Homeless Healthcare Collaboration Meeting Minutes May 11, 2018 Welcome & Introductions: Shane Bies, Oakland County Meeting minutes & dates are located on the website: https://www.oakgov.com/health/partnerships/pages/homeless-healthcare-collaboration-.aspx Hospital Transition Workgroup Update The Hospital Transition Workgroup has been providing outreach to Emergency Departments to raise awareness of services that exist in the community. Dr. Wasserman received an email stating that an attending physician used this information to better serve a patient and connect them to a resource in the community. Susan Stevens - Oakland Community Health Network, Complex Case Management Refer to PowerPoint Genoa Pharmacy organizes all pills into boxes that are color coded and labeled for clients Megan Phillips Oakland Community Health Network, Sober Support Unit Refer to PowerPoint Slide Located in the Resource & Crisis Center (with Common Ground) Opened at the end of August in 2017 Serviced about 300 individuals so far The Sober Support Unit can provide the services immediately to clients when they are ready for treatment. Available 24 hours a day/ 7 days a week The Sober Support Unit is a sobering and monitoring program that provides a supportive environment for people experiencing side effects of drug and alcohol use. Not a licensed detox facility Staffed by EMTs & peer recovery coaches Unit has 10 beds Megan Miller - Oakland University Conducted a study on Emergency Medical Services Providers Perceptions of Homeless Patients o Health care providers demonstrate poor attitudes toward homeless patients o Changes the perceived quality of care by patients 1
o EMS providers are the 1st point of contact to patients o EMS providers report a lot of fatigue and burnout o Sample size of 27 EMT s and paramedic o 3 different locations o Recruitment by email o Conducted open ended interviews o Awarded non-monetary compensation upon completion o Utmost importance and goals: quality and equal care to all patients o Motivation for career: desire to help people o EMS providers feel ill-equipped to provide meaningful solutions and resources: more shelters, more mental health services o Themes that positively impact perceptions: Exposure to underserved populations Supportive workplaces Sense of accomplishment o Themes that negatively impact perceptions Economic & political beliefs Negative workplace environment Lack of accomplishment Conclusions: o Attitudes and subsequent medical care is multifactorial o Deep-seated values o Recently-adapted values formed from experiential factors o Empathy while providing care o Positive work environment o Personal sense of accomplishment o Respect in the community o Associated with individual dispositions and positive outlooks Future Implications: o Negative perceptions create a communication barrier o Educate EMS providers on homelessness Limitations o Years of job experience o Employment models o Demographic variation o Firefighter/paramedic career Nellie Tsai - Michigan Nonprofit Association Refer to PowerPoint Nonprofit count campaign - next meeting about Census 2020 May 24 th in Lansing o Grants will be available from MNA to non-profits to use to contribute to getting people counted Priscilla Hohmann Michigan Community Health Workers Alliance (MCHWA) Refer to PowerPoint Partner Updates Shane Bies reported that the Hepatitis A Outbreak in Michigan is ongoing and OCHD is 2
continuing outreach with many agencies for vaccinations. If you are interested in partnering reach out to the Health Division. Catholic Community Response Team - Bridges Out of Poverty program begins in September. This is a 16-week course, two hours per week, includes meals. Program is meant for individuals in poverty looking to get ahead. $25 incentive per class. Looking for referrals. Elizabeth Kelly reported that they moved into the new Recuperative Care Center at 1416 Joslyn. Open house to come this Summer. Ernestine McRae reported that Haven is hosting a Back to School Bash for clients on August 18 and are looking for community organizations to host a booth. Oakland Integrated Health Network has a new program starting in August that provides recovery support services for people who have SUD issues, and helps with maintenance for medications. Disability Network for Oakland/Macomb has available funds for veterans for housing. Next Homeless Healthcare Collaboration Meeting Friday, July 13 th, 2018 from 9:00 a.m. 11:00 a.m. Oakland County Executive Office Building - Conference Center 2100 Pontiac Lake Road, Building 41 West, Waterford, MI 48328 East Conference Room 3
Welcome Friday, May 11 th, 2018
Hospital Transition Workgroup Update
Speakers Susan Stevens & Nicole Brown Oakland Community Health Network
Complex Case Management Nicole Brown, R.N. Susan Stevens, R.N. 248-858-9355 248-758-1984 brownn@oaklandchn.org stevenss@oaklandchn.org
Complex Case Management Program The Complex Case Management Program helps ensure appropriate healthcare for children and adults who have: An active managed Medicaid Health Plan as primary insurance Services through OCHN's network Serious and chronic medical and behavioral health conditions In depth care coordination with the individual and the individual's case manager, therapists, physicians, medicaid health plan, palliative care, caregivers, etc. **Note: OCHN s Complex Case Management Program is a voluntary program
