Attachment 2 - FL Agency for Health Care Administration

Attachment 2

Amount of funds

Hospital funding programs outside of inpatient and emergency room

budgeted to program

Primary Care

Baptist Hospital supports several Primary Care practices in the community who deal with indigent population.

$

900,000.00

All Children's Hospital provides primary care, pediatric subspecialty care, and diagnostic care at its main campus and through a network of 10 outreach centers spanning from Lee County in the south to Citrus county in the North. Primary care services include diagnostic services, laboratory services and pre and post operative surgical follow-up examinations. Expanded diagnostic services include MRI with pediatric sedation (if necessary), pediatric metabolic stress testing, stress echocardiogram, contrast echocardiogram, fetal echocardiogram and audiology services. All Children's Hospital has added two new outreach centers, expanded a third and has plans for a fourth center in Tampa (focusing on autism spectrum disorders), all over a five-year period. In addition to the services noted above, these centers provide a full array of therapy services, pediatric subspecialty clinics and other outreach activities such as screenings and health education events.

Number of individuals served (optional)

In order to provide ambulatory, primary and preventive care services in non-inpatient settings, Aventura Hospital and Medical Center has established physician practices through an affiliated corporation that is part of the consolidated hospital budget. These practices may include primary care services, multi-disciplinary practices, and multi-disciplinary surgical practices. These services are available to the entire patient population of the community.

$ Broward Health provides primary care clinics throughout the northern Broward County region. The sites provide adult care, well and sick child care, prenatal care, urgent care, dental care, physical examinations, immunizations, HIV/AIDS services, behavioral health services and pharmacy services., including services to the homeless. About 14% of the funding for this program is from federal grants.

$ Primary Care physician practice services are available through an affiliated corporation that is part of the consolidated hospital budget. These services are available to the entire patient community.

$ This primary care center owned and operated by CMHF provides primary care, laboratory, rehabilitation, and diagnostic imaging services. It also operates as a walk-in clinic. The clinic opened in September 14, 2009. The capital budget was $6,097,223, and the annual operating budget is $1,674,504 for a 2009 total of $7,771,727. Delray Medical Center, through an affiliated organization has worked to attract new physicians to meet the needs of our community. The following includes physician employment arrangements: 1 Primary Care,1 Cardiologist and 2 specialty surgeons. In addition, the facility has relocated 8 physicians to the community including 5 internal medicine, 1 Colorectal Surgeon, 1 ENT and 1 OB GYN.

$ LIP funding has enabled DeSoto Memorial Hospital to provide physician specialties in OB/Gyn, Pediatrics, and General Surgery. We have allocated approximately $20/visit to enable our physician clinics to provide services outside the hospital setting. We are projecting the service demands for non-inpatient services at DeSoto Memorial will increase by at least 10% in FY11 (highly dependent upon local economic environment, immigration regulations, and changes in Federal regulations regarding health insurance plans).

These physicians have been able to provide newer methodologies to the Community's ambulatory care resources. These physicians are able to service patients referred from the hospital's Emergency Services. The ability to maintain patient health records through electronic access streamlines follow up activity and reduces duplication of services. Medicaid and Charity Care represent over 25% of the non-inpatient services provided through DeSoto Memorial. The physicians Medicaid and Charity Care patients represent over 35% of their services provided.

$

$3,982,000

13,802

1,076,372.00

34,011,404.00

139,391

700,591 $7,771,727

Primary Care Visits = 6780 Diagnostic imaging = 4820

Lab = 10,720 Rehab patients = 350 Walk-in visits = 1200

4,220,485

Estimated Medicaid and Charity

Care visits for the most recent 12

months are: OB/Gyn--1,896;

Pediatrics--2,778; General Surgery--

100,000.00

512

Name

BAPTIST HOSPITAL

All Children's Hospital Aventura Hospital and Medical Center

Broward Health Capital Regional Medical Center Citrus Memorial Health Foundation (CMHF) Tenet Delray Medical Center, Inc.

DeSoto Memorial Hospital

Provider ID

100749

010151600 120375

100129, 120405, 108219 and 100218 119806 102199

012009000

10-923

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Loch Haven Ob/Gyn Group (Department 7780) Loch Haven OB/GYN, serving Central Florida since 1989, offers complete women's health care through a team of experienced physicians, all of whom are Board Certified by the American Board of Obstetrics and Gynecology. As leaders in both routine and advanced obstetric and gynecological services, the physicians at Loch Haven offer the most comprehensive women's care available. The Loch Haven physicians specialize in normal and high-risk pregnancies and are skilled in handling complications during pregnancy or delivery. In case an emergency arises, at least one Loch Haven physician is on duty in Florida Hospital Orlando 24-hours a day, every day. In addition, the physicians at Loch Haven are highly trained in advanced gynecological procedures and minimally invasive surgeries. They specialize in treatment for a variety of gynecological conditions, including abnormal uterine bleeding, pelvic and vaginal pain, ovarian cysts, uterine fibroids, urinary incontinence and more.

