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HHS waiver to boost New Orleans community clinics, access to care

Health and Human Services Secretary Kathleen Sebelius has announced a new program to help New Orleans community clinics and continue healthcare access for low-income and uninsured households that are still struggling five years after Hurricane Katrina.

Funding for a system of public and non-profit clinics will come from a three-year, $97.5 million Medicaid demonstration called 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 healthcare 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."

According to the Kaiser Family Foundation, 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 to 93. The clinics provide a full range of services, including primary care, behavioral healthcare and dental care.

To improve access, some health providers operate out of mobile clinics and school-based health centers.

“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,” Sebelius said. ”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.”

Among the accomplishments of the community-based clinics:

  • They now care for more than 175,000 individuals in the New Orleans area annually and provide services to nearly 76,000 of the region’s uninsured population, many of whom come from working families.
  • The number of individuals served has increased by 13 percent every six months since March 2007 for outpatient primary and behavioral healthcare.
  • Fourteen of the 25 organizations, representing 40 clinic locations, have been recognized by the National Committee on Quality Assurance as patient-centered medical homes.

Individuals eligible to receive services under the grant include those who have been uninsured for at least six months; who are between 19-64 years old; who are not pregnant; who are not eligible for Medicaid or the Children’s Health Insurance Program and who have a family income of 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 demonstration. “The decentralized payment system has encouraged team-based care and innovation.”

The demonstration will run until Dec. 31, 2013, during which clinics will strengthen their fee-for-service billing capabilities to ensure continuing revenues from Medicaid and health insurers.

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