working with federally qualified health centers ...€¦ · making the business case with your fqhc...
TRANSCRIPT
Wor
king
with
Fed
eral
ly Q
ualif
ied
Hea
lth
Cen
ters
: Pa
rtne
rshi
p Id
eas
Presen
ted�by:
Beth�W
robe
l�,�CEO
�Health
Linc
Khl
Rld
ThN
ilC
ilKathleen
�Reyno
lds,�The
�National�Cou
ncil
.
ww
w.T
heN
atio
nalC
ounc
il.or
g
Age
nda
for t
he W
ebin
ar>
Wha
t are
key
issu
es fo
r fol
ks o
n th
e ca
ll?>
Get
ting
to K
now
You
, Get
ting
to K
now
All
Abo
ut Y
ou•
Key�Facts�Abo
ut�FQHC’s�That�You
�Need�to�Kno
w
•Fram
ingCM
HC’sPo
sitiv
ely
•Fram
ing�CM
HCs�Po
sitiv
ely
>M
akin
g th
e B
usin
ess
Cas
e w
ith Y
our F
QH
C
ww
w.T
heN
atio
nalC
ounc
il.or
g
FQH
C P
artn
ersh
ips
–K
ey T
hing
s Fo
r C
MH
C’s
To
Kno
w•
Wha
t is
an F
QH
C?
•C
ost B
ased
Rei
mbu
rsem
ent
•B
H E
xpan
sion
Gra
nts
for F
QH
C’s
�Subcon
tractin
g�with
�CMHC’s
�Fede
ral�Tort�C
laim
s�Act�Liability�Co
verage
�S
cope
of S
ervi
ce
ww
w.T
heN
atio
nalC
ounc
il.or
g
Wha
t is
an F
QH
C?
•P
rovi
des
med
ical
, men
tal h
ealth
and
den
tal c
are
to a
ll re
gard
less
on
thei
r abi
lity
to p
ay –
unin
sure
d or
un
derin
sure
d•
Prov
ides
ena
blin
g se
rvic
es s
uch
as p
harm
acy,
tr
ansp
orta
tion,
pre
nata
l and
fam
ily c
are
serv
ices
, cas
e m
anag
emen
t and
oth
er re
ferr
als
to o
ther
bas
ic n
eeds
ag
ency
•Pr
ovid
es s
ervi
ces
thro
ugh
all t
he li
fe c
ycle
s-pr
enat
al,
pedi
atric
, adu
lt an
d ge
riatr
ics.
ww
w.T
heN
atio
nalC
ounc
il.or
g
Wha
t is
an F
QH
C?
•Se
rves
the
com
mun
ity-o
ffers
a s
lidin
g fe
e, a
ccep
ts M
edic
aid,
M
edic
are
and
priv
ate
insu
ranc
e.•
Allo
ws
for e
nhan
ced
Med
icai
d an
d M
edic
are
paym
ent s
yste
m-
paid
fairl
y fo
r ser
vice
s re
nder
ed•
340B
Dru
g Pr
ogra
m•
FTC
A c
over
age-
no m
alpr
actic
e fo
r ind
ivid
ual p
ract
ition
ers-
not o
n co
ntra
cts
•N
atio
nal H
ealth
Ser
vice
Cor
p (N
HSC
) :sc
hola
rs o
r loa
n re
paym
ent
Pti
iti
ith
HD
Cdi
bt
thd
iC
HF
d•
Part
icip
atio
nin
the
HD
C-d
iabe
tes,
ast
hma,
depr
essi
on,C
HF
and
othe
r chr
onic
dis
ease
s N
EW: P
SPC
–in
tegr
atin
g th
e Ph
arm
acis
t in
to th
e vi
sit
ww
w.T
heN
atio
nalC
ounc
il.or
g
Cos
t Bas
ed R
eim
burs
emen
t –Pr
ospe
ctiv
e Pa
ymen
t Sys
tem
py
y�
Per
pro
