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About MPHCA and member organizations
MS CHCs (Patients and Utilization)
BP Deep Water Horizon MS counties (Coastal Community Health Center
patients and utilization)
Overview of ACA/MS Rollout and Insurance Market Place
MS Outreach & Enrollment, funding, staffing and impact/activities
Health Insurance Marketplace websites and other information
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MPHCA’s MISSION is to support its members in a collaborative effort to advocate for the provision of
equal access to quality, comprehensive primary health care services and the elimination of health
disparities in Mississippi.
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501(c)(6) Nonprofit, Membership Organization (chartered in 1986)
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Organizational Members: Community Health Centers (CHCs)
◦ Typically referred to as Federally Qualified Health Centers (FQHCs)
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Other memberships include: Associate Members, Business Members & Individual Members
CHC Historical Overview
◦ Proud History
◦ Largest National Network
◦ Record of Achievement
◦ Bipartisan Support
Federal Law Requirements
◦ Non-Profit/Public
◦ Volunteer Board
◦ Comprehensive Services
◦ Sliding Fee Scale
◦ MUA/HPSA
◦ Federal Reporting Requirements
◦ Programmatic (Clinical and Financial Performance)
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21 Organizations
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Over 1600 FTEs
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Approx. 166 Sites
◦ Primary care clinics
◦ OB/GYN, Pediatrics
◦ Dental clinics
◦ School-based clinics
◦ Mobile medical units
Source: 2012 UDS Data
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894,772 visits annually
Over 249,000 (82%) live at or below 200% FPL
Over 128,000 (42%) are uninsured
Over 84,000 (28%) are insured through Medicaid
Over 50,000 (16%) are privately insured
Services provided to special groups:
◦ Over 900 migrant/seasonal farm worker patients/transitional
◦ Over 7,400 military veterans
◦ Over 8, 600 homeless patients
◦ Over 19,000 school-based patients
Race: 63% African American – 32% White – 5% Other
Gender: 60% Female – 40% Male
Source: 2012 UDS Data
Other Public Non-
Private
CHIP
16.7%
0.1%
Other Public CHIP
2.4%
Uninsured
42%
Medicare
10.8%
Medicaid
27.8%
Source: 2012 UDS State Summary Report
Total Users: 303,079
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Total Population
Uninsured Adults Under 400% FPL
Hancock
Harrison
Jackson
45,255
194,029
140,298
5,670
25,351
16,394
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30,730 patients
83,369 visits
27,713 (90.2%) live at or below 200% FPL
15,362 (50%) are uninsured
8,880 (28.9%) are insured through Medicaid
3,292 (10.7%) are privately insured
Services provided to special groups:
◦ 201 migrant/seasonal farm worker patients
◦ 212 military veterans
◦ 3,019 homeless patients
◦ 643 school-based patients
Race: 38.7% African American – 53.4% White – 7.9% Other
Gender: 59% Female – 41% Male
Source: 2012 UDS Data
Private
10.7%
Other Public CHIP
1.8%
Medicare
8.6%
Uninsured
50%
Medicaid
28.9%
Source: 2012 UDS Data
Total Users: 30,730
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 Implementation
began formally in
2010 and will continue through 2015
and later
 ACA consists of three major parts
Insurance coverage reforms
Insurance expansions
Delivery system reforms
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Individual Mandate: purchase coverage or pay
penalty, with income-based subsidies up to 400% of
poverty (41,000/$88,000) to make coverage affordable
Employer Contribution: offer coverage or pay penalty
Medicaid Expansion: all individuals up to 138% of
poverty (major new group: adults)
Health Insurance Exchanges: marketplace for
consumers, with competing plans
Insurance market reforms, to end discrimination
(gender, pre-existing conditions, MLR, etc)
Workforce Training Reforms, especially Primary Care
Payment System Reforms, especially Integrated Care
New Funding for Health Centers:
$11 Billion over 5 Years (dedicated funding),
over and above the $2.2 billion in
annual CHC funding
 $9.5 billion for CHC operations under Section 330
 $1.5 billion for Capital over 5 years
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Permanent Authorization: Original Sanders
language with increasing authorization levels
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MPHCA ACA presentations to:
1) CHCs Members
2) State Partner Organizations
3) Local Advocacy Groups
4) Community-Based Organizations
5) Faith-Based Organizations
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Insurance Market Place Development
1) Mississippi Insurance Department State-Based Exchanged Development
a. 2011 Legislation
b. Exchange Advisory Board and Sub-committees Developed
c. Exchange Planning & Development Funding
d. State-Based Exchange Default/Insurance Commissioner vs. Governor
e).Federally Facilitated Exchange Implementation and QHP
Development
2) Medicaid/QHP (275,000)
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Non-Medicaid Expansion
1) Total Medicaid Enrollees – 645,134 (as of Sept. 2013)
2) Total State Uninsured – approx. 275,000
3) Number in coverage gap – 137,800
4) Percent in coverage gap below 100% FPL – 89%
Mississippi
QHP
Coverage by
County
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HRSA Outreach and Enrollment Awards
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Outreach and Enrollment Staffing
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Outreach and Enrollment Impact
HRSA awarded the funds through a formula-based supplemental award criteria for eligible section 330 funded
health centers.
