HCAN 2021 Annual Report

Annual Report 2021

Health Center Association of Nebraska www.hcanebraska.org

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HCAN’s 2021 Annual Report

Content 3

BOARD CHAIR’S REPORT

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WHO WE ARE

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OUR HEALTH CENTERS

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OUR IMPACT

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10 YEARS OF SERVICE TO THE COMMUNITY

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PATIENT ADVOCACY AND YEAR IN REVIEW

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FUTURE PROJECTS AND SPONSORS

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MEET OUR TEAM

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Health Center Association of Nebraska (HCAN) is Nebraska’s nonprofit Primary Care Association, representing the state’s seven Federally Qualified Health Centers (FQHCs), also known as community health centers.

3929 S 147th St. Suite 100A Omaha, NE 68144 www.hcanebraska.org

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Board Chair’s Report It also came with the anguish of knowing that our patients are being disproportionately impacted by COVID-19.

Since the beginning of the COVID-19 pandemic, Nebraska’s community health centers have served as the circuit breakers in the health care system. Through patient education and the triage, testing, treating symptomatic patients, and administering vaccines, health centers have played a pivotal role in reducing hospital strain and freeing up scarce resources for the severely ill.

This work came with the same compassion, mission and commitment to providing the highest quality care possible.

As we came to the close of 2021, it was almost unimaginable that our providers and patients were still facing many of the same pressures and impacts from COVID-19. To date, health centers have provided COVID-19 testing to over 60,000 Nebraskans and administered over 85,000 vaccine doses. We are reaching into the community, going door-to-door to ensure everyone has access to the COVID-19 vaccine.

We continue to stretch resources to address the cultural, linguistic and systemic barriers to access care and treatment for COVID-19. All of these efforts are in addition to the comprehensive primary, medical, dental and behavioral health care provided each and every day.

Our frontline staff and providers are physically and emotionally exhausted. I continue to stand in awe of their resiliency and dedication to their patients and communities.

Looking ahead to 2022 we know that COVID-19 will continue to challenge our patients and providers. But we look forward with a sense of hope. Hope that we will harness the lessons learned throughout COVID-19 to make meaningful changes that tear down systemic barriers to equitable access to care.

Hope that we make significant

investments in the expansion of community health centers across Nebraska to increase health care access to thousands of individuals.

Hope that we will find creative solutions to address the health care workforce needs in our state and reduce the burden on overextended staff and providers. Hope that every Nebraskan can access the care they need, when they need it, in a compassionate and inclusive environment.

The significant upheaval of COVID-19 brings opportunity to make significant change in how we deliver care. We

must work together to build a health care infrastructure that fosters and supports growing workforce needs, provides unique opportunities for the health care providers of the future to train in all areas of the state, and ensures equitable access to all Nebraskans.

Health centers are an essential part of Nebraska’s safety net and can, and should, play a critical role in transforming our health care system to ensure health and well-being for all.

“Health centers have played a pivotal role in reducing hospital strain”

In 2020, Nebraska’s community health centers served over 107,000 unduplicated patients with integrated primary care, preventative services, chronic disease management, and support services addressing medical, dental, and behavioral health needs.

107,701 45% 68% 7%

of these patients served are UNINSURED

Health centers ensure that all underserved populations have access to high quality, comprehensive, affordable healthcare, regardless of their ability to pay.

of these patients identify as an ETHNIC or RACIAL minority

of these patients experience HOMELESSNESS

95 % Had incomes at or below 200% of the Federal Poverty Level

31,957 1%

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patients are CHILDREN & ADOLESCENTS

of these patients are AGRICULTURAL WORKERS

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Who We Are

HEALTH CENTER ASSOCIATION OF NEBRASKA IS COMMITTED TO EXPANDING AND ENHANCING ACCESS TO QUALITY, COMMUNITY-RESPONSIVE CARE FOR NEBRASKA’S HEALTH CENTERS. HCAN LEADS TRAINING AND TECHNICAL ASSISTANCE FOR THE HEALTH CENTERS WHILE PROVIDING ADVOCACY AND EDUCATION FOR PATIENTS WITHIN THEIR COMMUNITIES. MISSION To Advance the Health Center Movement

HCAN:

2021 BOARD OF DIRECTORS:

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Andrea Skolkin, Board Chair OneWorld Community Health Centers, Inc.

