Transcript GULF REGION HEALTH OUTREACH PROGRAM
Community-Centered Health Homes Demonstration Project
Introductory Webinar Friday, October 17, 2014 12:00 – 1:30 PM CST
Agenda
Welcome Dr . Eric Baumgartner, Community Health Strategist, LPHI Introduction to Community Prevention and the Community-Centered Health Home Model Rea Pañares, Senior Advisor, Prevention Institute Community-Centered Health Home Demonstration Project Jaymee L. Lewis, CCHH Program Manager, LPHI Questions and Answers 2
Gulf Region Health Outreach Program: Primary Care Capacity Project
Dr. Eric T. Baumgartner 3
Gulf Region Health Outreach Program (GRHOP)
Series of five integrated projects over five years extending from 2012 2017.
• • • • • Primary Care Capacity Project (PCCP) Mental and Behavioral Health Capacity Project (MBHCP) Environmental Health Capacity and Literacy Project (EHCLP) Community Health Workers Training Project (CHWTP) Community Involvement Developed jointly by BP and the Plaintiff Steering committee as part of the Deepwater Horizon Medical Benefits Class Action Settlement.
Supervised by the Federal Court and the GRHOP Coordinating committee.
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Gulf Region Health Outreach Program (GRHOP)
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Target Beneficiaries of GRHOP
GRHOP target beneficiaries are residents, especially the uninsured and medically underserved, of 17 coastal counties and parishes.
Florida • Escambia • Santa Rosa • Walton • Okaloosa • Bay Alabama • Mobile • Baldwin Mississippi • Hancock • Harrison • Jackson Louisiana • Orleans • Jefferson • Plaquemines • St. Bernard • Terrebonne • Lafourche • Cameron 6
Primary Care Capacity Project (PCCP)
Seeks to improve access to high quality, integrated, patient centered care in the 17 designate GRHOP parishes/ counties in support of sustainability and resilience of the Central Gulf Coast.
Guiding Principles • Commitments to communities we serve to be transparent, responsive, and respectful • Creating lasting community benefit • • • Supporting the alignment of community assets that support high-quality primary care services Drawing from the evidence based practices when designing interventions Working collaboratively to advance the PCCP mission 7
PCCP Strategies
I.
II.
III.
• • • • “Direct focal” funding to some clinics – already implemented per settlement terms and priorities, no new clinics planned Technical Assistance and Regional Care Collaborative peer exchange “Systems” investments in support of multiple clinics in quality and systems of care AL – electronic health systems interfaces to support behavioral health integration (pending) MS – • C-Change – community cancer outreach and access (under way) MS-HIN – HIE ability to provide ADT notification to coastal CHC (pending) LA – GNOHIE (already in play), 504HN (already in play), Quality initiative in support of GNOCHC (pending) 4 States :
Community-Centered Health Home Demonstration Project
informational webinar – the purpose of this
Primary Care Capacity Project
Community-Centered Health Home Demo Project
The Community-Centered Health Home (CCHH) Demonstration Projection a part of the PCCP of the GRHOP aims to advance health equity and community resiliency by enhancing the capacity of selected health center sites to take the next step beyond the patient-centered medical home model and serve as trusted, effective partners in community prevention.
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Community Prevention and the Community-Centered Health Home
Rea Pañares, MHS 10
Community-Centered Health Home Model: An Overview
Webinar Louisiana Public Health Institute October 17, 2014 Rea Pañares, MHS Senior Advisor
a
systematic
process that reduces the frequency and/or severity of illness or injury.
Promotes healthy environments and behaviors to prevent problems from occurring before the onset of symptoms
Child Restraint and Safety Belt Use
Smoking Prevention
Minimum Drinking Age Laws
Childhood Immunizations
Motorcycle and Bicycle Helmet Laws
Reduced Lead Levels in Children
The Triple Aim
Influencing Policy & Legislation Changing Organizational Practices Fostering Coalitions & Networks Educating Providers Promoting Community Education Strengthening Individual Knowledge & Skills
IHI Triple Aim image courtesy of Northern New England Accountable Care Collaborative: http://nneacc.com/
The Spectrum of Prevention Influencing Policy & Legislation Changing Organizational Practices Fostering Coalitions & Networks Educating Providers Promoting Community Education Strengthening Individual Knowledge & Skills
Swift & Cohen.
