p acific i slands h ealth o rganization a ssociation pacific basin primary care office angela...
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Pacific Islands Health Organization Association
Pacific Basin Primary Care Office
Angela Techur-Pedro, MO/PhD
PB-PCO Coordinator
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Pacific Basin PCO Program
Background• HRSA funded, Bureau of Health Workforce (BHW) and
Office of Shortage Designation (OSD)• The PIHOA PBPCO is in its year 7 • New grant: FY2• Supports PIHOA Secretariat Staff: 1 100% FTE; 1 20%
FTE; 1 10% FTE and 10% Administrative cost and deliverable related expenses—Travel, equipments/supplies, communications, etc.,
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Pacific Basin PCO Program
Goal of the PCO program
• Improve Access to Primary Care• Access to primary care is “the timely use of personal
health services to achieve the best health outcomes” (HP 2020)
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Pacific Basin PCO Program
To operationalize “Access to PC” based on the definition:
• Coverage• Services• Timeliness• Workforce
Note: Limited resources restrict needs assessment specific for HPSA and MUA health indicators
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Pacific Basin PCO Program
Generally, the PCO program has 3 core deliverables:
1. Statewide Primary Care Needs Assessment (SPCNA) Services
2. NHSC site certification/recertification3. NHSC provider recruitment, placement, and
retention
To assess, describe, and meet the identified primary care needs
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Pacific Basin PCO Program
First core deliverable:
1. Statewide Primary Care Needs Assessment (SPCNA) Services (Pacific Basin Regional SPCNA Data Book) endorsed by 57th PIHOA Executive Board during the last PIHOA meeting in Palaua. Coverage (insurance; accessible – within 30 minutes;
affordable; acceptable;)b. Services (primary care, dental and mental health)
c. Timeliness (appointments are <=2 weeks; clinic visits are within 2 hours after arrival
d. Workforce—qualified provider (culturally sensitive)
To assess, describe, and meet the identified primary care needs
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Pacific Basin PCO Program
2nd Core Deliverable: HPSA and MUAP Designations (New or Update)
HPSA: Health Professional Shortage Areas (HPSAs)1. 3 Types:
a. Primary care (Highest score=25)b. Dental Health (Highest score=26)c. Mental Health (Highest score=25)
2. May be geographic (county or service area), population (low income—at or below 100% Federal Poverty Level) or facilities (FQHCs, State or Federal facilities)
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Pacific Basin PCO Program
Data Sources:
1. Census for Population and SES indicators2. MCH Annual Reports from MCHB and USAPIJ’s3. CMS National Provider List based on National
Provider Index (NPI)4. Provider Survey (Physicians, Dentists, Psychiatrists
and NHSC providers including PA, NP, Nurse Corp)1. Primary Care Providers (PC Provider Survey)2. Dental Health Providers (Dental Provider Survey)3. Mental Health (Mental Health Provider Survey)
Note: Slight change to the Pacific Basin Regional SPCNA Data Book will be an expanded Health Workforce (Physicians, Dentists, and Psychiatrist) Inventory
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Pacific Basin PCO Program
Current Status:
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Pacific Basin PCO Program
MUAP Designations (New or Update)
MUAP: Medically Underserved Area/Population1. 1 types:
a. Primary care (Eligible score is <62 out of 100)
2. May be geographic (county or service area), population (low income—at or below 100% Federal Poverty Level)
3. Qualified Designation is based on an Index of Medical Underservice (IMU) score <62
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Pacific Basin PCO Program
MUAP Designations (New or Update)
MUAP: Medically Underserved Area/Population1. Qualifying for Designation is based on 4 indicator
values weighted values based on prescriptive criteria and added up to yield an IMU scorea. Ratio of primary medical care physicians per 1,000
population,b. Infant mortality rate (IMR)c. Percentage of the population with incomes at or below
100%FPLd. Percentage of the population aged 65 or over
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Pacific Basin PCO Program
Example of MUAP Designation Application
Qualifying CNMI as a MUA: Medically Underserved Area a. Ratio of primary medical care physicians per 1,000 population12.5 provider FTE to 62,392 population1/4991*1000=0.2, weight value~ 2.8
b. Infant mortality rate (IMR): <8.0 per 1000 LB ~ weighted value =26.0
c. Percentage of the population with incomes at or below 100%FPL: >50% ~weight value=0
d. Percentage of the population aged 65 or over: <7%, weighted value = 20.2
e. Together, these values total ~ 49 although OSDIMU=46.7
Note: Access to the methodology “demystifies” the process and allows us an opportunity to try to create Service areas that gets the best scores!!
