Issuu on Google+

Years of Strengthening Access

Oklahoma Primary Care Association 2013 Annual Report


BOARD OF DIRECTORS Tim Starkey, President Donna Dyer, Vice-President Anita Fream, Secretary Rosalyn Johnson, Treasurer John Silva, State Legislative Coordinator Robyn Sunday-Allen, Member at Large Angie Batton, Member at Large Gerard P. Clancy, MD, Member at Large Michael Goddard, MD, Clinical Advisor

ORGANIZATIONAL MEMBERS

Arkansas Verdigris Valley Health Centers, Inc. Caring Hands Healthcare Centers, Inc. Central Oklahoma Family Medical Center, Inc. Cherokee Nation Health Services Community Health Connection, Inc. Community Health Centers, Inc. East Central Oklahoma Family Health Center, Inc. Fairfax Medical Facilities, Inc. Family Health Center of Southern Oklahoma, Inc. Great Salt Plains Health Center Indian Health Care Resource Center of Tulsa, Inc. Kiamichi Family Medical Center, Inc. Lawton Community Health Center Morton Comprehensive Health Services, Inc. Northeastern Oklahoma Community Health Centers, Inc. Oklahoma City Indian Clinic Pushmataha Family Medical Center, Inc. South Central Medical & Resource Center Stigler Health & Wellness Center, Inc. Variety Care

ASSOCIATE MEMBERS

OU Tulsa School of Community Medicine Planned Parenthood of Central Oklahoma This publication was made possible, in part, by Grant Number U58CS06840 from Health Resources & Services Administration (HRSA)/Bureau of Primary Health Care (BPHC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the HRSA/BPHC.


From the President Over the past twenty years, Oklahoma Primary Care Association has been leading the way in navigating an ever-changing health care environment. The way its membership of community health center and safety-net providers delivers care is transforming. For the past two decades, OKPCA has continued to support member activities, develop communities and promote services so that more and more Oklahomans can receive access to affordable health care. In 1993, when talk of an ‘information superhighway’ surfaced, few realized how integral technology would be to health care delivery. Now, so many of our efforts are directly tied to technological advances, from establishing a health center to collecting patient information. OKPCA’s services are vast – from community development to advocacy; from workforce development to Patient-Centered Medical Home assistance. Through advocacy, education and technical assistance, OKPCA is accomplishing its mission of strengthening access to affordable community-based health care. Over the next twenty years, supporting these efforts and developing strong partnerships will enhance the strength of OKPCA and its membership. The information in this document outlines how OKPCA has assisted its members and the public in 2013, but the photos tell a story of a journey that spans the past twenty years. Please take a look at how OKPCA, as the state association for community health centers and safety-net providers, is piloting us in the journey for greater access to care in Oklahoma.

Tim Starkey, MBA, FACHE

Strengthening Access to Care for 20 Years! 2


Moving Forward As OKPCA celebrates 20 years of strengthening access to affordable community-based health care through advocacy, education and technical assistance. I’m amazed at how much health care has changed in Oklahoma as well as across the country. Twenty years ago, OKPCA was founded by a committed group of health care leaders and providers, who had already worked for ten years, to help Oklahomans find access to affordable, high-quality care in numerous underserved areas. In 1993, there were only three community health centers (CHCs) statewide with a total of five sites. Today, Oklahoma has eighteen grantees and more than fifty sites delivering health care to those who need it most. Many of those “New Start” health centers were established after then-President George W. Bush established the Presidential Initiative to Expand Health Centers in 2001. President Barack Obama continues the efforts today through the Affordable Care Act. The state’s CHC program has experienced unprecedented growth due to strong bipartisan support received over the past dozen years – an exciting time for OKPCA and the many Oklahomans benefitting from having health centers within their communities. Countless advocates have worked side-by-side to strengthen access in our state, as you’ll see through our collage of photos in this publication. While the information highlights all of our work in 2013, we always take time to reflect on the images and people who helped us get where we are today. It has been an honor to be a part of twenty years of growth and learn the true meaning of a servant’s heart.

