Fiscal Year 2017 and 2018 Annual Report
A Legacy of Care
“WE PROVIDE QUALITY HEALTH CARE TO EVERYONE IN THE COMMUNITIES WE SERVE.” -MISSION STATEMENT
Locations Health Center Locations 1 2 3 4
5 6 7 8
Cutler/Orosi Dinuba Farmersville Fresno
Deran Koligian ACC Surgical Services Center Disease Management Center
Goshen Hanford Ivanhoe Mobile Health Center Medical Dental
9 Pixley 10 Porterville – 2 Locations Porterville Health Center Porterville Dental Center 11 Springville 12 Strathmore 13 Terra Bella 14 Three Rivers 15 Traver 16 Tulare – 2 Locations Tulare Pediatric Group Tulare Health Center 17 Visalia – 3 Locations Visalia Bridge Visalia Oak Health Center Visalia School Health Center 18 Woodlake
Additional Locations
1 Annex 2 Corporate Office
Corporate Finance
3 Resource Center 4 Ventanilla de Salud
Services • Adult & Children’s Dentisty • Behavioral Health • Case Management • Chiropractic Care • Community Health & Outreach • Enrollment & Eligibility Assistance • Family Medicine • Health Education • Imaging/Ultrasound
• Internal Medicine • Nutrition Counseling • Obstetrics & Gynecology • On-Site Lab Services • Optometry • Pediatrics • Pharmacy • Podiatry • Transportation
• Allergy • Cardiology • Ears, Nose, and Throat • Endocrinology • Gastroenterology • General Surgery • Hematology • Infectious Disease • Neurology
• Ophthalmology • Orthopedic Surgery • Perinatology • Pulmonology • Rheumatology • Urology • Vascular Surgery • Urology
Board of Directors Steve Kabot Chairperson
John Zapalac Vice Chairperson
Emzy Cope
Maria Gonzalez Secretary
Minetta Costa
Teresa de la Rosa
Senior Leadership Kerry L. Hydash, MPA President & CEO
Marisol de la Vega Cardoso Chief Business Development Officer
Paramvir Sidhu, MD Chief Clinical Officer
Paul Curtis Treasurer
Michael Botello
Olivia Gamboa
Brandon Foster, P.h.D Chief Quality and Compliance Officer
Chad Vawter, MBA Chief Financial and Strategy Officer
Michelle Cano
Sandi Miller
Jay Kelley, MSHAI Chief Information Officer
Norma Verduzco, MPA Chief Operations Officer
A Message from the President & CEO Family HealthCare Network (FHCN) stands by its mission to provide quality health care to everyone in the communities we serve. For over 40 years, this focus on the needs of our communities has made us one of the largest networks of community health centers both in California and in the United States as a whole.
Highlights from fiscal years 2017 and 2018 (FY 17/18) serve to illustrate our commitment to the communities around us. In FYs 17-18, we served over 253,000 active patients at 30 sites. Our staff size exceeded 1,200 members, which allowed us to work cohesively to ensure that we provide quality care for all, regardless of their ability to pay.
For much of FHCN’s history, we have focused on providing high-quality comprehensive primary care and support services. Recently, to better serve our communities, we have expanded our service area to include Tulare, Kings, and Fresno Counties, and added or expanded 15 specialty services to our network. Having enhanced access to these specialties has had a tremendous positive impact on our patients who otherwise would have continued to struggle to access timely specialty care. As the seventh largest community health center in the United States, and the third largest in California, FHCN is also very honored to serve more agricultural workers than any other community health center in the nation. I invite you to learn more about FHCN and its progress in FYs 17-18 in the pages of our annual report. Sincerely,
Kerry L. Hydash, MPA President & CEO
Migrant/Seasonal Patients 123,506 113,865 114,040 2014
2014 2017
114,597,659
103,627
100,914,904 2014
563,346
2017
2014
619,283
2015
123,000,000
78,035,086
Operating Expenses** 108,218,852
98,183,553 90,069,735 2014
2015
635,546
806
Revenue**
2015
2016
687,341
902
2016
2017
2015
188,413
Total Billable Visits
2017
932
2016
2014
207,346
2016
956
2015
2015
211,983
2017
230,422
Total Employees
2016
Total Active Patients*
2016
2017
2016-2017 FAMILY HEALTHCA
75,700,154
FISCAL YEAR RE NETWORK DATA Total Utilization of Services
Patient Income Level by Federal Poverty Level
Medical - 76.50% Dental - 14.43% Other Professional Services - 2.04% Behavioral Health - 2.53% Enabling Services - 4.50%
100% and Below - 82.13% 101-150% - 11.32% 151-200% - 3.10% Over 200% - 2.30% Unknown - 1.15%
Primary Language of Patients
Who we Serve
*Data obtained from Family HealthCare Network’s Electonic Health Record system. **Revenue and Expense Totals were obtained from Family HealthCare Network Financial Reports.
