Primary Care and Public Health Exploring Integration to Improve Population Health (2012) / Chapter Skim
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Appendix B: HRSA-Supported Primary Care Systems and Health Departments
Appendix B: HRSA-Supported Primary Care Systems and Health Departments
Pages 163-174
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From page 163... ...
The most widely recognized of these primary care systems are the health centers funded under the Health Center Program or designated as federally qualified health center (FQHC) look-alikes.
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From page 164... ...
These challenges may be due to a relatively small number of individuals requiring care over a large geographic area, the transient nature of migrant and seasonal farm work, and/or the inability of existing health centers to handle the cyclical nature of seasonal work and the influx and outflow of patients. Approximately 90 percent of migrant health centers are funded as Health Center Program grantees serving special populations; the remaining 10 per 1 The term FQHC is a designation determined and used by CMS to indicate that an entity can be reimbursed using specific methodologies statutorily designed for FQHCs.
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From page 165... ...
TABLE B-1 Snapshot of Health Centers Characteristic Number Percentage Total Patients 19,469,467 Patients by Age Children (<18) 6,251,866 32.11 Adults (18-64)
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From page 166... ...
Rural health clinics are not required to provide any preventive health, preventive dental health, or case management services. The scope of their services is limited to emergency care; outpatient primary care; and basic laboratory services such as urine testing by stick or tablet, blood sugar tests, and the collection of cultures for transmittal to a certified laboratory for analysis (HRSA, 2006)
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From page 167... ...
, HRSA-supported primary care systems vary widely. Health centers and rural health clinics serve a variety of populations and population sizes.
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From page 168... ...
In 14 states, governance is wholly or largely centralized such that the state government has primary responsibility for leading local agencies, including decision-making authority in most matters related to budget, the issuance of public health orders, and the appointment of local health officials. In five states, a shared governance model is used whereby either local or state governments may lead local agencies, with responsibility for decisions regarding budget, the issuance of public health orders, and the appointment of local health officials (ASTHO, 2011a)
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From page 169... ...
, a category that includes access to care programs and direct clinical services, such as tuberculosis treatment, adult day care, early childhood programs, and local health clinics. Thirteen percent of state health department expenditures were for infectious disease programming, while 8 percent was dedicated to chronic disease prevention.
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From page 170... ...
Furthermore, standards for local public health have been established, and voluntary accreditation for local health departments started in 2011. The Public Health Accreditation Board, a national nonprofit organization, based the public health standards on the 10 essential public health services (see Box 1-2 in Chapter 1)
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From page 171... ...
Federal direct and pass-though funds accounted for approximately 20 percent of revenues for local health departments serving fewer than 500,000 persons and for nearly 30 percent of those for departments serving populations of 500,000 or more. The percentage of revenues derived from Medicaid funding differed the most by population size.
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From page 172... ...
. Local health departments offered the following 10 services most frequently: adult immunization, communicable disease surveillance, childhood immunization, tuberculosis screening, food service establishment inspection, environmental health surveillance, food safety education, tuberculosis treatment, school/child care facility inspection, and population-based nutrition services.
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From page 173... ...
Many local health departments reported using electronic syndromic surveillance systems for such activities as the detection of influenza-like and foodborne illnesses, the establishment of case definitions, and the evaluation of interventions (NACCHO, 2011a)
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From page 174... ...
2005. Operational definition of a functional local health department.
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