Greta Stewart, MPH, CAE

OKPCA Annual Report 2013 3


OKPCA Staff Greta Stewart, MPH, CAE • Excecutive Director Judy Grant • Director of Community Development Brent Wilborn, MS • Director of Public Policy Greg Newhouse • Director of Finance Alison Williams • Workforce & Communications Manager Chequita Owens, PhD • Data & Research Coordinator Jennifer Damron, MPH • Quality Improvement Analyst Justin Mead • Electronic Health Records Technologist Patricia Christensen, MBA • Policy and Program Analyst Fawn Meeks • Partnership & Resource Coordinator Karri Hood, CMP • Meeting Planner & Operations Coordinator Dawn Danner • Administrative Associate

Strengthening Access to Care for 20 Years! 4


20 Years of Access For twenty years, Oklahoma Primary Care Association has been working to strengthen access to affordable communitybased health care through advocacy, education and technical assistance. Governed by a Board of Directors, OKPCA focuses on strengthening community health centers and other safety-net providers. The original Board of Directors consisted of five people with a vision to increase access to care in Oklahoma. Their leadership started a trend of establishing new members, new services and most of all, more health care options for Oklahomans. 1993 Board of Directors Donna Neal Thomas, RNC, Ph.D • President Ruth Parkhurst, MPH • Vice-President Jean Kelsey, MSW • Secretary Sam Bowman, MSW • Treasurer Howard Vincent, MPH • State Legislative Coordinator In twenty years, milestones have been accomplished in both the community health center program and other national initiatives. In 1993, only three community health centers existed in Oklahoma. Now, there are eighteen organizations with more than fifty sites statewide. In 1995, OKPCA successfully advocated for prescriptive authority for Nurse Practitioners, changing the face of health care in Oklahoma. In 1996, sales tax exemption advocacy was successful. By 1998, HRSA PIN 98-23, the foundation for CHCs, is issued. By 2000, the CHC world changed significantly when then-President George W. Bush shares his plan to expand health centers. Through the next few years, OKPCA holds its first Legislative Breakfast, begins community development, workforce development, Board development, and adds several more CHC organizations. In 2006, the term EHR (electronic health records) is starting to float around and health care as we know it continues to change dramatically. OKPCA was elated in 2007 when then-HRSA administrator Dr. Betty Duke visits Oklahoma. Growth continues, and by 2010 the association is offering health information technology assistance, conducting statewide salary surveys, adding group purchasing and growing very quickly.

Oklahoma Primary Care Association Net Assets Comparison 1993 - 2013

400,000

347,410

350,000

356,486

391,221

300,000 250,000

195,478

200,000 150,000 100,000

44,982

The staff size and membership is its largest ever, and OKPCA strives to provide the highest 1993 1995 2000 2005 2010 2012 2013 quality of services available. OKPCA’s net assets continue to grow over time, further increasing the stability of the association. The association strives to continue the mission over the next twenty years of strengthening access to care for Oklahomans in the ever-changing health care environment. 50,000

-

20,723

OKPCA Annual Report 2013 5


Promoting Access • OKPCA fostered private-public collaborations by developing a regular meeting plan with health centers and Oklahoma Health Care Authority departmental directors to proactively address initiatives and gain clarifications • Spotlights on the Affordable Care Act drove media coverage. Many local, state and national news have produced stories on the work of safety-net providers and access to care • OKPCA’s social media increased dramatically, with Facebook overall reach increasing and Twitter followers nearly doubling • Redesign of the OKPCA website streamlined communication efforts to provide up-to-date information in an easily reachable format. The new website features more interactive and social media options

• The 11th Annual Legislative Breakfast was held, providing members the opportunity to showcase the work they do in their communities and speak directly with State Legislators on key issues • Oklahoma health centers continued to build awareness of CHCs by holding nearly 20 events across the state in celebration of National Health Center Week (NHCW) 2013 • OKPCA hosted the 3rd Annual NHCW Kick-Off Event at the State Capitol - bringing together health centers and other safety-net providers along with state partners and legislators - to bring media coverage of health centers’ work

