Funding Announcement: Service Area Competition for Health Center Program

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced funding for the Health Center Program. Health centers are located in underserved communities to provide quality health care services to vulnerable populations. Health Center Program grants support community-based and patient-directed public and private nonprofit organizations. Currently, the Health Center Program funds approximately 1,200 health centers operating in nearly 9,000 service delivery sites across the country. In 2012, over 21 million medically underserved and uninsured patients received high-quality health care services through the program.

A variety of health centers are funded by this grant, including Community Health Centers, Migrant Health Centers, Health Care for the Homeless and Public Housing Primary Care. Funding amounts and the specific health centers vary by location. For a list of service areas, maximum amounts of funding, and the specific health centers that will be funded, click here. HRSA will fund only one grant for each listed service area. Approximately $468 million is expected to be available in FY 2014 to fund an estimated 310 grants.

Funding beyond the first year is dependent on Congressional appropriation. Eligible applicants are public or private nonprofit agencies and can be a competing continuation, new or supplemental grant.

Due dates for applications vary by type of grantee and start at July 24 and extend into January 2014. For a list of due dates and technical assistance resources, click here.

The Affordable Care Act and Place-Based Community Work

On June 28, 2012, the Supreme Court upheld the Patient Protection and Affordable Care Act (ACA) as constitutional, meaning the law is legal and will mostly be implemented as originally written. Many experts predict that the ACA will have a concrete impact on every American individual, but what about communities and community work? As states strive to meet upcoming ACA implementation deadlines, how will place-based initiatives and their constituents be affected?

Going beyond Coverage to Improve Community Health is the first in a series of CSSP Issue Briefs that examine how place-based initiatives can harness ACA resources and programs to maximize community health. Some of the new or enhanced programs, initiatives and funding streams authorized by the ACA and highlighted in CSSP’s Issue Brief are described below: 

• Community Transformation Grants (CTG) are intended to combat health disparities and chronic illness by empowering local communities to recognize and address social determinants of health outcomes. Grantees will focus on reducing health disparities and chronic disease rates through targeted disease prevention and health promotion initiatives. CTG is also dedicated to supporting and expanding evidence-based strategies. Roughly $103 million CTG funds have been awarded thus far. Grantees for the small communities program will be announced in September 2012. See here for more information about CTG.

• The National Prevention, Health Promotion and Public Health Council, an inter-agency coalition of 17 federal departments, models the cross-sector collaboration that many place-based initiatives also operationalize. The Council’s first report, National Prevention Strategy: America’s Plan for Better Health and Wellness, highlights four strategic directions for prevention-oriented work, listed below, and serves as a guide for how communities can implement prevention strategies.

Strategic Directions for Prevention-Oriented Work:

1. Healthy and safe community environment
2. Clinical and community preventive services
3. Empowered people
4. Elimination of health disparities

The National Prevention Strategy has also defined seven priorities:

1. Tobacco Free Living
2. Preventing Drug Abuse and Excessive Alcohol Use
3. Health Eating
4. Active Living
5. Injury and Violence Free Living
6. Reproductive and Sexual Health
7. Mental and Emotional Well-Being

• In order to maintain their tax-exempt status, non-profit hospitals will now be required to conduct a periodic community health needs assessment and demonstrate concrete action to address identified needs. The needs assessment process must be public knowledge and will provide opportunities for place-based initiatives and community organizations to partner with local hospitals.

• The ACA enhances the evidence-based, two-generation Maternal, Infant and Child Home Visiting Program. ACA funding to states and native tribes will be partially categorical and partially competitive. As part of the application process, states must conduct a needs assessment, identify at-risk communities and assess home visiting programs already operating in the state. While this year’s funds have already been allocated, stay tuned for the $400 million that will be available through this program in FY 2013. 

• The ACA requires every state to launch a culturally competent and linguistically diverse Navigator program to assist individuals/ families enrolling in health insurance through their state Health Insurance Exchange (“a new ‘health insurance marketplace’ created by the ACA that is designed to offer a range of affordable, quality insurance coverage options to individuals and families”). Navigators are tasked with encouraging health insurance enrollment and ensuring that consumers have full and accurate information about their options.  

