Montana Primary Care Association

Congratulations to Community Health Partners Level 3 PCMH Recognition! Community Health Partners, serving Park and Gallatin Counties, has achieved PCMH (Patient Centered Medical Home) Recognition. The National Committee for Quality Assurance (NCQA) announced on Jan. 12, 2012,  that CHP was awarded NCQA PCMH Level 3 recognition. CHP provides high quality, affordable medical, dental and educational care to over 12,000 patients annually in both Gallatin and Park Counties, The Level 3 recognition represents the highest honor given to outpatient medical practices that must prove their adherence to a wide variety of standards that puts the patient in the driver’s seat of their healthcare. According to NCQA, the Patient Centered Medical Home is a health care setting that facilitates partnerships between individual patients, and their personal medical providers, and when appropriate the patient’s family. Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner. “We are thrilled that the hard work of our staff to create systems and workflows that put patients first has been recognized,” said Lander Cooney, CHP’s chief executive officer.  “This is how healthcare should be delivered and we will continue to take steps to improve the way we provide care to make the patient and family-centered health home our priority.” CHP has been working to achieve this recognition for two years and works collectively with its partners, such as Bozeman Deaconess Hospital and Livingston Healthcare, to provide services and programs for all of its patients, regardless of their ability to pay.  CHP operates medical clinics in Belgrade, Bozeman, Livingston and West Yellowstone and dental practices in Bozeman and Livingston.  CHP is a private, non-profit that serves all patients regardless of ability to pay, including those who have Medicaid, Medicare, Healthy Montana Kids, or private insurance, and offers services on a sliding fee scale for patients without insurance.

Like us on Facebook 2012 Brown Coding Webinars Coding Webinar Descriptions Coding Webinar Schedule Coding Webinar Registration Form

NEW Health Information Technology (HIT) page: The Montana Primary Care Association has entered into a valuable partnership with Montana's Regional Extension Center, Health Technology Services, to assist the community health centers in implementing, upgrading and utilizing electronic health records (EHR) to reach Meaningful Use. Click on the link to view the new page.   Facilitative Leadership Training! March 5th, 6th and 7th, 2012 (8:30 to 4:30 each day). Red Lion Colonial Inn, Helena Montana Participants will learn: Facilitating group conversations Leadership techniques for facilitating agreement Facilitating for action Inspiring respectful team interaction Helping teams toward solution-based interaction

UDS TRAINING RESOURCES – All latest resources on the Uniform Data Set including Nov. 3rd UDS Training Webinar information.

Montana CHCs Learn Even More about Patient Centered Medical Homes

On September 20-21, 67 Montana Community Health Center representatives and guests met at the Holiday Inn in downtown Helena for Part 2 of a three part training series on Patient Centered Medical Homes (PCMH).

Montana CHCs are using resources gleaned from The Safety Net Medical Home Initiative, (SNMHI),  sponsored by The Commonwealth Fund, Qualis Health and the MacColl Institute for Healthcare Innovation at the Group Health Research Institute.  The goal of this initiative is to help primary care safety net clinics become high-performing patient-centered medical homes using a model based on the SNMHI’s  Eight Change Concepts for Practice Transformation.

L-R Katie Coleman and Donna Daniel

The patient-centered medical home (PCMH) is a model of primary care delivery. In PCMH practices, patients receive well-coordinated services and enhanced access to a clinical team. Clinicians practicing in PCMHs use decision support tools, measure their performance, engage patients in their own care and conduct quality improvement activities to address patients' needs.

The PCMH model has the potential to improve clinical quality, improve patient experience and reduce health system costs.

The training series is structured around the Eight Change Concepts for Practice Transformation. "Change Concepts" are general ideas used to stimulate specific and actionable steps that lead to improvement. Primary care practices interested in becoming Patient Centered Medical Homes can go through these eight major changes to guide their clinic to transforming to a more 'patient-centered' clinic practice. The eight change concepts are:

Mark Horrocks, M.D.

1. Empanelment
2. Continuous Team Based Healing Relationships
3. Patient-Centered Interactions
4. Engaged Leadership
5. Quality Improvement
6. Enhanced Access
7. Care Coordination
8. Organized, Evidence-Based Care

Ed Wagner, M.D.

