Progress

January 2013 -

March 2014

Highlights

Goals & Outcomes at a Glance

Quality

• Training & TA

• Data Transparency*

• Viability

Access

• Employers of choice

• Community demand

• Access for the uninsured

Value

• Nationalinfluence

• Service & payment models

• CHC value*

• CCO collaboration

KeyGreen:Completed.

Yellow:Barriers encountered; one or more outcomes not achieved or will be delayed.

Red:Priority has changed; needs to be removed as a goal.

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*Goal partially achieved; see details in report.

Equity

• Social determinants

• Policy agenda

Assure all CHCs in Oregon provide

excellent care and are providers of choice.

General Training• Twostatewidetrainings(springandfallQuadrupleAimSymposia)offeredsessionsaddressingCHC

management,operations,qualityandpaymentinitiatives,andpatient-centeredcommunications.Ninety-threepercentof CHCswereinattendanceatoneorbothevents.

• Providedtentrainingsforhealthcenterboards.Alltrainingsincludedinformationonthe19Bureauof PrimaryHealthCare(BPHC)requirementsforCHCs.

• PartneredwithNorthwestRegionalPCA(NWRPCA)regardingICD-10training.

Patient-Centered Communications & Patient-Centered Medical Home (PCMH) Model• Providedpatient-centeredofficevisittrainingandmotivationalinterviewingworkshopstoourmembersand

completedaseriesof individualizedclinictrainingsinpatient-centeredcommunication.Fifty-threepercentof clinicsenhancedtheirskillsthroughtrainingsinpatient-centeredcommunications.

• Continuedourfocusonthekeytenetsof thePCMH-leadership,careteams,dataandcarecoordination.Onehundredpercentof OPCA’scommunityhealthcenters(CHCs)havebeencertifiedunderthestate’smedicalhomeprogram,oneCHChasachievedlevelthreeaccreditationundertheNationalCommitteeforQualityAssurance(NCQA)program,andoneCHChasachievedNCQAleveltwoaccreditation.OPCAhasalsoincreaseditsin-houseNCQAexpertise.

• OPCAleadseightclinics(representingsixcommunityhealthcenters)intheFQHCAdvancedPrimaryCarePracticeDemonstrationProject(APCP)fromtheCentersforMedicare&MedicaidServices.APCPsiteshavesubmittedorwillsubmitNCQAmedicalhomeapplications.

• CollaboratedwithOregon’sPatient-CenteredPrimaryCareInstitute(PCPCI)byprovidingaseriesof webinarsforstakeholdersstatewideandthroughactiveexecutiveparticipationinthePCPCI-sponsoredexpertlearningnetwork,supportingprimarycarepracticetransformation.

• Facilitatedthekick-off sessionof thePCPCITechnicalAssistanceExpertLearningNetwork.• ProvidedaPCPCIwebinaronUsingDataforQualityImprovement,CreatingGreatOrganizationalAlignment,

andIntegratingBehavioralHealth.• CollaboratedwiththeOregonHealthAuthority(OHA)onprojectyearfourof thePatientSelf-Management

Collaborative(PSMC).AllPSMCsitesdemonstrateapositivetrendinestablishing/adaptingtheprinciplesof self-managementasthefoundationof patient-centeredcare.

Goal 1: Support all Oregon CHCs to engage in robust training & technical assistance and peer learning in meaningful, data-driven, patient-centered practice transformation, including the integration of behavioral and oral health.

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Quality

Outcomes:

• OPCA’sparticipationintheSafetyNetMedicalHomeInitiative(SNMHI)endedinApril.Initiativeaccomplishmentsincluded:• 14of 15CHCscompletedtheinitiative.• 100percentof initiativeparticipantsarecertifiedunderthestate’smedicalhomeprogram.• 33percentof participatingsitesdemonstratedan“atorabove/positive”trendinchangesinreported

qualityperformancemeasures.• Wecreatedandimplementedadurableframeworktoguideeffective

transformationwithinandbeyondthesafetynet.• Wefacilitatedsignificantchangesinhealthcaredeliveryandcultureamong

participatingpractices.• Wedevelopedacohortof safety-netsitestoserveasexemplarsandleadersin

medicalhometransformation.• Wedevelopedacomprehensivelibraryof publicdomainresourcesandtools

createdbyandforprimarycarepractices.• Thefinalyearof theSNMHIincludedaQIprojectwithfiveclinics.Each

receivedtwodaysof Leantraining,sixmonthsof accesstoaQIwebsite(Tomorrow’sHealthCare)andQIprojectfacilitationbyOPCAstaff.

