State Innovation Model (SIM)

The Greater Flint Health Coalition (GFHC) is one of five organizations chosen by the Michigan Department of Health and Human Services (MDHHS) to lead the implementation of the State Innovation Model (SIM) within their communities. As the backbone organization for the Genesee Community Health Innovation Region (CHIR), the GFHC and its multisector partners are working to improve population health in Genesee County.

What is SIM?

SIM is a Centers for Medicare and Medicaid Services (CMS) Innovation Center initiative that partners with states to advance multi-payer health care payment and delivery system reform models in an effort to achieve better quality of care, lower costs, and improved health outcomes for Medicaid beneficiaries. The State of Michigan was one of eleven states awarded a four-year model test award, focused on implementing Michigan’s Blueprint for Health Innovation.

The vision for Michigan’s State Innovation Model is a person-centered health system that is coordinating care across medical settings, as well as with community organizations, to address social determinants of health to improve health outcomes; and pursue community-centered solutions to upstream factors of poor health outcomes. MDHHS is implementing the SIM initiative under three main umbrellas: population health, care delivery, and technology.

Community Health Innovation Regions

To address population health, MDHHS has funded five Community Health Innovation Regions (CHIRs) across the State. In addition to the GFHC’s Genesee CHIR, there are CHIRs in the Jackson, Muskegon, Northern Michigan and Livingston/Washtenaw County communities. CHIRs are broad partnerships of community organizations, local government agencies, businesses, healthcare providers, payers, and community members that collaborate to align and implement strategies to support population health.

SIM Priority Population

MDHHS has required Community Health Innovation Regions to focus on the SIM priority population of emergency department (ED) utilizers. The selection of this priority population is supported by the Genesee CHIR’s Community Health Needs Assessment (CHNA), adopted by Genesee County’s three hospitals and the GFHC. The GFHC and its stakeholders have defined this SIM priority population as:

1. High ED utilizers, or individuals using the ED five or more times in a year
2. “Inappropriate” ED utilizers, or individuals using the ED to receive care for conditions identified as typically treatable in a primary care setting; and
3. Preventable ED utilizers, or individuals using the ED who have not had a visit with their primary care provider in the previous year.

GFHC Clinical-Community Linkage Initiative

A primary goal set by MDHHS for each Community Health Innovation Region is to address non-medical factors that affect health, such as housing, transportation, and food insecurity, by supporting connections between primary care practices and community service providers, often referred to as clinical-community linkages. The Clinical Community Linkage Project is led by the Greater Flint Health Coalition, which has implemented a community “hub” model based on the early success of its Genesee Children’s Healthcare Access Program, or CHAP.

To achieve this goal of developing a functional clinical community linkage process, the GFHC has partnered with a variety of community stakeholders and institutions. These include, but are not limited to:

• Two local physician organizations: Professional Medical Corporation and McLaren Physician Partners;

• Genesee County’s six Medicaid Health Plans: Molina Healthcare, McLaren Health Plan, Meridian Health Plan, Blue Cross Complete, UnitedHealthcare Community Plan, and HAP Midwest;

• Genesee County’s three hospitals: Hurley Medical Center, Ascension Genesys Hospital, McLaren Flint;

• Three community-based specialty hubs: Genesee CHAP, Genesee Health Plan, and Genesee Health System;

• The local regional health information exchange (HIE), Great Lakes Health Connect;

• A collective of community and social service organizations including: United Way of Genesee County, Catholic Charities, Carriage Town Ministries, Child Care Connect, Crossover Downtown Outreach Ministries, Food Bank of Eastern Michigan, Genesee County Community Action Resource Department (GCCARD), Mass Transportation Authority, My Brothers’ Keeper, Salvation Army, Shelter of Flint, Valley Area Agency on Aging, and YWCA of Greater Flint.

