Agenda Delivery System Transformation Committee

Transcription

1 Agenda Delivery System Transformation Committee September 21 st, 4:30 6:00pm Samaritan Walnut Building, Endeavor Conference Room Dial in: Code: Introductions Sherlyn Dahl, Executive Director, Benton County Health Department 2. Transformation Update Traditional Health Worker Hub Extension 2018 Upcoming Changes Transformation Plan OHA Innovator Update p. 9 p Jenna Bates, Transformation Manager, IHN CCO 3. Health Equity Workgroup Strategic Plan Action Items p Miao Zhao, Clinic Manager, InReach Bettina Schempf, Executive Director, Old Mill Center 4:30 4:35 4:45 4. Behavioral Health in the PCPCH update on post pilot progress Tracy Bluhm, Marriage and Family Therapist, Corvallis Family Medicine 5:05 5. How to get the story out Sherlyn Dahl, Executive Director, Benton County Health Department 5:25 6. Wrap Up Next Meeting and Review of Next Steps for Pilots: October 5 th Sherlyn Dahl, Executive Director, Benton County Health Department 5:55

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3 Minutes Delivery System Transformation Committee September 7, :30 6:00 Samaritan Health Services Walnut Building: Endeavor (conference room) Dial in: Code: Introductions Kim Whitley Present: Kim Whitley, Charissa White, Stephanie Jensen, Jenna Bates, Annie McDonald, Jordan Butler, Renee Smith, Brenda Mainord, Danny Magana, Britny Chandler, Sherlyn Dahl, Jeff Blackford, Tyra Jansson, Bill Bouska, Barbara Croney, Kevin Ewanchyna, Jana Svoboda, Kevin Cuccaro, Clarice Amorim Freitas, Karen Douglas Phone: Joell Archibald Pilot Proposal Decisions The heatmap, created from the voters scorecards, will guide the discussion. The standard deviation on the heatmap shows where there is difference among votes regarding the specific criterion. o This could be due to disagreement among voters, different perspectives, or a lack of a common understanding of the criteria. Peer Support Wellness Training Program Ranked 1 st per the mean of rater criteria scores from the heatmap. Scored lowest on State Metrics and Reduces Costs. Voter deviation was greatest on Collaboration, Expertise, and Improves Healthcare; however, these criteria scored very high. Peer Wellness Specialists are defined as peers who have either an alcohol and drug addiction or a mental health condition. DECISION POINT: Yes, recommend for funding. o Yes: 9 o No: 1 o Abstain: 4 Children's Social Determinants of Health and Adverse Childhood Experiences Screening Ranked 2 nd per the mean of rater criteria scores from the heatmap. Voter deviation was greatest on Resource Investment and Need; however, these criteria scored very high. Collaboration is in question as they are working within one clinic. o Very focused intervention and the results will be shared. o Call for collaboration with the other Social Determinants of Health (SDoH) pilot in order to promote learning and best practices across the different environments. o The smaller scope provides easier changes at a lower cost. Questions regarding targeting foster children. The pilot has a large panel of IHN-CCO patients and is likely to be assisting these children. DECISION POINT: Yes, recommend for funding. o Yes: 13 o No: 0 o Abstain: 1 Community Doula Program Ranked 3 rd per the mean of rater criteria scores from the heatmap. Scored lowest on State Metrics. o Might not directly affect the metrics, but provides upstream intervention. The more support a mother has the better health the child has long-term. Voter deviation was greatest on Expertise; however, this criterion was scored very high. 3 of 14

