Guest Post by Jason Patnosh, NACHC Associate Vice President and Community HealthCorps National Director

Thank you to all who attended the recent NACHC Community Health Institute and Annual Meeting in Chicago. While there, participants heard about the need to protect health centers – not the least of which is to urge Congress and the President to fix the “fiscal cliff” that will occur in 2015.  Without a fix, health centers face drastic reductions in funding.  This is the top challenge for all health centers because severe funding cuts will threaten the progress they have made over the last few years in providing health care to millions of more patients, and they will certainly decimate the program in the years to come.

In addition to this key challenge, NACHC Board Chair Dr. Gary Wiltz asked the audience to participate in the ongoing conversation of operations management and improvement. Throughout the conference, participants were encouraged to share individual challenges their health centers faced.  While many of the centers mentioned similar challenges, two major themes arose: Sustainability and Workforce Development/Succession Planning. We have provided a sampling of the comments below with some suggested resources:

 

Sustainability
Comments / Challenges	Resources
“Lack of a base funding increase (except for Patient Centered Medical Home (PCMH) & Increase Demand for Services (IDS) funds) while the number of users in the past four years has grown by 50%”. “Solve the FY16 issue now!” and “Increasing / maintaining grant funding” “Moving from a fee for service world to a world of global bundled payments and Accountable Care Organizations”	On September 13, 2013 Bureau of Primary Health Care (BPHC) announced a small increase in base adjustments (FY13 Base Adjustments) and 23 new access points (NAPs) Stay up to date on ways to contact your Representatives and Senators to ensure they protect health center funding at http://www.saveourchcs.org Moving to any managed care environment requires contracting knowledge and skills. NACHC and Feldesman Tucker developed “The Managed Care Manual: A Practical Guide for Health Centers”
Workforce Development / Succession Planning
Comments / Challenges	Resources
“Ongoing push for National Health Service Corps (NHSC) funding” and “Funding for the Teaching Health Center Program” “Funding to recruit workforce necessary to provide the best care to our patients”, “deploying community health workers (CHWs) under the ACA”, and “Adequate manpower to meet needs” “Succession planning for the whole movement”, “Management and clinical leadership development” and “Board succession plan and leadership” “Need endorsed pool of health center knowledgeable, and reputable clinical recruitment firms that are affordable”	NHSC funding currently is only through the ACA Trust Fund and our partners join NACHC in calling to save this necessary program for the years to come! Learn more about the Teaching Health Centers program funded through the ACA. NACHC is also working hard to protect these funds. Transformation to a PCMH provides opportunity for health centers to evaluate and realign their current staffing models. Check out NACHC’s webinar series: Building Blocks for Staffing Your Patient Centered Medical Home (PCMH). In response to both the inevitable change of health center leaders as one generation hands leadership to another NACHC provides a new Leadership Webinar Series to assist with planning for and successfully executing succession plans. NACHC partners with S/RPCAs to offer the Managing Ambulatory Health Care (MAHC) training courses for any clinical leader, especially those with some experience in the leadership role. Community Health Ventures offers a number of physician, dentist and mid-level clinician recruitment agencies and were highly selective in their search through their Value in Staffing (ViS) program.

 

Additionally, some participants provided thoughts on how to improve the overall conference and learning experiences:

• “Placement of awards presentations in plenaries should be earlier to ensure the audience pays due respect to awardees.” NACHC agrees that all awardees have earned the respect of the health center community. We do our best to schedule presentations during plenaries and in-person opportunities to learn more about the awardees throughout the conference. We will continue to do our best to schedule these presentations for maximum recognition and to explore online opportunities to share their great stories with many more people. To learn more about the awards and how to submit your own nominations see NACHC Awards of Excellence.

• “Can NACHC provide accessible and affordable training for board members about the ACA and governance?” NACHC provides an up-to-date listing of requirements for health center board members: Governance Requirements. Additionally, NACHC continuously updates resources on the implementation of the ACA in the Policy Issues portion of the website and through the NACHC Blogs.

The Affordable Care Act presents Community Health Centers with the greatest opportunity in a generation to expand and improve health care for millions of Americans. While there are many challenges ahead, working together through NACHC, state primary care associations and health center controlled networks, we can continue to move the health center mission forward.