VISION Access Health Wellbeing for All

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107,701

Patients served in 2020 by Nebraska Community Health Centers

Brad Meyer, Vice Chair Bluestem Health

Networks with organizations at the regional and national level for healthcare excellence and equity

Tami Smith, Secretary/Treasurer Heartland Health Center

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Promotes healthcare workforce development, recruitment and retention

Kathy Nordby Midtown Health Center

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Educates Nebraskans on the mission, services and value of community health centers

DIVERSITY, EQUITY, INCLUSION HCAN is committed to building a culture that celebrates diversity and strives for equity. We engage with individuals, colleagues and leaders at the community, state and national level to combat the public health impact of the systemic inequities and racial injustice through advocacy, education and training. Inequitable access to health care, housing, and economic mobility, caused by systemic racism and discrimination, takes a physical and mental toll on communities of color on a daily basis.

Provides technical assistance and training to community health centers

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Promotes the cost effective delivery of affordable, quality primary health care services

Kenny McMorris Charles Drew Health Center, Inc.

Margo Hartman Community Action Health Center Steve Clark (Interim CEO) Good Neighbor Community Health Center Bill Wypski All Care Health Center Mari Kaptain-Dahlen Siouxland Community Health Center

1.1%

NATIVE AMERICAN

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33,448

47.6%

TOTAL BEHAVIORAL HEALTH VISITS

336,743 TOTAL PATIENT VISITS

29.6% BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH

HISPANIC ETHNICITY

233,692 TOTAL MEDICAL VISITS

5.2% ASIAN

45% UNINSURED

12.3% BLACK

35%

44,234 TOTAL DENTAL VISITS

NON-HISPANIC WHITE

27%

4.4%

MEDICAID

MEDICARE

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Our Health Centers

WHAT IS A COMMUNITY HEALTH CENTER? Nebraska has seven Federally Qualified Health Centers (FQHCs), also know as community health centers. Together they serve over 107,000 Nebraskans at 72 primary medical, dental and behavioral health care delivery sites across the state. Community health centers are community-based and patient-directed organizations that serve populations with limited access to health care.

Bluestem Health 1021 North 27th St | Lincoln, NE 68503 Ph. 402.476.1455 | www.bluestemlincoln.com 6 service delivery locations

Heartland Health Center 3307 West Capital Ave | Grand Island, NE 68803 Ph. 308.382.4297 | www.heartlandhealthcenter.org 8 service delivery locations

Charles Drew Health Center, Inc. 2915 Grant St | Omaha, NE 68111 Ph. 402.451.3553 | www.charlesdrew.com 15 service delivery locations

Midtown Health Center 302 West Phillip Ave | Norfolk, NE 68701 Ph. 402.371.8000 | www.midtownhealthne.org 18 service delivery locations

Community Action Health Center 975 Crescent Dr. | Gering, NE 69341 Ph. 308.632.2540 | www.capwn.org 2 service delivery locations

OneWorld Community Health Centers, Inc. 4920 South 30th St | Omaha, NE 68107 Ph. 402.734.4110 | www.oneworldomaha.org 18 service delivery locations

Good Neighbor Community Health Center 4321 41st Ave | Columbus, NE 68601 Ph. 402.562.7500 | www.ecdhd.ne.gov 5 service delivery locations

72 Delivery sites offering Medical, Dental & Behavioral Health

107,701 PATIENTS SERVED IN 62 COUNTIES

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Our Impact The health centers in Nebraska provide tremendous value and impact to the communities they serve.

24%

LOWER COSTS FOR HEALTH CENTER MEDICAID PATIENTS

$69 Million SAVINGS TO MEDICAID

Nebraska’s community health centers provide high-quality, affordable health care homes for any Nebraskan seeking medical, dental, or behavioral health

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services. Health centers ensure that all Nebraskans, especially underserved populations, have access to high quality, comprehensive, affordable healthcare, regardless of their ability to pay. Health centers serve a racially, culturally and socioeconomically diverse population and serve as a critical component of the safety net program, serving 31% of the uninsured population and 27% of the uninsured children in Nebraska.

ECONOMIC STIMULUS

$168 MILLION Savings to the overall health system

TOTAL JOBS

$208 MILLION

1,657

Total Economic impact of current operations

10 years of service to the

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Total FQHC Patients by Year Patient Growth rate from 2011

63,532

Total

62,589

64,376

69,306

76,504

84,556

94,142

101,400

115,473

107,701

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

63,532

62,589

64,376

69,306

76,504

84,556

94,142

101,400

115,473

107,701

70%

community health centers

2011

2013

Health Center Association of Nebraska was established in 2011 and is funded primarily through a Cooperative Agreement with the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA).

