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    Which is the main focus of community health nursing?What role is the nurse expected to have in a community based nursing practice if there is a sudden spread of malaria quizlet?Which purpose does block and parish?How does the international classification of nursing practice Icnp help nurses deliver effective care to clients?

    Community Health Center Week

Community Health Centers are nonprofit, health care practices located in medically underserved areas that provide high quality, primary health care in a culturally appropriate manner to anyone seeking care.  In 2006, Connecticut Community Health Centers provided comprehensive, community-based, primary and preventative health care for over 230,000 persons.  Also known as Federally-Qualified Health Centers (FQHCs) or FQHC look-alikes, they are located in areas where care is needed but scarce, and they improve access to care for thousands of CT residents regardless of their insurance status or ability to pay. They offer services, such as transportation, translation, and culturally sensitive healthcare that many other providers do not.

Affordable: Community Health Centers are open to everyone, with sliding scale fees based on income and family size.

Appropriate: Community Health Centers offer primary health, oral and mental health/substance abuse services, and preventive health care, as well as supportive services such as translation, transportation, case management, health education, and social services.

Accessible: Services that include primary and preventive care, outreach and dental care, must be available to all residents of their service areas to help ensure access to care and continuity of care.

Accountable: A community board, the majority of whose members are patients of the health center, governs Community Health Centers.

For a history of Community Health Centers, please link to the HRSA, Bureau of Primary Health Care, Health Center Program Expectations page : ://bphc.hrsa.gov/policy/pin9823/

What Services do Community Health Centers Provide?

Community Health Centers offer core health care services, either directly or though a contractual arrangement, including:

    Preventive and Primary CareDiagnostic services (lab and x-ray)Family PlanningPrenatal and Perinatal CareWell child care and ImmunizationsScreening for elevated blood levels, communicable diseases, and cholesterolEye, ear and dental screening for childrenPreventive dental servicesEmergency medical and dental servicesHospitalizationPharmacy services

Who receives health care services Community Health Centers?

In Connecticut, Community Health Centers provide health care to anyone who needs it, regardless of income or insurance status.

    Health centers serve as the family doctor and medical home for over 230,000 patients or 6.6% of the CT population who receive care over 110 sites in rural and urban areas across the state.

    More than three out of four (77%) health center patients have family incomes under 100% of the Federal Poverty Level ($19,350 per year for a family of four).

    Forty-nine percent (49.5%) of health center patients are Hispanic/Latino, 24% are African American, 24% are White, and 2.1% are Asian/Pacific Islander.  More than 85,698 (40%) are best served in a language other than English.

    Nearly half (46%) of health center patients are Medicaid beneficiaries and 28% are uninsured.

For more details, please link to CT CHC Data page.

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History of  Connecticut Community Health Centers

The State of Connecticut has long recognized the need to provide comprehensive primary health care services for the medically underserved.  Community Health Centers (CHCs) have been the critical source of health care for the poor, underserved, vulnerable, and risk for poor health status, in many communities throughout the state for almost 40 years. 

CHCs were first funded by the Federal Government as part of the Johnson administration’s War on Poverty in the mid 1960s. Initially named neighborhood health centers, these clinics were created to provide health and social service access points in poor and medically underserved communities and to promote community empowerment.  In return for providing needed medical care and enabling services, Community Health Centers received federal funds for start-up costs and received operating subsidies that allowed them to function in environments where most patients had limited means to pay for care.  By the early 1970s, about 100 neighborhood health centers had been established under the Economic Opportunity Act (EOA).  In 1975, Congress enacted legislation that authorized neighborhood health centers as “Community Health Centers”.  In the 1970’s, prior to the dissolution of the EOA, the health center program was moved to the US Dept, of Health & Human Services (DHHS).  Within DHHS, the Health Resources & Services Administration (HRSA), Bureau of Primary Health Care (BPHC) currently administers the program.

In 1989, Congress passed Section 4161 of the Omnibus Budget Reconciliation Act (OBRA), which created the special designation of Federally Qualified Health Centers (FQHC), thus the use of the acronym FQHC, often used to describe Community Health Centers.  OBRA made federally qualified health center services required services under Medicaid.

Health Centers refer to all the diverse public and non-profit organizations and programs that receive federal funding under Section 330 of the Public Health Service Act, as amended by the Health Centers Consolidated Act of 1996 and the Safety Net Amendment of 2002.  They include community health centers, migrant health centers, health care for the homeless health centers, primary care public housing health centers and school based health centers. Federally Qualified Health Centers that do not receive Section 330 funding may receive FQHC Look-Alike status if they meet a majority of the FQHC program requirements.

Today, federally qualified health centers serve over 14 million individuals and families annually in 50 state and territories.  In Connecticut, there are 10 Federally Qualified Health Centers and three Federally Qualified Health Centers look-a-likes who serve 230,000 patients annually over 110 sites throughout Connecticut. Among the 10 FQHCs, six receive funds to support health care for the homeless health centers, two receive funds for school based health centers, and one receives funds for primary care public housing.

