Academic Nurse-Managed Federally Qualified Health Centers
The purpose of this symposium is to provide a comprehensive crosswalk for academic institutions considering pursuit or operational transformation towards achieving Federally Qualified Health Center (FQHC) designation. The aims include: 1) review overarching business considerations for transformation, 2) discuss the financial implications for sustainability, 3) explain how the academic mission of student education and impacts workforce development and the triple aim 3) disseminate information regarding mandatory reporting requirements intended to improve population health, 4) convey best practice for integrated behavioral health within FQHC, 5) and showcase evidenced based care for chronic pain management.
Rationale/Background
There are over 250 Nurse Managed Health Centers (NMHCs) in the United States, not including birth centers. Of those, approximately 13 have been designated as federally qualified and at least half are linked to academic institutions. Considerable benefits and barriers exist for institutions forging this path. The benefits of connectedness with universities include rich clinical experiences, evidenced based practice dissemination, grant management, human resources, fiscal expertise, and financial support.
University-based FQHCs depend on grant support but also tend to infuse resources into the health centers. Barriers include the complexity of these systems. Onerous systemic issues impact agility and ultimately responsiveness. It is necessary to appreciate these intricacies in order to create a symbiotic relationship.
Co-applicant participation of NMHC with academic centers realizes summative gains from the capacity to render high quality, affordable care by advanced practice nurses (APNs). APNS work in conjunction with the integrated, behavioral health team. This model creates a breeding ground for workforce development and retention. Students are poised to lead quality improvement initiatives.
Outcomes achieved/documented
The organization transformed from a NMHC to a FQHC in June of 2012. Dentistry, pharmaceutical services, and substance abuse treatment ensued. From the coalescence of these programs within the construct of integrated primary and behavioral healthcare, best practice in chronic pain management evolved.
During programmatic development efforts, leadership simultaneously implemented an electronic health record, attested to meaningful use, reported Uniform Data Set measures to, and began true transformation towards becoming a nationally recognized patient centered medical home.
Conclusions
There are many facets to consider during pursuit of community health center sustainability through a FQHC designation. Understanding the layers of complexity will assist those considering the practicalities of transformation. The dual mission to educate students and improve population health is fully realized within this model.