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CHAMPS EXECUTIVE COMMITTEE CONFERENCE CALL AGENDA THURSDAY, MARCH 2, 2017 @ 3:00 PM MT/4:00 PM CT

Dial-In Number: 866-453-5550 / Participant PIN: 4382269#

I. CALL TO ORDER – Keith Horwood, MD II. CHAMPS SECRETARY'S REPORT – Cindy Smith

A. Establish Quorum B. Review/Approve 10/15/16 CHAMPS Executive Committee Meeting Minutes

III. CHAMPS TREASURER'S REPORT – John Santistevan

A. Review/Accept 9/16, 10/16, 11/16 and 12/16 CHAMPS Unaudited Financial Reports IV. CHAMPS STAFF REPORT – Julie Hulstein/Andrea Martin/Jen Anderson

A. CHAMPS 2016/2017 Organizational Membership B. CHAMPS Corporate Compliance Workplan C. CHAMPS/NWRPCA Fall Primary Care Conference D. CHAMPS/NWRPCA Education Health Center Initiative E. CHAMPS Workforce Development and Member Services F. Mountain/Plains Clinical Network (MPCN)

V. HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA) REPORT

VI. NACHC BOARD MEMBERS’ REPORT – John Mengenhausen/John Santistevan

VII. CHAMPS PRESIDENT'S REPORT – Keith Horwood, MD A. CHAMPS Strategic Plan

VIII. REGION VIII STATE PRIMARY CARE ASSOCIATION REPORTS

A. Association for Utah Community Health / AUCH B. Colorado Community Health Network / CCHN C. Community HealthCare Association of the Dakotas / CHAD D. Montana Primary Care Association / MPCA E. Wyoming Primary Care Association / WYPCA

IX. OTHER BUSINESS

X. ADJOURNMENT

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EXECUTIVE COMMITTEE ROLL CALL 2016–2018

PRESIDENT Keith Horwood, MD VICE PRESIDENT Kristi Halvarson IMMEDIATE PAST PRESIDENT John Mengenhausen TREASURER John Santistevan SECRETARY Cindy Smith

WYOMING REPRESENTATIVE Melissa Ipsen CLINICAL REPRESENTATIVE Kim McFarlane, PA-C

CHAMPS Mission The mission of CHAMPS is to provide opportunities for education and training,

networking, and workforce development to Region VIII Community Health Centers so we can better serve our patients and communities.

CHAMPS Vision

All patients and communities benefit from the impact of the resources that CHAMPS provides to Community Health Centers.

CHAMPS Values

Support Excellence Responsiveness Vision Integrity Collaboration Effectiveness

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COMMUNITY HEALTH ASSOCIATION OF MOUNTAIN/PLAINS STATES (CHAMPS) EXECUTIVE COMMITTEE MEETING MINUTES

SATURDAY, OCTOBER 15, 2016 / WESTIN DENVER DOWNTOWN, DENVER, CO

MEMBERS PRESENT John Mengenhausen, President Keith Horwood, MD, Vice President John Santistevan, Treasurer/Secretary Cindy Smith, MT Representative Kristi Halvarson, ND Representative Melissa Ipsen, WY Representative Kim McFarlane, PA-C, Clinical Representative

STAFF PRESENT Julie Hulstein Andrea Martin Jen Anderson

CALL TO ORDER The meeting was called to order at 12:10 PM MT. CHAMPS SECRETARY’S REPORT It was determined that a quorum was present. The minutes from the CHAMPS Executive Committee conference call on September 21, 2016 were reviewed. Melissa Ipsen moved to approve the minutes. Cindy Smith seconded the motion, which passed unanimously. CHAMPS TREASURER’S REPORT The unaudited financial reports for the month of August 2016 were reviewed. Cindy Smith moved to accept the financial reports. Keith Horwood seconded the motion, which passed unanimously. It was noted that CHAMPS’ UMB bank account exceeds the FDIC insurance threshold. Keith Horwood moved to transfer $90,000 from UMB to a CD with MorganStanley. Melissa Ipsen seconded the motion, which passed unanimously. It was also noted that due to the small increase in CHAMPS’ annual operating budget, CHAMPS’ designated operating reserves must also be increased commensurately. According to CHAMPS’ Financial Policies, the CHAMPS reserve fund should have a minimum of six months of cash. To maintain adherence to the policy, CHAMPS’ designated operating reserves need to be increased from $335,000 to $350,000. Kim McFarlane moved to increase CHAMPS’ designated operating reserves to $350,000. Melissa Ipsen seconded the motion, which passed unanimously. In July 2016, Primary Care Associations (PCAs) were notified by the Health Resources and Services Administration (HRSA) that HRSA would be changing the grant funding year for PCAs from April 1-March 31 to July 1-June 30. CHAMPS’ fiscal year is April 1-March 31 which has historically aligned with the federal/HRSA grant funding year. The possibility of changing CHAMPS’ fiscal year to align with the new federal funding year was discussed and it was determined that for now, CHAMPS will remain with its April 1-March 31 fiscal year; the Executive Committee can determine at a future meeting if a change in the fiscal year is necessary. CHAMPS STAFF REPORT The CHAMPS membership year began April 1st; as of October 3rd 78% of Region VIII CHCs and SPCAs paid their CHAMPS organizational membership dues. The goals of the CHAMPS Corporate Compliance program are to develop and implement a monitoring system designed to ensure that CHAMPS is in compliance with relevant state and federal laws; and, identify and correct compliance issues on an ongoing basis. John Santistevan moved to approve the Corporate Compliance report for the period ending March 31, 2017 as of October 10, 2016. Kim McFarlane seconded the motion, which passed unanimously. The 2016 CHAMPS/NWRPCA Fall Conference began today. As of October 10th over 340 people were registered for the conference including nearly 190 from Region VIII. The CHAMPS Board

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will hold its annual meeting tomorrow evening; Executive Committee members went over the Board meeting agenda together and reviewed the schedule of other meetings and events during the conference. The mission of the Education Health Center Initiative (EHCI) is to develop training and workforce solutions for the provision of quality primary care to underserved populations through support and transformation of primary care health workforce training partnerships. EHCI is considering a one year pilot which would add KCN Consulting as a non-voting member of the Steering Committee and if it is a successful pilot, potentially restructuring EHCI to include KCN as a partner along with CHAMPS and NWRPCA. There will be an EHCI session at the conference entitled “Grow Your Own-New Business Models and Collaboration for Clinical Workforce Training Program Development” as well as opportunities to meet with EHCI lead consultant Kiki Nocella. CHAMPS Outreach & Enrollment (O&E) annual report to the Board of Directors was included in the meeting packet. CHAMPS is currently recruiting for a new Programs/O&E Coordinator. CHAMPS hosted an O&E webinar series in partnership with CCHN starting in June that included four distance learning events on topics such as providing effective assistance to survivors of domestic violence, assisting clients with complex medical needs, engagement and issue advocacy for O&E staff, and habits of highly effective assisters. The evaluation summary for the last webinar was included in the packet; 27 people attended the event and gave it a median overall satisfaction score of 9 (on a scale of 1-10 with 10 being the highest). Andrea Martin gave the Workforce Development and Member Services update; the CHAMPS Workforce Development & Member Services annual report to the Board was included in the packet. The 2016 CHAMPS Region VIII Health Center Salary, Benefits, Turnover and Vacancy Survey Report is being finalized and will be released later this month. Included in the packet was an excerpt from the report highlighting key findings. CHAMPS is partnering with NWRPCA to create the Region X Health Center Salary Survey Report as well. The CHAMPS Region VIII CHC Preferred Pricing Program (PPP) for Employment Screening Services was recently launched offering a discount of 30-35% off regular screeningONE rates for employment screening products; additional information was included in the packet. The CHAMPS Training Summary report for October 2015-September 2016 was also included in the packet as was the 2015 UDS Region VIII Health Center Fact Sheet. Jen Anderson gave the Mountain/Plains Clinical Network (MPCN) update; the MPCN annual report to the Board was included in the packet which contained the MPCN Steering Committee membership list. The MPCN Steering Committee is recruiting representatives from Montana, North Dakota, and South Dakota so please let Jen know if you are aware of any clinicians who would like to be a part of the Steering Committee. Also included was the MPCN Strategic Action Plan for 2015-2016; MPCN will be conducting strategic planning during the Fall Conference in order to create an updated Strategic Action Plan. CHAMPS launched its first two Project ECHO (Extension for Community Healthcare Outcomes) learning communities in June and July. In partnership with the Rocky Mountain Public Health Training Center (RMPHTC) and Project ECHO Colorado, CHAMPS offered Behavioral Health Integration and Colorectal Cancer Screening ECHO learning communities for Region VIII CHCs. Each ECHO series allowed participants to see, hear, and interact with content experts and other participants in the learning community. The ECHO learning communities concluded last month; future ECHO topics are being determined. CHAMPS has offered the UpToDate Preferred Pricing Program (PPP) for CHAMPS Organizational Members for a few years, unfortunately, UpToDate is changing its policies and moving towards a seat-based model and eliminating personal subscriptions. UpToDate is still finalizing details of

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the transition, but this change will effectively end the CHAMPS PPP. CHAMPS did request that UpToDate offer discounted “seats” for FQHCs in their new model and they have agreed to do so. CHAMPS will investigate comparable clinical decision support tools in hopes of finding a suitable alternative PPP. The UpToDate PPP summary report as of October 1, 2016 was included in the packet; 15 Region VIII CHCs participated and purchased 101 individual provider subscriptions for a total savings of $7,400. Jen noted that discussions are continuing around the formation and goals of a Western Clinicians Alliance (WCA). Organizations included in the conversations in addition to CHAMPS are Northwest Regional Primary Care Association (NWRPCA), Western Clinicians Network (WCN), and the California and Arizona Primary Care Associations (PCAs). A meeting of these organizations will occur in conjunction with the Annual Conference. HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA) REPORT At tomorrow’s Board meeting, Nick Zucconi, Regional Administrator of HRSA Office of Regional Operations (ORO), will be speaking as will Margaret Davis, Director of the Office of Strategic Business Operations at the Bureau of Primary Health Care (BPHC). Other federal partners presenting at the conference include Tommy Driskill and Kara Hawthorne from the Veterans Health Administration Office of Rural Health. Included in the meeting packet was information on the Veterans Rural Health Advisory Committee (VRHAC). John Mengenhausen has been a member of VRHAC for the last few years and talked about the purpose and importance of the Committee. Membership nominations for VRHAC are currently being solicited; additional information was included in the meeting packet. Region VIII CHCs were notified by BPHC last month that effective September 19th the Northwest Division (NWD) Support Center/Project Officer pilot project will conclude and the NWD will return to the traditionally used model of the one-to-one Project Officer-to-Grantee. Three NWD Teams were announced grouping AK, CO and WY health centers into one, MT, OR, ND, and SD into another, and ID, UT and WA into the third. Each of the three teams has a team lead; CHCs are to contact the team lead or Kirsten Argueta with any questions. NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) REPORT NACHC Chair Ricardo Guzman will be attending this year’s Fall Conference as will Dan Hawkins, NACHC Senior VP of Public Policy and Research, and Joe Gallegos, NACHC Senior VP of the Western Region. They have been invited to address the CHAMPS Board tomorrow evening. John Santistevan mentioned discussions around NACHC membership dues and a plan developed by Colorado CHCs, via Colorado Community Health Network (CCHN), to address the NACHC dues issue. CHAMPS PRESIDENT’S REPORT The 2014-2016 CHAMPS Strategic Plan was included in the packet. The CHAMPS Executive Committee conducted strategic planning over the last two days and will present the new proposed strategic plan to the Board tomorrow evening. REGION VIII STATE PRIMARY CARE ASSOCIATION (SPCA) REPORTS CHAMPS staff participate in SPCA meetings/conferences and convene regular conference calls with their SPCA peers/colleagues to ensure coordination of Region VIII PCA programs and services and open, ongoing communication and collaboration. Brief SPCA updates were given by Executive Committee members. ADJOURNMENT The meeting was adjourned at approximately 1:30 PM MT. Respectfully submitted, Secretary John Santistevan

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MTD MTD YTD YTD BudgetedFederal Income Amount % Amount % AmountCHAMPS 41,334.30 7.95% 249,204.56 47.93% 519,941.00 Sub-Total Federal Income 41,334.30 7.95% 249,204.56 47.93% 519,941.00

Non-Federal IncomeInterest - Investments 522.43 11.00% 4,659.81 98.10% 4,750.00 Interest - Checking & Savings 12.03 9.25% 62.72 48.25% 130.00 Mid-Level Managers Training - 0.00% - 0.00% 3,500.00 NWRPCA/Region X Salary Survey - 0.00% - 0.00% 20,000.00 FTCA University - 0.00% 15,619.00 89.25% 17,500.00 Spanish Language Training - 0.00% 1,850.00 94.87% 1,950.00 Annual Conference - 0.00% - 0.00% 45,000.00 Education Health Center Initiative - 0.00% 1,043.25 0.00% 5,500.00 Lunchtime Learning Webinars & ECHO 573.18 0.00% 2,751.95 0.00% - Miscellaneous Product Income - 0.00% - 0.00% 1,000.00 Membership Dues 4,755.00 5.94% 92,410.00 115.51% 80,000.00 Sub-Total Non-Federal Income 5,862.64 3.27% 118,396.73 66.02% 179,330.00

TOTAL INCOME 47,196.94 6.75% 367,601.29 52.57% 699,271.00$

ExpensesSalaries 24,576.11 7.83% 135,480.48 43.15% 314,000.00 Fringe Benefits 3,272.92 6.01% 22,170.56 40.68% 54,500.00 Payroll Taxes 2,147.93 7.98% 12,004.36 44.63% 26,900.00 Sub-Total Labor Expense 29,996.96 7.59% 169,655.40 42.91% 395,400.00

Contract Labor 9,313.14 9.48% 47,530.93 48.40% 98,200.00 Sub-Total Contract Expense 9,313.14 9.48% 47,530.93 48.40% 98,200.00

Board & Committee Meetings (Non-Federal) - 0.00% - 0.00% 4,000.00 Gifts, Luncheons, Etc. (Non-Federal) 136.81 3.65% 1,727.67 46.07% 3,750.00 Gifts for Officers (Non-Federal) 808.16 67.35% 808.16 67.35% 1,200.00 Insurance & Bonding 262.00 6.55% 1,681.24 42.03% 4,000.00 Continuing Education - 0.00% - 0.00% 1,000.00 Registration Fees - 0.00% 4,885.00 57.47% 8,500.00 Office Expenses 795.80 2.49% 7,308.70 22.84% 32,000.00 Accounting Fees - 0.00% 3,540.00 68.08% 5,200.00 Occupancy/Rent 1,696.74 6.28% 11,034.76 40.87% 27,000.00 FTCA University - 0.00% 13,676.61 78.15% 17,500.00 Mid-Level Managers Training - 0.00% 2,914.81 83.28% 3,500.00 Staff Travel 252.66 0.94% 10,922.84 40.45% 27,000.00 Clinician Travel to Annual Conference (NF) - 0.00% - 0.00% 11,000.00 Reg. Reimb. for Annual Conference (NF) - 0.00% - 0.00% 10,000.00 Annual Conference (Non-Federal) - 0.00% - 0.00% 45,000.00 Receptions (Non-Federal) - 0.00% - 0.00% 5,000.00 Sub-Total Other Expense 3,952.17 1.92% 58,499.79 28.45% 205,650.00

TOTAL EXPENSES 43,262.27 6.19% 275,686.12 39.43% 699,250.00$

Financial Report FY 2016-2017 (FY 17)Six Periods Ending September 30, 2016 (50% of Year Gone)

COMMUNITY HEALTH ASSOCIATION OF MOUNTAIN/PLAINS STATES

With 50% of the year gone, 52% of income has been earned and 39% of budget has been expended.

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Description Face Value Unit Price MaturesInterest

Payments Market ValueUnrealized Gain/(Loss)

Estimated Annual Income Yield %

CERTIFICATES OF DEPOSITST Bank of INDIA - NY 50,000.00$ 100.80$ 4/27/2017 Semi-Annually 50,400.00$ 66.45$ 1,000.00$ 1.98%Trade Date 03/13/15

Ally Bank - UT 40,000.00$ 100.39$ 11/14/2017 Semi-Annually 40,156.80$ 156.80$ 420.00$ 1.04%Trade Date 07/16/15

Cap One NA - VA 60,000.00$ 101.44$ 8/27/2018 Semi-Annually 60,864.60$ 461.32$ 1,050.00$ 1.72%Trade Date 08/26/15

Capital One Bank - VA 60,000.00$ 101.44$ 8/27/2018 Semi-Annually 60,864.60$ 461.32$ 1,050.00$ 1.72%Trade Date 08/26/15

Amex Centurion - UT 100,000.00$ 101.66$ 12/31/2018 Semi-Annually 101,655.00$ 1,064.19$ 1,750.00$ 1.72%Trade Date 01/12/16

bmw Salt Lake City - UT 20,000.00$ 102.45$ 6/20/2019 Semi-Annually 20,489.00$ 23.41$ 390.00$ 1.90%Trade Date 05/05/16

bmw Salt Lake City - UT 95,000.00$ 103.86$ 8/21/2020 Semi-Annually 98,667.95$ 496.67$ 2,138.00$ 2.16%Trade Date 05/05/16

425,000.00$ 433,097.95$

Cash & money funds closing balance for this period: 57,731.73$

Balance in Non-Federal Account 8/31/16 282,917.00Membership Dues 4,755.00Reimbursement from CCHN for LL Webinars 573.18Interest 11.66Balance in Non-Federal Account 9/30/16 288,256.84$ $100,910.27 Matures 10/26/16

Interest 0.1%

Total in CHAMPS Non-Federal Accounts (MorganStanley + UMB Bank): 879,996.79$

Opening Balances in Non-Federal Account: Change:4/1/1991 26,013.93$ 4/1/1992 9,563.19$ (16,450.74)$ 4/1/1993 31,893.35$ 22,330.16$ 4/1/1994 38,480.59$ 6,587.24$ 4/1/1995 31,639.15$ (6,841.44)$ 4/1/1996 33,785.65$ 2,164.50$ 4/1/1997 77,869.88$ 44,084.23$ 4/1/1998 106,405.11$ 28,535.23$ 4/1/1999 116,615.80$ 10,210.69$ 4/1/2000 141,607.21$ 24,991.41$ 4/1/2001 199,013.39$ 57,406.18$ 4/1/2002 188,048.82$ (10,964.57)$ 4/1/2003 243,335.66$ 55,286.84$ 4/1/2004 265,005.06$ 21,669.40$ 4/1/2005 314,636.36$ 49,631.30$ 4/1/2006 375,309.88$ 60,673.52$ 4/1/2007 382,104.56$ 6,794.68$ 4/1/2008 343,417.01$ (38,687.55)$ 4/1/2009 414,549.40$ 71,132.39$ 4/1/2010 419,747.38$ 5,197.98$ 4/1/2011 483,726.84$ 63,979.46$ 4/1/2012 523,664.46$ 39,937.62$ 4/1/2013 599,003.08$ 75,338.62$ 4/1/2014 621,369.25$ 22,366.17$ 4/1/2015 663,110.66$ 41,741.41$ 4/1/2016 728,768.95$ 65,658.29$ 4/1/2017 TBD

CHAMPS UMB Bank of Colorado Account (Non-Federal)

CHAMPS MorganStanley AccountSeptember 1-30, 2016

CHAMPS UMB CD

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Assets

Cash ‐ CO State Bank 32,608.13$

Cash ‐ UMB 288,156.84$

Investments ‐ MorganStanley 492,392.77$

CD ‐ UMB 100,910.27$

Accounts Receivable 13,259.56$

Prepaid Expense 5,098.82$

Prepaid Workers' Compensation Insurance 772.39$

Prepaid Liability Insurance 2,081.83$

Prepaid Employee Benefits 609.78$

Deposit ‐ Letter of Credit CD for Office 2,336.90$

Total Assets 938,227.29$

Liabilities

Accounts Payable 36,221.24$

Salary Payable 5,619.47$

Accrued Vacation Payable 31,110.00$

Denver Use Tax ‐ Property 144.00$

Denver Use Tax ‐ Food 88.00$

Childcare Deduction/Reimbursement 800.00$

Medical FSA Deduction/Reimbursement 1,249.92$

Medical Savings Reimbursement (2,250.00)$

Total Liabilities 72,982.63$

Net Assets

Fund Balance ‐ Prior FY 438,329.49$

Retained Earnings ‐ Current Year 91,915.17$

Designated Operating Reserves 335,000.00$

Total Net Assets 865,244.66$

Total Liabilities & Net Assets 938,227.29$


Balance Sheet as of September 30, 2016

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Non-Federal IncomeInterest - Investments 635.63 13.38% 5,295.44 111.48% 4,750.00 Interest - Checking & Savings 12.60 9.69% 75.32 57.94% 130.00 Mid-Level Managers Training - 0.00% - 0.00% 3,500.00 NWRPCA/Region X Salary Survey - 0.00% - 0.00% 20,000.00 FTCA University - 0.00% 15,619.00 89.25% 17,500.00 Spanish Language Training - 0.00% 1,850.00 94.87% 1,950.00 Annual Conference - 0.00% - 0.00% 45,000.00 Education Health Center Initiative 1,043.25 0.00% 2,086.50 0.00% 5,500.00 Lunchtime Learning Webinars & ECHO 1,265.26 0.00% 4,017.21 0.00% - Miscellaneous Product Income - 0.00% - 0.00% 1,000.00 Membership Dues 2,885.00 3.61% 95,295.00 119.12% 80,000.00 Sub-Total Non-Federal Income 5,841.74 3.26% 124,238.47 69.28% 179,330.00

TOTAL INCOME 50,470.62 7.22% 418,071.91 59.79% 699,271.00$



Board & Committee Meetings (Non-Federal) 2,384.58 59.61% 2,384.58 59.61% 4,000.00 Gifts, Luncheons, Etc. (Non-Federal) 1,878.55 50.09% 3,606.22 96.17% 3,750.00 Gifts for Officers (Non-Federal) - 0.00% 808.16 67.35% 1,200.00 Insurance & Bonding 262.00 6.55% 1,943.24 48.58% 4,000.00 Continuing Education - 0.00% - 0.00% 1,000.00 Registration Fees 875.00 10.29% 5,760.00 67.76% 8,500.00 Office Expenses 3,366.34 10.52% 10,675.04 33.36% 32,000.00 Accounting Fees - 0.00% 3,540.00 68.08% 5,200.00 Occupancy/Rent 1,696.74 6.28% 12,731.50 47.15% 27,000.00 FTCA University - 0.00% 13,676.61 78.15% 17,500.00 Mid-Level Managers Training - 0.00% 2,914.81 83.28% 3,500.00 Staff Travel 250.46 0.93% 11,173.30 41.38% 27,000.00 Clinician Travel to Annual Conference (NF) 4,400.00 40.00% 4,400.00 40.00% 11,000.00 Reg. Reimb. for Annual Conference (NF) 3,485.00 34.85% 3,485.00 34.85% 10,000.00 Annual Conference (Non-Federal) - 0.00% - 0.00% 45,000.00 Receptions (Non-Federal) - 0.00% - 0.00% 5,000.00 Sub-Total Other Expense 18,598.67 9.04% 77,098.46 37.49% 205,650.00

TOTAL EXPENSES 59,036.43 8.44% 334,722.55 47.87% 699,250.00$

Financial Report FY 2016-2017 (FY 17)Seven Periods Ending October 31, 2016 (58% of Year Gone)



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Amex Centurion - UT 100,000.00$ 101.63$ 12/31/2018 Semi-Annually 101,634.00$ 1,064.98$ 1,750.00$ 1.72%Trade Date 01/12/16

bmw Salt Lake City - UT 20,000.00$ 102.40$ 6/20/2019 Semi-Annually 20,479.40$ 28.10$ 390.00$ 1.90%Trade Date 05/05/16

ST Bank of India - NY 50,000.00$ 103.27$ 12/5/2019 Semi-Annually 51,636.00$ 32.43$ 1,100.00$ 2.13%Trade Date 10/12/16


475,000.00$ 484,598.75$


Balance in Non-Federal Account 9/30/16 288,256.84Membership Dues 2,885.00Donation to Dr. Virgilio Licona Scholarship Fund -100.00Miscellaneous Product Income 109.00Reimbursement from CCHN for LL Webinars 1,265.26Interest 12.27Balance in Non-Federal Account 10/31/16 292,428.37$ $100,969.44 Matures 05/26/17




CHAMPS MorganStanley AccountOctober 1-31, 2016

CHAMPS UMB CD

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Assets


Cash ‐ UMB 291,528.37$


CD ‐ UMB 100,969.44$





Prepaid Employee Benefits 1,017.39$



Liabilities








Net Assets







Balance Sheet as of October 31, 2016

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Non-Federal IncomeInterest - Investments 34.58 0.73% 5,330.02 112.21% 4,750.00 Interest - Checking & Savings 10.20 7.85% 85.52 65.78% 130.00 Mid-Level Managers Training 5,265.72 150.45% 5,265.72 150.45% 3,500.00 NWRPCA/Region X Salary Survey - 0.00% - 0.00% 20,000.00 FTCA University - 0.00% 15,619.00 89.25% 17,500.00 Spanish Language Training - 0.00% 1,850.00 94.87% 1,950.00 Annual Conference - 0.00% - 0.00% 45,000.00 Education Health Center Initiative - 0.00% 2,086.50 0.00% 5,500.00 Lunchtime Learning Webinars & ECHO - 0.00% 4,017.21 0.00% - Miscellaneous Product Income 550.00 55.00% 550.00 55.00% 1,000.00 Membership Dues - 0.00% 95,295.00 119.12% 80,000.00 Sub-Total Non-Federal Income 5,860.50 3.27% 130,098.97 72.55% 179,330.00

TOTAL INCOME 54,836.13 7.84% 472,908.04 67.63% 699,271.00$



Board & Committee Meetings (Non-Federal) 369.12 9.23% 2,753.70 68.84% 4,000.00 Gifts, Luncheons, Etc. (Non-Federal) (65.55) -1.75% 3,540.67 94.42% 3,750.00 Gifts for Officers (Non-Federal) - 0.00% 808.16 67.35% 1,200.00 Insurance & Bonding 262.00 6.55% 2,205.24 55.13% 4,000.00 Continuing Education 19.19 1.92% 19.19 1.92% 1,000.00 Registration Fees 2,355.00 27.71% 8,115.00 95.47% 8,500.00 Office Expenses 783.52 2.45% 11,458.56 35.81% 32,000.00 Accounting Fees 1,175.00 22.60% 4,715.00 90.67% 5,200.00 Occupancy/Rent 3,308.74 12.25% 16,040.24 59.41% 27,000.00 FTCA University - 0.00% 13,676.61 78.15% 17,500.00 Mid-Level Managers Training - 0.00% 2,914.81 83.28% 3,500.00 Staff Travel 2,657.11 9.84% 13,830.41 51.22% 27,000.00 Clinician Travel to Annual Conference (NF) 1,400.00 12.73% 5,800.00 52.73% 11,000.00 Reg. Reimb. for Annual Conference (NF) 3,160.00 31.60% 6,645.00 66.45% 10,000.00 Annual Conference (Non-Federal) - 0.00% - 0.00% 45,000.00 Receptions (Non-Federal) - 0.00% - 0.00% 5,000.00 Sub-Total Other Expense 15,424.13 7.50% 92,522.59 44.99% 205,650.00

TOTAL EXPENSES 54,550.75 7.80% 389,273.30 55.67% 699,250.00$

Financial Report FY 2016-2017 (FY 17)Eight Periods Ending November 30, 2016 (67% of Year Gone)



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Amex Centurion - UT 100,000.00$ 101.40$ 12/31/2018 Semi-Annually 101,403.00$ 855.06$ 1,750.00$ 1.72%Trade Date 01/12/16

bmw Salt Lake City - UT 20,000.00$ 102.18$ 6/20/2019 Semi-Annually 20,435.80$ (1.67)$ 390.00$ 1.90%Trade Date 05/05/16

ST Bank of India - NY 50,000.00$ 103.02$ 12/5/2019 Semi-Annually 51,507.50$ (54.22)$ 1,100.00$ 2.13%Trade Date 10/12/16


JPM Columbus - OH 95,000.00$ 99.70 11/18/2021 Quarterly 94,716.90$ 286.9 1,710.00$ 1.80%Trade Date 11/23/16

475,000.00$ 578,329.75$


Balance in Non-Federal Account 10/31/16 292,428.37Transfer to MorganStanley Account -90,000.00Donation to Carousel of Happiness in Memory of M. Miller -100.00Mid-Level Management Training Revenue (NWRPCA) 6,308.97Miscellaneous Product Income 550.00Annual Conference Clinician Reimbursement -800.00Interest 10.07Balance in Non-Federal Account 11/30/16 208,397.41$ $100,969.44 Matures 05/26/17




CHAMPS MorganStanley AccountNovember 1-30, 2016

CHAMPS UMB CD

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Assets

Cash ‐ CO State Bank (11,631.15)$

Cash ‐ UMB 208,397.41$


CD ‐ UMB 100,969.44$








Liabilities








Net Assets






Balance Sheet as of November 30, 2016


14


Non-Federal IncomeInterest - Investments (4,955.79) -104.33% 374.23 7.88% 4,750.00 Interest - Checking & Savings 8.79 6.76% 94.31 72.55% 130.00 Mid-Level Managers Training 3,358.86 95.97% 8,624.58 246.42% 3,500.00 NWRPCA/Region X Salary Survey 19,870.00 0.00% 19,870.00 99.35% 20,000.00 FTCA University - 0.00% 15,619.00 89.25% 17,500.00 Spanish Language Training - 0.00% 1,850.00 94.87% 1,950.00 Annual Conference - 0.00% - 0.00% 45,000.00 Education Health Center Initiative - 0.00% 2,086.50 0.00% 5,500.00 Lunchtime Learning Webinars & ECHO - 0.00% 4,017.21 0.00% - Miscellaneous Product Income 250.00 25.00% 800.00 80.00% 1,000.00 Membership Dues - 0.00% 95,295.00 119.12% 80,000.00 Sub-Total Non-Federal Income 18,531.86 10.33% 148,630.83 82.88% 179,330.00

TOTAL INCOME 57,856.23 8.27% 530,764.27 75.90% 699,271.00$



Board & Committee Meetings (Non-Federal) - 0.00% 2,753.70 68.84% 4,000.00 Gifts, Luncheons, Etc. (Non-Federal) 408.54 10.89% 3,949.21 105.31% 3,750.00 Gifts for Officers (Non-Federal) - 0.00% 808.16 67.35% 1,200.00 Insurance & Bonding 262.00 6.55% 2,467.24 61.68% 4,000.00 Continuing Education - 0.00% 19.19 1.92% 1,000.00 Registration Fees - 0.00% 8,115.00 95.47% 8,500.00 Office Expenses 903.35 2.82% 12,361.91 38.63% 32,000.00 Accounting Fees 473.80 9.11% 5,188.80 99.78% 5,200.00 Occupancy/Rent 1,979.14 7.33% 18,019.38 66.74% 27,000.00 FTCA University - 0.00% 13,676.61 78.15% 17,500.00 Mid-Level Managers Training - 0.00% 2,914.81 83.28% 3,500.00 Staff Travel 1.94 0.01% 13,832.35 51.23% 27,000.00 Clinician Travel to Annual Conference (NF) 1,590.00 14.45% 7,390.00 67.18% 11,000.00 Reg. Reimb. for Annual Conference (NF) 1,580.00 15.80% 8,225.00 82.25% 10,000.00 Annual Conference (Non-Federal) - 0.00% - 0.00% 45,000.00 Receptions (Non-Federal) - 0.00% - 0.00% 5,000.00 Sub-Total Other Expense 7,198.77 3.50% 99,721.36 48.49% 205,650.00

TOTAL EXPENSES 42,936.28 6.14% 432,209.58 61.81% 699,250.00$

Financial Report FY 2016-2017 (FY 17)Nine Periods Ending December 31, 2016 (75% of Year Gone)



15








Amex Centurion - UT 100,000.00$ 100.77$ 12/31/2018 Semi-Annually 100,770.00$ 243.86$ 1,750.00$ 1.73%Trade Date 01/12/16

bmw Salt Lake City - UT 20,000.00$ 101.29$ 6/20/2019 Semi-Annually 20,258.80$ (164.32)$ 390.00$ 1.92%Trade Date 05/05/16

ST Bank of India - NY 50,000.00$ 101.85$ 12/5/2019 Semi-Annually 50,927.00$ (591.21)$ 1,100.00$ 2.15%Trade Date 10/12/16

bmw Salt Lake City - UT 95,000.00$ 101.99$ 8/21/2020 Semi-Annually 98,886.70$ (1,085.65)$ 2,138.00$ 2.20%Trade Date 05/05/16

JPM Columbus - OH 95,000.00$ 97.34 11/18/2021 Quarterly 92,468.25$ (1,961.75)$ 1,710.00$ 1.84%Trade Date 11/23/16

475,000.00$ 574,468.45$


Balance in Non-Federal Account 11/30/16 208,397.41Transfer to Federal Account -25,000.00NWRPCA Region X Salary Survey Report 19,870.00Miscellaneous Income 438.20Interest 8.65Balance in Non-Federal Account 12/31/16 203,714.26$ $100,969.44 Matures 05/26/17




CHAMPS MorganStanley AccountDecember 1-31, 2016

CHAMPS UMB CD

16

Assets


Cash ‐ UMB 203,714.26$


CD ‐ UMB 100,969.44$








Liabilities






Net Assets






Balance Sheet as of December 31, 2016


17

Participation of Region VIII CHCs and SPCAs in CHAMPS as Organizational Members - Last Five Membership Years

Colorado Community Health Centers (CHCs)

Year Gained

FQHC Status City ST

2012-

2013

2013-

2014

2014-

2015

2015-

2016

2016-

2017

Axis Health System 2013 Durango CO N/A X X X

Clinica Family Health 1977 Lafayette CO X X X X X

Clínica Tepeyac 2015 Denver CO N/A N/A N/A X X

Denver Health Community Health Services 1966 Denver CO X X X X X

Dove Creek Community Health Clinic 1975 Dove Creek CO X X X X X

High Plains Community Health Center 1995 Lamar CO X X X

Marillac Clinic, Inc. 2015 Grand Junction CO N/A N/A N/A

Metro Community Provider Network 1989 Englewood CO X X X X X

Mountain Family Health Centers 1978 Glenwood Springs CO X X X X X

Northwest Colorado Health 2008 Craig CO

Peak Vista Community Health Centers (acquired Plains Medical Center, 04/14) 1971 Colorado Springs CO X X X X X

Plains Medical Center (acquired by Peak Vista CHCs, 04/14) 2003 Limon CO X X N/A N/A N/A

Pueblo Community Health Center, Inc. 1983 Pueblo CO X X X X X

River Valley Family Health Center 2012 Olathe CO X X X X X

Salud Family Health Centers 1970 Fort Lupton CO X X X X X

Sheridan Health Services 2012 Denver CO X X X X

Stout Street Health Center 1984 Denver CO

Summit Community Care Clinic (formerly LAL) 2015 Frisco CO N/A N/A X X X

Sunrise Community Health, Inc. 1973 Evans CO X X X X X

Uncompahgre Medical Center 1979 Norwood CO X X X X X

Valley-Wide Health Systems, Inc. 1976 Alamosa CO X X X X X

Montana CHCs

Ashland Community Health Center (acquired by Bighorn Valley, 08/15) 1997 Ashland MT X X X N/A N/A

Bighorn Valley Health Center (acquired Ashland CHC, 08/15) 2012 Hardin MT X X X X X

Bullhook Community Health Center 2007 Havre MT X X X X X

Central Montana Community Health Center 2008 Lewistown MT X X X X X

Community Health Care Center, Inc. 1994 Great Falls MT X X X X

Community Health Partners 1997 Livingston MT X X X X X

Flathead Community Health Center 2009 Kalispell MT X X X X X

Glacier Community Health Center 2003 Cut Bank MT X X X X X

Marias Healthcare Services, Inc. (formerly LAL) 2015 Shelby MT N/A N/A X

Mineral Regional Health Center (acquired by Partnership Health Center, 07/15) 2012 Superior MT N/A N/A

Montana Migrant & Seasonal Farmworkers Council, Inc. (acquired WY migrant grant, 09/15) 1971 Billings MT X X X X X

Northwest Community Health Center 2002 Libby MT X X X X X

oneHealth 2003 Miles City MT X X X X X

Partnership Health Center (acquired Mineral Regional Health Center, 07/15) 1992 Missoula MT

PureView Health Center 1994 Helena MT X X X X X

RiverStone Health 1986 Billings MT X X X X X

Sapphire Community Health, Inc. 2015 Hamilton MT N/A N/A N/A

Southwest Montana Community Health Center 1986 Butte MT X X X X X

Sweet Medical Center 2003 Chinook MT X X X X X

North Dakota CHCs

Coal Country Community Health Center 2003 Beulah ND X X X X X

Community Health Service Inc. 1973 Grafton ND X X X X X

Family HealthCare 1990 Fargo ND X X X X X

Northland Community Health Center 2002 Turtle Lake ND X X X X X

Valley Community Health Centers 2004 Northwood ND X X X X X

South Dakota CHCs

allPOINTS Health Services 1985 Elk Point SD X X X X X

Community Health Center of the Black Hills 1992 Rapid City SD X X X X X

Falls Community Health 1980 Sioux Falls SD X X X X

Horizon Health Care, Inc. (acquired Prairie Community Health, 01/16) 1978 Howard SD X X X X X

Prairie Community Health, Inc. (acquired by Horizon Health Care, 01/16) 1976 Isabel SD X X X X N/A

Rural Health Care, Inc. 1987 Fort Pierre SD X X X X X

Utah CHCs

4th Street Clinic - Wasatch Homeless Health Care, Inc. 1988 Salt Lake City UT

Bear Lake Community Health Centers 2003 Garden City UT

Carbon Medical Service Association, Inc. 1992 East Carbon UT X X X X X

Community Health Centers, Inc. 1979 Salt Lake City UT X X X X X

Enterprise Valley Medical Clinic 1983 Enterprise UT

Family Healthcare 2002 Saint George UT

Green River Medical Center 1985 Green River UT X X X X X

Midtown Community Health Center 1995 Ogden UT

Mountainlands Community Health Center 1993 Provo UT

Paiute Indian Tribe of Utah 2013 Cedar City UT N/A X X X X

Utah Navajo Health System, Inc. 2000 Montezuma Creek UT X X X X X

Utah Partners for Health 2013 Magna UT N/A

Wayne Community Health Center 1978 Bicknell UT X X X X X

Wyoming CHCs

12th Street Health Care for the Homeless Clinic 1992 Casper WY X X X X X

Community Action's Health Care for the Homeless - Crossroads Healthcare Clinic 1992 Cheyenne WY X X X X X

Community Health Center of Central Wyoming 2000 Casper WY X X

Educational Health Center of Wyoming LAL 2014 Laramie WY N/A N/A X X X

HealthWorks 2004 Cheyenne WY X X X X X

Powell Health Care Coalition - Heritage Health Center 2015 Powell WY N/A N/A N/A X X

Sweetwater Health Center and Pharmacy (formerly LAL) 2013 Rock Springs WY N/A X X

WY Health Council/WY Migrant Health Prog. (WY migrant grant acquired by MT MSFW Council, 09/15) 1997 Cheyenne WY X X X N/A N/A

Current Membership as of 2/21/17 1

18

Participation of Region VIII CHCs and SPCAs in CHAMPS as Organizational Members - Last Five Membership Years

Region VIII State Primary Care Associations (SPCAs)

Year

Founded City ST

2012-

2013

2013-

2014

2014-

2015

2015-

2016

2016-

2017

Association for Utah Community Health 1985 Salt Lake City UT X X X X X

Colorado Community Health Network 1982 Denver CO X X X X X

Community HealthCare Association of the Dakotas 1986 Sioux Falls SD X X X X X

Montana Primary Care Association 1991 Helena MT X X X X X

Wyoming Primary Care Association 1995 Cheyenne WY X X X X X

Individual membership dues received from the following Primary Care Offices:

Colorado, Montana, South Dakota

FIVE YEAR MEMBERSHIP METRICS (as of 2/21/17)2012-

2013

2013-

2014

2014-

2015

2015-

2016

2016-

2017

2012-2013 CHC Members: 49 of 61 eligible Percentage of Region VIII CHCs that were/are CHAMPS Organizational Members

2013-2014 CHC Members: 50 of 65 eligible 80.3% 76.9% 80.6% 77.9% 79.1%

2014-2015 CHC Members: 54 of 67 eligible % Region VIII CHCs Members Last Year, as of 03/31/16 80.6%

2015-2016 CHC Members: 53 of 68 eligible

2016-2017 CHC Members: 53 of 67 eligible Annual CHC Membership Renewal Percentage

93.8% 95.9% 100% 94.4% 94.3%

Number of CHCs not renewing 3 2 0 1 TBD

One 2015-2016 member was absorbed by a 2016-2017 member.