$

Assistance provided to establish physician services in the community for Pediatrics, OB/GYN, Geriatrics, and ENT Good Samaritan Medical Center, through an affiliated organization, has worked to attract new physicians to our community to meet the following community Needs by the employment of primary care physicians and specialists including : 5 Primary Care, one OB, and 7 specialty surgeons. In addition, the facility has recruited three physicians to the community including one Orthopedic Surgeon, one Neurologist and one Breast Surgeon.

$

We operate two outpatient clinics. One clinic is for adults and provides a range of family practice style services. The 2nd clinic is for patients under the age of 18 and provides a full range of pediatric care. These clinics are available to everyone and reduced fees or patient assistance services are available to eligible patients. These clinics are located in low income areas.

$

During the State Fiscal Year 2009-2010, Healthmark of Walton, Inc. used Low Income Pool funding to pay

Physician Salaries and Physician Assistant Salaries in the operation of Healthmark of Walton Rural Health

Clinic. These services are available to the public through funding made possible by the Low Income Pool

program.

$

The expansion of the uninsured discount program from 60% to 62% during 2009, reduces the amount that underinsured or uninsured outpatients would have to pay for vital health care services. With the self insured discount program allowing testing and other healthcare services to be more affordable, these patients will seek care sooner, resulting in more successful outcomes in a less expensive setting.

$

The expansion of uninsured discount program from 60% to 62% during 2009, reduces the amount that underinsured or uninsured outpatients would have to pay for vital health care services. With the self insured discount program allowing testing and other healthcare services to be more affordable, these patients will seek care sooner, resulting in more successful results in a less expensive setting.

$

Jackson Health System has a network of four primary health care centers: Jefferson Reaves Senior Health Center, Rosie Lee Wesley Health Center, North Dade Health Center, and Rafael A. Penalver Clinic; and one HIV/AIDS specialty clinic: Prevention Education & Treatment (PET) Center.

1) Heart Failure Education- started 6/09. Heart Failure education classes are held on a monthly basis for

discharged patients and Community awareness. Started in conjunction with the Heart Failure

Accreditation process based on evidenced based practice.

2) Diabetes Program-Accredited for ADA programs in 07. In 2009 expanded DSME program to additional

site at Manatee Memorial Hospital. Also provide Gestational Diabetes classes, individual DSME

counseling and support group follow up.

$

Indigent write-offs by providing free care to poverty stricken people in the community. Private pay discounts and unfunded services are more then 35 million. These are given to all uninsured patients in the community.

Wound Care (started 8/09)? Practice of advanced wound care by physicians using evidence based medicine and utilization of advanced modalities. HBO (started 8/09)? Hyperbaric oxygen therapy used in treatment of non-healing wounds in conjunction with other advanced wound care modalities. Partial Hospitalization Program; started 9/09; PHP is a comprehensive, short-term outpatient program that provides support and treatment for adults facing emotional or mental difficulties, and who may have substance abuse problems. It features coordinated, intensive treatment that is more concentrated than traditional outpatient care. The structured format provides medical monitoring, plus therapeutic groups and activities.

$

Outpatient physician practices: 22 employed physicians under the name Health Care Partners with

support staff and full cost expenses

$

In order to provide ambulatory, primary and preventive care services in a non-inpatient settings,

Memorial Hospital Jacksonville has established physician practices through an affiliated corporation that

is part of the consolidated hospital budget. These practices may include primary care services, multi-

disciplinary practices, and multi-disciplinary surgical practices. These services are available to the entire

patient population of the community.