A newly launched Community Referral Platform is providing one platform linking participating practices, community-based specialty hubs, and community service agencies to support the needs of patients. Working together, the GFHC and its partners will address the upstream socio-economic factors affecting the health of Genesee County residents. An initial ten SIM-designated patient centered medical home (PCMH) practices are included in the Clinical Community Linkages pilot phase launch that began in November, 2017.

Genesee County Community Health Access Program (CHAP)

The Community Health Access Program (CHAP) is a collaborative, community-based medical home improvement model intended to improve the health outcomes of individuals covered by Medicaid insurance (specifically children), while raising the quality of care, better utilizing resources, and decreasing costs.

Children, and in some cases adults,  are referred to CHAP by participating pediatric and family practices, Medicaid health insurance plans, Genesee County’s 2-1-1 system, or through self-referrals. A multidisciplinary CHAP team provides services to clients that include:

  • Linkages to community resources to address social determinant of health needs
  • Parent education
  • Health literacy
  • Asthma education and case management
  • Care coordination
  • Patient navigation
  • Interpretation and transportation services

The CHAP team works with providers offering assistance to:

  • Improve office efficiency
  • Decrease no-show rates
  • Meet medical home certification requirements
  • Conduct follow-up on emergency department utilization
  • Create linkages to community resources
  • Educate on clinical best practices
  • Develop data reports on CHAP eligible clients
  • Implement quality improvement projects focused on preventative services
  • Connect with other providers

CHAP also facilitates change at the system level in the effort to reduce the health disparities experienced by individuals insured by Medicaid improving quality and access to medical homes, reducing emergency department visits and hospital admissions, and improving the overall health outcomes for the clients it serves.

For additional information or to learn how you may participate in Genesee CHAP, please phone (810) 953-CHAP or email

Commit To Fit

Commit to Fit is an ongoing health behavior improvement initiative that seeks to mobilize employers, schools, residents, neighborhoods, churches, and the community at-large to support and utilize a common message focused on healthier, more active lifestyles. Thus, the healthy messages of Commit to Fit are reinforced throughout the community, across settings where residents live, learn, work, and play.

The campaign promotes practical ways to increase health and wellness through simple daily choices. The Commit to Fit plan suggests 99 easy ways to better health, outlined in simple tools the community, businesses or your school can adopt and make their own. It also urges proper nutrition, hydration and rest as realistic ways to sneak healthy behaviors into your life.

Available resources include free fitness and nutrition education classes, materials and tools for individuals and employers to promote and maintain good health, and an online health behavior tracking website to monitor your health and wellness goals.

The broad support for the Commit to Fit movement relies on the shared use of the Commit to Fit messages by all Genesee County/Flint organizations or groups that are working to improve the practice of healthy behaviors. Using the common messaging of Commit to Fit, employers, schools, physicians, neighborhoods, churches and residents are all “spreading the word” throughout the community and – together – Commit to Fit is helping to build a more active, healthy community in which we can all live, learn, work, and play.

In 2011, the Michigan Department of Community Health selected the GFHC as one of six local coalitions to expand prevention activities and empower local residents to make healthy choices. The Commit to Fit campaign supports this through a common message focused on healthier, more active lifestyles in Flint and Genesee County.

Since its launch, Commit to Fit has expanded to develop and provide a number of associated community efforts including: Hosting an annual calendar of community-wide health and wellness challenges, Commit to Fit Project Healthy Schools, Commit to Fit Smart Bites, and the Commit to Fit Rethink Your Drink campaign. Additional Commit to Fit developed resources include: the Commit to Fit Breastfeeding Toolkit, the Commit to Fit Physician’s Toolkit and the Commit to Fit Employer-Based Comprehensive Wellness Toolkit. These resources can be downloaded for free at or requested by mail or delivery by completing a materials order form.

Commit to Fit is free to all Genesee County / Flint residents and workers. Visit today to join the movement and access all the resources Commit to Fit has to offer!