Injury Prevention (1999)
Community-Centered Health Homes
Community-Centered Health Homes Patient-Centered Medical Homes Medical Homes
A Different Way to Think about Health Care
Photo Credit: Daniel Bernstein
“
The last time we looked in the book, the specific therapy for malnutrition was food.
” - Jack Geiger, MD
Take 2 Steps to Prevention
Environment Exposures & Behaviors Medical Services
The 1
st
step ...
Environment Exposures & Behaviors Medical Services
Let’s take another step ...
Environment Exposures & Behaviors Medical Services
What’s Sold and Promoted
Elements of Community Health
EQUITABLE OPPORTUNITY Racial justice Jobs & local ownership Education HEALTH CARE SERVICES Preventative services Access Treatment quality, disease management, in-patient services, & alternative medicine Cultural competence Emergency response PLACE What’s sold & how it’s promoted Look, feel & safety Parks & open space Getting around Housing Air, water, soil Arts & culture PEOPLE Social networks & trust Participation & willingness to act for the common good Norms/Costumbres
“
It is unreasonable to expect that people will change their behavior
easily
when so many forces in the social, cultural, and physical environment conspire against such change.
” - Institute of Medicine Source: Institute of Medicine. (2000).
Promoting health: Intervention strategies from social and behavioral research
(B. D. Smedley & L. S. Syme, Eds.). Washington, DC: National Academies Press.
Existing Clinician Skills
PATIENT INTAKE DIAGNOSIS TREATMENT Transferable to Community Prevention INQUIRY
Capture and identify population level health trends
ANALYSIS
Analyze and prioritize relevant community conditions
ACTION
Engage in advocacy and translate clinic priorities into action
EQUITABLE OPPORTUNITY Education Living wages & local wealth PLACE What’s sold & how it’s promoted Look, feel & safety Parks & open space Getting around/transportation Housing Air, water, soil Arts & cultural expression
Inquiry
HEALTH CARE SERVICES Preventative services Access Treatment quality, disease management, in-patient services, & alternative medicine Cultural competence Emergency response PEOPLE Social networks & trust Participation & willingness to act for the common good Norms & Culture
Analysis
Analysis
“ I also believed… because of experience with my family, that rural low income people had capacity to plan and change… ” - Dr. John Hatch
Action
Asian Health Services
From Pedestrian Safety …
Photo courtesy of: Asian Health Services, http://www.ahschc.org/safety.htm
… to Policy, Systems, & Environmental Change
Photo Credit: http://metes.wordpress.com/2009/01/25/diagonal-crosswalks/
Moving More Upstream, Identifying Priorities
Community groups Business owners OCCC City planning agencies
Led by AHS
Priority 1: economic development and economic equity Priority 2: physical development in surrounding communities Priority 3: current state of transportation development
Legal Action Revive Chinatown!
Catalyst for Change “
An ecological system approach can more effectively address a chronic public health problem…
health centers can function as catalysts of community and economic development
.
”
- Liou and Hirota on the Revive Chinatown! campaign, as described in
From Pedestrian Safety to Environmental Justice: The Evolution of a Chinatown Community Campaign
Spring 2005
“ We are bringing together the health and human rights voices in south LA and beyond to discuss the healthcare crisis and how we build a movement for the right to health. ”
- Jim Mangia, CEO, St. John’s Well Ch
ild
Inquiry
Image Credit: User Thester11, Wikimedia Commons
Inquiry: Housing Questionnaire
Analysis: Partnership to Assess Housing Conditions
St. John’s Well Child & Family Center Esperanza Community Housing Corporation Strategic Actions for a Just Economy Los Angeles Community Action Network
Action: Policies that Improve Health
Community Engagement Medical Care Advocacy Outcomes
POLICIES: LA City Attorney’s Office; LA County Department of Public Health Landlord Compliance
Litigation
Action: Advocacy for Change
Success: Improved Health Outcomes
4 out of 5 residents
with anxiety related specifically to substandard housing conditions
reported health improvements
Among residents with more than 2-5 health conditions,
93% reported significant improvements in health
Photo credit:
The Shame of the City: Slum Housing and the Critical Threat to the Health of L.A. Children and Families
, (Los Angeles: Strategic Actions for a Just Economy, April 2007).
