Michigan is expanding access to health centers to improve healthcare for residents. With funding from foundations, 11 community development grants were awarded to build or renovate health center sites. This will generate $3.6 million annually in federal funding for expanded services. The expansion aims to serve more of the 600,000 residents who rely on health centers for care, and reduce health costs by increasing access to primary care.

1. Health Center Expansion
in Michigan
Michigan Primary Care Association
Michigan Health Center Capital Development Program
With funding from the Kresge Foundation
Neal Colburn
Director of Capital Development
Michigan Primary Care Association
www.mpca.net

2. What is a Health Center?
 Federally Qualified Health Centers
◦ Established 45 years ago
◦ Serve designated medically underserved areas; populations
◦ Governed by volunteer nonprofit boards (501c3)
 51%+ HC patients representing those being served
◦ Provide comprehensive, integrated primary care
 Medical, dental, behavioral health, preventive and referral services
◦ Provide ‘enabling services’ enabling access effective use of
services
 Translation, health education, case management & benefit assistance etc.
◦ Provide services to all; adjusting fees to ability to pay
◦ Meet strict federal performance & accountability requirements
 Clinical quality, administrative, financial

3. Faces of Michigan Health Centers

4. Increased Access to Health Care
 Nearly 600,000 Michigan residents rely on health
centers as their health care home
◦ 32 Michigan health center organizations; 190 clinic sites
◦ Nationally, over 20 million health center patients receive
health center services annually
 The MPCA/MDCH Strategic Plan
◦ MI access goal: 1.1 million patients; 40% of <200% FPL
◦ Five year growth estimate: +240,000 patients
 SE MI area: 8 health centers with 29 clinic sites
◦ Provide services to 100,000 patients annually and
expanding
◦ 8 FQHCs receive annual grant funds; (2 recently funded)
◦ 1 FQHC Look-Alike (3 sites) & 1 Indian Health Service Clinic
(These are eligible to apply for FQHC funding )

5. 32 Health Centers
provide care for nearly
600,000 residents
at over 190 delivery
sites across Michigan
3 additional Health Center
organizations funded in 2012
6 new delivery sites

6. Michigan’s Health Challenge
 High rates of obesity (32%); diabetes; asthma…
 High infant mortality/low birth weight rates
◦ 7.1/1,000 infant mortality; 8.5% low birth weight rate
 Shortage of primary care doctors, LPNs, PAs etc.
 1/4 of children live in families with incomes below poverty level
◦ Detroit: over 1/3 live in families with incomes below poverty &
over 1/2 below 200% of poverty level
 39% of Michigan’s population is below 200% of poverty level
 In Michigan, over 60% of health center patients are uninsured or
covered by Medicaid, Medicare or other public programs
 In Detroit, over 90% of health center patients are uninsured or
covered by Medicaid, Medicare or other public programs

7. Complex
health
needs
Uninsured,
Underinsured
Poverty

8. FQHC Expansion Initiative
 Collaborative efforts to expand access; ACA
◦ MI Primary Care Association & MDCH
◦ Detroit Wayne County Health Authority & FQHC Council of SE MI
◦ Foundations
◦ Kresge Foundation funding of MPCA MI Health Center Capital Development
Program
 Foundation grant funding (grant writing; training; TA)
 Potential FQHC grant applicants identified & encouraged
 Training & technical assistance (TA) provided
 Nine (9) planning grants awarded (Two [2] in Detroit area)
 Eleven (11) community development construction &
renovation grants awarded (Five [5] in Detroit area)
 Six (6) New Access Point (NAP) awards (Three [3] in Detroit area)
◦ Over an additional $3.6 million annual HRSA funding