• Through the new Community Health Center Trust Fund, the ACA will support federally qualified health centers (FQHCs) in an effort to bring them to greater scale and to encourage the development of new FQHCs in medically underserved communities. FQHCs already have a measurable impact, currently serving roughly 20 million uninsured patients. The first round of Community Health Center Trust Fund grantees was announced in May 2012.

• The School-based Health Center Capital Program will fund capital improvements to school-based health centers (SBHCs), prioritizing schools with high Medicaid- and CHIP-eligible student bodies. SBHCs often serve students’ families and neighbors in addition to the students themselves and present an opportunity to link clinical health to other community or school initiatives.

• New networks known as Accountable Care Organizations (ACOs) will provide targeted, coordinated, continuous care, including primary and specialty medicine. ACOs will structure payment based on outcomes, rather than the amount of services provided and will be closely linked to the communities served.

For more information and a full list of ACA opportunities applicable to place-based initiatives, see CSSP’s Issue Brief: Going beyond Coverage to Improve Community Health.

New Funding for School-Based Health Centers

Last week, the U.S. Department of Health and Human Services announced $75 million in funding to build or renovate school-based health centers. School-based health centers and their sponsoring facilities are eligible for grants aimed at using capital improvements to enhance service delivery, renovate or expand existing sites, or develop new ones. Funds awarded through this grant opportunity can also be used for the purchase of moveable equipment. These grants are part of the Affordable Care Act's School-Based Health Center Capital Program. The deadline to apply for funds through this opportunity is June 26, 2012, with supplemental information due by July 24, 2012.

In addition to posing its own problems, poor health can be a significant barrier to academic achievement. Students with unaddressed health issues, from vision problems to asthma, can have difficulty paying attention and learning in the classroom. Making frequent trips to see health care providers can also reduce the time students spend in school. Furthermore, accessing health services can be difficult for low-income families who may lack insurance or the ability to take time off from work to attend medical appointments. School-based health centers can give low-income families access to vital services that can keep them healthy while supporting their educational success.

For more information about this grant opportunity, please visit its Grants.gov page here.

$728 Million Awarded to Expand and Improve Community Health Centers

This week, the U.S. Department of Health and Human Services (HHS) awarded $728 million in grants to fund the renovation and construction of nearly 400 health centers in communities throughout the nation. As part of the Affordable Care Act (ACA), these capital investments will create new jobs, improve and expand the services available to patients and provide health care for new patients, particularly those that reside in medically underserved areas.

These awards were announced as the Obama Administration released a new report highlighting the crucial need for community health centers, as well as the ACA’s efforts to improve and expand health services in communities. According to the report, the number of patients receiving care from a community health center has increased by 3 million since 2008. In the next two years, an additional 1.3 million new patients will be served – an increase that will result in a total of 21 million patients receiving care from community health centers. Furthermore, the report states that nearly two-thirds of community health center patients are members of racial and ethnic minority groups and nearly 40% do not have health insurance.

With roughly 1 out of 16 people in the United States relying on community health centers for care, continued investment in the improvement and expansion of these centers is imperative, particularly in medically underserved communities. The awards made this week will fund 171 renovation and construction projects that will expand the healthcare services available in underserved communities. The funding will also support 227 new construction and renovation projects to improve already existing health centers. It is estimated that these investments will expand healthcare services to an additional 860,000 patients nationwide.

For a list of grantees, please click here.

HHS Awards $14 Million for School-Based Health Centers

This week, the Department of Health and Human Services (HHS) awarded $14 million to 45 school-based health centers throughout the nation. Made possible by the Affordable Care Act, the funds awarded this week are the second in a series of awards that will allow already exciting health care centers to expand their capacity and modernize their facilities.

School-based health centers are a critical component of quality healthcare for children and adolescents, particularly those that have chronic health conditions. In addition to providing primary care, school-based health centers generally provide mental health care, substance abuse counseling, dental health, and health education services. The $14 million awarded this week will allow an additional 53,000 children in 29 states to receive school-based healthcare, in addition to fostering job growth in areas of construction, renovation and equipment. For a complete list of grantees, please click here.

For more information on how your community can benefit from opportunities in the Affordable Care Act, please review CSSP’s “Affordable Care Act Funding Opportunities.”

For more information on school-based health centers, please click here.