Photo Credit: Daniel Bernstein
“ You can do more than bail out these medical disasters after they have occurred… go upstream from medical care to forge instruments of social change that will prevent such disasters from occurring in the first place.
”
- Jack Geiger, MD
221 Oak Street Oakland, CA 94607 Tel: (510) 444-7738 Sign up for our media alerts: http://www.preventioninstitute.org/alerts www.preventioninstitute.org
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PCCP: Community-Centered Health Home Demonstration Project
Jaymee L. Lewis, MS 54
Project Overview
The Community-Centered Health Home (CCHH) Demonstration Project a part of the PCCP of the GRHOP aims to advance health equity and community resiliency by enhancing the capacity of selected health center sites to take the next step beyond the patient-centered medical home model and serve as trusted, effective partners in community prevention.
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Eligible Entities
Only operational sites of Federally Qualified Health Centers (FQHC's) or Look-Alikes in the 17 eligible GRHOP counties and parishes of the central Gulf Coast are eligible to compete for this award. Florida Alabama Mississippi Louisiana • Escambia • Santa Rosa • Walton • Okaloosa • Bay • Mobile • Baldwin • Hancock • Harrison • Jackson • Orleans • Jefferson • Plaquemines • St. Bernard • Terrebonne • Lafourche • Cameron 56
Award Information
• Maximum of 1 award in Florida, 1 in Alabama, 1 in Mississippi and a maximum of 2 awards in Louisiana • Applicants may request up 250,000 for the two-year project period 57
Use of Funding
Funding may be used for… • Personnel • Training • CCHH Oriented Systems Changes • Sustainability Considerations Funding may NOT be used for… • Funding of medical services that are reimbursable • Subcontracting with LPHI • Construction costs of brand new building structure. 58
Application Process
• Application Instructions are listed on pages 16-20 of the RFP. • Interested parties should submit all elements listed in the Application Checklist (Attachment B) to: [email protected]
no later than Friday, November 21, 2014 at 5:00 pm CST. • All questions regarding the RFP should be e-mailed to: [email protected]
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Selection Process
Clinics are competing against two thresholds: • • Capacity and Readiness to implement the proposed project Superiority to other applications submitted within the state.
All applications will be reviewed by a panel comprised of internal staff, field experts, and GRHOP partners.
Applications will be placed in 1 of 4 Categories • Funded without condition or comment • • • Funded with condition or comment Not funded but invited for resubmission with improvements Not funded 60
Selection Process
The offering of this funding opportunity does not guarantee that awards will be made. If a highly qualified applicant is not identified in any or all states, LPHI and the PCCP CCHH Demonstration Project reserve the right to not make any awards. (please to refer pg. 9 of the RFP for further guidance) 61
Timeline
Dates October 14, 2014 October 17, 2014 November 21, 2014 By January 31, 2015 *February 2015 Milestones
RFP Release Technical Assistance Webinar Submission Deadline Award Notifications Project Period Begins 62
Questions and Answers
Jaymee L. Lewis, MS Program Manager, LPHI Community-Centered Health Homes [email protected]
504.301.9811
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PCCP: Direct Focal Funding
• PCCP 2-3 years of direct funding in GRHOP eligible counties/parishes to sole or prioritized FQHC, Look Alike or other community clinic, (Port Sulphur, Cameron). • To support direct operational costs of advancing capacity, quality, transitions of care, sustainability • Already committed - no new clinics to be added • • For Orleans Parish, the settlement prioritized NOELA.
For Jefferson Parish, the settlement prioritized the Jean Lafitte community which selected Jefferson Community Health Care
Centers