Ben Ernst, President Northwest Health Services, Inc.

Chris Stewart, Vice President Katy Trail Community Health

Dwayne Butler, Treasurer BJK People’s Health Center, Inc.

Pat Richards, Secretary Southern Missouri Community Health Center

Robert Massie, Past President Family Care Health Centers

Don McBride, Member-at-Large Access Family Care Dave Barber Swope Health Services

Ron Camp Cross Trails Medical Center

Angela Archibald Clabon Myrtle Hilliard Davis Comprehensive Health Centers Sherilyn Clark Missouri Highlands Health Center

Scott Crouch Ozarks Community Health Center Gloria Crull Family Health Center

Alan Freeman Grace Hill Health Centers, Inc. Hilda Fuentes Samuel U. Rodgers Health Center Andy Grimm Northeast Missouri Health Council

Laura Heebner Crider Health Center

Don Holloman Community Health Center of Central Missouri

Stephen Huss COMTREA Linda Lloyd Great Mines Health Center, Inc.

Lisa Odom Jordan Valley Community Health Center Richard Sims Missouri Ozarks Community Health

Robert Walters Central Ozarks Medical Center Cheryl White Southeast Missouri Health Network Joseph Pierle, CEO Missouri Primary Care Association

MPCA Associate Members Fordland Clinic Pathways Community Health Center

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ACCESS Family Care ACCESS Family Care has implemented an important Promotora Program in Southwest Missouri serving the Latino community. The Promotora serves as a liaison between the community, health professionals, and social service organizations. Classes taught in Spanish have been implemented in an effort to educate Latinos on nutrition, diabetes, dental care, family planning, cholesterol, HIV, stress, and obesity to expand health awareness and improve health outcomes. Currently the Hispanic population is the fastest growing minority population served by our clinics. ACCESS plans to extend this program beyond the boundaries of Spanish to include other known minorities located in Southwest Missouri.

Katy Trail Community Health Katy Trail Community Health (KTCH) has become an Asthma Ready Organization under the Asthma Ready® Communities (ARC) program sponsored by the University of Missouri, Columbia. Asthma Ready® Communities is an overarching endeavor to provide standardized, evidence-based educational programs for children with asthma, families and health professionals. For facilities, Asthma Ready® is a designation indicating that the facility has participated in asthma training, has the resources, and is committed to delivering appropriate services, maintaining communication standards, and conducting quality improvement efforts to ensure best practices for the care of children with asthma. KTCH is the only Asthma Ready Clinic in Pettis and Benton Counties.

Myrtle Hilliard Davis Comprehensive Health Cen-ters, Inc. Myrtle Hilliard Davis Comprehensive Health Centers, Inc. (MHDCHC) is extremely proud to congratulate one of its most faithful consumers (Ms. Edna McDaniel). The Missouri Senate (14th District) recently appointed Ms. McDaniel to the Missouri Quality Home Care Council. Ms. Daniels has been a MHDCHC patient since 1993. Her kindness and concern for the staff and other

patients is rooted in her background as a family counselor for the Human Development Corporation. Since being diagnosed with diabetes in 1993, she has not wavered in her commitment to live with, not die from, diabetes even through a related surgery. Her very outspoken but comical personality lights up the health center whenever she visits for services. Missouri home health consumers are truly blessed to have such a strong voice at the State level quality discussion table. So on behalf of the MHDCHC family we salute Edna McDaniel, a true “unsung” healthcare advocacy hero.

Samuel U. Rodgers Health Center

Samuel U. Rodgers Health Center (SURHC) has a new Chief Health Officer. Dr. Sudeep Ross, MD, MBA, recently joined the SURHC team to oversee the health care provided at its eight locations in the Kansas City area. Dr. Ross received his medical degree from J.S.S. College in India and then completed his residency in Family and Community Medicine at Penn State University. In addition, he has a Master of Business Administration from the University of Arizona. Dr. Ross said he is most enthused about helping the Health Center fully implement a Patient Centered Medical Home (PCMH) model of care, with the goal of improving the quality and

efficiency of care for patients. SURHC has applied for recognition as a PCMH from the National Committee for Quality Assurance.