HHS Announces Awards for Improving Primary Care Access in Communities

Today the U.S. Department of Health and Human Services (HHS) announced awards to over 900 community health centers and community-based organizations to enhance the quality and coordination of health care services across the country. Authorized by the Affordable Care Act, $47 million was awarded in every state to help improve quality and access to services and to support better primary care and behavioral health services for people with mental and substance abuse disorders. This includes $32 million administered by the Health Resources and Services Administration (HRSA) to support 904 community health centers in achieving recognition as a patient-centered medical home as well as $15 million in grants from the Substance Abuse and Mental Health Services Administration (SAMHSA) for improving services for individuals with mental and substance use disorders.

A list of grantees receiving Health Center Quality Improvement and Patient Centered Medical Home Supplemental Funding from HRSA is available here.

A list of grantees receiving Primary and Behavioral Health Integration awards from SAMHSA is available here.

HRSA Announces Capital Development Grants for Health Centers

This week, The Health Resources and Services Administration (HRSA) announced the availability of $700 million in grants to improve the physical infrastructure of health centers in medically underserved communities. Part of the Affordable Care Act, the funding is intended to provide underserved communities with access to quality healthcare services by improving and modernizing health center buildings and medical equipment. The funding is divided into two grants, both of which will support capital development projects in health centers that previously received FY 2011 Health Center Program funding.

Capital Development – Building Capacity Grant: With a total of $600 million available, this grant will provide funding for either the alteration/renovation of current facilities OR the construction of new health centers. Medical equipment with a useful life of one year or greater can be purchased with this grant. For a complete list of eligible projects, please click here. Approximately 125-150 grants are available with awards expected to range from $500,000 to $5,000,000.

Capital Development – Immediate Facility Improvements Program: With a total of $100 million available, this grant will provide funding for the renovation of smaller infrastructure projects, such as improving patient accessibility by providing sidewalks or ramps. For a complete list of eligible projects, please click here. Approximately 250-300 grants are available with awards capped at $500,000.

Eligible applicants for both grants MUST have received FY 2011 Health Center Program funding. Applicants that received FY 2010 or 2011 funding from the Facility Investment Program or Capital Development Program are NOT eligible. Both grant applications are due October 12, 2011.

Resources:

The Opportunities for Communities in the Affordable Care Act (CSSP) provides a summary of the existing and upcoming funding provisions from the Patient Protection and Affordable Care Act that can have an impact on local community change efforts.

New Awards to Community Health Centers

The U.S. Department of Health and Human Services recently announced awards of $28.8 million to support 67 community health centers across the country through the New Access Points grants program. A new access point is a "full time service delivery site for the provision of comprehensive primary and preventative health care services that will improve the health status and decrease health disparities of medically underserved and vulnerable populations.” By intent, community health centers are located in lower income, medically underserved communities that are mostly in rural and inner-city neighborhoods. Community health centers are often the sole source of care for many of the most underserved and vulnerable populations. As community based organizations were able to apply directly for this funding opportunity, this grant provided a significant opportunity to improve access to quality health services. In addition, the construction and operation of community health centers also plays a significant role in local job creation. For example, in 2009, with the $2 billion investment received through ARRA, community health centers were able to generate an additional $3.2 billion in economic activity for their local communities. For these reasons, many community partnerships that are engaged in improving outcomes for children and families are finding their local community health centers to be critical stakeholders and partners.


The list of Community Health Center receiving New Access Point grants can be found here. To find a health center in your area, visit http://findahealthcenter.hrsa.gov.

For more information:

Opportunities for Communities in the Affordable Care Act (CSSP) provides a summary of the existing and upcoming funding provisions from the Patient Protection and Affordable Care Act that can have an impact on local community change efforts.

A fact sheet about community health centers from HRSA

National Association of Community Health Centers

HHS Awards Funds to School-based Health Centers

$95 million in funding, provided through the Affordable Care Act, was recently awarded to 278 school-based health center programs across the country. These awardees are currently serving approximately 790,000 patients and the funding is estimated to increase their capacity to serve an additional 440,000 patients. The funds are to be used for construction for new sites or upgrades to current facilities. These funds are the first of a series of awards that are to support school-based health centers under the Affordable Care Act.


School districts in several communities across the country received awards. The full list of grantees can be found here.

For more information on the Affordable Care Act.