4 DST 9/21/17 The Traditional Health Worker (THW) Workgroup has been looking to partner with Doulas and is excited about this program. DECISION POINT: Yes, recommend for funding. o Yes: 10 o No: 2 o Abstain: 2 Regional Health Education Hub Ranked 4 th per the mean of rater criteria scores from the heatmap. Scored lowest on Reduces Costs, Sustainability, Replicability, and Resource Investment. Voter deviation was greatest on Expertise and Collaboration; however, these criteria were scored very high. Suggestion to combine/partner with other pilots including Mental Health Education Matters, Health Equity Summits and Trainings, and CHANCE Saving Lives. Development of education infrastructure is a large ask, but is needed. Early Learning Hub doing a similar infrastructure, Pollywog, for parenting and prenatal classes. Potentially connect with Pollywog for lessons learned in the development of that program. DECISION POINT: Yes, recommend for funding. o Yes: 8 o No: 4 o Abstain: 2 Veggie Rx in Lincoln County: A Strategic Collaboration Against Food Insecurity Ranked 5 th per the mean of rater criteria scores from the heatmap. Scored lowest on State Metrics, Outcomes and Measures, and Reduces Costs. Voter deviation was high on Reduces Costs. Fresh produce does not always mean healthy food. Ensure connection with the current SDoH with a Veggie Rx Intervention pilot. Concerns regarding the distribution of the food vouchers to children that may lose or misplace them. Missing the linkage to the primary care home. While this pilot may not reduce costs during the life of the pilot, food security does lead to improved health which will reduce costs long-term. Transportation is a huge barrier in Lincoln County and the pilot is working to be where people are. DECISION POINT: Yes, recommend for funding. o Yes: 10 o No: 1 o Abstain: 3 Tri-County Health Equity Summits and Trainings Ranked 6 th per the mean of rater criteria scores from the heatmap. Scored lowest on State Metrics, Sustainability, and Reduces Costs. Voter deviation was highest on State Metrics, Reduces Costs, Sustainability, and Collaboration. Health Equity trainings for the healthcare workforce has been identified by the Health Equity Workgroup as part of the strategic plan. Could tie in with the Regional Health Education Hub pilot, but there are benefits for it standing on its own; high impact, focused scope. The summits will generate a spark that will continue on. There will be a focus on learning local needs then doing trainings based on the assessment. DECISION POINT: Yes, recommend for funding. o Yes: 13 o No: 0 o Abstain: 1 Mental Health Education Matters 4 of 14

5 DST 9/21/17 Ranked 7 th per the mean of rater criteria scores from the heatmap. Scored lowest on State Metrics, Reduces Costs, Replicability, and Resource Investment. Voter deviation was highest on Expertise and Sustainability; however, Expertise was rated high. There has been other Mental Health education pilots in the past, questions regarding how this pilot is transformational. o This has more involvement with Patient-Centered Primary Care Homes as well as other community agencies. Helpful to focus on targeting a rural community or population, the focus may help with replicability and sustainability. Suggestions that this pilot may fit within the Regional Health Education Hub. DECISION POINT: No, do not recommend for funding. o Yes: 4 o No: 7 o Abstain: 3 Universal Social Service Entry Ranked 8 th per the mean of rater criteria scores from the heatmap. Scored lowest on State Metrics, Sustainability, and Reduces Costs. Voter deviation was highest on State Metrics and Sustainability. The DST has not funded development of software in the past; however, there is no sense by the committee that the proposers are only interested in a business investment. This aligns with the Universal Care Coordination Workgroup goal of collaboration and creation of universal referral system. Collaboration with the Regional Health Information Collaborative (RHIC, also known as Care Team Link) is a good sign. Differs from Care Team Link the pilot will be standardizing forms that will help input data into RHIC/Care Team Link. DECISION POINT: Voting resulted in a tie, will go to the Regional Planning Council (RPC). o Yes: 6 o No: 6 o Abstain: 2 CHANCE Saving Lives Ranked 9 th per the mean of rater criteria scores from the heatmap. Scored lowest on Transformational, State Metrics, and Reduces Costs; voter deviation was also highest in these areas. Emergency Department (ED) utilization could be positively affected by the pilot long-term. Suggestion to combine/partner with Samaritan Health Plans and Samaritan Professional Development to target training the workforce. Safety net as currently written, but could be a touch point to get people involved into the community again. Perhaps the project could link up with the opiate grant funding with the counties. DECISION POINT: No, do not recommend for funding. o Yes: 2 o No: 11 o Abstain: 1 Summary of Proposal Decisions Pilots approved to move on to the RPC: o Children s SDoH ACE Screening o Community Doula Program o Peer Support Wellness Training Program o Regional Health Education Hub 5 of 14

6 o Tri-County Health Equity Summits and Trainings o Veggie Rx in Lincoln County: A Strategic Collaboration Against Food Insecurity Pilot with a tied vote, Kim to check in with the RPC on process (move to RPC or?) o Universal Social Service Entry (vote ended in a tie) Pilots not moving onto the RPC: o CHANCE Saving Lives o Mental Health Education Matters 6 of 14

