Capital Health Community Health Needs Assessment and Actions

Transcription

1 Capital Health Community Health Needs Assessment and Actions Robert J Remstein, DO, MBA Vice President for Accountable Care President of Trenton Health Team

2 Capital Health Mercer County, New Jersey Regional Medical Center Hopewell Medical Center

3 A Tale of Two Cities Hopewell Medical Center Replacement hospital for the former Mercer Medical Center Suburban medical center with focus on Maternal/fetal and pediatric care Oncology Surgery Cardiology Major focus of low income care revolves around maternal fetal and pediatric care Regional dedicated pediatric ED Link to regional perinatal center at our Trenton campus

4 A Tale of Two Cities Regional Medical Center Urban Tertiary Center Teaching hospital with primary care residency clinics Regional Trauma Center Regional Psychiatric Center (ED and inpatient) Comprehensive Stroke Center Focal point of Trenton Health Team

5 Community Health Needs Assessment Robert Wood Johnson Foundation grant recipient at each campus Hopewell through the Greater Mercer CHNA comprising Capital-Hopewell, University Medical Center at Princeton, RWJ University Hospital Hamilton all coordinated through the United Way Regional through the Trenton Health Team comprising Capital-Regional, St. Francis, Henry J. Austin and the City

6 Regional Medical Center CHNA done under the auspices of the Trenton Health Team Consortium of Capital Health, St. Francis Medical Center, Henry J Austin FQHC, City of Trenton Five goals of the Trenton Health Team Assure access to primary care for all Trentonians Coordinate clinical care across the City for high risk patients and diagnoses Engage the community in health care; population and individual Develop a health information exchange Develop a Medicaid ACO

7 Hopewell Medical Center CHNA done under the auspices of the United Way of Greater Mercer County Coalition of Capital Health Hopewell, Princeton Healthcare, RWJ Hamilton, St. Lawrence Rehabilitation, local and county public health agencies

8 Key Focus Priorities Identified by CHNA Regional Obesity and unhealthy lifestyles Substance abuse and behavioral health Disparities in access and health literacy Safety and crime Chronic diseases (Diabetes, hypertension, cancer) Hopewell Obesity and healthy eating Substance abuse and mental health issues Disparities in access and health literacy Preventive health services Public transportation services and walkability of community Health needs of the growing elderly population

9 Capital Health Response to CHNA Campus Specific programs that directly address the findings of the CHNA as well as unique projects that meet our patient needs Have taken the findings of the CHNA and applied them to the DSRIP project

10 Delivery System Reform Incentive Payment (DSRIP) Replaces DSH payments in New Jersey Total of $166 million annually for 5 years in NJ Requires competitive application to NJDOHSS Unique programs that must be responsive to local CHNA Select from 16 projects; all focus on role of hospital as provider of population health Not every hospital will be accepted, and payments predicated on performance; project specific and hospital wide Coordinated through the New Jersey Hospital Association

11 DSRIP Decision Matrix Identified needs based on CHNA Match program to population served by hospital Choose a program that is doable Chose a program that is unique and will be acceptable to NJDOHSS and CMS

12 Capital Health Regional Medical Center Substance abuse and behavioral health a key focus of the CHNA Regional Medical Center has a strong internal medicine residency program that has fostered in-patient screening and treatment program for alcoholism RMC has Regional Psychiatric emergency room Trenton Health Team has begun a grant funded process that is implementing SBIRT (Screening with Brief Intervention and Referral to Treatment) for outpatients in the clinics and ED identified with a co-occurring substance and behavioral issue.

13 RMC DSRIP Hospital Wide Screening for Substance Use Disorder The objective is to increase the number of individuals entering Capital Health Regional Medical Center system who receive a screening for an alcohol or other drug dependence/substance use disorder Those who screen positive for an AOD/SUD will receive an assessment, a brief therapeutic intervention, and support in obtaining further treatment in an AOD/SUD and/or a behavioral health program. The project will enhance our clinicians ability to recognize incipient withdrawal syndromes, provide early evidence-based intervention, and prevent complications of the withdrawal syndrome. This should result in fewer individuals seeking treatment in the Emergency Department, a lower mortality rate for patients going through withdrawal, and, overall, better health outcomes for individuals with AOD/SUDs and co-occurring disorders.

14 Annual Budgets RMC Total direct and indirect costs $ 880,435 Economic value of this project $1,281,000 Total Program Value Peak Year $2,161,435 State DSRIP funds $3,585,000 60% of the DSRIP funds go toward program cost and generating community value.

15 Capital Health Hopewell Medical Center Regional pediatric emergency department Dedicated pediatric inpatient unit Largest Department of Pediatrics in region 50% of both pediatric ED patients and pediatric inpatients are Medicaid or self insured Key partner in three novel programs to address pediatric obesity Shaping New Jersey New Jersey Partnership for Healthy Kids Serving Up Health.

16 Hopewell DSRIP After School Obesity Program Provide nurse navigator and exercise physiologist to begin a structured parent/child after school program to enhance healthy eating, exercise and weight loss Partner with two local schools; one public and one charter to identify students and provide facilities Semester based program that will run 10 weeks and occur 2 days per week. Enroll children between the ages of 4 through 12 who have a BMI of at least 30 (Obesity Class I) or a BMI percentile for age of >85%. Children who complete the program will be monitored on an ongoing basis to enhance and ensure compliance by the care team defined below. Provide parent focused sessions both for education about nutrition and exercise and to assess their own health status vis-à-vis obesity.

17 Annual Budgets Hopewell Total direct and indirect costs $719,301 Economic impact in peak year $217,000 Total Program Value Peak Year $ 936,301 State DSRIP funds $1.5 million. 62% of the DSRIP funds go toward program cost and generating community value

18 Next Step Await final State/CMS approval Competitive process among 53 applicant hospitals statewide Nearly 35 hospitals applied for projects surrounding heart failure, hypertension and or diabetes Only 3 hospitals applied for a substance abuse project Capital Health Hopewell Medical Center is the only hospital that applied for the After School Obesity Project