Peer Networks• Facilitatedmeetingsand/orcommunicationsforthefollowingpeernetworks:Executivedirectors,medical

directors&providers,dentists,data/qualityimprovement,outreach&enrollmentworkers(OEWs).• Ninety-fourpercentof healthcentershavestaff membersengagedinoneormorepeernetworks.Morethan

50percentparticipatedinpeernetworkactivitiesfocusedonoralorbehavioralhealthintegration.

Special Populations• AnOPCAstaff memberkeepscurrentontrends,threatsandopportunitiesaffectingspecialpopulationsserved

byCHCs.Thestaff memberworkscloselywiththePrimaryCareOfficetoenhancetheflowof informationtoclinics.WealsopartnerwithNWRPCAtoensuresufficientspecialpopulationtrainingforCHCstaff members.

• PartneringwithMultnomahCountyHealthDepartmentinsharingsuccessfulpracticesforprovidingappropriate,barrier-freecaretoindividualswithHIV.

Behavioral and Oral Health Integration• Launchedapilotprogramtotrainatotalof fiveOregonCHCsintheuseof theSBIRTtool(forScreening,

Brief InterventionandReferraltoTreatment)inYear1(morearejoiningin2014).SBIRThelpsclinicsscreenallpatientsformental/behavioralhealthissuesanduseof tobacco,alcoholordrugs.

• FocusedonoralhealthintegrationthroughaDentaQuest-fundedinitiative,StrengtheningtheOralHealthSafetyNet.Facilitatedquarterlyface-to-facepeernetworkmeetingswithdentaldirectors;providedleadershiptrainingsfor“dentalhome”transformationandpracticeintegration;collaboratedwithlocalandstatetrainingpartnerstoincorporatedental-centricexamplesintocurricula;facilitatedandparticipatedinthesteeringcommitteeof theOregonCommunityFoundationOralHealthStrategicPlan,2014-20.

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Goal 3:SupportthefinancialandoperationalviabilityofcurrentandfutureCHCs,including an emphasis on process improvement.

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Outcomes:

Goal 2: Encourage maximum participation in a transparent learning community where cost, quality, access, staff engagement and patient experience data/indicators are definedandsharedopenlytoinformimprovement.

• Pulledtogetherthreecohortsof datatransparencyworkgroupscomprisingallbutthreeof Oregon’sCHCs.• MovedfromunderstandableCHCconcernaboutsharingdatatransparentlytoenthusiasticopenness!Data

hasbeensharedwithinthecohortsaroundqualitymetrics.Cohortsarereviewingorganizationaldifferencesandrankingsacrossthestate.Theymeettodiscussthedataandsharebestpracticesastheyworktoimprovemeasuresrelatingto:depressionscreening;diabetes;emergencydepartmentutilization;hypertension;SBIRTscreening;staff engagement;socialdeterminantsof health.

• Oregon’sCHCshadgreatsuccesswithhypertensionimprovement.Weachieved72.4percentcontrolled,exceedingourfive-yeargoalof 65percent.Additionally,100percentof ourCHCshavemetoneormoreof theHealthyPeople2020goals.

• Wedidnotmeetourgoalof improvingPAPratesto57percentstatewide.AlthoughmanyCHCsareworkingtoimprovetheirPAPrates,mostarenowmorefocusedonthosemeasuresadoptedbytheCCOsasincentivemetrics.Inkeepingwiththisareaof focus,ourDataTransparencyGroupsadoptedCCOincentivemeasuresasadeterminationof CHCvalue.

• KristaCollinsjoinedOPCAasourdataanalyticsandqualityimprovementspecialist.KristaandherteamarecentraltoOPCA’sworkindefiningvalue,helpinghealthcentersuseperformanceindicatorstodemonstratevalue,connectingCHCworkflowtomeasurableimprovement,andassistingincreatingstrategiesthatbuildpaymentbaseduponhigh-qualityservices.

• DedicatedadditionalresourcestodataanalysisthroughateamcomprisingBrandonLane,DianeLechnerandBobMaxwellwithmorerecentcontributionsfromJessicaYen,OPCA’ssocialdeterminantsof healthmanager.