7 DST 2017 Calendar 2017 January 12th, 26th February 9th, 23rd March 9th 23rd April 6th, 20th May 4th, 18th June 1st, 15th, 29th July 13th, 27th August 10th, 24th September 7th, 21st October 5th, 19th November 2nd, 16th, 30th PMH 11/30/16 COMPAR YWES CMAS 3/31/17 CHW2 Non-THW APM CPC 8/31/16 CVAIS 10/31/16 SANE 7/31/17 DMID 1/31/17 TFAT RFP Update Legistlative update PPC 5/30/17 WG Discussion PSWTP (1st) CSAS VRxL HEST MHEM RHEH (1st) CSL CDP USSE CAPEI CCCM 9/30/16 MHC Meeting 1 Meeting 2 Meeting 3 (June and November) Planning Planning - Workgroups Planning Debrief No Meeting COMPAR RFP Decisions RFP Process HE WG RFP Process PIHL Planning Planning HE WG Strategic Plan Funding HE WG Strategic Plan BH PCPCH How to get the story out Acrynom Pilot Name APM2 End Date Alternative Payment Methodology (2) Behavioral Health in the BH PCPCH PCPCH 12/31/15 CAPEI CHW2 CRSC Child Abuse Prevention & Early Intervention Community Health Worker (2) Colorectal Screening Campaign MHC Maternal Health Connections TFAT YWES DMID Tri-County Family Advocacy Training Youth WrapAround & Emergency Shelter Dental Medical Integration for Diabetes 1/31/17 CMAS CMA Scribes 3/31/17 Chrysalis Therapeutic Support Groups 6/30/17 CTSG December 14th HPC Home Palliative Care 6/30/17 Top 5 LOI Review Pilot Proposal Key: August 10 & August 24 Meetings PSWTP: Peer Support Wellness Training Program CSAS: Children's SDoH and ACE Screening VRxL: Veggie Rx Pilot in Lincoln County: A Strategic Collaboration Against Food Insecurity HEST: Tri-County Health Equity Summits and Trainings MHEM: Mental Health Education Matters RHEH: Regional Health Education Hub CSL: CHANCE Saving Lives CDP: Community Doula Program Tentative transformation Tentative closeout Tentative update Tenative extension Booked closeout Booked update Booked extension IPRP Improving the Pain Referral Pathway in the PCPCH 6/30/17 Physician Wellness Initiative School/Neighborhood Navigator (2) Sexual Assault Nurse Examiner USSE: Universal Social Service Entry Tenative workgroup Booked workgroup SPC SHS - Palliative Care 9/30/17 HE WG Health Equity Workgroup N/A KEY Booked transformation PWI SNN2 SANE 6/30/17 6/30/17 7/31/17 Health & Housing Planning HHPI Initiative 8/31/17 revised 9/18/2017 sj 7 of 14

8 InterCommunity Health Network Coordinated Care Organization Delivery System Transformation (DST) Request for Proposal Timeline Key Request for Proposal (RFP) Released June 6 Scheduled DST Meeting DST Member Action Pilot Proposer Action Transformation Team Action Question & Answer (Q&A) Session for Pilot Proposers June 13 MANDATORY Letter of Intent (LOI) Due June 20 5:00 pm LOI Distributed to DST by June 23 LOI Feedback Due from DST by June 29 Invitations Issued to Submit Full Pilot Proposal June 30 DST Decisions September 7 Pilot Proposal Presentations to DST August 24 Pilot Proposal Presentations to DST August 10 Full Pilot Proposals Due July 24 5:00 pm MANDATORY Technical Assistance Meetings July 3 July 21 Proposers Notified of DST Decision by September 11 Regional Planning Council (RPC) Funding Decisions September 21 Proposers Notified of Pilot Denial or Approval by September 25 Contracting Begins by November 1 Pilot Invoices/Payments Begin January 1, /5/17 8 of 14