Number of New CHC Members in Year (not members in previous year)

3 2 5 2 3

Percentage of Region VIII CHCs and SPCAs that were/are CHAMPS Organizational Members

81.8% 78.6% 81.9% 79.5% 80.6%

Current Membership as of 2/21/17 2

19

CHAMPS Corporate Compliance

FY 2017 (04/01/16 - 03/31/17) Workplan - Updated 02/27/17

Approved by the CHAMPS Executive Committee 05/17/16

ACTION ITEM

Target

Completion

Most Current/

Notes

CHAMPS Corporate Compliance Officer and Staff

Corporate Compliance Officer will ensure staff are aware of Corporate

Compliance activities.

Ongoing Ongoing

Corporate Compliance Officer and Executive Director will meet at least one

time annually to review Corporate Compliance workplan.

Q4

Corporate Compliance risk assessment will be conducted one time annually. Q4

Executive Committee / Board of Directors

Conduct debarment verification review against the OIG web site for

participation / exclusion status of current Board of Directors (BOD) members

each month.

Monthly Ongoing

All CHAMPS BOD members receive BOD Position Summary, Standards of

Conduct (SOC), and Conflict of Interest and Compensation Disclosure

Statement (COI) annually, and are given access to the CHAMPS Bylaws and

policies electronically.

Q1 Ongoing

Signed Standards of Conduct and Conflict of Interest/Compensation Disclosure

Statements are kept on file for each CHAMPS BOD member in accordance with

Form 990 regulations.

Q1 Ongoing

Review CHAMPS Bylaws every two years and submit recommendations for

change to Executive Committee (EC) for consideration; EC-approved updates

to the Bylaws require full BOD approval.

Q4 2018

Review CHAMPS Articles of Incorporation every five years and submit

recommendations for change to EC and BOD for consideration.

Q3 2020

Policies

Review, and update as needed, the CHAMPS HIPAA Policy annually to ensure

compliance with state and federal legislation.

Q1 June 2016

Review, and update as needed, the CHAMPS Emergency Business Continuity

Plan (EBCP) annually.

Q4

Review the CHAMPS 401(k) Managing Fiduciary Responsibility Policy annually

with action items completed and documentation placed in Central Files.

Q4 In Process

February 2017

Review, and update as needed, the CHAMPS Executive Director Emergency /

Retirement Succession Policy annually. Submit recommendations for change to

the Executive Committee for consideration.

Q4 February 2017

Review, and update as needed, the CHAMPS Financial Policies every two years.

Submit recommendations for change to CHAMPS Executive Committee for

consideration.

Q4 2018

Conduct internal reviews of other approved policies and update as needed. Ongoing January 2017:

Record Retention;

Employee File

February 2017:

Disclosure; Employee

Expense

Reimbursement;

Check Control

For more information, please contact Julie Hulstein (303) 867-9582 or [email protected]. 1

20




ACTION ITEM

Target

Completion

Most Current/

Notes

Financial, Operations, and Human Resources

Ensure timely completion of annual financial audit. Q2 August 2016

Complete flexible spending account discrimination / compliance testing

submission prior to the deadline.

Q2 April 2016

Ensure Form 990 is reviewed and approved by the CHAMPS Board President,

shared with the Executive Committee, and filed with the IRS prior to the

annual deadline.

Q3 November 2016

Review, and update as needed, the CHAMPS 401(k) plan documents to ensure

compliance with state and federal laws, regulations and standards of

operating.

Q3 In Process

February 2017

Complete 401(k) 5500 plan discrimination / compliance testing submission by

January month-end annually.

Q4 Testing Complete

February 2017;

Form 5500 Filing in

Process

Update SAM (System Award Management; previously CCR) registration

annually.

Q4

File / register with Colorado Secretary of State annually. Q4 January 2017

Review, and update as needed, insurance policies annually to ensure liability

limits meet overall business needs and state / other funder requirements.

Q4 November 2016

Prepare, release, and award an auditor services RFP every five years. FY 18

All CHAMPS staff members receive Standards of Conduct (SOC) and Conflict of

Interest and Compensation Disclosure Statement (COI) annually. Signed SOC

and COI forms are kept on file for each CHAMPS staff member.

Q1 May 2016

Review, and update as needed, staff job descriptions one time annually.

Evaluate exempt vs. non-exempt designations annually.

Q2 CPD: TBD;

ED: 10/16;

PCC: 05/16, 09/16;

POEC: 05/16, 09/16;

WDMSD: TBD*

Ensure new staff review and sign all, and all staff review and sign any

new/updated, required signature pages from the Employee Handbook.

Ongoing August 2016: IT

Acceptable Use and

Employment

Opportunities Policies

February 2017:

Corporate Credit

Card Procedure

Conduct staff performance reviews one time annually. Ensure each staff

completes a review verification form.

Variable - upon

anniversary

dates annually

Ongoing

Conduct debarment verification review against the OIG web site for

participation / exclusion status of current employees and contractors each

month.

Monthly Ongoing

Review the CHAMPS Employee Handbook every two years. Submit

recommendations for change to the Executive Committee for consideration.

Q3 2017

*CPD: Clinical Programs Director; ED: Executive Director; PCC: Programs & Communications Coordinator;

POEC: Programs/Outreach & Enrollment Coordinator; WDMSD: Workforce Development & Member Services Director


21




ACTION ITEM

Target

Completion

Most Current/

Notes

Annual Audits

Conduct records retention audit annually as defined within the CHAMPS

Records Retention Audit Policy.

Q3 Rescheduled for

May 2017

Conduct HIPAA internal PHI audit annually. Q3 February 2017

Conduct IT / AV / Telecom inventory audit annually as defined within the

CHAMPS Inventory Audit Policy.

Q4 February 2017

Annual Staff Trainings

Conduct supervisor training one time annually (employment law, performance

documentation, conflict strategies, etc.).

Q1 January 2017

With CCHN

Conduct employee safety and emergency preparedness training one time

annually (including OSHA if/when appropriate).

Q2 September 2016

Conduct EEO / harassment / standards of conduct training one time annually. Q3 March 2017

With CCHN

Conduct internal Corporate Compliance training one time annually. Q4 May 2016

Conduct HIPAA Privacy and Security Awareness training one time annually. Q4 March 2017

With CCHN


22

Q1 Please select the most appropriate titlefor your position.

Answered: 101 Skipped: 1

Board Member

BehavioralHealth Provider

Billing Manager

CEO/ED

COO

CommunityHealth Worker

ClinicalOperations

FacilityOperations

Fiscal

GovernmentEmployee

HumanResources...

IT

MedicalDirector

Nurse

Outreach(Insurance)

Physician/PA

Primary CareAssociation

Program Manager

QA/QI/Complianc

1 / 30

Fall 2016 CHAMPS/NWRPCA Conference Evaluation 23

13.86% 14

1.98% 2

1.98% 2

14.85% 15

2.97% 3

0.00% 0

4.95% 5

1.98% 2

11.88% 12

0.00% 0

0.99% 1

0.99% 1

10.89% 11

3.96% 4

1.98% 2

2.97% 3

11.88% 12

2.97% 3

2.97% 3

0.00% 0

5.94% 6

Total 101

# Other (please specify) Date

1 Director of Quality Improvement 10/28/2016 12:43 PM

2 Center Director 10/26/2016 3:39 PM

3 Nurse Practitioner 10/26/2016 12:46 PM

4 Accountant 10/26/2016 11:44 AM

5 Case Manager 10/25/2016 6:25 AM

e Specialist

Training &Education

Other (pleasespecify)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Answer Choices Responses

Board Member

Behavioral Health Provider

Billing Manager

CEO/ED

COO

Community Health Worker

Clinical Operations

Facility Operations

Fiscal

Government Employee

Human Resources Professional

IT

Medical Director

Nurse

Outreach (Insurance)

Physician/PA

Primary Care Association

Program Manager

QA/QI/Compliance Specialist

Training & Education

Other (please specify)

2 / 30


6 Health Policy Professional 10/21/2016 8:34 AM

3 / 30


14.00% 14

29.00% 29

26.00% 26

35.00% 35

1.00% 1

0.00% 0

19.00% 19

0.00% 0

3.00% 3

Q2 How did you learn about the FallConference?


Total Respondents: 100

# Other (please specify) Date

1 NWRPCA board member 10/26/2016 11:43 AM

Direct mail(flyer or...

CHAMPS orNWRPCA website

Colleague

Email

Facebook

LinkedIn

Supervisor

Twitter

Other (pleasespecify)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Direct mail (flyer or brochure)

CHAMPS or NWRPCA website

Colleague

Email

Facebook

LinkedIn

Supervisor

Twitter

Other (please specify)

4 / 30


2 Clinic 10/20/2016 8:14 PM

3 i'm an MPCN board member and also received lots of emails via work 10/20/2016 5:18 PM

5 / 30


8.91% 9

43.56% 44

3.96% 4

64.36% 65

9.90% 10

20.79% 21

Q3 What made you decide to attend the FallConference?


Total Respondents: 101

# Comments Date

1 Mo is a very educational speaker. 10/27/2016 11:24 AM

2 Asked to present. Attended in the past. 10/26/2016 3:02 PM

3 SBIRT and medication assisted treatment for opioid dependence 10/26/2016 2:45 PM

4 My director signed me up 10/26/2016 12:12 PM

5 O & E was new so my supervisor wanted someone in attendance 10/26/2016 12:07 PM

6 To become a better and more educated in becoming a stronger and more involved part of our board. I think it was veryinteresting and i learned some valuble information.

10/26/2016 12:00 PM

7 Auditor advisement 10/26/2016 11:48 AM

8 location 10/26/2016 11:47 AM

EmployerRequirement

GeneralInterest

Other Reason(please spec...

ProfessionalDevelopment

SpecificSpeaker/Topi...

Comments

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Employer Requirement

General Interest

Other Reason (please specify in Comments)

Professional Development

Specific Speaker/Topic (please specify in Comments)

Comments

6 / 30


9 NWRPCA support 10/26/2016 11:43 AM

10 Dental related programs 10/24/2016 4:27 PM

11 MAT talk on Sunday 10/21/2016 1:58 PM

12 oral health and beh health 10/21/2016 12:44 PM

13 Additional Board training 10/21/2016 9:11 AM

14 Opportunity to build relationships between CHCs and integrative health and medicien professionals 10/21/2016 8:34 AM

15 New in the CEO position and wanted to learn/network 10/21/2016 8:27 AM

16 Networking and past experience 10/21/2016 8:10 AM

17 Specific interest in MAT discussion 10/21/2016 7:59 AM

18 This is my third Fall Conference and they have all been outstanding 10/21/2016 6:41 AM

19 Trauma informed care 10/20/2016 7:34 PM

20 colorectal cancer screening 10/20/2016 6:40 PM

21 To attend NWRPCA Board Meeting 10/20/2016 5:13 PM

7 / 30


Q4 Ratings - Please rate on a scale of 5(strongly agree) to 1 (strongly disagree)


46.51%40

43.02%37

6.98%6

2.33%2

1.16%1

86

4.31

45.24%38

42.86%36

8.33%7

2.38%2

1.19%1

84

4.29

35.80%29

48.15%39

9.88%8

4.94%4

1.23%1

81

4.12

41.98%34

41.98%34

12.35%10

2.47%2

1.23%1

81

4.21

46.34%38

40.24%33

10.98%9

2.44%2

0.00%0

82

4.30

33.33%27

30.86%25

27.16%22

7.41%6

1.23%1

81

3.88

46.99%39

49.40%41

3.61%3

0.00%0

0.00%0

83

4.43

Theinformation...

I will use thetools I gain...

Theeducational...

Theeducational...

There wereadequate...

The exhibitsshowcased...

The conferencefacilities w...

The conferencefood and...

Theregistration...

Overall, Ifeel the...

0 1 2 3 4 5 6 7 8 9 10

5 4 3 2 1 Total WeightedAverage

The information presented in this conference will enhance my professionaleffectiveness.

I will use the tools I gained to improve the quality of services in my organization.

The educational sessions were consistent with their written descriptions.

The educational sessions met their stated learning objectives.

There were adequate networking opportunities.

The exhibits showcased products and services that could be useful to myorganization.

The conference facilities were conducive to learning.

8 / 30


34.15%28

29.27%24

26.83%22

8.54%7

1.22%1

82

3.87

60.49%49

32.10%26

3.70%3

1.23%1

2.47%2

81

4.47

53.93%48

39.33%35

5.62%5

1.12%1

0.00%0

89

4.46

# Comments Date

1 The breakfast was much appreciated, but it didn't provide significant satiation. 11/3/2016 9:44 AM

2 For the welcome receptions more food was needed and you really didn't need the band - it was way to loud tonetwork with others.

10/28/2016 12:43 PM

3 The registration process online was one of the worst- very difficult to get information and use the web based processfrom NWRPCA - please improve that

10/27/2016 8:02 AM

4 I feel it was a lot of the same information I have received before at other conferences, 10/26/2016 2:31 PM

5 I thought overall the presentations were helpful. I appreciated discussion and learning around our shared missions ofhelping underserved populations, in the midst of challenging reimbursement changes. Just a small comment: thebreakfasts (oatmeal and bagels every day) were lacking (how about some protein and fruit??).

10/26/2016 1:57 PM

6 The conference was great 10/26/2016 1:46 PM

7 would like to see more protein options for breakfast the coffee bar was a great idea! sessions were well planned andpresented

10/26/2016 11:43 AM

8 The only session I found lacking was #45 Emergency and Disaster Preparedness. Presenter had less knowledge thanmy HR Manager in shooter safety.

10/26/2016 11:43 AM

9 There were two sessions I attended (emergency preparedness and Leading from Within) that had misleadingdescription/objectives and ended up not being as helpful as I'd liked. I did note this on this on the evaluation for thesessions. Otherwise the sessions were outstanding.

10/26/2016 10:11 AM

10 I thought that the breakfast should have offered more selections 10/25/2016 6:24 AM

11 Would like more networking time - the 1 1/2 went by very fast. 10/24/2016 4:27 PM

12 While the conference was full of various topics of interest, I unfortunately felt like it was the "same old thing." Being inthe finance department I was hoping for that "Ah-haa" moment and to be provided with the tools necessary to put whatI learned into action. Most of the sessions that I attended were either spent reviewing graphs or stating what I feel isthe obvious. I don't mind reviewing graphs if I am provided with the tools to calculate the same numbers as it pertainsto my organization/area. I was hoping for more technical assistance rather than history of why things are the way theyare. I have to say that I am a bit disappointed, at least from a PCA standpoint.

10/24/2016 11:58 AM

13 Sitting for longer than an hour each session was very difficult, but I made it. 10/24/2016 9:46 AM

14 First time attendee and I look forward to attend next year's conference. 10/24/2016 9:15 AM

15 A variety in breakfast would be much appreciated. The same thing for 4 days was very unappealing. 10/24/2016 8:40 AM

16 Protein at breakfast would be nice. 10/24/2016 7:40 AM

17 Facility was awesome, only problem I ran into was getting kicked off the Wi-Fi quite frequently! 10/24/2016 5:48 AM

18 Several of the presentations were trying to sell their product or program - not ideal. It would be nice to have proteinoption for breakfast - possibly greek yogurt instead of regular yogurt.

10/23/2016 6:28 AM

19 breakfast was a food desert 10/21/2016 6:20 PM

20 Glad to have an O&E track, however the topics either need to be tailored towards PCAs or towards assisters andnavigators, one or the other. The split audience focus makes some sessions less valuable. It was great to have someleadership (CEOs, board members) in the room to get a better sense of the work.

10/21/2016 3:16 PM

21 I would have liked to have had access to the handouts prior. I would be happy to pay more to have handouts to makenotes on!!

10/21/2016 12:56 PM

22 The survey is not working properly. In the section “4. Ratings - Please rate on a scale of 5 (strongly agree) to 1(strongly disagree)” as I selected a response on a different row or column, it removed one or more of my responsethat I previously selected.

10/21/2016 9:55 AM

The conference food and beverage service was satisfactory.

The registration process was easy and efficient.

Overall, I feel the conference was a worthwhile experience.

9 / 30


23 The survey monkey wouldn't let me fill out all the questions. In brief, overall I had a great experience and enjoyed it. Acouple items for improvement would be the following. During the Sunday night networking event, you ran out of foodVERY quickly and it was also horrible for networking. I couldn't hear a thing so I couldn't talk to people. Most of thetime I was talking, I was either in their ear, or I was "smiling and nodding" but have no idea what they said. Also aminor complaint, on the name tags, I like to see where people are from and their organization was so small, youcouldn't read. Can you please print the organization larger next time.

10/21/2016 9:20 AM

24 My selections above won't stay "clicked". I marked "4" on all of them. 10/21/2016 9:11 AM

25 The questions above only allowed for one answer for each column. 10/21/2016 8:27 AM

26 the first and last day sessions were not very helpful. except the closing session. 10/21/2016 8:26 AM

27 This scale is not letting me rate all 5 it only lets me mark one in each number 10/21/2016 8:10 AM

28 The buttons for this section didn't work. When I would answer the first question, I could select my choice of response.When I went to the second question, it deleted my first response, and so on.

10/21/2016 7:31 AM

29 This question doesn't seem to be functioning correctly. It won't let you select one number more than once. 10/21/2016 7:19 AM

30 The above options did not work properly. my comments: a hot protein option for breakfast would have been nice, theconference was a bit too long. Perhaps on the 4th day - ending at noon would have increased attendance for theclosing plenary. Everything else was perfect! Thanks

10/21/2016 6:41 AM

31 You may want to fix your survey above. If you select "5" and "5" was already selected for a previous question, itremoves it from the previous question. Hence why the rest of my questions are unanswered.

10/21/2016 6:40 AM

32 I tried to mark most of the questions with a 5, but it would only allow me to mark one line item with a 5 rating. 10/20/2016 9:13 PM

33 My check marks will not hold 10/20/2016 8:14 PM

34 It seems I can only select each value once and I would rate each of these a 5 or 4. 10/20/2016 5:18 PM

35 The above tool has an issue. If I select a 4 on one line, it won't let me select 4 again. 10/20/2016 5:13 PM

36 SURVEY TOOL IS BROKEN!! I can only click one radio button in each column. 10/20/2016 5:13 PM

10 / 30


Q5 Monday Opening Plenary Speakers:Please rate on a scale of 5 (strongly agree)

to 1 (strongly disagree)Answered: 101 Skipped: 1

32.67%33

27.72%28

9.90%10

2.97%3

0.00%0

26.73%27

101

4.23

33.66%34

24.75%25

12.87%13

2.97%3

0.00%0

25.74%26

101

4.20

32.00%32

23.00%23

11.00%11

6.00%6

0.00%0

28.00%28

100

4.13

# Comments Date

1 Touch climate with elections in the air, no real clear direction from Federal level. 10/28/2016 10:32 AM

2 Would like classes on Board Governance not Monday, so to hear Plenary Speaker. 10/26/2016 8:31 PM

3 We Board members attended Saturday and Sunday only. 10/26/2016 7:16 PM

4 I work at a rural CHC; it seemed that Ms. Frizzera brought up all these changes in reimbursement that are coming,that I could not figure out how in the world we would make that happen in our setting. Then, in response to a questionat the end, she said, "This will not apply to rural sites".--????

10/26/2016 1:57 PM

5 Really appreciate these updates. 10/26/2016 12:11 PM

6 The keynote speaker was dry and would have like to have a speaker that gets the audience excited about the futureand what we are doing.

10/23/2016 6:28 AM

7 This was too political and felt the speakers were telling us who we should vote for. I believe in our Federally QualifiedHealth Centers, but do not believe our leaders should tell us who to vote for.

10/21/2016 9:55 AM

8 All aspects were beneficial. 10/21/2016 6:41 AM

The HRSAupdate from...

The NACHCupdate from ...

The Keynoteaddress by...

0 1 2 3 4 5 6 7 8 9 10

5 4 3 2 1 Didn'tattend

Total WeightedAverage

The HRSA update from Margaret Davis was timely and helpful.

The NACHC update from Dan Hawkins was timely and helpful.

The Keynote address by Charlene Frizzera offered useful insights andinformation.

11 / 30


Q6 Tuesday Closing Plenary Speaker:Please rate on a scale of 5 (strongly agree)

to 1 (strongly disagree)Answered: 101 Skipped: 1

17.82%18

9.90%10

3.96%4

0.00%0

0.00%0

68.32%69

101

4.44

# Comments Date

1 Entertaining, and very human insights, a nice close (hugs and all). 10/28/2016 10:32 AM

2 Inspiring, thoughtful individual. 10/26/2016 3:38 PM

3 Had to leave to catch flight out; sorry I missed it. 10/26/2016 1:57 PM

4 Was only there for Sat and Sun sessions. 10/26/2016 12:00 PM

5 I was unable to attend as I had to catch a flight home. I was disappointed, however, as I had heard many good thingsabout this speaker.

10/26/2016 10:11 AM

6 I really wanted to be there, but due to the time my flight was scheduled to depart and my unfamiliarity with the area Ihad to leave early. I hope that I can find it through the conference and watch it later.

10/24/2016 9:46 AM

7 Unfortunately due to my flight conflict, I was unable to attend the closing plenary session. 10/24/2016 8:40 AM

8 It seems add to have the closing address at the end of the last day - perhaps it would be better suited to the morningof the last day.

10/24/2016 7:40 AM

9 Awesome 10/21/2016 9:55 AM

10 Had to catch a flight. 10/21/2016 9:20 AM

11 Due to concerns about travel home, left on the final break. 10/21/2016 6:41 AM

12 too late in the day, I would have had to stay an extra day 10/20/2016 9:13 PM

The closingaddress by...

0 1 2 3 4 5 6 7 8 9 10

5 4 3 2 1 Didn'tattend

Total WeightedAverage

The closing address by Roberto Dansie offered useful insights andinformation.

12 / 30


Q7 I attended the Health Center Tour; it wasa worthwhile experience. Please rate on ascale of 5 (strongly agree) to 1 (strongly

disagree)Answered: 100 Skipped: 2

4.00%4

2.00%2

0.00%0

0.00%0

0.00%0

94.00%94

100

4.67

# Comments Date

1 After attending all the other lunch things I was feeling a little worn out by then, but it sounded worthwhile and if I amever brought back again I would surely go.

10/24/2016 9:46 AM

2 Best part of the conference 10/23/2016 8:31 AM

3 Great Tour 10/21/2016 3:59 PM

4 I have been there before. 10/21/2016 6:41 AM

Tour of SaludFamily Healt...

0 1 2 3 4 5 6 7 8 9 10

5 4 3 2 1 Didn't attend Total Weighted Average

Tour of Salud Family Health Centers

13 / 30


Q8 We measure the long-term impact of oureducational events, so please tell us how

you will apply the information, skills and/orresources gathered from this conference at

your organization.Answered: 50 Skipped: 52

# Responses Date

1 I connected with a vendor that may prove to be very useful for an initiative we plan to take. 11/3/2016 9:44 AM

2 I will be working with the National Center for Farmworkers health as a direct result of this session to pilot anassessment they are creating. We will be using the slides from the number 25 session to help in spreading our MATproject. We will be using the Healthcare Equity Index that I learned about at session 16.

10/28/2016 12:43 PM

3 There is always a lot more than can be processed. My goal is to come away with 2 insights that I can share and feelwill have an impact. 2 high leverage ideas/contacts is actionable, and more than compensates for the time and cost ofthe meeting.

10/28/2016 10:32 AM

4 I have taken back notes and tools to help implement in our meetings. 10/27/2016 11:24 AM

5 I appreciated the resources and best practices shared in the clinical, Behavioral health, and QI sessions. 10/27/2016 9:34 AM

6 Good advice to try at Board Meetings. 10/26/2016 8:31 PM

7 The VA session was of interest to me as I am a vet. We plan to recruit vets and treat them at our FQHC. 10/26/2016 7:16 PM

8 Try to incorporate into my practice 10/26/2016 3:39 PM

9 As a result of some of the sessions, I already shared ways that we can help with O&E marketing from a PCA'sperspective.

10/26/2016 3:38 PM

10 Useful BH integration ideas - will try to increase the effectiveness of our BH providers. 10/26/2016 3:02 PM

11 talking with a medical director helped me in putting together our new privileging process 10/26/2016 2:57 PM

12 Looking at ways to better integrate BH provider within medical clinic; also with clinical pharmacist. Helpful informationabout pain management; interesting presentation on buprenorphrine (which we do not prescribe but are beingpressured to); I now have face to face acquaintance with colleagues in the state, which will be a good resource.

10/26/2016 1:57 PM

13 To strengthen my role as board member 10/26/2016 1:53 PM

14 As a brand new board member I found a lot of the information useful. I will be proposing that we try a few things togain more Medicare patients.

10/26/2016 1:27 PM

15 I provided a brief summary of things we could add for consistant messaging throughout the organization 10/26/2016 12:07 PM

16 Make me a stronger and better board member. 10/26/2016 12:00 PM

17 I felt that some of the fiscal reports can be simplified for board members. 10/26/2016 11:48 AM

18 continued movement into payment reform, PCMH 10/26/2016 11:47 AM

19 brought back ideas for operations talked with vendors who will be of service in the near future 10/26/2016 11:43 AM

20 Ideas from other clinics on workflow, management and recruitment add creativity to our thought about how we dothings. Even though we may not want to duplicate or possible do have the staff to duplicate some of the new andcreative workflows it always gives us ideas on how we can improve on what we are currently doing.

10/26/2016 11:43 AM

21 Incorporate social determinant info in to our care management program Loved reminder to welcome new patients tothe practice.

10/26/2016 11:35 AM

22 I will use the suggestions on quality measures. 10/26/2016 10:11 AM

23 Educating others on value based payment at my clinic 10/25/2016 9:48 AM

24 Brought back information to suggest and possible implementation. Developed some resources with other CHC's in mystate to reach out to, which I plan to do.

10/24/2016 1:42 PM

14 / 30


25 Dental integration was what I wanted to get the most out of as we just added Dental to our scope of services. 10/24/2016 1:04 PM

26 I enjoyed Willam Augustine's presentation regarding the calendar affecting financials. This is something that I waspreviously aware of, however William explained it in a little more detail...and in a way that I will be able to share withthe Health Centers

10/24/2016 11:58 AM

27 We run an AmeriCorps program. The workforce development track will help us to implement a new model of avenuesto career.

10/24/2016 11:00 AM

28 Attending the events helped me to consider other perspectives and review my macro level of involvement as I havebeen often swept away by all that is going on at the patient level. I learned a lot about what others are doing, what iscoming ahead and how I might be apart of that in my clinic or help facilitate what others are doing at the macro level.

10/24/2016 9:46 AM

29 I am new to my position, as well as the Behavioral Health field and CHC's, and was very pleased with the wealth ofknowledge that I received.

10/24/2016 8:40 AM

30 It was wonderful to have so many sessions related to to behavioral health - thank you! 10/24/2016 7:40 AM

31 The Salud tour will help me plan future expansion of my clinic 10/23/2016 8:31 AM

32 Enhance our practice quality 10/22/2016 7:27 AM

33 The insights gained related to current and projected policy issues will highly influence my strategic thinking for myorganization.

10/21/2016 8:24 PM

34 We will go over lessons learned and implement change as necessary 10/21/2016 3:59 PM

35 The conference gave me a better perspective of the work on the ground level. It also highlighted how the lack ofMedicaid expansion in my state has stalled a lot of growth that could be happening in the O&E departments, creatinggreater sustainability for the work.

10/21/2016 3:16 PM

36 The information will be shared with appropriate staff, conduct trainings, implement/revise some processes anddocuments.

10/21/2016 12:56 PM

37 I always enjoy hearing about the different tactics various organizations are trying. We may not end up implementingthose tactics, but we will definitely explore them as possibilities.

10/21/2016 10:56 AM

38 This will help us as prepare for the quality reimbursement vs ffs etc. We also, brought several staff members todevelop their debt of knowledge in FQHC and operations etc.

10/21/2016 9:55 AM

39 Starting off with implementation. It is useful to have someone that has already done the process explain where to startand how to really make it take hold in the facilities

10/21/2016 9:11 AM

40 With each conference attendance I gain a better sense of the needs of CHCs and how we may partner for sharedsuccess.

10/21/2016 8:34 AM

41 Change theory worksheets, more strategic recruitment, focus on food security in clinical services 10/21/2016 8:26 AM

42 provider training and compliance 10/21/2016 8:26 AM

43 There were many resources and tools that we brought back to utilize. 10/21/2016 8:10 AM

44 We are starting are on Suboxone treatment program. And we may be contacting University of Washington to join thePMI program. Both of which were presented at the conference.

10/21/2016 7:59 AM

45 I will utilize the information I learned in the sessions I attended to expand and evolve training and technical assistanceofferings for our members.

10/21/2016 7:19 AM

46 Will use various spreadsheets provided by session leaders to help financial reporting 10/21/2016 7:03 AM

47 Still synthesizing the information -- there are some presentations that I will retrieve their power points. 10/21/2016 6:41 AM

48 I am thinking long and hard about clinical pharmacy. I'd really like to see if we can make that happen. 10/20/2016 5:18 PM

49 Will use lessons learned from Integrated BH sessions. 10/20/2016 5:13 PM

50 for strategic planning 10/20/2016 5:13 PM

15 / 30


Q9 What were your favorite sessions?Answered: 59 Skipped: 43

# Responses Date

1 The Star 2 Center presentation on recruitment and retention 11/3/2016 9:44 AM

2 Session 12 and 16 10/28/2016 12:43 PM

3 BH integration by the Salud manager. Community College partnerships 10/28/2016 10:32 AM

4 The trauma informed session. 10/27/2016 11:24 AM

5 How to implement clinical pharm services at your CHC; Opioid addiction epidemic: Using technology to expand MATtreatment in primary care; Responding to Rx Opioid epidemic: six building blocks for primary care; Evaluatingintegrated BH treatment outcomes; We need a bigger boat! Developing innovative programs to compete in newhealthcare marketplace

10/27/2016 9:34 AM

6 VA, those pertaining to Board members, and recruiting of populace (Veterans, Medicare, dental care) to our healthcenters.

10/26/2016 7:16 PM

7 Leadership within - Social Determinants of Health ****** 10/26/2016 4:47 PM

8 HR sessions 10/26/2016 3:39 PM

9 Oral health, O&E, and Salary Survey 10/26/2016 3:38 PM

10 Dental telehealth VA 10/26/2016 3:02 PM

11 Recruiting and Retention Project ECHO and Buprenorphine 10/26/2016 2:57 PM

12 Integrating BH, clinical pharmacist session, pain management by the presenter from Washington 10/26/2016 1:57 PM

13 Intro to Board Finance was by far my favorite session. 10/26/2016 1:27 PM

14 session 38 and 60 10/26/2016 12:11 PM

15 I only attended the O & E day the enroll america was a good session 10/26/2016 12:07 PM

16 Govt. Sessions and VA 10/26/2016 12:00 PM

17 Fiscal #8 Veteran Choice Programs; #21 Application of the Uniform Guidance Update; #30 Navigate the ChangingFederal Funding Environment,; #33 One Touch Billing; #43 Revenue Cycle; #48 Strengthening HLT Ctr RevenueCycle; CFO- CEO round table was great

10/26/2016 11:48 AM

18 leading from Within Health Centers in the searchlight 10/26/2016 11:47 AM

19 we need a bigger boat and colorectal cancer screening 10/26/2016 11:43 AM

20 #35, We need a bigger boat #52 medical/dental collaboration #55 Leadership presence - my favorite #60 Workforcebenchmarking - very informative

10/26/2016 11:43 AM

21 #1 Roberto Dansie - we need to work on our mindfulness and this was great! 10/26/2016 11:35 AM

22 Colorectal cancer screening (both sessions), Try a Mock Patient Visit, 10/26/2016 10:11 AM

23 I especially enjoyed the session on trauma and bringing together mental health into your practice. 10/25/2016 6:25 AM

24 Speaker from the ADA and Ethan from Salud 10/24/2016 4:27 PM

25 #27-Mock Visit with Lara Salazar Round Table Lunch #15 Food Insecurity with Prantl, Sleland and Kubik 10/24/2016 1:42 PM

26 Colorado clinic who did dental integration. 10/24/2016 1:04 PM

27 “Revenue Cycle Predictions…How the Calendar Can Affect your Financial Performance” – William Augustine. 10/24/2016 11:58 AM

28 Revenue Management and What does a CEO need from a CFO 10/24/2016 11:03 AM

29 Star2 Center workshops 10/24/2016 11:00 AM

30 My favorite session was one done around HR and how to help employees with wellness and investing in them. Wedon't have an official HR person and after listening to them and learning about what they are doing it just reinforcedhow much they are an important member of the team to retain employees and help with many tasks.

