Transcript Patient Centered Medical Home - Kids

Patient Centered Medical
Home – Kids
Thursday, February 6, 2014
7:30-9:00 a.m.
301 Metro Center Blvd., Warwick, RI
Patricia Flanagan, MD, FAAP, Co-Chair
Elizabeth Lange, MD, FAAP, Co-Chair
Selection Sub-Committee
Charge:
• Develop criteria for selection of initial pilot PCMH-Kids practices
• Develop application and scoring process for practice selection
• Develop outreach strategy to insure eligible practices are informed
• Recommend selection process to Planning Committee/Conveners
• With staff support, conduct selection process, score applications,
and make recommendations to Conveners
• Develop timeline for the application and selection process.
Selection Sub-Committee
Members(10)
• Dr. Elizabeth Lange, Waterman Pediatrics, Co-Chair
• Dr. Renee Rulin, Unitedhealth Care, Co-Chair
• Dr. Ailis Clyne, Baldhill Pediatrics
• Andrea Galgay, RI Blue Cross/Blue Shield
• Blythe Berger, Department of Health
• Deb Florio, Office of Health and Human Services
• Dr. Deidre Gifford, Office of Health and Human Services
• Mary Evans, RI Health Centers Association
• Dr. Stephen Davis, Neighborhood Health of RI
• Tina Spears, Rhode Island Parent Information Network
Selection Sub-Committee
Summary of Call 1/22/14:
• Population focus: focus on high utilizers, which are often CSHCN, Medicaid, Cedar. But way to put in
application is murky. Leadership will take and think about
• Goal of PMCH-Kids: To improve the pediatric practice to make them more able to accept these
populations. If we improve practices we will improve care. Goal is transformation.
o Need a clear definition of children with special health care needs
o Get at this through an essay question: what do you currently do for care coordination
and behavioral health? What are your barriers?
• Want a mix of practices: high-achieving as well as practices who want to change, but don’t have the
resources. Will consider using the pre-reqs from CSI Adults. Believe requiring EHR is
necessary for this round (can take a practice 6-12 months to implement EHR, additional time
to produce reports. This would affect the PMCH-Kids timeline.)
• Also want to look at cultural diversity (i.e. languages spoken)
• Next conference call: February 19 7:30-8:30am
Measures Sub-Committee
Charge:
• Review available data on quality, health disparities, disease
prevalence, utilization and cost of healthcare for children in RI
• Review standardized measures of pediatric healthcare quality,
including those used in other pediatric PCMH programs
• Review available measures for feasibility of collection and alignment
with other RI programs
• Recommend set of quality, patient experience and utilization
measures to Stakeholder coalition for inclusion in contract
Measures Sub-Committee
Current Members (23)
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Dr. Patricia Flanagan, Lifespan Co-Chair
Ronald Seifer, Bradley Co-Chair
Stacey Aguiar, Department of Health
Blythe Berger, Department of Health
Dr. Elizabeth Lange, Waterman Pediatrics
Dr. William Hollinshead, RIAAP
Dr. Betty Vohr, Woman & Infants Hospital
Carrie Feliz, Providence Public Schools
Dr. Dinusha Dietrich, Smithfield Pediatrics
Dr. Deidre Gifford, Office of Health and Human Services
Dr. Keivan Ettefagh, Aquidneck Medical Associates
Dr. Marco Ferretti, East Bay Pediatrics
Dr. Nicole Gergen, Hasbro Children’s Hospital
Dr. Joanna Brown, Lifespan
Junhie Oh, Department of Health
Dr. Nathan Beraha, Anchor Pediatrics
Peter Hollmann, Blue Cross Blue Shield Rhode Island
Dr. Jose Polanco, Blackstone Valley Community Health Center
Dr. Shirley Spater Freedman, Samuels Sinclair Dental Center
Judi Stevenson Garcia, Rhode Island Department of Education
Debra Hurwitz, CSI Adults
Rebecca Labeau,
D Bergh,
Measures Sub-Committee
Summary of Call 1/27/14:
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The goal of the Measures Sub-Committee is to select measures that will drive
outcomes and change in practices. Come up with ideas, as a group, on how children
are different and think about how to build the child into the medical home.
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Reviewed charge. No further edits needed at this point.
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Reviewed current measures in specific areas: dental, developmental, behavioral,
social emotional and school settings.
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Next meeting will be a discussion of specific measures: complex care coordination
(CEDARR & foster care), family engagement, equity and transition.
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Next conference call: March 6, 2014 from 7:30-8:30 am
CSI-RI Community Health
Teams
• Part of our strategic to create two community health
teams (CHT)
• South County (serves 9 CSI Practices) and Pawtucket
(serves 8 CSI Practices)
• Teams will incorporate a community health worker-a
person to connect patients to community resources
• Teams will also incorporate a behavioral health care
manager
• CHT will work with the primary care provider and nurse
care manager as part of the team to coordinate care and
manage the patient
• Focus on high-risk patients as identified by the health
plans
CSI-RI Integrated Behavioral Health Workgroup
• Goals: to eliminate disparity in health care outcomes for people with
mental health conditions, prove communication and coordination,
leverage existing resources
• Focus areas of medical conditions: Diabetes, COPD, and CHF
• Focus areas of behavioral health: depression, anxiety, and
substance abuse
• What needs to happen for goals to be reached:
– Clear consensus definition of behavioral health
– Develop and test potential models of intervention (compacts, CHT,
consultative model, co-location, integration)
– Define data needs and metrics
– Payment system that supports integrated behavioral health
• Current work: inventory CSI practices and response to Senator
Miller and Representative Bennett’s Joint Commission to Study
Integrated Behavioral Health
Race to the Top
• Survey of Wellbeing in Young Children (SWYC)
o Developmental milestones
o Social/emotional development
o Family risk factors
o Autism-specific screening at 18 & 24 months
• Collaboration Efforts
o Rhode Island Department of Education
o Healthcentric Advisors
o American Academy of Pediatrics
o Executive Office of Health and Human Services
• DRAFT Resource Grid
Questions
Contact Information
Patricia Flanagan MD, FAAP, Co-Chair
[email protected]
401-444-7987
Elizabeth Lange MD, FAAP, Co-Chair
[email protected]
401-751-8683