Flint Healthcare Employment Opportunities (FHEO) Program

The Flint Healthcare Employment Opportunities (FHEO) Program was designed to assist unemployed and underemployed residents of Flint and Genesee County with obtaining training and employment in the healthcare industry. These training programs include: Certified Nurse Assistant, Medical Assistant, Pharmacy Technician, Health Unit Coordinator, Medical Billing and Coding, Registered Nurse, and other high demand health careers.*

*Training opportunities based on funding availability

Spend less than 5 minutes to be on 
your way to a career in healthcare.


For eligible participants accepted into the FHEO Program, training funds are awarded throughout the year and are based on local employer hiring needs, applicant qualifications, training availability, and the following criteria:

  • Resident of GST MI Works service area and eligible for WIOA Adult, Dislocated Worker or Out-of-School Youth services
  • Demonstration of need or experiencing circumstances that make it difficult to focus on a career transition
  • A compatibility for a career in healthcare – clear criminal background, aptitude and capabilities assessments, healthcare career suitability assessment, and drug screening
  • Minimum age: 18 years old
  • High school diploma/GED
  • Veterans strongly encouraged to apply
Don’t Screen Yourself Out. Let Us Screen You In! Call 810-232-2228
for more information!


1. Contact the FHEO Program at 810-232-2228 with your questions and to sign up for the next information session.

2. Get a step ahead, fill out your program application now.

Spend less than 5 minutes to be on your way to a career in healthcare.


Program components are designed by FHEO Program employers to give participants the background, skills, and experience needed to succeed in a health care career.

Participants receive:

  • Career readiness and “fit” assessments
  • Three week Healthcare Life Skills Training and Career Exploration Workshops
  • A career advisor to assist with decision making and goal achievement
  • Tuition funding
  • Assistance with books, uniforms, exam/license fees and work supplies
  • Resume, interview skills, financial literacy and other workshops to improve competitiveness in the workplace
  • Employer connections and job search assistance


FHEO Program Steps


The Flint Healthcare Education Opportunities (FHEO) Program has been identified by GST Michigan Works! Agency as the lead healthcare service provider for the Workforce Innovation Opportunity Act (WIOA) Career Services (Adult and Dislocated Workers Program) and WIOA Out-of-School Youth Services.
The FHEO Program’s partner organizations make our work to assist residents with training and education for future healthcare careers a shared success by helping participants find sustainable careers while helping meet the needs of local healthcare employers.


The Greater Flint Health Coalition (GFHC) is the lead agency for the Flint Healthcare Employment Opportunities (FHEO) Program and the lead Healthcare Service Provider for GST Michigan Works. Established in 2002, the FHEO Program trained its first graduating class in January 2003. Started thanks to the vision of the Charles Stewart Mott Foundation, the FHEO Program has received funding from the C.S. Mott Foundation, Community Foundation of Greater Flint, GST Michigan Works, the Aspen Institute, and the United States Department of Labor.

Smart Bites

The Commit to Fit! Smart Bites program is a new community- based project created to help local residents, families, and children make healthy decisions when they dine out. Commit to Fit! Smart bites and restaurants work together to identify and promote healthy foods and beverages and reward residents when they make smart menu choices.

Healthy Menu Options

A Commit to Fit! Smart Bites program representative from our community will work with restaurants to review menus and identity healthy options. Once these options are selected, participating restaurants will be provided with marketing materials to promote healthy menu items.

Community Rewards

When a community member visits a Commit to Fit! Smart Bites program restaurant and selects a healthy menu option, they will be rewarded with a discount determined by each restaurant. Community members will also be eligible for incentives by participating in the program.

Commit to Fit! Smart Bites Cards

Community members can pick up a Commit to Fit! Smart Bites card at participating restaurants and Flint Farmers’ Market cooking demonstrations. When a resident selects a Smart Bites program new item at a participating restaurant, they receive one sticker per visit regardless of the number of items selected. Each restaurant receives a unique Smart Bites sticker that helps track residents and restaurant participation.