• OKPCA continues to strengthening relationships with other organizations by collaborating on the “Facilitating Partnership between State Oral Health Programs and Primary Care Associations” • Delivered timely news and information with the State Department of to members, partners and legislators Health and participating in the through the quarterly newsletter, the “Governor’s Interagency Council PCA Pulse, and a members-only on Homelessness” to identify ways weekly newsletter the PCA Pulse to improve access to care for the Weekly homeless in Oklahoma Strengthening Access to Care for 20 Years! 6


Supporting Access • Distributed monthly Board Bulletin issues to over 220 Oklahoma CHC board members with the 2013 series focusing on enhanced leadership

• Supported health centers by maintaining a singular, ongoing record of current state public policy and environmental considerations

• Participated in 9 HRSA site visits and provided grantees with exit interview notes and appropriate TA/resources

• Successfully obtained policy change to allow Medicaid FQHC PPS encounter payments with four new behavioral health provider types after a multi-year effort

• Gained favor of the Oklahoma Legislature through strong and direct advocacy at the State Capitol • Successfully promoted local flexibility in tobacco policy resulting in localities being able to have tobacco control policies more restrictive than the state on property owned by local government (passage of SB501) • Routinely provided summaries of HRSA TA calls/initiatives and site visit information to assist health centers in preparing for reviews

OKPCA Annual Report 2013 7

• Continued providing information regarding funding and traininginternship opportunities to CHCs • Facilitated Strategic Planning sessions for health centers • Successfully advocated for Congressional support of health centers with Oklahoma representation. Health centers nationally were awarded a $300 million increase


• Completed diabetes management survey project as a technical assistant tool and summarized generic report available to all health centers

• OKPCA continues to participate in a regional consortium of PCAs to help support the efforts of CHCs in their efforts to achieve PCMH recognition

• Facilitated direct communication of health centers to Oklahoma State Department of Health contracted consultant regarding uncompensated care

• OKPCA staff met, presented or communicated with students and/ or residents from state Physician Assistant, Dental and Medical programs, as well as Nursing

• OKPCA worked with State to improve • OKPCA supports workforce awareness of health centers’ role recruitment and retention efforts for in health care delivery by providing all safety-net facilities by generating input to the Oklahoma Health Care prospective employment leads and Authority Board of Directors including assisting health centers in recruiting hosting a call with OHCA contracted suitable candidates consultant about access to care, Medicaid and insurance coverage and • Supported health center workforce worked to ensure direct input from development by providing technical health centers assistance to health center organizations seeking executive level • Renewed agreements and negotiated recruitment assistance, including new agreements with Group position templates Purchasing Organization (GPO) partners on behalf of member • Partnering with 12 other PCAs, organizations OKPCA assists the Central Regional Advanced Primary Care Practice • Continued to provide summarized (APCP) demonstration sites with count-, state- and national-level achieving National Committee for health, economic and Census data for Quality Assurance (NCQA) PCMH updating grant worksheets and other Level 3 Recognition. Oklahoma has purposes four demonstration sites • Based on member request, OKPCA continued the Medical Directors’ Roundtable, as part of Oklahoma Clinicians’ Network, continuing discussion on needs of clinical staff in community health centers

• Worked with National Association of Community Health Centers (NACHC) and SuccessEHS to create a national user group chaired by OKPCA to assist with Electronic Health Record (EHR) utilization

Strengthening Access to Care for 20 Years! 8


Supporting Access • OKPCA staff attended SuccessEHS User Conference, learning new features and ways to better use the current features, assisting OKPCA members with maximizing their EHR

• Patient-Centered Medical Home (PCMH) was an ongoing focus throughout the year, with two OKPCA staff members earning NCQA Content Expert Certification

• OKPCA continues to provide wellreceived trainings. Overall score for trainings was averaged at 4.78 out of 5.0 overall for the year

• Assisted health centers with achieving NCQA PCMH recognition by reviewing documentation for each standard, providing feedback on the documentation and identifying standards that are being completed