• UsedaprogramdevelopedinColoradotobeginpullingandanalyzingUDStrendsmoreeasily,allowingustocomparemultiplefactorsandshareresults.Nextstepswillhavehealthcentersreportingandsharingtheirowndataandworkflows.

• Duringthe2013statelegislativesession,defeatedeffortstorestricttheprocessof contractingwithCoordinatedCareOrganizations(CCOs)toprovideservicesfororalhealthcare.

• AllCHCsitesexperiencingfinancialchallengesreceivedongoingsupporttoturnaroundthesituation,inpartnershipwiththeBPHC.Bytheendof 2013,Oregon’sCHCswerefreeof financial“goingconcerns.”Additionally,52percenthadcostincreaseslessthanthenationalCHCaverage.

• LedsuccessfulCHCtriptoCapitolHillin2013,culminatinginnosequestercutstohealthcenters.• Organizedandleda2014visittoCapitolHillby13representativesfromOregon’shealthcenters.Attendees

metwithhealthpolicystaff membersforeverymemberof Oregon’sCongressionaldelegation.AttendeeseducatedCongressionalstaff membersabouttheimportantworkbeingdonebyOregon’shealthcenters.

• OPCAstaff hosted10fiscalofficersgroupteleconferencesandprovidedfourface-to-faceorientationsfornewCFOs.Attendedsixbi-monthlymeetingsof thestateDivisionof MedicalAssistancePrograms.Addedface-to-faceCFOtrainingswithexpertstohelpCHCsremainfreeof “goingconcern”issueswhilebecomingeducatedonICD-10coding.

• HiredMattPayneasoperationsmanager.HehasextensiveexperienceinhealthcenteroperationsadministrationinColorado.

• AllexecutiveleadersandboardchairpersonsweremadefamiliarwithBPHCrequirements.

Outcomes:

Support models that improve community

health center value and efficiency.

• Morethan15statesareinterestedinimplementingtheOregonAlternativePaymentMethodology(APM)modelandhaveaskedOPCAforassistance.

• OPCAhasprovidedon-siteconsultingservicestoCalifornia,Indiana,Michigan,MontanaandWisconsin.Weareinpreliminarydiscussionswithseveralotherstatestoprovidewebinaroron-siteservices.

• TheNationalAssociationof CHCs(NACHC)contractedwithOPCAtoreview,andprovideadviceon,apaymentreformpaperindevelopment.

• PresentedourworkinAPM,theadvancedcaremodel(ACM),andsocialdeterminantsof healthatseveralNACHC,NWRPCAandotherCHCconferencesandpaymentreformworkgroupmeetings.

• PresentedourpaymentreformstrategyatNACHCstrategymeetings,aswellastheNACHCPolicies&IssuesForum,incombinationwithinformationabouttheadvancedcaremodel.

• MetthreetimeswithJimMacraeof theBPHCandhisstaff toreviewprogressonourAPMproject.TheBPHCiscommittedtohelpingmaketheprojectsuccessful.

• CraigHostetlerwasaskedtoserveasoneof thevicechairsof theNACHCPolicyCommittee,basedonOPCA’sworkonpaymentreform.

Goal 4:LeadandinfluencenationalconversationsaboutCHCvalueandtheCHCroleinhealth care transformation to position Oregon’s health centers and OPCA effectively for resources to support transformation and align payment reform.

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Value

Outcomes:

Goal 5: Support Oregon CHCs in preparation for and leading the implementation of new service delivery and payment models.

Outcomes:

• InMarchof 2013,OPCA’sAPMpilotwent“live”atthreePhaseIsites—MosaicMedical,OHSUFamilyMedicineatRichmond,andVirginiaGarciaMemorialHealthCenter.Thenewfinancialmodelisworking.Wearepreparinganalysestodemonstratesuccessrelativetothemodelrequirements—remainingbudget-neutral,forexample,forboththestateandtheclinics.

• AsecondAPMpilotphaseisscheduledtolaunchinJulyandwillincludefourmorehealthcenters:CHCsof Benton&LinnCounties,CoastalFamilyHealthCenter,MultnomahCountyHealthDepartmentandYakimaValleyFarmWorkersClinic.OncePhaseIIbegins,themajorityof communityhealthcenterpatientsinOregonwillbeincludedintheAPMprogram.

• AnAPMworkgrouptroubleshootsbillingandpaymentissues.Membersprovidesupporttooneanotherindevelopingnewfinancialmanagementsystemstotrackcapitatedpaymentandpatientenrollment.

