Fykeson Sarmiento Radhika Shah Aiman Sohail

About 250 centers located throughout US in 40

different statesthe Northeast, Southeast, and Midwest being the regions with the greatest numbers Community-based health centers led by advanced practiced registered nurses (APNs) Predominantly staffed by nurse practitioners (NPs) Other members of care team include: social workers, health educators, RNs, outreach workers, physicians, and other health professionals

 Uninsured
Insured Pediatrics

Adults
Low-income Vulnerable

Ethnic minorities

 Nurses provide health screenings, vaccinations, direct

care for minor acute problems, health education, and counseling services Nurses also focus on community-based health promotion programs in order to address problems such as smoking, obesity, and poor nutrition

 Works to help NMHCs meet the costs of providing

care to the low income and vulnerable populations.

 Many NMHCs were initially launched with start-up

grants Grants were nonrenewablecenters were unable to secure sustainable long-term funding once the grant period ended Many NMHCs closed down once funding dried up Others attempted to acquire funding from private foundations and improve reimbursement from thirdparty payersall with varying degrees of success

 NMHCs are safety net providers for patients regardless

of their ability to paypatients are guaranteed care About 35%-40% of patients are uninsured Sliding fee scale used to collect payment from such patients but these contributions alone do not cover the actual cost of care Charitable grants used to make up the difference but not always available on a consistent basis leading to budget instability from year to year Further problems include lack of access to predictable governmental funding and inconsistent reimbursement from insurers

 State laws and policies have a great impact on NMHCS

and their capability to provide services to patients. Some state governments have made additional funding and other resources available -Ex. Pennsylvania governor Edward G Rendells prescription for PA - Prescription for PA is a set integrated practical strategies for improving the health care of all people in PA, by making the health care system more efficient and containing its cost.

 NHMCs needed funding to provide care

The National Nurses Center Consortium (NNCC)

advocated for NMHCs Helped introduced the Nurse-Managed Health Clinic Investment Act of 2007 and 2009 Patient Protection and Affordable Care Act of 2010

 Health Resources Services Administration (HRSA)

supports the growth of NMHCs Between fiscal years 2000-2009 the HRSA awarded a total of $50,443,123 for NMHCs NNCC (National Nursing Centers Consortium) have played a role in political advocacy and education efforts. NMHC advocates work with Congressional Health staffers

 In 2010 more than 1200 community health centers

served more than 20 million people at 8,000 clinical sites in the U.S. CHC provide medical, dental, mental health, substance abuse services, nutrition counseling, outreach, transportation, and other social services. Mainly located in areas designated by federal government Funded primarily by a mix of public insurance and federal grants

 Health service institutions that are community

oriented, culturally sensitive model of health care services integrated with social and educational services. Governed by consumer boards, that by federal law where majority of members who are patients at the health center Safety net providers, caring for people who are no insurance

NMHC
More extensive care Low-income+

CHC
Limited care Uninsured + no income

population Located in many communities federal and state government

population Location is designated by the federal government Mostly funded by Medicaid

 CHCs were created as part of the War on Poverty by

physicians and the federal government They served the community and not just individuals Created to help provide jobs as well as health services Continues to play a role in health today

 There was not an understanding of CHCs in the

political environment. Members of Congress and federal agency officials started becoming advocates for CHCs creating the National Association of Community Health Centers (NACHC) CHCs expanded during the Bush Administration

 The American Recovery and Reinvestment Act of 2009

Community Health Center advocates were active in

health care reform Patient Protection and Affordable Care Act

 made during the 1930s

Created by Franklin D. Roosevelt

Provides economic security for those who can not

work Taxes are collected from income and placed in the system

 NMHCs and CHCs are both federally funded which

makes a big impact on Social Security.

 Nurses have the ability to become global leaders

This requires personal initiative (more extensive

education in issues related to global healthcare and the investment of time by being active in international work) In order for leadership to occur on a global level, there must first be the existence of leadership on a local and national level (see notes below)

 Nurses can become leaders on a global level

Many poor and desperate third world countries in

need of help with healthcare Nurses can volunteer their help and expertise For example: nursing students who went to Sierra Leone, West Africa

 Doing work on a global level provides nurses the

opportunity to gain experiences that are vastly different from what they may be accustomed to Allows them to become aware of values and beliefs of other cultures, thus giving them new perspectives as healthcare providers

 Do you think that the survival of Community Health

Centers is crucial to our healthcare system?

 Recent annual Trustees Reports indicate that Old Age,

Survivors, and Disability Insurance (OASDI) funds will cover full scheduled benefits until 2037. Do you believe that no cuts to benefits are necessary or serious cuts to benefits are necessary? Why?