1.Afshan N. Baig, M.D., F.A.A.P. Chief Medical Officer Clinicas De Salud Del Pueblo, Inc. ACA from the Clinical Perspective

2. Introduction For more than 45 years, health centers have delivered comprehensive, high-quality preventive and primary health care to patients regardless of their ability to pay. During the at time, health centers have become the essential primary care medical home for millions for Americans including some of the nations most vulnerable populations. With a proven track record of success, health centers will play a key role in implementation of the Affordable Care Act. 3. The Essential Role Health Centers Will play an essential Role in implementation of ACA Those who emphasize coordinated primary and preventive services or a medical home that promotes reductions in health disparities for low-income individuals, racial and ethic minorities, rural communities and other underserved populations. 4. The Affordable Care Act and Health Centers Delivery of Care: Increased Access to Health Services Health Centers, supported by the Health Resources and Services Administration (HRSA), treated approximately 21 Million people in 2012 One out of every 15 people living in the U.S. now relies on a HRSA-funded clinic for primary care Health Centers are an integral source of local employment and economic growth in many underserviced and low- income communities. 65 and up 7% under 5 11% 5 to 12 13% 13 to 17 8% 18 to 24 10% 25 to 64 51% Series 1 7 11 13 8 10 51 Column1 0 10 20 30 40 50 60 5. The ACA: Essential Role of Community Health Centers The Affordable Care Act established the Community Health Center Fund that provides $11 billion over 5 a year for the operation, expansion, and construction of health centers throughout the Nation $9.5 billion is targeted to: Support ongoing health center operation. Create new health center sites in medically underserved areas. Expand preventive and primary health care services , including oral health, behavioral health, pharmacy, and /or enabling services, at existing health center sites. 6. The ACA: Essential Role of Community Health Centers $1.5 billion will support major construction and renovation projects at community health centers nationwide. 7. ACA and Health Centers FY 2012 Health Center New Access points Health Center Capital Development- Building Capacity Program: 129 million was awarded to establish 219 health center new access points across the country. 629 million was awarded to 171 organizations for new large renovation, expansion or construction projects to improve health center capacity to provide primary and preventive health services to underserved populations. Grants are expected to expand 8. ACA and Health Centers Health Center Capital Development Immediate Facility Improvement Program: 99 million was awarded to 227 organizations for new construction and renovation projects to help support health center efforts to address immediate facility needs within existing sites that are providing primary and preventive health services. 9. ACA and Health Centers FY 2013, through the ACA, the Health Center Program will award the following new funding Health Center Controlled Networks: 18 million was awarded in December 2012 to 37 network organizations to support the adoption and meaningful use of EHRs, and the other HIT to improve quality in health centers. These networks must include at least 10 Health Center Program grantees and overall will provide support to more than 600 health centers nationwide. 10. ACA and Health Centers FY 2013, through the ACA, the Health Center Program will award the following new funding Health Center Outreach and Enrollment Assistance supplemental funding opportunity: HRSA awarded 150 million in early July to 1,159 health centers in support of outreach and enrollment activities nationwide. The outreach efforts are to be in line through Insurance Marketplaces, Medicaid or the Childrens Health Insurance Program, as well as other federal efforts such as the Navigator program, as well as state consumer assistance efforts. 11. ACA and Health Centers FY 2013, through the ACA, the Health Center Program will award the following new funding Health Center New Access Points: 19 Million will be awarded to help establish 25 new health center access points. Grants will support new full-time service delivery sites for provision of comprehensive primary and preventive health care services. HRSA anticipates 12. ACA and Health Centers FY 2013, through the ACA, the Health Center Program will award the following new funding School-Based Health Center Capital Program ** Create new School-based HC sites in medically underserved areas; and ** Expand preventive and primary health care services at existing school-based health center sites. Hoping to serve an addition 875,000 through the use of SBHCC ACA authorized a new program and appropriated 200 million in funding from 2010 to 2013 to address significant and pressing capital needs to improve delivery and support expansion on services at school-based health centers. HRSA awarded these funds under SBHCC program in FY 2011,2012 and 2013 to 470 school-based health Center programs 13. Coverage Breakdown 14. Current eligibility categories & income standards Infants and children (ages 0-19), up to: 250% FPL $28,725/year for an individual $58,875/year for a family of4 Pregnant women up to: 200% FPL $22,980/year for an individual $47,100/year for a family of 4 Seniors and persons with disabilities up to: 133% FPL $15,282/year for an individual Parents with dependent children up to: 100% FPL $11,170/year for an individual $23,550/year for a family of 4 15. Essential Health Benefits Ambulatory patient services Emergency services Hospitalization Maternity and Newborn Care Mental health and substance use disorder services, including behavioral health treatment Rehabilitative and habilitative services (e.g. physical therapy and occupational therapy, speech Laboratory Services Preventative and wellness services and chronic disease management Pediatric services, including dental and vision care Prescription drugs 16. Transitions of care hospital to ED to primary care medical home Prevention of chronic disease - promoting effective prevention strategies and evidence-based treatment of chronic disease Patient centered care and engaging patient and families in care Improved patient experience Reduced hospital readmissions and ED utilization Improved care coordination across the continuity of care - promoting effective communication and coordination of care across providers Increased focus on measurement and improvement of clinical outcomes Meaningful use of health information technology for example, use of technology to identify high utilizers of care to target cost effective interventions 17. Effect on our population The Law will help the issue of disparities in access to care. Increase access to quality affordable health coverage. Invest in prevention and wellness and give individuals more control over their care. Latinos suffer from certain illnesses at higher levels than other groups. E.g. Obesity, Diabetes heart disease, Cervical cancer screening. Only 46.5 of Latinos received Colorectal cancer screening compared to 59.9 non Latinos. 18. Resources Council of Community Clinics HRSA www.hrsa.com