2023 AACHC Annual Report

2023 Annual Report

Building Healthy Communities, Together aachc.org

Our collective focus remains steadfast: “Collaborating to expand Community Health Centers’ capacity to deliver high-quality and equitable healthcare.”

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Message from the CEO & Board Chair Dear Members & Partners,

Jessica Yanow, MPH

President & CEO Arizona Alliance for Community Health Centers and Collaborative Ventures Network

Wendy Armendariz, MBA

Chief Executive Officer Neighborhood Outreach Access to Health (NOAH) Board Chair Arizona Alliance for Community Health Centers

In 2023, the Arizona Alliance for Community Health Centers experienced significant progress alongside challenges that we tackled head-on, emerging stronger and more resilient than ever. Reflecting on the past year, I am grateful for the journey we’ve taken together and the opportunities that lie ahead.

Throughout the year, we focused on strengthening our internal infrastructure while working towards a sustainable future aligned with our vision. Our comprehensive three-year strategic plan emerged from this effort, defining our ambitions and milestones. Our collective focus remains steadfast: “Collaborating to expand Community Health Centers’ capacity to deliver high-quality and equitable healthcare.”

Central to our strategic blueprint are key priorities: increasing advocacy and community engagement; strengthening and elevating our workforce; fostering innovation and growth; and championing health equity. Each priority aims to amplify support for our member Community Health Centers (CHCs) and strengthen our Alliance team. I eagerly look forward to seeing these efforts come to fruition, breathing life into our shared vision in the coming months and years.

As a network, 2023 brought new adventures and new challenges.

Arizona CHCs have continued to persevere despite the end of COVID-19 funding, reductions in 340B savings, and limited workforce.

In the face of challenges, CHCs continued to provide a wide range of needed care in their communities, centering patients, and remaining committed to ensuring primary healthcare for all.

Several CHCs undertook ambitious capital improvement projects that expanded care to thousands of Arizonans. Ongoing initiatives promise to bolster capacity and service offerings for existing patients, ensuring a brighter future for healthcare accessibility in our communities.

What stands out most vividly when I look back on 2023 is the collaboration that took place and the collective impact we achieved. We worked closely with the Arizona Health Care Cost Containment System (AHCCCS) to establish an Alternative Payment Model, securing essential reimbursement to deliver vital care to AHCCCS members. Likewise, our partnership with AHCCCS during the redetermination process safeguarded healthcare coverage for our patients.

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Additionally, the Alliance partnered with CHCs on innovative initiatives to address critical needs in the community, such as deploying harm reduction harm reduction vending machines offering free naloxone and fentanyl testing strips. We also fostered collaboration through the establishment of a value-based care peer networking committee and expansion of our Electronic Health Record (EHR) user groups. Witnessing our network unite, share insights, and flourish reaffirms my belief in our collective potential.

Arizona’s Community Health Centers now serve more than 10% of the state’s population, playing a critical role in Arizona’s healthcare system.

Here’s to celebrating the triumphs of 2023 and embracing the promise of an even brighter 2024 ahead!

About Us In health,

Jessica Yanow, MPH

Wendy Armendariz, MBA

The Arizona Alliance for Community Health Centers (the Alliance) is the Primary Care Association for Arizona. We’re a nonprofit member organization that represents Community Health Centers (CHCs) — Arizona’s largest primary care network.

Vision Equitable access to high-quality healthcare for everyone

Mission Advance the vital work of Community Health Centers to serve the unique needs of our communities

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Table of Contents

Board of Directors Officers

Board of Directors

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Arizona’s Community Health Centers Serving Arizonans Statewide Improving the Health of Arizonans Healthcare Heroes

6-7 8-9 10-11

Alliance Programs Advocacy & Community Engagement Health Equity Innovation & Growth Strengthening & Elevating Our Workforce

12-13 14-15 16-17 18-19 20-21

Financials Sponsors Looking Ahead CHC Map

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Chair Wendy Armendariz, MBA

Vice Chair Karen Hoffman Tepper, PhD

Treasurer Dan Provost, MBA

Chief Executive Officer Neighborhood Outreach Access to Health (NOAH)

