2022 AACHC Annual Report

2022

ANNUAL REPORT

MESSAGE FROM THE CEO & BOARD CHAIR

DEAR MEMBERS & PARTNERS,

In 2022, the Health Resources & Services Administration reported that in 2021 Community Health Centers (CHCs) across the country reached the historic milestone of serving 30 million patients In Arizona, Community Health Centers proudly served over 800,000 patients in 2021 – an increase of 30 percent since 2018. Arizona’s Community Health Centers now serve more than 10% of the state’s population, playing a critical role in Arizona’s healthcare system.

In addition to significantly increasing access to healthcare in our communities, the scope of Community Health Centers’ work continues to evolve COVID-19 heightened the need for mental healthcare, and Community Health Centers were prepared to respond to the needs of our communities, resulting in increased behavioral health and substance use disorder services provided The number of patients receiving substance use disorder services in Arizona CHCs has more than tripled since 2017, and behavioral health services have nearly doubled. While primary medical services remain the majority of what CHCs do, CHCs continue to expand services based on community needs and employ innovative models that further advance whole-person care

We have seen significant expansion and innovation among our CHCs over the last 12 months. From mobile outreach to pharmacy home delivery to medical assistant fast-track programs – Arizona’s Community Health Centers have responded to the needs of our communities by identifying opportunities for growth and change, implementing new practices, and evolving as necessary to ensure patient and staff needs are met.

Arizona’s CommunityHealth Centersnowserve morethan10%of thestate’s population,playing acriticalrolein Arizona’s healthcare system.

As we look forward to the #Next50Years of the Health Center Program, ensuring a strong and qualified health center workforce is critical. The workforce challenges occurring throughout the healthcare industry and impacting urban and rural CHCs present opportunities for innovation, for new approaches to recruitment and retention, new staffing models, and new ways to lead. As an employer and provider of choice, we must continue to tell our story with data that demonstrates both the outstanding level of care that CHCs provide and the cost effectiveness of how CHCs deliver care The Alliance is committed to advancing the work of our CHCs by continuing to lead initiatives that build and develop our workforce, strengthen partnerships with payers, and leverage the use of health information technology to improve outcomes and reduce costs. Ultimately, these efforts, along with the training and technical assistance that the Alliance provides, serve to strengthen our health centers and their ability to best serve their diverse communities throughout the state.

We believe in the strength of the Alliance and the power we have working together to ensure equitable access to high-quality primary healthcare for everyone. And we look forward to continuing head.

ollaborative Ventures Network

Mountain Park Health Center 2022 Alliance Board Chair

ABOUT US

The Arizona Alliance for Community Health Centers (the Alliance) is the Primary Care Association for Arizona We’re a nonprofit member organization that represents Community Health Centers (CHCs) Arizona’s largest primary care network.

CHCs deliver healthcare services that meet the needs of their communities, connecting people to quality care that gives everyone an equal opportunity to thrive. We facilitate that vital work by providing CHCs with training, technical assistance, programmatic support, and advocacy

VISION MISSION

Equitable access to high-quality healthcare for everyone

Advance the vital work of Community Health Centers to serve the unique needs of our communities

BOARD OF

OFFICERS

CHAIR

JohnSwagert,MD

CEO,MountainParkHealthCenter

VICECHAIR&CVNCHAIR

JonathanLeonard,MPA

DIRECTORS

SECRETARY

KarenHoffmanTepper,PhD

President&CEO,TerrosHealth

MEMBERSATLARGE

ChristopherHansen,MHA

CEO,DesertSenitaCommunityHealthCenter

TREASURER

WendyArmendariz,MBA

CEO,NeighborhoodOutreachAccesstoHealth(NOAH)

BOARD MEMBERS

AnneNewland,MD,MPH

CEO,NorthCountryHealthCare

BlaineBandi,MLS,MHSA

CEO,WesleyCommunity&HealthCenters

ClaudettePippen,BBA,CPA

InterimCEO,UnitedCommunityHealthCenter

ClintonKuntz,DBH CEO,ElRioHealth

DanPrevost,MBA

CEO,MariposaCommunityHealthCenter

EddieEstrada,MD

CEO,SunLifeHealth

HunterAdams,MBA

CEO,CreekValleyHealthClinic

JoetteWalters,RN

CEO,TubaCityRegionalHealthCareCorporation

JonathanMelk,MD

CEO,ChiricahuaCommunityHealthCenters,Inc.