The first Community Health Center to receive federal funds for start-up costs was established in Connecticut in 1968.  The following table shows the history of the establishment of community health centers in CT.

Community Health Center Timelines

Date*CHC TimelineYear FQHC Status Rec'd.

1877

United Community & Family Services 

FQHC Look-Alike in 2002

1910-1920

Health Center Model Utilized

1930s

Health Center Concept Faded

1965

First Neighborhood Health Center Funded

Medicaid Program Enacted

1968

Hill Health Center - 1st FQHC in CT

FQHC in 1968 

1970

Community Health Services, Inc.

FQHC in 1989 

1971

Fair Haven Communirty Health Center, Inc.

FQHC in 1980 

1972

Southwest Community Health Center, Inc.

FQHC in 1976 

1972

StayWell Health Center, Inc.

FQHC in 1994 

1972

Community Health Center, Inc.

1977

Bridgeport Community Health Center, Inc.

(Now known as Optimus Health Care, Inc.)

FQHC in 1990 

1979

Charter Oak Health Center, Inc.

FQHC in 1979 

1984

Generations Family  Health Center

FQHC in 1992 

1989

Connecticut Primary Care Association

1996

East Hartford Community Healthcare, Inc.

FQHC in 2002 

1999

Norwalk Community Health Center, Inc.

FQHC Look-Alike in 2000 

2004

Community Health & Wellness Center of Greater Torrington

FQHC Look-Alike in 2006 

 

*Date center became established or operational

For a history of Community Health Centers, please link to the HRSA, Bureau of Primary Health Care, About Health Centers:  Health Center Program History page: ://bhpr.hrsa.gov/kidscareers/community_hc_program.htm

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Understanding Federally Qualified Health Centers  (FQHC)

Federally Qualified Health Centers (FQHC) are health centers that receive Public Health Service (PHS) Act, Section 330 funds, and provide primary care services in underserved, urban and rural communities.  FQHC is a federal designation from the U.S. Dept. of Health & Human Services, Health Resources & Services Administration (HRSA), Bureau of Primary Health Care (BPHC), and the Center for Medicare and Medicaid Services (CMS) that is assigned to private non-profit or public health care organizations that serve predominantly uninsured or medically underserved populations. 

The primary purpose of Federally Qualified Health Centers is to expand access to primary health care for uninsured and underserved populations, who experience financial, geographic or cultural barriers to care and who live in or near federally designated health professional shortage areas (HPSAs) and medically underserved areas (MUAs).  FQHCs are also called Community/Migrant Health Centers (C/MHC), Community Health Centers (CHC) and Section 330 Funded Clinics.

To meet federal requirements, a FQHC must meet certain statutory requirements specified by the Bureau of Primary Health Care for funding authorized by Section 330 of the Public Health Service Act.  

These five essential elements differentiate them from other providers.  A FQHC must:

    Be located in a federally designated medically underserved area (MUA) or serve a federally designated medically underserved population (MUP);

    Provide comprehensive primary care services, referrals, and other services needed to facilitate access to care, such as case management, translation, and transportation;

    Provide services to all in the service area regardless of ability to pay and offer a sliding fee schedule that adjusts according to income.

    Have nonprofit, public, or tax exempt status;

    Have a governing board, the majority of whose members are patients of the health center.

The Section 330 Grant Program is subdivided into separate grant competitions thereby allowing communities to tailor applications to their particular need. They include Community Health Centers, Migrant Health Centers, Health Care for the Homeless, Federal School Based Health Centers, and Public Housing grantees.  The BPHC also reviews applications from health centers that are seeking to qualify as a FQHC- Look-Alike because they meet the statutory requirements for these programs but do not receive Section 330 grant-funding.

Under the FQHC program, health centers are automatically eligible for certification as a Medicare and Medicaid FQHCs, receiving cost-based reimbursements for Medicaid and Medicare patients.

For more information on FQHC and Look-Alike Programs, please link to the HRSA, Bureau of

Primary Health Care, Health Center Program Expectations page:

://bphc.hrsa.gov/policy/pin9823/

For more information about MUAs and MUPs, please link to the DPH Health Professional Shortage Areas page: ://www.ct.gov/dph/cwp/view.asp?a=3132&q=388118

Uniform Data System (UDS)

The Uniform Data System (UDS) is a nationally recognized method of reporting patient data to the Health Resources & Services Administration (HRSA), Bureau of Primary Health Care (BPHC).  The BPHC requires that all Section 330 health centers submit data electronically each year.  Aggregate information on health center patients, staff size, and composition, utilization, financing and other characteristics is available through the Uniform Data System (UDS) on a calendar year basis.  FQHC Look-Alikes and tribal FQHC are not required to report data to the BPHC and do not participate in the UDS.  In Connecticut, there are (10) FQHCs that submit data on an annual basis to HRSA and three (3) FQHC Look-alikes that are not required to submit data.