• Reviewed Meaningful Use (MU) Stage 2 requirements and developed a guide to assist health centers with understanding the requirements for MU Stage 2 and the updated requirements for MU Stage 1 that were adopted in the Stage 2 rule • OKPCA staff assisted community health centers with conducting HIPAA Policy and Procedure assessments, keeping organizations compliant

OKPCA Annual Report 2013 9

• Worked with Oklahoma firm Crowe and Dunlevy to conduct HIPAA training on new requirements, and distributing newly updated policies and procedures to ensure requirements were met


Developing Access • OKPCA continues to build • Provided TA with the development relationships with companies and of New Access Point (NAP) grant foundations that intersect with OKPCA applications which included three and its members to garner support, NAPs that were submitted in April sponsorships and donations 2013 for the following areas: Norman - Cleveland County, Shawnee • Conducted five on-site board Pottawatomie County and Afton development trainings to strengthen Ottawa County health center governance/program compliance • Conducted regional board development workshop in March • Participated and presented at eight 2013 attended by 22 participants Community Development forums to from four health centers; attendees highlight the Oklahoma community gave the workshop a 4.68 rating (on health center program to foster a scale from 1 to 5); another regional collaboration and health center board workshop was conducted in development September 2013 • Provided four CHC-specific HIV/AIDS webinar sessions, in conjunction with the Ryan White-funded Texas/ Oklahoma AIDS Education and Training Center

• OKPCA continued updating health care access and core barrier maps, including MUAs, poverty level, safetynet locations and providers accepting new Medicaid patients

Strengthening Access to Care for 20 Years! 10


Developing Access • Successfully worked for a State appropriation of over $3.4 million to support health care the uninsured and health center development • Partnered to develop a significant coalition in support of expanded health insurance coverage in Oklahoma • Continued partnership with State Office of Rural Health to showcase Oklahoma workforce needs through the National Rural Recruitment and Retention (3RNet), to recruit job seekers to the state, increasing Oklahoma’s health care workforce • Provided regulatory review and assistance in the implementation of Federal health reform policies including topics such as Health Insurance Exchange and related Qualified Health Plans, state adoption of MAGI basis for determinations of Medicaid eligibility, Navigators, and employer requirements and benefits • Provided county-, state- and national-level data to all interested organizations seeking section 330 resources, and maintained database for all 77 counties on ongoing-basis, updating no-less than twice annually

OKPCA Annual Report 2013 11

• OKPCA, as the lead of a consortium of organizations, was awarded $860K to train Navigators to assist with outreach & enrollment related to the Health Insurance Marketplace under the Affordable Care Act • OKPCA staff participated in NACHC’s PCMH Institute (learning labs, coaching activities & meetings), which served as a resource center and peer learning network for members and the association • Assisted health centers and providers in customizing their electronic health record (EHR) to better meet workflows and to assist in reaching Uniform Data System (UDS), Meaningful Use, Patient-Centered Medical Home (PCMH) goals and budget goals • Worked with Oklahoma State Department of Health in drafting literature to increase awareness of access options at health center in light of Federal health reform • Coordinated PCMH efforts at the PCA through policy review, development of tools/resources and contracted technical assistance


• Conducted trainings regarding ICD-10 preparation, Federal Tort Claims Act, and the national HIV/AIDS strategy • OKPCA was a guest speaker about the Value of Access to Health Care for Women, Children and Families to Oklahoma Public Health Committee • OKPCA works with the Health Center Controlled Network, SoonerVerse, Inc., to provide specialized technical assistance to HCCN members, providing comprehensive TA and technical assistance

• Collaborated with local health information exchanges through the HCCN to assist members with achieving various levels of Meaningful Use and receiving payments • Conducted HIPAA policy and procedure assessments as part of the HCCN • Conducted additional training regarding workflow redesigns and implementation for New Access Point awardees as part of the HCCN

• Through the HCCN OKPCA Assisting health centers with electronic health record implementation and upgrades