HRSA Announces Community Health Center Planning Grants

The Health Resources and Services Administration (HRSA) has issued a planning grant notice to support the development of comprehensive community health centers in medically underserved communities. Authorized under the Public Health Service (PHS) Act, HRSA will award $10 million in funding to support approximately 125 grantees. In the notice, HRSA requires a one year-project period with an annual cap of $80,000. Applicants that exceed the maximum planning grant amount of $80,000 will not be considered for this funding opportunity. In addition, proposed planning activities should be consistent with the requirements of the PHS Act such as: conducting a needs assessment; designing an appropriate health service delivery model; increasing community involvement; developing partnerships; and securing technical assistance.  This funding opportunity will help to support and sustain critical health services on the neighborhood level. Public or private nonprofit entities, including tribal, faith-based and community based organizations must apply by March 18, 2011.

View the Affordable Care Act Funding Opportunities chart for more. 

Billing 101 Webinar Series for Health Centers

The National Association for Community Health Centers will be sponsoring a series of webinars on how health care reform impacts reimbursement at Federally Qualified Health Centers (FQHCs). Co-sponsored by Priority Management Group (PMG), the Billing 101 Webinar Series seeks to provide guidance on the following:

• an overview of the new coding systems that you’ll use as coverage expands and new rules for pre existing conditions come into effect;
• benchmarking tools to analyze existing operations and FQHC billing best practices
• an understanding of the changes in payment methodology for Medicare; and
• approaches to successfully managing new and increased revenue opportunities.

 Starting in January 2011, the following sessions will be covered:

 · Session #1: Benchmarking and Key Performance Indicators; Thursday, January 13 (2 – 3:30 pm Eastern); online registration cutoff: January 11.

 · Session #2: Credentialing, 855 Forms and NPI; Wednesday, January 19 (2 – 3:30 pm Eastern); online registration cutoff: January 17. 

· Session #3: Sliding Fee Scale Management / Development; Thursday, January 27 (2 – 3:30 pm Eastern); online registration cutoff: January 25.

· Session #4: Charge Capture via EMR vs. Data Entry; Thursday, February 10 (2 – 3:30 pm Eastern); online registration cutoff: February 8. 

· Session #5: Electronic Data Interchange (EDI); Thursday, February 17 (2 – 3:30 pm Eastern); online registration cutoff: February 15. 

· Session #6: Payment Posting; Thursday, March 3 (2 – 3:30 pm Eastern); online registration cutoff: March 1. 

· Session #7: Unpaid Claims Management; Wednesday, March 9 (2 – 3:30 pm Eastern); online registration cutoff: March 7. 

· Session #8: ICD 10: An Introduction; Thursday, March 17 (2 – 3:30 pm Eastern); online registration cutoff: March 15. 

Registration for each session in the Billing 101 webinar is $119. You must register online for each webinar separately. To register for each dynamic webinar, visit the series Web page, and click on the corresponding webinar registration link, then complete the individual webinar electronic registration form.

HHS Awards $8 Million to Support Community Health Centers

Last week, the Department of Health and Human Services awarded $8 million to support existing community health center cooperative agreements. With funding from the Affordable Care Act, these cooperative agreements will help to provide training and technical assistance to community based organizations that work alongside community health centers. Traditionally, health centers are community-based and patient-directed organizations that serve populations with limited access to health care.  Often operated in low-income communities, health centers provide comprehensive primary health care services as well as support services such as education and translation services. In 2009 alone, health centers served 18.8 million people of which 38% were uninsured.  The research also shows 92% of patients served by health centers in 2009 were making less than twice the poverty level (<200%).The community health center cooperative agreements awarded by HHS will help to sustain this vital support for children and families in communities across the country.

For more information. 

School-Based Health Center Capital Program Grants Available

HRSA has released the grant application for the School-Based Health Center Capital Grant program, which seeks to address the equipment needs of school-based health centers across the country. By assisting with the needs assessment process, communities can play a significant role in supporting applicants for this exciting opportunity. Applications are due December 1, 2010.

View the updated ACA Health Care Opportunities chart for more details.

The Patient-Centered Medical Home: An Innovative Approach to Delivering Primary Care in Communities

With the enactment of President Obama’s health care reform legislation, much attention has been placed on the provisions affecting health care coverage. However, the delivery of pimary care services to children and families should be given equal attention. The Affordable Care Act calls for the creation of practice reform in primary care using Patient-Centered Medical Homes. Praised by its’ supporters as an innovative approach to delivering higher-quality, cost effective primary care, medical homes could potentially be adopted on a wider scale.