Health centers receiving outreach and enrollment funding must:
1) Increase the CHC’s Outreach and Enrollment assistance capacity
2) Ensure all CHC Outreach and Enrollment assistance workers are trained
3) Demonstrate the capacity to conduct “in reach” and “outreach”
4) Demonstrate collaboration with other CHCs and providers in their service area
5) Comply with all Section 330 Requirements of the PHS Act, as amended
Allowable use of funds:
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Adding a Minimum of 1.0 New FTEs
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Pre-award Costs
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Hiring of Veterans as O/E Assistance Workers
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Fringe Benefits for O/E Assistance Workers
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Moveable Equipment and Supplies to Support O/E Assistance Workers
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Leasing of Temporary Space
Allowable use of funds:
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Training in support of the grant
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Local travel in support of the grant
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Personal computers/laptops
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Educational materials
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Wireless cards
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Technology to Protect Personally Identifiable Information (PII)
Non-Allowable use of funds:
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Provision of primary health care services or personnel other than O/E assistance
workers
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To supplant other resources (federal, state, local, or private) intended to support O/E
assistance activities
MPHCA has received $143,724 from HRSA to support its member CHCs in the coordination and execution
of their outreach and enrollment activities via:
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Ongoing communications about training opportunities
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Continued partnerships with state agencies in the development of the overall, state-wide FFE strategy
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Coordination with other consumer assistance efforts in the state
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Continuing to work with the Qualified Health Plans for Mississippi - Magnolia Health Plan and Humana
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Providing training and technical assistance to CHCs
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Monitoring and reporting of successes and barriers regarding CHC O/E activities
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MPHCA Lead Staff Appointed
Applied to Become Certified Application Counseling Organization (CACO) –
Certification Obtained late October
Provided on-site enrollment training assistance for eleven (11) CHCs
Participated in numerous Health Fairs, Town Hall Meetings, Church and
Community Meetings
CHCs received CACO Certification
79 CACs Trained, 90% certified
Over 1,000 Customers Assisted by Outreach & Enrollment CHC Staffs
Conducted Several State Level Meetings and ongoing reporting to Federal,
State and Regional Partners, such as CMS, BPHC, NACHC, MS Dept. of
Insurance, UMMC, Oak Hill Baptist Church, Magnolia Health Plan
/Ambetter and Humana
Participated in development of Cover MS State Coalition
Developed MPHCA O & E Web Page.
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MPHCA O & E Webpage: www.mphca.com/outreach-and-enrollmentresources
www.healthcare.gov
www.CoverMS.org
www.getcoveredms.org (Navigators)
-Oak Hill Missionary Baptist Church Ministries Incorporated
-University of Mississippi Medical Center
-Enroll America
-Mississippi Health Advocacy Program
-Aaron E. Henry Community Health Services Center
University Mississippi Medical Center:
www.ummchealth.com/healthplan
Oak Hill Missionary Baptist Church:
www.info@getcoveredMississippi.org
www.mid.ms.gov
FAQ website: www.healthreformbeyondthebasics.org
FAQ Website Categories
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Marketplace Eligibility, enrollment periods, plans & premiums
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Young Adults and Students
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Individual Responsibility to have health coverage
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Pregnancy
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Minimum Essential Coverage
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Non Traditional Households
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Help paying private health insurance premiums
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Immigrants
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Cost sharing reductions
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Agricultural Workers
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Tobacco surcharge for premiums
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Workers/Families with job-based health coverage questions
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Marketplace verification and appeals
Early retirees
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People with variable incomes
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Medicare
Robert M. Pugh, MPH
Executive Director
Email: rmpugh@mphca.com
Mississippi Primary
Health Care Association (MPHCA)
P.O. Box 11745 l Jackson, MS 39283
Phone: 601.981.1817 l Fax: 601.981.1217
www.mphca.com