Plan Community Health Centers Overview kj

							Community Health Centers

Description

Community Health Centers (including Migrant and Homeless healthcare) have provided high-quality,
affordable primary and preventive care for over 40 years. CHCs also provide dental and mental health
services. Community Health Centers serve as the medical home for 20 million people across the nation.
Most patients are low income and tend to be members of minority groups. Additionally, 38% of health
center patients are uninsured, while 36% are Medicaid eligible. About 50% of all health center patients
reside in rural areas. Community Health Centers strive to provide high quality, cost-effective care to
patients, regardless of their ability to pay. At present, about 1200 health centers deliver care through
over 7500 service sites in all states.

Overview

Montana‘s CHCs serve as the safety net health care provider for uninsured and underinsured
Montanans. In 2009, CHCs provided primary care services to 90,448 patients—nearly 1 in 10
Montanans. Currently, there are 40 total sites throughout the state that provide integrated healthcare
services. With increased funding through the American Recovery and Reinvestment Act, a new center
was opened in Kalispell, and CHCs statewide were able to see 26,631 new patients. The Affordable Care
Act will offer significantly greater access to care for underserved citizens, but, increasing access will also
increase the need for providers. MT CHCs have served as community-based training sites for numerous
healthcare professionals including medical, dental, mental health, mid-level, nursing and allied health.
Workforce

The Montana Primary Care Association reports that 545 full-time employees worked in CHCs in 2009.
Major occupations include:

        Physicians               35                      Dental Hygienists         8
        Nurse Practitioners      16                      Dental Assistants         30
        Physician Assistants     19                      Clinical Psychologists    2
        Nurses                   86                      Clinical Social Workers   8
        Dentists                 15                      Other Mental Health       5

CHCs across the nation anticipate provider shortages in the wake of health reform activities. CHCs offer
competitive salaries, benefits, financial incentives (including loan forgiveness programs), and a collegial
work environment, but rural clinics still have difficulty recruiting primary care providers.

Education and Training

CHCs function very well as community based training sites for medical, dental, mental health, mid-level,
nursing and allied health professionals. The Billings residency program, based at RiverStone Health CHC,
has demonstrated great success in placing medical graduates in Montana. The new primary care
residency program being developed in Missoula will also be located in a CHC (Partnership Health
Center).

Workforce Strategies

 CHC Strategy                             Resources and Organizations      Measures and Outcomes
 To recruit and retain the primary        MT Primary Care Association      Track number of new
 care workforce at rural Community        (MPCA); MT Primary Care          providers hired into CHC
 Health Centers, support and expand       Office; local CHCs; SC MT        programs, track professions
 financial incentives and loan            AHEC – MT Recruitment            that are hired
 forgiveness programs (i.e. NHSC,         Collaborative, E MT AHEC
 MRPIP, MT state loan repayment,
 and private programs).

 Engage community support to              CHCs and partnering              Survey new recruits at rural
 recruit/retain providers:                community organizations;         facilities—how were they
      Determine current and              MPCA; AHECs                      recruited
         future needs
      Identify the benefits that                                          Track non-traditional
         each community can offer to                                       providers that have been
         new recruits                                                      recruited to CHCs
      Develop recruitment tools
         for non-traditional providers
         (i.e. older or non-medical
         training)
Develop system for relief providers
(i.e. locum tenens or respite provider
pool) to allow for personal time off for
primary providers.

Develop capacity to better analyze         MPCA; MT Department of
workforce data and plan workforce          Labor and Industry; MHWAC;
needs. Develop a system that can           AHEC/MORH; MHWAC
react to needs with flexibility and in a
timely manner.

Education/training strategies:             NHSC; Montana GME Council;
    Provide incentives for training       CHCs; Admissions
       at rural CHCs.                      committees; AHECs; WWAMI;
    Review training programs to           other health professions
       train a workforce with skills       programs
       adapted to patient centered
       medical home model.
    Implement best practices for
       selecting students with the
       highest probability for rural
       primary care practice.
    Increase number of rural
       rotation sites.
    Expand continuing education
       opportunities for all
       providers, particularly online
       options.