Community Health Centers of Southern Iowa 2015 Annual Report

2015 annualCommmunity Health Centers of Southern Iowareport



Community Health Centers ofSouthern Iowa MissionCHCSI will make high quality health careaccessible to everyone in our region.

table of contents05 Letter to the Community06 Board of Directors and Center Leadership07 Providers08 Services10 Serving the Community11 Improving Patient Health12 Growing to Meet Patient and Community Needs14 2015 Iowa PCA Outstanding Provider of the Year15 Thank You to Our Partners16 Financials18 Locations I was happy when I finally found a dental clinic in Iowa that took Medicaid. I wasn't expecting to have the greatest experience I have ever had at a dentist! I was taken care of fast and efficiently. The staff was so nice and the friendly conversations I had with staff were just so welcoming. I have to drive quite a bit to get4 out to Leon, but it is worth it after the services I received today. Very thankful I can be a patient here. -TF

letter to the community There’s nothing better than havingOn behalf of the Community Health Centers of Southern Iowa Board co-workers whoof Directors, I am pleased to share with you our 2015 Annual Report. share your passionAs you will read in this report, CHCSI saw continued growth, provided for others. CHCSI isexceptional clinical care,and ended the year in a strong financial a great place to workposition.Investments were made to increase medical, dental, and and be part of a teambehavioral health services, and funding was secured to significantly that’s committed torenovate and expand our Leon clinic, which will allow us to add new making our communityonsite services such as pharmacy and mammography. a better place. IIn 2015, we also reached an organizational milestone by celebrating appreciate havingten years of service to the community. Since opening our doors as a an active role thatFederally Qualified Health Center in 2005, we have continued to extend provides challengesour reach in the community, and today our staff of nearly 100 operates that are fulfilling andsix locations and provides comprehensive primary and preventive also having accessservices to more than 7,000 patients each year. CHCSI also has the to staff developmentdistinction of being the only Iowa FQHC designated as a Community opportunities thatMental Health Center. promote professionalThe coming year promises to bring new challenges and additional growth. -BBservices to CHCSI. In 2016, the State of Iowa moves to Medicaidmanaged care. CHCSI has planned for this transition and is well- 05positioned to ensure all of our patients continue to receive high-qualitycare, while also maintaining our financial stability.Thanks to a grant received in March 2016 from the U.S. HealthResources and Services Administration, we will also increase ourefforts this year to fight the opioid abuse and addiction epidemic thathas spread across our region. This funding will provide us with muchneeded resources to treat opioid use disorders through medication andcounseling services.As I reflect on CHCSI’s growth over the last decade, I recognize mygood fortune to be part of an organization that continues to have atremendous impact on the lives of so many across the region. Thisimpact is only possible because of our dedicated and compassionatestaff members, the leadership of our Board of Directors, and ourcollaborative partnerships.Walking the halls of our clinics and talking with staff, board members,and patients, I am reminded each day of the important role we play insouthern Iowa and the responsibility we have to our patients and thecommunities we serve. In the coming year, CHCSI will continue ourcommitment to our mission of making high quality healthcare accessibleto everyone in our region.Samantha Cannon, CEO

board of directorsShirley Kessel Board Chair Sharon South Member Dien Judge MemberJanelle Anders Vice Chair Patricia Magle Member Mark Waits MemberRick Lindgren TreasurerWilliam Morain SecretaryAlan Wilson At-Large Rep.Marcy Biesemeyer MemberDave Daughton MemberRobert Kilgore Membercenter leadership Samantha Cannon Jodi Wharff, RN, BSN Janeen Boswell Sean SaxtonChief Executive Officer Clinical Director Chief Strategy Officer Chief Information OfficerAs a Charter Member of the Board of Directors of CHCSI, it has been supremely gratifying to watch our small,struggling startup grow into a vast network of multidisciplinary services. Especially under the recent leadershipof CEO Samantha Cannon and her management team, we have attained sound financial and professionalcompetence with an ever brighter future. -WDMWorking for CHCSI providing care for so many communities truly makes it feel like I’m working at/for home awayfrom home. - RD

providersNathan Allen, DO Deborah Anderson, RN, Jessica Bain, RDH Kevin Comer, LMSW LMSW, IADC, SAPEvelyn Conrad, LISW Courtney Cook, MA, Roshan Dasari, MD Richard Davenport, LMHC CRC, LMHCMatthew Dzak, Psy.D, Mark Easter, DO Jenifer Grissom, ARNP Melissa Groh, LMSW LMHC, LPCDennis Hartman, CADC Terrilee Jackel, ARNP Danielle O’Brien-Day, Larry Richard, MD LMHC, CRCJennifer Spoerl, ARNP Andrew Sullivan, PA-C John Young, MS, 07 LMHC, RPT

servicesCHCSI is a Federally Qualified Health Center that provides comprehensive primaryand preventive medical, oral health, and behavioral health services to individuals of allages, regardless of their ability to pay. We operate modern health care facilities andutilize electronic medical and dental records to better coordinate care and improveoverall quality of care for our patients.Medical • Primary and preventive health care, including: • Screenings - cancer, communicable disease, cholesterol and blood lead • Diagnostic lab and radiology • Voluntary family planning • Immunizations • Wellchild services • Gynecological care • Obstetrical care by referral • Vision • Chronic conditions health home • Tobacco cessation • DEXA bone density scanning • Sports medicine • Pharmaceutical services, including access to affordable medication through the 340B Drug Pricing Program • Case management • Eligibility assistance • Health education • Diabetic education • Weight management consultation • Outreach • Transportation • Translation and interpretationOral Health • Primary and preventive dental • Secondary dental • Emergency dental • Dental rehabilitation08