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• Ledaconcurrentprocesstodevelopquality,costandutilizationmetricsandassociatedreports.Developedagreementswiththestateforreportingtimelinesandprocedures.Reportingandmetricscontinuetoevolveunderthemodel.

• Amethodologytoattributeandreassignpatients,if needed,hasbeendeveloped.Weareintheprocessof planningtheimplementationpriortoPhaseII.

• Nowturningourfocustocollaboratingwithourpilotclinicsontransformingthemodelof careunderAPM.HostedasummittobegindevelopinganapproachtoanACMforpopulationhealth.Staff membersfromOregon’sCHCslistenedinwhileagroupof nationalleaderswithyearsof healthcareexperiencediscussedpossibleapproaches.Theygeneratedideas-backedbyevidenced-basedmedicine-thathealthcenterscanuseinconsideringadvancedcareconceptsandtools.

• We’reconveningalearningcommunityof interestedhealthcenterstodeveloptheACM.Wewillplanandfacilitaterobustquarterlylearningeventsandopportunities,provideaccesstonationallyrecognizedexpertsonthecuttingedgeof healthcaretransformation,andfacilitatepeernetworkingandsharingof bestpractices.

Goal 6:DefineandpromoteCHCvalueamongpartnersandpatients,supportedbyrobust process and outcome data and strategic communications.

Outcomes:

• DatatransparencylearningcommunityadoptedCCOincentivemeasuresasadeterminationof CHCvalue.• CHCvalueprojectisnotyetcompleted.Anticipatingthelaunchof anupdatedstrategiccommunicationsplan

whentheprojectwrapsupinspring2014.• CHCvaluecommunicatedtotargetaudiencesthroughavarietyof channels,

including:E-bulletinsonPCMH/TechnicalAssistance&Trainingwork(Transformations)andOPCA’spolicywork(Weekly Legislative Update -readershipgrew28percentoverthe2013legislativesessionandanadditional17percentoverthe2014session);OPCAwebsite;comprehensivesummaryof CHClegislativepriorities;keytalkingpointsforbothconservativeandliberalaudiences;newfactsheetserieswithdataandinfoaboutCHCsandpatientsineachstateandfederallegislativedistrict;60+personalizedintroductoryandthank-youvideosforlegislators.Mediacoverageof CHCspromptedbyOPCA’snewsreleases,conversationswithreportersand/orworkwithCHCsincluded:Oregonian, Portland Business Journal, Bend Bulletin, Oregon Coast Daily News, Medford Mail-Tribune, El Hispanic News, Ashland Daily Tidings, East Oregonian, The Lund Report,KFLSradio.

Goal 7: Support CHCs in their efforts to build collaboration and partnerships with key communitystakeholdersintheCCOenvironmentthrougheducation,identificationofbest practices and peer learning.

Outcomes:

• HeldCCO-relatedlearningsessionsatspringandfall2013QuadrupleAimSymposiaandatOPCA’sfallstrategicplanningretreat.

• CreatedamessagingguideforCCOsandotherkeyexternalaudiences,basedonthefindingsof ahealthcenterstakeholdersurvey.DistributedtheguideviahardcopyandawebinarpresentationforallOPCAmembers.

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• MadeapresentationoninnovativeCHC/CCOpartnershipsatLincolnCountyHealthCenter’sstrategicplanningmeeting.

• Commissionedareportonthe340BprogramthathighlightedinnovativeCHC/CCOpartnershipsintheareaof prescriptiondrugs.

• ParticipatedinPortlandmetroareaCCOmeetingsinpartnershipwiththeCoalitionof CommunityHealthClinicsandincollaborationwithHealthShareof Oregon,toaddresstheissueof CCOpatientassignment.

• WorkingwithCHCsandCCOstoaddresstheissueof dentalpatientassignment.PacificSourcehasdevelopedbestpractices,andweareworkingwiththemtoseeif theirstrategywouldbeagoodfitforotherCCOs.

• Createdauser-friendlygridthatprovidesasummaryof theinnovativeaspectsof eachCCO’stransformationplans.

Assure that Oregon’s health centers can

meet demand for their services.

• CreatedandfacilitatedaDentalStudentRotationsRoundtableattherequestof CHCdentaldirectors.WorkingcollaborativelywithpreceptorsitesandOHSUfacultytoenhancethevalueandimpactof dentalrotationsinOregonCHCs.