$

5,931,156.00 $805,544

1,143,733

1,300,000

129,766.00

3036

2,113,000.00

All uninsured patients in the surrounding communities

260,000.00 $20,300,000

107,129.00 509,623

966,642.00 24,991,120.00

1,000,000

4,926

Florida Hospital Florida Hospital Waterman, INC

Tenet Good Samaritan, Inc. Halifax Health

Healthmark of Walton, Inc. Heart of Florida Regional Medical Center

Highlands Regional Medical Center Jackson Health System

Lakewood Ranch Medical Center Lower Keys Medical Center

Manatee Memorial Hospital Medical Center - Peninsula

Memorial Hospital Jacksonville

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Medicare 10-0007, Medicaid 0101290 101095

010152400 10-0017 10188500 102288

Medicaid #100897

0103420-00 101192

0101168-00 101851 101931

Three primary care centers, located throughout the community, including adult, pediatric, high-risk obstetric and low-risk obstetric services. Amounts represent growth since 2006.

$

Morton Plant Mease Primary Care, Inc. is a part of Morton Plant's commitment to meet the total health

care needs of our community. Currently we have physicians at several locations serving Pinellas and

Pasco Counties, each of which provide comprehensive medical care, from health screening to complex

diagnostic evaluations. The services that our primary physicians provide allow patients to receive the

health care needed at the appropriate care level and setting thus reducing ER visits for non-emergent

care.

$

Morton Plant Mease Primary Care, Inc. is a part of Morton Plant NorthBay's commitment to meet the total health care needs of our community. Currently we have physicians at several locations serving Pinellas and Pasco Counties, each of which provide comprehensive medical care, from health screening to complex diagnostic evaluations. The services that our primary physicians provide allow patients to receive the health care needed at the appropriate care level and setting thus reducing ER visits for nonemergent care.

$

North Shore Medical Center, through an affiliated organization, has worked to attract new physicians to

our community to meet the following community Needs by the employment and relocation of primary

care physicians and specialists including : 7 Primary Care, 2 OB, and 3 specialty surgeons, 1 Cardiologist

and 1 GI.

$

In order to provide ambulatory, primary and preventive care services in a non-inpatient settings, Orange Park Medical Center has established physician practices through an affiliated corporation that is part of the consolidated hospital budget. These practices may include primary care services, multi-disciplinary practices, and multi-disciplinary surgical practices. These services are available to the entire patient population of the community.

$

Orlando Health (current corporate name of Orlando Regional Medical Center) operates primary care clinics in the specialties of Internal Medicine, Obstetrics and Gynecology, and General Pediatrics.

$

Palmetto General Hospital, through an affiliated organization, has worked to attract new physicians to our community to meet the following community needs by the employment of primary care physicians and specialists including : 4 Primary Care and 2 specialty surgeons.

$

9,950,000.00

51,000 new encounters + 6,300 new patients assigned to mainstream primary care physicians

3,506,752.00

2,311,040.00 2,271,369.00

517,623 14,426,702.00

2,022,000.00

Memorial Regional Hospital

Morton Plant Hospital Association, Inc.

Morton Plant North Bay Hospital North Shore Medical Center Orange Park Medical Center

Orlando Regional Medical Center Palmetto General Hospital

The community medical clinic for the last 13 years has been serving the indigent community. In the last five years the clinic was expanded, almost tripling its capacity. This enables PMC to provide greater access to quality healthcare to the community's medically underserved and uninsured. Projections are

for the clinic to provide more than 15,000 visits serving over 5,000 people annually. Families who use the clinic for care are assisted with prescription medications, dental care, applying for food stamps, and other federal aid programs that meet basic needs. The Community Medical Clinic has 12 full-time staff.

Over the last five years we have added three physicians ( 2- family practice and 1- OB/GYN) as well as a

second ARNP. Additionally, nearly 70 PMC medical staff and physicians volunteer their time and

expertise to the health and well-being of Community Medical Clinic patients.

$

Support Women's Center for education to uninsured

and underinsured females who are planning or expecting children. This includes a Pregnancy Hotline and

other counseling services.

$

UF and Shands Jacksonville Primary Care network operates 27 centers around the Jacksonville area.

Since 2006 the network has seen an 18% growth in primary care services and has added five new centers

of which 27% represent uninsured and underinsured patients. Continuation of LIP funding continues to

allow the Medical Center to support its primary care initiatives.

$

Shands Lake Shore, a statutory rural hospital, opened 2 primary care clinics in FY 2008-09 for citizens of Columbia and the surrounding counties in addition to its ER. The primary care clinic has been successful in diverting unnecessary ER care as seen in the service data provided.

Shands Live Oak, a critical-access and statutory rural hospital, provides a primary care clinic for the citizens ( including pediatrics)of Suwannee and the surrounding counties in addition to its ER. The primary care clinic has been successful in diverting unnecessary ER care as seen in the service data provided.