Southeast Missouri Health Network SEMO Health Network has opened a new facility in Benton, Missouri. Benton Wellness Center opened on April 22, 2013 with an open house held on April 25, 2013. Those in attendance at the open house included, the mayor of Benton, City officials, Ben-ton and Sikeston Chamber of Commerce, commu-nity members and SEMOHN staff and BOD. Tours and refreshments were available to those in at-tendance. The facility offers an indoor walking track, treadmills, weight machines and exercise classes to help lead members to a healthy lifestyle.

Southern Missouri Community Health Center Staff members at Southern Missouri Community Health Center have completed the work necessary to apply for recognition by the National Committee for Quality Assurance (NCQA). Applications for the West Plains and Thayer clinics have been submitted and everyone at SMCHC is anxiously awaiting results. The NCQA-PCMH (Patient Care Medical Home) compliance team has been working since late 2011 on policies, procedures and processes that show that SMCHC is meeting the requirements for recognition. Additionally, the SMCHC Board of Directors and senior leaders recently completed a three-year strategic planning process, assisted by a capacity building grant from the Missouri Foundation for Health.

Congratulations to Jordan Valley Community Health Center

on Achieving Excellence

n May of 2013, Jordan Valley Community Health Center in Springfield, Missouri, received notice from The Joint

Commission that they would be awarded the Gold Seal of Ap-proval for re-accreditation. Less than a month later, they were awarded National Committee for Quality Assurance (NCQA) Patient Centered Medical Home (PCMH) Level 3 recognition.

The MPCA recognizes and commends Jordan Valley for the hard work and tireless dedication behind these achievements. Congratulations!!

n September of 2012, Missouri Primary Care Association awarded Jim Macrae with its prestigious Champion of Community Health Centers award.

The Champion award honors individuals in legislative and administrative branches of city, county, state, and federal government who have

demonstrated notable support of the Community Health Center model. In nominating Jim Macrae for the Champion of Community Health Centers Award, Alan Freeman, CEO of Grace Hill Health Centers, Inc., submitted the following letter:

It is my privilege to nominate Mr. Jim Macrae to receive the Missouri Primary Care Association’s Champion of Community Health Centers Award in 2012. Recipients demonstrate support for the Community Health Center model and are committed to public service and to increasing health access for all. Jim consistently embodies these criteria and thus deserves our recognition.

Jim is a native St. Louisan. He has enjoyed a distinguished 20-year career at HRSA. For the past several years, he has served as head of the Bureau of Primary Health Care, overseeing the $3 billion program through a period of rapid and unprecedented growth.

Jim has been a stalwart supporter of Community Health Centers, a faithful steward of federal resources, and a recognized voice within both the Bush and Obama administrations. He represents the needs of Missouri’s CHCs extremely well, and is a friend to all who advocate for the uninsured and underserved.

The MPCA congratulates Mr. Macrae on this award and thanks him for Championing Community Health Care!

arlier this year, Missouri was named the “Best Trails State” by American Trails, a national nonprofit organization dedicated to

promoting our nation’s hiking, biking and riding trails. From our cities and suburbs to our small towns and rural areas, Missouri is crisscrossed by hundreds of miles of trails to accommodate a wide variety of activities and interests.

Governor Jay Nixon and First Lady Georganne Nixon are encouraging all Missouri families to get outside and take advantage of the incredible resources found here in the Show-Me State by joining the Governor’s 100 Mile Challenge. They’re asking Missourians to complete “100 Missouri Miles” of physical activity by the end of the year. Whether you run, walk, bike, paddle or roll, everyone can participate. To sign up visit 100MissouriMiles.com and take the Challenge!