• ParticipatedintheOregonRecruitmentandRetentionWorkgroupwithOHSU,theOfficeof RuralHealth,AreaHealthEducationCentersandtheOregonPrimaryCareOffice(PCO)tostreamlineworkforceactivitiesinOregon.Workgroupmembersarerespondingcollaborativelytoworkforceissuesandopportunities.

• InvitingstudentsandfacultyfromATStillUniversity’sPortlandD.O.programtoattendOPCAtrainings.• PartneredwiththeWrightCenter’sOregonCommunityHealthCenterResidencyProgram.Includedresidents

intrainingopportunities.• Providedfacilitativeleadershiptrainingto58percentof CHCs.• Conductedasurveyof allexecutivedirectorsregardingtheirworkforceneedsastheyrelatetoOPCA.

Responsesindicatedinterestinsalary/marketsurveys,engagementstrategyandcompensationphilosophy.• TrainedallSNMHIparticipantsinstaff engagement.Facilitatedall-staff surveysforeachSNMHIclinic.The

PCOaddedOPCA’smaterialstoitsClinicianRecruitingandRetentionToolkit.• WorkedcloselywithCHCsthatmeasurestaff engagement.Helpingclinicsaddmorefrequent,actionable

metricsthroughwebinars,emailsandourdatatransparencygroups.• ReachingouttoallnewCHCmanagers/leadersandplanningtomatchthemwithmentorsastheydesire.

EnsuredthatallnewCHCleadersfeltinformedandpartof alargermovement,withmanyexpertstocontact.AllnewCHCexecutivedirectorsreceivedtheCHCorientationmanualintheirfirstmonthonthejob.

• OngoingCFOtrainingisimbeddedinOPCAwebinars,eventsandmonthlyphonecalls.• Boardtrainingsnowhighlightwaystoenhanceorganizationalcultureandimproveretention,plustheconcept

of “employerof choice”anditsimportanceasadriverof change.• Offeredwebinarsandemailsonemployeeengagementstrategiesandcreatingculturesthathelprecruitand

retaingreatstaff members.

Goal 8: Assist Oregon CHCs in becoming employers of choice, and assist health centers in addressing future workforce needs.

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Access

Outcomes:

Goal 10: Promote access for the uninsured as health care reform is implemented, including undocumented individuals.

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Outcomes:

Goal 9: Support CHC efforts to adapt to changing demand in their communities.

Outcomes:

• AssistedBandonclinic(nowaCHC!)andWindingWatersClinicwithinformationaboutgrants,healthcenterrequirements,non-profitcreation,budgetdesign,needdetermination,andhowtoprojectneedsandservices.

• Workedwithallcommunitiesinterestedintheestablishmentof ahealthcenter:Bandon,Florence,GrantCounty,LaneCounty,OakridgeandPortland.

• ContinuetointeractwitharuralhealthclinicinterestedinpursuingCHCstatusinthenextonetotwoyears.

• ProvideongoingtrainingandinformationforallOEWstohelpthemenrollpatientsintheOregonHealthPlanandqualifiedhealthplans.WorkedwithOHAandCoverOregontoprovidethelatestupdatesforOEWsduringtheturbulentrolloutof thehealthinsuranceexchange.BetweenJulyandDecember,OEWsathealthcentersassistedanestimated43,000Oregoniansintheenrollmentprocessandenrolledanestimated16,000.

• WorkedinpartnershipwiththeOregonLatinoHealthCoalitiontoachievestatewideexpansionof theCAWEM-plusprogramtoprovideprenatalservicestoallresidentsof Oregon.

• CreatedanddistributedinternalandexternaloutreachprojectionsforallCHCsinOregon.Holdingconversationsonnewenrollees,highdemandandcreatingcapacity.

Advance health equity for all.

• PartneredwithNACHC,theAssociationof AsianPacificCommunityHealthOrganizationsandtheInstituteforAlternativeFuturesandreceivedfundingtosupportworkaroundsocialdeterminants,patientcomplexityandareasof intervention.

• Hiredasocialdeterminantsof healthmanager,JessicaYen,whohasbeenengagedinnationalconversationsaroundriskadjustment,toolcreation,innovativeprogramsregardingsocialdeterminants,imbeddingthesemeasuresinclinics,andoperationallydefiningtermssuchaspatientcomplexity,riskadjustmentandsocialdeterminantsof health.