Shands Starke, a critical-access and statutory rural hospital, provides a primary care clinic for the citizens ( including Pediatrics) of Bradford and the surrounding counties in addition to its ER. The primary care clinic has been successful in diverting unnecessary ER care as seen in the service data provided.

1,600,000.00 35,000.00

15,706,387 $1,003,348.00

$458,773.00 $354,332.00

Parrish Medical Center/ North Brevard County Hospital District Peace River Regional Medical Center

322,544 7,817 visits 10,741 visits 43,444 visits

Shands Jacksonville Medical Center Shands Lake Shore Shands Live Oak Shands at Starke

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0100200-00

101583

101508 100498 111741 101338 010460400

100102 10028500

100676 100331 101796 100072

Shands UF operates or supports 3 primary care clinics in Gainesville, FL: Magnolia Park, East Side Community Practice and the 4th Avenue Clinics. These clinics serve children and adults with physical check-ups and immunizations; health screenings; dental exams and treatment; healthcare advice and education; psychological check-ups and therapy; and links with community resources.

Primary care clinic for indigent residents of south Lake County and recruitment of primary care

physicians to community (OB Gyns and internal medicine)

$

St. Anthony's Primary Care is a part of St. Anthony's commitment to meet the total health care needs of

our community. Currently we have physicians at nine locations serving central and south Pinellas

County, each of which provide comprehensive medical care, from health screening to complex diagnostic

evaluations. The services that our primary physicians provide allow patients to receive the health care

needed at the appropriate care level and setting thus reducing ER visits for non-emergent care.

$

HealthPoint Primary Care and Specialty Care is a part of St. Joseph's Hospital's commitment to meet the

total health care needs of our community. Currently we have physicians at several locations serving

Hillsborough County, each of which provide comprehensive medical care, from health screening to

complex diagnostic evaluations. The services that our primary physicians provide allow patients to

receive the health care needed at the appropriate care level and setting thus reducing ER visits for non-

emergent care.

$

Tenet St. Mary's, Inc., through an affiliated organization, has worked to attract new physicians to our community to meet the following community Needs by the employment of primary care physicians and specialists including : 3 Primary Care, and 11 specialist. In addition, the facility has recruited two physicians to the community including one Maternal Fetal Medicine and one Neurologist.

$

Family Medical Center services for:

Self Pay

$

Medicaid

$

Medicaid HMO

$

Total

$

Our FMC clinic is designed to help provide medical care to the under-served portion of our population. The payers listed above, along with Medicare, account for 76% of the patients served. Our services include prenatal and OB services to young women including those without any health insurance when they come to see us. Actual services provided for FY09-10 total $6,734,421; of which $3,865,606 is for Self Pay and Medicaid/Mcd HMO patients.

$2,796,534.00 591,687.00

49,582 visits 657 clinic patients

2,050,000

14,121,000

5,825,262 5,283

23,041 211

28,536

3,057 13,329

121 28,758

The Rural Health Care Network is active in four counties involving primary care medicine. Physicians and nurse practitioners work at four offices providing primary care in these rural, under-served counties. Support services of these offices are maintained through the Department of Practice Management and

this support allows and ensures continued services in the mentioned communities.

$

Total Cost of providing care to under and uninsured patients at all of Tampa General's outpatient clinics.

A total of 82,779 visits were performed in FY 2009 for a cost of $ 14,487,210. $

Morton Plant Mease Primary Care, Inc. is a part of Morton Plant Mease's commitment to meet the total health care needs of our community. Currently we have physicians at several locations serving Pinellas and Pasco Counties, each of which provide comprehensive medical care, from health screening to complex diagnostic evaluations. The services that our primary physicians provide allow patients to receive the health care needed at the appropriate care level and setting thus reducing ER visits for nonemergent care.

West Boca Medical Center has expanded Primary Care Services to fulfill Community need and expanded capacity to provide services through recruitment of 4 Specialty Care Physicians with an affiliated organization. Those physician s include 1 specialist in Endocrinology and 1 specialist in Pediatric Orthopedics. In addition the facility has relocated an OB/GYN to the area with plans to expand services based on service area needs.

$

Winter Haven Hospital currently contracts with the Polk Healthcare Plan (est. 1999) to provide hospital services to the uninsured and under insured in Polk County. As part of this contract the Hospital accepts a reimbursement rate less than the actual cost of providing services. The lower rate accepted by the Hospital allows the Polk Healthcare Plan to redirect more funding to primary care services for the uninsured and under insured in Polk County, thus allowing the Hospital to indirectly subsidize primary care services.