HCAN expanded its funding streams in 2013, by being awarded its first Philanthropic grant for the expansion of Outreach and Enrollment staff at all seven health centers. This grant was funded alongside the implementation of the Affordable Care Act.

Prior to 2011, Nebraska’s Federally Qualified Health Centers were members of the Iowa- Nebraska PCA (IANEPCA).

To date, the health centers have educated over 470,000 Nebraskans on medical coverage and economic assistance programs.

2015 The Rural Health Grant was funded in 2015, supporting pediatricians at 4 of the rural health clinics in Nebraska.

The expansion of pediatric services was critical to serving the most vulnerable pediatric populations.

This same funding also afforded HCAN the opportunity to wrap vans and address transportation barriers to care within these communities.

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2021 Today, Nebraska health centers serve over 107,000 patients. As HCAN celebrates its 10 year anniversary, it’s important to point out highlights from the past year including; securing the first ever federal Navigator funding, continued COVID-19 relief efforts, record sponsorship funding, and a new Medical Assistant apprenticeship program supported by our new Workforce Coordinator position at HCAN.

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Patient Advocacy LEGISLATIVE ACTIVITY FOR 2021

27 Total number of bills HCAN testified, or advocated on, in order to promote access, health and well-being for ALL.

HCAN plays a vital role in educating our federal, state and local policy makers about community health centers.

We advocate for health access and coverage and set legislative priorities and policies that promote access to quality, equitable healthcare. Examples of bills HCAN advocated for the 2021 session: FQHC Specific • LB67- Fixes school based health center provisions • LB421- Appropriates funds for loan repayment programs including specific FQHC carve-out Medicaid • LB127- Provides for 12 month continuous eligibility for children Equity • LB120- Prohibit discrimination based upon sexual orientation and gender identity

PATIENT ADVOCACY HCAN spearheads advocacy efforts for the community health centers, focusing on issues that directly impact access to affordable, community-based health care as well as social factors like food security, housing and economic assistance that impact our health center patients.

Policy monitoring and analysis is provided to health centers to help staff, board members, and community supports be better informed and take action.

Telehealth • LB400- Allow for telephonic billing for behavioral health services Prescription Drugs • LB30- Limit the amount an insured pays for prescription insulin drugs

2021 Year in Review

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PEER LEARNING NETWORKS FOR 2021

2021 YEAR IN REVIEW

HCAN’s peer learning networks educate health center providers and staff on requested topics, and provide a peer-based network for dialogue. HCAN facilitates these educational opportunities in collaboration with national and local presenters, while regularly offering continuing education credits throughout the year. The following networks were hosted in 2021:

Sample of HCAN offerings facilitated throughout the year: • Executive Leadership Training Program | Jan – June 2021 • Joint Commission Training | April 2021 • NACHC Virtual Training for New Clinical Directors | May 2021 • 2021 HCAN Virtual Conference | June 2021 • HCAN awarded Navigator Funding | August 2021 • CAC Fall Training | October 2021 • Region VII UDS Training | November 2021

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Nursing/Quality Improvement Roundtable Billing and Revenue Cycle Roundtable Behavioral Health Team Clinical Governance Committee Emergency Preparedness Team Finance Leadership Team Human Resources Team Oral Health Leadership Team Outreach and Enrollment Team

120 Total Trainings

3,148 Total Attendees

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Future Projects

THE VERY CORE OF THE HEALTH CENTER MOVEMENT CONSISTS OF COMMUNITY, EQUITY, ACCESS, AND COMPASSIONATE HEALTH CARE THAT TOUCHES THE SOCIAL DRIVERS OF HEALTH CARE AS A WHOLE. AS A STATEWIDE ORGANIZATION, OUR PURPOSE ADVANCES HEALTH EQUITY, AND HEALTHY COMMUNITIES. WE LOOK FORWARD TO GROWING IN 2022 TO BETTER SERVE OUR STATE.

WHAT’S COMING IN 2022 HCAN Online Community HCAN is partnering with YourMembership to launch an online community platform. Health center staff will be able to search through an online member directory to foster one-on-one connections and seamlessly connect with peer networks, share resources, pose questions to your peers, read blogs, and much more. Look for more this spring!