English - 47.13% Spanish - 52.21% Arabic - 0.23% Laotian - 0.10% Hmong - 0.05% All others - 0.28%
Medi-Cal - 70.24% Private - 11.64% Commercial - 9.11% X-Over - 4.46% Family Planning - 1.51% Medicare - 2.15% Other - 0.90%
Migrant/Seasonal Patients 132,002 123,506 113,865 2015
2015 2018
123,000,000
114,040
114,597,659 2015
619,283
2018
2015
635,546
2016
141,072,655
100,914,904
Operating Expenses** 126,947,356
108,218,852 98,183,553 2015
2016
687,341
902
Revenue**
2016
2017
756,121
932
2017
2018
2016
211,983
Total Billable Visits
2018
956
2017
2015
218,337
2017
1,219
2016
2016
230,422
2018
253,850
Total Employees
2017
Total Active Patients*
2017
2018
2017-2018 FAMILY HEALTHCA
90,069,735
FISCAL YEAR RE NETWORK DATA Total Utilization of Services
Patient Income Level by Federal Poverty Level
Medical - 76.71% Dental - 14.56% Other Professional Services - 3.20% Behavioral Health - 1.73% Enabling Services - 3.80%
100% and Below - 74.83% 101-150% - 16.02% 151-200% - 4.41% Over 200% - 3.41% Unknown - 1.33%
Primary Language of Patients
Who we Serve
*Data obtained from Family HealthCare Network’s Electonic Health Record system. **Revenue and Expense Totals were obtained from Family HealthCare Network Financial Reports.
English - 46.89% Spanish - 52.46% Arabic - 0.25% Laotian - 0.09% Hmong - 0.04% All others - 0.27%
Medi-Cal - 69.26% Private - 12.61% Commercial - 9.43% X-Over - 4.35% Family Planning - 1.32% Medicare - 2.18% Other - 0.85%
Humble Beginnings Family HealthCare Network began in 1976 with just one office in a two-room house in Porterville. Then called United Health Organization, the fledgling non-profit clinic was started by a group of dedicated individuals determined to find a way to bring health care to Spanish-speaking farm workers in the area. At that time, only the county hospital in Tulare was providing access to care, however, prenatal care was nearly impossible to receive. The county’s infant mortality rate at the time was a staggering 14.8 for every 1,000 live births.
In 1978, the organization restructured and the Porterville clinic became known as Porterville Family Health Center, Inc. Two providers were added to the staff and in 1980 the program relocated into a gas station/mini-market on Highway 190. This location was renovated and turned into a clinic with six exam
rooms. During these early years, our organization was so successful at serving individuals in the Porterville area that over the next four decades, the building had to be expanded twice to meet community needs. Currently, this health center has 65 exam rooms—and still sits on the original site. In 1989, the Board of Directors determined it was time to expand this successful model into other communities also in need of care. The community of Ivanhoe became the first of many expansions that focused on addressing the lack of accessible care. This was followed over the years by sites in multiple communities. During this same time, we expanded not just in size but in range of services provided.