Strengthening Access to Care for 20 Years! 12


Financial Information Fiscal 2013 financials reflect minimal growthgrowth during aduring difficultaeconomic environment that produced funding cuts in FiscalYear Year 2013 financials reflect minimal difficult economic environment that produced existing however,programs; with personnel diligently prioritizing needs, OKPCA’s net revenue of $34,735 for the fundingprograms; cuts in existing however, with personnel diligently prioritizing needs, OKPCA's netyear is up compared to last year’s net revenue of $5,913 and net assets grew by 9.74% over 2012. OKPCA’s financial revenue of $34,735 for the year is up compared to last year's net revenue of $5,913 and net assetsposition grew remains strong with a Current Ratio offinancial 5.22 (Generally Principles standard or greater) and by 9.74% over 2012. OKPCA's positionAccepted remainsAccounting strong with a Current Ratioisof1.0 5.22 (Generally 121.76 days in operating reserves. OKPCA maintained a clean audit for the year with no findings or questioned costs. Accepted Accounting Principles standard is 1.0 or greater) and 121.76 days in operating reserves. OKPCA maintained a clean audit for the year with no findings or questioned costs. Statement of Financial Position Current Assets Cash Accounts Recievable Prepaid Expenses Total Current Assets Non Current Assets Furniture & Equipment Less Depreciation Total Noncurrent Assets Total Assets

Statement of Activity

335,389 129,156 3,050 467,595 243,450 (227,098) 16,351 483,946

Liabilities & Net Assets Current Liabilities Accounts Payable Accrued Payroll & Other Liabilities Total Current Liabilities

50,744 41,981 92,725

Net Assets Unrestricted Total Liabilities & Net Assets

391,221 483,946

Revenues Operating Grants Program Income Membership Dues Interest Income Contracts & Miscellaneous Total Revenue

946,692 72,367 75,125 827 54,323 1,149,334

Expenses Program Services Management & General Total Expenses

864,594 250,004 1,114,599

Change in Net Assets Net Assets at Beginning of Year

356,486

Net Assets at End of Year

391,221

Note: A copy of the financial audit is available for review upon request.

OKPCA Annual Report 2013 13

34,735


Partnership Information OKPCA partners with and participates in numerous groups to address health care and development, focusing on improving access, ensuring workforce, building capacity and eliminating disparities. These include: • Oklahoma Health Improvement Planning Team • Agency for Healthcare Research and Quality (OHIP) (AHRQ) Effective Health Care Program • Oklahoma Health Information Security & Privacy • American Public Health Association Committee - Governor’s Task Force • American Society of Association Executives • Oklahoma Health Information Security and Privacy • Cardiac Learning and Action Network Council (OKHISPC) • Central Regional Advanced Primary Care • Oklahoma Health Information Exchange Trust Practice (APCP) Consortium (OHIET) • Child Health Advisory Task Force (CHATF) • Oklahoma Healthcare Information and • Children’s and Oral Health Advisory Managements Systems Society (OkHIMSS) Committee - Governor’s Task Force • Oklahoma Public Health Association • Children’s Oral Health Coalition • Oklahoma Physicians Resource/Research Network • Insurance Department: Patient Centered (OKPRN) Medical Homes - Governor’s Task Force • Oklahoma Workforce Steering Committee • Meeting Professionals International • Oklahoma Society of Association Executives • Meeting Professionals International of • Perinatal Advisory Task Force (PATF) Oklahoma • Public Health Institute of Oklahoma • National Rural Health Association • Primary Care Access Taskforce (PCAT) • The National Rural Recruitment and Retention • Rural Enterprises of Oklahoma Advisory Committee Network (3RNet) • Senior Advisory Committee-Emergency • Oklahoma Academy for State Goals Preparedness • Oklahoma City Health Access/Development • Rural Health Association of Oklahoma Summit • Tobacco Use Prevention Coalition • Oklahoma Health Care Authority • Turning Point • Oklahoma Commission on the Status of • Wellness Now Coalition Women


Strengthening access to affordable community-based health care through advocacy, education and technical assistance.

Oklahoma Primary Care Association 4300 N. Lincoln Blvd., Ste. 203 • Oklahoma City, OK 73105 (405) 424-2282 • www.okpca.org


OKPCA Annual Report - 2013