CEO,CanyonlandsHealthcare

DavidRogers,MBA

CEO,SunsetHealth

JoshuaCarzoli,MBA,PharmD CEO,MHCHealthcare

KennethG.Poocha,MA

CEO,NativeAmericansforCommunityAction

KimberlyDespres,DHA,RN CEO,CircletheCity

LauraLarson-Huffaker,MC,LPC CEO,HorizonHealthandWellness

MichelleBarker,DHSc SrVPAmbulatoryServices&CEOFQHCClinics, ValleywiseHealth

PedroCons,MA CEO,AdelanteHealthcare

SharonRickman,MPA

Exec.Director,CommunityHealthCenterofYavapai

TerriLeon,MSW InterimCEO,ValledelSol

WalterMurillo,BS CEO,NativeHealth

MEMBERS

FULL MEMBERS

ASSOCIATE MEMBERS

C O M M U N I T Y H E A L T H

23 Health Center Program Grantees

7,879 200+ Sites Across Arizona

Serving ~1 in 9 Arizonans Total

800,024

Patients

Served

Staff FTEs (Full Time Equivalent) AGE 29% Under 18 59% 18 to 64 12% 65 and older

58% 82% 66% Children Age 6-9 Who Received Dental Sealants 86%

Patients with Hypertension (HTN) Whose Blood Pressure (BP) was Controlled

Adults Screened for Tobacco Use and Receiving Cessation Intervention www aachc org 8

C E N T E R I M P A C T

QUALITY AWARDS

Percentage of Arizona CHCs that received the following awards:

83%

65%

39%

2022 HEALTHCARE HEROES

2022 LIFETIME ACHIEVEMENT AWARD

EdSicurello Former CEO, Mariposa Community Health Center

NancyJohnson Former CEO, El Rio Health

PeggyChase Former CEO, Terros Health

2022 LEGISLATORS OF THE YEAR

Representative AlmaHernandez SenatorDavidGowan

2022 INNOVATION AWARD

BenjaminWilliams,DO Creek Valley Health Clinic

MargaretRay,MD Tuba City Regional Health Care Corporation

2022 COMMUNITY LEADERSHIP AWARD

EladioPereira,MD Mariposa Community Health Center

2022 PRECEPTOR OF THE YEAR

William"Bill"Orman,MD Tuba City Regional Health Care Corporation

2022 COMMUNITY HEALTH WORKERS OF THE YEAR

2022 DENTAL ASSISTANTS OF THE YEAR

DianeCesena Community Health Center of Yavapai

JulioRodriguez Adelante Healthcare

2022 SPECIAL POPULATIONS AWARD

CarmenAndrade Mariposa Community Health Center

BeatriceVega El Rio Health

CrystalWinstead Terros Health

2022 MEDICAL ASSISTANTS OF THE YEAR

KarinaFernandez Chiricahua Community Health Centers, Inc.

AndresYubeta El Rio Health

MichaelLucas Horizon Health and Wellness

SHAPING ARIZONA'S HEALTHCARE

ALLIANCE PROGRAMS

ADVOCACY

STATE LEGISLATIVE AGENDA

Protect 340B funded programs by prohibiting discrimination against 340B drugs and pharmacies

Grant expenditure authority for enhanced Federal Medical Assistance Percentage (FMAP) and Home and Community Based Services ($1.49 billion)

Extend AHCCCS postpartum coverage from 60 days to 12 months

Facilitate continuous AHCCCS coverage for former foster children until age 26

Establish a Health Workforce grant program

Prevent bill allowing school attendance for students with no vaccinations during a public health outbreak

Stop bill imposing liability on employers for vaccination requirements

FEDERAL LEGISLATIVE AGENDA

Protect 340B covered entities and pharmacies from discrimination

Extend telehealth and telephonic services for mental health permanently and for medical telehealth for two years

Extend subsidies on Marketplace insurance premiums; Extend ability to join the Marketplace if lose Medicaid through July 2024

Expand healthcare workforce programs, especially for education, training, and retention

Protect patients & CHCs during unwinding of the Public Health Emergency

TRAINING & TECHNICAL ASSISTANCE

Training and technical assistance (TA) are a priority of the Alliance. Our job is to ensure CHCs and other safety-net providers have the information and support they need to focus on patient needs, delivering the whole-person, quality, and affordable care that is their hallmark Below are some highlights from our 2022 training and TA activities

~40

70+

1,800+ 4.3/5 TRAINING & TA ACTIVITIES

PEER NETWORKING COMMITTEE MEETINGS

ON-DEMAND LEARNING

PARTICIPANTS AVERAGE SATISFACTION RATING

3.3/5

AVERAGE BEHAVIOR CHANGE* RATING

*Defined as the degree to which the training had an impact on the participant's behavior 3-6 months after the training occurred

4,100+ VIEWS SINCE BEING RELEASED

We also developed five online learning modules on key topics identified through our annual health center needs assessment.