$

260,000 14,487,210

948,198 664,537.00

501,759

80,542 82,779

Shands Teaching Hospital & Clinics, Inc. South Lake Hospital St. Anthony's Hospital

St. Joseph's Hospital, Inc. Tenet St. Mary's, Inc.

St. Vincent's Medical Center

Tallahassee Memorial HealthCare Tampa General Hospital

Trustees of Mease Hospital, Inc. West Boca Medical Center Inc

Winter Haven Hospital

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100030 101087 120227 100978 101486 100731

0010-0135 0100994-00 and 0100994-01

120081 and 101541 12024300 101699

Funding provided to Brevard Health Alliance (BHA), which is a Federally Qualified Health center opened

to uninsured and underinsured residents of the community, regardless of their ability to pay. BHA provides primary health care service offices providing on-site primary care and mobile health unit. Wuesthoff also contributes Diagnostic Testing and Prescription Drug assistance to BHA. ALSO,

Wuesthoff has similar relationship with the Brevard County Health Department and their P.A.T.H Clinic program.

$

Total Primary Care

$

Out reach Screenings for torticollis and other developmental issues at a clinic in North Pinellas County

Screenings for late effects clinic for cancer survivors

Collaborated with local YMCA on a wellness and exercise program for cancer survivors and children suffering from other chronic health conditions. Therapy screenings (physical, occupational, speech) for children with autism spectrum disorders

Pediatric wellness program on Main Campus including individual attention and small groups.

Therapy screenings for post-neonatal intensive care infants

Quarterly health screenings with the Early Childhood Coalition

Safe Kids Program - Through its membership in the Florida Suncoast Safe kids Coalition, All Children's provides education and support to prevent the unintentional injury of children, the leading cause of death in children in the United States.

Fit4Allkids Program - The Fit4Allkids program is a weight management and fitness program for families that encourages children to do their personal best and reach their own goals for weight loss/weigh management and physical activity. The program encompasses both intervention and prevention and serves children and their families in a 17-county area.

Through out the year, the hospital reaches out to the community by offering free screenings, health fairs, educational programs, physician lectures on various health topics. These educational events are

available to public with no expense to those attending. $

Baptist Hospital has provided "Free" health screenings to over 4,000 community residents. This includes Heart and Stroke analysis, Body composition, speech and hearing, breast cancer risk, osteoporosis heel scan, blood glucose testing and sleep disorder analysis.

$

Baptist Hospital has provided over 200 "Free" seminars to the community for disease risk awareness,

medication support training, Fitness, mental health, pool and beach safety and general health wellness. $

Baptist Hospital has over 12 unique support groups to help patients with challenges faces with their

health care situation.

$

Bay Medical Center has many off-site locations that provide outpatient services regardless of ability to

pay. The amount here represents the charity portion of services provided at these locations. $

School based clinics provide physicals, prenatal services and immunizations for students, their families

and neighborhood residents.

$

Beginning in July 2009, CMHFpartners with the State of Florida Department of Children and Families, ACCESS Florida and Trinity Health to provide an on campus assistance center for the residents of Citrus

County, Florida. The center is equipped to provide for assistance in Medicaid Eligibility, food stamps, the Hospital Sponsored Care Program and other programs that might be available. There is staff on site to assist in the above mentioned programs.

Diabetes Education Program - This program provides education to community members who have recently been diagnosed with diabetes or pre-diabetes. The program offers small group classes and support groups directed and staffed by certified diabetes educators and a multidisciplinary team to meet the needs of the diagnosed person. The program meets the National Standards for Diabetes SelfManagement Education endorsed by the American Diabetes Association.

$

Outreach - Community Health Fairs and Outreach Programs

533,600 209,291,941

$4,160 $5,000 $6,240 $8,000 $25,000 $30,000 $100,000 $145,500

$148,500

107,348.00

60,000.00 10,500.00

3,500.00 11,565,037.00

4,291,228.00

$40,000

58,043

48 150 208 156 1,000 1,100 58,415 2,000

3,300

Adj to cost Adj to cost Adj to cost

17,587

1,000

Wuesthoff Hospital - Rockledge All Children's Hospital

Aventura Hospital and Medical Center BAPTIST HOSPITAL

BAY MEDICAL CENTER Broward Health

Citrus Memorial Health Foundation (CMHF) Tenet Delray Medical Center, Inc.

Medicaid # 100111 HCCCB # 100092 010151600

120375 100749 10-006400 100129, 120405, 108219 and 100218 102199 012009000

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