Behavioral HealthCHCSI is the only Iowa FQHC that is also a Community Mental Health Center. As such, we providecomprehensive mental health and substance abuse services. • Mental health counseling • Medication management • Psychological evaluation • Substance abuse counseling • Integrated Health Home for patients with serious mental illness or serious emotional disturbance your medical home CHCSI is proud to be recognized as a Patient-Centered Medical Home (PCMH) by the National Committee for Quality Assurance (NCQA). Our Lamoni clinic was recognized in June 2014 and the Leon clinic in March 2015. Both clinics achieved the highest recognition- Level 3. As a Level 3 PCMH, CHCSI demonstrates strong performance or significant improvement in performance measures across the national Triple Aim of better patient experience, better health, and lower per capita cost. The five pillars of PCMH are• A patient-centered orientation toward each patient’s unique needs, culture, values, and preferences; support of the patient’s self-care efforts; and involvement of the patient in care plans.• Comprehensive, team-based care that meets the majority of each patient’s physical and mental health care needs, including prevention and wellness, acute care, and chronic care and is provided by a cohesive team.• Care that is coordinated across all elements of a complex health care system and connects patients to both medical and social resources in the community.• Superb access to care that matches patients’ needs and preferences, including care provided after hours and by email and telephone.• A systems-based approach to quality and safety that includes gathering and responding to patient experience data, committing to ongoing quality improvement, and practicing population health management.

serving the community7,307 payor mixpatients served 21% self-pay 17% medicare 31% medicaid 31% private39,135 agetotal visits 23% self-pay 25% medicare17,844 medical 34% medicaid 18% private3,725 dental16,328 mental health1,168 substance abuse70 diabetic education31%of patients* are under 200%Federal Poverty Guidelines(*of those reporting theirincome status)10

improving patient health80% hypertension 80% of adults with hypertension have their blood pressure under control88% heart attack/stroke treatment 88% of adults with Ischemic Vascular Disease receive aspirin or antithrombotic therapy84% coronary artery disease 84% of with adults diagnosed with CAD have been prescribed a lipid lowering therapy100% asthma 100% patients aged 5-40 who have persistent asthma have an acceptable pharmacological treatment plan78% tobacco use assessment & counseling 78% adult patients who are tobacco users received counseling to quit tobacco use70% child health 70% children received age-appropriate vaccinations before their third birthday

growing to meet patient andcommunity needsMeeting the health care needs of our patients and the communities we serve byproviding quality medical, dental, and behavioral health services remains our highestpriority. In 2015, we continued to add and expand services to meet those needs.Leon Clinic ExpansionIn September 2015, the U.S. Health Resources and Services Administration awarded CHCSI a$999,999 grant to expand and improve our Leon clinic. This project will expand the lobby, adda medical exam room and a dental operatory, and will provide us with space to add an in-housepharmacy, mammography, and vision services. Renovations will begin by July 2016 and are scheduledto be completed by the end of the year.Expanded Clinic HoursTo accommodate our patients’ busy schedules, CHCSI added early morning and evening hours atour Leon and Lamoni clinics. The Leon clinic is now open Monday – Wednesday from 7 am to 7 pm,Thursday – Friday from 7:45 am – 5:00 pm, and Saturday 9:00 am – 1:00 pm and the Lamoni clinic isopen Monday and Tuesday from 8:30 am – 5 pm and Wednesday – Friday from 7 am to 7 pm.Expanded Medical ServicesIn September 2015, the U.S. Health Resources and Services Administration awarded CHCSI$241,284 to expand medical services by hiring an advanced registered nurse practitioner (ARNP), aphysician assistant (PA), and a care coordinator. Andrew Sullivan, PA-C (Lamoni), Jenifer Grissom,ARNP (Leon), and Shirley Richards, LPN (Leon and Lamoni) were hired to fill these positions.Funding was also used to purchase telepsychiatry equipment for the Lamoni facility to enhance ourbehavioral health services and allow for the provision of psychiatric services in all locations.Mobile Dental ClinicA mobile dental clinic was purchased with funding from Telligen, allowing us to provide basic dentalservices in our Centerville and Lamoni clinics.Behavioral Health Services • Added Psychology Services Dr. Matt Dzak joined the CHCSI staff in 2015, making us one of the very few organizations in southern Iowa to offer psychologist services. Dr. Dzak’s expertise complements our existing comprehensive behavioral health services by allowing us to provide psychological evaluations to better understand factors that contribute to a patient’s behavioral, emotional, cognitive, academic, psychiatric, social, or physical A mobile dental van was purchased in 2015 with funding from Telligen.

