Developing Federally Qualified Health Centers into Community ...

NOTES
1 N. Kaye and M. Takach, Building Medical Homes in State Medicaid and CHIP Programs
(Portland, Maine, and New York: National Academy for State Health Policy and The
Commonwealth Fund, June 2009).
2 D. R. Rittenhouse, L. P. Casalino, R. R. Gillies et al., ―Measuring the Medical Home
Infrastructure in Large Medical Groups,‖ Health Affairs, Sept./Oct. 2008 27(5):1246–58.
3 Federally funded health centers receive competitive federal 330 grants to support their
operations. Not all FQHCs receive federal funds. Some, referred to as FQHC look-alikes, meet
the same requirements as FQHCs but do not receive federal 330 grants. When it is important to
make this distinction, the authors use the term health center rather than FQHC.
4 Health Care and Education Reconciliation Act of 2010, 2010, Public Law 111-152, 11th
Cong., 2nd Sess. (30 March 2010), Sec. 2303, available at http://www.gpo.gov/fdsys/pkg/PLAW-
111publ152/pdf/PLAW-111publ152.pdf; Patient Protection and Affordable Care Act, 2010,
Public Law 111-148, 111th Cong., 2nd. Sess. (23 March 2010), Sec. 10503, available at
http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf; Patient
Protection and Affordable Care Act, 2010, Sec. 2703, 3021, 3502, 5405, 10333.
5 M. K. Abrams, E. L. Schor, and S. C. Schoenbaum, ―How Physician Practices Could Share
Personnel and Resources to Support Medical Homes,‖ Health Affairs, June 2010 29(6):1194–99.
6 Healthy Montana Kids Plus is Montana’s Medicaid Children’s Health Insurance Program
expansion group. Its members are Medicaid Passport members and, as such, eligible for HIP.
7 Community Care of North Carolina, ―Program Overview,‖ 2010, available at
http://www.communitycarenc.com.
8 The Federal Tort Claims Act provides health centers with malpractice coverage for liabilities
arising from services included in a health center’s scope of project that are furnished by its
providers to its patients.
9 According to an official with the Montana Primary Care Association:
The answer was ―no‖ because some of the patients who receive HIP services have
providers who are not health center employees, i.e., private practice docs, mid-levels, etc.
Those patients were not considered by HRSA to be patients of the health center.
Medicaid, however, pays the health centers to operate the program on a per person per
month basis according to how many Medicaid eligibles there are in each health center’s
area of coverage. To date, those payments have covered the cost of the services. The
health centers do not bill Medicaid for any case/care management services for HIP
patients. (Montana Primary Care Association, e-mail from MaryBeth Frideres, December
3, 2010.)
10 CMS approved the waiver amendment in October 2009.
11 Dual eligibles—those who receive both Medicare and Medicaid coverage—are not eligible
for Passport, and therefore not eligible for HIP.
12 Many HIP children also receive services through Montana’s Title V program. In these
cases, Title V generally takes the lead in providing case management services.
13 HealthSciences Institute, ―Chronic Care Professional (CCP) Certification,‖ 2010, available
at http://www.healthsciences.org/information_about_ccp_certification.html.
14 The importance of having in-person meetings between primary care providers and remotely
based support staff has been noted in the case of the Massachusetts Child Psychiatry Access
Project (MCPAP). MCPAP staff based in hubs throughout the state assist primary care providers
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