1976
Oct. 1980 Porterville Health Center on 190 Opened
Nov. 1990 1992 Transportation Dental Program Program Launched Launched
Oct. 1989 Ivanhoe Health Center Opened
1980
April 1999 Visalia Bridge Health Center Opened
July 2001 Three Rivers Health Center Opened
Complementary Alternative Health Program Launched
May 2002 Integrative Behavioral Health Program Launched
Nov. 1999 Woodlake Health Center Opened
Dec. 2000 Springville Health Center Opened
1985 1990 1995
Aug. 2001 Cutler/Orosi Health Center Opened
2000
Feb. 2003 Visalia Oak Health Center Opened
Aug. 2004 Goshen Health Center Opened
Dec. 2006 Hanford Health Center Opened
May 2007 Putnam Dental Opened
Aug. 2007 Promotora Program Launched
Aug. 2012 New Porterville Dental Center Opened
Aug. 2008 A.T. Still University Medical School Established
May 2011 Porterville Pharmacy Opened
July 2008 Ventanilla de Salud Site Opened
2005
2010
Jan. 2012 Farmersville Health Center Opened
May 2012 New Woodlake Health Center Opened
May 2012 Woodlake Community Garden Established
Oct. 2012 New Goshen Health Center Opened
April 2013 Woodlake Community Mural Established
July 2013 A.T. Still PA Program Established
Sept. 2013 Visalia Oak Health Center Pharmacy Opened
Jan. 2014 Terra Bella Health Center Opened
June 2014 Visalia School Avenue Health Center Opened Sept. 2014 Hospitalist Program Launched
Nov. 2014 Visalia Bridge Walk-In Center Opened
Aug. 2015 Tulare West Health Center Opened
Dec. 2015 Optometry Program Launched
April 2015 General July 2014 Surgery Dental Residency Program Program Launched Launched
2015
April 2016 Traver Health Center Opened
Openings & Expansions July 2016 Tulare Pediatrics Opened & Expanded
Family HealthCare Network opened its second health center in the city of Tulare providing pediatric services.
Aug. 2016 Cutler-Orosi Pharmacy Opened
By opening pharmacies inside of health centers, FHCN provides patients convenient and affordable medications.
Nov. 2016 Pixley Health Center Opened
With the opening of this health center, FHCN was the first FQHC to have a health center in the community of Pixley.
2016 - 2017
May 2017 PRAPARE Program Launched
The Protocol for Responding to March 2017 and Assessing Mobile Mammography Patient’s Assets, Services Offered Risks, Experiences (PRAPARE) aims Through a partnership to address social between Family determinants of health HealthCare Network by providing wholeand Assured Imaging, person care. FHCN began providing on-site mammography services.
Openings & Expansions Oct. 2017 Hanford Health Center Relocated & Expanded
Family HealthCare Network relocated and expanded services, staff, and exam rooms in the city of Hanford.
April 2018 Mobile Dental Health Center Opened Feb. 2018 Strathmore Health Center Opened
Family HealthCare Network became the first FQHC to provide health care in the community of Strathmore.
The Mobile Dental Health Center began to offer dental services in multiple locations throughout Tulare, Kings, and Fresno Counties.
2017 - 2018
June. 2018 May 2018 Dinuba Health Center Opened
Family HealthCare Network added internal and family medicine services in the community of Dinuba.
Family HealthCare Network opened three new health centers in the city of Fresno, and becomes a training site for the UCSF Medical Residency Education Program.
The opening of the new three-story Hanford Health Center expanded the services we offer in the community of Hanford. The new site more than doubled the size of the former Hanford Health Center, and is home to more than 125 employees.
Hanford Health Center OPENED IN 10 MONTHS!
Continuity of Care with a Provider & Care Team
Coordinated, Integrated Care
In FY 2018 38,050 Sq. ft.
45 Exam Rooms
10 Dental Operatories
4 Optical Lanes
Patient, Family, & Community Centered
Data Driven Quality Improvement
CostEfficient & Payment Alignment
Innovative Partnerships to Expand Care Through an innovative partnership with Community Medical Center, the region’s largest health care system, and UCSF Fresno Medical Education Program, Family HealthCare Network assumed the operations of three primary and specialty care centers located in downtown Fresno. The new locations include the Deran Koligian Ambulatory Care Center, the Surgical Services Center, and the Disease Management Center. Family HealthCare Network will work with the UCSF Fresno Medical Education Program to continue training residents and fellows within our clinics. The innovative partnership builds upon our strengths to meet the growing demand for health care services in the Valley.
