2018-475-E Finance - Piedmont Health Services Inc outside agency agreement

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DocuSign Envelope ID: CCFF6125- AA47- 438A- 98CA- B42519499D42 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Finally, many individuals in the County also face cultural /linguistic barriers to care. First, Orange County has experienced rapid growth of the Latino population since the early 1990s (in 2015, an estimated 8.2% of the population was of Hispanic ethnicity), with many preferring care in Spanish. PHS hires Spanish - bilingual professionals in lieu of separate interpreters. Second, over the last decade, there has also been significant growth in the county's refugee population, primarily from Burma (speak multiple languages /dialects), and more recently from Syria and the Democratic Republic of Congo. The Orange County health department began its refugee health program in FY 2007 -2008 to better address the unique health care needs of these newcomers, and asked PHS to be the principal on -going primary care home for the population. The program has grown rapidly as the number of new arrivals through resettlement agencies has grown, and with in- migration of refugees from other counties and states. CCHC served no refugee patients in CY 2006, by CY 2011 it had 399 refugee patients, and in CY2017 it served 590 refugee patients (PHS served a total of 695 refugees across the agency, with Orange County CHC sites serving 680). Many refugees are also public housing residents. Due to growth in the number of patients and increasing breadth of languages spoken, since 2013, CCHC is now spending nearly 90% (approximately $40,000 annually) of the total agency budget for interpretation. CCHC is striving to have a best practice refugee health program based on national guidelines. f) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? The Carrboro Community Health Center is open to all comers (subject to appointment availability for medical and dental visits) regardless of county of residency, citizenship status, or insurance status. The target population for FQHC services is the low- income population living below 200% of the Federal Poverty Guideline, and the funding request will be directed toward the medical program. Most hear of the program word -of- mouth, but many are referred to our program by other health and human services programs. With the exception of WIC, HRSA requires all individuals receiving primary care services at CCHC to register as patients, at which time they are provided information about all CCHC program services and its sliding fee scales for medical and dental care. Those who wish to be placed on CCHCs sliding fee scales (overwhelmingly those without health insurance, although those with health insurance may also apply) submit their family size and income documentation on an annual basis to qualify for sliding fees. With regard to the refugee health program, CCHC accepts direct referral of patients through the Orange County Health Department following completion of the initial screenings. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) CCHC's administrative site director is Tinesha Smith. Its lead medical provider is Kim Christopher, MSN, RN, FNP -BC, while Quang Pham, MD is lead for the refugee health initiative. The Table below presents a staffing picture for the Carrboro Health Center by service. A majority of staff speak Spanish, and again, the Center uses contracted interpreters or language line as necessary. CCHC Prim ry Care Program Staffing Service Staffing Primary Medical Care with integrated 3.656 FTE physicians, 2.2 FTE advanced practitioners behavioral health on -site Lab (FNP); 2 FTE RNs, 6.6 medical assistants, 1.2 FTE behaviorist, 1 FTE contract phlebotomist Lab Corp) Dental Care 2.0 FTE dentists, 1.475 FTE hygienists, 8.025 dental assists Pharmacy walk -in 1.9 FTE pharmacists, 3 FTE pharmacy technicians WIC Nutrition Program 2 FTE nutritionists, 0.4 FTE breastfeeding peer counselor, 1.6 admin PROGRAM INFORMATION 1/23/2018 11:00:54 AM Page 16 of 23