ADVOCACY BURNOUT LEADERSHIP SOCIAL DETERMINANTS OF HEALTH

STARTING AN IN-HOUSE PHARMACY PROGRAM

With support from the Maricopa County Department of Public Health, we developed a second video series focused on substance use disorder (SUD). This new series, Pregnancy & Parenting with a Substance Use Disorder, was created to reduce the stigma associated with having a SUD while pregnant and parenting The videos share stories from people with lived experiences to highlight their resilience and dispel myths commonly associated with pregnancy and SUD

LEARNING, NETWORKING,

INNOVATING & GROWING

MEDICAL ASSISTANT, DENTAL ASSISTANT & COMMUNITY HEALTH WORKER SEMINAR

RECRUITMENT & RETENTION CONFERENCE

BILLING & CODING TRAINING

UDS TRAINING

WORKFORCE

The Alliance supports our CHCs with the recruitment and retention of providers and staff and connects them with special programs and resources that support staffing needs and operations. We also facilitate pipeline programs, including matching students with CHCs, with a focus on expanding our primary care workforce Our workforce programming saw the following outcomes in 2022

National Health Service Corps (NHSC) Scholars in Arizona supported through the Annual NHSC Scholars Conference

Primary care students and residents outreached, promoting the role of CHCs in rural and underserved communities in Arizona, and state and federal loan repayment and scholarship programs for CHC providers

CHCs assisted in the completion of their strategic workforce plans

WeadvocatedfortheexpansionofclinicaltrainingsitesinArizonathroughtheHealthResources& Services Administration's Teaching Health Center Graduate Medical Education initiatives. We also participatedinthedevelopmentoftheCommunityHealthWorkerVoluntaryCertificationprogramand theassociatedreimbursementstructureinpartnershipwiththeArizonaDepartmentofHealthServices

FAST TRACK MEDICAL ASSISTANT (MA) PILOT PROGRAM

In 2022, we launched a pilot program, AHEAD AZ, through which CHC employees interested in an MA role receive on-site training that includes virtual education and clinical hours We graduated 35 students from the program in the inaugural year. Each graduate passed their national certification exam and is now a Certified Clinical Medical Assistant. As a result of this program, CHCs have been able to address MA shortages while supporting internal career advancement and the up-skilling of current staff.

1,050

Healthcare professionals received continuing education

764 High school students reached in health career exploration and club events

163 Students placed for clinical rotations or internship opportunities

31

AHEC scholars from the Rural Health Professions Program immersed in rural underserved communities

OUTREACH & ENROLLMENT

The Alliance provides training, consultation, and technical assistance to CHC staff who are tasked with application assistance and/or outreach. We accomplish our work by equipping CHC staff with updated information, peer-to-peer support, and facilitation of workgroups so that our communities are connected to quality and affordable healthcare. Through funding provided by the Centers for Medicare & Medicaid Services, the Alliance continues to work with our CHCs and partners to provide education on health insurance options and facilitate enrollment in health insurance

OTHER ACTIVITIES

8,755,821 MEDIA IMPRESSIONS

PROGRAM IMPACT

A 63-year-old male became ill with COVID-19 in early 2021 He had to be hospitalized for several months, was intubated, and ended up losing his job Thankfully, he finally overcame the illness Upon being released from the hospital, he began receiving large medical bills, including one for emergency helicopter ambulance transportation. Because he was uninsured, he and his spouse were having to pay for these expenses out of pocket.

He continued having medical issues because of his time with COVID-19 and had to make continuous trips to the emergency room During one trip he heard about the Marketplace options being offered through Chiricahua Community Health Centers, Inc. (CCHCI). He made an appointment with CCHCI's outreach and enrollment team for assistance in obtaining healthcare insurance through the Marketplace. He was enrolled in coverage on May 6, 2021 with a monthly premium of only $43.52.

He did not know he had health insurance options until being connected with his local CHC He is so thankful for the assistance and guidance he was provided during the application process

QUALITY IMPROVEMENT

The Alliance partners with our CHCs to advance clinical quality and performance through a focus on continuous quality improvement (QI). We promote QI best practices, facilitate QI collaboratives, and discuss methods for the effective deployment of QI initiatives at both the individual CHC and network levels We also support the optimization of reporting tools to ensure CHCs have consistent and up-todate access to their quality measures and gaps in patient care. With a focus on improving care delivery and health outcomes, our team monitors key data points throughout the year and uses that data to identify opportunities for training and technical assistance.

DIABETES & HEART DISEASE PREVENTION & MANAGEMENT

In partnership with the Arizona Department of Health Services and the American Heart Association, the Alliance facilitated a fourth cohort of CHCs for our Diabetes and Heart Disease Prevention Program As a cohort, participating CHCs increased rates of controlled hypertension by 2 5%, despite many other quality measures decreasing over the last few years as a result of the pandemic.