104 Exam Rooms
300 Residents
232 Providers
Mobile Health
Family HealthCare Network launched its first Mobile Health Center in May 2017 and expanded with a Mobile Dental Health Center in April 2018. The Mobile Health Centers allow us to offer medical and dental services in communities without a stationary health center, including: preventative screenings, health exams, well child exams, immunizations, lab services, dental services, and enrollment assistance. Through several partnerships with community entities, FHCN has been able to provide convenient access to care for individuals without the resources to travel.
In FYs 17/18 Serving 12 locations
Increased access to 9 rural communities
DIABETIC CLINIC Take Control Today
Family HealthCare Network launched a pilot Diabetic Clinic in January 2017. The Diabetic Clinic gave patients the opportunity to understand risky behaviors, explore ways to manage their nutrition by viewing a cooking demonstration, and set goals with a nutritionist and provider. The Diabetic Clinic pilot produced tremendous success between a cohort and control group of patients. 7.5% decrease in Hgba1c for cohort vs. 1.5% increase for control 60% of cohort with BP under 140/90 vs. 50% of control
Overwhelming positive feedback from participants “I really liked the ability to question people who were experts in their field.� -Diabetic Clinic Patient
Primary Care As a patient-centered health home, FHCN offers a wide range of comprehensive primary care services to meet the needs of the communities served. Primary care services are also integrated in to one location to improve accessibility for individuals and families to address their health care needs. Services such as family medicine, pediatrics, obstetrics and gynecology, internal medicine, adult and children’s dentistry, optometry, pharmacy, and chiropractic services complement ancillary and specialty services offered at FHCN health centers. Fiscal years 2017 and 2018 were no exception to FHCN’s continued success in offering a patientcentered model of care as noted in the Fiscal year’s highlights.
In FY 2017
In FY 2018
3,035 infants delivered 97,961 pediatric visits
2,924 infants delivered 98,403 pediatric visits
230,422 active patients
253,850 active patients
687,341 patient encounters
756,121 patient encounters
256,775 prescriptions filled
260,833 prescriptions filled
3,327 vision exams 1,738 prescription glasses sold
7,693 vision exams 4,589 prescription glasses sold
94,329 dental visits
108,917 dental visits
Specialty Services As part of FHCN’s Patient - Centered Medical Home (PCMH) model, FHCN expanded its specialty services during fiscal years 2017 and 2018, offering multiple new specialty services.
DECEMBER 2016 Vascular Surgery
FEBRUARY 2017 Perinatology
MAY 2017 Endocrinology
JULY 2017 Orthopedic Surgery
JUNE 2018 Ears, Nose, and Throat Gastroenterology Infectious Disease Ophthalmology Hematology Cardiology Neurology Rheumatology Urology Allergy
Community Impact FY 17 BOOKS DISTRIBUTED VIA REACH OUT & READ
19,881 HEALTH SCREENINGS AT COMMUNITY EVENTS
7,800
3,891 APPLICATIONS FOR ENROLLMENT INTO SPECIAL PROGRAMS*
104 FAMILIES, INCLUDING 260 CHILDREN, SUPPORTED THROUGH THE ANITA FUND
8,172 KINDER CARE ORAL HEALTH SCREENINGS
73,636
PEOPLE EDUCATED THROUGH OUTREACH
687,341
FITCLUBS CREATED IN: Farmersville (1) Woodlake (2) Tulare (3) Ivanhoe (2) Visalia (3) Cutler-Orosi (1)
*Special Programs include: Covered CA, Medi-Cal, M-CAPRepHi, Cal Fresh, Medicare, Social Security, VEA Apps, etc.
Community Impact FY 18 BOOKS DISTRIBUTED VIA REACH OUT & READ
33,166 HEALTH SCREENINGS IN COMMUNITIES
9,311
4,293 APPLICATIONS FOR ENROLLMENT INTO SPECIAL PROGRAMS*
108 FAMILIES, INCLUDING 256 CHILDREN, SUPPORTED THROUGH THE ANITA FUND
7,019 KINDER CARE ORAL HEALTH SCREENINGS
121,356 PEOPLE EDUCATED THROUGH OUTREACH
FITCLUBS CREATED IN: Cutler-Orosi (2) Tulare (1) Visalia (3) Woodlake (1)
*Special Programs include: Covered CA, Medi-Cal, M-CAPRepHi, Cal Fresh, Medicare, Social Security, VEA Apps, etc.
Here’s to Another 40 years!