9. Partnerships & Collaboration

11. Program Value Opportunity
 Full range of FQHC services provided at 3 new sites
 Annual FQHC NAP award: $3.6M annually, plus:
◦ 6 health centers received$3,663,021 in federal grant funds
(@16.65% of typical budget; +$22M in annual FQHC operational budgets)
◦ Eligible for special Medicaid/Medicare bundled rates
◦ Eligible for future funding: service expansion; capital funding
◦ Eligible for National Health Services Corps doctors, LPNs etc.
◦ Eligible for FTCA malpractice coverage (like military coverage)
◦ Well positioned to apply for additional programs; HIV, PCMH, IT
 FQHCs save money
◦ 24% of global healthcare cost reduction
 Over $100 million, 2010 Michigan Medicaid savings
 Michigan FQHC economic benefit $½ Billion (NACHC 2009)

12. Increase Reduce Generate
Access to Health Economic
Care Care Costs Benefits

13. Michigan Health Center Capital
Development Program
 Established by Michigan Primary Care Association
(MPCA) with funding from the Kresge Foundation
 Provides technical assistance, consultation,
financing and fund raising to FQHCs
 27 MI FQHC capital projects: over $50 million
◦ Eleven (11) MI FQHC projects awarded $19,600,806
 (5 construction projects; 6 renovation projects; )
◦ Four (4) awards in the Greater Detroit area: $3,257,000
 (1 construction project; 3 renovation projects - 2 in Detroit)
 Additional projects continue in development
 Public and private grant funding and finance
options are being actively sought

16. HRSA Immediate HRSA New Access Point
HRSA Building Capacity
Facility Improvement Grant Awards
Awards
(May 1, 2012) Awards (June 2012)
(May 1, 2012)
Downriver Downriver
Covenant Community
Community Community
Care
Services Services
$868,750
$1,887,000 $490,000
Family Health
Center of Baldwin Family Genesee County
Battle Creek Health Care, Inc. Community Mental
$3,000,000 $500,000 Health
$608,333
Family Medical
Covenant
Center of Michigan Cherry Street Health
Community Care
$5,000,000 Services
$500,000
$566,667
Detroit
Cassopolis MidMichigan
Community Health
Family Care Community Health
Connection
$4,400,000 Services
$473,756
$319,271
East Jordan Family Cherry Street
Health Center Health Services
$2,480,050 $500,000 Wayne County Health
& Human Services
$650,000
Western Wayne
Family Health
Centers The Wellness Plan
$370,000 Medical Centers
$650,000

17. Program Value Opportunity
 Affordable Care Act (ACA)
◦ Upheld by the Supreme Court
◦ Medicaid expansion is optional by state; federally funded
 ACA reduction in uninsured = potential for FQHC expansion
◦ MI: potential $50M additional annual FQHC operational revenue
◦ Wayne County: potential $10 million additional annual revenue
 Massachusetts expansion - primary care overwhelmed
◦ Resulted in reduced access to appropriate care; delayed care
◦ Inappropriate use of hospital emergency departments and other
hospital services
◦ Diminished population health benefit; increased cost to all parties
 MI expansion needed; increase in FQHCs desperately needed

18. Emerging Needs
 Primary Care Medical Facilities; PCMH (2013 project starts)
◦ New; expanded; renovated
◦ Pre-development (Construction & renovation projects)
 Project planning: architects, site selection; space planning; builders, developers,
project management etc.
 Financial planning: financial analysis, finance plan, financing & fundraising
◦ Construction; renovation and completion
 Interim initial & operational funding (2014 Medicaid expansion)
◦ Expansion of medical staff to expand capacity
 Recruitment needed in 2013 (July & August end of residency)
 Recruitment expenses
◦ Expansion of benefit assistance personnel
 Medicaid enrollment assistance
 Conversion assistance of auto-assigned to appropriate providers & plans
◦ Expansion of outreach staff
 Identify, approach and encourage eligible populations
 Work with community organizations; churches etc.

19. Facilities
Emerging Needs
Funding
Staff
Staff

20. Questions?
For further information, please contact:
Neal Colburn
Director of Capital Development
Michigan Primary Care Association
(517) 827-0472
ncolburn@mpca.net
www.mpca.net
Our mission is to promote, support and develop comprehensive,
accessible and affordable community-based primary health care
services to everyone in Michigan.