The term ‘medical home’ does not have one specific definition, instead there is an agreed upon set of principles behind the concept. Medical home refers to primary care that is "accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective.” Medical homes are not actually a physical place. The “medical home” approach refers to a coordination of services led by a primary care physician, who works closely with a patient's pharmacist, medical cost advisor, or specialist in order to improve the delivery of services. For example, a primary care physician team may use electronic health records (EHRs) to share medical history in real time with a patient's specialist. In 2008, more than half of all U.S adults report a lack of care coordination, such as a specialist not receiving basic information from their primary care provider and vice versa. Supporters, argue that this model will help to eliminate the problems often associated with primary care practices in the United States. Recent surveys have shown only 27 percent of adults in the United States can easily contact their primary care physician by telephone, obtain care or advice after hours, and schedule timely office visits. Further, an overwhelming 50 percent of patients report that they often do not understand what their primary care physicians have told them during office hours.


Currently, there are over 100 demonstration projects testing the patient-centered medical home approach. These approaches differ in each state. Community Care of North Carolina, a state-wide project to better coordinate care for high-cost Medicaid patients, has reduced hospitalization for asthma patients by 40% with state savings of $516 million per patient. Under the Affordable Care Act, the Centers for Medicare and Medicaid Services at the Department of Health and Human Services will continue to test medical homes among other new primary care-delivery models through demonstration project grants.

On August 17, 2010, HHS received state applications for the Multi-Payer Advanced Primary Care(APC) Initiative. More details on this opportunity can be found here.

Other Resources:
Can Patient-Centered Medical Homes Transform Health Care Delivery?, Common Wealth Fund
Patient-Centered Medical Home Collaborative Video, Patient Centered Primary Care Collaborative
Joint Principles of a Patient Centered Medical Home, Patient Centered Primary Care Collaborative
Health Policy Brief: Patient-Centered Medical Homes, Robert Wood Johnson Foundation

New Funding for Health Centers

The U.S. Department of Health and Human Services recently announced the availability of $250 million to fund "new access points" for the delivery of health care services. Awarded by the Health Resources and Services Administration (HRSA) and funded through the Patient Protection and Affordable Care Act, these two-year grants are expected to fund approximately 350 clinics in fiscal year 2011. The deadline for submission is November 17, 2010.

According to the NOFA, a new access point is a "full time service delivery site for the provision of comprehensive primary and preventative health care services that will improve the health status and decrease health disparities of medically underserved and vulnerable populations." For the purposes of the grant, "health centers" refers to the various health centers defined in the Public Health Service (PHS) Act, e.g. community health centers, migrant health centers, health care for the homeless, and public housing primary care. Applicants may also propose to establish a school-based health center as a new access point.

In their proposal, aapplicants must demonstrate a high level of need in their community/population, a sound plan to meet this need that is responsive to the health care environment, and a readiness to rapidly implement the proposal. Additionally, applicants must demonstrate the the new access point will increase access to comprehensive, culturally competent, quality primary health care services and improve the health status of underserved and vulnerable populations in the area to be served.  Eligible organizations include public or nonprofit private entities, including tribal, faith based and community based organizations. Current HRSA grantees may apply as well.

The New Access Points funding opportunity has been added to CSSP's Affordable Care Act Funding Opportunities database.

Creating Jobs through Community Health Centers

A recent report from the Center for American Progress, The Importance of Community Health Centers: Engines of Economic Activity and Job Creation,  lifts up the role that community health centers play in job creation and stimulating the economy. By intent, community heath centers are located in lower income, medically underserved communities that are mostly in rural and inner-city neighborhoods. In addition to providing high quality health care services to communities, these health centers have also served as an engine of economic activity for the community.

For example, in 2009, with the $2 billion investment received through ARRA community health centers were able to generate an additional $3.2 billion in economic activity for their local communities. The Affordable Care Act provides community health centers with $9.5 billion in operating costs and 1.5 billion for new construction over the next five years to expand services for new patients. It is estimated that this new funding will generate $53.7 billion in economic activity ($33 billion directly attributed to ACA) for some of the most disadvantaged neighborhoods in the country over the next five years and nearly 500,000 jobs in these communities over that same time period.

For more information on this opportunity, please also visit the National Association of Community Health Centers.