President and Chief Executive Officer Terros Health

Chief Executive Officer Mariposa Community Health Center

Secretary Pedro Cons, MA

Member at Large & Immediate Past President John Swagert, MD

Member at Large Jonathan Leonard, MPA

Chief Executive Officer Mountain Park Health Center

Sunset Health

Chief Executive Officer Adelante Healthcare

Chief Executive Officer

Board Members Anne Newland, MD, MPH

Daniel Barbara, DHSC

Kimberly Despres, DHA, RN

CEO, North Country HealthCare

CEO, Desert Senita Community Health

CEO, Circle the City

Blaine Bandi, MLS, MHSA CEO, Wesley Community & Health Centers

Christopher David, MS CEO, Native Americans for Community Action

Christopher (CJ) Hansen, MHA CEO, Canyonlands Healthcare

Claudette Pippin, CPA Interim CEO, United Community Health Center

Clinton Kuntz, DBH CEO, El Rio Health

Center

Eddie Estrada, MD CEO, Sun Life Health

Laura Larson-Huffaker, MC CEO, Horizon Health and Wellness

Leslie Horton, MA, MCHES

Hunter Adams, MBA

Director, Yavapai County Community

CEO, Creek Valley Health Clinic

Health Services

Joette Walters, RN

Michelle Barker, DHSc

CEO, Tuba City Regional Health Care

Sr VP Ambulatory Services & CEO FQHC

Corporation

Clinics, Valleywise Health

Jonathan Melk, MD

Mike Renaud

CEO, Chiricahua Community Health

President & CEO, Valle del Sol

Centers, Inc.

Joshua Carzoli, MBA, PharmD

Walter Murillo, BS CEO, Native Health

CEO, MHC Healthcare

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AZ Community Health Centers

Arizona’s Community Health Centers CHCs deliver healthcare services that meet the needs of their communities, connecting people to quality care that gives everyone an equal opportunity to thrive. We facilitate that vital work by providing CHCs with training, technical assistance, programmatic support, and advocacy.

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Associate Members Associate Members are nonprofit, communitybased, or public primary healthcare organizations operating within Arizona that have an interest in primary healthcare services for the underserved. These organizations are partners in the quest for primary healthcare for all Arizonans.

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AZ Community Health Centers

Community Health Center Impact Making Communities Healthier

62%

Patients with Hypertension (HTN) Whose Blood Pressure (BP) was Controlled

84%

HIV Patients Who were Newly Diagnosed with HIV and Received Follow-up Treatment Within 30 Days

Arizona’s Largest Primary Care Network

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Patient Gender

200+

Health Center Program Grantees

Sites Across Arizona

10,795

Public Housing Adjacent Patients

Agricultural Workers

33,690

14,042

Individuals Experiencing Homelessness

Veterans

65%

88%

Racial & Ethnic Minority Patients

At or below 200% FPL

Female

Male

8,579

Staff FTEs (Full Time Equivalent)

Children Age 6-9 Who Received Dental Sealants

Adults Screened for Tobacco Use and Receiving Cessation Intervention

59%

237,769

41%

58%

86%

Special Populations

Community Health Centers (CHCs) are local, nonprofit, healthcare providers serving people of all income levels in medically underserved communities. CHCs employ a comprehensive, wholeperson, integrated model of care that includes primary medical, oral health, behavioral health, pharmacy, and other preventive and enabling services. CHCs are crucial to ensuring primary healthcare for all Arizonans.

Payor Mix

Patient Age

29% Serving ~1 in 9 Arizonans

817,026

3,503,011

Total Patients Served

Patient Visits

Under 18

58% 18 to 64

13%

65 and older

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AZ Community Health Centers

Healthcare Heroes

2023 Community Health Workers of the Year

Each year the Alliance recognizes Community Health Center staff that have made a substantial contribution to primary healthcare in Arizona through its Annual Healthcare Hero Awards. The awards celebrate achievements in community leadership, innovation, student precepting, and exemplary patient care. Congratulations once again to our 2023 awardees!

2023 Community Leadership Award

2023 Distinguished Service Award

DR. JONATHAN MELK CEO, Chiricahua Community Health Centers, Inc.

LYNETTE BONAR Former CEO, Tuba City Regional Health Care Corporation

CECILIA NAVARRO Mariposa Community Health Center

ANA DOLORES SERRANO El Rio Health

2023 Dental Assistants of the Year

SARA MASON Desert Senita Community Health Center

PERLA NUNEZ RODRIGUEZ Valleywise Health

2023 Innovation Award 2023 Medical Assistants of the Year

DR. SARAH COLES Program Director, Colorado Plateau Family & Community Medicine Residency Program​, North Country HealthCare

KIMBERLY CHEN Director of Pharmacy, North Country HealthCare

2023 Preceptors of the Year

DR. MOLLY LARSON-WAKEMAN Clinical Pharmacist, North Country HealthCare

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DR. TANYA HENRY Pediatrician, Mariposa Community Health Center

BARBARA HARDING Former Sr VP of Ambulatory Services & CEO of FQHC Clinics, Valleywise Health ODILIA ALVAREZ Circle the City

SHAKILIA CANALES Chiricahua Community Health Centers, Inc.

