LOCAL HEALTH CENTER AND 100% ACCESS ZERO DISPARITY EFFORTS

The Access Project, under a cooperative agreement grant with The Health Resources & Services Administration (HRSA) of the Department of Health and Human Services, partnered with HRSA and other national organizations to provide technical assistance to community groups across the country working to expand health care access and reduce health disparities.

We hope this forum keeps you informed and allows you to take advantage of the support services we can provide to your local access expansion effort or disparity reduction initiative. To take advantage of our services, please join our Peer Learning Network by filling out the Enrollment Form.

Topic: This conference call was structured to assist Health Center Initiative New Start applicants through a consideration of strategic alliances, resource requirements, and other keys to success that better ensure long-term stability of a community health center.

Background: Today's market-oriented delivery system raises concern about viability of safety-net providers such as Community Health Centers (CHC's.) Increased competition for Medicaid patients, declining revenue sources, and increased incentives to avoid the uninsured are common factors that threaten a center's stability. Moreover, the increasing complexity of the delivery system demands interorganizational relationships; it is difficult for a single provider to survive without establishing relationships with other providers in the delivery system.

Conference Call Presenters:

• Deborah Gurewich, PhD- Brandeis University
• Dan Hawkins, VP for Federal and State Affairs-National Association of Community Health Centers, Inc.
• Bob Seifert, Senior Policy Analyst-The Access Project
• Bill Lottero, Health Center Initiative Technical Assistance Coordinator-The Access Project
• Karen Hall, Director of Administration-Fort Bend Family Health Center
• Marsha Perry-Richford Community Center

If you were not able to join the conference call, you can listen to it by clicking on the link below (it will take a minute or so to download the audiofile.)

New Start Health Centers; Start Smart for Long-Term Stability and Growth
Conference Call Agenda
Support Information related to the Topic
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January 15, 2002 Conference Call: Protecting and Expanding Health Care Access

Our first conference call in the series was held on January 15, 2002 entitled:
Protecting and Expanding Health Care Access: Surviving Tough Times

You can listen to the conference call by clicking on the link above (it will take a minute or so to download the audiofile.)

Provided below are some follow up materials that are relevant to the January 15th conference topic:

"Highlights -- National Health Expenditures, 2000" from the Centers for Medicaid and Medicare Services. A concise description of what is driving the recent acceleration in national health care costs

"Whither Health Care? The Economic and Political Winds Shaping the Future of Our Health Care System."

Transcript of a plenary session from Families USA 's Health Action 2002 conference, January 18, 2002.  "A Perfect Storm: The Confluence of Forces Affecting Health Care Coverage" by Joel E. Miller of the National Coalition on Health Care. This report conveniently lays out the set of economic factors - including rising health care costs and premiums, increasing unemployment, and a slowing economy - that threatens to swell the ranks of the uninsured.
 
"The Sad History Of Health Care Cost Containment As Told In One Chart" by Drew Altman and Larry Levit with commentary by Henry J. Aaron, Thomas Bodenheimer and Helen Darling. An explanation of why the failure of managed care to control health care costs was just latest in a long line of attempts.
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Primary Care Associations Providing Assistance to Local Health Center and 100% Zero Disparity Efforts
Primary Care Associations ( PCA) represent an important resource for community groups working to achieve 100% access and zero health disparities and/or an expansion of health centers. Your PCA can be the first place you reach to for help with your health center project or other 100% / 0 initiative. The Access Project often works in partnership with a Primary Care Association because we believe local community initiatives ought to develop relationships with statewide organizations when ever possible. Here is a list of Primary Care Association websites or go to the HRSA website for a Directory of Primary Care Associations containing detailed contact information.

Alabama: AL Primary Health Care Association
Alaska: Alaska PCA
Arizona: Arizona Association of Community Health Centers
Arkansas: CHC's of Arkansas, Inc.
California: California PCA
Colorado: Colorado Community Health Network
Community Health Association of Mountain/Plains(CHAMPS)
Connecticut: Connecticut Primary Care Association
District of Columbia: DC PCA
Florida: Florida Association of Community Health Centers
Georgia: Georgia Association for Primary health Care
Hawaii: Hawaii State PCA
Idaho: Idaho PCA
Illinois: Illinois PHCA
Indiana: Indiana PHCA
Iowa-Nebraska: Iowa-Nebraska PCA
Kansas: Kansas Association for the Medically Underserved
Kentucky: Kentucky PCA
Louisiana: Louisiana PCA
Maine: Maine Ambulatory Care Coalition
Maryland: Mid-Atlantic ACHC's
Massachusetts: Massachusetts League of CHC's
Michigan: Michigan PCA
Minnesota: Minnesota PCA
Mississippi: Mississippi PHCA
Missouri: Missouri Coalition for PHA and Heartland
Montana: Montana PCA
Nevada: Great Basin PCA
New Hampshire: Bi-State PCA
New Jersey: New Jersey PCA
New Mexico: New Mexico Primary Care Association
New York: CHC Association of NY State
North Carolina: North Carolina PHCA
North Dakota: CHCA North Dakota
Ohio: Ohio PCA
Oklahoma: Oklahoma PCA
Oregon: Oregon PCA
Pennsylvania: Pennsylvania Forum for PHC
Puerto Rico: Asociacion de Salud Primaria de Puerto Rico
Rhode Island: Rhode Island HCA
South Carolina: South Carolina PCA
South Dakota : CHCA South Dakota
Tennessee : Tennessee PCA
Texas : Texas Association of Community Heath Centers
Utah : Association of Utah Community Health Centers
Vermont : Bi-State Vermont
Virginia : Virginia PCA
Washington : Washington Association of CMHC Systems;
Northwest Reginal PCA
West Virginia: West Virginia ACHCs INC
Wisconsin : Wisconsin PHCA
Wyoming : Wyoming PCA
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Association of State and Territorial Health Officials
American Academy of Pediatrics
Buncombe County Medical Society Project Access
International City and County Managers Association
National Association of Counties
United Way of America
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The Homeless Population
The National Coalition on Homelessness (NCH) suggests that in order to find the number of homeless persons by county or city level, it is better to contact the individual local homeless coalitions. The NCH provides the directory for contacting the local homeless coalitions at web site http://www.nationalhomeless.org/state/