10/24/2016 9:46 AM

16 / 30


31 Building a Comprehensive and Strategic Recruitment & Retention Plan; Cybercrime, Ransonware and How toMinimize Risk at Your Facility; Emergency & Disaster Preparedness; Beyond Team Building: Creating a Culture ofValue & Connection; Workforce Benchmarking & Trends

10/24/2016 9:15 AM

32 Behavioral Health integration. The BH Roundtable discussion was phenomenal. 10/24/2016 8:40 AM

33 Behavioral health, Ag Worker 2020, PRAPARE tool implementation 10/24/2016 7:40 AM

34 Governance session on Cultural diversity by Maureen, Salud tour 10/23/2016 8:31 AM

35 I gained a lot from sessions on Integrating Behavioral Health, several workforce related sessions were very good andnetworking with Bestyr University folks was excellent.

10/21/2016 8:24 PM

36 Salud on shared visits 10/21/2016 6:20 PM

37 All equally enjoyed 10/21/2016 3:59 PM

38 Creating culture of coverage. 10/21/2016 3:16 PM

39 MAT session by CHC 10/21/2016 1:58 PM

40 FTLF's presentation. She always presents relevant information. 10/21/2016 12:56 PM

41 Dr G- Oral all beh health 10/21/2016 12:44 PM

42 Other than the general networking, I appreciate hearing what services organizations are integrating and whatinnovating ideas they are trying.

10/21/2016 10:56 AM

43 18, 27,34,46,58 10/21/2016 9:55 AM

44 Revenue Cycle Management 10/21/2016 9:20 AM

45 Opioid trainings and prevention. 10/21/2016 9:11 AM

46 HHS plenary session 10/21/2016 8:34 AM

47 Build Your Own (Residency programs) 10/21/2016 8:27 AM

48 Clinica nurse shared visits for the change theory model, medical directors roundtable 10/21/2016 8:26 AM

49 value based PCMH 10/21/2016 8:26 AM

50 Workforce benchmarking - Salary Survey; Medical/Dental Collaboration; Evaluating integrated BH; CHC Boards andthe Affordable Care Act

10/21/2016 8:10 AM

51 MAT discussion and the PMI discussion. 10/21/2016 7:59 AM

52 Leading from within: Impacts on Social Determinants of Health 10/21/2016 7:19 AM

53 What does a CEO need from a CFO, 19 program requirements from a fiscal perspective 10/21/2016 7:03 AM

54 4-How to implement Clinical Pharmacy. 27-Try a Mock Patient Visit. 50-Beyond Team Building 10/21/2016 6:52 AM

55 Everything that was timely and changing. I.e. payment reform, new approaches to clinical care and/or quality, etc. 10/21/2016 6:41 AM

56 Ransomware/Cyber security; however, it was geared toward the tech saavy individual not their actual audience. Theyalso did not have adequate knowledge in the area.

10/21/2016 6:40 AM

57 clinical pharmacy, integrated bx health (intro), opioid lecture with Tauben and Haddad were excellent 10/20/2016 5:18 PM

58 Integrated BH sessions. 10/20/2016 5:13 PM

59 networking with other CEOs 10/20/2016 5:13 PM

17 / 30


Q10 Do you have any suggestions forimproving future conferences?


# Responses Date

1 None 11/3/2016 9:44 AM

2 More high level QI/QA sessions - just having the CRC specific sessions was not beneficial. 10/28/2016 12:43 PM

3 Could it be somewhere where could be a little cheaper? Quite a few of our other Utah health centers can not affordone go!

10/26/2016 8:31 PM

4 It's disappointing that people leave early and do not stay for the closing session. I'm not certain how to help with thisbut here are some ideas: - have a closing speaker with lunch - entice people to stay by winning giveaway items - haveclosing speaker in the morning before all the sessions end

10/26/2016 3:38 PM

5 As a clinician, I sometimes felt like there wasn't a session aimed at me in a few of the time slots. 10/26/2016 3:02 PM

6 more clinician (medical) networking and co-learning opportunities 10/26/2016 2:57 PM

7 Would like the powerpoints on thumb drive or a webb based site for participants to pull from during the presentation.Like to take notes on the particular slide when and where applicable.

10/26/2016 2:48 PM

8 Newer information for the Revenue Cycle 10/26/2016 2:31 PM

9 I thought it would be good to have a short time (perhaps 30min) set aside at end of day; those of us who had multipleattendees from the same CHC could meet up, exchange the "hot topics" they learned about in their various tracks,and prioritize which and how to start to address them on our return home. Yes, we could have set that up after 5 pmfor ourselves, but of our group, one person had a Board meeting, another was networking with colleagues from othersites, etc, so having it scheduled into the agenda would have helped it happen.

10/26/2016 1:57 PM

10 More and better laydowns to aid in educating board members . 10/26/2016 1:53 PM

11 More about specific outreach activities would be nice to share with other organizations. Like I go to Farmers Marketsin the summer. What do other organizations do for outreach

10/26/2016 12:07 PM

12 None 10/26/2016 12:00 PM

13 Is there anyway to wind down around noon on the 4th day, I often miss the last part of the conference due to timeaway from work and flight availability.

10/26/2016 11:43 AM

14 no 10/26/2016 11:35 AM

15 No. I think the sessions are relevant and useful, the facility is outstanding. 10/26/2016 10:11 AM

16 The days seemed long especially after if there was going to be an evening event. 10/25/2016 6:25 AM

17 4 days was very long..... 10/25/2016 6:24 AM

18 Liked the Denver location much better than the Seattle location. 10/24/2016 1:42 PM

19 keep apprised as to up coming changes with HRSA and CMS requirements. New PIN/PAL about changes toEmergency Operations Plan just came out and should have been a topic discussed. Timing could have been an issue.

10/24/2016 1:04 PM

20 I have been with our PCA for less than a year and have been to several conferences. I continue to hear the sameinformation at each event, and believe the majority of the attendees have as well. For me personally, I would like toattend a conference that provides more technical assistance...the "how to's" rather than (again) reviewing graphs ordiscussing history.

10/24/2016 11:58 AM

21 More technology involvement 10/24/2016 11:00 AM

22 If there was some way to do tables differently so that all the seating options faced forward that would be great.Rectangular tables would be nice and can still be gathered around if needed.

10/24/2016 9:46 AM

23 none 10/24/2016 9:15 AM

24 Make sure the class descriptions match the content. I came early for a Saturday session that was different than thedescription.

10/24/2016 8:41 AM

18 / 30


25 Rooms got too cold in the afternoon, and a breakfast variety would be appreciated. 10/24/2016 8:40 AM

26 Moving the closing plenary to the beginning of the last day, rather than at the end of the day 10/24/2016 7:40 AM

27 Having advanced and basic governance tracks was good when available 10/23/2016 8:31 AM

28 Clinical sessions - I would really like to have a longer peer to peer session - I think this was by far the best session ofthe whole 4 days.

10/23/2016 6:28 AM

29 No...it was a great conference. Thank you for posting the slides for all the sessions. It is good to have the ones for thesessions we weren't able to attend.

10/21/2016 8:24 PM

30 N/A 10/21/2016 3:59 PM

31 More rooms with windows, warmer in the room 10/21/2016 1:58 PM

32 Some of the speakers, especially on the finance side where extremely difficult to listen to. Their tone was to monotoneand flat. It was not engaging at all. The content was excellent, but the delivery was unengaging.

10/21/2016 9:55 AM

33 In brief, overall I had a great experience and enjoyed it. A couple items for improvement would be the following. Duringthe Sunday night networking event, you ran out of food VERY quickly and it was also horrible for networking. I couldn'thear a thing so I couldn't talk to people. Most of the time I was talking, I was either in their ear, or I was "smiling andnodding" but have no idea what they said. Also a minor complaint, on the name tags, I like to see where people arefrom and their organization was so small, you couldn't read. Can you please print the organization larger next time.

10/21/2016 9:20 AM

34 As the majority of the Board training was held on a different floor, it felt like we were out of the loop from the rest ofthe conference.

10/21/2016 9:11 AM

35 more racial diversity with speakers/presenters 10/21/2016 8:34 AM

36 During many of the breakout sessions, all of the lights were left on and so it was VERY difficult to read anything on thescreens that were used for the PowerPoint presentations. There lights should have been turned down. Atleast at theend of the room where the screens were located.

10/21/2016 8:27 AM

37 Better organized and prepared clinical track - perhaps choose member organizations to present on qualityimprovement, value-based purchasing developments or other evidence based programs. Some of the services felt likethey were selling their wares to us

10/21/2016 8:26 AM

38 yes. I wonder why there is not even an option for NP & DNP in the tile section, both on this online format and in-session evaluation forms. as the national leaders in healthcare, I am surprised that our leading organizations are notupdated on the landscape changes. DNP is a doctorate-prepared NP. It is an unique animal in its training andeducation. it should be recognized separately. in addition, NP is the main workforce in PCP, especially in rural areas,why it is not stated clearly in the options for participants to choose?

10/21/2016 8:26 AM

39 Dynamic speakers certainly help energize the topics 10/21/2016 8:10 AM

40 None 10/21/2016 7:19 AM

41 Not sure why the conference dates include the weekend, but would rather see the conference held between Mondayand Friday.

10/21/2016 7:03 AM

42 Perhaps shorten the total length. 10/21/2016 6:41 AM

43 Yes, add additional IT courses. It seems like FQs are far behind the power curve of understanding the importance oftechnology in removing barriers for the organization. Check out some of the larger health systems to see how theyembrace IT and how it positively affects patient care. I also challenge you to have additional tracks that include more"soft skill" classes. Leadership, Organizational Culture, Change Management...etc. Leaders can't implement whatthese classes are teaching if they don't have the transformational leadership skills, the ability to influence culture,and/or the ability to implement change effectively.

10/21/2016 6:40 AM

44 great sessions! 10/20/2016 5:18 PM

45 More healthy food options during social hour and breaks. Minimize the use group discussions during thepresentations.

10/20/2016 5:13 PM

46 perhaps do an advanced skills track. Financial analysis, ratio use, etc. Overall organizational review tools, efficiencybenchmarking, etc.

10/20/2016 5:13 PM

19 / 30


Q11 What are some topics you would like tosee explored at future conferences?


# Responses Date

1 healthcare website trends and best practices 11/3/2016 9:44 AM

2 More sessions on working with the LGBTQ community along with other specialty populations such as migratory andseasonal farmworkers, homeless and elderly. Would also like to see best practices on how providers areaccomplishing everything needed for the Medicare Advantage population and keeping up with encounter numbersoverall. A session or 2 on care management/care coordination.

10/28/2016 12:43 PM

3 Integrated Strategic and Financial Planning - Kaufman Hall is the best at this, though might be challenging as we arevery small generally i.e. not their typical market. Realistic ways to avoid the general trend to PCP burnout - even usingit as a strategic weapon for recruiting in an ever more competitive landscape.

10/28/2016 10:32 AM

4 More about trauma informed care, cultural diversity and more peer driven services. 10/27/2016 11:24 AM

5 Recruitment and retention of providers to community health centers. 10/26/2016 3:38 PM

6 VA and IHS partnering. Community Center Health Home ideas Difficult clinician topics - alcohol addiction medicine,rural health delivery, PTSD/adrenal fatigue, health care disparities for the Deaf or non-English speaker

10/26/2016 3:02 PM

7 more on new health care payment model... still very confused on how it will e rolled out. Maybe everyone is? 10/26/2016 2:48 PM

8 Ongoing discussions in helping balance numbers of patients seen, along with Quality measures, reaching out to"difficult" populations, etc. Perhaps some training on the work( or even a presentation?!? I don't know if she does any)by Ruby Payne. More detailed info about how to reconcile/address all the MULTIPLE measures: UDS, PCMH, allthese others where we are always trying to work on--and maybe it could be split such that groups that use eCW haveone presenter, and those using other EMR's could work together, etc.

10/26/2016 1:57 PM

9 I am fairly new to the position so i'm not sure 10/26/2016 12:07 PM

10 I would of liked a little more information on the cost reports ( allowable vs non allowable); program, overhead, etc. 10/26/2016 11:48 AM

11 Models of full integration, medical, dental and behavioral health. Leadership tools for the generational challengesResource training, there are a lot of entities and information out there, what would be the best and how can we worktogether so we are not all creating our own wheel.

10/26/2016 11:43 AM

12 Clinical measures - presentations from those at the top of the 1st quartile....how did they get there? 10/26/2016 11:35 AM

13 Continue with the same - PCMH, MU, UDS, Quality are all subjects that fall into my work. 10/26/2016 10:11 AM

14 QI, optimal staffing of support staff to provider and rooms per provider to optimize care. 10/25/2016 8:15 AM

15 continue to offer integration and quality topics 10/24/2016 1:04 PM

16 Anything FQHC finance related, but hands on education 10/24/2016 11:58 AM

17 Medicare Cost Reporting 10/24/2016 11:03 AM

18 none 10/24/2016 9:15 AM

19 All areas Behavioral Health 10/24/2016 8:40 AM

20 Social determinants of health, additional behavioral health sessions 10/24/2016 7:40 AM

21 Conflicts of interest for board members 10/23/2016 8:31 AM

22 I expect there will be many health systems testing various clinical models with "whole person care/health" and valuebased payment alignment. It would be great to be learning from others as we explore our own.

10/21/2016 8:24 PM

23 Focused discussions on QI/QA, PCMH, MACRA, MIPS, and so on 10/21/2016 3:59 PM

24 Long term planning for O&E work (what's the future of O&E), better integration into other duties, creative ways to fundO&E, implications of new POTUS on ACA and insurance.

10/21/2016 3:16 PM

25 Deeper discussion on the Medicare value-based payment reform (MACRA) and how to prepare and effectivelyimplement the new initiative into our organizations.

10/21/2016 10:56 AM

20 / 30


26 I like the meat of numbers and business processes. However, what I find is that the hardest part of our jobs is dealingwith employees (adult baby siting) effectively. Some training for HR and Exec about this. Also, what does it mean to bea leader? What is the leaders role in setting the tone for the organization, for other exec, etc. Do they allow room forstaff to develop and grow within the organization?

10/21/2016 9:55 AM

27 Different aspects of revenue cycle management 10/21/2016 9:20 AM

28 Consolidations, Mergers, Acquisitions of Health Centers Negotiation of Risk/Value Based contracts 10/21/2016 8:27 AM

29 PCMH workflow - optimizing staff members; case management activities 10/21/2016 8:26 AM

30 more provider specific and CMO oriented 10/21/2016 8:26 AM

31 social determinants; more dental integration; How to be better at telling our story of what we do to business and whatwe do better than anyone else; disaster and emergency warm handoffs;

10/21/2016 8:10 AM

32 Provider retention, and changing primary care order to retain more providers. 10/21/2016 7:59 AM

33 Provider productivity, how to develop meaningful training opportunities and programs for front line staff 10/21/2016 7:19 AM

34 Operations budgeting - best practices; 990 tax issues and updates 10/21/2016 7:03 AM

35 More Quality transformation sessions and PCMH sessions. 10/21/2016 6:52 AM

36 I appreciate the effort and time it took to coordinate a conference of this magnitude with nearly 60 breakouts --- notsure what additional topics could be offered. Just to stay in tuned to what is happening nationally and regionally.

10/21/2016 6:41 AM

37 See statement above regarding soft skill classes... 10/21/2016 6:40 AM

38 more opioid presentations. these were great. would like to learn more about shared care management b/w bx healthand primary care

10/20/2016 5:18 PM

39 See # 10 How to avoid burnout and still stay effective in small organizations. 10/20/2016 5:13 PM

21 / 30


Q12 Are there speakers and/or vendors youwould recommend for future conferences?


# Responses Date

1 None 11/3/2016 9:44 AM

2 Continue to bring Mo on, she is awesome. 10/27/2016 11:24 AM

3 see #11 10/26/2016 1:57 PM

4 Ms. Heidi Traylor with Terry Reilly Hlth Ser. was inspirational and that hlth center progress was amazing. 10/26/2016 11:48 AM

5 Adele Allison Andrea Martin Lisa Hardmeyer Gray and George Brewster Steve Geiermann 10/26/2016 11:43 AM

6 Next >> 10/25/2016 3:24 PM

7 Although the vendors probably would have preferred to talk with another professional rather than directly with theprovider in many instances I feel like I learned something from several of them as they were familiar with who theyworked with such as my CEO and identified them by name. That was impressive to me and again helped me to learnabout how our CHC is working with some of them already to care for patients, employees and the community at large.

10/24/2016 9:46 AM

8 none 10/24/2016 9:15 AM

9 Honestly, I didn't spend that much time with the vendors. Just glad they are supporting the conference. 10/21/2016 8:24 PM

10 N/A 10/21/2016 3:59 PM

11 Jessica Kendall from Families USA. 10/21/2016 3:16 PM

12 Nope. 10/21/2016 9:20 AM

13 Patrick Bucknum, CEO & President, Community Clinic Contracting Network 10/21/2016 8:27 AM

14 would like to have dr. Roberto to be back! 10/21/2016 8:26 AM

15 Professor Robert McCann - Communicating for Impact; Pamela Byrnes always great!; Steven Geiermann was alsogreat and oral health topics

10/21/2016 8:10 AM

16 None 10/21/2016 7:19 AM

17 Possibly someone from the AICPA 10/21/2016 7:03 AM

18 None at this time 10/21/2016 6:41 AM

19 Stand up comedian - a funny speaker would be a good break from all the seriousness... 10/20/2016 5:13 PM

22 / 30


Q13 Are there any other comments orsuggestions you would like to make?


# Responses Date

1 None 11/3/2016 9:44 AM

2 You put on a good conference! 10/28/2016 10:32 AM

3 Overall great sessions, useful information, and engaged particpants! Thanks! 10/27/2016 9:34 AM

4 Don't like having to register with different emails and then can only reserve rooms after registration! 10/26/2016 8:31 PM

5 thanks! 10/26/2016 2:57 PM

6 Thanks! I really enjoyed it. 10/26/2016 1:57 PM

7 another great conference - thank you for making it happen 10/26/2016 11:43 AM

8 Thank you for providing this opportunity to learn and network. 10/26/2016 11:43 AM

9 The food service was very disappointing. The snacks were out or late. Some of the lunches were out of salads andmeats and staff had to be found and asked to refill them.

10/25/2016 8:15 AM

10 Thank you for the wonderful experience and I hope to be offered the opportunity to attend again as I feel I can onlylearn more.

10/24/2016 9:46 AM

11 The venue was nice and convenient to downtown Denver. 10/24/2016 9:15 AM

12 Thank you for a very wonderful experience. 10/24/2016 8:40 AM

13 The speakers on emerging state and federal policy issues is really great to have. 10/21/2016 8:24 PM

14 It gets better every time. 10/21/2016 3:59 PM

15 Great to network. 10/21/2016 3:16 PM

16 Same as already noted. 10/21/2016 9:20 AM

17 Overall, very good and informative. Well Done!!! 10/21/2016 9:11 AM

18 Great conference! 10/21/2016 8:34 AM

19 as I have stated in the #10. also, I would highly recommend using provider neutral language. As the healthcareworkforce evolved, it is inevitably that NP will be taking on more and more responsibilities. Neither Mid-level orextender is accurate nor respectful when referring to NPs. thanks.

10/21/2016 8:26 AM

20 None. Thank you for all of your hard work related to this. 10/21/2016 7:19 AM

21 Great conference -- thank you! 10/21/2016 6:41 AM

22 Add "IT" onto your feedback forms that are handed out in the class. 10/21/2016 6:40 AM

23 Do we really have to have completely healthy food at NWRPCA board retreat meals? 10/20/2016 5:13 PM

23 / 30


Q14 Are there speakers and/or vendors youwould recommend for future conferences?


# Responses Date

1 None 11/3/2016 9:44 AM

2 ISFP - if you can get Kaufman Hall to come that would be ideal. If not, I am willing to give it my best shot. 10/28/2016 10:34 AM

3 Peak Vista CHC regarding their APN fellowship and MD residency program. 10/26/2016 3:40 PM

4 I think her name was Adele - great information and good speaker! 10/26/2016 2:50 PM

5 See question 12 10/26/2016 11:44 AM

6 No 10/26/2016 10:12 AM

7 Pharmacy and limited pharmacy for CHC's. 10/24/2016 1:43 PM

8 don't know of any 10/24/2016 1:06 PM

9 The vendors were all great! The speakers I can remember as I don't have my booklet in front of me were the twopresenting on veterans issues which was very helpful, HR, behavioral health presenter group of three psychologistsand the clinical provider who presented on the elderly and how he is reaching them.

10/24/2016 9:52 AM

10 none 10/24/2016 9:15 AM

11 Not at this time. 10/21/2016 8:27 PM

12 N/A 10/21/2016 4:00 PM

13 Dr. Gail Christopher Dr. Kim Tippens- IM4US Board Member 10/21/2016 8:35 AM

14 Patrick Bucknum, President & CEO, Community Clinic Contracting Network 10/21/2016 8:31 AM

15 direct relief; ECHO 10/21/2016 8:27 AM

16 No. 10/21/2016 7:20 AM

17 none that I can think of. 10/21/2016 7:05 AM

18 none at this time 10/21/2016 6:42 AM

19 no. 10/20/2016 5:21 PM

20 someone to discuss the triple aim 10/20/2016 5:14 PM

24 / 30


100.00% 7

85.71% 6

85.71% 6

Q15 We are looking for health centers thathave innovative, effective best practices in

all areas of operations: clinical, fiscal,technology, customer service, marketing,etc. If your health center is working with

new programs or approaches, we invite youto share your expertise with your peers at a

future conference. List your topic andcontact information below.You can also

submit your proposal online in the NWRPCA abstract portal.


# Topic Date

1 ISFP - Integrated Strategic and Financial Planning 10/28/2016 10:34 AM

2 Whole Person Health Group Visits Care Model 10/21/2016 8:27 PM

3 Value Based Provider Compensation: Aligning Incentives 10/21/2016 8:31 AM

4 Rural CHC-Public Health partnership to combat opioid dependence; Diabetes wellness group visits; Prenatal groupvisits

10/21/2016 8:28 AM

5 Medical Assistant Training Program 10/21/2016 7:20 AM

6 None at this time 10/21/2016 6:42 AM

7 Opioid Oversight in the FQHC/Primary Care Setting: How to Do It and How to Get Paid For It; Advanced IntegratedCare: Shared Care Management Between Behavioral Health and Primary Care

10/20/2016 5:21 PM

# Name Date

1 David Edwards 10/28/2016 10:34 AM

2 Jesus Hernandez 10/21/2016 8:27 PM

3 David Olson, CEO Columbia Valley Community Health 10/21/2016 8:31 AM

4 James Wallce 10/21/2016 8:28 AM

5 N/A 10/21/2016 6:42 AM

6 Lesley Brooks, MD 10/20/2016 5:21 PM

# Email address Date

1 [email protected] 10/28/2016 10:34 AM

2 [email protected] 10/21/2016 8:27 PM



5 N/A 10/21/2016 6:42 AM


Topic

Name

Email address

25 / 30


2013 Median 2014 Median 2015 Median 2016 Median

Financial Indicators

Total Margin 3.0% 10.1% 2.6% 5.0%

Operating Margin 4.80% 6.05% 2.58% 4.95%

Growth in Net Patient Revenue 11.48% 9.18% 4.16% 18.64%

Current Ratio 3.72 3.84 4.35 3.38

Net Days in Accounts Receivable 39 44 71 33

Average Payment Period (Days) 14.24 15.00 19.60 16.04

Days Cash on Hand 65 63 86 74

Debt to Equity 28.4% 22.6% 24.8% 20.8%

Operating Indicators

Revenue Per Encounter 212$ 259$ 235$ 272$

Cost Per Encounter 198$ 243$ 209$ 249$

Bad Debt as % of Net Patient Revenue 6.3% 3.4% 8.5% 4.8%

Salary Per FTE 49,268$ 50,826$ 48,571$ 50,524$

Benefits Per FTE 9,646$ 10,760$ 11,908$ 9,816$

Fully Loaded Labor Costs Per FTE 61,507$ 63,522$ 60,733$ 60,395$

Employee Benefits as % of Fully Loaded Labor 16.46% 16.30% 17.32% 17.65%

Program Expenses as % of Total Expense 85.46% 79.06% 80.01% 81.79%

General & Administrative as % of Total Expense 14.22% 20.94% 19.99% 18.21%

Productivity & Other Measures

Patients Per Physician 2,114 3,125 3,349 2,215

Medical Patients Per Physician and Mid‐Level 983 941 969 918

Daily Medical Encounters Per Provider 14.4 14.1 13.7 12.7

Dental Patients Per Dentist 1,117 1,178 1,233 1,049

Dental Patients Per Dentist & Hygienist 678 324 763 627

Daily Dental Encounters Per Dentist & Hygienist 13.8 13.0 13.3 13.4

Average Daily Encounters Per Billing Dept. FTE 33.92 34.91 28.26 25.67

Average Patients Per Billing Dept. FTE 2,258 2,539 2,173 1,673

Revenue Per FTE 101,771$ 110,551$ 107,910$ 105,161$

Net Patient Service Revenue Per FTE 52,815$ 58,143$ 45,851$ 55,560$

2016 AMFOP Participants

12 CHCs participated ‐ 4 from CO, 3 from MT, 2 from ND, 1 from SD, 1 from UT, 1 from WY.







Annual Measure of Finance, Operations and Productivity (AMFOP)

2013 ‐ 2014 ‐ 2015 ‐ 2016 Region VIII Comparison

48

CHAMPS Outreach & Enrollment (O&E) & Special Populations (SP) Activities

October 2016 – February 2017 O&E Resource Creation Activities

o Update Affordable Care Act (ACA)/ Outreach and Enrollment / Health Insurance Literacy webpages regularly. For example, added the HHS Uninsured Outreach Mapping Tool and Tutorial.

o Created the 2015 UDS O&E Infographic.

O&E Communications o Send weekly information and resource updates to Region VIII PCA Outreach &

Enrollment (O&E) colleagues. o Write weekly O&E LinkedIn posts on CHAMPS Region VIII Health Center Program

Network Discussion Group. o Send monthly O&E resource emails to Region VIII health center O&E staff. o Send Region VIII O&E updates to Health Resources and Services Administration

(HRSA) and National Association of Community Health Centers (NACHC), as appropriate.

o Provide O&E articles for the CHAMPS quarterly newsletter such as articles outlining the Internal Revenue Service (IRS) 2017 Tax Season resources and RUPRI Center for Rural Health Policy Analysis on 2016 Rural Enrollment in Health Insurance Marketplaces, by State.

O&E Partnerships o Host twice-monthly calls with Region VIII PCA O&E staff. o Collaborate with Enroll America representatives in Region VIII. o Attend calls and webinars on O&E issues from local and national partners, send notes

to Region VIII PCA O&E staff. o Engage and collaborate on educational events and resource creation and distribution

with the Community Health Improvement Project Manager at NWRPCA.

O&E Meeting/Conference Attendance o Attended the Colorado Community Health Network (CCHN) January triannual

meeting O&E Managers Workgroup on January 12, 2017. o Attended the Families USA Health Action Conference February 15-17, 2017.

Region VIII Open Enrollment 4 Data

o Region VIII had 453,972 individuals with 2017 plan selections through the State-Based (SBM) or Federally-Facilitated (FFM) Marketplaces. Of these individuals 103,390 (23%) were new consumers who did not have a Marketplace plan selection as of November 2016. In Region VIII, out of the 453,972 individuals with 2017 plan selections 296,320 (65%) received an advanced payment of a premium tax credit and/or a cost-sharing reduction.

Future Outreach and Enrollment Activities

o In collaboration with CCHN, CHAMPS will offer an O&E Distance Learning Series during summer of 2017 focused on O&E topics identified by Region VIII O&E staff.

49

SP Resource Creation Activities o Update Special Populations/ Homeless and Public Housing Resources/ Lesbian, Gay,

Bisexual, and Transgender (LGBT) Resources/ Migrant and Seasonal Farmworkers (MSFW) Resources/ Veterans Resources webpages regularly. For example, the addition of the National Center for Farmworker Health (NCFH) bilingual health education mini-lesson packets.

SP Communications

o Host quarterly calls with Region VIII PCA Special Populations (SP) staff. o Send information and resource updates to Region VIII PCA SP colleagues, as

appropriate. o Write weekly SP LinkedIn posts on CHAMPS Region VIII Health Center Program

Network Discussion Group. o Provide SP articles for the CHAMPS quarterly newsletter. For example, highlighting

new lead guidelines for migrants from Migrant Clinicians Network (MCN), and Medical-Legal Partnerships Promote Community Health from the Rural Health Information Hub.

SP Partnerships

o Attend calls and webinars on SP issues from local and national partners; send notes to Region VIII PCA SP staff. For example, attending “Health and Other Discrimination Protections for the LGBTQ Community” hosted by HRSA and “Connecting American Indian and Alaska Native Children to Health Coverage” hosted by InsureKidsNow.gov.

o Engage in information sharing on SP activities with the Community Health Improvement Project Manager at NWRPCA.

Future Special Populations Activities

o In collaboration with Region VIII PCA SP staff, will pilot hosting a quarterly video conferencing call for Region VIII community health centers (CHCs) receiving homeless funding.

50

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Community Health Association of Mountain/Plains States

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(CHAMPS)(CCHN)

Don't Miss:

The 2016 Outreach and Enrollment Distance Learning Series occurred from June-September 2016.All of the events are now available as on-demand webinars on the CHAMPS YouTube channel.

The following events are currently available:

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http://bit.ly/2cTCpBl

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52

Community Health Association of Mountain/Plains States (CHAMPS) 1

2016 CHAMPS/CCHN Outreach & Enrollment (O&E) Distance Learning Series All Events Summary CHAMPS/CCHN Live and Archived ClickWebinar Events

Summary of Events This document provides a brief overview of the 2016 CHAMPS/CCHN O&E Distance Learning Series events, speakers, verified attendees, and the overall satisfaction rating from the event surveys (sent out after each webinar for participants to complete). The 2016 CHAMPS/CCHN O&E Distance Learning Series had an average satisfaction score of 8.90. CHAMPS/CCHN will continue to offer the Summer O&E Distance Learning Series and work on increasing participation throughout Region VIII Community Health Centers.

Event Title Speaker Organization Date Average Participant

Satisfaction on a Scale of 1–10 (10=most satisfied)

Providing Effective Assistance to Survivors of Domestic Violence

Colorado Coalition Against Domestic Violence

Future without Violence, O’Rourke Health Policy Strategies

June 23, 2016 9.63

Assisting Clients with Complex Medical Needs

Center on Budget and Policy Priorities

July 14, 2016 8.75

Engagement and Advocacy for O&E Staff

Families USA CHAMPS

August 18, 2016 8.75

Habits of Highly Effective Assisters Enroll America Sept. 22,

2016 8.46 *This data was collected from the completed individual event surveys sent to participants after each webinar event.

Participation by State This table shows the number of participants who attended each webinar session via their computer or telephone. Total number of participants was 161 in all four webinars.

Event Title CO MT ND SD UT WY

Unknown/Outside of

Region VIII

Providing Effective Assistance to Survivors of Domestic Violence 9 9 0 3 5 7 0

Assisting Clients with Complex Medical Needs 10 3 0 2 5 5 1 Engagement and Advocacy for O&E Staff 22 10 0 2 7 5 5 Habits of Highly Effective Assisters 30 8 0 2 6 5 0

*This was collected from the ClickWebinar attendee tracking function (i.e. those who attended each session the day of).

53


2016 O&E Distance Learning Series Follow-up Summary Report Out of the 161 participants attending the four webinar events, 88 were unique participants. To gain insight on the implementation of resources and information from the 2016 O&E Distance Learning Series, CHAMPS sent a follow-up survey in February 2017 to the 88 unique participants. Below are the survey questions and responses. Twelve participants filled out the survey representing 11 different organizations from four Region VIII states: CO-6, MT-1, ND-0, SD-2, UT-0, WY-3. Evaluation Questions

1) Did you participate in the distance learning event “Providing Effective Assistance to Survivors of Domestic Violence” on Thursday, June 23, 2016? (Answered:12, Skipped:0)

Response # Responses Yes 4 No 8

2) Did you participate in the distance learning event “Assisting Clients with Complex Medical Needs” on Thursday, July 14, 2016? (Answered:8, Skipped: 4)


3) Did you participate in the distance learning event “Engagement and Advocacy for O&E Staff” on Thursday, August 18, 2016? (Answered:7, Skipped:5)


4) Did you participate in the distance learning event “Habits of Highly Effective Assisters” on Thursday, September 22, 2016? (Answered:6, Skipped:6)


5) Since the webcast, have you or other assistance staff in your health center implemented a screening policy to identify survivors of domestic violence? (Answered:3, Skipped:9)

Response # Responses Yes 1 No 0 Unsure 2 Comments: We incorporated the information hen sharing information with Climb

Wyoming and other informational sessions to educate how survivors of domestic violence can obtain health insurance on the Health Insurance Marketplace.

6) Did you participate in the distance learning event “Assisting Clients with Complex Medical Needs” on Thursday, July 14, 2016? (Answered: 4, Skipped: 8)


7) Since the webcast, have you or other enrollment assisters in your health center utilized the plan selection worksheet to help consumers compare plan options? (Answered: 3, Skipped: 9)

Response # Responses Yes 1 No 2 Unsure 0 Comments: We use the plan and compare on HealthCare.gov.

54


8) Since the webcast, have you used any of the strategies presented in the webcast to assist enrolled members of federally recognized tribes enroll in health insurance? (Answered: 3, Skipped: 9)

Response # Responses Yes 2 No 0 Unsure 1

9) Did you participate in the distance learning event “Engagement and Advocacy for O&E Staff” on Thursday, August 18, 2016? (Answered: 4, Skipped: 8)


10) Since the webcast, have you or other assisters at your health center registered clients to vote or provided voter education activities? (Answered: 4, Skipped: 8)


11) Did you participate in the distance learning event “Habits of Highly Effective Assisters” on Thursday, September 22, 2016? (Answered: 5, Skipped: 7)


12) Since the webcast, have you used any of the messaging suggested during the presentation in your own outreach activities? (Answered: 10, Skipped: 2)


13) Do you have any other comments, questions, or concerns about the series?

(none)

14) Do you have suggestions for future Outreach & Enrollment Distance Learning Series Topics?

Timely updates on changes occurring with the new president and congress.

15) Health Center Name Cheyenne Regional Medical Center Clinica Family Health Rural Health Care, Inc. Uncompahgre Medical Center Pueblo Community Health Center

55

COMMUNITY HEALTH ASSOCIATION OF MOUNTAIN/PLAINS STATES TRAINING & CONFERENCE CALENDAR

2017

March 21-22 CHAMPS/NWRPCA CORE Competency Training for New CHC Supervisors & Managers

Embassy Suites Portland Downtown, Portland, OR www.champsonline.org March 28-April 2 NACHC Policy & Issues Forum Marriott Wardman Park, Washington, DC www.nachc.org April 19-20 Montana PCA Spring Symposium Best Western Great Northern Hotel, Helena, MT www.mtpca.org April 21-24 CHAMPS Spanish Language for Healthcare Professionals Denver Medical Society, Denver, CO www.champsonline.org May 2-3 CHAD Membership Conference Hotel TBD, Fargo, ND www.communityhealthcare.net May 3-5 Wyoming PCA Annual Conference Hotel TBD, Casper, WY

www.wypca.org

May 11-12 AUCH Annual Primary Care Conference Utah Cultural Celebration Center, West Valley City, UT www.auch.org May 22-24 Conference for Agricultural Worker Health Savannah Marriott Riverfront, Savannah, GA www.nachc.org August 25-29 NACHC Community Health Institute Manchester Grand Hyatt, San Diego, CA www.nachc.org October 21-24 CHAMPS/NWRPCA Conference

Hyatt at Olive 8, Seattle, WA www.champsonline.org

November 13-15 NACHC PCA & HCCN Conference Hilton Austin, Austin, TX www.nachc.org

56

2018 March 13-18 NACHC Policy & Issues Forum Marriott Wardman Park, Washington, DC www.nachc.org May 5-7 Conference for Agricultural Worker Health Hilton Palacio Del Rio, San Antonio, TX www.nachc.org August 24-28 NACHC Community Health Institute Hyatt Regency Orlando, Orlando, FL www.nachc.org October 20-23 CHAMPS/NWRPCA Conference

Westin Denver Downtown, Denver, CO www.champsonline.org

2019

March 26-April 2 NACHC Policy & Issues Forum Marriott Wardman Park, Washington, DC www.nachc.org August 16-20 NACHC Community Health Institute Hyatt Regency Chicago, Chicago, IL www.nachc.org

2021 August 20-24 NACHC Community Health Institute Hyatt Regency Orlando, Orlando, FL www.nachc.org

57

CHAMPS Executive Committee

2016 – 2017 Recruitment Activities Report

April 2016 – January/February 2017

CHAMPS advertises Region VIII Health Center career opportunities through the CHAMPS online

Job Opportunities Bank (JOB).

395 positions have been advertised on JOB between

April 1 and January 31, 2017, posted by 64 different Health

Centers and Primary Care Associations (PCAs) from all six

Region VIII states:

o 53 Administration/Management (AM) positions

(13.4% of total)

o 47 Behavioral Health (BH) positions (11.69%)

o 41 Clinical Dental (CD) positions (10.4%)

o 126 Clinical Medical (CM) positions (31.9%)

o 70 Clinical Support (CS) positions (17.7%)

o 58 Non-Clinical Support (NCS) positions (14.7%)

CHAMPS advertises the positions posted on JOB and promotes the Health Center model of care

through attendance at career fairs and conferences and via e-marketing to a growing

distribution list of job seekers and regional and national educational institutions.

