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HAWAI‘I PRIMARY CARE ASSOCIATION ANNUAL REPORT 2012


FROM PROVIDING ESSENTIAL CARE TO COMMUNITIES IN NEED, TO TREATING THE WHOLE PERSON ALL IN ONE PLACE, COMMUNITY HEALTH CENTERS ARE DOING WHAT’S RIGHT FOR HAWAI‘I


EXECUTIVE MESSAGE

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ADVOCACY 7 COMMUNICATIONS 9 TECHNICAL ASSISTANCE

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CHC PATIENT PROFILE

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ORGANIZATION 15 The Hawai‘i Primary Care Association (HPCA) is the voice for the future of health care in our state, delivered through Community Health Centers that employ an integrated, comprehensive, and attentive approach that emphasizes personcentered wellness, care coordination, and disease prevention. HPCA believes in building vibrant, healthy communities that work together. To that end, we endeavor to build partnerships, foster innovation, and support collaboration that will transform the health care system for all of Hawai‘i’s people.

HAWAI‘I PRIMARY CARE ASSOCIATION 735 BISHOP STREET, SUITE 230 HONOLULU, HAWAII 96813 (808) 536-8442

hawaiipca.net/feelgood HPCA 2012 ANNUAL REPORT

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EXECUTIVE MESSAGE

A TIME OF CHANGE

In this time of transformation and transition, HPCA will continue to be a strong, reliable advocate for a more effective, equitable, and accountable health care system.

Every industry must learn to adapt in order to thrive during difficult times. In Hawai‘i we’ve seen that reality unfold in other sectors like tourism and agriculture. During the past two years, we’ve also watched it happen in health care as the Affordable Care Act established a new reality for all of us. In this era of health care reform, accountability is the new paradigm, as providers are paid for health outcomes, not just for incidence of care. Community Health Centers are well positioned for this new world given that they’ve built their organizations to deliver integrated, coordinated, and effective care. Health centers have also focused on reducing disparities through patientcentered care, and on addressing social determinants of health like homelessness and access to healthy foods. Likewise, our work with industry partners - insurers, hospitals, and policy makers - remains vital to creating comprehensive improvements to the health care system. The Hawai‘i Primary Care Association (HPCA) will continue to be a strong, reliable advocate, leveraging technical assistance programs that help health centers and their communities thrive. As we all adapt to present and future challenges, HPCA and its members will continue to move the health care system toward greater access, equity and accountability. And that’s good for everyone.

Sheila Beckham Board Chair, Hawai‘i Primary Care Association

Robert Hirokawa, DrPH CEO, Hawai‘i Primary Care Association

HPCA 2012 ANNUAL REPORT

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ADVOCACY

POLICY AND PUBLIC AFFAIRS

CONSUMER ENGAGEMENT

Community Health Centers have long been viewed as the health care “safety net,” a network of providers vital to meeting the needs of underserved communities and populations. However, safety net organizations are often the first to experience resource cuts at the very time that demand for services is rising.

Protecting the underserved from inequality requires the active involvement of consumers and their communities. In addition to championing fair and transparent policies before the legislature, HPCA also works with the consumer-driven boards that oversee Hawai‘i’s fourteen community health centers to ensure that they have the tools and support they need to address collective challenges. The process is a bilateral one, with consumer board members providing their insights and direction for future HPCA initiatives.

HPCA advocacy staff work tirelessly to educate legislators and policymakers of the critical work that health centers perform and of the need to support policies that strengthen these systems of care, particularly during difficult economic times. Despite the promise of health care reform, thousands of people in Hawai‘i will lose coverage due to Medicaid eligibility changes, creating increased risk for health centers. HPCA sought to mitigate this with a comprehensive plan that included funding for uninsured care, a viable and consumer-oriented insurance exchange, and strengthened partnerships with hospitals. Over the past three years, HPCA has provided in-depth briefings for policymakers, partners, and other organizations to demonstrate that health centers are going beyond safety net services and are truly transforming how health care is delivered. The integrated, comprehensive care delivered by health centers make them exemplars of patient-centered, quality, accountable care.

The most important tool for protecting fairness and equity in our health care system is engagement.