For selected cities, the Conference of Mayors Report on Hunger and Homelessness releases status report every year. Please see web site at http://www.usmayors.org/

National Health Care for the Homeless Council (http://www.nhchc.org/index.html)

Corporation for Supportive Housing (http://www.csh.org/)

Public Housing Residents
The Department of Housing and Urban Development (HUD) has a database on the public housing residents at http://www.huduser.org/datasets/assthsg.html.

The number of residents can be sorted by state or county level (Number of Units x occupy rate x Average number of occupants). If you have additional questions, please call Mr. Ron Icpsepanic at (202) 708-1060 ext. 5887.

Foreign Born Population
On February 7, 2002, the U.S. Census Bureau released the first comprehensive document on foreign-born population: "Profile of the Foreign-Born Population in the United States: 2000". This report presents the percentage of foreign-born population by state.

School Children
Information on Public Schools and School Districts in the United States is a data source provided by the National Center for Education Statistics. The Public School Locator and the School District Locator will enable you to find the correct name, address, telephone number, NCES ID number, locale (rural, large city, etc.), and other student and teacher information (total classroom teachers (FTE), total students, student/teacher ratio, low grade, high grade, total eligible students for free/reduced price lunch) for public schools or school districts for school year 1999-2000 as reported to NCES by state education officials in each state.

The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted by the CDC to assess school health policies and programs at the state, district, school, and classroom levels. The SHPPS 2000 was designed to provide info rmation on characteristics of health education, physical education and activity, health services, mental health and social services, food service, school policy and environment, faculty and staff health promotion, and family and community involvement at the state, district, school, and classroom levels nationwide. Web site:

Medically Underserved Areas (MUA) / Health Professional Shortage Area (HPSA) Designations provides information on the shortage of health care provides by zip codes and census tracks. There is a need to identify users of SBHC services by MUA/HPSA, school district, place of residence. We need a contrast between all to determine targeted impact. Web site: http://www.bphc.hrsa.gov/databases/newmua/

KIDS COUNT
has compiled indicators of child well-being released by the 2000 U.S. Census into an interactive online database called The KIDS COUNT Census Data Online. View profiles and download raw data for states, counties.

 The Children’s Defense Fund has the most up-to-date children's data available on a uniform basis called Children in the States. It provides information on children's health coverage, babies born to mothers who received early prenatal care, infant mortality, babies born with low birthweight, child immunizations for two-year-olds, children living in poverty, state spending per student for public, and elementary and secondary pupils by state.

Check the U.S. Census Data 2000 for more info rmation on school children.

Migrant Farmworkers
Data on this population exists but is limited, and much of it is anecdotal and not published. Much of the published scientific research is outdated, ranging from 1991 to 1997, primarily regarding overall migrant and seasonal farmworker demographics and health status. To date, the 1991 Alan Dever monograph titled Migrant Health Status: Profile of a Population with Complex Health Problems (remains the most recent and most quoted study of its kind), and the 1990 George Rust study titled Health Status on Migrant Farmworkers: A Literature Review and Commentary being the most recent published literature review.

The National Center for Farmworker Health provides some detailed information on America's farmers.

Older Adults
Check the U.S. Census Data 2000 for more information

The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a nationally representative sample of aged, disabled, and institutionalized Medicare beneficiaries. MCBS, which is sponsored by the Centers for Medicare & Medicaid Services (CMS), is the only comprehensive source of information on the health status, health care use and expenditures, health insurance coverage, and socioeconomic and demographic characteristics of the entire spectrum of Medicare beneficiaries, which can be located at county level. The county code is available by special request to CMS.

Medicare Health Outcomes Survey (HOS), formerly the Health of Seniors survey for managed care, is the first outcomes measure to be used in the Medicare population and the largest survey effort ever undertaken by HCFA. It is a longitudinal, self-administered survey which utilizes the SF-36 (a health status measure which assesses both physical and mental functioning) and additional case-mix adjustment variables. One thousand randomly sampled Medicare beneficiaries who were continuously enrolled for a six-month period in the plan are surveyed every Spring.

Two years later, these same respondents are surveyed again. In addition, a new baseline survey is administered to a new cohort each year. The first baseline cohort was surveyed in 1998 and was resurveyed in March of 2000. Cohort two baseline was administered 1999 and was resurveyed in the Spring of 2001. Cohort three baseline was surveyed in March 2000 and cohort four baseline was administered in Spring 2001. The report on the health status of the Medicare dual eligible from the survey is also available. This detailed survey information can be located to region, state, and county levels.