April 2016-February 2017: Monthly/Bimonthly JOB E-mail Blast to 600+ job seekers

advertising CHAMPS Member openings posted on JOB in the previous month plus job-seeking

tips, resources, and upcoming events

July 2016: American Academy of Family Physicians (AAFP) National Conference,

targeting family medicine students and residents – 46 contacts made

November 2016: National Network for Oral Health Access Annual Conference, targeting

dentists, hygienists, dental directors, and dental students – 25 contacts made

January 2017: Biannual E-mail Blast advertising JOB openings to 40+ representatives at 25+

educational institutions

February 2017: Regis University Career and Internship Fair, targeting business, health

administration, information technology, and psychology students – 39 contacts made

July 2017: American Academy of Family Physicians (AAFP) National Conference

CHAMPS collaborates with Region VIII state PCAs, National Health Services Corps (NHSC), and

other partners to coordinate activities and develop recruiting events.

May, August, November 2016 and February 2017: Region VIII PCA Recruitment &

Retention Networking Call, quarterly call to discuss upcoming activities and future

collaborations

May, August, November 2016 and February 2017: Region VIII Veterans Steering

Committee calls to plan and implement activities aimed at lowering the rate of unemployment

among returning veterans in Region VIII by connecting eligible veterans to vacancies and

training opportunities in HRSA-supported programs, and increasing the number of veterans

receive health care in Region VIII health centers

May 2016, February 2017: Denver Area Health Care Recruiters Association (DAHCRA),

meetings to discuss recruiting issues and resources

November 2016: Colorado Corps Community Connection to celebrate current and past

Colorado and National Health Service Corps members and create interest in potential future

Corps members through NEW trainings addressing various clinical and dental topics plus a

reception and awards ceremony

AM

BH

CD

CM

CS

NCS

58

http://www.champsonline.org/JobBank/JobOpportunitiesBank.html

CHAMPS Job Opportunities Bank (JOB)

Data Comparison Infographic

Clinical Dental 10.7%

Behavioral

Health

12.3%

Admin./

Mngmnt.

13.3%

Non-Clinical

Support

15.9%

Clinical

Support

18.0%

Clinical

Medical

29.9%

Average Recruiting Length of

Closed Positions (In Months) Top Recruiting Resources

Employee Referral

8.2%

Newspaper/Local Advertising

3.5%

Local Referral/Word of Mouth 2.9%

Contacted by Candidate Directly 2.9%

Clinical Medical

Clinical Dental

Administrative/

Management

Behavioral Health

Clinical Support

Non-Clinical

Support

3.7

4.0

5.0

5.4

5.8

14.0

Read the complete CHAMPS JOB Data Comparison Report at www.CHAMPSonline.org/ToolsProducts/PublicationsMedia/Publications.html#job

422 Positions Posted (Up 14.7% from previous year)

247 Positions Closed (Up 3.3% from previous year)

173 Positions Filled (Down 2.3% from previous year)

Types of Positions Posted

CHAMPS Job Opportunities Bank (JOB) data is from 02/2016 - 01/2017.

Online Listing 20.0%

Internal

Hire 11.8%

Hired Former Employee/Intern 2.9%

59

Region VIII CO MT ND SD UT WY Region VIII CO MT ND SD UT WY POSITIONS ON JOB DURING YEAR*Total Number All Positions+ 385 269 50 12 18 20 16 434 311 37 28 18 30 10Total Number CHC-Specific Positions 368 255 49 12 17 19 16 422 302 36 28 17 29 10CHC Positions Carried Over from Previous Year 125 83 25 2 6 6 3 133 77 22 9 10 10 5CHC Positions Newly Posted During Year 243 172 24 10 11 13 13 289 225 14 19 7 19 5Number of CHCs Posting Positions 58 20 18 5 3 7 5 56 18 16 5 4 10 3All CHC-Specific Positions - Breakdown by Position Type***

Administrative/Management Positions 77 58 9 1 2 5 2 56 43 2 2 0 7 2Behavioral Health Positions 21 14 7 0 0 0 0 52 38 7 6 0 0 1

Clinical Dental Positions 31 21 4 2 4 0 0 45 28 7 2 5 3 0Clinical Medical Positions 122 66 26 6 7 7 10 126 66 19 12 9 14 6Clinical Support Positions 56 45 3 1 3 2 2 76 61 1 5 3 5 1

Non-Clinical Support Positions 61 51 0 2 1 5 2 67 66 0 1 0 0 0

CHC-SPECIFIC POSITIONS CLOSED DURING YEAR**Total Number CHC-Specific Positions Closed 239 181 26 5 7 9 11 247 203 16 1 4 16 7Percentage of Total Active During Year 64.9% 71.0% 53.1% 41.7% 41.2% 47.4% 68.8% 58.5% 67.2% 44.4% 3.6% 23.5% 55.2% 70.0% Average Recruitment Length in Months 8.9 6.6 25.9 6.3 20.3 6.3 3.7 6.5 6.0 10.5 4.8 12.0 7.5 7.8Positions Filled 177 153 7 4 6 2 5 173 143 10 1 4 9 6 Average Recruitment Length in Months 6.5 5.8 9.8 6.0 23.5 5.7 3.6 6.1 5.3 11.6 4.8 12.0 9.7 6.7Positions Withdrawn, Not Filled 27 18 5 0 1 1 2 13 10 1 0 0 1 1 Average Recruitment Length in Months 18.5 8.5 66.7 0.8 11.3 0.3 7.0 5.3 2.9 - - 20.5 17.3Positions Status Unknown 35 10 14 1 0 6 4 59 49 4 0 0 6 0All Closed CHC-Specific Positions (Filled, Withdrawn, and Unknown) - Breakdown by Position Type***

Closed Administrative/Management Positions 62 47 8 1 2 2 2 47 36 2 1 0 7 1 Average Recruitment Length in Months 4.1 4.1 4.3 7.1 2.0 6.3 0.6 5.4 5.0 1.8 4.8 - 9.3 0.9

Closed Behavioral Health Positions 11 9 2 0 0 0 0 30 25 4 0 0 0 1 Average Recruitment Length in Months 11.2 6.9 30.4 - - - - 5.0 4.1 9.6 - - - 9.9

Closed Clinical Dental Positions 20 16 3 0 1 0 0 23 16 4 0 1 2 0 Average Recruitment Length in Months 11.9 8.7 32.1 - 2.0 - - 3.7 3.9 4.1 - 3.4 1.9 -

Closed Clinical Medical Positions 60 37 10 3 2 2 6 44 27 6 0 2 5 4 Average Recruitment Length in Months 18.8 12.5 43.8 7.5 65.4 19.7 5.8 14.0 14.5 18.5 - 12.8 10.2 10.3

Closed Clinical Support Positions 38 33 3 0 1 0 1 49 45 0 0 1 2 1 Average Recruitment Length in Months 6.9 6.4 14.3 - 4.3 0.0 4.4 5.8 5.8 - - 19.0 0.6 2.6Closed Non-Clinical Support Positions 48 39 0 1 1 5 2 54 54 0 0 0 0 0 Average Recruitment Length in Months 2.8 3.2 - 1.5 0.9 0.9 0.1 4.0 4.0 - - - - -

Filled Clinical Positions - Breakdown by TitleFilled Dentist/Dental Director Positions 14 12 1 0 1 0 0 13 9 2 0 1 1 0

Average Recruitment Length in Months 9.4 10.4 4.7 - 2.0 - - 3.7 3.5 5.2 - 3.4 3.2 -Filled Physician/Medical Director Positions 20 13 1 1 2 0 3 11 8 1 0 0 1 1

Average Recruitment Length in Months 18.5 12.1 49.7 18.2 65.4 - 4.5 16.3 16.6 17.1 - - 17.9 11.7Filled PA/NP/CNM Positions 12 10 0 2 0 0 0 12 5 1 0 1 3 2

Average Recruitment Length in Months 8.6 9.8 - 2.2 - - - 9.0 9.0 1.1 - 18.2 10.8 6.1

*Positions posted on JOB do not represent all Region VIII CHC positions available.**Filled or otherwise closed positions may not have been de-activated immediately by posting organizations.***Refer to page 2 for a breakdown of posted and closed positions by discipline within each type.+Includes postings by Region VIII Primary Care Associations (PCAs).

Region VIII Job Opportunities Bank (JOB) Data Comparison Report

February 2015 - January 2016 February 2016 - January 2017

60

Region VIII Job Opportunities Bank (JOB) Data Comparison Report, continued

02/2015 - 01/2016 02/2016 - 01/2017POSTED CLOSED FILLED** POSTED CLOSED FILLED** RECRUITMENT RESOURCES FOR FILLED CHC-SPECIFIC POSITIONS

CHC-SPECIFIC POSITIONS POSTED, CLOSED, & FILLED DURING YEAR Total Number Closed 239 247Total Number 368 239 177 422 247 173 Positions Filled 177 170CHC-Specific Positions - Breakdown by Discipline Recruitment Resources for All Filled CHC-Specific Positions

Admin./Management Positions 77 62 49 56 47 29 Recruitment Resource Unknown 41 76Chief Executive 10 9 6 7 7 1 Online Listing 38 34

Finance Executive/Manager 12 7 5 10 6 3 Internal Hire 38 20Operations Executive/Manager 5 4 2 4 4 4 Employee Referral 21 14

Clinical Operations Executive/Manager 14 12 11 4 4 3 Newspaper / Local Advertising 9 6Clinical Programs Executive/Manager 4 4 3 2 2 2 Local Referral / Word of Mouth 11 5

Quality Improvement (QI) Executive/Manager 4 4 4 1 1 1 Contacted by Candidate Directly 6 5Human Resources Executive/Manager 2 2 1 1 1 0 Hired Former Employee / Intern / Extern 4 5

Other Executive/Manager 26 20 17 26 18 14 Recruiter / Locums 5 2Behavioral Health Positions 21 11 8 52 30 23 Educational Facility 2 2

Behavioral / Mental Health Executive/Manager 0 0 0 0 0 0 Hospital Contract 0 1Behavioral Healtlh Provider1 21 11 8 36 16 13 Top Recruitment Resources by Position Type***Clinical Dental Positions 31 20 16 45 23 18 Total Filled Admin./Management Positions 49 29

Dental Director 1 1 1 3 1 0 Internal Hire 16 6Dentist 25 14 13 31 13 13 Newspaper / Local Advertising 7 5

Dental Hygienist 5 5 2 8 5 3 Online Listing 9 4Clinical Medical Positions 122 60 34 126 44 29 Employee Referral 1 2

Medical Director 13 10 6 10 7 3 Total Filled Behavioral Health Positions 8 23Physician (see below for specialties) 60 27 13 57 14 8 Online Listing 1 5

Nurse Practitioner &/or Physician Assistant 45 21 13 53 19 12 Internal Hire 1 2Pharmacist/Pharmacy Manager 4 2 2 5 4 4 Contacted by Candidate Directly 0 2

Physician Positions - Breakdown by Specialty Employee Referral 1 1Physician Positions 60 27 13 57 14 8 Local Referral / Word of Mouth 0 1

Family Practice 28 10 5 25 10 5 Newspaper / Local Advertising 1 1Family Practice with OB 3 1 1 2 1 1 Total Filled Clinical Dental Positions 16 18

Family Practice or Internal Medicine 3 2 0 2 0 0 Internal Hire 2 5Internal Medicine 2 1 0 2 0 0 Employee Referral 3 4

Extended Care 0 0 0 0 0 0 Hired Former Employee / Intern / Extern 1 2Faculty 2 2 1 1 0 0 Online Listing 0 1

OB/GYN 3 1 1 2 0 0 Educational Facility 1 1Pediatrics 1 1 0 2 1 0 Total Filled Clinical Medical Positions 34 29

Primary Care 2 2 0 0 0 0 Online Listing 6 4Senior Care 0 0 0 0 0 0 Local Referral / Word of Mouth 2 3

Sports Medicine 1 0 0 1 0 0 Internal Hire 6 3Urgent Care 1 0 0 1 0 0 Employee Referral 4 2Unspecified 14 7 5 17 2 2 Hired Former Employee / Intern / Extern 1 2

Contacted by Candidate Directly 2 1Educational Facility 1 1

Total Filled Clinical Support Positions 30 36Online Listing 9 10

Employee Referral 8 3Internal Hire 3 1

Recruiter / Locums 0 1Total Filled Non-Clinical Support Positions 40 35

Online Listing 11 10Internal Hire 10 4

Employee Referral 4 4Contacted by Candidate Directly 3 2

Reruiter / Locums 0 1

1Includes postings with the credentials of LCSW, LCPC, LPC, MSW, Clinical Psychologist

*Positions posted on JOB do not represent all Region VIII CHC positions available.

**Includes positions that were specifically reported as filled; other closed positions may also have been filled, but are not listed unless specifically reported as such.

***Numbers of filled positions with unknown recruitment resources are not shown.

Successful Recruitment Resources for Filled PositionsPosted, Closed, & Filled Positions by Discipline within Each Type*02/2015 - 01/2016 02/2016 - 01/2017

61

*BPHC Health Center Program Grantees; Region VIII included one Health Center Program Look-Alike (LA) organization in 2015. LA data is not available at state or regional levels, and is not included in this fact sheet.

Health center data from BPHC’s Uniform Data System (UDS) State and National Grantee Rollups, http://bphc.hrsa.gov/datareporting/. For more Region VIII UDS information, visit http://champsonline.org/tools-products/publications-electronic-media/champs-publications#UDSsummary.

Colorado 20

Grantees

Montana

17

Grantees

North Dakota

4 Grantees

South Dakota

6 Grantees

Utah 13

Grantees

Wyoming

6 Grantees

660,985

(72%)

493,815

(54%) 385,786

(42%) 273,888

(30%) 162,980

(18%) 79,193

(9%)

71% 54% 42% 31% 17% 8% 76% 58% 33% 41% 15% 8% 0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

At or Below

200% FPL

At or Below

100% FPL

Regular Medicaid

(Title XIX)

Uninsured Private

Insurance

Medicare

(Title XVIII)

2015 2014 2013

REGION VIII HEALTH CENTERS IN 2015 – 66 TOTAL GRANTEES

LOCATION OF REGION VIII HEALTH CENTERS

920,231 TOTAL REGION VIII HEALTH CENTER PATIENTS IN 2015

Agricultural Worker/Dependent Patients 24,757 3% Patients Aged Under 1-17 299,005 32%

Homeless Patients 51,762 6% Patients Aged 18-64 552,841 60%

School-Based Health Center Patients 41,731 5% Patients Aged 65+ 68,385 7%

Veteran Patients 16,255 2%

Region VIII Health Center* Fact Sheet

Region VIII = Colorado, Montana, North Dakota,

South Dakota, Utah, and Wyoming

The health centers within the Bureau of Primary Health Care (BPHC) Health Center Program provide high-

quality, affordable, and accessible primary health care, most often to indigent, medically underserved, and

underinsured populations in a wide range of communities, from inner cities to rural expanses. As of 2015 there are

more than 1,370 health center organizations operating in the United States, serving over 24.2 million people.

These include community health centers, school-based health centers, migrant health centers, health care for the

homeless centers, and public housing primary care health centers. Each of these health centers must:

Be located in area of high need Be open to all regardless of ability to pay

Provide services that fit the needs and priorities of the community

Offer primary care and other services to ensure access (translation, transportation, etc.)

Provide high quality care, reducing disparities and improving patient outcomes

REGION VIII PATIENTS BY FEDERAL POVERTY LEVEL (FPL) AND INSURANCE

74.2% 54.8%

25.8% 45.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Health Centers in

Region VIII, 2015

Health Centers

Nationwide, 2015

Rural Grantees Urban Grantees

62

http://bphc.hrsa.gov/datareporting/

http://champsonline.org/tools-products/publications-electronic-media/champs-publications#UDSsummary

*BPHC Health Center Program Grantees; Region VIII included one Health Center Program Look-Alike (LA) organization in 2015. LA data is not available at state or regional levels, and is not included in this fact sheet.

Health center data from BPHC’s Uniform Data System (UDS) State and National Grantee Rollups, http://bphc.hrsa.gov/datareporting/. For more Region VIII UDS information, visit http://champsonline.org/tools-products/publications-electronic-media/champs-publications#UDSsummary.

**For more information about Healthy People 2020, visit www.healthypeople.gov/2020/default.aspx.

Total Full Time Equivalent (FTE) 7,489.86

Total Visits 3,488,129

Medical Services FTE 2,793.87

Medical Services Visits 2,506,062

Physicians FTE 399.82

Physician Visits 1,046,269

NPs / PAs / CNMs FTE 529.76

NP / PA / CNM Visits 1,369,107

Dental Services FTE 647.20

Dental Services Visits 481,417

Dentists FTE 169.81

Dentist Visits 356,743

Dental Hygienists FTE 108.04

Dental Hygienist Visits 124,674

Mental Health Services FTE 270.89

Mental Health Services Visits 189,075

Enabling Services FTE 888.25

Enabling Services Visits 272,299

Pharmacy FTE 291.31

Substance Abuse Services Visits 6,485

Facility / Non-Clinical Support FTE 2,494.84

REGION VIII PERFORMANCE ON SELECTED CLINICAL PERFORMANCE MEASURES /

HEALTHY PEOPLE 2020 GOALS (HP2020**)

Percentage of appropriate patients with/receiving the following:

Region VIII Health Centers* in 2015, continued

REGION VIII HEALTH CENTER STAFFING AND VISITS

REGION VIII MEDICAL AND DENTAL

PRODUCTIVITY (VISITS/FTE)

REGION VIII PERFORMANCE ON

FINANCIAL PERFORMANCE MEASURES

$827

$177 $146

$-

$100

$200

$300

$400

$500

$600

$700

$800

$900

Total Cost

per Patient

Medical Cost

per Medical

Patient

330 Grant Cost

per Patient

2,617 2,584

2,101

0

500

1,000

1,500

2,000

2,500

3,000

Physicians NPs / PAs /

CNMs

Dentists

78.1% 68.2%

54.3% 65.3%

8.0%

76.3%

32.9%

80.0% 85.4%

93.0%

61.2%

7.8%

77.9%

70.50%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Immunizations Controlled

Diabetes

PAP

Test

Controlled

Hypertension

Low Birth

Weight

Prenatal

Care in 1st

Trimester

Colorectal

Cancer

Screening

Region VIII Health Center Performance - 2015 HP2020 Goal

63

http://bphc.hrsa.gov/datareporting/

http://champsonline.org/tools-products/publications-electronic-media/champs-publications#UDSsummary

http://www.healthypeople.gov/2020/default.aspx

CHAMPS Region VIII (CO, MT, ND, SD, UT, WY) Summary of 2015 Bureau of Primary Health Care (BPHC)

Health Center Program Grantee* Uniform Data System (UDS) Information

November 2016

Table of Contents:

I. Overview: Grantees, Patients, Staffing, Clinic Visits, and Income Page 2 Region VIII Summary of 2011-2015 Information

Page 3 Region VIII 2015 Breakdown by State, Region, and Nation Page 4 Region VIII 2015 Percentages by State, Region, and Nation

II. Selected Staffing Metrics Page 5 Medical and Dental Productivity: Region VIII and National Comparison, 2013-2015 Page 6 Medical and Dental Productivity: Region VIII 2015 Breakdown by State, Region, and Nation

Page 7 Key Staff Tenure: Region VIII and National Comparison, 2014-2015 Page 8 Key Staff Tenure: Region VIII 2015 Breakdown by State, Region, and Nation

III. Health Center Program Financial Performance Measures and Related Factors Page 9 Region VIII and National Comparison of 2013-2015 Information Page 10 Region VIII 2015 Breakdown by State and Region

IV. Health Center Program Clinical Performance Measures

Selected Health Outcomes and Disparities: Diabetes and Hypertension Page 11 Region VIII and National Comparison of 2013-2015 Information

Page 12 Region VIII 2015 Breakdown by State and Region Page 13 Region VIII 2015 Percentages by State, Region, and Nation

Selected Healthy People 2020 Goals Page 14 Region VIII 2013-2015 Breakdown by State and Region

Page 15 Region VIII and National Comparison of 2013-2015 Information

Highlighted Emerging Topic: Depression

Page 15 Region VIII 2014-2015 Breakdown by State, Region, and Nation

Community Health Association of Mountain/Plains States (CHAMPS)

600 Grant Street #800, Denver, CO 80203

Phone (303) 861-5165 Fax (303) 861-5315

www.CHAMPSonline.org

*There was one Region VIII Health Center Program Look-Alike (LA) organization in 2015.

LA data is not available at state or regional levels, and is not included in this report.

64

http://www.champsonline.org/


Region VIII (CO, MT, ND, SD, UT, WY) Uniform Data System (UDS) Summary, 2011-2015

2011 2012 Change

'11-'12 2013 Change

'12-'13 2014 Change

'13-'14 2015 Change

'14-'15

Change

'11-'15

Grantees

Total Grantees 56 60 7.1% 62 3.3% 63 1.6% 66 4.8% 17.9%

Service Sites N/A 380 N/A 389 2.4% 362 -6.9% 399 10.2% N/A

Patients

Total Patients 796,870 811,659 1.9% 825,405 1.7% 868,720 5.2% 920,231 5.9% 15.5%

Agricultural Worker/Dependent Patients 23,165 25,763 11.2% 21,106 -18.1% 23,575 11.7% 24,757 5.0% 6.9%

Homeless Patients 52,457 49,227 -6.2% 48,988 -0.5% 49,391 0.8% 51,762 4.8% -1.3%

School Based Health Center Patients 30,211 27,624 -8.6% 30,441 10.2% 35,121 15.4% 41,731 18.8% 38.1%

Veteran Patients 13,096 12,470 -4.8% 13,135 5.3% 15,210 15.8% 16,255 6.9% 24.1%

Uninsured Patients 343,028 340,100 -0.9% 335,096 -1.5% 269,075 -19.7% 273,888 1.8% -20.2%

Regular Medicaid (Title XIX) Patients 246,145 254,761 3.5% 270,798 6.3% 360,959 33.3% 385,786 6.9% 56.7%

Medicare (Title XVIII) Patients 59,603 62,452 4.8% 66,105 5.8% 72,951 10.4% 79,193 8.6% 32.9%

Private Insurance Patients 116,741 120,385 3.1% 127,664 6.0% 145,661 14.1% 162,980 11.9% 39.6%

Patients at 100% and Below FPL* 467,934 486,968 4.1% 476,503 -2.1% 471,025 -1.1% 493,845 4.8% 5.5%

Patients at 101-200% FPL* 140,608 148,287 5.5% 150,832 1.7% 147,597 -2.1% 167,170 13.3% 18.9%

Patients above 200% FPL* 42,524 42,720 0.5% 46,339 8.5% 49,718 7.3% 103,686 108.5% 143.8%

Patients Aged Under 18 269,293 270,866 0.6% 277,938 2.6% 284,226 2.3% 299,005 5.2% 11.0%

Patients Aged 18-64 474,667 485,551 2.3% 490,667 1.1% 521,357 6.3% 552,841 6.0% 16.5%

Patients Aged 65+ 52,910 55,242 4.4% 56,800 2.8% 63,137 11.2% 68,385 8.3% 29.2%

Staffing

Total Full Time Equivalent (FTE) 5,581.21 5,866.94 5.1% 6,139.21 4.6% 6,786.10 10.5% 7,489.86 10.4% 34.2%

Physicians FTE 360.6 366.28 1.6% 354.58 -3.2% 373.31 5.3% 399.82 7.1% 10.9%

NPs / PAs / CNMs FTE 384.55 409.1 6.4% 666.61 62.9% 481.62 -27.8% 529.76 10.0% 37.8%

Dentists FTE 128.19 135.11 5.4% 140.78 4.2% 152.76 8.5% 169.81 11.2% 32.5%

Dental Hygienists FTE 66.78 72.55 8.6% 75.91 4.6% 90.82 19.6% 108.04 19.0% 61.8%

Pharmacy FTE 223.39 232.41 4.0% 241.79 4.0% 261.88 8.3% 291.31 11.2% 30.4%

Mental Health Services FTE 140.43 180.95 28.9% 205.68 13.7% 209.42 1.8% 270.89 29.4% 92.9%

Enabling Services FTE 655.55 687.56 4.9% 738.34 7.4% 901.11 22.0% 888.25 -1.4% 35.5%

Facility / Non-Clinical Support FTE 1,863.46 1,980.01 6.3% 2,017.20 1.9% 2,261.64 12.1% 2,494.84 10.3% 33.9%

Clinic Visits

Total Visits 3,054,383 3,121,809 2.2% 3,137,359 0.5% 3,316,957 5.7% 3,488,129 5.2% 14.2%

Medical Services Visits 2,262,050 2,299,114 1.6% 2,312,147 0.6% 2,429,959 5.1% 2,506,062 3.1% 10.8%

Dental Services Visits 378,074 390,806 3.4% 399,692 2.3% 426,010 6.6% 481,417 13.0% 27.3%

Mental Health Services Visits 132,644 146,026 10.1% 156,990 7.5% 164,952 5.1% 189,075 14.6% 42.5%

Substance Abuse Services Visits 16,721 11,885 -28.9% 9,392 -21.0% 7,291 -22.4% 6,485 -11.1% -61.2%

Vision Services Visits 12,880 14,086 9.4% 4,185 -70.3% 5,435 29.9% 6,387 17.5% -50.4%

Enabling Services Visits 220,979 226,930 2.7% 230,167 1.4% 253,410 10.1% 272,299 7.5% 23.2%

Income**

Total Income from All Sources $552.8M $595.0M 7.6% $640.4M 7.6% $732.6M 14.4% $823.9M 12.5% 49.1%

Health Resources and Services Administration. 2015 Health Center Data. Available from URL: http://bphc.hrsa.gov/uds/datacenter.aspx [accessed October 3, 2016].

*Federal Poverty Level. **Collected patient-related revenue plus other revenues.

65

http://bphc.hrsa.gov/uds/datacenter.aspx


Region VIII Uniform Data System (UDS) Breakdown by State, Region, and Nation, 2015

CO MT ND SD UT WY Region VIII Nation

Grantees

Total Grantees 20 17 4 6 13 6 66 1,375

Rural Grantees* 12 16 3 5 8 5 49 754

Urban Grantees* 8 1 1 1 5 1 17 621

Service Sites 191 74 20 49 52 13 399 UNK

Patients

Total Patients 553,807 104,033 36,016 64,271 143,712 18,392 920,231 24,295,946

Agricultural Worker/Dependent Patients 11,985 3,568 329 336 8,532 7 24,757 910,172

Homeless Patients 31,906 5,848 2,224 3,473 5,700 2,611 51,762 1,191,772

School Based Health Center Patients 26,841 335 0 5,652 8,903 0 41,731 649,132

Veteran Patients 6,965 4,240 1,070 2,119 1,176 685 16,255 305,520

Uninsured Patients 119,979 40,770 10,276 20,062 76,379 6,422 273,888 5,927,831

Regular Medicaid (Title XIX) Patients 316,869 19,034 10,782 11,024 25,166 2,911 385,786 11,719,096

Medicare (Title XVIII) Patients 44,393 13,171 3,149 7,334 8,890 2,256 79,193 2,167,040

Private Insurance Patients 61,699 29,769 11,706 21,574 31,449 6,783 162,980 4,071,824

Patients at 100% and Below FPL** 331,075 47,862 12,510 19,846 78,242 4,310 493,845 12,599,400

Patients at 101-200% FPL** 101,000 21,336 6,349 12,626 23,026 2,833 167,170 3,779,143

Patients above 200% FPL** 33,578 10,695 5,597 6,797 36,477 10,542 103,686 1,381,574

Patients Aged Under 18 196,249 20,280 10,157 19,973 48,867 3,479 299,005 7,589,449

Patients Aged 18-64 322,346 72,353 22,376 36,817 85,746 13,203 552,841 14,785,556

Patients Aged 65+ 35,212 11,400 3,483 7,481 9,099 1,710 68,385 1,920,941

Staffing

Total Full Time Equivalent (FTE) 4,798.36 835.36 282.85 459.81 917.17 196.31 7,489.86 188,851.75

Physicians FTE 272.89 42.36 6.03 19.23 52.53 6.78 399.82 11,687.21

NPs / PAs / CNMs FTE 316.39 54.61 21.69 51.49 71.58 14.00 529.76 10,332.14

Dentists FTE 98.82 24.39 9.25 11.79 22.64 2.92 169.81 4,108.23

Dental Hygienists FTE 66.34 14.10 8.90 8.05 8.17 2.48 108.04 1,920.86

Pharmacy FTE 167.05 26.16 19.60 1.56 59.71 17.23 291.31 4,105.69

Mental Health Services FTE 183.29 44.42 5.28 3.04 28.80 6.06 270.89 7,780.76

Enabling Services FTE 621.58 97.90 28.78 18.12 104.59 17.28 888.25 18,859.49

Facility / Non-Clinical Support FTE 1,541.09 288.03 103.81 184.03 293.72 84.16 2,494.84 67,961.50

Clinic Visits

Total Visits 2,248,349 390,334 116,885 208,169 467,807 56,585 3,488,129 96,951,585

Medical Services Visits 1,615,611 255,084 75,773 164,584 351,216 43,794 2,506,062 67,399,269

Dental Services Visits 291,302 64,703 28,826 33,771 56,074 6,741 481,417 13,157,202

Mental Health Services Visits 126,976 29,096 2,255 5,744 22,547 2,457 189,075 7,251,495

Substance Abuse Services Visits 512 2,459 761 54 2,699 0 6,485 1,038,230

Vision Services Visits 2,641 194 1,787 79 1,606 80 6,387 672,015

Enabling Services Visits 196,196 37,115 4,529 3,478 27,468 3,513 272,299 5,789,657

Income+

Total Income from All Sources $533.9M $86.1M $30.2M $44.3M $113.0M $16.3M $823.9M $21.0B


*From BPHC’s State and National UDS Summary Reports. **Federal Poverty Level. +Collected patient-related revenue plus other revenues.

66



Region VIII Uniform Data System (UDS) Percentages by State, Region, and Nation, 2015


Grantees

Grantees as % of RVIII Grantees 33.3% 28.3% 6.7% 10.0% 21.7% 10.0% 100.0% N/A

Rural Grantees* as % of All Grantees 60.0% 94.1% 75.0% 83.3% 61.5% 83.3% 74.2% 54.8%

Urban Grantees* as % of All Grantees 40.0% 5.9% 25.0% 16.7% 38.5% 16.7% 25.8% 45.2%

Patients

All Patients as % of RVIII Patients 60.2% 11.3% 3.9% 7.0% 15.6% 2.0% 100.0% N/A

Agricultural Worker/Dependent Patients as % of All Patients 2.2% 3.4% 0.9% 0.5% 5.9% 0.0% 2.7% 3.7%

Homeless Patients as % of All Patients 5.8% 5.6% 6.2% 5.4% 4.0% 14.2% 5.6% 4.9%

School Based Health Center Patients as % of All Patients 4.8% 0.3% 0.0% 8.8% 6.2% 0.0% 4.5% 2.7%

Veteran Patients as % of All Patients 1.3% 4.1% 3.0% 3.3% 0.8% 3.7% 1.8% 1.3%

Uninsured Patients as % of All Patients 21.7% 39.2% 28.5% 31.2% 53.1% 34.9% 29.8% 24.4%

Regular Medicaid (Title XIX) Patients as % of All Patients 57.2% 18.3% 29.9% 17.2% 17.5% 15.8% 41.9% 48.2%

Medicare (Title XVIII) Patients as % of All Patients 8.0% 12.7% 8.7% 11.4% 6.2% 12.3% 8.6% 8.9%

Private Insurance Patients as % of All Patients 11.1% 28.6% 32.5% 33.6% 21.9% 36.9% 17.7% 16.8%

Patients at 100% and Below FPL** as % of All Patients 59.8% 46.0% 34.7% 30.9% 54.4% 23.4% 53.7% 51.9%

Patients at 101-200% FPL** as % of All Patients 18.2% 20.5% 17.6% 19.6% 16.0% 15.4% 18.2% 15.6%

Patients above 200% FPL** as % of All Patients 6.1% 10.3% 15.5% 10.6% 25.4% 57.3% 11.3% 5.7%

Patients Aged Under 18 as % of All Patients 35.4% 19.5% 28.2% 31.1% 34.0% 18.9% 32.5% 31.2%

Patients Aged 18-64 as % of All Patients 58.2% 69.5% 62.1% 57.3% 59.7% 71.8% 60.1% 60.9%

Patients Aged 65+ as % of All Patients 6.4% 11.0% 9.7% 11.6% 6.3% 9.3% 7.4% 7.9%

Staffing

Total Full Time Equivalent (FTE) as % of RVIII FTE 64.1% 11.2% 3.8% 6.1% 12.2% 2.6% 100.0% N/A

Physicians FTE as % of Total FTE 5.7% 5.1% 2.1% 4.2% 5.7% 3.5% 5.3% 6.2%

NPs / PAs / CNMs FTE as % of Total FTE 6.6% 6.5% 7.7% 11.2% 7.8% 7.1% 7.1% 5.5%

Dentists FTE as % of Total FTE 2.1% 2.9% 3.3% 2.6% 2.5% 1.5% 2.3% 2.2%

Dental Hygienists FTE as % of Total FTE 1.4% 1.7% 3.1% 1.8% 0.9% 1.3% 1.4% 1.0%

Pharmacy FTE as % of Total FTE 3.5% 3.1% 6.9% 0.3% 6.5% 8.8% 3.9% 2.2%

Mental Health Services FTE as % of Total FTE 3.8% 5.3% 1.9% 0.7% 3.1% 3.1% 3.6% 4.1%

Enabling Services FTE as % of Total FTE 13.0% 11.7% 10.2% 3.9% 11.4% 8.8% 11.9% 10.0%

Total Facility / Non-Clinical Support FTE as % of Total FTE 32.1% 34.5% 36.7% 40.0% 32.0% 42.9% 33.3% 36.0%

Clinic Visits

Total Visits as % of RVIII Visits 64.5% 11.2% 3.4% 6.0% 13.4% 1.6% 100.0% N/A

Medical Services Visits as % of Total Visits 71.9% 65.4% 64.8% 79.1% 75.1% 77.4% 71.8% 69.5%

Dental Services Visits as % of Total Visits 13.0% 16.6% 24.7% 16.2% 12.0% 11.9% 13.8% 13.6%

Mental Health Services Visits as % of Total Visits 5.6% 7.5% 1.9% 2.8% 4.8% 4.3% 5.4% 7.5%

Substance Abuse Services Visits as % of Total Visits 0.0% 0.6% 0.7% 0.0% 0.6% 0.0% 0.2% 1.1%

Vision Services Visits as % of Total Visits 0.1% 0.0% 1.5% 0.0% 0.3% 0.1% 0.2% 0.7%

Enabling Services Visits as % of Total Visits 8.7% 9.5% 3.9% 1.7% 5.9% 6.2% 7.8% 6.0%

Income+

Total Income from All Sources as % of RVIII Income 64.8% 10.5% 3.7% 5.4% 13.7% 2.0% 100.0% N/A


*From BPHC’s State and National UDS Summary Reports. **Federal Poverty Level. +Collected patient-related revenue plus other revenues.