This initiative is a great opportunity to promote Missouri’s proud outdoor heritage, improve your health and – best of all – have fun with family and friends. More than 18 million Missourians visited our state parks last year and there are hundreds of other local trails, greenways and blueways to enjoy. From Forest Park in St. Louis to the Cliff Drive Scenic Byway in Kansas City to the Ozarks Greenway in Springfield, Missouri’s nationally-recognized trails are far more than a means of getting from one place to another. They are pathways to enrichment and adventure, to time-honored traditions and new discoveries, to quiet contemplation and strenuous exertion. Most importantly, Missouri’s trails weave our communities together.

 

 

“Such unfortunate beings (those with mental illness) are confined to our county jails where they seldom, if ever, receive any of those soft kind attentions that have been found so necessary for their recovery and restoration to society.”

ov. Meredith Marmaduke made these remarks to the Missouri Legislature in 1844, following the suicide of Gov. Thomas Reynolds. Missouri went on to es-tablish the first mental hospital west of the Mississippi at Fulton. Missouri has been continuously committed ever since to serving those with serious mental illness. That covenant is now in jeopardy of being critically compromised due to the

Legislature’s plan to reject Medicaid expansion for the state. Here’s why:

Over the last generation, the number of acute-care psychiatric beds for adults 18-64 in Missouri has shrunk to less than a quarter of our previous number. The majority of those beds were once public. Now, none are. Private nonprofit hospitals have taken up the burden, but have real limits.

The state shifted its resources to community-based care, reserving inpatient care for longer-stay court-ordered assessments and treatment in criminal cases. Community-based care is economical and it works well, helping individuals who years ago would have languished in institutions to lead more productive lives. However, community programs reach only a minority of those who could benefit from such care.

Over the past two decades, the portion of Missouri’s general revenue budget dedicated to services for people with serious mental illness declined from over a tenth of all general revenues to about half that. This happened because the state has shifted heavily to community-based care and replaced state general revenue funding with financing from Medicaid. Unfortunately, this means there is little funding available for earlier interventions with young adults who have more likelihood of finding employment after recovery-oriented rehabilitation. If Medicaid were expanded in Missouri, eligibility would be determined by income, and more people, particularly young adults, could end up working and maintaining their own insurance, subsidized under the Affordable Care Act.

In reality, most community-based services are reserved for those who have reached a point of being declared “permanently and totally disabled.” We shouldn’t have to wait to serve those young adults until they meet that standard.

Currently, too many Missourians with serious mental illness get in trouble with the law, usually with nuisance violations. Our overburdened jails and prisons are no place for people with serious mental illness. Sheriffs around Missouri must take deputies off a whole shift of public safety to transport a mentally ill person to a psychiatric bed in a community hospital. A disproportionate number of these individuals are not eligible for Medicaid and have no insurance. Hospitals are now subsidized by the federal government to take these uninsured patients. That subsidy will be cut in half beginning in January 2015. As a result, many rural hospitals could close.

Starting next January, deputy sheriffs may have to drive 100 or 200 miles to a suburban hospital to commit the psychiatric patient. Suburban hospitals will find they are overburdened by uninsured psychiatric patients and may well be in a position of having to close psychiatric beds because of financial realities.

Karl Wilson & Mark U erback

Missouri is at a critical choice point. If it accepts federal funds to expand Medicaid eligibility, it will save a large portion of its budget, and its citizens burdened with serious mental illness will have a good chance of leading full productive lives. If Missouri rejects this funding:

Many rural hospitals will close

Statewide, the number of psychiatric beds will shrink precipitously as hospital after hospital faces a large financial drain by continuing to provide this service

Jails and prisons will have to be expanded to become the mental health system of last resort

People with serious mental illness will have their hopes dashed of being contributing citizens of our great state of Missouri, one of the first to make a covenant with its citizens challenged with serious mental illness

It is expensive, inhumane and ineffective to make our jails and prisons into our state’s dominant mental health system, but that will be the result if the Missouri General Assembly rejects Medicaid expansion.

Karl Wilson is the former chair of the board and Mark Utterback is the CEO of Mental Health America of Eastern Missouri.