vide
r fee
for e
ach
enco
unte
r reg
ardl
ess
of
amou
ntof
time
amou
ntof
time
�D
eter
min
ed b
ased
on
cost
s, p
rosp
ectiv
e pa
ymen
t�
Pot
entia
l for
incr
ease
d re
venu
e fo
r psy
chia
tric
visi
tsp
y�
Fede
ral T
ort C
laim
s A
ct li
abilit
y co
vera
ge
�In
crea
sed
paym
ent f
or B
H s
taff
unde
r thi
s m
odel
too
ww
w.T
heN
atio
nalC
ounc
il.or
g
Cu
rren
t S
tate
of
Fed
eral
Fu
nd
ing
an
d
Per
son
s S
erve
d(2
007
OM
B)
ved
Co
mm
un
ity
Me
nta
l He
alth
Co
mm
un
it y68
# of People Serv(millions)
yP
rima
ry C
are
4
#
2
.51
1.5
2
Fed
eral
/Sta
te F
un
din
g(b
illio
ns)
ww
w.T
heN
atio
nalC
ounc
il.or
g
BH
Exp
ansi
on G
rant
s
�Fu
ndin
g av
aila
ble,
ofte
n ea
ch y
ear,
to e
xpan
d B
Hse
rvic
esin
FQH
Cse
tting
sB
Hse
rvic
esin
FQH
Cse
tting
s�
Mos
t rec
ent a
pplic
atio
n Fe
brua
ry, 2
009
All
NS
tt
thb
hi
lhlth
�A
llN
ewS
tarts
mus
thav
ebe
havi
oral
heal
thse
rvic
es�
Dire
ctH
ires
�D
irect
Hire
s�
Con
tract
with
loca
l CM
H
ww
w.T
heN
atio
nalC
ounc
il.or
g
Con
trac
ting
with
CM
HC
’s
>FQ
HC
’s c
an c
ontra
ct w
ith C
MH
C’s
–a
spec
ialty
care
appr
oach
spec
ialty
care
appr
oach
>H
as to
be
in S
cope
of S
ervi
ce a
t the
loca
tion
the
serv
ice
will
bepr
ovid
edan
das
ase
rvic
eth
ese
rvic
ew
illbe
prov
ided
and
asa
serv
ice
>Is
sues
with
gro
up h
omes
cur
rent
ly b
eing
in
clud
edin
scop
e–
reve
rse
inte
grat
ion
incl
uded
insc
ope
–re
vers
ein
tegr
atio
n>
MO
U in
stea
d of
“con
tract
”
ww
w.T
heN
atio
nalC
ounc
il.or
g
Scop
e of
Ser
vice
�FQ
HC
onl
y ge
ts re
imbu
rsed
for t
hing
s ap
prov
edw
ithin
thei
rsco
peap
prov
edw
ithin
thei
rsco
pe�
Can
sub
mit
Sco
pe C
hang
e do
cum
ent t
o in
clud
epr
ovid
ing
prim
ary
care
atC
MH
/BH
incl
ude
prov
idin
gpr
imar
yca
reat
CM
H/B
Hsi
tes
ww
w.T
heN
atio
nalC
ounc
il.or
g
Wha
t Sho
uld
FQH
C’s
Kno
w A
bout
C
MH
C’s
?>
% M
edic
aid
in y
our p
opul
atio
n>
Why
so
man
y pe
rson
s w
ith m
enta
l illn
ess
are
alre
ady
in p
rimar
y ca
re•
CMHC�Focus�on
�Serious,�Persisten
t�Men
tal�Illness
•Co
mmitm
ent�o
f�uninsured
�is�th
ere�–issue�is�fu
nding
•Feeforservice/capita
tedfund
ing–NOTCo
streim
bursem
ent
Fee�for�service/capita
ted�fund
ing�
NOT�Co
st�reimbu
rsem
ent
•70
%�of�A
ntidep
ressants�prescribe