67



Region VIII Uniform Data System (UDS) Medical and Dental Productivity

Region VIII/National Comparison, 2013-2015

2013

Region VIII

Visits/FTE

2013

National

Visits/FTE

2014

Region VIII

Visits/FTE

2014

National

Visits/FTE

2015

Region VIII

Visits/FTE

2015

National

Visits/FTE

Region VIII Change '14-'15

National Change '14-'15

Medical Personnel Productivity: Physicians

Family Physicians 2,980.0 3,345.9 2,831.3 3,238.2 2,829.8 3,156.0 -0.1% -2.5%

General Practitioners 3,794.2 3,609.4 3,720.7 3,427.0 570.9 3,303.9 -84.7% -3.6%

Internists 2,448.8 3,189.1 2,273.7 3,058.9 2,061.3 2,997.7 -9.3% -2.0%

Obstetrician/Gynecologists 1,797.0 2,996.8 2,031.6 2,968.1 1,619.6 2,880.5 -20.3% -3.0%

Pediatricians 3,259.2 3,448.2 3,585.0 3,451.3 3,069.3 3,316.4 -14.4% -3.9%

Other Specialty Physicians 2,684.3 3,244.3 2,396.6 3,452.0 2,629.4 3,422.6 9.7% -0.9%

Total Physicians 2,888.3 3,315.6 2,799.1 3,241.5 2,616.9 3,152.2 -6.5% -2.8%

Medical Personnel Productivity: NPs, PAs, CNMs

Nurse Practitioners 2,621.3 2,674.0 2,528.0 2,638.9 2,401.8 2,569.8 -5.0% -2.6%

Physician Assistants 2,790.9 2,968.2 2,769.6 2,936.9 2,723.7 2,886.3 -1.7% -1.7%

Certified Nurse Midwives 2,921.2 2,356.2 3,177.7 2,335.4 2,739.7 2,231.2 -13.8% -4.5%

Total NPs, PAs, CNMs 2,724.7 2,738.5 2,683.2 2,703.3 2,583.4 2,632.4 -3.7% -2.6%

Medical Personnel Productivity: Nurses

Nurses 200.5 235.9 192.0 205.3 167.1 176.1 -12.9% -14.2%

Dental Personnel Productivity

Dentists 2,145.4 2,609.6 2,119.3 2,637.4 2,100.8 2,622.7 -0.9% -0.6%

Dental Hygienists 1,286.6 1,269.7 1,126.0 1,237.4 1,154.0 1,240.3 2.5% 0.2%


68



Region VIII Uniform Data System (UDS) Medical and Dental Productivity

by State, Region, and Nation, 2015

CO MT ND SD

FTE Visits

Visits/

FTE FTE Visits

Visits/

FTE FTE Visits

Visits/

FTE FTE Visits

Visits/

FTE Medical Personnel Productivity: Physicians

Family Physicians 153.9 426,689 2,772.3 38.5 108,210 2,807.7 6.0 20,066 3,333.2 11.4 27,442 2,413.5

General Practitioners 11.0 4,265 387.7 0.0 0 N/A 0.0 0 N/A 0.9 2,388 2,776.7

Internists 43.4 90,673 2,088.3 0.9 2,585 2,971.3 0.0 0 N/A 2.7 3,937 1,480.1

Obstetrician/Gynecologists 20.0 31,359 1,566.4 0.0 63 N/A 0.0 28 2,800.0 0.9 1,183 1,329.2

Pediatricians 41.3 127,260 3,081.4 2.9 7,989 2,764.4 0.0 0 N/A 2.5 7,000 2,857.1

Other Specialty Physicians 3.2 13,782 4,253.7 0.1 811 13,516.7 0.0 0 N/A 1.0 2,542 2,542.0

Total Physicians 272.9 694,028 2,543.3 42.4 119,658 2,824.8 6.0 20,094 3,332.3 19.2 44,492 2,313.7


Nurse Practitioners 132.3 341,901 2,583.9 31.0 67,360 2,172.9 12.9 27,569 2,140.5 25.9 46,014 1,780.0

Physician Assistants 162.9 484,146 2,973.0 22.7 46,735 2,059.7 7.2 15,692 2,182.5 25.2 51,155 2,029.2

Certified Nurse Midwives 21.4 60,664 2,832.1 0.9 1,212 1,317.4 1.6 4,440 2,740.7 0.4 506 1,176.7

Total NPs, PAs, CNMs 316.6 886,711 2,800.8 54.6 115,307 2,111.5 21.7 47,701 2,199.2 51.5 97,675 1,897.0


Nurses 284.0 34,872 122.8 97.0 20,119 207.3 34.9 7,978 228.5 90.6 22,417 247.5


Dentists 98.8 207,287 2,097.6 24.4 48,162 1,974.7 9.3 20,144 2,177.7 11.8 27,135 2,301.5

Dental Hygienists 66.3 84,015 1,266.4 14.1 16,541 1,173.1 8.9 8,682 975.5 8.1 6,636 824.3

UT WY Region VIII Nation

FTE Visits Visits/

FTE FTE Visits Visits/



FTE Medical Personnel Productivity: Physicians

Family Physicians 43.2 136,307 3,153.1 4.2 9,316 2,218.1 257.3 728,030 2,829.8 5,456.0 17,219,154 3,156.0

General Practitioners 0.2 232 1,160.0 0.0 0 N/A 12.1 6,885 570.9 414.4 1,369,184 3,303.9

Internists 1.2 2,395 1,995.8 0.3 258 889.7 48.4 99,848 2,061.3 1,860.2 5,576,205 2,997.7

Obstetrician/Gynecologists 2.9 2,964 1,008.2 1.7 5,751 3,443.7 25.5 41,348 1,619.6 1,184.9 3,413,112 2,880.5

Pediatricians 2.3 8,057 3,457.9 0.0 0 N/A 49.0 150,306 3,069.3 2,567.0 8,513,151 3,316.4

Other Specialty Physicians 2.6 2,029 771.5 0.6 688 1,109.7 7.6 19,852 2,629.4 384.7 1,316,761 3,422.6

Total Physicians 52.5 151,984 2,893.3 6.8 16,013 2,361.8 399.8 1,046,269 2,616.9 11,867.2 37,407,567 3,152.2


Nurse Practitioners 21.1 59,555 2,817.2 9.0 15,147 1,692.4 232.1 557,546 2,401.8 6,906.1 17,747,244 2,569.8

Physician Assistants 50.4 135,818 2,692.7 5.1 11,193 2,216.4 273.4 744,739 2,723.7 2,758.6 7,962,150 2,886.3

Certified Nurse Midwives 0.0 0 N/A 0.0 0 N/A 24.4 66,822 2,739.7 667.4 1,489,222 2,231.2

Total NPs, PAs, CNMs 71.6 195,373 2,729.4 14.0 26,340 1,881.4 530.0 1,369,107 2,583.4 10,332.1 27,198,616 2,632.4


Nurses 24.6 3,859 156.6 11.4 1,441 126.4 542.6 90,686 167.1 15,857.3 2,793,086 176.1


Dentists 22.6 49,503 2,186.5 2.9 4,512 1,545.2 169.8 356,743 2,100.8 4,108.2 10,774,800 2,622.7

Dental Hygienists 8.2 6,571 804.3 2.5 2,229 898.8 108.0 124,674 1,154.0 1,920.9 2,382,402 1,240.3


69



Region VIII Uniform Data System (UDS) Average Months of Key Staff* Tenure**


Region VIII National

2014 2015 Change '14-'15 2014 2015 Change '14-'15

#

Avg.

TTL

Mo./

Person #

Avg.

TTL

Mo./

Person #

Avg. TTL

Mo./

Person #

Avg.

TTL

Mo./

Person #

Avg.

TTL

Mo./

Person #

Avg. TTL

Mo./

Person

Medical Staff

Family Physicians 429 64.0 460 63.6 6.7% -0.5% 8,484 60.2 9,112 59.1 6.9% -1.7%

General Practitioners 14 76.0 22 61.8 36.4% -22.9% 682 63.7 728 61.0 6.3% -4.5%

Internists 62 79.3 76 71.3 18.4% -11.2% 3,236 66.9 3,438 68.3 5.9% 2.0%

Obstetrician/Gynecologists 27 51.9 49 27.7 44.9% -87.2% 2,247 58.7 2,486 58.3 9.6% -0.7%

Pediatricians 69 79.4 81 75.9 14.8% -4.6% 3,700 73.5 4,061 72.2 8.9% -1.9%

Other Specialty Physicians 42 44.9 40 62.4 -5.0% 28.1% 1,569 85.8 2,117 83.6 25.9% -2.5%

Nurse Practitioners 274 59.6 356 56.4 23.0% -5.7% 8,432 49.9 9,925 47.8 15.0% -4.3%

Physician Assistants 320 56.2 377 54.2 15.1% -3.8% 3,474 59.9 3,772 58.3 7.9% -2.9%

Certified Nurse Midwives 24 53.8 32 57.9 25.0% 7.2% 971 66.2 1,064 62.3 8.7% -6.3%

Nurses 648 56.5 777 55.3 16.6% -2.2% 18,500 59.8 21,152 60.8 12.5% 1.5%

Dental Staff

Dentists 203 48.7 263 43.7 22.8% -11.5% 4,655 61.5 5,988 52.6 22.3% -17.0%

Dental Hygienists 164 38.5 189 34.5 13.2% -11.6% 2,451 58.6 2,744 57.4 10.7% -2.2%

Mental Health Staff

Psychiatrists 13 68.1 18 49.7 27.8% -36.9% 1,173 54.4 1,335 50.2 12.1% -8.2%

Licensed Clinical Psychologists 42 44.0 45 39.5 6.7% -11.5% 869 62.1 1,078 60.3 19.4% -3.1%

Licensed Clinical Social Workers 99 33.4 148 38.9 33.1% 14.0% 2,849 52.5 3,633 46.9 21.6% -12.0%

Other Licensed Mental Health Providers 97 33.6 117 32.9 17.1% -2.0% 2,711 49.9 3,018 41.7 10.2% -19.7%

Vision Staff

Ophthalmologists 6 86.0 6 65.0 0.0% -32.3% 177 104.2 196 89.0 9.7% -17.1%

Optometrists 8 40.1 12 29.3 33.3% -37.2% 395 73.8 474 68.8 16.7% -7.3%

Administrative Leadership Staff

Chief Executive Officers 65 78.1 68 82.9 4.4% 5.8% 1,292 123.5 1,390 119.8 7.1% -3.1%

Chief Medical Officers 59 81.0 66 72.3 10.6% -12.1% 1,230 73.8 1,372 70.5 10.3% -4.8%

Chief Financial Officers 60 46.7 62 49.1 3.2% 4.9% 1,219 72.6 1,331 69.2 8.4% -5.0%

Chief Information Officers 24 75.2 25 73.9 4.0% -1.7% 543 78.5 579 80.0 6.2% 1.9%

TOTAL for All Key Staff 2,749 56.4 3,289 54.0 16.4% -4.5% 70,859 61.7 80,993 59.6 12.5% -3.4%

*Includes Full and Part Time Staff (Full Time Staff, Part Time Staff, Part Year Staff, Contract Staff, and NHSC Assignees), and Locum, On-Call, Etc.

(Locum Tenens, On-Call Providers, Volunteers, Residents/Trainees, Off-Site Contract Providers, and Non-Clinical Consultants), subject to restrictions.

**Number of continuous months in current position.


For reporting provisions: http://bphc.hrsa.gov/datareporting/reporting/.

70


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Region VIII Uniform Data System (UDS) Average Months of Key Staff* Tenure**

Breakdown by State, Region, and Nation, 2015


#

TTL

Mo./

Person #

TTL

Mo./

Person #

TTL

Mo./

Person #

TTL

Mo./

Person #

TTL

Mo./

Person #

TTL

Mo./

Person #

TTL

Mo./

Person #

TTL

Mo./

Person

Medical Staff

Family Physicians 238 66.5 80 39.5 7 113.3 47 81.7 82 67.5 6 16.0 460 63.6 9,112 59.1

General Practitioners 13 23.2 0 N/A 0 N/A 7 140.1 2 38.5 0 N/A 22 61.8 728 61.0

Internists 59 75.5 2 47.0 0 N/A 9 25.8 5 126.4 1 4.0 76 71.3 3,438 68.3

Obstetrician/Gynecologists 24 32.6 1 156.0 0 N/A 3 68.3 13 11.5 8 8.4 49 27.7 2,486 58.3

Pediatricians 67 83.5 4 43.3 0 N/A 7 38.6 3 38.0 0 N/A 81 75.9 4,061 72.2

Other Specialty Physicians 25 58.4 1 42.0 0 N/A 5 108.0 8 51.0 1 45.0 40 62.4 2,117 83.6

Nurse Practitioners 219 61.7 42 45.0 19 57.7 34 51.6 33 53.0 9 10.0 356 56.4 9,925 47.8

Physician Assistants 231 58.5 30 37.7 10 37.3 34 86.9 66 35.5 6 17.7 377 54.2 3,772 58.3

Certified Nurse Midwives 26 60.6 2 7.5 2 91.0 2 41.0 0 N/A 0 N/A 32 57.9 1,064 62.3

Nurses 423 59.0 134 36.1 59 42.8 120 71.6 25 65.4 16 24.1 777 55.3 21,152 60.8

Dental Staff

Dentists 145 49.9 31 36.4 20 18.0 20 39.0 43 44.6 4 13.8 263 43.7 5,988 52.6

Dental Hygienists 92 34.8 19 42.2 11 79.4 16 40.5 48 19.9 3 16.3 189 34.5 2,744 57.4

Mental Health Staff

Psychiatrists 14 50.5 1 5.0 0 N/A 2 88.5 1 6.0 0 N/A 18 49.7 1,335 50.2

Licensed Clinical Psychologists 36 38.2 3 15.7 0 N/A 1 24.0 4 72.8 1 38.0 45 39.5 1,078 60.3

Licensed Clinical Social Workers 101 47.1 28 16.1 1 84.0 1 5.0 16 26.1 1 33.0 148 38.9 3,633 46.9

Other Licensed Mental Health Providers 67 38.2 13 21.7 5 8.8 5 38.4 24 29.9 3 17.0 117 32.9 3,018 41.7

Vision Staff

Ophthalmologists 5 70.2 0 N/A 0 N/A 0 N/A 1 39.0 0 N/A 6 65.0 196 89.0

Optometrists 3 28.7 0 N/A 2 32.0 2 58.0 5 17.0 0 N/A 12 29.3 474 68.8

Administrative Leadership Staff

Chief Executive Officers 22 95.1 17 56.6 4 34.5 6 185.0 13 90.2 6 27.0 68 82.9 1,390 119.8

Chief Medical Officers 26 80.5 14 59.4 5 74.6 4 149.0 13 61.8 4 18.3 66 72.3 1,372 70.5

Chief Financial Officers 20 35.9 18 49.2 4 36.8 5 83.2 12 70.1 3 12.3 62 49.1 1,331 69.2

Chief Information Officers 13 75.7 6 57.7 0 N/A 2 142.0 3 70.3 1 23.0 25 73.9 579 80.0

TOTAL for All Key Staff 1,869 57.9 446 38.7 149 47.3 332 71.7 420 47.9 73 18.0 3,289 54.0 80,993 59.6

*Includes Full and Part Time Staff (Full Time Staff, Part Time Staff, Part Year Staff, Contract Staff, and NHSC Assignees), and Locum, On-Call, Etc.

(Locum Tenens, On-Call Providers, Volunteers, Residents/Trainees, Off-Site Contract Providers, and Non-Clinical Consultants), subject to restrictions.

**Number of continuous months in current position.


For reporting provisions: http://bphc.hrsa.gov/healthcenterdatastatistics/reporting/2012udsmanual.pdf.

71


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Financial Performance Measures; Region VIII/National Comparison, 2013-2015

2013

Region

VIII

2013

National

2014

Region

VIII

2014

National

2015

Region

VIII

2015

National

Region VIII

Change '14-'15


Health Center Program Financial Performance Measures - Financial Viability / Costs

Total accrued cost before donations and

after allocation of overhead $610,641,003 $15,662,859,760 $684,502,651 $17,443,687,411 $780,622,790 $20,088,900,118 14.0% 15.2%

Total number of patients 825,405 21,726,965 868,720 22,873,243 920,231 24,295,946 5.9% 6.2%

TOTAL COST PER PATIENT $739.81 $720.89 $787.94 $762.62 $848.29 $826.84 7.7% 8.4%

Total accrued medical staff and medical

other cost after allocation of overhead

(excludes lab and x-ray cost) $353,021,111 $9,156,412,910 $392,709,848 $10,058,397,093 $443,623,611 $11,416,595,235 13.0% 13.5%

Non-nursing medical encounters (excludes

nursing (RN) and psychiatrist encounters) 2,220,528 57,925,120 2,337,211 60,891,522 2,415,376 64,606,183 3.3% 6.1%

MEDICAL COST PER MEDICAL VISIT $158.98 $158.07 $168.02 $165.19 $183.67 $176.71 9.3% 7.0%

Total accrued BPHC section 330 grants

drawn-down $128,597,298 $2,531,170,359 $148,547,828 $2,948,720,119 $171,240,745 $3,548,744,102 15.3% 20.3%

Total unduplicated patients 825,405 21,726,965 868,720 22,873,243 920,231 24,295,946 5.9% 6.2%

330 GRANT COST PER PATIENT $155.80 $116.50 $171.00 $128.92 $186.08 $146.06 8.8% 13.3%

Selected Factors Relating to Health Center Program Financial Performance Measures

Special Populations, Language, and Location

Agricultural Worker/Dependent Patients 21,106 861,120 23,575 891,796 24,757 910,172 5.0% 2.1%

Homeless Patients 48,988 1,131,414 49,391 1,151,046 51,762 1,191,772 4.8% 3.5%

Special Populations as % of Total Patients 8.5% 9.2% 8.4% 8.9% 8.3% 8.7% -0.1% -0.2%

Patients best served in a language other

than English (LOTE) 186,797 4,969,391 201,121 5,295,742 157,264 5,533,142 -21.8% 4.5%

LOTE Patients as % of Total Patients 22.6% 22.9% 23.2% 23.2% 17.1% 22.8% -6.1% -0.4%

% of Grantees Considered Rural* 74.2% 48.4% 73.0% 54.5% 74.2% 54.8% 1.2% 0.3%

Enabling Services

Enabling Services Patients 109,334 2,077,351 105,940 2,205,003 112,199 2,388,722 5.9% 8.3%

Enabling Services Visits 230,167 5,121,714 253,410 5,362,625 272,299 5,789,657 7.5% 8.0%

Enabling Accrued Cost $38,174,214 $770,817,257 $46,994,077 $923,698,059 $49,781,461 $1,024,976,170 5.9% 11.0%

Enabling Cost per Enabling Patient $349 $371 $444 $419 $444 $429 0.0% 2.4%

Enabling Cost per Enabling Visit $166 $150 $185 $172 $183 $177 -1.2% 2.9%

Enabling Patients as % of Total Patients 13.2% 9.6% 12.2% 9.6% 12.2% 9.8% 0.0% 0.2%

Visits and Patients

Total Visits 3,137,359 85,641,647 3,316,957 90,379,441 3,488,129 96,951,585 5.2% 7.3%

Total Patients 825,405 21,726,965 868,720 22,873,243 920,231 24,295,946 5.9% 6.2%

Visits per Patient 3.80 3.94 3.82 3.95 3.79 3.99 -0.8% 1.0%

Patients per Staff FTE+ 134.45 138.55 128.01 134.29 122.86 128.65 -4.0% -4.2%

Income**

Total Income from All Sources $640.4M $15.9B $732.6M $18.0B $823.9M $21.0B 4.6% 9.4%

Income per Patient $775.87 $732.88 $843.33 $786.38 $895.37 $864.39 6.2% 9.9%

Income per Staff FTE+ $104,314.57 $101,541.01 $107,958.14 $105,600.28 $110,008.52 $111,204.60 1.9% 5.3%


*From BPHC’s State UDS Summary Reports . **Collected patient-related revenue plus other revenues. +Full Time Equivalent.

72



Financial Performance Measures; Region VIII Breakdown by State and Region, 2015 CO* MT ND* SD UT WY Region VIII

Selected Health Center Program Business Plan Performance Measures - Financial Viability / Costs

Total accrued cost before donations and

after allocation of overhead $500,497,774 $83,197,295 $29,527,696 $45,614,935 $103,413,408 $18,371,682 $780,622,790

Total number of patients 553,807 104,033 36,016 64,271 143,712 18,392 920,231

TOTAL COST PER PATIENT $903.74 $799.72 $819.85 $709.73 $719.59 $998.90 $848.29

Total accrued medical staff and medical

other cost after allocation of overhead

(excludes lab and x-ray cost) $293,006,375 $43,595,611 $12,567,039 $29,437,420 $53,743,554 $11,273,612 $443,623,611

Non-nursing medical encounters (excludes

nursing (RN) and psychiatrist encounters) 1,580,739 234,965 67,795 142,167 347,357 42,353 2,415,376

MEDICAL COST PER MEDICAL VISIT 185.360376 $185.54 $185.37 $207.06 $154.72 $266.18 $183.67

Total accrued BPHC section 330 grants

drawn-down $85,692,605 $28,695,230 $7,671,597 $14,658,376 $28,543,469 $5,979,468 $171,240,745

Total unduplicated patients 553,807 104,033 36,016 64,271 143,712 18,392 920,231

330 GRANT COST PER PATIENT $154.73 $275.83 $213.01 $228.07 $198.62 $325.11 $186.08

Selected Factors Relating to Health Center Program Business Plan Performance Measures

Special Populations, Language, and Location

Agricultural Worker/Dependent Patients 11,985 3,568 329 336 8,532 7 24,757

Homeless Patients 31,906 5,848 2,224 3,473 5,700 2,611 51,762

Special Populations as % of Total Patients 7.9% 9.1% 7.1% 5.9% 9.9% 14.2% 8.3%

Patients best served in a language other

than English (LOTE) 109,230 3,736 3,027 5,787 34,966 518 157,264

LOTE Patients as % of Total Patients 19.7% 3.6% 8.4% 9.0% 24.3% 2.8% 17.1%

% of Grantees Considered Rural** 60.0% 94.1% 75.0% 83.3% 61.5% 83.3% 74.2%

Enabling Services

Enabling Services Patients 77,810 12,504 1,380 1,703 17,525 1,277 112,199

Enabling Services Visits 196,196 37,115 4,529 3,478 27,468 3,513 272,299

Enabling Accrued Cost $35,491,951 $5,432,591 $1,285,294 $1,348,493 $5,601,025 $622,107 $49,781,461

Enabling Cost per Enabling Patient $456 $434 $931 $792 $320 $487 $444

Enabling Cost per Enabling Visit $181 $146 $284 $388 $204 $177 $183

Enabling Patients as % of Total Patients 14.1% 12.0% 3.8% 2.6% 12.2% 6.9% 12.2%

Visits and Patients

Total Visits 2,248,349 390,334 116,885 208,169 467,807 56,585 3,488,129

Total Patients 553,807 104,033 36,016 64,271 143,712 18,392 920,231

Visits per Patient 4.06 3.75 3.25 3.24 3.26 3.08 3.79

Patients per Staff FTE++ 115.42 124.54 127.33 139.78 156.69 93.69 122.86

Income+

Total Income from All Sources $533,900,939 $86,121,122 $30,228,315 $44,348,918 $113,039,275 $16,309,859 $823,948,428

Income per Patient $964.06 $827.83 $839.30 $690.03 $786.57 $886.79 $895.37

Income per Staff FTE++ $111,267.38 $103,094.62 $106,870.48 $96,450.53 $123,247.90 $83,082.16 $110,008.52


*Medicaid-expanded states. **From BPHC’s State UDS Summary Reports. +Collected patient-related revenue plus other revenues. ++Full Time Equivalent.

73



Selected Clinical Health Outcomes and Disparities Performance Measures*;


2013

RVIII

2013

National

2014

RVIII

2014

National

2015

RVIII

2015

National

Region VIII Change '14-'15


Diabetes (DM) - Patients 18-75 Diagnosed with Type I or Type II Diabetes, Most Recent Test Results

Total Patients with Diabetes 50,542 1,537,072 52,913 1,637,436 57,630 1,737,060 8.9% 6.1%

Diabetes Pts as % of Est. Adult Med. Pts 18-75** UNK+ 12.60% UNK+ 12.72% UNK+ 0.0% UNK+ -12.7%

Est. % Patients Hba1c <= 9% ('13-'14) > 9% ('15) 68.6% 68.9% 67.9% 68.8% 31.8% 29.8% N/A++ N/A++

Est. % Patients Hba1c < 7% ('13) < 8% ('14-'15) 40.3% 39.1% 55.8% 56.6% 55.8% 56.8% 0.0% 0.4%

Race: Asian 1,180 49,205 1,299 56,705 1,462 63,208 12.5% 11.5%

Race: Native Hawaiian and Pacific Islander 173 18,519 189 17,167 253 18,552 33.9% 8.1%

Race: Black/African American 3,269 349,397 3,531 364,758 3,749 386,754 6.2% 6.0%

Race: American Indian/Alaska Native 2,600 16,405 2,532 17,677 2,761 19,544 9.0% 10.6%

Race: White 37,019 851,781 38,707 927,502 42,686 993,582 10.3% 7.1%

Race: More than One Race 502 47,298 694 41,645 598 40,858 -13.8% -1.9%

Race: Unreported/Refused to Report 5,109 173,604 4,996 179,898 4,769 179,571 -4.5% -0.2%

Ethnicity: Hispanic/Latino (H/L) 21,882 532,514 22,869 571,471 25,344 616,082 10.8% 7.8%

Ethnicity: Non-Hispanic/Latino (H/L) 27,970 973,695 29,079 1,033,881 30,934 1,085,987 6.4% 5.0%

Ethnicity: Unreported/Refused to Report 690 30,863 965 32,084 1,352 34,991 40.1% 9.1%

H/L DM Patients as % of DM Patients 18-75 43.3% 34.6% 43.2% 34.9% 44.0% 35.5% 0.8% 0.6%

H/L Patients (ALL) as % of All Medical Patients 43.7% 39.4% 43.1% 39.8% 42.1% 40.2% -1.0% 0.4%

Hypertension (HTN) - Patients 18-85 Diagnosed with Hypertension, Last Blood Pressure < 140/90

Total Hypertensive Patients 93,861 2,967,554 97,221 3,083,149 100,679 3,226,170 3.6% 4.6%

HTN Patients as % of Est. Adult Med. Pts 18-85** UNK+ 23.61% UNK+ 23.25% UNK+ 0.0% UNK+ -23.3%

Est. % Patients w/Controlled Blood Pressure 63.9% 63.6% 65.4% 63.7% 65.3% 63.8% -0.1% 0.1%

Race: Asian 2,222 96,242 2,332 109,012 2,505 118,691 7.4% 8.9%

Race: Native Hawaiian and Pacific Islander 255 23,439 269 22,183 324 6,271 20.4% -71.7%

Race: Black/African American 7,748 791,075 7,677 797,259 8,116 824,688 5.7% 3.4%

Race: American Indian/Alaska Native 3,209 26,949 3,431 29,005 3,536 32,350 3.1% 11.5%

Race: White 71,596 1,650,169 73,946 1,762,654 76,682 1,863,526 3.7% 5.7%

Race: More than One Race 598 79,831 767 73,093 675 60,953 -12.0% -16.6%

Race: Unreported/Refused to Report 7,002 237,454 6,902 228,971 6,432 236,119 -6.8% 3.1%

Ethnicity: Hispanic/Latino (H/L) 30,963 732,957 31,893 773,400 33,443 828,252 4.9% 7.1%

Ethnicity: Non-Hispanic/Latino (H/L) 61,667 2,172,202 63,431 2,248,777 64,826 2,332,763 2.2% 3.7%

Ethnicity: Unreported/Refused to Report 1,231 62,395 1,897 60,972 2,406 65,155 26.8% 6.9%

H/L HTN Patients as % of HTN Patients 18-85 33.0% 24.7% 32.8% 25.1% 33.2% 25.7% 0.4% 0.6%

H/L Patients (ALL) as % of All Medical Patients 43.7% 39.4% 43.1% 39.8% 42.1% 40.2% -1.0% 0.4%


*Clinical data in BPHC’s State and National Reports have been weighted to account for sites reporting through sampling instead of total patient population.

**From BPHC’s State and National UDS Summary Reports. +Unknown: unable to extrapolate Region VIII percentage from state reports. ++Non-comparable: changed from <=9% in 2014 and previous years to >9% in 2015.

74




Region VIII Breakdown by State and Region, 2015

CO MT ND SD UT WY

Region

VIII


Total Patients with Diabetes 37,272 6,051 1,485 2,787 8,906 1,129 57,630

DM Patients as % of Est. Adult Medical Patients 18-75** 11.69% 9.44% 8.46% 7.90% 11.01% 8.55% UNK

Est. % Patients Hba1c > 9% 32.3% 29.8% 27.1% 30.6% 30.4% 44.2% 31.8%

Est. % Patients Hba1c < 8% 55.7% 59.2% 60.7% 57.8% 53.8% 45.1% 55.8%

Race: Asian 1,133 49 78 105 88 9 1,462

Race: Native Hawaiian and Pacific Islander 122 22 4 21 84 0 253

Race: Black/African American 3,285 60 123 108 122 51 3,749

Race: American Indian/Alaska Native 372 397 118 429 1,424 21 2,761

Race: White 28,013 5,155 1,079 1,915 5,701 823 42,686

Race: More than One Race 176 56 13 18 315 20 598

Race: Unreported/Refused to Report 3,390 155 45 80 1,018 81 4,769

Ethnicity: Hispanic/Latino (H/L) 20,120 381 126 195 4,412 110 25,344

Ethnicity: Non-Hispanic/Latino (H/L) 16,371 5,513 1,334 2,481 4,340 895 30,934

Ethnicity: Unreported/Refused to Report 781 157 25 111 154 124 1,352

H/L DM Patients as % of DM Patients 18-75 54.0% 6.3% 8.5% 7.0% 49.5% 9.7% 44.0%

H/L Patients (ALL) as % of All Medical Patients 51.9% 7.0% 8.5% 8.8% 51.0% 15.1% 42.1%


Total Hypertensive Patients 65,003 11,754 3,743 5,887 11,824 2,468 100,679

HTN Patients as % of Est. Adult Medical Patients 18-85** 19.88% 17.69% 20.50% 15.81% 14.25% 18.17% UNK

Est. % Patients w/Controlled Blood Pressure 66.6% 66.0% 63.9% 62.8% 61.3% 55.1% 65.3%

Race: Asian 1,939 57 189 152 157 11 2,505

Race: Native Hawaiian and Pacific Islander 183 29 4 25 82 1 324

Race: Black/African American 7,229 128 230 210 230 89 8,116

Race: American Indian/Alaska Native 578 550 184 500 1,689 35 3,536

Race: White 48,212 10,443 2,961 4,680 8,408 1,978 76,682

Race: More than One Race 275 78 31 31 212 48 675

Race: Unreported/Refused to Report 5,068 227 66 75 862 134 6,432

Ethnicity: Hispanic/Latino (H/L) 28,041 467 171 228 4,373 163 33,443

Ethnicity: Non-Hispanic/Latino (H/L) 35,443 11,045 3,493 5,445 7,267 2,133 64,826

Ethnicity: Unreported/Refused to Report 1,519 242 79 214 184 168 2,406

H/L HTN Patients as % of HTN Patients 18-85 43.1% 4.0% 4.6% 3.9% 37.0% 6.6% 33.2%

H/L Patients (ALL) as % of All Medical Patients 51.9% 7.0% 8.5% 8.8% 51.0% 15.1% 42.1%



**From BPHC’s State and National UDS Summary Reports. +Unknown: unable to extrapolate Region VIII percentage from state reports.

75




Region VIII Percentages by State, Region, and Nation, 2015

CO MT ND SD UT WY Region

VIII Nation


Total Patients with Diabetes as % of RVIII Diabetes Patients 64.7% 10.5% 2.6% 4.8% 15.5% 2.0% 100.0% N/A

Race: Asian as % of Total Patients with Diabetes 3.0% 0.8% 5.3% 3.8% 1.0% 0.8% 2.5% 3.6%

Race: Native Hawaiian and Pacific Islander as % of Total Pts with Diabetes 0.3% 0.4% 0.3% 0.8% 0.9% 0.0% 0.4% 1.1%

Race: Black/African American as % of Total Patients with Diabetes 8.8% 1.0% 8.3% 3.9% 1.4% 4.5% 6.5% 22.3%

Race: American Indian/Alaska Native as % of Total Patients with Diabetes 1.0% 6.6% 7.9% 15.4% 16.0% 1.9% 4.8% 1.1%

Race: White as % of Total Patients with Diabetes 75.2% 85.2% 72.7% 68.7% 64.0% 72.9% 74.1% 57.2%

Race: More than One Race as % of Total Patients with Diabetes 0.5% 0.9% 0.9% 0.6% 3.5% 1.8% 1.0% 2.4%

Race: Unreported/Refused to Report as % of Total Patients with Diabetes 9.1% 2.6% 3.0% 2.9% 11.4% 7.2% 8.3% 10.3%

Ethnicity: Hispanic/Latino (H/L) as % of Total Patients with Diabetes 54.0% 6.3% 8.5% 7.0% 49.5% 9.7% 44.0% 35.5%

Ethnicity: Non-Hispanic/Latino (H/L) as % of Total Patients with Diabetes 43.9% 91.1% 89.8% 89.0% 48.7% 79.3% 53.7% 62.5%

Ethnicity: Unreported/Refused to Report as % of Total Patients with Diabetes 2.1% 2.6% 1.7% 4.0% 1.7% 11.0% 2.3% 2.0%


Total Hypertensive Patients as % of RVIII Hypertensive Patients 64.6% 11.7% 3.7% 5.8% 11.7% 2.5% 100.0% N/A

Race: Asian as % of Total Hypertensive Patients 3.0% 0.5% 5.0% 2.6% 1.3% 0.4% 2.5% 3.7%

Race: Native Hawaiian and Pacific Islander as % of Total Hypertensive Pts 0.3% 0.2% 0.1% 0.4% 0.7% 0.0% 0.3% 0.2%

Race: Black/African American as % of Total Hypertensive Patients 11.1% 1.1% 6.1% 3.6% 1.9% 3.6% 8.1% 25.6%

Race: American Indian/Alaska Native as % of Total Hypertensive Patients 0.9% 4.7% 4.9% 8.5% 14.3% 1.4% 3.5% 1.0%

Race: White as % of Total Hypertensive Patients 74.2% 88.8% 79.1% 79.5% 71.1% 80.1% 76.2% 57.8%

Race: More than One Race as % of Total Hypertensive Patients 0.4% 0.7% 0.8% 0.5% 1.8% 1.9% 0.7% 1.9%

Race: Unreported/Refused to Report as % of Total Hypertensive Patients 7.8% 1.9% 1.8% 1.3% 7.3% 5.4% 6.4% 7.3%

Ethnicity: Hispanic/Latino (H/L) as % of Total Hypertensive Patients 43.1% 4.0% 4.6% 3.9% 37.0% 6.6% 33.2% 25.7%

Ethnicity: Non-Hispanic/Latino (H/L) as % of Total Hypertensive Patients 54.5% 94.0% 93.3% 92.5% 61.5% 86.4% 64.4% 72.3%

Ethnicity: Unreported/Refused to Report as % of Total Hypertensive Patients 2.3% 2.1% 2.1% 3.6% 1.6% 6.8% 2.4% 2.0%



76



Selected Healthy People 2020 Goals*;

Region VIII Breakdown by State and Region, 2013-2015

2015 UDS CO MT ND SD UT WY RVIII Goal Met?*

% 3 Year Old Children Immunized 79.1% 65.8% 65.9% 86.8% 75.7% 59.8% 78.1%

% Diabetic Patients with controlled HbA1c 67.7% 70.2% 72.9% 69.4% 69.6% 55.8% 68.2%

% Female Patients with PAP Test 57.5% 50.2% 47.2% 48.9% 51.5% 26.9% 54.3%

% Hypertensive Patients with controlled BP 66.6% 66.0% 63.9% 62.8% 61.3% 55.1% 65.3%

% Low Birth Weight 8.7% 6.6% 4.0% 8.1% 6.6% 11.1% 8.0%

% Prenatal Patients Served in 1st Trimester 77.5% 80.5% 78.9% 66.9% 71.0% 78.8% 76.3%

% Pts with Appropriate Colorectal Cancer Screening 34.8% 35.5% 41.1% 38.5% 21.3% 9.9% 32.9%


% 3 Year Old Children Immunized 79.2% 70.4% 68.3% 80.4% 82.4% 56.9% 78.9%




% Low Birth Weight 7.5% 5.4% 5.5% 7.0% 6.1% 6.7% 7.1%







% Low Birth Weight 8.0% 7.5% 5.4% 7.3% 7.2% UNK 7.8%



*Selected Healthy People 2020 Goals

% of 3 Year Old Children Immunized is 80%+**

% Diabetic Patients with HbA1c less than or equal to 9% is 85.4%+ % Low Birth Weight is 7.8% or lower

% Female Patients with PAP Test is 93%+

% Prenatal Patients Served in 1st Trimester is 77.9%+

% Hypertensive Patients with BP less than 140/90 is 61.2%+

% Patients 51-74 with Colorectal Cancer Screening is 70.5%+

**Measure added in 2014; data not available for prior years.


For more information about Healthy People 2020, visit www.healthypeople.gov/2020/default.aspx.

77




Selected Healthy People 2020 Goals*;


2013

Region

VIII

2013

National

2014

Region

VIII

2014

National

2015

Region

VIII

2015

National

Region VIII

Change

'14-'15

% 3 Year Old Children Immunized N/A N/A 78.9% 77.2% 78.1% 77.5% -0.8% Increase=improvement

% Diabetic Patients with controlled HbA1c 68.6% 68.9% 67.9% 68.8% 68.2% 70.2% 0.3% Increase=improvement

% Female Patients with PAP Test 55.1% 57.8% 52.4% 56.3% 54.3% 56.0% 1.9% Increase=improvement

% Hypertensive Patients with controlled BP 63.9% 63.6% 65.4% 63.7% 65.3% 63.8% -0.1% Increase=improvement

% Low Birth Weight 7.8% 7.3% 7.1% 7.3% 8.0% 7.6% 1.0% Decrease=improvement

% Prenatal Patients Served in 1st Trimester 73.1% 71.6% 76.2% 72.2% 76.3% 73.0% 0.1% Increase=improvement

% Pts with Appropriate Colorectal Cancer Screening 27.5% 32.6% 30.5% 34.5% 32.9% 38.3% 2.4% Increase=improvement

*Selected Healthy People 2020 Goals

% of 3 Year Old Children Immunized is 80%+**

% Diabetic Patients with HbA1c less than or equal to 9% is 85.4%+ % Low Birth Weight is 7.8% or lower

% Female Patients with PAP Test is 93%+

% Prenatal Patients Served in 1st Trimester is 77.9%+

% Hypertensive Patients with BP less than 140/90 is 61.2%+

% Patients 51-74 with Colorectal Cancer Screening is 70.5%+

**Measure added in 2014; data not available for prior years.


For more information about Healthy People 2020, visit www.healthypeople.gov/2020/default.aspx.

