Creation of the CHRC

The Maryland General Assembly created the Community Health Resources Commission in 2005 to expand access to affordable, high quality health care services in the state’s underserved communities; support the adoption of health information technology in community health resources; increase access to specialty health care services for the uninsured and
low-income individuals; and promote interconnected systems of care and partnerships among community health resources and hospitals. The CHRC is an independent commission within the Maryland Department of Health & Mental Hygiene, and its 11 members are appointed by the Governor. The CHRC fulfils its authorizing statutory responsibilities through its grantmaking activities, awarding 142 grants totaling $41.9 million, supporting programs in all 24 jurisdictions of the state. These programs have collectively served more than 140,000 Marylanders and enabled CHRC grantees to leverage $14.7 million in additional federal and private/non-profit resources.

In creating the CHRC, the Maryland General Assembly recognized the need to have an independent commission that focused on strengthening Maryland’s diverse network of community health centers and safety net providers and addressed service delivery gaps in Maryland’s dynamic health care marketplace. The role that the CHRC plays in strengthening Maryland’s network of community health resources and safety net providers becomes increasingly important as Maryland implements the ACA and hundreds of thousands of individuals gain access to health insurance. The newly insured individuals will place increasing demands on Maryland’s community health centers and safety net providers as they seek health care services in higher volumes.

The CHRC has awarded a number of grants and provided technical assistance to enable safety net providers to build capacity and expand access and to promote their transition from a grant-based revenue model to a more sustainable system of billing third-party payers. In addition, Maryland is currently implementing a new Medicare All-Payor Waiver (Waiver) which transitions the hospital revenue structure from an inpatient fee-for-service model (quantity) to a system based on total patient revenue and global budgeting that rewards quality and promotes reductions in inpatient care costs. This Waiver presents enormous challenges for Maryland’s hospitals and may provide an increased focus on importance of the delivery and accessibility of services in an ambulatory care setting. This transition presents new opportunities for community health resources and safety net providers.

A number of recent grants awarded by the CHRC have promoted innovative community-hospital partnerships and programs that target reductions in hospital emergency department visits, admissions, and readmissions. These types of community-hospital partnerships to reduce hospital inpatient costs and efforts to build capacity of community health resources are expected to continue.

The CHRC supports the work of community health care resources and fulfills its statutory mission in the following activities:

1. Awarding grants to expand access in underserved areas and support public health priorities;
2. Supporting the Local Health Improvement Coalitions (LHIC) and efforts to promote population health initiatives;
3. Implementing the Health Enterprise Zones Initiative jointly with DHMH; and
4. Executing additional special projects.