Promoting the Program

The Commit to Fit! Smart Bites program will be showcased throughout our community, in the press, and on, among other places. Restaurants will receive Commit to Fit! Smart Bites program marketing materials for in-house display, and Commit to Fit! Smart Bites program restaurants will be regularly promoted within the community- reaching thousands of potential patrons.

Perks for your Restaurant

The Smart Bites program creates business and expands your customer base and builds your reputation as a business that cares about its community and its residents. YOU will have a dramatic impact by helping families choose healthy and eat smart.

Get Started Today

Our community has the opportunity to shape the future of the Smart Bites program, potentially impacting the healthy of people nationwide. Contact the Smart Bites program representative from your community to join the program!

Advance Care Planning – Your Health Your Choice

In life, we plan for many things. We prepare for our retirement, plan trips, and save money for our children’s education. Yet, we often forget to plan for our future healthcare treatment. No one can predict when a sudden illness or accident may occur, leaving a person unable to make personal healthcare decisions. Advance care planning is about ensuring that the healthcare treatment you receive is consistent with your wishes and preferences. It’s a gift to you and your family that promotes peace of mind.

Advance care planning is the process of coming to understand, reflect on, discuss, and plan for a time when you cannot make your own medical decisions. Effective planning is the best way to make sure your views are respected by your loved ones and health providers. This process provides great comfort to those who may make end-of-life decisions for you.

Your Health Your Choice is provided as a free service to the residents of Genesee County. First Steps® certified advance care planning facilitators are available at no cost to meet with individuals and guide them through the ACP process. ACP facilitators help you to reflect on and document your end-of-life healthcare wishes and preferences. They help make sure that those wishes are shared with your family, loved ones, and healthcare professionals to ensure that they are honored when you can no longer speak for yourself. To find out additional information or schedule an appointment to complete an advance directive or review your existing advance directive, please visit

Flint Registry

People who were impacted by the Flint Water Crisis can now participate in a voluntary secure registry which will aim to connect them to programs and other resources that serve to minimize the effects of lead on their health while promoting wellness and recovery.

Michigan State University will carry out the registry in collaboration with a broad partnership including leadership form the City of Flint, Greater Flint Health Coalition, educators, clinicians, and community-based organizations that serve Flint residents.

In addition to linking residents to supportive programs and resources, the registry will document the effects on residents affected by lead-tainted tap water and evaluate the effectiveness of health, educational, environmental and community services on improving the health of participants.

Enrollment into the registry will begin in fall of 2018.

Registry Pre-Enrollment

Enrollment into the registry will begin in fall of 2018, however pre-enroll now to get the most up-to-date information. To pre-enroll, visit, contact (833)GO-FLINT or email, for more information.

Health Happens Here

Health Happens Here – Genesee County & Flint is a social marketing campaign that aims to improve health by bringing awareness to residents of all communities in Genesee County and Flint regarding the following:

1. How social determinants of health in one’s community can impact their health and well-being.

2. What resources are available for residents to take advantage of in their neighborhood or community.

3. How they can take action to improve social determinants (where we live, learn, work and play) of health in their respective neighborhood or community.

Health Happens Here – Genesee County & Flint is based on a best practices model previously implemented through the California Endowment which informs residents of differences in average life expectancy in various local zip codes as one tool to engage residents in action. Community-based marketing provides powerful messaging to raise awareness of the social determinants (where we live, learn, work and play) of health and the resources available to improve health in the community.

The Health Happens Here program supports local residents in improving health behaviors by encouraging participation in existing health-related resources, programs, events, and other activities that support individual and community well-being.


  • As an online resource,, is linked to a community calendar to include health and community-related activities, and includes a link to the “Health Happens Here Genesee County & Flint” Facebook page.
  • The website also contains information on how residents can take action to improve health in their community (for example, an “Advocacy & Action” document is available to specifically outline ways that residents can contact legislators on health-related issues).
  • Fact Sheets for all communities/zip codes in Genesee County & Flint are offered as resources to residents, highlighting health-related statistics as well as resources related to each specific community where residents live, learn, work, and play.