Building Momentum for State Policy Change: Highlights from Around the Country Overarching Themes from other states State- Specific Examples Kim Prendergast, Feeding America kprendergast@feedingamerica.org FEEDING AMERICA / 1 /
Conditions that Support Successful State Efforts Existing Payment Structure & Incentives Cross-Sector Collaboration Availability of Data FEEDING AMERICA / 2 /
Vermont Statewide Accountable Care Organization OneCare Vermont Statewide ACO led by Dartmouth-Hitchcock Hospital and University of Vermont Medical Center, includes hospitals, FQHCs, specialists, rural clinics Goals for Care Coordination, Clinical Data Sharing, and Improved Quality Focus on Systems and Data Tracking How to capture population health data in a useful way such that health care providers can act on it and ultimately support health outcomes Opportunities from a statewide approach: Public/private partnerships to support goals Rise VT - community collaborative to embrace healthier lifestyles, improve QOL, support through health coaches Bridging for Health: RWJF/Georgia Health Policy Center Challenges: Creating New Regulations - Green Mountain Care Board Funding Federal $ requires state match; State Budget didn t include the $40M match so $100M wasn t received Incentives are still incongruent - ex: compensation for high value procedures FEEDING AMERICA / 3 /
Priority Area Housing University of VT Medical Center has invested housing: Provide funding for and discharge patients to Harbor Place in Shelburne; Help fund the services provided at Beacon Apartments in South Burlington; Partner with Support And Services at Home; Help fund the Street Outreach initiative through Howard Center; Participate in the Chittenden County Homeless Alliance; and Help fund and provide services for the Warming Shelters in Burlington. 3-year outcomes: 50 % reduction in homelessness in Chittenden County Savings of $1 million in health care expenses FEEDING AMERICA / 4 /
Priority Area: Food Insecurity St. Albans Hospital doing Food Insecurity Screening & Referrals Vermont Food Bank Veggie VanGo distributions at eight VT hospital sites Coupling this work with Collective Impact efforts through Accountable Health Community in Northeast Vermont through a Pilot project of Feeding America
Massachusetts: New ACO Structure MA Medicaid 1115 waiver creates Accountable Care Organizations (ACOs) and Community Partners (CPs) to organize the delivery of care Effective March 1, 2018, ACOs, networks of physicians, hospitals and other community based health care providers, will be financially accountable for cost, quality, and member experience for over 850,000 MassHealth members Small amount of DSRIP Funds or flexible services: transition from institution to community physical activity and nutrition support for individuals who have experienced violence Support to ACOs to think about SDOH Housing, Food Security & Quality, Income, Energy, & others FEEDING AMERICA / 6 /
Massachusetts: Food Is Medicine State Plan Co-Organized by Harvard Law School CHLPI and Community Servings Assessment & Planning for a state-wide approach to FEEDING AMERICA / 7 /
California California s Medicaid (Medical) primarily managed through MCO s In 2013, created a uniform Staying Healthy Assessment to help providers address priority health, behavior and lifestyle issues Currently includes Nutrition, Physical Activity, Alcohol & Tobacco, Safety, Mental Health, Dental Health, and Sexual Issues Must be completed annually and signed by the clinician New Version for 2018 to include questions about SDOH. Draft list includes: Housing Transportation Food Insecurity Expanded questions about Dental care Advocates are working toward an electronic solution FEEDING AMERICA / 8 /
Alabama Regional Care Organizations: Alabama Legislature created RCO model in 2013 Expensive program implementation and lack of long term funding à Program is not going forward University Hospitals and others addressing Social Determinants of Health: University of Alabama Hospital pantry for NICU families in partnerships with CFB of Central AL Coosa Valley Medical Center 2 nd Site of CFB of Central AL University of South Alabama Outpatient diabetes clinic food pantry and a second pantry will open in 2018 FEEDING AMERICA / 9 /
Others States with Coalition Partners Addressing Food Insecurity Florida Hunger & Health Task Force, Orlando Hunger Action Alliance, Tampa Bay Feeding Florida Colorado Hunger Free Colorado, Kaiser Permanente, Food Banks, Community Based Organizations Texas Feeding Texas, VISTA, Food Bank-Health Sector Efforts FEEDING AMERICA / 10 /