• OPCA’sIt Takes a Neighborhoodinitiativesupports,intwopilotcommunities,afull-timepositionwhosejobistoweaveabroader,strongernetworkof workingrelationshipsacrossa“healthneighborhood”(medical,socialservice,andothernon-traditionalstakeholderswhoadvancehealthamongasubpopulationinuniqueways).TheHealthInstigator(HI)helpsbreakdownbarrierstoadvancinghealthandcontainingcostsandelevatesawarenessof thefactthatsocialdeterminantsof healthconstitutesomeof thosecriticalbarriers.• Throughtheworkof theHI,barrierswithineachcommunityhavealreadybeenbrokendownwith

significantimpact.Forexample:• ERdiversion.• Newwarmhandoffs.• NewservicesdirectlyimpactingtheTripleAim.• Spreadof criticaltrainingthatisalreadysavinglivesandreducingdownstreamcosts.• Culturalcompetencytrainingforcriticalserviceproviders.• Significantelevationof thehealthissuesfacedbytwosub-populationsthathave,inthepast,

generallynotbeenontheradarof payers.• CCOsineachpilotareaareactivelyengagingwiththehealthinstigators.• Asadirectresultof theHI’sworkbehindthescenes,plusin-personconversationsconvenedand

facilitatedbytheHI,oneof thefirstAPMinitiativesproposedbytheSalemareaCCOwillbedirectedtowardsservingchildrenwithcomplexspecialneeds.A$450,000transformationgrantwillprovidecoordinatedcareandwraparoundservicesforthesekidsandtheirfamilies.

Goal 11: Support CHCs in addressing population health and the social, behavioral and environmental determinants of health.

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Equity

Outcomes:

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• InthePortlandarea,FamilyCarehasinvestedasignificantamountinthehomelessyouthsystem.Asaresultof HI-ledconversations,grant-writingandon-goingsupport,theyarefundinganurseandnavigatorwhoserveacrossthesystem.

• TheFamilyCarecommunityadvisorycouncil(CAC)nowhasahomelessyouthamongitsmembership.Theseatisuniquelyheldjointlybytheyouthandthehealthinstigator,sothattheHImaysupporttheyouthtofullyengage.TheCAChasbeensoimpactedbywhattheyhavelearnedfromthisyouthandtheHIthattheyhavemadetransitionalyouththeirkeyCHIPfocusarea.

• Theevaluationteamisexcitedbytheinitiative’squalitativeresultsandisbeginningtoundertakequantitativeanalysisasIt Takes a Neighborhoodentersitsfinalyear.

• Effortsareunderwaytoobtainfundingthatwillsupport:1)deepeningandspreadinglearningsfromtheinitiative,2)theroleof theHealthInstigator,and3)long-termsustainabilityof thisapproachtobettercommunityhealth.

Goal 12: Develop and execute a policy agenda that assures active participation of CHC’s in health reform implementation, including the issue of payment and measurement for social, behavioral and environmental determinants of health and development of a culturally competent, primary care workforce to meet future needs.

Outcomes:

• Inthe2013legislativesession,wepassedabilltoimprovethecontinuityof careforpatientswhotransitionbetweenCCOsandCoverOregon.

• CurtailedeffortsbyOHAtodivertfundsfromOregon’s340Bprescriptiondrugprogram.Fundedacomprehensivereportonthevalue-addof the340BprogramforOregon’sCHCsandforthestate.NowpartneringwithOHAtoaddressissuesthatgaverisetoOHA’sinitialefforts.

• Providedexpertiseandguidancetoorganizationsrepresentingunderservedcommunities.Helpedthemaccomplishtheirlegislativepriorities.

• Inthe2014legislativesession,wehelpedpassbillsthatwillrequireOHAtostudythecostsandimpactof aBasicHealthPlanforOregon,appropriatefundingforaprimarycareloanforgivenessprogramandrequirecertainhealthplanstocoverrefillsof prescriptiondrugs.OPCAalsoinfluencedbillsthatmandatepilotprojectstoprovideuseddurablemedicalequipmenttomedicalassistancerecipientsandsubsidizethecostsof commercialhealthcoverageforchildrenwithfamilyincomesfrom200-300percentof federalpovertyguidelines.

Oregon Primary Care Association • 503.228.8852 • www.orpca.org