d�in�primary�care
>S
kills
of C
MH
C s
taff
in C
ase
Man
agem
ent
>P
sych
iatri
cR
esou
rces
>P
sych
iatri
cR
esou
rces
>M
orbi
dity
and
Mor
talit
y S
tatis
tics
for o
ur p
opul
atio
n>
Hea
lth C
are
Eco
nom
ics
ww
w.T
heN
atio
nalC
ounc
il.or
g
Det
erm
inin
g th
e B
usin
ess
Cas
e fo
r Par
tner
ing
with
an
FQH
Cg
Q
�P
sych
iatri
c S
ervi
ces
in P
rimar
y C
are
�M
aste
rs le
vels
+ c
linic
ians
in P
rimar
y C
are
�P
hysi
cal H
ealth
Issu
es in
BH
�C
ase
Man
agem
entS
ervi
ces
�C
ase
Man
agem
entS
ervi
ces
ww
w.T
heN
atio
nalC
ounc
il.or
g
Psyc
hiat
ric S
ervi
ces
in P
rimar
y C
are
�FQ
BH
billi
ng is
bas
ed o
n a
pros
pect
ive
tf
td
thi
syst
em o
f pay
men
t and
they
rece
ive
an
enco
unte
r rat
e re
gard
less
of t
ime
spen
t C
MH
Ct
diff
tt
lth
vs.C
MH
C g
ets
diffe
rent
rate
s pe
r len
gth
of v
isit
�To
rt lia
bilit
y in
sura
nce
is fr
ee
ww
w.T
heN
atio
nalC
ounc
il.or
g
Cal
cula
ting
Psyc
hiat
ric O
ffset
sPs
ych
Serv
ice
# of
Uni
tsPr
ovid
edin
CM
H
CM
H R
ate
CM
HR
even
ueFQ
HC
Enco
unte
rR
ate
FQH
CR
even
ueD
iffer
ence
Liab
ility
Cov
erag
eN
/AN
/A$0
N/A
ww
w.T
heN
atio
nalC
ounc
il.or
g
Mas
ter’s
Lev
el C
linic
ians
+
�S
ame
situ
atio
n as
psy
chia
try –
tb
di
bt
enco
unte
rbas
ed re
imbu
rsem
ent
�U
se s
ame
char
t as
for p
sych
iatri
st to
ev
alua
te b
enef
it of
mov
ing
mas
ter l
evel
cl
inic
ians
to F
QH
C e
ither
on
empl
oym
ent b
asis
or c
ontra
ct
ww
w.T
heN
atio
nalC
ounc
il.or
g
Phys
ical
Hea
lth Is
sues
Phys
ical
Hea
lthD
iagn
osis
# of
C
onsu
mer
sat
CM
H w
ith
this
% o
f tho
se
cons
umer
sw
ithM
edic
aid
Aver
age
# or
Vi
sits
@
FQH
C/y
ear
Enco
unte
rR
ate
of
FQH
C
Incr
ease
dR
even
uePo
tent
ial
this
Dia
gnos
isM
edic
aid
Dia
bete
s
Car
diac
Issu
es
Obe
sity
CO
PD
HIV
/AID
S
ww
w.T
heN
atio
nalC
ounc
il.or
g
Cas
e M
anag
emen
t Ser
vice
s
�N
ot b
illabl
e in
FQ
HC
; Billa
ble
at C
MH
C�
CM
H p
rovi
des
case
man
agem
ent a
t FQ
HC
, und
er c
ontra
ct b
ut b
ills o
wn
reve
nue
sour
ce,
for a
ll pa
tient
s
ww
w.T
heN
atio
nalC
ounc
il.or
g
The
Cor
e Fa
ctor
s
>Its
abo
ut th
e re
latio
nshi
p(s)
Mi
(Ad
i&
Cli
il)
>M
eetin
gs(A
dmin
&C
linic
al)
>Ti
me
com
mitm
ent
>V
isio
n co
mm
itmen
t
ww
w.T
heN
atio
nalC
ounc
il.or
g