HPCA 2012 ANNUAL REPORT

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COMMUNICATIONS FEEL GOOD CAMPAIGN

Community Health Centers - and those that support them - work in the service of a mission-oriented goal: quality health care for all. It shouldn’t matter if you’re rich or poor, insured or uninsured, male or female, young or old; everyone in our society deserves access to health care that’s safe, timely, effective, and equitable. And that’s the inherent message of HPCA’s Feel Good awareness campaign on behalf of health centers. The campaign captures the deep emotional resonance of the truly noble goal pursued by CHCs, and positions them as the natural solution for transforming the health care system. The Feel Good campaign received many accolades, including a Pele Gold Award for public service advertising. CONSUMER EDUCATION

HPCA used innovative storytelling, animation technology, and social media tools to explain a very complex subject to consumers in its nationally-recognized “What is a Community Health Center” video. The project showcased some of the best things about health centers while also addressing the most common misconceptions about them, all in a playful and consumer-friendly format.

This scene from the Pele Award-winning “Feel Good” awareness campaign, shot for both print and commercial use, was taken at Ho‘oulu ‘Āina, a watershed preserve deep within Kalihi Valley. Community-based programs - including organic farming, watershed & forest restoration, and ancient cultural site preservation - forge deep community bonds among Valley residents. Ho‘oulu ‘Āina is a program of Kōkua Kalihi Valley Comprehensive Family Services, a FederallyQualified Health Center. HPCA 2012 ANNUAL REPORT

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The Department of Health & Human Services has one clear expectation for primary care associations: enhance the performance and operation of community health centers.


TECHNICAL ASSISTANCE & PROGRAMS QUALITY

HAWAI‘I COVERING KIDS

For over a decade, HPCA has worked closely with its member CHCs to develop programs that improve quality through data collection and analysis, staff training, and rigorous use of evidenced-based best practices to transform how they deliver health care services. These programs continue to form the nexus of HPCA’s technical assistance to health centers and fulfill the Association’s responsibility to improve health center performance.

Hawai‘i Covering Kids (HCK) is more than an awareness campaign for uninsured keiki and youth. It’s also a key facilitator and education resource for outreach workers, government agencies, and stakeholder groups. Through taskforce collaboration, health fairs, community meetings, wellness events, and special training sessions, HCK has supported efforts to insure Hawai‘i’s children for fourteen years.

PATIENT-CENTERED HEALTH CARE HOME

HEALTH CENTER CONTROLLED NETWORK

The Affordable Care Act’s most critical component is transformation of the system to more accountable, quality-oriented care. Community Health Centers are well positioned to be leaders in this area, and HPCA staff manage a broad array of program services to support CHCs in this effort.

The foundation of transformation and patientcentered care is improvement of health outcomes. A strong and versatile health information system is therefore essential, and the work of the Health Center Controlled Network (HCCN) to leverage common resources have improved health center adoption and use of this technology. HCCN staff have spent hundreds of hours on-site, embedded with health center staff, facilitating the rapid development of these IT resources.

These programs include project-based peer groups, quarterly trainings, learning teams, and leadership in the Med-QUEST health care home collaborative. HPCA is also leading an innovative pilot project with four health centers that will aid patient-centered care implementation in all CHCs statewide. PARTNERSHIP DEVELOPMENT

OTHER PROJECTS

Transformation to more accountable, patientcentered care is a massive undertaking that involves all stakeholders in the system. HPCA plays a vital role in connecting health centers to resources and serving as an unbiased facilitator for system-wide projects.

Uniform Data Systems Training

HPCA helped to develop many potential partnerships in behavioral health integration, community transformation, and Medicaid innovation, involving hospitals, insurers, provider organizations, and government agencies.

Health Information Warehouse Quality Improvement Training QI Digital Dashboard Primary Care Contracts Primary and Behavioral Healthcare Integration CHC Peer Groups HPCA Annual Conference Health Information Exchange / Data Warehouse Hawai‘i Immigrant Health Initiative Advanced Primary Care Demonstration Project Social Determinants of Health Awareness Project

HPCA 2012 ANNUAL REPORT

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HEALTH CENTER PATIENTS

46100 130,309

TOTAL PATIENTS, ALL HEALTH CENTERS

ADULTS, 58%

61,209

2001

34+58+8J 26+47+720J ELDERLY (65+), 8%

PRIVATE / EMPLOYER, 20% MEDICARE, 7%

2011

23047024060

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HPCA 2012 ANNUAL REPORT

HAWAIIAN AND PACIFIC ISLANDER, 47%

WHITE, 24%

OTHER, 6%

CHILDREN, 34%

UNINSURED, 26%

COVERAGE

MEDICAID, 47%

ETHNICITY ASIAN, 23%

AGE


Thanks in part to HPCA programs like Hawai‘i Covering Kids, the state’s uninsured rate for children is now among the lowest in the nation: just 1.3% for newborns and 3.2% overall.