ORAL Q32022 Q42022 CHC1 CHC2 CHC3 CHC4

www aachc org 20 Participating Community Health Centers in Arizona 3 5,048 Patients aged 0-40 months received preventive oral health services during a well-child visit 7 Arizona CHC sites total

100% 75% 50% 25% 0%

HEALTH CENTER CONTROLLED NETWORK

In 2022, the Alliance successfully applied for the 2022-2025 Health Center Controlled Network (HCCN) grant, effectively transitioning this program from its sister organization, Collaborative Ventures Network, to the Alliance, as of August 1, 2022. HCCN includes 28 Participating Health Centers (PHCs) across Arizona and Nevada, with four project coaches and a Power BI Analyst to support the work of the individual PHCs across these states The purpose of the HCCN is for all PHCs to work together, in conjunction with the HCCN team, to strengthen and leverage health information technology to improve health centers’ operational and clinical practices, resulting in better health outcomes for the communities they serve.

2022 ACTIVITIES

Development of Individual Work Plans and goals for each PHC

Quarterly Azara UserGroup trainings and dedicated training hours for individual health centers

Monthly eClinicalWorks and NextGen UserGroup trainings

Quarterly HCCN Peer Learning Teams to share possible solutions to common HIT challenges

Monthly Health Information Exchange/Contexture meetings to facilitate discussion around common challenges among health centers, which led to the development of new advanced alerts, resulting in new dashboards in Azara with advanced hospital discharge information

Leveraged other grants and programs to support HCCN activities and vice versa, including partnership with the Arizona Department of Health Services on improving HIT to support hypertension control and the development of Power BI dashboards

SAMPLE POWER BI DASHBOARD

RURAL HEALTH

DOMESTIC AND SEXUAL VIOLENCE ADVOCACY

Domestic and sexual violence occur in every community and impact health outcomes. CHCs are trusted, confidential community-based service providers where victims can receive services while accessing primary healthcare. Through our rural health programming, we funded advocate positions at four CHC sites. These advocates were able to:

Screen or provide information on domestic and sexual violence during routine patient visits for 45,973 CHC patients

Provide services to 740 victims of intimate partner violence, sexual assault, stalking, and trafficking

Provide services to 668 secondary victims (family, including children)

With our domestic and sexual violence funding we were also able to support the launch of a forensic exam site in Santa Cruz County

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM IMPLEMENTATION

6 531

Consortium members partnered on prevention, treatment, and recovery activities in Gila, Graham, and Mohave Counties

ARIZONA RURAL WOMEN'S HEALTH NETWORK

4

Provider and community members received training on harm reduction, naloxone, and other opioid overdose prevention best practices

Virtual sexual violence training sessions for Community Health Workers/Promotoras were provided in partnership with the Arizona Coalition to End Sexual and Domestic Violence

2022 RURAL WOMEN'S HEALTH CHAMPIONS

The following individuals were recognized as Rural Women's Health Champions during the 2022 Arizona Rural Women's Health Symposium:

Dr. Judith Hunt - Innovative Approach to Rural Women’s Health

Dr. Denise Muesch Helm - Outstanding Achievement in Rural Women’s Health

Brenda Sanchez - Emerging Leader in Rural Women’s Health

Dr. Charlotte Richards - Rural Women’s Health Practitioner of the Year

CAPITAL IMPROVEMENT

In partnership with Maricopa County, the Alliance was able to award over $45 million to CHCs in Maricopa County for capital improvements and renovations that aim to improve access to services for residents with low income, who are medically underserved, or who may be uninsured. The funds were awarded in two rounds - the first totaling $21 million and the second $24.3 million.

Round 1

NATIVE HEALTH - $3.68 million

Neighborhood Outreach Access to Health (NOAH) - $4 1 million

Terros Health - $5.5 million

Valleywise Health - $656,000

Wesley Community & Health Centers - $7.5 million

Round 2

Circle the City - $6.1 million*

Mountain Park Health Center - $7 5 million

NATIVE HEALTH - $1 7 million

Neighborhood Outreach Access to Health

(NOAH) - $3.4 million

Valle del Sol - $533,500

Valleywise Health - $5 million*

*Totalamountformultipleprojectsfundedinthisround

$45 million investment

Funds distributed will support more than 20 CHC locations across Maricopa County

Maricopa County's support for these capital projects is federally funded through the American Rescue Plan Act (ARPA), enacted to provide programs and services to help people, families, and businesses recover from the effects of the pandemic These projects are helping prepare Maricopa County to meet current and future public health crises and daily healthcare needs

FINANCIAL OVERVIEW

2023 ANNUAL SPONSORS

ARIZONA'S COMMUNITY HEALTH CENTERS

Disclaimer: This publication was supported by Centers for Medicare and Medicaid Services (CMS) of the U S Department of Health and Human Services (HHS) as part of financial assistance awards totaling $7,021,245 and $1,500,000, with 0% funded by non-government source(s) The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U S Government

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