Highlighted Emerging Topic: Depression-Related Clinical Performance Measure

Region VIII Breakdown by State, Region, and Nation, 2014-2015

% Patients 12+ screened for clinical depression with standardized tool and, if positive, with follow-up plan documented

CO MT ND SD UT WY RVIII National

2015 UDS 40.4% 49.6% 67.7% 49.5% 50.1% 50.7% 45.0% 50.6%

2014 UDS 19.0% 42.4% 70.1% 47.7% 31.6% 46.9% 28.5% 38.8%

Related Healthy People 2020 Goals

% of primary care physician office visits including screening for depression in adults aged 19+ is 2.4%

% of primary care physician office visits including screening for depression in youth aged 12-18 is 2.3%


This project is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under cooperative

agreement number U58CS06861, “State and Regional Primary Care Associations,” total award of $519,941, 27% of the total PCA project is financed with non-federal

sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements

be inferred by HRSA, HHS or the US Government.

78




CHAMPS 2016/2017 Region VIII HC T/TA Needs Assessment Summary – EC Report 03/17 For Internal Planning Only – DO NOT DISTRIBUTE 1

2016/2017 Region VIII Health Center Training and Technical Assistance (T/TA) Needs Assessment

CHAMPS Region VIII Summary Report CHAMPS Executive Committee Meeting – March 2017

The Region VIII Health Center Training & Technical Assistance (T/TA) Needs Assessment

is an annual component of the CHAMPS Bureau of Primary Health Care (BPHC) Cooperative

Agreement (CA). As this activity is required of all Primary Care Associations (PCAs), CHAMPS

works collaboratively with the Region VIII State PCAs to design and distribute one survey for the

entire region.

2016/2017 Data Collection Timeframe: November 28 – December 9, 2016

Participation: 267 respondents from 61 Region VIII Health Center Program Awardees and Look-

Alikes (HCs – 92.4%); 216 (80.1%) selected a Health Center

PARTICIPANT DEMOGRAPHICS

Participation by State (determined by individualized web links to survey)

Colorado: 65 respondents from 18+ HCs (90.0%)

Montana: 58 respondents from 17 HCs (100%)

North Dakota 28 respondents from 5 HCs (100%)

South Dakota: 47 respondents from 4+ HCs (80.0%)

Utah: 72 respondents from 12+ HCs (92.3%)

Wyoming: 27 respondents from 5+ HCs (83.3%)

Participation by Role(s) Held at Health Center (297 responses; asked to choose all that apply;

response was required)

Answer Options Count %

Health Center Board Member* 9 3.0%

Behavioral Health Director 6 2.0%

CEO/Executive Director 29 9.8%

CFO/Finance Director 20 6.7%

CIO/Information Technology Director 7 2.4%

COO/Operations Director 23 7.7%

CDO/Dental Director 12 4.0%

CMO/Medical Director 21 7.1%

Human Resources Director 20 6.7%

Provider (Behavioral, Medical, Oral, etc.) 21 7.1%

Quality Improvement Director/Officer 19 6.4%

Other Administrative Staff 95 32.0%

Other Clinical Staff 38 12.8%

*Board responses received from UT only; no board responses from CO, MT, ND, SD, or WY

In this document, unless otherwise noted, the term “health center(s)” is used to refer to organizations that receive awards under the Bureau of Primary Health Care (BPHC) Health Center Program as authorized under section 330 of the Public

Health Service Act, as amended, as well as Health Center Program Look-Alikes. It does not refer to clinics that are sponsored by tribal or Urban Indian Health Organizations, except for those that receive Health Center Program grants.

February 2017

79


Top Health Center Challenges/Concerns (247 responses; asked to choose top five from a list

of 18 total topics)

Respondents were asked to rank their HC’s top five challenges/concerns, given 17 total topics

deemed timely/relevant by the state and regional PCAs designing the survey. Respondents also

had the opportunity to select “Other” and provide additional detail.

Respondents were allowed to identify five total topics, ranking them from 1-5 with “#1” being the

top challenge.

Each “#1” response received 5 points, each “#2” received 4 points, each “#3” received 3

points, each “#4” received 2 points, and each “#5” received 1 point.

Overall Score = the topic average (sum of points divided by total number of

respondents selecting a challenge level for the topic) multiplied by the number of

total respondents selecting a challenge level for the topic.

RVIII Rank Challenge/Concern Options Overall

Score

Ranked #1 A. Recruitment of Providers 442.50

Ranked #2 B. Staff Retention 370.04

Ranked #3 C. Meeting Patient Targets/Projections 365.94

Ranked #4 D. Billing/Coding Issues 268.80

Ranked #5 E. Clinic Operations 255.42

Ranked #6 F. Behavioral Health Integration 243.36

Ranked #7 G. Data Analytics 224.64

Ranked #8 H. Quality Improvement Processes 212.16

Ranked #9 I. Care Coordination 205.13

Ranked #10 J. Payment Reform 177.84

Average Overall Scores in 2016/2017 and 2015/2016 Assessments: Presented in descending order from highest average overall score for 2016/2017 respondents

0.0

100.0

200.0

300.0

400.0

500.0

600.0

A B C D E F G H I J K L M N O P Q R

2016/2017 2015/2016

Additional Topics: K. 340B Regulations L. Oral Health Integration* M. High-Functioning Board of Directors N. Credentialing/Privileging O. Recruitment of Leadership P. Other Q. Formal Referral Procedures/Agreements R. Data Security *New Topic for 2016/2017 Assessment

80


Health Center Need for T/TA in ACCESS TO CARE, OPERATIONAL EXCELLENCE, and

HEALTH OUTCOMES AND HEALTH EQUITY Areas

Respondents were asked to rank their HC’s need for training and technical assistance (T/TA)

activities on 144 total topics:

43 topics within four ACCESS TO CARE Activity Areas

A. Build Workforce Recruitment, Retention, and Development (11 topics)

B. Improve Access to Care for Special and Vulnerable Populations (6 topics)

C. Develop and Strengthen Primary Care Capacity (16 topics)

D. Improving Strategic Planning for Filling Access Gaps and to Support Provision of

Comprehensive Services (10 topics)

44 topics within five ORGANIZATIONAL EXCELLENCE – PATIENT CENTERED MEDICAL

HOME (PCMH) Activity Areas

E. Strengthening Readiness for PCMH Recognition Site Visits and Surveys (9 topics)

F. Advancing Utilization of Team-Based Models of Care (11 topics)

G. Enhancing Integration of Care to Provide Comprehensive Primary Care Services (5

topics)

H. Improving Care Coordination (8 topics)

I. Enhancing Health Center Engagement with the Medical Neighborhood (11 topics)

36 topics within four ORGANIZATIONAL EXCELLENCE – COST Activity Areas

J. Strengthening Strategic Health Center Board Decision-Making (13 topics)

K. Improving Health Center Financial Sustainability (8 topics)

L. Preparation for Increased Engagement in Value-Based Reimbursement Models and

Systems (9 topics)

M. Enhancing Health Center Operations through State/Regional Data Analysis and

Sharing (6 topics)

21 topics within three HEALTH OUTCOMES AND HEALTH EQUITY Activity Areas

N. Reducing Health Disparities (10 topics)

O. Increasing Patient Engagement in Care (6 topics)

P. Developing Strategic Partnerships with External Partners (5 topics)

Respondents were asked to select “No Need,” “Low Need,” “Moderate Need,” or “High Need” for

each topic. They also were allowed to entirely skip any topic. Ratings provided in this report are

based on weighting of these responses:

Each “No Need” received 0 points, each “Low Need” received 1 point, each “Moderate Need”

received 2 points, and each “High Need” received 3 points.

Average Rating = sum of points divided by total number of respondents selecting a

“Need” category.

o 0.00-1.00: overall low need for T/TA

o 1.01-2.00: overall moderate need for T/TA

o 2.01-3.00: overall high need for T/TA

Overall ’16/’17 Average for all T/TA Topic Areas Combined: 1.84 (’15/’16-1.85, ’14/’15-1.71)

Note: 2016/2017 activity areas and individual topics are not comparable with prior years.

Average Need Ratings for 2016/2017 Assessment Activity Areas:

1.84

2.26 2.09 2.02 2.01 1.99 1.91 1.86 1.85 1.84 1.80 1.75 1.74 1.72 1.72 1.70 1.60

0.00

0.50

1.00

1.50

2.00

2.50

ALL L P H M G F N O E B D K C I A J

81


Health Center Need for T/TA in ACCESS TO CARE, OPERATIONAL EXCELLENCE, and

HEALTH OUTCOMES AND HEALTH EQUITY Areas

Region VIII Overall: 2016/2017 Top 10 Ranked Topics Needing T/TA

All Individual Responses Equally Weighted

Focus Area Activity Area Topic RVIII

Rank

RVIII

Avg.

RVIII

Count

Operational Excellence - Cost

Preparation for Increased Engagement in Value-Based Reimbursement Models and Systems

Preparing for Payment Reform (e.g., Managing Total Cost of Care, Value-Based Payment Models, Accounting for Social Determinants, etc.)

1 2.45 75



Alternative Payment Model (APM) Options (e.g., P4P, Partial Capitation, Primary Care Capitation, Shared Savings, Forming an ACO, etc.)

2 2.42 69


Preparation for Increased Engagement in Value-Based Reimbursement Models

and Systems

Role of Health Centers in APMs 3 2.40 70

Health Outcomes and Health Equity

Developing Strategic Partnerships with External Partners

Partnerships to Offset Costs for Patients (e.g., Medication, Labs, Screenings, etc.)

4 2.33 79



Improving Care Delivery through APMs (e.g., Team-Based Care, Patient Engagement/Activation, Population Health Interventions, Behavioral/Oral Health Integration, Effective Use of HIT, etc.)

5 2.28 69



Aligning APM Outcome Metrics 6 2.27 66


Preparation for

Increased Engagement in Value-Based Reimbursement Models and Systems

Leveraging APMs for Funding Non-

Medical Services (e.g., Nutritional Support, Social Determinants, Wellness Coaching, Fitness Classes, Peer Support Networks)

7 2.25 73

Health Outcomes

and Health Equity

Developing Strategic

Partnerships with External Partners

Partnerships to Fund Programs that

Improve Health Outcomes 8 2.23 77

Access to Care

Recruitment, Retention, and Development of Workforce

Staff Engagement/Satisfaction (e.g., Analysis/Metrics, Program Development, etc.)

9 2.19 153

Access to

Care

Developing and

Strengthening Primary Care Capacity

Support Staff Professional Development Series (e.g., Front Desk

Academy, Billing Boot-Camp, Medical Assistant Boot-Camp, etc.)

10 2.19 137

82


2016/2017 Region VIII Top Five Ranked High Need T/TA Topics by Leadership Role*

Focus Area Activity Area Topic Avg. Count

CEO/Executive Director


Value-Based Reimbursement


2.85 20




2.76 21



Role of Health Centers in APMs 2.71 21



Aligning APM Outcome Metrics 2.65 20



Improving Care Delivery through APMs (e.g., Team-Based Care, Patient Engagement/Activation, Population Health Interventions, Behavioral/Oral Health Integration, Effective Use of HIT, etc.)

2.62 21

CFO/Finance Director Operational Excellence - PCMH

Improving Care Coordination

Capturing Care Coordination in EHR 2.43 7

Operational Excellence - PCMH

Team-Based Models of Care

Ensuring Team Members Work at Top of License 2.43 7

Access to Care Improving Access for Special and Vulnerable Populations

Monitor Local, State, and Federal Policy and Regulatory Requirements (e.g., HRSA, CMS, HHS, Legislative Activity, O/E Licensing & Training Requirements, Insurance Options, etc.)

2.40 10


Development of Funding Opportunities, Reporting Requirements, and Change in Scope (e.g., Data, Performance Benchmarks, Templates, UDS Mapper Data and Mapping, etc.)

2.40 10


Readiness for PCMH Recognition Site Visits and Surveys

Measure and Improve Performance (e.g., Implement and Demonstrate Continuous Quality Improvement; Measure Clinical Quality Performance, Resource Use and Care Coordination, and Patient/Family Experience; Report Performance; Use Certified EHR, etc.)

2.38 8

COO/Operations Director Operational Excellence - Cost

State/Regional Data Analysis and Sharing

Operational Workflow Benchmarking (e.g., Scheduling, Patient Flow/Cycle Time, etc.)

2.40 10



HR/Recruitment & Retention Benchmarking (e.g., Turnover Rates, Vacancy Rates, E-Mod Metrics, Workers Compensation Ratios, Benefits to Salary Ratios, etc.)

2.40 10



Health Outcomes/Equity Benchmarking (e.g., Health Center Program Clinical Performance Measures, Healthy People 2020 Measures, Quality Improvement Plans, etc.)

2.30 10


Financial Sustainability Coding and Billing Best Practices (e.g., Auditing, Education, Staffing for Efficiency, etc.)

2.20 5


Financial Sustainability Development/Negotiation of Provider/Payer Contracts (e.g., Medicaid, Medicare, Private Insurance, etc.)

2.20 5



Financial/Cost Benchmarking (e.g., Health Center Program Financial Performance Measures, Cost of Care, Cost per Patient, Productivity Indicators, etc.)

2.20 10

Human Resources Director/Manager


Marketing and Outreach Strategies (e.g., Outreach to Potential New Patients to Meet/Exceed Patient Targets, Social Media, Community Awareness/Education/Events, Print Materials, etc.)

2.67 6



2.33 6

Access to Care Recruitment, Retention, and Development of Workforce

Burnout Prevention (e.g., Mindfulness Training, Peer Support, etc.)

2.29 17

*Includes only topics ranking 2.01+ with five+ respondents

83


2016/2017 Region VIII Top Five Ranked High Need T/TA Topics by Leadership Role*, continued

Focus Area Activity Area Topic Avg. Count

Human Resources Director/Manager, continued


Recruitment and Retention Plans/Procedures (e.g. Succession Planning, Diverse Hiring, Promising Recruitment Practices, etc.)

2.22 18



2.17 6

Quality Improvement Director/Officer Health Outcomes and Health Equity

Reducing Health Disparities

Using Health Information Exchange (HIE) to Access Comprehensive Patient Records

2.67 6

Health Outcomes and Health Equity

Reducing Health Disparities

Patient Care Coordination 2.57 7


Engagement with the Medical Neighborhood

Services via Telemedicine 2.33 6


Readiness for PCMH Recognition Site Visits and Surveys

Track and Coordinate Care (e.g., Referral Tracking and Follow-Up, Test Tracking and Follow-Up, Coordinate Care Transitions, etc.)

2.31 13



2.30 10

Health Outcomes

and Health Equity

Patient Engagement in

Care

Patient Use of Portals (e.g., Two-Way Messaging,

Marketing, etc.) 2.30 10

Behavioral Health Director


Enhancing Integration of Care to Provide Comprehensive Primary Care Services

Integrating Social Determinants of Health (e.g., Workflows, Policies, Procedures, Services, Partnerships, etc.)

2.20 5

CDO/Dental Director


Development of Compensation/Benefits Packages (e.g., Salary, Incentives, Insurance Options, etc.)

2.14 7


Enhancing Integration of Care to Provide Comprehensive Primary Care Services

Integrating Primary and Oral Health Services (e.g., Workflows, Policies, Procedures, Peer Learning, Community Partnerships, etc.)

2.14 7

CMO/Medical Director Operational Excellence - Cost

Financial Sustainability Coding and Billing Best Practices (e.g., Auditing, Education, Staffing for Efficiency, etc.)

2.67 6




2.44 9




2.44 9


Board Decision-Making Strategic Planning 2.43 7


Development of Compensation/Benefits Packages (e.g., Salary, Incentives, Insurance Options, etc.)

2.42 12

*Includes only topics ranking 2.01+ with five+ respondents

84


2016/2017 Region VIII Top Three Ranked T/TA Topics by Activity Area

ACCESS TO CARE: Recruitment, Retention, and Development of Workforce Avg. Count

Staff Engagement/Satisfaction (e.g., Analysis/Metrics, Program Development, etc.) 2.19 153

Burnout Prevention (e.g., Mindfulness Training, Peer Support, etc.) 2.15 150

Recruitment and Retention Plans/Procedures (e.g. Succession Planning, Diverse Hiring, Promising Recruitment Practices, etc.)

2.05 146

ACCESS TO CARE: Improving Access to Care for Special and Vulnerable Populations Avg. Count


2.06 133


2.03 119


1.98 121

ACCESS TO CARE: Developing and Strengthening Primary Care Capacity Avg. Count

Support Staff Professional Development Series (e.g., Front Desk Academy, Billing Boot-Camp, Medical Assistant Boot-Camp, etc.)

2.19 137

Leadership Development and Training 2.08 133

Customer Service (e.g., Culturally Competent Care, Managing Difficult Behavior, Motivating Consumers to Enroll, etc.)

2.05 138

ACCESS TO CARE: Improving Strategic Planning for Filling Access Gaps and to Support Provision of Comprehensive Services

Avg. Count

Expanding Behavioral Health Services 2.05 121

Expanding Substance Abuse Services 2.04 117

Identifying Strategic Service Expansion Opportunities 1.95 104

ORGANIZATIONAL EXCELLENCE - PCMH: Strengthening Readiness for PCMH Recognition Site Visits and Surveys

Avg. Count

Measure and Improve Performance (e.g., Implement and Demonstrate Continuous Quality Improvement; Measure Clinical Quality Performance, Resource Use and Care Coordination, and Patient/Family Experience; Report Performance; Use Certified EHR, etc.)

1.98 121

Population Health Management (e.g., Collection/Analysis/Use of Data for Population Management, Patient Information/Registries, Implementation of Evidence-Based Decision-Support, etc.)

1.97 117

Plan and Manage Care (e.g., Care Planning and Self-Care Support, Identifying Patients for Care Management/Patient Empanelment, Medication Management, E-Prescribing, Supporting Self-Care and Shared Decision-Making, etc.)

1.95 119

ORGANIZATIONAL EXCELLENCE - PCMH: Advancing Utilization of Team-Based Models of Care Avg. Count

Leadership and Team Communication 2.14 114

Ensuring Team Members Work at Top of License 2.04 108

Team Roles in Utilizing EHRs to Plan and Manage Care 2.01 98

ORGANIZATIONAL EXCELLENCE - PCMH: Enhancing Integration of Care to Provide Comprehensive Primary Care Services

Avg. Count

Integrating Social Determinants of Health (e.g., Workflows, Policies, Procedures, Services, Partnerships, etc.)

2.03 110

Integrating Enabling Services (e.g., Workflows, Policies, Procedures, Case Management, Outreach, Education, Transportation, Translation, etc.)

2.00 109

Integrating Primary and Behavioral Health Services (e.g., Workflows, Policies, Procedures, Peer Learning, Community Partnerships, etc.)

1.97 108

ORGANIZATIONAL EXCELLENCE - PCMH: Improving Care Coordination Avg. Count

Care Coordination Billing 2.19 99

Capturing Care Coordination in EHR 2.18 106

Care Coordination Team Structure & Workflow 2.17 100

ORGANIZATIONAL EXCELLENCE - PCMH: Enhancing Health Center Engagement with the Medical Neighborhood

Avg. Count

Data Exchange (e.g., Registry Connectivity, Health Information Exchange [HIE] Connectivity, Bi-Directional Exchanges, etc.)

2.01 78

Partnerships with Substance Use Treatment Providers 1.92 78

Services via Telemedicine 1.87 77

85


2016/2017 Region VIII Top Three Ranked T/TA Topics by Activity Area, continued

ORGANIZATIONAL EXCELLENCE – COST: Strengthening Strategic Health Center Board Decision-Making

Avg. Count

Strategic Planning 1.92 76

Board Advocacy/Community Connections (e.g., State Legislation, Community Education, Fundraising, Training, etc.)

1.87 77

Board Use of Needs Assessment Data (e.g., Using Chronic Health Indicators, Demographics, etc. to Support Determination of Health Center Services, Hours of Operation, Board Composition, etc.)

1.80 74

ORGANIZATIONAL EXCELLENCE - COST: Improving Health Center Financial Sustainability Avg. Count

Coding and Billing Best Practices (e.g., Auditing, Education, Staffing for Efficiency, etc.) 2.10 90

Development/Negotiation of Provider/Payer Contracts (e.g., Medicaid, Medicare, Private Insurance, etc.) 1.95 82

Medicare/Medicaid Updates (e.g., PPS, Medicare PPS, Alternative Payment Methodology, Cost Reports, etc.)

1.89 87

ORGANIZATIONAL EXCELLENCE - COST: Preparation for Increased Engagement in Value-Based Reimbursement Models and Systems

Avg. Count


2.45 75


2.42 69

Role of Health Centers in APMs 2.40 70

ORGANIZATIONAL EXCELLENCE - COST: Enhancing Health Center Operations through State/Regional Data Analysis and Sharing

Avg. Count

Operational Workflow Benchmarking (e.g., Scheduling, Patient Flow/Cycle Time, etc.) 2.05 84

Documenting and Tracking Data (e.g., Clinical Documentation, Using EHRs for Performance Measures, PCMH Requirements, UDS and Other Reporting, etc.)

2.03 86

Financial/Cost Benchmarking (e.g., Health Center Program Financial Performance Measures, Cost of Care, Cost per Patient, Productivity Indicators, etc.)

2.03 80

HEALTH OUTCOMES AND HEALTH EQUITY: Reducing Health Disparities Avg. Count

Utilizing EHRs to Plan and Manage Care (e.g., Clinical Decision Support, Data Capture/Validation, etc.) 1.99 78

Patient Care Coordination 1.96 81

Team-Based Care for Clinical Measures 1.92 77

HEALTH OUTCOMES AND HEALTH EQUITY: Increasing Patient Engagement in Care Avg. Count

Patient Use of Portals (e.g., Two-Way Messaging, Marketing, etc.) 2.04 102

Bidirectional Patient Support (e.g., Telehealth via Real-Time Records of Digital BP, Home Glucose Monitoring/Recording, etc.)

2.02 93

Secure Emailing with Patient 2.02 93

HEALTH OUTCOMES AND HEALTH EQUITY: Developing Strategic Partnerships with External Partners

Avg. Count

Partnerships to Offset Costs for Patients (e.g., Medication, Labs, Screenings, etc.) 2.33 79

Partnerships to Fund Programs that Improve Health Outcomes 2.23 77

Partnerships to Assess, Track, and Alleviate Related Social Determinants (e.g., Housing, Food, Transportation, Legal, Utilities, Insurance Insecurities, etc.)

2.00 80

2016/2017 Clinical Measures

Respondents were also asked to rank four clinical measures based on their overall need for support in improving health outcomes and reducing disparities (with 1 being the greatest need and 4 being the lowest need). Each “#1” received 4 points, each “#2” received 3 points, each “#3” received 2 points, and each “#4” received 1 point. The Average Rating equals the sum of points divided by the total number of respondents selecting a rank.

Measure Avg. Count

Diabetes Care 3.11 148

Hypertension Control 2.40 148

Colorectal Cancer Screening 2.47 146

Cervical Cancer Screening 2.07 150

86

Don’t Miss These Upcoming CHAMPS Distance Learning Events!

2016 Region VIII Health Center Workforce Data: Understanding and Utilizing Statistics from the CHAMPS Salary, Benefits, Turnover, and Vacancy Survey Project

Presented by Andrea Martin, Workforce Development and Member Services Director, CHAMPS

Tuesday, March 7, 2017, 11:30AM-1:00PM Mountain

Overview: The health centers of Region VIII make up a unique group of employers that benefit from analysis of their own workforce-related benchmarks and trends. During the spring and summer of 2016, CHAMPS undertook a region-wide survey of the region’s community, migrant, and homeless health centers to collect salary, benefits, and other workforce data from 55 organizations. This event will explain the history and methodology of the survey, and highlight findings relating to salaries and benefits for all health center staff including a look at base vs. additional pay and the structure of health center benefits packages. The presenter will also address trends in additional workforce metrics including vacancies, turnover, and challenging areas of recruitment and retention, and will present an analysis of data relating to medical, behavioral health, and dental provider vs. support staffing ratios as well as and medical and dental provider productivity expectations.

Learning Objectives: 1. Understand the history and methodology of the Region VIII health center salary, benefits, turnover, and

vacancy survey project. 2. Be able to utilize the most appropriate salary/benefits data and recruitment/retention metrics as

presented in the 2016 Region VIII Health Center Salary, Benefits, Turnover, and Vacancy Survey Report. 3. Understand and utilize data presented in companion reports addressing medical, behavioral health, and

dental staffing ratios and medical and dental provider productivity expectations.

Participation in the LIVE version of this webcast is FREE for participants from CHAMPS Organizational Members and non-members who submitted data for the 2016 Region VIII Health Center Salary, Benefits, Turnover, and

Vacancy Survey Project, including computer link and 1.50 HRCI recertification HR (General) credit hours. 2017 Immunization Update

Presented by Donna Weaver, RN MN, Nurse Educator, Centers for Disease Control and Prevention

Tuesday, June 13, 2017, 11:30AM-1:00PM Mountain

Overview: The purpose of this annual presentation is to update healthcare personnel on the latest recommended immunization schedules and the most recent Advisory Committee on Immunization Practices (ACIP) immunization recommendations.

Target Audience: This program is intended for providers and clinical support staff at federally-funded health centers (FQHCs) in Region VIII including physicians, PAs, NPs, nurses, MAs, and other interested health care professionals. Learning objectives and additional curriculum information will be available soon.

Participation in the LIVE version of this event is FREE for health centers (Health Center Program Grantees and FQHC Look-Alikes) and Primary Care Associations (PCAs) in Region VIII (CO, MT, ND, SD, UT, and WY). 1.5 hours of Continuing Medical Education (CME) Credit through American Academy of Family Physicians

(AAFP) will be applied for.

Advance registration is required for both events. Learn more and link to registration by visiting

www.CHAMPSonline.org/Events/DistanceLearning.html. Questions? Contact [email protected]

87

CHAMPS 2/21/17

MPCN MOUNTAIN/PLAINS CLINICAL NETWORK 2017 STEERING COMMITTEE MEMBERS

MEMBER CHC PHONE E-MAIL START DATE

COLORADO Angela Green, PsyD Metro Community Provider Network (303) 762-6546 [email protected] 5/12 Chad Hess, PA-C Pueblo Community Health Center, Inc. (719) 543-8711 [email protected] 2/09 Lesley Brooks, MD Sunrise Community Health (970) 353-5884 [email protected] 4/15

MONTANA Megan Littlefield, MD RiverStone Health (406) 247-3214 [email protected] 5/12

Sandi Larsen, MEd, LCPC, LAC RiverStone Health (406) 247-3350 [email protected] 2/17 NORTH DAKOTA Chastity Dolbec, RN (Vice-Chair) Coal Country Community Health Centers (701) 873-4445 [email protected] 5/12 SOUTH DAKOTA Jim McNeely, CFNP Rural Health Care, Inc. (605) 669-2121 [email protected] 10/05

UTAH Keith Horwood, MD Community Health Centers, Inc. (801) 964-6214 [email protected] 10/05

Kim McFarlane, PA-C (Chair) Green River Medical Center (435) 564-3434 [email protected] 4/07 WYOMING

Tharanie Sivarajah, MD HealthWorks (307) 635-3816 [email protected] 10/15 QI* CONSULTANT Ken Davis, PA-C NCC Health Partnership (970) 439-4200 [email protected] 2/15 CHAMPS PRESIDENT Keith Horwood, MD Community Health Centers, Inc. (801) 964-6214 [email protected] 10/16

CHAMPS STAFF Julie Hulstein (303) 867-9582 [email protected] Jen Anderson (303) 867-9583 [email protected] Andrea Martin (303) 867-9581 [email protected] Rachel Steinberg (303) 867-9584 [email protected] Valerie Steinmetz (303) 867-9544 [email protected]

*QI – Quality Improvement

88

mailto:[email protected]













../October%202015%20Meeting%20Packet/[email protected]




2/22/17

1

MOUNTAIN/PLAINS CLINICAL NETWORK (MPCN)

STRATEGIC ACTION PLAN, 2017-2018

Goal Area 1: Increase awareness and communicate value of MPCN

Strategic Intent: Increase utilization of MPCN programs and services by patient-facing staff

Objective 1a: Advertise and promote CHAMPS’ clinical and quality improvement programs, services, and resources to MPCN members

Actions to Accomplish Progress/Notes When Who

Outcomes/Measures

i. Utilize targeted emails, CHAMPS website, newsletter, etc. to promote clinical and quality improvement programs, services, and resources

MPCN news and resources will be included in each CHAMPS Quarterly Newsletter

CHAMPS staff

Newsletters Completed:

2017 Winter

Special email to all clinicians on SLT sent January 2017

ii. Utilize social media (LinkedIn) and the Clinicians Listserv, etc. to promote programs, services, and resources

Posts to Clinicians Listserv about once per week

CHAMPS staff

2 Quality/Clinical social media posts

5 Clinicians Listserv posts

iii. Provide MPCN Steering Committee (SC) members with flyers, etc. to share with coworkers about programs, services, and resources

August 2017

CHAMPS staff and MPCN SC

iv. Promote programs, services, and resources to Region VIII State PCAs and other partners, and provide articles for their publications

CHAMPS staff

v. Track use of online clinical and quality improvement resources to gauge interest and usefulness using Google Analytics or similar metrics

Now tracking on monthly basis, exploring best ways to analyse trends

CHAMPS staff

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2

Objective 1b: Maintain database of all MPCN members

Actions to Accomplish Progress/Notes When Who Outcomes/Measures

i. Acquire provider contact information from all sources, e.g. correspondence, notification of new hires, CHAMPS Directory updates, SC members, etc.

CHAMPS staff with input from MPCN SC

ii. Provide reminders to CHC human resource staff to notify CHAMPS of new clinical hires

Reminder will be included with the Directory Survey

June 2017

CHAMPS staff

iii. Explore feasibility of tracking clinical support staff contact information

CHAMPS staff

Objective 1c: Provide MPCN orientation to new Region VIII providers and clinical staff


i. Send welcome packets to new clinician leaders

CHAMPS staff

0 welcome packets sent to new clinician leaders

ii. Send emails with MPCN flyer to newly identified MPCN members and copy medical director on those emails

CHAMPS staff

0 emails sent to new clinicians

iii. Explore possibility of developing a web-based CHAMPS welcome and orientation program for new MPCN members and clinical support staff


iv. Include information about MPCN in “CHC 101” annual conference session

October 2017

October 2018

CHAMPS staff

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2/22/17

3

Objective 1d: Recruit and maintain a diverse MPCN Steering Committee that represents MPCN members


i. Post at least one article per year in the CHAMPS newsletter about MPCN SC

Spring 2017

CHAMPS staff

ii. Promote MPCN and open SC positions at the annual conference including the clinicians roundtable

October 2017

October 2018


iii. Identify and contact clinicians active with CHAMPS programs about SC member positions as needed

CHAMPS staff

Sandi Larsen, BH Director for RiverStone Health, joined SC in February 2017

iv. Discuss open SC member positions and/or possible SC candidates with CHAMPS Executive Committee and MPCN SC as needed

Will discuss need for dentist on SC on March 2017 Executive Committee call

CHAMPS staff

Discussed need for dentist on SC on February 2017 SC call

v. Discuss open SC member positions with Region VIII state PCA clinical/quality staff on quarterly calls as needed

Will discuss need for dentist on SC on March 2017 QI call

CHAMPS staff

vi. Identify more behavioral and oral health, and vision providers as potential MPCN SC members as needed


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2/22/17

4

Goal Area 2: Provide clinical education and training opportunities and resources

Strategic Intent: Assist MPCN members with staying up-to-date on best practices, utilizing them at their health center, and sharing innovative application across MPCN

Objective 2a: Identify and leverage MPCN members with best practices and share those across the network


i. Explore the development of a referral mechanism/network to identify Region VIII experts as well as promising and best practices in clinical and quality improvement


ii. Explore innovative ways to disseminate best and promising practices throughout Region VIII

CHAMPS staff

iii. Utilize identified experts to provide training and technical assistance to MPCN members


Objective 2b: Utilize distance learning events to provide education/training to MPCN members


i. Offer at least two distance learning events appropriate for MPCN members each year

Planning:

IZ Webcast

Diabetes ECHO Series

Colorectal Cancer Screening ECHO Series

June 2017

July 2017

Fall 2017


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2/22/17

5

ii. Continually seek desired/preferred distance learning topics for MPCN via SC calls/meetings, program evaluations, annual needs assessment, surveys, professional certification requirements, etc.


iii. Assure accreditation for continuing education credit is obtained for pertinent disciplines as feasible

CME will be applied for on IZ Webcast

May 2017

CHAMPS staff

iv. Explore the use of podcasts that can be archived and accessed at any time as a training tool

Planning podcast series on effective clinical literature and resource searches

February 2017

CHAMPS staff

Objective 2c: Utilize face-to-face educational events as appropriate to provide training to MPCN members


i. Continually seek desired/preferred face-to-face training topics via SC calls/meetings, event evaluations, annual needs assessment, surveys, professional certification requirements, etc.


ii. Provide annual face-to-face trainings relevant to MPCN such as Spanish language for health professionals, medical director training, etc.

SLT scheduled and registration open

April 2017


iii. Assure accreditation for continuing education credit is obtained for pertinent disciplines as feasible

CHAMPS staff

SLT CME credit obtained by Rios Associates

93

2/22/17

6

Objective 2d: Offer annual conference to support training, education, and networking needs of MPCN members


i. Offer annual conference sessions appropriate for MPCN members

October 2017

October 2018


ii. Survey MPCN members regarding conference session topic needs as appropriate

April 2017

CHAMPS staff

iii. Include MPCN members on conference planning committees

Spring 2017


iv. Use annual conference to offer focused, intensive trainings as appropriate

October 2017

October 2018


Objective 2e: Provide a library of online clinical resources appropriate for MPCN members


i. Identify new types of online resources needed by MPCN members through SC calls/meetings, evaluations, surveys, needs assessments, etc.


ii. Evaluate clinical and quality improvement resources on CHAMPS website for needed updates on an annual basis

Link update currently underway

Evaluation survey to be completed in next program year between July 2017 and June 2018

February 2017

CHAMPS staff

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7

Goal Area 3: Build and nourish partnerships

Strategic Intent: Identify and cultivate key external partners that support MPCN strategic goals

Objective 3a: Enhance the CHAMPS network of partners to broaden offerings of programs, services, and resources to MPCN members


i. Identify new potential partners with like goals of providing/ promoting health care services including medical, behavioral, oral health, vision, pharmacy, enabling services, etc.


ii. Continue to develop collaborations and partnerships with other clinical networks such as MidWest Clinicians Network, Migrant Clinicians Network, CDN, ACU, WCN, WCA, etc.

WCA meeting scheduled for NACHC P&I


iii. Offer partners opportunities to include articles/blurbs in CHAMPS newsletter and/or link(s) on website

Will reach out to partners for Spring Newsletter submissions

CHAMPS staff with input from MPCN

iv. Explore potential T/TA to support the needs of health centers to develop community partnerships and build an accountable health community model


Objective 3b: Increase partners’ awareness of the value of health centers


i. Promote/advertise CHAMPS programs/services to partners – e.g. email event announcements and quarterly newsletters

SLT sent to CCCHN for inclusion in Newsletter

CHAMPS staff

ii. Explore the possibility of writing articles for non-CHAMPS publications to increase awareness of health center activities and value

CHAMPS staff

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Objective 3c: Promote behavioral and oral health integration through partnerships


i. Explore possible collaborations with existing or new partners that will support integrated care


ii. Promote/advertise CHAMPS programs/services that address integrated care to partners

CHAMPS staff

iii. Explore possible collaborations regarding oral/behavioral health integration with Region VIII State PCAs

CHAMPS staff

Goal Area 4: Support members in retaining an engaged and joyful workforce

Strategic Intent: Leverage MPCN to support CHAMPS in making health centers the employers of choice

Objective 4a: Develop resources and opportunities to build resiliency in the workforce, with a focus on rural and frontier health centers


i. Identify resiliency and joyful workplace resources needed by MPCN members through SC calls/meetings, evaluations, surveys, needs assessments, etc.