Complex Case Management Program What services are offered? Community outreach to conduct comprehensive clinical assessments of an individual s needs Care Coordination, assistance in locating specialists and arranging appointments, acting as a liaison between specialists and their Primary Care Physician (PCP), and medicaid health plan Creating referrals to community resources Medication reconciliation, including medication education with the individual Care plan development with performance goals that assist individuals in achieving selfmanagement and will demonstrate improved adherence to their treatment plan Condition specific education
Complex Case Management Program Objectives: Improve relationships between individuals, providers and health plans Assist individuals in navigating the healthcare delivery system Teach individuals to be independent in their self-care as much as possible Improve quality of life by assisting individuals to work towards meeting their overall health goals Facilitate communication among individuals, their families, caregivers, healthcare providers, the community, and their health plans in an effort to enhance cooperation while planning and meeting the health care needs of the individual Allocate resources effectively and maximize the available benefits
Complex Case Management Program Objectives: Increase individual and provider satisfaction through the collaboration and management of health care resources Collaborate with OCHN provider network staff, primary care physicians and/or specialists in the development and communication of the individual s complex case management care plan Function as an educator for the individual, their family, friends, and allies, the healthcare team, and the community regarding the complex case management process and specific health issues Partner with providers, individuals, aligned network case manager, medicaid health plans and the community in assisting the individual to reach maximum achievable medical and mental health potential as well as maximum independence
Complex Case Management Program Who can be referred to this program? Any individual with an active managed Medicaid Health Plan as their primary insurance, open to OCHN services and who meets any two of the following criteria: Actively under the care of two medical speciality providers Multiple hospital admissions (>three in the last 12 months) Multiple ER visits (>fifteen in the last 12 months) Has prolonged/repeat medical hospital admissions An inpatient readmission to the hospital within (30) days of discharge
Complex Case Management Program Complex Case Managers will consider referrals for an individual: Requiring many resources, such as home health care services or durable medical equipment in order to return home or remain at home At high risk for readmission to the hospital In need of information about referrals to community based services In need of an enhancement to manage complex medical needs along with their current service model Who has suffered a life threatening event or received a life threatening diagnosis Whose symptoms of illness impacts their ability to perform activities of daily living (ADL)
Complex Case Management Program Who can send referrals to this program? Case Managers Hospital discharge staff Mental Health Practitioners Caregivers Primary Care Physicians Common Ground staff OCHN staff Individuals in service External Specialists
Complex Case Management Program Where do I find a referral form On OCHN s website at www.oaklandchn.org / Access and Services Tear off pads are being given to each agency to put in their lobby
Complex Case Management Program Referral submissions can be: Completed online at www.oaklandchn.org. The information is secure and only accessible to OCHN nurses Emailed to CCM@oaklandchn.org Faxed to 855-414-4884 Mailed to OCHN s Troy location-- 5505 Corporate Drive, Troy, MI 48098
Complex Case Management Program What happens after a referral is made? A chart review is performed within (14) days Criteria met: Individual contacted and assessment date scheduled; referral source notified Criteria not met: referral source notified Opts out: case is closed; referral source notified
Complex Case Management Program
Speakers Megan Phillips Oakland Community Health Network
Oakland Community Health Network (OCHN) Sober Support Unit (SSU) The first step towards long term substance use treatment services The SSU is located at the Resource and Crisis Center (RCC) 1200 N. Telegraph Road, Building 32 East Pontiac, MI 48341 For more information call the Resource & Crisis Line: 800-231-1127 Law enforcement can transport individuals who come to a station seeking substance use treatment to the SSU. The Sober Support Unit (SSU) is a sobering and monitoring program that provides a supportive environment for people experiencing side effects of drug and alcohol use. The SSU is a non-medical unit managed by Common Ground and staffed by trained recovery coaches and Emergency Medical Technicians (EMT). The unit accommodates up to ten individuals at any given time, 24 hours a day, 7 days a week.