2023 Special Populations Award

NATALIE CERVANTES Native Health

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Learning, Networking, Our Team, Our Mission

Alliance Programs

The Alliance offers a robust collection of programs designed to support Community Health Centers in optimizing operations, leveraging technology, and setting a high bar for quality and outcomes.

We are a team of experts and thought leaders who are dedicated to improving the health of Arizonans through access to quality healthcare. We work hard to support our members, our partners, each other, and the community.

2023 National Health Center Week

2023 Board Retreat

2023 Annual Conference

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Alliance Programs

Advocacy & Community Engagement A Strong Voice for Arizona Community Health Centers The advocacy work we do is focused on impacting policy and regulatory decisions that support the delivery of integrated health services across Arizona – especially in medically underserved communities and to medically underserved populations. In 2023 our policy priorities included:

State

Federal

Obtain state funding for unreimbursed costs of on-call OB/GYN services if necessary to maintain service availability in rural communities ($7.5M funded)

Extend Community Health Center and workforce programs funding including National Health Service Corps (NHSC) and Teaching Health Centers (THCGME)

Create Arizona Health Education Center (AHEC) program to start or expand primary care Graduate Medical Education programs at Community Health Centers, Rural Health Clinics, and Tribal Outpatient Health Clinics ($5M funded)

Reform 340B statutes to protect low-cost pharmaceuticals, patient services, and use of contract pharmacies

Enable Physician Assistants to provide services under a collaborative agreement, rather than under physician supervision after 8,000 hours of clinical supervision

Work with federal and state agencies as work to assist patients to keep or obtain health care coverage following the end of the pandemic

Shorten the time frame for credentialing and loading providers to 45 days (from 100); Require retroactively pay claims accrued during credentialing process for providers ultimately enrolled

=Accomplished

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=Ongoing

Extend telehealth and telephonic services permanently

Government Relations We advocate for CHC priorities in Congress and at the State Legislature; collaborate with CHCs on grassroots advocacy efforts to build awareness and demonstrate the value of the CHC model; and keep CHCs updated on changes in the complex policy and regulatory environment. This work involves educating and building relationships with policy makers, state agencies, the general public, media outlets, and other stakeholders on the value of CHCs. From left to right: Dan Prevost, CEO of Mariposa Community Health Center; Dr. Eladio Pereira, CMO of Mariposa Community Health Center; Rep. Consuelo Hernandez LD21, 2023 Legislator of the Year; Dr. Philip Williams, Mariposa Community Health Center; Rep. Alma Hernandez LD20; Jennifer J. Burns, Sr. Director of Gov’t & Media Relations at the Alliance. Rep. Consuelo Hernandez sponsored HB2563 to protect OB/ GYN on-call services for Santa Cruz County mothers and babies.

From left to right: David Rogers, CEO of Sunset Health, and 2023 Legislator of the Year, Rep. Michele Pena, LD23.

Pena sponsored HB2753: GME; Residency Programs - a bill that will help bring primary care residents to Community Health Centers in rural and underserved areas.

Some items which failed or are pending in 2023, may have success in 2024.

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Alliance Programs

Health Equity

Outreach & Enrollment

Everyone Deserves Quality Healthcare The Alliance is committed to advancing equitable access to high-quality healthcare for all Arizonans.

Our dedication to promoting health equity is reflected in our efforts to integrate health equity principles into all components of our work, paving the way for integrated programs and services aimed at enhancing health outcomes

Domestic & Sexual Violence Women in small rural and isolated areas often report the highest prevalence of intimate partner violence (IPV). Unfortunately, they also have limited access to healthcare services and support due to their geographic location.

Through a Department of Justice grant, CHC staff and advocates helped address this need by providing outreach, training, services, and support to patients experiencing domestic violence (DV), sexual assault, stalking, and/or trafficking.

25,179

Total patients screened for IPV

331

Primary victims served

445

Secondary victims (children/family members) served

16

108

Events that offered training/community education on DV, sexual violence, stalking, and trafficking

1,360

Times a service was provided to a primary victim

Harm Reduction Through a grant with the Maricopa County Department of Public Health, the Alliance was able to purchase three harm reduction vending machines for CHC locations in the Phoenix area. These vending machines will provide free naloxone/Narcan, fentanyl testing strips, and other prevention/safety items to patients, family members, and the general public. The ability to provide these harm reduction tools where the community also seeks primary care and substance use disorder services is key to reducing overdose, deaths and the stigma associated with opioid use disorder.