Paula Block, Clinical Coordinator for Montana Primary Care Association led the group. Experts invited to present at the conference included Dr. Mark Horrocks, medical director at Health West in Pocatello, Idaho; Dona Daniel, Ph.D, Director of Technical Assistance, Safety Net Medical Home Initiative Qualis Health; Katie Coleman, MSPH, Research Associate, McColl Institute for Healthcare Innovation, Group Health Research Institute; and Ed Wagner, M.D., MPH, director, MacColl Institute. Presentations were also given from Montana CHC clinics moving toward PCMH including RiverStone Health of Billings, Community Health Partners of Livingston, Bullhook CHC in Havre, and Northwest CHC in Libby. Julie Wood, medical director from Cascade Community Care Clinic and Helen Amundson, Operations Manager of Cooperative Health Center in Helena helped the group to understand their models of behavior health integration into primary care delivery. For more information about the Safety Net Medical Home Initiative, see http://www.qhmedicalhome.org/safety-net/index.cfm.   To learn more about the Montana Community Health Center Initiative, contact Paula Block at .

Lander Cooney Presents to the Select Committee on Efficiency in Government

At their first meeting last month, the Montana Interim Select Committee on Efficiency in Government heard from key health leaders regarding  “Perspectives on Medicaid: Charting a Solution for Montana.” Senator Mary Caferro (D-Helena) was the moderator of a panel that included Bob Olson, MHA; John Goodnow, CEO Benefis Health System, Great Falls; Sheila Smith, Director, Stillwater Therapeutic Services, Kalispell; Lander Cooney, CEO, Community Health Partners; and Cindy Romesha, Medicaid beneficiary.

Lander Cooney provided general information and statewide data to the committee about Montana’s health centers. She reviewed the history of the Livingston center and its expansion to Bozeman, Belgrade, and West Yellowstone. Lander based much of her presentation on the principles of the CHC model – access, respect, better health outcomes, improved patient experiences, and how health centers lower healthcare costs. She reviewed the results of the Colorado Department of Health Care Policy and Financing which compared the use of hospital-related services by Medicaid patients whose usual source of care was a private, fee-for-services provider to those Medicaid patients whose usual source of care was a CHC. The study, she told the committee, found that the CHC users were about one-third less likely than the other group to have ER visits and preventable hospitalizations.

Lander also described the Medicaid Health Improvement Program (HIP) and told the committee that Montana is receiving national attention for its innovative approach. “In an effort to design a new program that could use a whole person perspective, address the unique rural and cultural needs of this state, and give a voice to those without a voice,” Lander said, “DPHHS worked with the Montana Primary Care Association to design a new care management system.” Lander reported that the program, which included CHCs, was 10% less expensive than the previous care management contract, and that a study of 6 months of claims data from 2010 showed a conservative estimate of over $500,000 in savings.

Lander told the committee how Community Health Partners (CHP) implements strategies to address root causes of poor health – education level, income, housing, transportation, and others. CHP sites integrate literacy and educational programming within the health center services wherever possible. The Livingston site, she said, hosts a robust parent, early childhood, and job skills education program which includes the community’s adult basic education program. Last year, 40 students earned GED’s at the Livingston CHC and, in contrast, Park High School graduated 110 students. “Promoting the importance of early literacy and school readiness is one of the most effective preventive health strategies,” Lander said.

Lander’s presentation was well-received by members of the audience. Kristianne Wilson, of Billings Deaconess Clinic, said that most people in Montana do not understand the broad scope of health center services and the support centers provide to their communities.

Sweet Medical Center Sponsors Successful Fundraiser

Sweet Medical Center raised $5,557 at its annual fundraiser before expenses with about 220 people paying their $5 entry fee and dozens of volunteers and contributors pitching in.

“Our staff put together a really fun event,” Executive Director Jared Payne said. “Taking into consideration the hours committed with the in-kind donations, gate, raffle, and other cash donations, the fundraiser was among the most profitable for Sweet Medical Center.”

The Saturday afternoon of games, music and barbecue for the family, raffle tickets and live auction for the acquisitive and tours of the remodeled clinic for everyone was blessed with sunshine and a cooling breeze. The trees, building and marquees provided shady comfort for those less enamored of the sun.

The music was nonstop, clinic Executive Director Jared Payne said, with seven quality local performers and groups taking the stage: Dr. Joe Nemes, The Halingstad Family, Ken Overcast, Willie Hellman, The Baird Family, Michele Bilodeau, and Sharaya Payne.