9 Pilot Extension or Expansion Request Traditional Health Worker Hub Brief Summary: This pilot creates a Traditional Health Worker Training Hub in Benton County to train and supervise Community Health Workers (CHW) and Health Navigators for primary care and community agencies in the IHN CCO region of Benton, Lincoln, and Linn counties. Original Pilot Funding Amount: $156,310 Original Start Date: 7/1/2017 Original End Date: 6/30/2018 DST 9/21/17 A. Type of Request: Additional Funds o Attach new budget o Additional amount: Click here to enter text. Change in Scope o Attach new measures and outcomes Additional Time Only o New End Date: 12/31/2018 B. What is the rationale for the requested change? The agency that Benton County Health Services (BCHS) was going to purchase the CHW curriculum from has gone through a staffing change and they are not able to work with us as previously arranged until spring To address this issue, the agency is going to allow BCHS to purchase their curriculum and adapt it to fit local needs. This is going to take longer, but will potentially lead to a better end product. BCHS will need more time to develop the curriculum, then train the trainers, then train the CHWs. C. If this request is not granted, will any activities or outcomes from the original proposal not be possible? Yes BCHS will likely only have time to develop the curriculum, train the trainers, and probably only complete one CHW training in Benton/Linn counties. The CHW training planned for Lincoln County is the one that will not take place. D. If this request is granted, are there new activities or outcomes that will be possible? There will be the outcome of a CHW curriculum that is more tailored to the needs of the rural and coastal areas of Linn/Benton/Lincoln counties than if we were directly using the curriculum developed for the urban Portland area. 9 of 14

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11 Innovator Agent Update for IHN CCO Delivery System Transformation (September 21 st, 2017) OHA Current Leadership Summary: OHA Director Lynne Saxton has resigned; Patrick Allen has been named as interim. OHA Chief Medical Officer Jim Rickards, MD has resigned, second interviews have been conducted and an offer/hiring announcement will be announced soon. OHA Medicaid Director Lori Coyner has resigned, state and national recruitment effort under way. OHA Chief Health Systems Officer Varsha Chauhan has resigned, Leslie Clements is interim OHA Director of Operations and Finance Mark Fairbanks has resigned and position split into 2 separate roles (COO and CFO). Patrick Allen has appointed internal DCBS staff to these 2 roles. OHA Director of External Relations BethAnne Darby had resigned, Patrick Allen has appointed Dawn Jagger to this position. In light of continued discussion at the Federal level related to potential changes in Medicaid, Oregon s Medicaid Advisory Committee has developed a guidance document to inform and advise state leaders on Oregon s Medicaid priorities. Titled Guiding Principles for Oregon Medicaid, it is available on the MAC s webpage here: The National Academy for State Health Policy (NASHP) released a September issue brief titled Integrating Oral Health into Oregon Medicaid s Coordinated Care Model: Lessons for State Policymakers. It is exciting to see this review of Oregon s efforts (in conjunction with the DentaQuest Foundation) highlighted and shared nationally in the brief; download the entire document here Educational/Training Opportunities for CCO Leaders, staff and partners (in date order): Behavioral Health Screening Webinar Series: Depression screenings in primary care: implementation, efficiency and providing plans of care Thursday, 9/21, 12:30-1 p.m. 11 of 14

12 Register here: oseq=&c=&ch EDIE/PreManage Learning Collaborative 10/5, 8 AM-4 Portland Doubletree Metrics TA : Introduction to the Emergency Department Utilization Among Members Experiencing Mental Illness/Disparity Metric (webinar). OHA will provide an in-depth review of the draft specifications for the 2018 CCO incentive metric to reduce emergency department utilization for members experiencing mental illness, along with time devoted to Q&A. OHA staff will also present an initial overview of Oregon Medicaid member data for a better understanding of the primary physical health reasons members experiencing mental illness access the emergency department. Tuesday, 10/10, 1-2 p.m. Register here: Oregon PH Association (OPHA) Annual Conference 10/9 and 10/10, LaSells Stewart Center, OSU, Corvallis Register at The Future of CCOs in Oregon, 10/10, 11 AM-3 SEIU 49 Ballroom, Portland (Sponsored by Allies for a Healthier Oregon) coordinated-care-organization-cco-forum-tickets State of Reform Health Policy Fall Conference, 10/11, Marriott Portland Downtown Waterfront Register at Oregon Rural Health Conference, 10/18, 10/19 and 10/20 in Bend. Register at Nuka Health Care Innovation Conference-Oregon, 10/23 and 10/24 at the Portland Art Museum. The Southcentral Foundation of Alaska will present. Find more details at Oregon Oral Health Coalition Fall Conference Health Reform Impact on Oral Health, 11/17, Crowne Plaza Hotel, Portland. Register at: oseq=&c=&ch= 12 of 14

