PCASG Fund Recipients Used PCASG Funds to Support Primary Care Services by Hiring Health Care Providers and Other Staff and Adding Services and Sites

PCASG fund recipients reported that they used PCASG funds to hire or  retain health care providers and other staff, add primary care services, and  open new sites. Recipients also said that the PCASG funds have helped  them improve service delivery and access to care. Almost All PCASG Fund Recipients That Responded to Our Survey Used PCASG Funds to Hire or Retain Health Care Providers and Other Staff

Most of the PCASG fund recipients that responded to our survey reported  they used PCASG funds to hire health care providers or other staff. PCASG fund recipients also reported using grant funds to add or expand  specialty care services or to add ancillary services. For example, one of these recipients  reported that it added podiatry services. Other Federal Hurricane Relief Funds Helped PCASG Fund Recipients to Pay Staff, Purchase Equipment, and Expand Mental Health Services to Help Restore Primary Care

PCASG fund recipients also used other federal hurricane relief funds to  provide services. Two PCASG Fund Recipients Used SSBG Supplemental Funds Designated for Mental Health Care to Provide a Range of Services, Including Crisis Intervention and Substance Abuse Prevention and Treatment

The two PCASG fund recipients that received SSBG supplemental funds  designated for mental health care used them to provide crisis intervention,  substance abuse, and other mental health services. This  recipient expended $7.9 million of the $29 million in CCP funds awarded to  Louisiana. PCASG Fund Recipients Face Multiple Challenges and Have Various Plans for Sustainability

PCASG fund recipients face significant challenges in hiring and retaining  staff, as well as in referring patients outside of their organizations, and  these challenges have grown since Hurricane Katrina. For example, 16 of the 23 recipients reported that retaining  health care providers was a great or moderate challenge. Specifically,  14 of the 23 recipients reported that the availability of mental health  providers willing to accept referrals was a great or moderate challenge,  and over two-thirds of those reporting that level of challenge responded  that this challenge had grown since Hurricane Katrina. Although PCASG fund recipients have completed or planned actions to  increase their ability to be sustainable, it is too early to know whether  their various sustainability strategies will be successful. The PCASG funds were targeted to the greater New  Orleans area—specifically, Jefferson, Orleans, Plaquemines, and St.  Bernard parishes—because of the impact Hurricane Katrina had on this  area. In this report we examine (1) how PCASG fund recipients used the  PCASG funds to support the provision of primary care services in the  greater New Orleans area, (2) how PCASG fund recipients used and  benefited from other federal hurricane relief funds that support the  restoration of primary care services in the greater New Orleans area, and  (3) challenges the PCASG fund recipients continued to face in providing  primary care services, and recipients’ plans for sustaining services after  PCASG funds are no longer available. In  addition, we reviewed and analyzed data gathered by LDHH related to the  incentive payments made under the Professional Workforce Supply Grant  and expenditures under the Crisis Counseling Assistance and Training  Program (CCP). Appendix II: Primary Care Access and Stabilization Grant Fund Recipients: Characteristics, Patients, and Services

In July 2007, HHS awarded the $100 million PCASG to LDHH, which in  turn provided funds to 25 outpatient provider organizations in the greater  New Orleans area in September 2007.
Why GAO Did This Study

The greater New Orleans area--Jefferson, Orleans, Plaquemines, and St. Bernard parishes--continues to face challenges in restoring health care services disrupted by Hurricane Katrina. In 2007, the Department of Health and Human Services (HHS) awarded the $100 million Primary Care Access and Stabilization Grant (PCASG) to Louisiana to help restore primary care services to the low-income population. Louisiana gave PCASG funds to 25 outpatient provider organizations in the greater New Orleans area. GAO was asked to study how the federal government can effectively leverage governmental resources to help area residents gain access to primary care services. This report examines (1) how PCASG fund recipients used the PCASG funds to support primary care services in greater New Orleans, (2) how PCASG fund recipients used and benefited from other federal hurricane relief funds that support the restoration of primary care services in the area, and (3) challenges PCASG fund recipients continued to face in providing primary care, and their plans for sustaining services after PCASG funds are no longer available.

What GAO Found

PCASG fund recipients reported that they used the PCASG funds to hire or retain health care providers and other staff, add primary care services, and open new sites. For example, 20 of the 23 recipients that responded to the GAO survey reported using PCASG funds to hire health care providers, and 17 reported using PCASG funds to retain health care providers. In addition, most of the recipients reported that they used PCASG funds to add primary care services and to add or renovate sites. Recipients also reported that the grant requirements and funding helped them improve service delivery and expand access to care in underserved neighborhoods. Other federal hurricane relief funds helped PCASG fund recipients pay staff, purchase equipment, and expand mental health services to help restore primary care. Eleven recipients received HHS Social Services Block Grant (SSBG) supplemental funds designated by Louisiana for primary care, and two received SSBG supplemental funds designated by Louisiana specifically for mental health care. The funds designated for primary care were used to pay staff and purchase equipment, and the funds designated for mental health care were used to provide a range of services for adults and children, including crisis intervention and substance abuse prevention and treatment. About two-thirds of the PCASG fund recipients benefited from the Professional Workforce Supply Grant incentives. These recipients hired or retained 69 health care providers who received incentives totaling over $4 million to work in the greater New Orleans area. In addition, one PCASG fund recipient expended $7.9 million it received from Louisiana to provide services through the federal Crisis Counseling Assistance and Training Program. PCASG fund recipients continue to face multiple challenges and have various plans for sustainability. Recipients face significant challenges in hiring and retaining staff, as well as in referring patients outside of their organizations, and these challenges have grown since Hurricane Katrina. For example, 20 of 23 recipients that responded to the GAO survey reported hiring was a great or moderate challenge, and among these 20 recipients over three-quarters reported that this challenge had grown since Hurricane Katrina. Six of the 7 recipients that primarily provide mental health services reported that both hiring and retention of providers were great or moderate challenges. Many PCASG fund recipients also reported challenges in referring patients outside their organization for mental health, dental, and specialty care services. Although all PCASG fund recipients have completed or planned actions to increase their ability to be sustainable, it is too early to know whether their various sustainability strategies will be successful.