Games for the children included the fishing booth, hoop shoot, face painting, duck pond, Hula-Hoop bubbles, pie throwing contest and spin-a-prize.

Food and cooking donations also helped keep costs down:

• Ken McHenry provided the grill and did the barbecuing;
• Bear Paw Meats donated 200 hamburger patties;
• Lincaire also helped with the barbecuing and donated $400 toward the barbecue;
• Finley’s donated the burger fare;
• Albertsons donated the dinnerware;
• The Turner Colony donated 200 homemade hamburger buns.

The raffle winners were: Lou Ann Paulson, who won an iPod Touch; Barb Sather, who won a Sony Reader, and Ann Davies, who won a camping package.

“We are going to hit it again next year with a similar venue,” Payne said. “We will be evaluating the outcomes and process for an even better event next year!”

How Healthy is Your County?

2011 County Health Rankings Available:

The Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute released the second annual County Health Rankings on Wednesday. Counties were ranked within their state according to their health outcomes (such as mortality and morbidity) and health factors (such as healthy behaviors, socio-economic factors, clinical care, and physical environment) in hopes to advocate for community health interventions. Visit http://www.countyhealthrankings.org/ to view all of the rankings by state.

Community Health Center Dentist Tells it Like it Is.

Practicing Dentistry in a Community Health Center in Montana
Joanna Wales, D.D.S.

Earlier this year, I made the monumental decision to leave private practice in order to work for Community Health Partners and practice dentistry in Livingston.  I had been in private practice for nine years, seven of which were spent in Bozeman building a practice of great patients whom I enjoyed.  I felt frustrated, however, at the confines of the for-profit, production driven model of dentistry and wanted to work in a non-profit, community health center setting.  As you can imagine, the past five months have been filled with both challenges and rewards.

Thinking about an underserved population in theory is much different than actually working with them.  I have been awakened to the prevalence of mental illness in our society.  I am continually shocked at how rampant dental disease is among the underserved.  I was simply unaware of the numbers of people with chronic periapical and periodontal infection who have just learned to deal with pain.  I have met teenagers who are already missing several of their permanent first and second molars and young adults who are missing maxillary anterior teeth.  I have heard countless stories of job loss, death of spouses, catastrophic injury or illness, or simply retirement and the subsequent inability to pay for dental care.

Much of how I practice dentistry is the same as when I was in private practice.  I encourage people who come in for an emergency to return for a comprehensive exam.  I perform risk assessment during comprehensive exams and educate patients of their biomechanical (caries, structural compromises), periodontal, and functional (occlusion, TMJ disorders) risk factors.  I encourage patients to complete their treatment plans. (In the past six months our clinic has averaged an 80% completion of 6-month treatment plans.)  Just as in private practice, our goal is to help patients attain a functional, stable dentition.

Some of what I do, however, is very different.  Quadrant dentistry has become much more difficult because the complexity of direct restorations is increased.  I have placed more 4 and 5 surface fillings in the last five months than in all of my nine years of private practice.  I have also extracted what for me is a great number of teeth.  300 teeth in five months is definitely more than I either extracted or even referred for extraction in my previous nine years of private practice.  Dental emergency appointments are a daily occurrence.  It is difficult to balance how to provide the best care for the greatest number of patients.

What do I love about my job?  What do you love about yours?  The patients!  While I was hoping for a sense of contribution to my community, I didn’t expect the inspiration I feel at many of my patients’ stories.  To see the many adversities that my patients face has been a daily reminder to be grateful for what I have and deepens my sense that “To those whom much is given, much is expected.”

If you have a Community Health Center in your area and haven’t done so already, I would encourage you to meet and talk with the clinic’s dentist.  Our practices share many similarities as well as differences.  It is my hope that Community Health Centers can work in partnership with local private practice dentists and not be seen as adversaries.  We can work together to address the many problems facing both our profession and our communities.

Health Center Program Terms and Definitions (pdf)

Where to find information about the Federal Tort Claims Act (FTCA)

• Federal Tort Claims Act (FTCA) Health Center Policy Manual (pdf)

How to Apply for a Federally Qualified Health Center Look-Alike

• http://bphc.hrsa.gov/policiesregulations/policies/fqhclookalikes.html

••••• PAST NEWS •••••