NEW HHS WAIVER WILL HELP CITY REBUILD COMMUNITY CLINICS
Low-income, uninsured residents of Louisiana, many of whom are still struggling to rebuild their lives five years after Hurricane Katrina, will continue to have access to community health clinics, regardless of their ability to pay, under a program announced today by the U.S. Department of Health and Human Services Secretary Kathleen Sebelius.
Funding for a system of public and non-profit clinics will flow from a three-year $97.5 million Medicaid demonstration, the “Greater New Orleans Community Health Connection.” This waiver will replace a post-Katrina stabilization grant set to expire at the end of this month.
“Five years ago Hurricane Katrina completely shattered the health care delivery system in New Orleans and the surrounding area,” Sebelius said. “The infusion of funds from an earlier HHS grant gave the city a chance to replace the old, institution-based system with more community based clinics that offer better access to those who rely upon them.
“This community-based model captures many of the elements our nation is seeking in improving access and quality of care and warrants a look by policy makers as an innovative delivery solution that should be continued and replicated,” she added. .”This waiver was made possible due to the strong advocacy of Senator Mary Landrieu, who has been a tireless advocate for finding innovative ways to help the people of New Orleans, Congressman Charlie Melancon, and other members of Louisiana’s congressional delegation.”
Prior to the storm, the Kaiser Family Foundation reports that nearly 90 percent of uninsured residents relied heavily on two large public hospitals that were lost during Katrina. After the storm, HHS approved a $100 million Primary Care Access and Stabilization Grant (PCASG) that allowed the greater New Orleans area to expand community-based clinics from 67 prior to the storm to 93. The clinics provide a full range of services from primary care, behavioral health care and dental care. To improve access, some health providers operate out of mobile clinics and school-based health centers.
Among the accomplishments of the new community-based clinics are:
• These organizations now care for over 175,000 individuals in the New
Orleans area annually, and provide services to nearly 76,000 of the region’s uninsured population each year, many of whom come from working families.
• The total number of individuals served has increased by 13 percent every six months since March 2007 for outpatient primary and behavioral health care.
• Fourteen of the 25 organizations, representing 40 clinic locations, have been recognized by the National Committee on Quality Assurance (NCQA) as Patient Centered Medical Homes.
Individuals eligible to receive services under the grant include individuals who have been uninsured for at least six months; between 19-64 years old; not pregnant; not eligible for Medicaid or the Children’s Health Insurance Program (CHIP) and have a family income up to 200 percent of the federal poverty level, or $44,100 for a family of four. Individuals must also be a resident of the Greater New Orleans region and U.S. citizens.
“This program has responsibly and quickly built access to quality primary care and mental health services through a highly collaborative public-private partnership,” said Cindy Mann, deputy administrator and director of the Center for Medicaid, CHIP, Survey and Certification for the Centers for Medicare & Medicaid Services, the agency that will administer the 1115 demonstration. “The decentralized payment system has encouraged team-based care and innovation.”
The new Section 1115 demonstration will run until Dec. 31, 2013. During the life of the demonstration clinics will begin to strengthen their fee-for-service billing capabilities to ensure continuing revenues from Medicaid and health insurers (including, in 2014, insurers offering coverage to low-income individuals through state health benefit exchanges). The goal of the waiver is to bring financial stability to these much needed community clinics.