Will attend MPCA Spring Symposium focused on resiliency and preventing provider burnout


ii. Explore opportunities to offer resiliency support for MPCN members such as through peer support or educational programs


iii. Explore opportunities to increase joy for MPCN members, such as through creation of peer support or educational programs


96

1

Spanish Language Training for

Health Care Professionals

A Four-Day Intensive Training

Denver, Colorado

Friday, April 21 – Monday, April 24, 2017

Immersion approach, shown to be

effective in learning new languages

Four full days of instruction, course book,

and continuing medical education (CME)

credit included in the cost

Beginner and intermediate language skill

levels available

Recommended for physicians, physician

assistants, nurse practitioners, nurses,

medical assistants, and other clinical personnel

Course location near downtown Denver with ample parking

Register early as class size is limited!

Presented by Ríos Associates Authors of the book Complete Medical Spanish published by McGraw-Hill, and

presenters of workshops accredited by the American Academy of Family Physicians,

American Academy of Nurse Practitioners, American Medical Society, and

American College of Emergency Physicians

Sponsored by

Community Health Association of Mountain/Plains States (CHAMPS)

and the Denver Medical Society (DMS)

For more information, contact Rachel Steinberg,

CHAMPS Programs & Communications Coordinator at

303-867-9584, [email protected], or fax 303-861-5315

97


2

CHAMPS and DMS Spanish Language for Health Care Professionals

Dates and Times: Friday, April 21 - Monday, April 24, 2017; 8:00 am-5:00 pm each day.

Target Audience: The course is targeted for physicians, PAs, NPs, nurses, medical

assistants, and other medical personnel. Other types of health care professionals are welcome

to attend, however it is important to note that only a limited amount of time is spent on

terminology for other disciplines such as oral health or behavioral health.

Course Description: This four-day course is an intensive conversational and medical Spanish

workshop consisting of medical dialogues, role-plays, visual aids, cross-cultural discussions,

and daily practice. The course curriculum provides an experience of immersion learning, an

approach that is highly suitable for those with limited time who must use their new language

skills immediately with their Spanish-speaking patients.

Beginner and intermediate skill levels will be offered, with separate classes for each level. The

skill levels will be based on the results of the participants’ completed self-assessment forms. It

is anticipated that a first-time beginning level and a more advanced intermediate level will be

offered depending on the skill levels of participants who register. If it is not possible to offer

the needed skill level for an individual, full tuition will be refunded.

Course Objectives: Participants who complete the course will:

1. Acquire/strengthen their ability to interview patients in Spanish, take a medical history,

conduct a physical exam, give prescriptions and instructions, and intervene in medical

emergencies.

2. Be exposed to a Spanish vocabulary of at least 1,500 general and medical words.

3. Develop a good flow of speech in present, future, and past tenses, and command forms.

4. Develop an awareness of differences in attitudes between Latinos and other Americans

concerning time, space, clothing, foods, health, and medical care.

5. Develop skills to continue language acquisition through daily practice and experience.

6. Intermediate students will be able to do all of the above, in addition to using more idioms as

well as complex tenses and moods (conditional, present and past progressive, present and

past perfect tenses, plus subjunctive mood and its tenses).

Course Instructors: Ríos Associates has been successfully presenting intensive medical

language and cultural workshops throughout the United States since 1983.

Course Fees: The registration fee is $649 for CHAMPS and/or DMS Members and $799 for

Non-Members of CHAMPS or DMS.

The registration fee includes four days of Spanish language instruction, course book, CME,

and snacks.

Full payment of the registration fee is due in advance. Refunds will not be provided,

however, if necessary, another individual may substitute for a registrant.

Payment should be made in the form of a check made payable to Rios Associates

along with the registration and self-assessment forms.

Course Location and Parking: The training will be held at the DMS offices at 1850 Williams

Street, Denver, Colorado, 80218; approximately two miles from downtown Denver. Free

parking is available at the training site.

Lodging: Lodging options are available near the training site and listed on page 5 of this

document. Participants will be responsible for reservations and payments for lodging.

CME: Continuing medical education (CME) is available as follows:

45 prescribed hours by the American Academy of Family Physicians (AAFP)

43 hours of Category 1 CME from the American College of Emergency Physicians

45 contact hours of continuing education by the American Academy of Nurse Practitioners

43 hours of Category 1 CME from the American Medical Association.

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3

CHAMPS Spanish Language for Health Care Professionals April 21–24, 2017

Registration Form

Please print clearly.

Name/Credentials: _____________________________________________________

Position Title: _________________________________________________________

Health Center Name: ___________________________________________________

Address: _____________________________________________________________

City: _______________________________ State: ______ Zip: ________

Phone: _________________________ Email: ___________________________

Level (check one): Beginner Intermediate Do Not Know

Very Important: Please complete the attached Self-Assessment Form and return it with the registration form and payment. This will assure that each

student is placed in the proper level and receives the appropriate level course book.

Amount Enclosed (check made payable to Rios Associates): $_____ CHAMPS Member* $649

$_____ CHAMPS Non-Member $799

*To determine if your health center is a member of CHAMPS, please contact Rachel Steinberg at 303-867-9584 or check the CHAMPS website at:

http://champsonline.org/about/champs-overview/champs-organizational-members

Full payment is due in advance of the course. CHAMPS is not able to provide refunds; however, another individual may substitute for the registered participant. CHAMPS must be notified in writing of the substitution and the substitute participant must

complete this registration form including the self-assessment form.

Make check payable to Rios Associates and mail check, completed registration form and self-assessment form to Rachel Steinberg, CHAMPS, 600 Grant Street, Suite 800, Denver, CO 80203. You may fax the registration form in advance to 303-

861-5315 with “Attention Rachel Steinberg” or email [email protected].

The registration due date is April 1, 2017. Class size is limited, and therefore registration openings are subject to availability and will be processed on a first-come

first-served basis. You will be sent a registration confirmation email after CHAMPS receives your completed registration, self assessment form, and full payment.

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http://champsonline.org/about/champs-overview/champs-organizational-members


4

Ríos Associates Self Assessment Form

CHAMPS/DMS Course Dates: April 21-24, 2017 - Denver, CO

Please complete the following information. Name___________________________

Title and Specialty: __________________________________________________

WELCOME (Bienvenido) to our Intensive Medical Spanish Workshop. Please complete the

following Self-Assessment. This ENSURES that Ríos Associates ships proper amounts of

Books and CDs for your level to the class site. If not, we may not have sufficient materials on

hand. Please return this completed assessment with you registration form to Rachel

Steinberg, CHAMPS, 600 Grant Street, Suite 800, Denver, CO 80203 or fax to 303-861-5315.

Have you ever studied a foreign language before? Yes No If yes, what

language(s) and for how long?

________________________________________________________________

Please answer in full sentences in Spanish on your own without a dictionary. Don’t

worry about spelling or answering only parts or even nothing. This form simply

allows us to place you in the most appropriate level.

1. ¿Cómo se llama, dónde vive y cómo está Ud. hoy? ________________________________

___________________________________________________________________________

2. ¿Qué va a tomar y comer mañana por la mañana? _________________________________

_________________________________________________________________________

3. Describa en detalle lo que hace en su trabajo. ___________________________________

___________________________________________________________________________

___________________________________________________________________________

4. ¿Qué hizo anoche? __________________________________________________________

PLEASE TRANSLATE #5-7 TO SPANISH IN FULL SENTENCES!

5. Lie down. Bend your knees. Sit up. Stand up. Stick out your tongue and say “Ah”. Walk

straight ahead. Walk on your heels and turn around. Close your eyes. Hold still.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

6. Have you ever had heart problems or difficulty breathing? ___________________________

___________________________________________________________________________

7. What kind of pain is it? Is it sharp, dull, intermittent, throbbing, crushing? Can you describe

it? _________________________________________________________________________

___________________________________________________________________________

8. Si ganara la lotería, ¿qué haria? _______________________________________________

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5

CHAMPS and DMS Spanish Language Training for Health Care Professionals April 21-24, 2017

List of Nearby Lodging

Following is a listing of hotels and bed & breakfast facilities located near the course location; the Denver Medical Society, 1850 Williams Street, Denver, Colorado, 80218.

Warwick Denver Hotel

1776 Grant Street, Denver, CO 80203 Approximately one mile from the course location www.warwickdenver.com

Hampton Inn & Suites Denver-Downtown

1845 Sherman Street, Denver, CO 80203 Approximately one mile from the course location http://hamptoninn.hilton.com/en/hp/hotels/index.jhtml?ctyhocn=DENDTHX

Castle Marne Bed & Breakfast

1572 Race Street, Denver, CO 80206 Approximately six blocks from the course location

www.castlemarne.com

In addition, hotels in downtown Denver are located approximately one to three miles from the course location and there are many to choose from. The following website

lists many of the downtown Denver hotel options: http://www.denver.com/hotels/downtown.html.

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http://www.warwickdenver.com/

http://hamptoninn.hilton.com/en/hp/hotels/index.jhtml?ctyhocn=DENDTHX

http://www.castlemarne.com/

http://www.denver.com/hotels/downtown.html

1

ECHO Evaluation Summary Behavioral Health Integration for Community Health Centers The Rocky Mountain Public Health Training Center in partnership with ECHO Colorado and the Community Health Association of Mountain/Plains States, provided an opportunity for Community Health Centers to come together and participate in a highly interactive and engaging virtual training opportunity to improve behavioral health integration.

5 3 Sessions Months

The series engaged a total of 29 registrants representing 18

health centers from 4 states.

Session Attendance

79% of registrants attended at least one session.

47% of participants attended 50% of sessions.

Post-series Survey Results Registrant Details

29 Professionals registered for the series

28 Identified as working in medically underserved

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2

Perceived Barriers

6

When asked about barriers to applying key knowledge and skills addressed during the series, participants reported a similar perceived barrier around all options both before and after completing the series.

1. Contributed to their professional network.

2. was a valuable use of time.

Knowledge, Skill, and Competency Change

Overall, respondents reported an increase in knowledge, skill,

and competencies around the two series learning objectives. Please note that one

respondent only reported skill level for objectives AFTER completing the series.

Perceived Value

1. of respondents have identified actions they will take to apply what they’ve learned.

2. Of responded that their understanding of the subject matter has improved as a result of participating in this series.

75% of respondents agreed that participation in this series:

100%

17% of participants completed the survey.

BEFORE AFTER CHANGE

Identify appropriate strategies to increase behavioral health staff integration into the primary care workflow. 3.75 4 0.25

Address cultural issues affecting integration; both internally (between types of providers) and externally (between staff and the differing population who they serve).

3.25 3.33 0.18

Implement appropriate strategies to increase behavioral health staff integration into the primary care workflow. 3.5 3.33 -0.17

Evaluate the current level of integration at your CHC. 3.75 3.66 -0.09

“I liked the cultural competency and health equity speaker a lot. In general, I thought the speakers were really

great.”

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3

6

Recommendations

“I think it felt like there was too much to fit into an hour. I think either having

just a consult-based series or speaker series might be most effective.”

“Too short of time to try to do a couple of things in the session.”

This series had a small amount of attrition between registrants and participants. For the next round, consider using similar recruitment

strategies.

Several respondents commented that the length of the sessions were too short for the amount of content being covered. Some suggested

covering one topic per session. For the next round, consider narrowing the focus of the sessions to allow for a deeper dive into material which will influence participants’ change in knowledge,

skills, and competencies as well as perceived barriers.

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1

ECHO Evaluation Summary Colorectal Cancer Screening for Community Health Centers The Rocky Mountain Public Health Training Center in partnership with ECHO Colorado and the Community Health Association of Mountain/Plains States, provided an opportunity for Community Health Centers to come together and participate in a highly interactive and engaging virtual training opportunity to improve colorectal cancer screening rates.

5 4 Sessions Months

The series engaged a total of 40 participants representing 18 community health centers from

6 states.

Session Attendance

28% of participants attended 3 or more sessions.

75% of participants attended 1 or more sessions.

Survey Response

Post-series Survey Results Respondent Details

20% of participants completed the survey.

4 identified

as clinicians.

3 identified

as support staff.

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2

Perceived Barriers

6

When asked about barriers to applying key knowledge and skills addressed during the series, participants reported a lower perceived barrier around time, knowledge, skillset, resources, and support. The biggest changes were around time and resources.

1. Improved their understanding of the subject matter, and

2. was a valuable use of time.

Knowledge, Skill, and Competency Change

Overall, participants

reported an increase in knowledge, skill,

and competencies around the four series level objectives.

Perceived Value

of respondents have identified actions they will take to apply what they’ve learned.

100% of respondents agreed that participation in this series:

100%

BEFORE AFTER Change

Engage your team in creating, supporting and following a CRC screening policy. 2.42 3.57 1.15

Identify appropriate patient education materials for their communities.

2.66 3.71 1.05

Maximize the roles of different members of the care team to facilitate the CRC screening process. 2.71 3.33 0.62

Implement clinical decision support tools. 2.71 3.28 0.57

“I like hearing about what other clinics were doing to improve colo-

rectal cancer screenings. I also like that they

shared what worked and didn't work for them.”

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3

6

Recommendations

Of those who responded to the survey, 50% reported that participating in the series did not contribute to the growth of their professional

network. Conversely, the other 50% felt that participation did contribute to the growth of their network. Several participants also commented that they liked connecting with other providers working on similar issues. For future series, consider implementing strategies to emphasize professional connections such as promoting this in sessions, utilizing the discussion board in canvas, or creating a

social media group.

Several participants commented on the time of day. Several reported that the lunch hour wasn’t an ideal

time, but didn’t offer more convenient times. Consider adjusting the time of day to morning or later

in the afternoon.

“What I liked least about the series was that it was during my lunch hour.”

Technology related issues were reported by several participants when asked what they least liked about the series and what their

biggest barrier was to attending. For future series, revisit current technology support processes to identify areas for improvement.

“Didn't find the technical issues with the cameras really worth it.”

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2/28/2017

1

BPHC All‐Programs WebcastFebruary 28, 2017

Agenda

• Updates• 340B Program Update• 2016 Survey Results• EHBs New Home Page• BPHC Newsletter and Website Improvements• Wear Red Day• Questions

2

340B Program Update

J. T. MorrisOperations Branch Chief, Office of Pharmacy AffairsHealthcare Systems BureauHealth Resources and Services Administration (HRSA)

3 4

340B Drug Pricing Program Update

Health centers may register until March 10, 2017

Requirements• EHB record indicates “active”• Cannot prospectively register

Process1) Review EHB record2) Contact 340B Prime Vendor Program

• 1‐888‐340‐2787• [email protected]• Home ‐ 340B PVP

3) Office of Pharmacy Affairs willreach out with a one time link(The link is active immediately for 72 hours)

Health centers must provide the Call Center with:• Health center name• Site/clinic name• Site ID for all sites• HRSA/BPHC grant number• Contact name and email address• Authorizing official name and email address

2016 Survey Results:

• BPHC Stakeholder Satisfaction Survey (SSS)

• HRSA Grantee Satisfaction Survey (GSS)

Adam RobbinsTeam Lead, Strategic Planning and Quality ImprovementBureau of Primary Health Care (BPHC)Health Resources and Services Administration (HRSA)

5

6

BPHC Surveys & Action Plans

• BPHC Action Plans provide a roadmap for improving the outcomes of our organization

• Survey results inform BPHC Action Plans

Your voice was heard; Action is underway

• Action Plans reflect many inputs, including:

HRSA Priorities Staff Engagement

Survey Results Leadership perspective

6

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2/28/2017

2

7

BPHC’s External Surveys

BPHC Stakeholder Satisfaction Survey (SSS)1

Description:

Administered: Response Rates

HRSA Grantee Satisfaction Survey (GSS)

BPHC: 27% (493 of 1798)

HCP: 29% (403 of 1381)

PCAs: 56% (29 of 52)

NCAs: 55% (12 of 22)

LALs: 23% (14 of 60)

HCCNs: 61% (27 of 44)

Free Clinics: 15% (36 of 233)

Mar 23rd – May 4th, 2016

BPHC‐specific survey managed by OSBO

Results:

Aug 2nd – Sept 9th, 2016

2

Description:

Administered:

HRSA‐wide survey managed by OPAE

HRSA: 44% (2001 of 4548)

BPHC: 744 respondents

Scores for 68 questions across 22 Topics

Response Rates

Results: Scores for 50 questions across 9 Topics

7

BPHC SSS Results for 2016

Overall 2015 to 2016

• Improved 67% of questions (42 of 63)

• Improved overall Stakeholder Satisfaction Index (SSI) by 1pt (70pts to 71pts)

Topic Areas: 2015 to 2016

• Largest Increase: “Application Process Clarity” increased 3pts (73pts to 76pts)

“UDS TA” increased 3pts (73pts to 76pts)

• Highest 2016 Score: “Primary Health Care Digest” 2016 score was 85pts

• Largest Decrease: “BPHC All‐Programs Calls” decreased 2pts (75pts to 73pts)

• Lowest 2016 Score: “EHB” 2016 score was 64pts

(note: this topic improved 2pts from 2015 to 2016)

8

BPHC SSS Results for 2016

1,978 Narrative Comments Across 22 Topics

• Analysis of comments will inform BPHC actions in 2017

• Narrative comments must be viewed along with relevant quantitative survey results to provide context

• Comments are important to BPHC leadership, they can help lead to constructive actions, when appropriate.

9

BPHC SSS Focus Areas for 2017

• Satisfaction with BPHC All Program Calls.

• Project Officer (PO) knowledge of policy & program issues specific to your state or region.

• PO keeps you informed about upcoming changes or issues that affect your program.

• Ease of navigating the BPHC website to find information you need.

• Ease of understanding information on the BPHC website.

• Helpfulness of BPHC Guidance for site visit preparation.

• Adequate time to prepare for site visits.

• EHB system is easy to navigate.

• Error messages in EHB are easy to understand and, when appropriate, provide clear instructions on how to fix mistakes, or how to report an error.

• Information provided in the BPHC submission system is easy to understand.

Selection

Criteria:

• Score < 74pts AND Topic “Impact Score” greater or equal to 0.5

• Score < 65pts

• Score decreased by 2pts or more from 2015 to 2016

10

BPHC GSS Results for 2016BPHC Compared to HRSA Overall

• BPHC scores higher than HRSA for 30% of questions (15 of 50)

• BPHC & HRSA have the same Stakeholder Satisfaction Index (SSI) (both 73pts)

A Closer Look at Topic Areas

• Highest 2016 Score: “Call Center” 2016 score was 83pts

• Most pts above HRSA: “Notice of Award” 1pt above HRSA (BPHC = 72pts; HRSA = 71pts)

“Grants Mgmt. Specialist” 1pt above HRSA (BPHC = 73pts; HRSA = 72pts)

“EHB” 1pt above HRSA (BPHC = 66pts; HRSA = 65pts)

• Lowest 2016 Score: “Objective Review” & “EHB” 2016 scores both 66pts

• Most pts below HRSA: “Project Officer” 3pts below HRSA (BPHC = 76pts; HRSA = 79pts)

11

BPHC GSS Focus Areas for 2017

• Frequency of communication with your Project Officer.

• Project Officer resolution of your issues and concerns.

• Timeliness of your Project Officer in resolving your issues or concerns.

• Helpfulness of advice and assistance received from your Project Officer.

• Appropriateness of your Project Officer’s referrals to Tech Assistance resources.

• Overall performance of your Project Officer.

• Timeliness of the receipt of the objective review Summary Statement.

• Usefulness of the Summary Statement feedback on the review of your application.

• Overall experience with the HRSA Objective Review process.

• Ability to retrieve previously submitted information on EHBs.

• Able to find the content you are looking for on the HRSA/BPHC websites.

Selection Criteria:

• Below HRSA by at least 3pts AND Topic “Impact Score” > 1.0

• Score < 70pts AND Below HRSA Overall

12

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3

Themes from 2016 Survey Results(Based on Combined Analysis of SSS & GSS)

1

2

3

4

5

Enhance policy communications & Technical Assistance resources for BPHC stakeholders

Enhance “Objective Review” processes

Enhance relationships among Project Officers & stakeholders

Enhance the Electronic Handbooks to support stakeholders

Enhance stakeholder support for site visit preparations

13

14

14

EHBs New Home Page

Neera Agarwal IT SpecialistOffice of Information Technology (OIT)Health Resources and Services Administration (HRSA)

15

15

EHBs User FriendlinessImprovement Areas

16

16

Home Page Link: https://hrsamck.reisys.com/EHBUIExternalNew/Interface/DefaultIntro.aspx#

EHBs New Home Page

17

17

EHBs Usability EnhancementsSurvey Responses

18

18

Business Priority Enhancements(Milestones)

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2/28/2017

4

19

19

• The new EHBs Home page Beta site for Grantee user acceptance test (UAT) will be made available around March 2017

• The new EHBs home page would be released end of April 2017

Next Steps BPHC Newsletter Improvements

• BPHC continues to improve the Primary Health Care Digest, based on continual feedback from the Foresee survey

• To date, we’ve had 275 respondents

• Areas where we scored well: clarity of information, relevancy of content, timeliness of newsletter

• Areas to improve: balance of graphics and text, readability, topics and types of information

• 2016 improvements included updating the look and feel of the newsletter, and adding graphics and images where appropriate

• The highest 2016 SSS score was the “Primary Health Care Digest” (85pts)

20

BPHC Website Improvements

• BPHC also continues to improve the website, focusing on usability and navigation

• To give feedback on the BPHC website, please take the pop‐up Foresee survey the next time you visit bphc.hrsa.gov

21

111

Federal Funding Report - Federal Fiscal Year (FFY) 2017

HRSA New Access Point Grant Awardshttps://bphc.hrsa.gov/programopportunities/fundingopportunities/newaccesspoints/fy2017awards/index.html

Date State Organization Amount12/15/2016 ND Northland Health Partners Community $691,66712/15/2016 WY University of Wyoming $812,500

Region VIII Total $1,504,167National Total $50,996,285Region VIII % of National 2.9%

GRAND REGION VIII TOTAL FFY 2016 $1,504,167GRAND NATIONAL TOTAL FFY 2016 $50,996,285GRAND REGION VIII % OF NATIONAL FFY 2016 2.95%

As of 02/21/17 1

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Rural Veterans and Federal Health Care Reform In its pursuit of health care reform, the Trump Administration must continue to address the unique access challenges and needs of rural Veterans as part of the country’s commitment to care for those who served.

Within the American health care system, Veterans rely on a blend of services from The U.S. Department of Veterans Affairs (VA), Medicare, Medicaid and private health care providers. Changes to any or all of these services will disproportionately impact rural Veterans, who rely more on public services due to their generally poorer health and lower incomes.

The country's tenuous rural health care infrastructure means that VA is necessary to ensure rural Veterans receive consistent, high-quality care. VA must continue to seek partnerships at local, state and national levels to extend health care access to Veterans in the rural communities where they live and work. In light of this complex problem, VA must use its experience to enhance private partnerships and tailor programs that address the challenges, dynamics and needs of rural Veterans.

Greatest Return on Investment for Rural Veterans' Health and Well-being

The Secretary of Veterans Affairs appointed an independent advisory committee of third-party rural health care professionals in 2008 to provide objective analysis and feedback for continual improvement of health care delivery to rural Veterans. In 2016, this Veterans Rural Health Advisory Committee (VRHAC) identified three areas that have the greatest ability to positively affect care for the rural Veteran population:

1. Address workforce shortages. Evaluate differences in rural vs. urban clinician recruitment, specialty care skills, salary and retention rates. Identify best practices and revise procedures to contract with Federally Qualified Health Centers to address the unequal health outcomes associated with Veteran-centric provider shortages in rural communities.

2. Provide personalized Veteran health care. Implement a personalized and flexible approach to Veteran health care in order to address persistent appointment wait times, reimbursement delays, and lack of private health care infrastructure in rural communities. This should include VA and private options, per the needs and preferences of each Veteran.

• Designate VA as primary payer, locally managed scheduler and point of contact for all care, whether received in a VA or private facility.

• Study and evaluate VA-provided care and VA-purchased care, such as the Veterans Access, Choice and Accountability Act of 2014 (Choice Act), to determine the most equitable options for Veterans.

• Continue to support creation of Community Based Outpatient Clinics in rural communities.

3. Maximize telehealth use. Conduct a location-based analysis to identify where limited broadband and mobile phone service stifles innovative tele-medicine centered health approaches, and decide how best to overcome those challenges based on available technology and regional needs.

• Partner with Congress and state and local governments to encourage increased funding for broadband services and pilot telehealth technology.

Read more about the advisory committee’s recommendations at www.ruralhealth.va.gov/aboutus/vrhac.asp.

Complexity of Rural Health Care DeliveryMore than 80 percent of the 2.9 million rural Veterans enrolled in the VA health care system have other health insurance (e.g., Medicare, Medicaid, private insurance) in addition to their VA benefits, on which they rely heavily. As a result, rural Veterans are likely to present for care at a variety of locations—both VA and private—and are therefore impacted by U.S. health care reform, including changes to the Affordable Care Act, Medicare, Medicaid, National Defense Authorization Act and the Veterans Health Administration. In fact, 22 percent of all care authorized by VA is currently done in a private facility. But private care options are often unavailable in rural communities, forcing Veterans to remain reliant on VA, which spends more than $14 billion every year providing care that would otherwise not be available.

Released January 2017

2017 Veterans Rural Health Advisory Committee Brief113

The rural Veteran population is older and has more complex health problems than Veterans who live near cities. In fact, 57 percent of VA-enrolled rural Veterans are 65 years or older, compared to less than 17 percent of all Americans.1 An aging population typically experiences multiple chronic conditions and often requires complex long-term care. Also, Veterans who reside in rural communities often face transportation challenges, such as long distances traveling to and from health care appointments, lack of public transportation, weather or higher cost. Injuries or multiple illnesses, especially those that require routine doctor visits, can intensify these challenges.

Deteriorating U.S. rural health care infrastructure2 Private health care infrastructure simply does not exist or is shrinking in the communities where rural Veterans reside. Therefore, excellent and accessible VA care is more essential than ever for many rural Veterans who have no alternative.

• More than 80 rural hospitals closed in the last six years, and closures are happening six times faster today than they did in 2010.

• Nearly 700—one of every three—rural hospitals are currently at risk of closure.

• Only about 10 percent of physicians and other health care providers practice in rural communities, even though one-quarter of the U.S. population lives there.

Due to these rural infrastructure and workforce issues, recent efforts like the Veterans Access, Choice and Accountability Act of 2014 (Choice Act) did not fully solve rural Veterans' health care challenges. In fact, rural Veterans are increasingly at-risk since they rely on both VA and private community care. The Choice Act is set to expire in August 2017 and Congress has not proposed an alternative. Creative and innovative solutions are needed to address these complex challenges.

VA-Enrolled Rural Veteran Population 3,4,5

• 54 percent earn an annual household income of less than $36,000

• 36 percent do not access the internet

• 57 percent are 65 years or older

• Nearly half consider VA their primary source of health care

• 6 percent are female, a small but growing population

• 9 percent report being a racial or ethnic minority

VA Answers the Rural Call • VA is the largest provider of telehealth in the country, and provided Veterans with more than 2.1 million telehealth encounters

in fiscal year 2015.

• Since 2004, the independent American Customer Satisfaction Index survey showed Veterans give VA health care higher ratings than most private hospital patients.6

• VA mental health care was better than private-sector care by at least 30 percent on all seven performance measures, with VA patients with depression more than twice as likely as private-sector patients to get effective long-term treatment.

1 U.S. Census Bureau, “Age and Sex Composition: 2010,” (May 2011).

2 “Rural Healthy People 2010: A Companion Document for Rural Areas” and the North Carolina Rural Health Research Program, The Cecil G. Sheps Center for Health Services Research, University of North Carolina.

3 U.S. Department of Veterans Affairs National Center for Veterans Analysis and Statistics Veteran Population Projection (2014)

4 U.S. Department of Veterans Affairs, VSSC Enrollment Cube (fiscal year 2015).

5 U.S. Department of Veterans Affairs, Survey of Enrollees (fiscal year 2015).

6 U.S. Department of Veterans Affairs, “VA Secretary and Deputy Secretary tell Commission on Care: Transformation is Underway and Already Delivering Measurable Results for Veterans” (April 2016).

This document was produced by the Veterans Rural Health Advisory Committee (VRHAC). VRHAC is managed by the congressionally mandated VA Office of Rural Health, which implements enterprise-wide initiatives to improve the health and well-being of rural Veterans by increasing their access to care and services. Learn more at ruralhealth.va.gov.

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2017 WINTER STRATEGY MEETING January 26-28, 2017 – Delray Beach, Florida

REPORT TO THE CHAIR J. Ricardo Guzman, MPH, LMSW

February 23, 2017

Mr. Chairman: The 2017 Winter Strategy Meeting (WSM) came at a time when major change and uncertainty had produced high levels of concern and anxiety among attendees and the entire movement. While we did not want to underplay the serious challenges we face, we needed to convey that we had an aggressive plan of action. In addition to informing attendees about that plan, we wanted them to question and test it and to offer enhancements. By the end of this year’s meeting, most attendees had a good understanding of the path forward, including immediate next steps; that in turn produced a degree of certainty in our actions and diminished anxiety. However, we underscored the enormity of the task ahead, and that success would only come from a commitment to a coordinated, sustained plan of action. Our presenters challenged and stimulated the attendees who came prepared to engage in all parts of the meeting. Even though we had fewer external speakers than in past years, those we had delivered messages that continue to resonate with all of us and contributed to reducing some of the concern and anxiety. The internal speakers (staff from health centers, networks, PCAs, and NACHC) shared specific experiences and conveyed information that again helped assure people that we can and will meet the challenges ahead. The seriousness of the situation and the quality of the presentations increased attendee involvement in all parts of the meeting and led to concrete recommendations to improve our plan of action. The current environment dictated allocating the majority of our time to advocacy (“Strengthening the Health Center Message” and “Delivering the Message”); however, we also conveyed the long-range importance of continuing to improve health center operations and being prepared for delivery system and payment reform (“Preparing for Tomorrow’s Challenges Today”).

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Attached to this report are the major ideas and recommended actions from this year’s meeting. A summary of the principal observations and priority actions are described below. GENERAL OBSERVATIONS Because of the important decisions that will affect the future ability of health centers to be successful, NACHC consultants, staff, and external presenters described in detail the political landscape – both in DC and state capitals – where these decisions will ultimately be made. Different presenters drove home points related to vulnerabilities and assets of which we must be aware: Vulnerabilities

1) Insufficient numbers of health center organizations and people involved in advocacy. 2) Actions that inadvertently weaken our non-partisan image and bi-partisan support. 3) Too few elected officials who understand why preserving Medicaid is so important to

health centers. 4) Lack of knowledge about health centers among key members of the new administration.

Assets

1) People! – patients, providers, board members, and staff can best tell the “health center

story” to elected officials and policy makers. Our strongest voice is from “the people back home”.

2) Economic Impact – employment, purchasing, and a healthy workforce all contribute to local economies.

3) Front-line Responders – backbone of the safety-net in local communities responding to public health issues and problems.

4) Effect on the Cost Curve – proactive, continuous, and coordinated care delivered by health centers saves $24 billion annually.

Acknowledging these vulnerabilities and assets, the breakout groups identified a short list of principles needed for effective advocacy efforts: Recognize that we are engaged in a multi-front battle – retain the essential elements of

existing health center legislation; avoid a funding cliff (health centers and workforce); and preserve Medicaid.

Prepare for a marathon – this is not a sprint and will require the capacity to mount a sustained action plan.

Coordinate national, state, and local advocacy action plans – only some states and very few health centers have 12-month advocacy “calendars”.

Tailor messages to multiple audiences – simple (easy to share); core points (easy to adapt to specific situations); precise (easy to understand).

Engage messengers who are more than “the usual suspects” – physicians, patients, community partners, and other non-traditional community representatives must join in delivering the message.

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In addition to their work related to advocacy, the breakout groups produced a set of principles associated with health centers succeeding in the transformation of health care delivery: Concrete operational improvement action plans are still crucial – we cannot put these

efforts “on hold” while dealing with advocacy issues. Be prepared for MCOs and other payers to push for increased managed care, cost control,

and revised payment arrangements. Meet Leavitt’s challenge to be in marketplace-driven networks by responding to his “Seven

Challenging Questions”: a) Can you change patient behavior? b) Do you have a strong brand? c) Do you have access to adequate capital? d) Can you assume and manage risk? e) Do you have a big enough clinical footprint? f) Does your clinical footprint enable you to be the primary care provider for a critical

mass of patients? g) Can you be a strategic integrator with high “collaborative IQ” that brings hospitals,

specialty providers, social service providers, and others into integrated networks? PRIORITY ACTION AREAS The challenge from all WSMs is to sort through the many good ideas and suggestions and identify priority actions requiring immediate attention. This year’s meeting produced a resounding “Call to Action” that we have already begun to rally around. Our joint email (2/7/2017) sent this “Call to Action” to all attendees and many of their counterparts who were not at the WSM. Beyond the “Call to Action” and activities associated with making it happen, there are several other actions requiring immediate attention: While we have more information than most groups, we need more and sharper detail.

Actions to consider are expanding economic impact analysis to local health center service areas and refining impact analysis to focus on congressional districts.

Most health centers are still unable to access and analyze relevant claims data from MCOs and other payers/ purchasers. We must enhance our data analytics / business intelligence capacity, enabling the integrating of patient data from EHRs with claims data from payers/ purchasers.

An adequate health center workforce – primary care providers and other essential staff – continues to challenge most health centers. Workforce concerns will continue to require a multi-faceted approach – advocacy (NHSC, THC), retention (competitive salaries, team practice models), supply (“grow our own”), and recruitment.

In response to the requests to examine the value of a national health center branding campaign, we should consider if the benefits outweigh the costs.

Recognizing the challenges we face and the magnitude of the effort required to meet them, continue to explore ways to assure there are sufficient resources to support the efforts.

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CONCLUSION This year’s WSM certainly confirmed the notion that we live in interesting times. While we acknowledged real and serious challenges, we also affirmed the tremendous assets we have when we operate as a coordinated primary care network. These assets can continue to create opportunities if used wisely. To that end, the broad NACHC (members, boards, PCAs, networks, and staff) must all expand their leadership activities. People are hungry for information and guidance about how to respond to this changing environment. For the sake of the more than 25 million people health centers serve today and the many more health centers could serve, all of us at NACHC will need to step-up to the challenges and redouble our efforts to preserve and strengthen the largest primary care network in the country.

Sincerely,

Tom Van Coverden President and CEO

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1

NACHC WINTER STRATEGY MEETINGJanuary 26-28, 2017

Delray Beach Marriott – Delray Beach, FL

SUMMARY ANDRECOMMENDATIONS

Attachment 1

SETTING THE STAGE

Threats are real!

Challenges are real!

But opportunities

are still there!

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SETTING THE STAGE

PERIOD OF CHANGE WHICH BRINGS UNCERTAINTY

• Still more questions than answers

• In our world, the only constant is change

• How are we going to respond to change?–Fight it

–Accept it

–Lead it

SETTING THE STAGE

STAGES OF LEGISLATIVE CHANGE – IMPLICATIONS FOR OUR ADVOCACY EFFORTS

• Budget Resolution Phase (completed)

• Presidential “Magic” Phase – executive orders and actions

• Repeal Phase 1.0 – completed by Congress’ spring recess

• Repeal Phase 2.0

• Replacement Phase(Leavitt)

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3

SETTING THE STAGE

HEALTH CENTERS MUST BE IN MARKETPLACE-DRIVEN NETWORKS – IMPLICATIONS FOR OUR

DELIVERY SYSTEM TRANSFORMATION EFFORTS

• Can you change patient behavior?• Do you have a strong brand?• Do you have access to adequate capital?• Can you assume and manage risk?• Do you have a big enough clinical footprint?• Can you aggregate a critical mass of patients?• Can you be strategic aggregators with high

“collaborative IQ”? (Leavitt)

PRIORITY FOCUS AREAS

FOCUS AREA 1:

Advocacy Capacity – Strengthening the Health Center Message

FOCUS AREA 2:

Advocacy Capacity – Delivering

the Message

FOCUS AREA 3:

Preparing for Tomorrow’s Challenges Today

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4

CHARGE: Focus Area #1: ADVOCACY CAPACITY –Strengthening the Health Center Message

Must make the case:

1) that Health Centers are an essential asset in health care delivery, aka “value”

2) that the asset needs to be preserved, aka “impact”

3) with multiple and key audiences – elected officials, policy makers, payers, patients, providers, and partners

EXPECTED OUTCOME: Identify ways to strengthen and adjust the message to work with the various audiences.

Focus Area #1: ADVOCACY CAPACITY –Strengthening the Health Center Message

CURRENT CHC MESSAGE

• HCs are the largest primary care network in the country• HCs are the health care home for more than 24 million Americans,

operating as locally-owned businesses, providing local solutions for local (& national) problems, and boosting local economies

• HCs are on the front lines of the most challenging health care crises: Zika, opioid addiction, Veterans’ access, etc.

