Required and Additional Services: Community Health Center (CHC) provides all required primary, preventive, enabling health services, and additional health services as appropriate and necessary, either directly or through established written arrangements and referrals. (Section 330(a) of the PHS Act)
A primary resource for understanding Health Center Program Requirement 2: Required and Additional Services can be found in HRSA’s resources for Health Center Program Requirement 16: Scope of Project, which details the services a CHC provides to patients and how these services are delivered. In particular:
- Services Descriptors for Form 5A: Services Provided outlines the general elements for all required and additional services, including detailing what the minimum is for a required service. As well, this document cites the statute and regulation behind why a particular service is required as part of the Health Center Program.
- Service Deliver Methods for Form 5A outlines how a CHC may provide access to a service within the CHC or by a formal referral arrangement in which the CHC covers a portion or all of the cost for any services provided, or by a formal referral arrangement where the CHC does not cover the cost of the service. In all cases, a CHC should ensure that it is complying with PIN 2014-02: Sliding Fee Discount and Related Billing and Collections Program Requirements.
- Details about how CHCs are reviewed for compliance with this requirement are found on pages 4 through 6 of the Health Center Site Visit Guide.
- Due to the fact that access to pharmacy services is a required services, CHCs should consider participating in the 340B Drug Pricing Program. Further resources related to this program can be found in the 340B section of CCHN’s Online Resource Center.
The Illinois Primary Health Care Association explored this requirement in detail in Examining Requirement 2: Required and Additional Services, which explores provides a description of this requirement and performance improvement suggestions.
Dental Health Resources:
Operations Manual for Oral Health: Published by the National Network for Oral Health Access (NNOHA), this manual consists of six chapters on a range of topics covering the basics of operating a CHC Dental Program.
Dental Program Management Resources: Offered by the National Network for Oral Health Access (NNOHA), this web page offers resources on oral health program start up and expansion, health information technology, and financial management.
Dental Forms Library: Offered by the National Network for Oral Health Access (NNOHA), this website shares forms that safety net clinics nationwide have shared with NNOHA for dental program use. Forms are available in these categories: consent forms, dental practice policies and procedures, guidelines and instructions, human resources, and quality.
“Oral Health: An Essential Component of Primary Care:” Published by Qualis Health, this white paper outlines a framework for integrating oral health into primary care settings.
“Integration of Oral Health with Primary Care in Health Centers: Profiles of Five Innovative Models:” Published by the National Association of Community Health Centers (NACHC), this report describes the importance of integrating oral health with primary care, and outlines successful CHC integration models from around the country.
The Oral Health Integration Manual: provides information about successful methodologies for integration of oral health into a CHC. The manual details barriers and solutions, challenges and successes, and provides a framework for oral health integration. The framework and concepts posed therein are largely based upon the patient centered medical home standards for integration of care: a natural complement to the work Colorado CHCs have already embarked upon. The manual is comprised of six sections:
- Role of Leadership
- Team-Based Care
- Patient Centeredness
- Transformative Access
- Community Resources and Partnerships
Continuity of Care Resource:
Cancer Survivorship E-Learning Series: Launched in April 2013, The National Cancer Survivorship Resource Center’s E-Learning Series is designed to heighten the awareness of the ongoing needs of cancer survivors and gives primary care providers free continuing education credits with first-hand patient experiences, presentations by national leaders on survivorship issues, and case studies. The goals of the series are to: To provide information on how to tailor care to cancer survivors and to teach primary care providers the skills they need to provide follow-up care for cancer survivors.
Special Populations Resources
- CDC Steadi Toolkit for Falls Prevention in Older Adults: CDC’s Injury Center created the STEADI Tool Kit for health care providers who see older adults in their practice who are at risk of falling or who may have fallen in the past. The STEADI Tool Kit gives health care providers the information and tools they need to assess and address their older patients’ fall risk
- Prevention and Training Center National HIV Resource: Key STD clinical resource
- List of Colorado Providers offering HIV treatment by region
- Health Resources and Service Administration (HRSA) offers a variety of special population resources ranging from clinical care to public housing programs.
- NACHC Ag Worker Access 2020 Campaign: NACHC has just established a Learning Community for the Ag Worker Access 2020 Campaign on My NACHC Learning Center. This is a way for you to learn all about the Ag Worker Access 2020 campaign to locate materials and resources, upcoming training and webinars, effective community outreach strategies and learn what health centers, PCAs and other stakeholders are doing to increase access to care for farmworkers. The Ag Worker Access 2020 Learning Community is for anyone to join the campaign, learn from each other and network with your colleagues with an interest in improving care for farmworkers.It is easy and fast to get involved by following these easy steps:
- Migrant Clinicians Network (MCN) Health Network: provides services to facilitate continuity of care and treatment completion regardless of the patient’s physical location. Offerings include comprehensive case management, medical records transfer, and follow-up services for mobile patients.
Care Coordination Resource
Template for Memorandum of Agreement With Specialists: Template is available to provide an example of purpose, agreement and level of care consideration. This template may be edited and use for your needs.
Social Determinants of Health Resources
- “Community Health Centers Leveraging Social Determinants of Health” Handout: Institute for Alternative Futures: An abridged description of a newly released study from the Institute for Alternative Futures that discusses the ways in which CHCs are extending beyond the scope of medical care to include disparities that exist primarily within the social and culture aspects of patients’ lives.
- “Community Health Centers Leveraging Social Determinants of Health”: Institute for Alternative Futures: A 2012 study conducted by the Institute for Alternative Futures and supported by the Kresge Foundation that identifies current efforts on the part of CHCs to address the social, economic, and physical barriers to health care for its patient population. The report depicts the inclinations of the current health care system and offers successful methodologies used by CHCs to mitigate these obstacles.
- “Community Health Centers Leveraging Social Determinants of Health” Case Studies from the Institute for Alternative Futures: These supplemental case studies detail the current efforts of CHCs nationwide to address social determinants of health, using viable, tangible, and sustainable systems for diminishing disparities.
- Health Equity and Race and Ethnicity Data From the Colorado Trust: This report observes the importance and rationale behind collecting race and ethnicity data within health care, and offering practical solutions for doing so when limited data is available. The report discusses best practices for data collection, new federal requirements based upon the Patient Protection and Affordable Care Act and Culturally and Linguistically Appropriate Services, and ways to ensure CHC staff is successful in meeting these standards.
- The Patient Engagement Toolkit: is a resource for CHCs to gauge patient engagement. The toolkit presents qualitative and quantitative tools for the CHC to measure the patient experience and facilitate opportunities for patient engagement.
- Data for Quality: the first piece of the toolkit details how to design and implement a data for quality project at a Community Health Center (CHC).
- Patient Experience Data: the second part of the toolkit utilizes pieces of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey as a quantitative data collection mechanism for patient engagement.
- Patient Advisory Councils: this piece of the toolkit centers upon the development, implementation, and sustainability of Patient Advisory Councils at a CHC.
- Social Determinants of Health: the final section of the toolkit presents resources for increasing patient and staff understanding of social determinants of health.
- Social Determinants of Health Needs Assessment Tool: This tool may be used by CHC patients, whether or not the CHC has a PAC forum, to identify SDH barriers and assets within the CHC community. This tool may be disseminated electronically, in-person, or over the telephone.