Speakers Megan Miller Oakland University
Speakers Nellie Tsai Michigan Nonprofit Association
MICHIGAN NONPROFITS COUNT CAMPAIGN Michigan Nonprofits Count Campaign Nellie Tsai Community + Civic Engagement Director ntsai@mnaonline.org May 11, 2018 20
MICHIGAN NONPROFITS COUNT CAMPAIGN Established in 1990 About MNA State-wide membership organization that serves the diverse nonprofit sector though advocacy, training, and resources MNA is a sponsoring organization for AmeriCorps VISTA Membership is open to all Michigan nonprofit organizations. For-profit businesses and government entities may join as affiliate members. 21
MICHIGAN NONPROFITS COUNT CAMPAIGN About the campaign Goal: To maintain statewide participation rates from the 2010 census for the statewide number of respondents to the 2020 census. To create a multi-level coalition of nonprofits ready to address future democracy issues. Strategy: To cultivate involvement of nonprofit organizations in census 2020 with a focus on hard-to-count communities. 22
MICHIGAN NONPROFITS COUNT CAMPAIGN WHAT S AT STAKE? THERE IS STRENGTH IN NUMBERS The more people counted means more money and power for Michigan residents at home and in Washington. What s at stake: MICHIGAN S HARD-TO-COUNT POPULATIONS People of color Immigrants Undocumented people Young children Low-income people Homeless individuals Those traditionally served by nonprofits Michigan stands to lose $1,800 per person per year of federal funding to support programs that use Census data. Census data are used by public officials to determine distribution of federal funds for programs, including: Title l and Special Education grants; Foster Care and Child Care grants; Section 8 Vouchers; K-12 Education; and Head Start/Early Start, among others. Michigan stands to lose another Congressional seat and a reduction in the number of electoral college votes reduced representation at the federal level. Federal funding for infrastructure programs, including rebuilding roads, highways and bridges. An inaccurate Census count means the hard-to-count populations will rely more heavily on nonprofit organizations for services. 23
MICHIGAN NONPROFITS COUNT CAMPAIGN WHY NONPROFITS? MICHIGAN NONPROFITS: UNIQUELY QUALIFIED TO MOBILIZE THE HARD-TO-COUNT POPULATIONS FOR CENSUS 2020 Historically, the Census has missed disproportionate numbers of racial minorities, immigrants, young children and those living in poverty ( hard-to-count populations ) leading to inequality in political power, government funding and private-sector investment for these communities. WHY NONPROFITS TO MOBILIZE THE HARD-TO-COUNT POPULATIONS: Located in communities most at risk of being under counted urban and rural. Maintain everyday contact and have trusting relationships with the communities they serve. Manage cultural sensitivities and language needs within their communities. Nonprofits driven by social missions strive to ensure their communities have access to the funds, services, representations, and physical and social infrastructure affected by the Census count. Nonprofits are keenly aware of the negative impact an undercount will have on their communities, and that they will need to find ways to make up for the shortfalls. 24
MICHIGAN NONPROFITS COUNT CAMPAIGN WHAT S AT STAKE? LARGEST FEDERAL SOURCES THAT USE CENSUS DATA FOR DISTRIBUTION 25
MICHIGAN NONPROFITS COUNT CAMPAIGN Thank you! Nellie Tsai Community + Civic Engagement Director ntsai@mnaonline.org 26
Speakers Priscilla Hohmann Michigan Community Health Worker Alliance
Structured Networking Break What did you learn about today s topics that you did not previously know? How do today s topics align with the work your organization does? How will you use this new information in the work that you do?
Agency Updates
Online Evaluation Will be sent out Monday, May 14 th Complete by Tuesday, May 29 th
Next Meeting Friday, July 13 th, 2018
L. BROOKS PATTERSON OAKLAND COUNTY EXECUTIVE