For more information on UDS, please link to HRSA, Bureau of Primary Health Care, Health Center Data, Uniform Data System (UDS) website: ://bphc.hrsa.gov/uds/

Community Health Center Requirements

Federally Qualified Health Centers (FQHC) must comply with Section 330 program expectations/requirements and all applicable federal and state regulations.  All FQHC are required to provide the following services directly or through a written contractual agreement:

    Primary Care

    Dental

    Mental Health

    Substance Abuse

    Diagnostic Lab and X-Ray

    Prenatal and Perinatal

    Cancer and Other Disease Screening

    Blood Level Screenings

      Lead Levels

      Communicable Disease

      Cholesterol

Well Child Services

Child and Adult Immunizations

Eye and Ear Screening for Children

Family Planning Services

Emergency Medical

Pharmacy Services

Case Management

Outreach and Education

Eligibility/Enrollment Services

Transportation and Interpretation

Referrals to Specialty Providers and Hospital Services

FQHC clinical services requirements include:

    FQHC provide “A “Continuum of Care”. Patients must have access to all required services, access to specialty and hospital services, and after-hours coverage.The Health Center location must be physically located on or near a major road or public transportation stop to ensure accessibility.The Health Center hours of operation must facilitate access to care by having early morning, evening or weekend hours.The Health Center must ensure the appropriate mix of services for the target population to minimize duplication of services and maximize financial resources.The Health Center should have written agreements with other service providers for those required services not directly provided by health center.FQHC must establish and update health care goals and objectives to address the highest priority of health care needs of patients.The Health Center must have a Medical Director that supervises all clinical activities and medical doctors that are licensed and residency trained.  Other clinicians must have appropriate licensure.  

To receive Section 330 federal funding, a Community Health Center must meet the program expectations of the Bureau of Primary Health Care.  These expectations describe aspects of organizational structure and processes that are associated with successful health center programs.  Every CHC should have a sound infrastructure able to respond to the needs of its community within the constraints of its resources, and should develop processes and procedures designated to ensure the provision of high quality services supported by strong management and governance.

The four parts of the program expectations are as follows:

1.  Mission and Strategy

Community Health Centers are required to address the importance of adapting to health care trends and remain financially viable, while fulfilling the health center mission of providing preventive and primary care services. 

2.  Clinical Program/Health Services

Community Health Centers are required to operate a system of care that ensures access to primary and preventive services as well as facilitate access to comprehensive health and social services.  Services must be responsive to the defined health care needs and culture of the community.

3.  Governance

Community Health Centers are required to have a board of directors, which assumes full authority and oversight responsibility for the health center.  The board of directors, 51% of whom must be consumers of the health center, should govern within the context of a long-term strategic mission and goals, as well as an annual operating budget. 

4.  Management and Finance

Community Health Centers are required to have a management team that implements the health centers’ mission and strategic objectives.  Strong personnel, financial, information and clinical systems must support the health center management.

For more information on FQHC and Look-Alike Programs, please link to the HRSA, Bureau of Primary Health Care, Health Center Program Expectations page:

://bphc.hrsa.gov/policy/pin9823/

Community Health Center Week

Each year, the second week of August is a special week dedicated to recognizing the services and contributions of Community, Migrant, Homeless and Public Housing Health Centers, sponsored by the National Association of Community Health Centers, Inc.  In 2006, over 1,000 community health centers in the United States received federal funds.

For a list of the Community Health Center Week Events taking place in Connecticut, please link to the National Association of Community Health Centers webpage:

://www.nachc.org/default.cfm

 

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Which is the main focus of community health nursing?

The primary goal of community health nursing is to help a community protect and preserve the health of its members, while the secondary goal is to promote self-care among individuals and families.

What role is the nurse expected to have in a community based nursing practice if there is a sudden spread of malaria quizlet?

What role is the nurse expected to have in a community-based nursing practice if there is a sudden spread of malaria? As an epidemiologist, the nurse is responsible for community surveillance for risk factors such as the sudden spread of malaria.

Which purpose does block and parish?

What purpose does block and parish nursing serve in preventive and primary care services? Block and parish nursing provides services to older clients or those who are unable to leave their homes. Block and parish nursing provides primary care to a specific client population that lives in a specific community.

How does the international classification of nursing practice Icnp help nurses deliver effective care to clients?

The International Classification for Nursing Practice (ICNP) provides an agreed set of terms that can be used to record the observations and interventions of nurses across the world. ICNP also provides a framework for sharing data about nursing and for comparing nursing practice across settings. Tải thêm tài liệu liên quan đến nội dung bài viết What purpose does a community health center serve in preventive and primary care services?

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