The Unlearned Lessons of Failing Community Health Centers – Part 4 -

The Unlearned Lessons of Failing Community Health Centers – Part 4 -

The failure of executive directors to believe, despite their mission, and demonstrate through measurable behaviors, that Community Health Centers are established to serve all the medically underserved in its area -

As we continue to address Community Health Centers’ central role in providing primary health care to the unemployed, underemployed, and part-time employed who are uninsured or underinsured.

The way this can be dealt with immediately is through local Community Health Centers that are well-led, well-managed, and well-financed.

If Community Health Centers (CHCs) are vital to resolving the health crisis, what can Community Health Center Board members do to help their Center?

Our sense is that Boards can insist that their Executive Director immediately overcome the following four issues:

1. The lack of transparency.
2. The evolution of community health center financial statements into a dark art.
3. Financial statements as fairytales.
4. The failure of the executive director to believe, despite their mission, and demonstrate through measurable behaviors, that CHCs are established to serve all the medically underserved in its area.

Yesterday we discussed: 3. Financial Statements as Fairytales – Financial Statements that have a somewhat flexible relationship with reality.

Today we address:

4. The failure of executive directors to believe, despite their mission, and demonstrate through measureable behaviors, that CHCs are established to serve all the medically underserved in its area -

Examples:
§ If the Community Health Centers’ Board and Executive Director’s lack behaviorally-demonstrated knowledge of the number of uninsured, underinsured, 100%, 200%, and 300% of poverty level people in your area.

§ If there is a lack of comparative monthly reporting of progress toward the goal of expanding to 100% service in that Centers’ service area. http://bphc.hrsa.gov/policy/pin9823/

§ If your Board members demonstrate a tendency to focus on areas other than increasing patient base and growing visits per day.

§ If you have an Executive Director who has failed to present an effective business model for serving as many of the medically underserved as possible.

§ If your CHC has failed to secure the funds, through direct Medicaid, etc. billing and timely reimbursement, to serve the medically underserved today and tomorrow.

§ If the real growth for the Center consists almost solely of new providers or new lines of business.

§ If the CHC’s new providers and lines of business grow, but established providers have not increased their patient base and visits per day.

Questions to ask
§ Have your established providers increased their patient base and visits per day?

§ Have the CHCs patient encounters per day and per provider increased this year? This quarter?

§ Have the patient-service reimbursements increased?

§ Is the CHC still reliant on periodic grants, or, worse yet, loans?

If any of these issues make you uneasy or defensive, then, as a Board member or Senior Manager, your fiduciary responsibilities need to be exercised toward expanding direct care medical services to the medically underserved in your area.

Next post: Community Health Centers –Governing Boards That Do Their Job