Farmworker Health We kicked off an Agricultural Worker Enumeration Study, which hasn’t been done in Arizona since 2008. The study will provide timely agricultural worker estimates for Arizona to ensure proper allocation of resources and services

2023 was a big year for Outreach and Enrollment. Medicaid redeterminations began for over 2.5 million beneficiaries. Community Health Centers (CHCs) worked hard to put processes in place to help mitigate a drop in coverage for our communities and the Alliance supported these efforts by providing information and technical support. Our team was also able to provide feedback to AHCCCS on the redetermination process that led to the sharing of meaningful data. This data helped health centers and community partners be successful in their efforts to maintain coverage for individuals and families across the state.

Enrollment Services

Other Activities

1,692

12,596

42,603

56,250

3,332

8,287

Marketplace

AHCCCS/KidsCare

SNAP

194 WIC

Cover Arizona 800# Calls

General Inquiries

Referrals

1,405

Outreach Events

6.2M Media Impressions

Program Impact Through the Cover Arizona Coalition, the Alliance’s Outreach and Enrollment team supports CHCs and other community partners across the state in helping Arizonans understand and navigate state and federal health insurance programs, including the Marketplace, AHCCCS/ KidsCare, SNAP, and WIC. Finding and maintaining coverage is not easy, but through the Cover Arizona hotline, referrals, events, and other outreach activities we are able to connect communities that have historically experienced lower access to health coverage and greater disparities in health outcomes to appropriate coverage.

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Alliance Programs

Innovation & Growth Ultimately, a renovated health center is more than just a building; it’s a catalyst for positive change, transforming lives, and revitalizing communities.

The Alliance is committed to both strengthening our organizational infrastructure and ensuring the sustainability of Arizona’s Community Health Centers (CHCs). In 2023, we spent time optimizing our systems, investing in essential infrastructure, and securing strategic funding with a goal of upholding our values and providing robust support to CHCs.

We took a step back in 2023 to evaluate the structure and goals of our HCCN program. We restructured to focus equally on quality, data and informatics, and project management, where in the past the team was primarily focused on project management.

This shift has resulted in better collaboration and integration across the organization, and more impactful activities for CHCs.

New Peer Networking Committees

We also conducted a comprehensive HIT and Network Assessment to assess network and individual health center maturity and identify opportunities to better support health centers in Arizona and Nevada, and developed HIT Strategic Plans for both states based on the findings of the assessment.

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Value-Based Care Committee - maximizing value through quality and other metrics to improve CHC sustainability and patient care

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Pediatric Leaders Committee - enhancing quality of care and advocating for system changes that will improve outcomes for vulnerable children

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Mobile Health Workgroup - Bringing together local resources and national best practices to collaboratively advance health equity in Arizona

Capital Improvement Projects We allocated an additional $5 million to Maricopa County capital improvement projects in 2023, bringing the total invetment to $52 milltion. We also oversaw the completion of four projects. From opening new clinics to the rollout of new HIT infrastructure and the upgrade of existing clinics, these projects signify a transformation in the healthcare experience for the entire community.

Beyond enhancing access to vital healthcare services, a renovated health center becomes a focal point for community engagement, hosting outreach programs, educational initiatives, and wellness events. Investing in CHC renovations can spur economic development, create jobs, attract talent, and revitalize local neighborhoods. Ultimately, a renovated health center is more than just a building; it’s a catalyst for positive change, transforming lives, and revitalizing communities.

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Health Center Controlled Network

The healthcare space for CHCs has been dynamic and requiring continuous reshaping of workflows and processes to incorporate UDS+ preparation, multiple EHR version upgrades, adoption of AI, and more advanced HIT tools. 2023 was a year of evolution and has strengthened the network overall.

2023 Highlights •

The Annual HIT symposium had record attendance compared to previous years, with 77 participants and an overall satisfaction score of 4.4 out of 5.

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Our NextGen and eCW user-groups grew and facilitated enhanced engagement and collaboration, with a 90% participation rate between the two groups.

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We identified the need for and will be implementing a Peer Networking Committee for Chief Information Officers and other HIT leaders within CHCs to better support the sharing of best practices across the network on a consistent basis.

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Alliance Programs

Strengthening & Elevating Our Workforce Supporting Arizona’s Community Health Centers (CHCs) with recruitment and retention efforts is a strategic priority for the Alliance. In 2023, we continued operating the pilot program, AHEAD AZ, that allows CHC employees interested in a Medical Assistant role to receive on-site training comprised of virtual education and hands-on clinical hours. We graduated 35 students from the program in the inaugural year, 2022. In 2023, 47 additional students graduated. A third cohort of 30 students began in September and will graduate in early 2024.