Renovation to expand and improve the cliniclocated in Leon will begin in July 2016.symptoms. Identifying these factors helps our treatment team develop an appropriatetreatment plan to address the problem.• Maintained Psychiatric Services With a $35,149 grant from the Iowa Department of Public Health in 2015, we are able to maintain the full-time psychiatric services provided by Dr. Roshan Dasari.• Expanded Integrated Health Home Program Services Initiated by Iowa Medicaid Enterprise in 2013, the Integrated Health Home (IHH) Program provides coordinated care for Medicaid enrollees with serious mental illness or serious emotional disturbance. IHH helps these patients address barriers they often face when trying to access health care services. CHCSI has participated in the Iowa Health Home Program since its inception.In 2015, we secured State Community Mental Health Block Grant funding to extendthe IHH Program to our non-Medicaid patients. IHH services include care coordination,family support, peer support, health promotion and support groups, and nursecare management. Funding has also supported Eye Movement Desensitization andReprocessing therapy and Trauma-Focused Cognitive Behavioral therapy training for anumber of our providers this year.Colorectal Cancer ScreeningCHCSI received a second year of funding in 2015 from Walgreens and the American CancerSociety to increase colorectal cancer education and screenings. Funding supports staffing,provides screening incentives, and helps cover screening costs.Quality Health Care RecognitionCHCSI was recognized in August 2015 as a Clinical Quality Improver by the U.S. HealthResources and Services Administration. As shown in the “Improving Patient Health” sectionof this annual report, CHCSI continues to make a positive impact on the lives of our patientsas demonstrated by numerous quality indicators, such as children receiving age-appropriateimmunizations, children and adults with controlled asthma, and hypertensive adults withcontrolled blood pressure. 131

2015 iowa pca outstandingprovider of the yearThe Iowa Primary Care Association selected CHCSI’s Dr. Larry Richard as the 2015Outstanding Provider of the Year.The Award Selection Committee chose Dr. Richardbecause of his commitment to helping patients achieve optimal health, his dedicationof time and resources to CHCSI and his patients, and his enthusiasm for sharing hisknowledge with co-workers and with tomorrow’s medical providers through his workas a preceptor. Dr. Richard is truly an asset to the community and to CHCSI! To the Staff and Employees, You wear the best smiles and offer great care for the patients who see you. It is nice to have ability to ask questions, along with calming reasons received. Thank you for your professionalism and skills. -RW Thank you for taking such great care of me! You are super awesome! -KT Even after many years of employment with CHCSI, the company as a whole still feels like an extended family! It is rewarding to work for an organization that continues to grow and focus development based on the needs of our patients. Glad to know our roots are deep and our branches are strong! -LC Since I was diagnosed with diabetes in June, I struggled to find the right answer, until I had an appointment with the dietician Linda Klejch and Deb Cooper, LPN. They gave me hope and encouragement. I have lost 29 lbs. and continue to lose. We do have the power to help ourselves with ALL the help from the staff at Community Health Centers of Southern Iowa. -BG

thank you toour partnersCHCSI’s success relies on collaborations withother local, regional, and state organizations.These important partnerships help us maximizescarce resources, ensure continuity of care,and provide comprehensive services for all ofour patients. 15

financialsStatement of Financial Position As of November 30, 2014 and November 30, 2015ASSETS 2015 2014Current Assets $1,319,962 $828,686Property and Equipment Net $2,444,814 $2,616,266Total Assets $3,764,776 $3,444,952LIABILITIES Short Term Liabilities $488,763 $543,509Long Term Liabilities $83,174 $179,274Total Liabilities $571,937 $722,783NET ASSETS Unrestricted $3,192,839 $2,722,169 $3,444,952Total Liabilities and Net Assets $3,764,776 Statement of ActivitiesPatient Billed Revenue $5,647,123 $4,621,170Total Grants $1,272,808 $1,534,139Other Income $603,415 $514,286TOTAL REVENUE $7,523,346 $6,669,595Health Care Services $4,030,318 $3,499,125General and Administrative $3,022,358 $2,624,013TOTAL EXPENSES $7,052,676 $6,123,138Increase in Net Assets $470,670 $546,45715

assets 35% current assets 65% property and equipment netliabilities 85% short term liabilities 15% long term liabilitiestotal revenue 75% patient billed revenue 17% total grants 8% other incometotal expenses 57% short term liabilities 43% long term liabilities 17

locations1 Leon 302 NE 14th Street Leon, IA 50144 Services available:2 Lamoni 802 E Ackerley Street Lamoni, IA 50140 Services available:3 Albia 12 W Washington Avenue Albia, IA 52531 Services available:Union clarke lucasringgold decatur 5 21 wayne 6 harrison mercer

4 Centerville 221 E State Street Centerville, IA 52544 Services available:5 Chariton 125 S Grand Street Chariton, IA 50049 Services available: 6 Corydon 204 S Franklin Street Corydon, IA 50060 Services available: monroe Medical Dental 3 Behavioral Healthiowae appanoose 19 4missouri