13 Health Equity Workgroup Strategic Plan Action Items DATA: Increase the availability and knowledge of quantitative and qualitative data to inform, prioritize, and monitor strategies to meet the needs of culturally diverse members and to reduce health disparities. Completed Date Action Item Responsible Party Due Date Notes Identify data sources about health disparities, including IHN CCO Transformation Pilot projects and regional Community Needs Assessment and Community Health CW, PB, MZ 6/1/2017 Aug 16 Improvement Plans. Nov 17 Identify health disparities and consider incentive metrics JB, ES, RP, PB, MZ 6/17/2017 Assess available data sources JB, ES, RP, PB, MZ 12/1/2017 Identify data gaps and needs JB, ES, RP, PB, MZ 12/1/2017 Make recommendations to improve data collection, analyses, and reporting about health disparities. JB, ES, RP, PB, MZ 12/17/2017 Develop and submit an implementation plan to improve data collection, analyses, and reporting of health disparities JB, ES, RP, PB, MZ 12/17/2017 TRAINING: Support and champion cultural competence and health equity trainings for the IHN CCO Health Equity Workgroup, IHN CCO staff, IHN CCO providers, and other community stakeholders. Completed Date Action Item Responsible Party Due Date Notes Identify appropriate health equity trainings and work with IHN CCO to establish training resources and opportunities (including licensing, orientation, and continuing education 9/30/2017 requirements). Identify and secure funding for trainings and training resources. 12/31/2017 Meet with IHN CCO RPC to clarify vision for health equity training. 12/31/2017 Identify existing training opportunities for IHN CCO workgroups, staff, providers, and other community stakeholders. 6/30/2018 Develop proposed training plan for adoption by IHN CCO workgroups, staff, providers, and other community stakeholders. 6/30/2018 DIVERSE WORKFORCE: Support and encourage IHN CCO provider and staff composition that reflects member diversity. Completed Date Action Item Responsible Party Due Date Notes Identify IHN CCO provider workforce demographic data Develop recommendations for collecting demographic data on IHN CCO provider workforce Identify best practices to increase workforce diversity thru recruitment and retention policies and procedures 13 of 14

14 Make recommendations to operationalize the identified best practices related to recruitment and retention TRADITIONAL HEALTH WORKERS (THW): Increase, retain, and sustain support for THW to address health disparities across IHN CCO services and in Linn, Benton and Lincoln counties. Completed Date Action Item Responsible Party Due Date Notes Review inventory of THW and the specific populations they serve Compile best practices for using THW to reduce health disparities and resources to support, retain, and sustain THW Develop recommendations for implementing best practices for supporting, retaining, and sustaining THW to reduce health disparities Develop recommendations for long term sustainability of THW COMMUNICATION: Ensure regular communication between the IHN CCO Health Equity Workgroup, IHN CCO staff, IHN CCO DST Steering Committee, IHN CCO CAC, other stakeholders and IHN CCO workgroups about health disparities and health equity activities in the community. Completed Date Action Item Responsible Party Due Date Notes Develop IHN CCO Health Equity Strategic Plan and gain approval from IHN CCO DST Steering Committee BS/MZ Prepare and submit mid year reports to IHN CCO DST Steering Committee and receive feedback BS/MZ 10/6/2017 Prepare and present end of year reports to IHN CCO DST Steering Committee and receive feedback BS/MZ 4/6/2018 Propose any needed amendments to this strategic plan to IHN CCO DST Steering Committee for approval Co Chairs Engage regular representation from IHN CCO CAC, IHN CCO workgroups (THW and dental), and community members Committee 10/31/2017 Done Establish joint quarterly meeting with THW workgroup BS/MZ ongoing Establish regular meetings with IHN CCO staff, IHN CCO CAC, IHN CCO Clinical Advisory Panel, County Health Departments and other stakeholders Committee 10/31/2017 Propose and support uploading of content about this Workgroup s activities on IHN CCO website and through stakeholder and partner organizations Committee ongoing 14 of 14