America's only not-for-profit foundation dedicated to supporting the work of community health centers

In August 2006, Chorus had the opportunity to speak with Feygele Jacobs, the executive vice president of the then newly-formed RCHN Community Health Foundation, the only not-for-profit foundation in the country dedicated exclusively to supporting the work of community health centers.

Chorus: When was the RCHN Community Health Foundation established and what are its goals?

Ms. Jacobs: The RCHN Community Health Foundation is a not-for-profit foundation established in October 2005 to support the work of community health centers - the local, non-profit, community-governed healthcare providers that offer comprehensive primary and preventive care to underserved populations.

The Foundation concentrates its work in three areas that are of critical importance to community health centers and their patients:

• healthcare access
• affordable prescription drugs
• health information technology

Through strategic investments and partnerships in research, education and advocacy, the Foundation is helping to address community health centers' primary challenges and establish opportunities to sustain CHCs in the future.

Chorus: Why does the Foundation focus exclusively on community health centers?

Ms. Jacobs: The RCHN Community Health Foundation builds on the long history and commitment to CHCs of the Ryan Community Health Network (RCHN), a New York-based not-for-profit network and management services organization that was dedicated to creating an integrated, community-based, healthcare delivery system. RCHN was the parent company of CenterCare, a CHC-controlled Prepaid Health Services Plan (PHSP) as well as of the William F. Ryan Community Health Center, its satellite Ryan-NENA, and the Ryan/Chelsea-Clinton Community Health Center.

The Ryan Community Health Network's defined mission was to expand and enhance primary care, and to improve the quality of healthcare services available to low income, medically underserved populations. Over the years, the Network developed substantial managed care expertise, a solid technical infrastructure and an expansive knowledge of community-based primary care delivery systems.

By 2004, the Ryan Network -- including RCHN, the Ryan Centers and CenterCare --had become the largest community health center network in New York state, and a nationally known model for care with 85,000 members in CenterCare, and the Centers providing over 200,000 primary care and specialty visits at three locations.

On September 30, 2005, RCHN transferred ownership of CenterCare to The Catholic Health Plan of New York state (also known as "Fidelis Care New York"). The goal of the transaction was to make available substantial resources for the broader support of community health centers. As part of the reorganization of the companies, the Centers became self-governing, and the RCHN Community Health Foundation was formed.

Chorus: Tell me about the leadership of the Foundation.

Ms. Jacobs: The Foundation carries forward the legacy of Julio Bellber, the Foundation's president and CEO. Julio, or "Jay" as he known to most of us, first began working at the William F. Ryan Community Health Center (Ryan) in 1968. He was appointed as executive director in 1979, and after literally building the center from the ground up, was named president and CEO of CenterCare and RCHN. Jay was asked to join the Foundation as president and CEO, and the Foundation benefits from his extraordinary vision, commitment and accomplishments over 40 years.

Chorus: Why has the Foundation chosen Health Information Technology ("HIT") as one of the areas for strategic investment?

Ms. Jacobs: RCHN had a long interest in and commitment to supporting HIT, both for its own use and that of the broader CHC market place. Some of this goes back to RCHN's history in selecting HIT for its own centers. The Foundation has carried forward RCHN's historical commitment and built on it.

Chorus: How did RCHN become involved with Chorus?

Ms. Jacobs: In 2001, RCHN issued an RFP to select a practice management system for one of the Network's new sites. Later that year, RCHN joined forces with Presbyterian Medical Services of New Mexico ("PMS") to obtain an interest in a practice management software development firm then known as MDSERVE, which had begun to establish a presence as a CHC-oriented product. In December 2003, PMS and RCHN acquired MDSERVE and it became the first healthcare software development firm to be completely owned by community health centers and operated for their benefit. With the formation of the well-capitalized Foundation, the Board of Directors re-affirmed its commitment not only to MDSERVE, but to a broader technology vision and strategy.

Chorus: What is the Foundation's vision for HIT?

Ms Jacobs: The Foundation's technology vision is to provide CHCs with affordable access to technology infrastructure that's customized to address their unique operating needs, supports their operations and enables them to provide clinical care of the highest quality. The Foundation's strategy to make this vision a reality has three components:

• Technology-related research, policy and advocacy
• Applications, managed implementation, training and support that form a "Total Technology Solution" for CHCs
• Technology financing, loans and grants

Chorus: Why is a focus on the unique needs of CHCs so important?

Ms. Jacobs: While CHCs share many core HIT needs with other ambulatory care providers, the scope of what CHCs need to report and operate goes well beyond those basic requirements. In addition to routine clinical capabilities, financial management, and reporting, CHCs must meet stringent federal reporting requirements. Adding another layer of complexity are such factors as sliding fee scales and encounter billing, the need to interface with UDS and PECS, and unique, state-specific requirements.

Historically, CHCs have had little success in getting their unique health information technology needs met by traditional vendors. Given the complex requirements for the operations of CHCs, and the history of the HIT vendor marketplace, the Foundation maintains that there must be an affordable technology solution designed especially for health centers. The technology solution must be delivered by an organization which understands the operating infrastructure of a health center and can address the issues associated with limited financial resources.

Chorus: What is the relationship of the Foundation to Chorus today?

Ms. Jacobs: After engaging an independent consultant to evaluate the Chorus strategy and products, the RCHN Community Health Foundation's board of directors reaffirmed its commitment to the company and agreed to considerable financial support, as a program investment. The Foundation is dedicated to helping CHORUS be successful.

Chorus: What role does Chorus play in the realization of the Foundation's vision?

Ms. Jacobs: Our board of directors endorsed a broader technology vision that encompasses HIT applications, research, and financing Chorus, with its focus on the delivery of customized applications and services to CHCs, is a cornerstone of that vision.

Chorus: You mentioned partnerships. Is the Foundation working with others to achieve this technology vision?

Ms. Jacobs: As part of its expanded HIT strategy, the Foundation has formed a long-term partnership with the National Association of Community Health Centers ("NACHC") and NACHC's affiliate, Community Health Ventures, to deliver, in conjunction with CHORUS, the Technology Support Program (TSP™) with applications and services tailored to the CHC market. In addition, the Foundation has been involved in a collaborative grant with NACHC and several other foundations to develop the case for an adjustment to health center reimbursement rates to cover costs related to HIT acquisition and implementation.

We are proud to be part of this historic, strategic partnership devoted to health center needs and proud to support CHORUS, which is the only technology solution provider in the country that is focused on and committed exclusively to meeting the needs of community health centers.