• HCs bring together medical, dental, mental health & addiction care in locally integrated settings, partnering w/other local service providers

• HCs’ focus on prevention, early care & care integration saves more than $24 Billion annually, for governments & private payers

• HCs are bending the “cost curve” by reducing: ER use, diagnostics & hospital admissions

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5


CURRENT CHC MESSAGE

• To continue to do their job well, HCs need Congress to address the twin pillars of their success:

• Stable, continuous grant funding to support care for un/underinsured & services not covered by most insurance (e.g., outreach, transportation, health/nutrition education, care management)

• A strong Medicaid program that works for low-income communities & their care providers, like HCs


CURRENT CHC MESSAGE

• Inaction (or contrary action) on the twin pillars would cause:• Loss of care for 9 Million people, loss of 50,000 jobs, closure of

2800+ sites• Flexibility is already built into PPS payment system

• Turning either program (CHCs or Medicaid) into a Block Grant would bring deep & irreparable harm

• For HCs, fixed funding obviates growth when needs spike• Similarly, in Medicaid, a Block Grant or Per Capita Cap will

leave states facing either financial ruin or serious health crises when public health threats emerge (opioid epidemic, Zika virus, Vets unmet care needs)

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CURRENT CHC MESSAGE

Most of all:

Don’t repeal the ACA unless & until you have a viable

replacement plan

We need to lead in the work to develop the solution


Overarching Observations:

• Different Lens - Revisit our message so that it is relevant to both Rs and Ds

• What “they” want to hear – when they want to hear it

• Personal relationships are essential – messaging without the relationship does not go very far – get folks into health centers

• Capacity to mount a sustained, coordinated campaign

• “Do No Harm”• People (covered and served)• Investments (past R and D Administrations)

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7


RECOMMENDATIONS

• Brand recognition strategy, including advertising campaign

• What we are (local, businesses, integrated care, high quality, bend cost curve)

• Enhanced impact analyses capacity (Local, Congressional District, State, National)

• Economic impact• Employment impact• Cost avoidance impact• Total cost of care impact


RECOMMENDATIONS

• Principles to guide our messaging• Simple – easy to share• Core points – easy to adapt to specific situations• Precise – easy to understand• Condensed – option to get details• Alignment – avoid fragmentation

• Enhanced Social Media Capacity• Tweeting “101” at P&I• Toolkits• Other training

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RECOMMENDATIONS

• Finding additional people to deliver our message

• Clinicians

• Partners

• Patients

• Community Representatives (who have not traditionally been involved)


OTHER NOTEWORTHY SUGGESTIONS

• Suggested Tagline – “I work for my patients…”: “Healthy people work”

• Medicaid Primer – one legislative authority, but many specific State names

• Better sharing of information already available – new cooperative agreement may help

• Use the “50 Year Anniversary” video

• Get P&I “read aheads” out earlier

• Waianae Coast PPS example (graph)

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9

CHARGE: Focus Area #2: ADVOCACY CAPACITY –

Delivering the Health Center Message

Successful delivery of the message requires multiple people delivering it consistently, while tailoring it to a variety of audiences. Ultimately, this will require state

specific strategies and solid, actionable plans that reflect the unique character of each state.

EXPECTED OUTCOME: Development of specific state plans for enhanced advocacy.

Focus Area #2: ADVOCACY CAPACITY –Delivering the Health Center Message

BOTTOM LINE: NEED TO PUT IN PLACE LOCAL, STATE, AND NATIONAL ADVOCACY PLANS

Rationale: Lack of local, state, and national advocacy plans increase likelihood of “worst case” scenario

• Block grants (HC Program//Medicaid Program)

• Inadequate Medicaid coverage and payment

• Major reduction of grant support

• Loss of primary care provider resources (NHSC, THC, etc.)

• What’s it look like – lives lost, decrease in health status, lost

jobs, increased costs, etc.

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10


CRITICAL ELEMENTS OF LOCAL, STATE & NATIONAL ADVOCACY PLANS

• Advocate! And in doing so, keep the messaging simple, brief, and concise. Perfect the art of making your case in 1 minute.

• Demonstrate the old axiom that Politics make strange bedfellows. In other words partner with others that you haven’t partnered with before.

• Be consistent and repetitious. Delivering a message once or twice during a state legislative session is not enough; prepare for a marathon.

• If you don’t ask, you shall not receive.



• Understand your audience. If you’re in a red state, talk about tenets of health centers that align with Republican thinking i.e. local control, “access” to care, patients paying on a sliding fee, patients paying full rate over 200%, patients taking ownership of their health care.

• Become acquainted on a first name basis with both the elected official and his or her staff.

• Be prepared. Do your research. Be able to anticipate questions.

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• LEAD, don’t just be at the table, otherwise you might end up on the menu. Bring solutions. Policy makers want solutions. They don’t want to just hear about problems. Bring them ideas about health care innovation, how to control cost, and improve quality.

• Keep it local, invite them to your health center. Don’t underestimate the power of this simple act.

• Utilize our most important assets and make them the face of our action plans: Our providers and Our patients!


CALL TO ACTION

• PCAs develop annually a 12-month advocacy action plan.

• CHCs develop annually their own 12-month advocacy action plan.

• Then execute the PCA and HC plans!

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MAJOR CHALLENGES TO

IMPLEMENTING PLANS• Complacency – prior successes cause some to defer

action

• Business as usual will be sufficient – NOT!

• HC Board member commitment and involvement

• Engaging the “folks back home”

• Finding the “sweet spot,” e.g., “reason for every elected official to support health centers, challenge is finding that reason.”

• Reluctance to enable and empower HC staff to participate in advocacy


ADVOCACY ASSETS

1. People – patients, board members, providers, staff

2. Footprint/market share (local and state)

3. Economic impact – including stabilize neighborhoods and communities

4. Established integrated care model –access/quality/cost – bend the cost curve

5. Front-line responders to public health issues

6. Data capacity – turn data into impactful information

7. Others too numerous to list!!

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13


PRIMARY STAKEHOLDERS

• State and local elected officials, especially those with the “majority party” & those who are newly elected

• Employers and businesses, including Chambers and service organizations

• Hospitals

• State Associations (Hospitals, Rural Health, Nursing Homes, etc.)

• MCOs/Health Plans

• Institutions of higher education


PRIMARY STAKEHOLDERS

• Medicaid Directors

• Major HC vendors

• Again, others too numerous to list!! Including having a clinician group that meets with physicians who are in senior leadership positions, e.g., Dr. Price and Dr. Shulkin.

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14


IMPORTANT THINGS TO REMEMBER WHEN PUTTING A STRATEGY IN PLACE

• Must reinforce the bi-partisan support for health centers and the non-partisan nature of HCs

• Always leave your personal political ideology at the door. Always wear CHC and our patients on your sleeve.

• Achieve the notion of “help me, help you”

• Be able to talk the business side of HCs, as well as we talk the mission and value of HCs

• Build the coalitions even before they may be needed


IMPORTANT THINGS TO REMEMBER WHEN PUTTING A STRATEGY IN PLACE

• Be on “other groups” policy priorities list

• Need congressional district and state-specific data to support the “value proposition”

• Acknowledge that this is a marathon

• “Accept chaos, offer calm, bring back hope”

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CHARGE: Focus Area #3: PREPARING FOR TOMORROW’S CHALLENGES TODAY

States will continue to move toward more autonomy in their Medicaid programs, with quality care and

lower costs being the ultimate objectives.

We will need to recognize this reality and take deliberate steps to define our futures.

EXPECTED OUTCOME: Development of specific state plans for enhanced health center operations and preparation for payment reform.

Focus Area #3: PREPARING FOR TOMORROW’S CHALLENGES TODAY

OVERVIEW

In addition to a state advocacy action plan, each

state needs an integrated organizational model

that ensures health centers are operating

effectively and responding to changes in local and

state environments.

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OVERVIEW

While there will be different organizational models, the critical competencies that need to be in place in each state are:

• Advocacy and member services

• Quality, practice improvement

• Converting data to information

• Information aggregator and negotiator

• Back office and administrative service provider


OVERVIEW

This capacity is needed to provide services that:

• Enable all ships, aka health centers, to rise

• Enable all HCs to be recognized as quality providers

• Show that all HCs are prepared to respond to change

• Enable all HCs to move from volume to value

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HEALTHY INDIANA 2.0

What people want to know:

• What has worked/what has not?

• What features to support/what to challenge?

• How does it fit with Medicaid plans in DC – Capitol Hill

and/or Administration?

• What other plans have been enacted that extend

Medicaid?


HEALTHY INDIANA 2.0

RECOMMENDED ACTION

• NACHC prepare a white paper based on HIP 2.0 and other Medicaid extension options that addresses the above questions

• Establish capacity at the state level to replicate what the North Carolina “example” accomplishes

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WHAT’S KEEPING YOU UP AT NIGHT?

National Policies/Issues

• Workforce Development• Supply

• Changing policies, e.g., HPSA scoring

• Data Infrastructure – too much data, not enough information!

• Integration and Differentiation – how to bring more organizations under the tent while staying who we are

• Policies that have implications or potential collateral damage for HCs, e.g., Immigration/Refugees

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19


WHAT’S KEEPING YOU UP AT NIGHT?

State Policies/Issues

• Changes to 340(b)

• Waivers (1332, 1115, etc.)• State Budget “deficits” – what will get cut

• National Association of Medicaid Directors “wish list”


WHERE ARE HEALTH CENTERS VULNERABLE?

Health Center Operations

• Ability to assume risk

• Care management & care transition capacity

• Accurate and appropriate documentation of patient visits – it is more than just coding!!

• Primary care provider capacity

• Necessary services that may be outside scope of project

• Inadequate capacity to provide needed information in a useable fashion

• Patient attribution methodologies

• Aging HC leadership

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WHERE ARE HEALTH CENTERS VULNERABLE?

Marketplace

• Hospital movement into primary care

• Retail urgent care operations

Delivery System

• Inadequate specialty care referral capacity


WHAT DO WE NEED TO DO?

• Improve ability to identify and share best practices –leverage new technologies

• Identify the “trusted experts”• Re-brand – more than clinics who only serve limited

types of people• Respond to changing patient expectations, e.g.,

Millennials• Develop closer relations with Academic Medical Centers

and Public Health Departments• Make succession planning a priority• Create and implement a clear plan in support of

pursuing the “Quadruple Aim”

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Never forget that to be successful, we must:

• View things from a different context

• Establish critical partnerships

• Remain nimble and flexible

• Stay united!

WRAP UP

Manny LopesTess KuenningLindsay FarrellEva TurbinerLolita LopezCheri RinehartKim SchwartzPhil HarewoodLarry McCulleyBerneice Mills-Thomas

Lucy Ramirez-TorresSeferino MontanoTeresita BatayolaDennis KruseTom TrompeterRoss BrooksJohn SantistevanAvein Saaty-TafoyaBen Flores

Thank you, Group Leaders!

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February 9, 2017

LIST OF NACHC MEMBERS ELIGIBLE IN REGION VIII FOR ELECTION IN 2017 AS REGIONAL REPRESENTATIVES TO THE NACHC BOARD OF DIRECTORS

With this memo, the 2017 Regional Election Process begins! As you know, each region annually elects one representative for a two year term. To begin the process, NACHC is providing the following list of eligible members in Region VIII who meet the minimum qualifications:

NACHC INDIVIDUAL MEMBERSHIP: must be a NACHC Individual Member in good standing and have maintained current Individual Membership for the past three consecutive years.

REPRESENTING NACHC ORGANIZATIONAL MEMBER OR CHARTERED REGIONAL AFFILIATE: must be employed by or serve on the board of a NACHC Organizational Member in good standing that has maintained current membership for the past three consecutive years, or be employed by a chartered State, Territorial or Regional Affiliate for the past three consecutive years.

NACHC COMMITTEE PARTICIPATION: must have served on at least two different NACHC committees at any time within the last five years, with at least a 50% record of attendance on each committee.

ABOUT THIS LIST: As with any database associated with dues payments and date-specific information, it is somewhat of a moving target. We try extremely hard to maintain eligibility for our members. For instance, when individual dues are received late but within the current dues year, we are able to apply the payment without interruption of “consecutive years” membership. Once a full dues year (July 1 to June 30) goes unpaid, we cannot restore consecutive membership, and the individual’s “member since” status resets to the current payment year. Committee participation is another area that can slip away from folks – as each year passes, a year drops off the list and someone may lose that “second” committee, or both! The current eligibility list for committee participation is pulled from January 2011 to the present. As in previous years, we are providing information on who might be “nearly eligible” for one reason or another, both as information to assist with inquiries as to why someone didn’t make the eligibility list, and so that you can continue to encourage members in your region to participate in NACHC. We thank you for your assistance! BETWEEN NOW AND JUNE 1, regional associations will prepare for their elections: assemble their Nominating Committee, seek interested candidates from the eligible list, and collect and submit completed Petition for Candidacy packets from each candidate (see guidance, “Role of the Chartered Regional Affiliate/Regional Association – Vetting and Certification Process” on page two). Regions opting to have NACHC conduct their election process must notify NACHC by April 30. Please review the enclosed guidance, and feel free to contact Darline DeMott at [email protected] or 301-347-0400 x 2014 for assistance or with questions.

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LIST OF NACHC MEMBERS ELIGIBLE IN REGION VIII FOR ELECTION IN 2017 AS REGIONAL REPRESENTATIVES TO THE NACHC BOARD OF DIRECTORS

(Eligible in bold) COLORADO --------------------------------------------------------------------------------------------------------------------------------- ------- Polly Anderson Colorado Community Health Network Denver Ross Brooks Mountain Family Health Center Glenwood Springs Tillman Farley, MD Salud Family Health Centers Fort Lupton Steve Federico, MD Denver Community Health Services Denver Simon Hambidge, MD, PhD Denver Community Health Services Denver Ed Hendrickson, PhD, PA-C Salud Family Health Centers Fort Lupton Julie Hulstein CHAMPS Denver Annette Kowal Colorado Community Health Network Denver Carol L. Lewis, LISW Denver Community Health Services Denver Lucy Loomis, MD Denver Community Health Services Denver

Pamela McManus Peak Vista Community Health Center Colorado Springs Jennifer Morse Salud Family Health Centers Fort Lupton John A. Reid Metro Community Provider Network Englewood Jessica Sanchez, FNP Colorado Community Health Network Denver John Santistevan Salud Family Health Centers Fort Lupton–current Regional Rep Frank Taylor Metro Community Provider Network Englewood Needs only additional committee participation to be eligible Holly Batal, MD Denver Community Health Services Denver (needs 1 more) Art Fernandez Mountain Family Health Center Glenwood Springs (needs 1 more) Mitzi Moran Sunrise Community Health Evans (needs 1 more) Eligible in 2018, assuming membership remains current Ethan Kerns, DDS Salud Family Health Centers Fort Lupton Venita Pine Peak Vista Community Health Center Colorado Springs (also needs 1 committee) Eligible in 2019, assuming membership remains current Rebecca McCay Peak Vista Community Health Center Colorado Springs (also needs 1 committee) MONTANA ----------------------------------------------------------------------------------------------------------------------------- ------------ Roxanne Fahrenwald RiverStone Health Clinic Billings John Felton RiverStone Health Clinic Billings Kim Mansch Partnership Health Center Missoula Needs only additional committee participation to be eligible Carol Townsend Montana Migrant Council Billings (needs 1 more) Eligible in 2018, assuming membership remains current Megan Littlefield, MD RiverStone Health Billings (also needs 1 committee) NORTH DAKOTA ----------------------------------------------------------------------------------------------------------------------------- ---- NONE SOUTH DAKOTA --------------------------------------------------------------------------------------------------------------------------------- John Mengenhausen Horizon Health Care Howard – current Regional Rep Eligible in 2019, assuming membership remains current Shelly Ten Napel Community HealthCare Assn of Dakotas Sioux Falls UTAH ----------------------------------------------------------------------------------------------------------------------------- ------------------ Keith Horwood, MD Community Health Centers Midvale Alan Pruhs Association for Utah Community Health Salt Lake City WYOMING ----------------------------------------------------------------------------------------------------------------------------- ------------ NONE

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NACHC Position Description: Regional Representatives to the NACHC Board (Board Members)

Purpose: Regional Representatives are elected to the NACHC Board of Directors on an annual basis, by the majority of the NACHC organizational members in their Region. Elections are conducted by the applicable Chartered Regional Affiliates. General Board Responsibilities:

• Oversees the funds, property and affairs of the Association. • Approves the annual budget, and reviews and accepts the annual audit. • Adopts personnel and financial management policies including policies as appropriate and consistent with NACHC’s Bylaws. • Works with the Chair to establish appropriate committees and ratifies all appointments made by the Executive Committee. • Reviews and receives reports from NACHC Committees. • Receive proposed amendments to the bylaws from organizational members and determine whether to refer a proposed

amendment to the voting membership for approval as outlined in the Bylaws. The Board may, in its discretion, refer a proposed amendment to one or more committees and receive recommendations from such committees with respect to such amendment.

• Performs any acts or functions consistent with NACHC’s bylaws.

Responsibilities Specific to Regional Representation: • Actively pursues membership recruitment and retention efforts in their region, including active dialogue with PCAs. Also,

ensures that “listening time” is conveniently scheduled at state and regional PCA meetings. • Promotes NACHC-endorsed products and programs nationally, and within his/her state and region.1

• Serves as NACHC spokesperson in his or her region and state, providing NACHC updates at state and regional meetings and forums. Also, gathers and communicates to the Chair, concerns and issues from members in the states and regions.

Elected By: NACHC Organizational Members voting in their respective Region Length of Term: Two years (eight consecutive board meetings) Time Commitment: Attendance at four board meetings per year; occasionally at other one-time events Qualifications: In addition to the minimum qualifications outlined in NACHC’s Bylaws (re: member status and committee participation): • Commitment to NACHC, its priorities, and its mission and values; an understanding of NACHC’s objectives, organization,

services, and staff responsibilities. • Abides by NACHC’s standards and policies concerning confidentiality, conflict of interest, and disclosure expectations. • Ability to analyze the internal and external forces affecting health centers and NACHC and to advise on the development of

strategies that result in a unified health center posture and an enhanced environment for health centers. • Understanding of national health policies and ability to present and defend NACHC’s positions on national issues. Budget Support: NACHC’s Board Members serve strictly on a volunteer basis* and are not reimbursed. It is expected that in as much as these individuals are active members of NACHC, they would routinely attend NACHC’s major conferences. The President and CEO may authorize travel expense reimbursement for other travel the board member is requested to make on behalf of NACHC. (Whenever possible, NACHC encourages the inviting organization to underwrite some or all of the travel expenses.) * except the NACHC-Elected Consumer/Board Member Representative serving on the NACHC Executive Committee, as stipulated in the bylaws.

1 Because there have been specific programs and or products that have been developed within a particular state or region, in specific instances a regional representative might be unable in good faith to promote a particular NACHC-endorsed product or program in his or her state or region.

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Your Weekly Source for Health Center Policy Updates

As Congress Returns, Leaks, Rumors and Disagreements Dominate the ACA Debate

Normally, a Congressional recess, where Members travel home to hold meetings with constituents in their districts, is a relatively quiet time for those of us in Washington. Last week was different, especially for those of us following the health care debate closely. By the end of the week, leaked legislation, intra-party feuding, and mixed signals from the administration had all come into the open, leaving the debate in a major state of confusion as Congress returns to Washington. Get the latest at Health Centers on the Hill.

HC Advocacy Launch Webinar on March 15 at 3PM ET

Join us on March 15 at 3PM ET for the Health Center Advocacy Network Launch Webinar. It is a great opportunity to explore our brand new website, navigate new tools and resources and give us feedback on our new site. Register here.

Registration Open for the 2017 Policy & Issues Forum

Registration for the NACHC Policy & Issues Forum is now open. The meeting will be held March 29-April 1, 2017 in Washington, D.C. at the Marriott Wardman Park hotel. We encourage all health center advocates and board members to join as healthcare issues will be at the forefront of the new administration's agenda. The focus at P&I will be to preserve Medicaid and the unique role of health centers, as well as ensure strong funding to enhance health center capacity.

National Health Center Week 2017 August 13-19

It's never too early to start planning! Mark your calendars for NHCW 2017, August 13-19. The theme this year is "Celebrating America's Health Centers: The Key to Healthier Communities". As you start your planning, please send along any high-resolution photos from past NHCW events that we can use to promote this important celebration online. Send photos to [email protected].

February 28, 2017

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What We’re Reading

A Look at Republican Interventions? Diving into the Leaked ACA Replacement Bill by Timothy Jost at Health Affairs

GOP Governors Split on Obamacare Replacement by Rachana Pradhan and Brianna Ehley at Politico

Trump to Meet with Top Health Insurance Execs Monday by Max Greenwood at The Hill

A Divided White House Still Offers Little Guidance on Replacing Obamacare by Juliet Eilperin and Amy Goldstein at The Washington Post

http://www.hcadvocacy.org/

February 24, 2017 NACHC Washington Update Highlights

House Republicans Release Overview of their ACA Repeal and Replace Plan

Before Congress adjourned for a one-week recess, House Republicans released an overview of the major features of their forthcoming proposal to repeal the Affordable Care Act. The newly released document, “Obamacare Repeal and Replace: Policy Brief and Resources” largely follows the approach taken in Speaker Ryan’s 2016 health policy proposal “A Better Way.” We expect to see more detailed legislative language regarding this latest proposal after Congress returns from their recess on February 27, and will provide you with updated information as soon as we have it. If you have questions or concerns in the meantime, please contact us at [email protected].

Follow Up to the February Policy & Advocacy Update Webinar

If you missed it, you can access the slides and recording by visiting the HC Advocacy past events page. Once again, we encourage advocates to take action in support of health centers and the patients they serve. There are three easy action steps you can take right away to advocate for your health center. To learn more visit: http://www.hcadvocacy.org/makethecase. Be sure to mark your calendar for the next Policy and Advocacy Update Webinar taking place on March 21 at 3:30PM ET.

NEW Data Driven Health Center Resources Two new data driven infographics have been developed to illustrate how health centers have expanded their reach into communities and their capacity to deliver a variety of integrated services to patients between 2010 and 2015.

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Hopefully you have heard the exciting news about the new Health Center Advocacy Network website. As of February 20th, the Campaign for America’s Health Centers has become the Health Center Advocacy Network. Our new web address is www.hcadvocacy.org. The new site, social media presence and supporting resources were designed with two specific goals; 1) to make it as easy as possible for advocates like you to take action and 2) to continue to encourage even more people to become advocates while effectively supporting the needs of the Advocacy Network as a whole.

Now, more than ever, we need all our Health Center Advocates to take action in support of America’s Health Centers and the patients they serve. There are three easy action steps you can take right away to advocate for your Health Center and its patients:

1. Create a formal Health Center Advocacy Plan for Your Health Center: The first step in building a robust grassroots advocacy program at your Health Center is to create a concrete plan that outlines the specifics of who, what, where, and when for your advocacy activities.

2. Engage Your State Elected Officials: Work with your state and local elected officials to demonstrate deep, committed support for your health center by collecting letters of support that can be sent to your Members of Congress and Governor. MAKE SURE TO COORDINATE WITH YOUR STATE/REGIONAL PRIMARY CARE ASSOCIATION WHEN TAKING THIS STEP.

3. Engage Your local Network & Spread the Word: Continue to recruit new advocates so that together we can increase our grassroots power. Then, share your story – let people know why you value your local health center.

You can access more information and supporting resources – including template advocacy plans and letters – on the Health Center Advocacy Network website.

Our new Health Center Advocacy Network website reflects our growth as a grassroots force. It has integrated social media and engagement features, which make it easy to take action and communicate with legislators using your computer or any mobile device. To learn more about the new website, tools and resources, mark your calendars for our formal HC Advocacy Launch Webinar on March 15 at 3PM ET. If you have questions now, please email [email protected].

In the meantime, we encourage you to complete each of the three advocacy action steps outlined above and show your support for the new Health Center Advocacy Network by adding our web badge to your website or social media page.

Thank you for your ongoing commitment to Health Center Advocacy. Much the same way patients are at the heart of each Health Center, you, our advocates, are at the heart of our network. Amanda Pears Kelly - Health Center Advocacy Network www.hcadvocacy.org

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NACHC 2017 POLICY & ISSUES FORUMê

CONFERENCE SCHEDULE(as of Februray 27, 2017 and frequently updated)

Tuesday, March 28, 201712:00pm – 6:30pm Grassroots Advocacy Leadership Program (special registration required) Lincoln 54:00pm – 6:00pm Registration and Exhibitor/Speaker Check-In Lobby Level7:00pm – 8:30pm State Legislative Coordinators Meeting Exhibit Hall C

Wednesday, March 29, 20177:30am – 5:00pm Registration and Exhibitor/Speaker Check-In Lobby Level8:00am – 10:00am Legislative Committee Marriott Ballroom: Salon 18:00am – 2:45pm Board Member Boot Camp* Washington 4

Setting the Stage (8:00am – 8:30am) PWA1 Part A: The Board’s Financial Responsibilities (8:30am - 10:00am) *Registration is necessary, but fee is not

required if paying the full-conference fee. 7:30am – 9:00am Coffee provided 12:15pm – 1:15pm Lunch on your own

PWA2 Part B: The Quality Umbrella (10:15am – 11:05am) PWA3 Part C: Administrative Oversight (11:20am – 12:15pm) PWA4 Part D: Legal Responsibilities and Liability (1:15pm – 2:45pm)

10:30am – 1:30pm PCA and HCCN General Session (invitation only; special registration required)

Sponsored by Thurgood Marshall Northeast

12:30pm – 2:45pm PWB1 Be Ready to Head to the Hill: 2017 Health Center Policy Agenda, Advocacy Strategy, and How to Move Congress to ACT!

Exhibit Hall C

3:00pm – 5:30pm PGS1 Opening General Session Marriott Ballroom5:45pm – 6:45pm State Delegation Meetings See handout in registration bag for state

delegation meeting times and locations.7:00pm – 8:00pm State Delegation Meetings

Thursday, March 30, 20177:00am – 3:30pm Registration and Exhibitor/Speaker Check-In Lobby Level8:00am – 5:00pm Capitol Hill Visits8:30am – 10:00am Education Sessions10:00am – 10:30am Refreshment Break Lobby Level Foyer10:30am – 12:00pm Education Sessions2:00pm – 3:30pm NACHC NextGen User Group Thurgood Marshall North6:30pm – 9:00pm Healthcare Leadership Reception and Awards Sponsored by

2017 Leader SponSorS

Off Site: Newseum

Friday, March 31, 20177:00am – 3:30pm Registration and Exhibitor/Speaker Check-In Lobby Level7:30am – 8:30am Continental Breakfast in EXPO Hall Exhibit Hall C7:30am – 6:00pm EXPO HALL OPEN

Be one of the first 250 in the EXPO Hall for a chance to win a $250 Amazon gift card! (Prize drawing at 5:45pm)

Exhibit Hall C

8:00am – 9:30am Education Sessions 9:30am – 10:30am Dedicated Exhibit Time (Refreshment Break in EXPO Hall) Exhibit Hall C9:45am – 10:15am PT3-1 NACHC’s Payment Reform Readiness Assessment Tool Exhibit Hall C: Theater, Aisle

100, next to Booth #11610:30am – 12:30pm PGS2 General Session: Federal Update Marriott Ballroom 12:30pm – 1:30pm Dedicated Exhibit Time (lunch on your own; refreshments in EXPO Hall) Exhibit Hall C12:30pm – 1:30pm PCA Lunch (invitation only) Wilson B

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Friday, March 31, 2017, continued

12:30pm – 1:30pm NACHC eClinicalWorks User Group Roosevelt 112:45pm – 1:15pm PT3-2 NACHC’s Advocacy Center of Excellence (ACE) Program Exhibit Hall C: Theater, Aisle

100, next to Booth #1161:30pm – 3:00pm Education Sessions 3:00pm – 3:30pm Refreshment Break in EXPO Hall Exhibit Hall C3:00pm – 3:30pm PT3-3 What’s New in the UDS? Everything! Exhibit Hall C: Theater, Aisle

100, next to Booth #1163:00pm – 5:00pm Consumer Board Member Committee Roosevelt 33:30pm – 5:00pm Education Sessions 5:00pm – 6:00pm Conference Networking Reception in EXPO Hall Exhibit Hall C5:15pm – 5:45pm PT3-4 Showcase of the NEW Health Center Advocacy Network Website Exhibit Hall C: Theater, Aisle

100, next to Booth #1165:45pm “EXPO Early-Bird” Amazon Gift Card and NACHCopoly Prize Drawings, and Announcement

of Twitter Contest Winners in EXPO Hall! Exhibit Hall C

6:00pm – 7:00pm National LGBT Primary Care Alliance Reception Wilson A6:00pm – 7:00pm Board Members CONNECT! Health Center Board Members Networking Event Roosevelt 46:00pm – 7:00pm New Member Welcome Reception (invitation only) Wilson C6:00pm – 7:30pm NACHC GE Centricity User Group Roosevelt 16:30pm – 8:00pm Young Professional Leadership Exchange Reception Sponsored by

2017 Leader SponSorS

Off Site: Bar Civita

Saturday, April 1, 20177:30am – 8:30am Coffee Break Lobby Level Foyer7:30am – 10:30am Registration and Speaker Check-In Lobby Level7:30am – 5:00pm Training for New Clinical Directors – Day 1 (preregistration required; no on-site registration) Wilson B8:00am – 10:00am Education Sessions10:00am – 10:30am Refreshment Break Lobby Level Foyer10:30am – 12:00pm PGS3 General Session Marriott Ballroom 1:00pm – 3:00pm Health Professions Education in Health Centers Task Force Wilson C1:00pm – 3:00pm Rural Health Committee Virginia1:00pm – 3:00pm LGBT Task Force Washington 61:00pm – 3:00pm Subcommittee on Health Center Financing Maryland1:00pm – 3:00pm Committee on Health Center Excellence and Training Delaware 1:00pm – 3:00pm Health Care for Homeless Committee Washington 41:00pm – 3:00pm Subcommittee on Elderly Issues Washington 53:30pm – 5:30pm Health Center Controlled Networks Task Force Washington 5 3:30pm – 5:30pm Committee on Agricultural Worker Health Maryland3:30pm – 5:30pm Health Care in Public Housing Task Force Washington 63:30pm – 5:30pm Membership Committee Delaware3:30pm – 5:30pm Committee on Service Integration for Behavioral Health and HIV Virginia6:00pm – 8:00pm Health Policy Committee Marriott Ballroom: Salon 1

Sunday, April 2, 20177:30am – 12:30pm Training for New Clinical Directors – Day 2 Wilson B8:00am – 10:00am Finance Committee Coolidge8:00am – 10:00am Clinical Practice Committee Marriott Ballroom: Salon 312:00pm – 2:30pm NACHC Board of Directors Meeting Marriott Ballroom: Salon 3

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CHAMPS 2016-2018 Strategic Plan Approved by the CHAMPS Board of Directors on October 16, 2016

Goal 1: CHAMPS is an essential resource for health center (CHC) training and workforce development. Objective 1.1: CHAMPS will achieve at least an 80% membership rate of Region VIII CHCs and State Primary Care Associations (SPCAs). Strategies 1.1.a: Explore opportunities to enhance membership benefits. 1.1.b: Increase awareness of CHAMPS through CHAMPS staff participation in Region VIII SPCA meetings. 1.1.c: Include content in CHAMPS trainings to promote the benefits of CHAMPS membership. 1.1.d: CHAMPS Executive Committee members will raise awareness by providing CHAMPS reports at their respective SPCA meetings. 1.1.e: CHAMPS Executive Committee members will assist in recruiting members from their respective states. Objective 1.2: At least 75% of Region VIII CHCs will participate in one or more CHAMPS trainings; trainings will be rated as useful by at least 80% of participants. Strategies 1.2.a: Explore ways to integrate content related to the CHC mission in all CHAMPS trainings. 1.2.b: Develop additional opportunities for sharing CHC-related best practices utilizing experienced leaders within Region VIII CHCs. 1.2.c: Provide Region VIII CHC-specific trainings to strengthen leadership and address Social Determinants of Health (SDOH). 1.2.d: Increase number of NACHC New Medical Directors, Managing Ambulatory Health Care (MAHC), and other trainings in Regions VIII and X. 1.2.e: Explore the feasibility of providing a feedback loop for Region VIII CHCs to monitor staff attendance at CHAMPS trainings. 1.2.f: Make CHAMPS trainings available to provider pre-professionals.

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Objective 1.3: CHAMPS will achieve at least an 85% response rate in its Workforce Surveys. Strategies 1.3.a: Conduct a Recruitment and Retention Survey of Region VIII CHC staff. 1.3.b: Enhance the Region VIII CHC Salary Survey to address identified workforce needs. 1.3.c: Develop educational materials related to Workforce Surveys for CHC staff and boards.

Goal 2: CHAMPS is a financially sustainable organization. Objective 2.1: CHAMPS will achieve a positive operating margin of at least 4% and maintain six or more months of operating reserves. Strategies 2.1.a: Establish a reserves subcommittee to explore and recommend short- and long-term options for reserves in excess of six months. 2.1.b: CHAMPS Executive Committee will advocate for equitable resources for CHAMPS from the Health Resources and Services Administration (HRSA).

Goal 3: CHAMPS is a valued partner both within the CHC community as well as among other relevant stakeholders. Objective 3.1: CHAMPS will maintain Memoranda of Agreement (MOAs) with 100% of Region VIII SPCAs and NACHC, and identify and work with other partners with similar missions and goals. Strategies 3.1.a: Forge partnerships with Area Health Education Centers (AHECs) to strengthen CHAMPS workforce-related efforts. 3.1.b: Explore ways to promote CHAMPS programs and services to Region VIII National Health Service Corps (NHSC) providers.

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Memorandum of Agreement Between the

State and Regional Primary Care Associations of Region VIII July 1, 2017 to June 30, 2020

The Region VIII State Primary Care Associations (SPCAs) - Association for Utah

Community Health (AUCH), Colorado Community Health Network (CCHN), Community HealthCare Association of the Dakotas (CHAD), Montana Primary Care Association (MPCA), and Wyoming Primary Care Association (WYPCA), and the Region VIII Primary Care Association, Community Health Association of Mountain/Plains States (CHAMPS) - work together to support existing and potential Health Center Program award recipients and look-alikes (health centers) across Region VIII (CO, MT, ND, SD, UT, WY) to increase access to care, achieve operational excellence, and enhance health outcomes and health equity through the dissemination of promising practices, facilitation of trainings, coordination of stakeholder meetings, and other training and technical assistance (T/TA) activities.

Region VIII Primary Care Associations (PCAs) are a working model of service integration and collaboration. We share the work of supporting health centers, communicating regularly in order to create new knowledge, to disseminate best practices, to assess and evaluate the needs of the region’s health centers, to problem solve, and to develop joint activities whenever feasible. Region VIII PCAs work closely together to ensure effective coordination between the Regional and State Primary Care Associations to maximize the impact of HRSA-supported T/TA and reduce duplication of effort.

In order to strengthen the health care safety net in Region VIII and ensure the provision of coordinated, collaborative, complementary programs and services among Region VIII PCAs, the following actions will be taken: CHAMPS staff will continue to attend Region VIII SPCA meetings and conferences and Region VIII SPCA staff will continue to attend CHAMPS meetings and conferences. CHAMPS, in collaboration with Northwest Regional Primary Care Association (NWRPCA), will continue to host and facilitate a meeting of PCA Executive Directors/CEOs from Regions VIII and X during the annual CHAMPS/NWRPCA Fall Primary Care Conference. CHAMPS will continue to facilitate the creation, dissemination, and analysis of the annual Region VIII Health Center Needs Assessment in partnership with Region VIII SPCAs. CHAMPS will continue to host and facilitate conference calls for Region VIII PCA staff members; the conference calls will include:

Monthly Region VIII PCA Executive Director/CEO Monthly Region VIII PCA Outreach and Enrollment Quarterly Region VIII PCA Clinical/Quality Quarterly Region VIII PCA Emergency Preparedness Quarterly Region VIII PCA Special and Vulnerable Populations Quarterly Region VIII PCA Training/Technical Assistance Quarterly Region VIII PCA Workforce Development/Recruitment and Retention Quarterly Region VIII PCA, Primary Care Office, and HRSA

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Our shared long-term mission and commitment is to support health centers in providing comprehensive, high quality primary health care and improving the health of individuals and communities. Support of CHAMPS’ proposed regional project will not result in a reduction of the amount or quality of Region VIII SPCA T/TA to be provided to health centers; on the contrary, CHAMPS enhances goal attainment by leveraging the work of Region VIII SPCAs and providing exceptional T/TA that is value-added.

United in supporting Region VIII health centers and one another since 1985 – Region VIII PCA Executive Directors/Chief Executive Officers (CEOs), December 13, 2016: Association for Utah Community Health, Grant # U58CS06848 Alan Pruhs, Executive Director

Colorado Community Health Network, Grant # UA58CS06862 Annette Kowal, President and CEO

Community Health Association of Mountain/Plains States, Grant # U58CS06861 Julie Hulstein, Executive Director

Community HealthCare Association of the Dakotas, Grant # U58CS06844 Shelly Ten Napel, CEO

Montana Primary Care Association, Grant # U58CS06863 Cindy Stergar, CEO

Wyoming Primary Care Association, Grant # U58CS06849 Jan Cartwright, Executive Director

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champs executive committee conference call agenda … · champs hosted an o&e webinar series in...

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