 The MPCA thanks Chief Development Officer, Danny O’Neill, for leading Community Health Center Advocacy efforts, working in conjunction with CHC staff, providers, and board members to achieve the following significant state legislative accomplishments:

-Fully funded FQHC Grants: $3.02 million

-Fully funded Health Home Initiative: $12.3 million

-New funding for scholarships/loan forgiveness: $250,000

-Maintenance of Women and Minority Health Care Outreach Pro-gram: $1,114,750

-Maintenance of Mental Health and Primary Care Integration: $1.5 million

-Likely New Coverage for certain Adult Dental Services through MoHealthNet

-Likely Reimbursement for Certain Behavioral Health Assessment Codes

-Dental Assistant Scope of Service Clarification Language

Job Well Done by All!

 

ver the final three months of the Missouri Legislative session, policymakers will continue to deliberate whether or not to increase access to affordable health insurance. Medicaid expansion is being scrutinized by the Senate, but was voted down this week by the Government Oversight and Accountability Committee of the House. Throughout this discourse, there is a bipartisan declaration that patients deserve to be treated with dignity. Some argue that this is best

accomplished only after Medicaid is transformed. For my patients, however, this is akin to leaving shipwrecked passengers treading water and sinking because the rescue vessel could benefit from some business process improvement.

One of my patients recently spent the morning serving heavy plates of free food at a professional medical function. Riddled with lupus arthritis and calcified tendonitis, she lifted dirty dishes while overhearing two physicians discussing the abomination of Medicaid expansion. This waitress, without any health insurance, spent the same afternoon in our health center requesting sample medications to get her through her next shift. With Medicaid, however, I could get her a rheumatologist and powerful medication to prevent the destructive effects of lupus, I could get her the stress test she declined because she can’t afford it, I could get her into clinic without a co-pay equivalent to half day of wages, I could more effectively prevent a hospitalization, and I could keep her working long-term to support herself. I have hundreds of uninsured patients whose health and employability similarly hinge on getting coverage, and they are only a small part of the approximately 300,000 Missourians who would benefit from Medicaid expansion.

Medicaid is not perfect, but it can be life saving compared to being uninsured, and it is getting stronger. Currently our Medicaid patients with complex chronic diseases are benefiting from a massive transformation of care delivery. Missouri Medicaid was the first state in the nation to implement in full force the “health home” model. Because of this, we are delivering the most comprehensive proactive primary care to our sickest, most vulnerable Medicaid population. We are utilizing nurse care managers and social workers who collaborate with me in the exam room and then reach out to our patients monthly to promote their health in a personalized patient-centered manner and to avoid unnecessary emergency visits and hospitalizations. We are improving care for these patients, and we are tracking quality measures to prove it.

If we decline the expansion and ongoing transformation of Medicaid, we stand to lose the capacity to care for Missourians with the dignity they deserve. One warning sign lies silently in my mailbox, where reams of letters attempt to recruit me (and likewise my primary care colleagues) out of Missouri. The states already planning Medicaid expansion have recognized the national health worker shortage and achieved a head start in recruitment. Therefore, if our policymakers decline Medicaid expansion, our doctors and nurses, as well as our Federal tax dollars and health-related business opportunities, will leave Missouri to support the Medicaid expansion of other states.

Dr. Heidi B. Miller is an internal medicine doctor at the Family Care Health Centers, a St. Louis-based Community Health Center that practices the Health Care Home model. She completed her medical school and residency training at Harvard, and she now takes care of adults with complex medical and psychological problems. Dr. Miller also serves as a health policy advisor to the Missouri Primary Care Association.

June Men’s Health Month Men’s Health Network www.menshealthmonth.org Scleroderma Awareness Month Scleroderma Foundation www.scleroderma.org

June 2-8 Community Health Improvement Week Association for Community Health Improvement www.communityhlth.org/chiweek

June 17-21 Healthcare Risk Management Week American Society for Healthcare Risk Management www.ashrm.org/hrmweek

July Fireworks Safety Month National Council on Fireworks Safety www.fireworksafety.com

August Children’s Eye Health and Safety Month Prevent Blindness America http://preventblindness.org

Relay for Life American Cancer Society www.relayforlife.org

August 1-7 Health Center Week www.healthcenterweek.org