INCOME

100 MEMBER DUES - $109,300 148 OTHER - $147,870 357 PRIVATE GRANTS - $357,046 700 BUREAU OF PRIMARY HEALTH CARE - $700,531 1000595 FEDERAL CONTRACTS - $1,595,289 1000841 STATE CONTRACTS - $1,841,328 EXPENSES

4 MEETING & TRAVEL SUBSIDIES FOR MEMBERS - $38,822 4 DEPRECIATION - $43,414 119 TRAININGS, MEETINGS, CONFERENCES - $119,571 1000658 OPERATING EXPENSES - $1,658,064 10001000 665 PAYMENTS TO HEALTH CENTERS, CONSULTANTS - $2,664,784 FUNDERS

Bureau of Primary Health Care Centers for Medicare and Medicaid Services Office for the Advancement of Telehealth Office of Health Information Technology Office of Policy & Program Development State of Hawai‘i Department of Human Services State of Hawai‘i Department of Health

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HPCA 2012 ANNUAL REPORT

AlohaCare Hawai‘i Community Foundation HMSA Foundation


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BOARD OF DIRECTORS

MEMBERS

DANA ALONZO-HOWETH Mālama I Ke Ola Health Center (Board Vice-Chair)

FEDERALLY QUALIFIED HEALTH CENTERS Bay Clinic, Inc. Hāmākua Health Center Hāna Community Health Center Kalihi-Pālama Health Center Kaua‘i Community Health Center Kōkua Kalihi Valley Comprehensive Family Services Ko‘olauloa Community Health & Wellness Center Lāna‘i Community Health Center Mālama I Ke Ola Health Center Moloka‘i Community Health Center Wai‘anae Coast Comprehensive Health Center Waikīkī Health Center Waimānalo Health Center West Hawai‘i Community Health Center

SHEILA BECKHAM Waikīkī Health Center (Board Chair) RICHARD BETTINI Wai‘anae Coast Comprehensive Health Center IRENE CARPENTER Consumer Board Member DAVID DERAUF Kōkua Kalihi Valley Comprehensive Family Services (Board Secretary) KAMAHANAHOKULANI FARRAR Consumer Board Member (Board Treasurer) PATRICK LINTON Hāmākua Health Center

NATIVE HAWAIIAN HEALTH CARE SYSTEMS Ho‘ōla Lāhui Hawai‘i Papa Ola Lōkahi Hui Mālama Ola Nā ‘Ōiwi Hui No Ke Ola Pono Ke Ola Mamo Nā Pu‘uwai Inc.

EMMANUEL KINTU Kalihi-Pālama Health Center (Board Officer At-Large) MARY ONEHA Waimānalo Health Center DAVID PETERS Ho‘ōla Lāhui Hawai‘i BEN PETTUS Ko‘olauloa Community Health & Wellness Center (Board Officer At-Large) DESIREE PUHI Moloka‘i Community Health Center VIJA SEHGAL Wai‘anae Coast Comprehensive Health Center DIANA M.V. SHAW Lāna‘i Community Health Center

ASSOCIATE AND INDIVIDUAL MEMBERS Hawai‘i Health Systems Corporation Hawai‘i Medical Service Association (HMSA) Hawai‘i Pacific Health (Kapi‘olani Health Foundation) Kaiser Permanente Pacific Islands Health Officers Association Puna Community Medical Center Queen Emma Clinics Elin Godbey Carson

HAROLD L. WALLACE, JR. Bay Clinic, Inc. RICHARD TAAFFE West Hawai‘i Community Health Center CHERYL VASCONCELLOS Hāna Health

EXECUTIVE STAFF

STAFF

ROBERT HIROKAWA Chief Executive Officer

Charlene Blair, Quality Improvement Coordinator Elin Koo, Accountant Barbara Luksch, Hawai‘i Covering Kids Project Director Nani Medeiros, Policy and Public Affairs Director Matthew Nagato, Communications Director Matt Okahata, IT Director Alison Rowland-Ciszek, Administrative Coordinator Dustin Stevens, Senior Policy Analyst Monique van der Aa, Health Center Controlled Network (HCCN) Project Manager Cristina Vocalan, Quality Improvement Director

KATHY SUZUKI-KITAGAWA Chief Operating Officer TRICIA SIAROT Chief Financial Officer

HPCA 2012 ANNUAL REPORT

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HPCA Annual Report 2012