HCAN LAUNCHES NEW CAREER CENTER IN 2021 Health Center Association of Nebraska (HCAN) has officially launched our Career Center, a new career site that connects professionals looking to work at a community health center. The HCAN Career Center is powered by YM Careers, the leading provider of job websites and career centers for organizations that serve specialized members. https://hcan.careerwebsite.com/

Updated Website HCAN’s website is getting a makeover! Our modern, updated site will launch in spring 2022. Key features will include: Event management, health center program updates, advocacy and policy priorities, and much more.

2022 HCAN Priority Areas • Workforce (Retention and Recruitment) • Value Based Care (SDOH Risk Stratification) • Health Center Growth (Expanding the Health Center Footprint) • Emergency Management (COVID-19 Recovery) • Finance and Operations (Revenue Cycle Management & Outreach and Enrollment)

“THERE IS NO POWER FOR CHANGE GREATER THAN A COMMUNITY DISCOVERING WHAT IT CARES ABOUT.” - MARGARET J. WHEATLEY

Thank you to our 2021 Sponsors!

Platinum Level Partners

Gold Level Partners

Silver Level Partners

Bronze Level Partners

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CEO’s Report

The foundation of the health center movement is the belief that community-centric health care, that seeks to address underlying social factors while also attending to health care needs of their patients, can be a catalyst for change. HCAN will continue to focus our efforts on advancing the health center movement to ensure access, health and well-being for all.

We began 2021 with a sense of hope that we had weathered the worst of the COVID-19 pandemic.

Vaccines were more readily available and eligibility was expanding. While we knew the road ahead was still long, there was a glimmer of hope that we had moved from trying to keep the waves of the pandemic from crashing over us to combating the seemingly unstoppable spread. While we certainly hoped that 2021 would be much different than our 2020 experience, COVID-19 again dominated the majority of the year. Once again, Nebraska’s health centers demonstrated the critical role they play in the health care safety net. Ensuring patients could return to routine care safely, addressing the lingering physical, mental and economic impacts of COVID-19, and compassionately supporting Nebraskans as they navigated misinformation and centuries-old systemic barriers that lead to distrust of the COVID-19 vaccine, health centers ensured all Nebraskans had equitable access to medical, dental and behavioral health care.

Amy Behnke, J.D. Chief Executive Officer Health Center Association of Nebraska

IN 2021, THE HCAN TEAM CONDUCTED OVER 120 TRAINING AND PEER LEARNING EVENTS AND ENGAGED HEALTH CENTER STAFF IN OVER 170 INDIVIDUAL TECHNICAL ASSISTANCE OFFERINGS. IN TOTAL, 3,148 PEOPLE ATTENDED HCANSPONSORED TRAININGS IN 2021.

2021 also brought the 10-year anniversary of HCAN. What began as a staff of two working out of one of our health centers has grown alongside the health centers, expanding services and opportunities to support the critical work they do each day. I cannot say enough about the dedication and mission-driven focus of the HCAN team. They worked tirelessly to ensure the health centers had access to all the resources they needed to adequately respond to COVID-19 and supported the health centers as they navigated a return to routine care.

As we turn the page on another year, I think 2022 will be a monumental year for HCAN and Nebraska’s community health centers. With one decade of service to our members under our belt, it is critical that we take all of our successes, lessons learned, and hopes for the future to help us define how HCAN can better serve our health centers and expand access to care. Every Nebraskan has a right to equitable access to health care – and we believe that Nebraska’s health centers can, and should, drive that access. In addition, addressing health center workforce needs, from staff shortages to the physical and mental toll of COVID-19, is critical to expanding access to health care. Finally, we cannot adequately address health care needs in our state if we do not address the social drivers of health. All of these issues – COVID-19, workforce, health center access, and social drivers of health – will be key strategic areas of focus for HCAN in 2022.

Meet Our Team HCAN STAFF ARE AVAILABLE TO ASSIST YOU WITH A WIDE RANGE OF AREAS OF EXPERTISE.

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COVID-19

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Workforce

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Clinical quality

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Emergency Preparedness

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Health center funding

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Health Center Operations

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Advocacy

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Communications

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Outreach & Enrollment

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Health Center Expansion

Jenna Thomsen

Alex Bakke

Angela Lindstrom

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Keshia Bradford

Stefanie Torres Chan

Shelly Uhing

Pat McVea

Daphne Calhoun

Annual Report 2021

Health Center Association of Nebraska www.hcanebraska.org