The Alliance offers numerous learning opportunities annually through a variety of formats, including in-person training events, webinars, and hybrid events.

We also operate a Peer Networking Committee Program focused on providing opportunities for CHC team members to share best practices and network with peers from other CHCs across the state.

These group learning opportunities help strengthen the network and the impact we are able to achieve together.

The Alliance also provides 1:1 technical assistance to CHCs on a variety of topics, including governance, HIT, and process improvement.

We also supported recruitment and retention efforts through our Annual Workforce Recruitment and Retention Conference, providing resources related to recruitment and retention planning, workforce strategies, state and federal loan repayment programs, marketing tactics, and healthcare policy to address workforce shortages. Additionally, we provided training and technical assistance to CHCs to support the development and implementation of Strategic Workforce Plans for Health Professions Education and Training and Comprehensive Workforce Plans.

Continuous Improvement Leads to Lasting Change

Growing our Workforce To help grow Arizona’s primary healthcare workforce we also facilitate pipeline programs and work with students and residents through community-based rotations and internships. Our pipeline programs expose students grades 6th through 12th to the healthcare industry and give them the opportunity to learn about and experience various healthcare professions.

285

High school students participating in health-related clubs in Maricopa, Pinal and Southern Yavapai Counties

29,255

Hours of students participating in field experiences (i.e. rotations and internships)

45

Students participating in field experiences (i.e. rotations and internships).

32

CAAHEC Scholars were exposed to a rural community

2023 Impact

40+

Trainings

Due to the success of AHEAD AZ, the Alliance was able to replicate this model and develop a Dental Assisting Upskilling Program. Like the Medical Assistant program, Community Health Workers can enroll in the Dental Assistant track and receive support on National Board (DANB) Review Courses and testing. In 2023, 21 Community Health Workers participated in the Dental Assisting Upskilling Program.

To further support workforce development, we provided access to a 40-hour online course for Community Health Worker Spanish Medical Interpretation Certification for 15 CHC team members representing nine CHCs.

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Training & Technical Assistance

1,900+ Participants

4.6/5

Average satisfaction rating

3.6/5

Average behavior change rating

1,507

Healthcare professionals received continuing education credit through events supported by the Central Arizona Area Health Education Center (CAAHEC)

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Financials

Financial Overview

Annual Sponsors

The Alliance has a diverse portfolio of federal, state, and private grants along with other funding streams to help support our work. As a strong advocate for collaboration, we are proud of the proportion of our funding we are able to pass on to our members and partners to further advance our mission.

Pass-through Funds*

We are grateful for the generous support of our sponsors who join with us to make quality, affordable healthcare available to all. Through their support, we are impacting the lives of more Arizonans by expanding delivery of integrated health services, especially in medically underserved communities and to underserved populations.

67%

13% Other Federal Grants 8% Administrative Contracts 6% PCA Cooperative Agreement 3% Azara Participation 1% Group Purchasing 2% HCCN Cooperative Agreement 1% Sponsorships 1% Membership Dues

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*Pass-through funds are grant dollars received by the Alliance but passed on to our members and partners to carry out grant deliverables

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Looking Ahead As we look forward, we boldly envision and encourage additional changes that move us forward toward more innovation, collaboration, and advocacy, fostering an environment where ideas flourish, partnerships thrive, and our collective voice resonates even more powerfully in the halls of decisionmaking.

As we embark on another year of service and advocacy, we celebrate not only our collective achievements but also the resilience and dedication of our Community Health Centers across the state.

This year has been marked by significant milestones, including a transformative organizational realignment and the recruitment of key personnel. Our reimagined approach to collaboration and synergy aims to enhance our capacity to effectively navigate the complex landscape of healthcare advocacy.

Central to our success are the talented individuals who have joined our team, as well as our existing staff, each bringing with them a wealth of expertise and passion for our mission. With their combined efforts, we strengthen our foundation and expand our collective capabilities, ensuring that we remain at the forefront of advancing community health initiatives and addressing the evolving needs of underserved populations.

As we look forward, we boldly envision and encourage additional changes that move us forward toward more innovation, collaboration, and advocacy, fostering an environment where ideas flourish, partnerships thrive, and our collective voice resonates even more powerfully in the halls of decision-making.

Thank you for your unwavering support, dedication, and partnership. Together, we stand as advocates, caregivers, and champions of health equity, united in our dedication to building healthier, more vibrant communities across Arizona.

Disclaimer: This publication was supported by Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of financial assistance awards totaling $3,420,383, with 0% funded by non-government source(s). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.

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