousands of Missourians. In addition, investment also leads to reductions in health care spending. As shown in Figure 4, health centers on average receive only 17.6% of their total revenue from federal grants. The largest single source of revenue is Medicaid, representing 40.0% of total revenue and 67% of all patient-related revenue. Another major source (24.6%) of revenue comes from non-federal grants and contracts, the vast majority of which comes from state and local funds. Already cited as one of the most eff ective programs by the OMB, a continued and expanded investment in health centers will guarantee improved health outcomes for thousands more Missourians and further cost savings.

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For Immediate ReleaseFebruary 19, 2011

MPCA Statement in Response to U.S. House of Representatives drastic cuts

Joseph Pierle, the CEO of Missouri Primary Care Association, has issued the following statement:

Early this morning, the U.S. House of Representatives, in a clear att empt at political grandstanding, pillaged $1.3 billion in community health center funding from an already fi scally challenged safety net system. Sadly, this action will have a perilous impact on underserved and uninsured populations in Missouri. Millions of patients nationwide will lose access to basic healthcare services, and in Missouri, many communities will face the elimination or downsizing of community health center sites and services.

Missouri’s Community Health Centers have long enjoyed strong, bipartisan support as one of the best investments of taxpayer dollars. Now is not the time for partisan politics to play a hand in the foreclosure on a health lifeline for tens of thousands of Missourians. Additionally, hundreds of health center employees will be lose their jobs and drag down an already weak economy.

Community Health Centers understand the need for fi scal restraint and support thoughtful fi scal discipline. Yet, making draconian cuts to a program that has been deemed as one of the most eff ective programs to receive federal funding makes no sense. Further, this cut is totally contrary to the expansion of CHCs which began while Newt Gingrich was Speaker of the House in the mid-90s and signifi cantly increased through both the Bush and Obama presidencies.

These indiscriminate spending cuts are short-sighted and will increase federal spending by the resulting increased usage of more expensive health care through unnecessary hospitalizations and emergency room visits.

Missouri’s Community Health Centers urge our House members to reverse these nonsensical cuts.

Missouri Primary Care Association3325 Emerald LaneJeff erson City, MO 65109(573) 636-4222Fax (573) 636-4585www.mo-pca.org

Press Release

Missouri Primary Care Association3325 Emerald LaneJeff erson City, MO 65109(573) 636-4222Fax (573) 636-4585www.mo-pca.org

2010 Calendar of EventsFEBRUARY 2011American Heart Monthwww.americanheart.org

International Prenatal Infection Prevention Monthwww.groupbstrepinternational.org

National Children’s Dental Health Monthwww.ada.org/2714.aspx

National Wise Health Consumer Monthwww.aipm.net/wise

MARCH 2011National Nutrition Monthwww.eatright.org

National Endometriosis Awareness Monthwww.endoceter.org

Save Your Vision Monthwww.aoa.org

APRIL 2011Alcohol Awareness Monthwww.samhsa.gov

National Autism Awareness Monthwww.autism-society.org

National Irritable Bowel Syndrome Awareness Monthwww.aboutibs.org

National Donate Life Monthwww.organdonor.gov

National Minority Health Monthminorityhealth.hhs.gov

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April 11, 2011MPCA Board MeetingOffi cial Board Members OnlyMPCA Offi ce

April 21, 2011Corporate Compliance/Risk Management WorkshopMPCA, Jefferson City, MO