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Pacific Basin PCO Program
2 Core Benefits of HPSA and MUAP Designation
1. Qualifies USAPIJ to apply for $ Funding for Community Health Centers (MUAP) among other funding opportunities
2. Qualifies USAPIJ sites for provider placements and other funding opportunities (CAH), Rural Health Clinics
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Pacific Basin PCO Program
Application Process
1. HRSA BHW online application software system –SDMS (Shortage Designation Management System)
2. SDMS rolled out in December 15, 20143. Many technical and non-technical issues4. Pacific Basin sites
1. Only Guam has an account2. BHW has not completely developed the application for
the USAPI3. Proposed solution: Paper application yet to be
approved
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Pacific Basin PCO Program
3nd core deliverable:
1. NHSC site certification and recertification a. Certification (4/1-6/2); Recertification (Aug 1-9/30)
b. Bureau of Health Workforce (BHW) Program Portal (https://programportal.hrsa.gov/)
• Each USAPIJ can create accounts for advertisements, recruitments, and profile sharing of sites information
Note: CAH
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Pacific Basin PCO Program
3rd core deliverable (cont):
2. NHSC provider recruitment, placement, and retentiona. Rationale: short-term gap solution for HPS in the region
1) Feasible for AS, CNMI, Guam2) Currently not as feasible in the FAS
b. PCO Annual Meeting: 6/22-6/25/2015 in Rockville, MD1) ASTHO sponsored PCO Director Peer Mentoring Program (Danielle Garrett
(ASTHO) and Lynnette Araki (HRSA)2) 2-days Meetings with NHSC, ASTHO, BPHC, HIV, STI, MCH, COINN etc., 3) Potential Solution – SLRP4) Requires non-federal matching dollars5) New Application cycle opens in 9/2016
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Pacific Basin PCO Program
Updates:
1. PCO Annual Meeting: 6/22-6/25/2015 in Rockville, MD1. Address many of the SDMS technical issues face to face/one-on-one so
that the system’s technical team can see on the computer screen what I encounter with the SDMS system for the USAPIs
2. ASTHO sponsored PCO Director Peer Mentoring Program (Danielle Garrett (ASTHO) and Lynnette Araki (HRSA)1) 2-days Meetings with NHSC, ASTHO, BPHC, HIV, STI, MCH, COINN etc., 2) Potential Solution – SLRP3) Requires non-federal matching dollars4) New Application cycle opens in 9/2016
2. Upcoming Site visits: 9/6-10/5a. PBMA in Palau (Face-to-face provider interview)b. Site visits across—Guam, CNMI, Chuuk, Pohnpei, Kosrae, Ebeye,
Majuro
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Pacific Basin PCO Program
• Comments?• Questions?
• Recommendations?
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Acknowledgements
Executive Board Members• Palau Board Members & Partners• Guam Board Members & Partners
• CNMI Board Members & Partners
• FSM Board Members & Partners
• RMI Board Members & Partners
• American Samoa Board Members and Partners
Associate and Affiliate Members
Pacific Basin Dental Association Board
Pacific Basin Medical Association
Pacific Basin Mental Health Association
Pacific Islands Primary Care Association
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Contact & Helpful
• US HRSA Health Professional Shortage Designation• http://bhpr.hrsa.gov/shortage
• HPSA or MUA/P Designation Scores• http://hpsafind.hrsa.gov/• http://muafind.hrsa.gov/
• Primary Health designated Areas or Facilities in the Pacific Basin• http://
datawarehouse.hrsa.gov/DataDownload/FRN/D_BCD_HPSA_H1_FederalRegister.pdf (pg. 224 – 234)
• Dental Health designated Areas or Facilities in the Pacific Basin• http://
datawarehouse.hrsa.gov/DataDownload/FRN/E_BCD_HPSA_H6_FederalRegister.pdf (pg. 192-200)
• Mental Health designated Areas or Facilities in the Pacific Basin• http://
datawarehouse.hrsa.gov/DataDownload/FRN/F_BCD_HPSA_H7_FederalRegister.pdf (pg. 205-213)
• (PIHOA & PB-PCO)• Web: http://www.pihoa.org/initiatives/pco.php• Web: www.pihoa.org• Angela Techur-Pedro (HPSA/MUAP/SPCNA)
• [email protected]• Dr. Greg Dever (HRH & TA for Workforce Dev.)
• [email protected]• Emi Chutaro (PIHOA Ex. Director)
• [email protected]• Regie Tolentino (Honolulu Office Manager)
• [email protected]• PIHOA/PB-PCO Office in Honolulu, HI
Pacific Guardian CenterSuite #2075, Mauka Tower737 Bishop StreetHonolulu, Hawaii 96813Office: (808) 537-3131 I Fax: (808) 537-6868