Jan-9-Board-Presentation-for-Website

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RHP 7: Anchor Entity Presentation

Presented to the Central Health Board of Managers January 9, 2012

RHP 7 Overview

 Texas – 20 RHPs   $11.4 billion in DSRIP funds available $17.5 billion in UC funds available  RHP 7   Six counties including Bastrop, Caldwell, Fayette, Hays, Lee, and Travis RHP 7 Plan consists of both UC and DSRIP www.CentralHealth.net

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UC-Only Hospitals

1. Austin State Hospital 2. St David’s Medical Center 3. St David’s North Austin 4. St David’s South Austin 5. Seton Edgar B Davis 6. Seton Medical Center Austin 7. Seton Medical Center Hays 8. Seton Southwest 9. Seton Northwest 10. Seton Shoal Creek 11. Smithville Regional Hospital www.CentralHealth.net

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Region 7 RHP Plan DSRIP Totals

  Available   $689 million in total DSRIP valuation available DY 1 = $30 million – Preliminary Funding  DY2-5 = $659 million – Performance Based Actual       68 projects $637 million valuation 9 Performing providers 5 Hospitals (including CCC) 3 LMHAs 1 LHD www.CentralHealth.net

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Region 7 : No. of DSRIP Projects

Performing Providers Hospitals – 33 LMHAs – 29 LHD – 6 DSRIP Categories Cat 1 – Infrastructure Development – 23 Cat 2 – Program Innovation and Redesign - 45 5 www.CentralHealth.net

RHP 7 DSRIP Valuation by Performing Provider Type

LHD $18 504 758 3% LMHAs $167 061 380 26% CCC $237 176 362 37% Hospitals $215 062 843 34%

$637m Total

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Travis County Performing Provider Participation- DY 2-5 Performing Provider # of DSRIP Projects DSRIP Project Valuation (All Cats)

City of Austin HHSD Dell Childrens UMC Brackenridge ATCIC Community Care Collaborative

TOTAL

6 3 14 9 14

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$18.5m

$36m $163m $97m $237m

$551.5m

www.CentralHealth.net

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City of Austin HHSD: 6 projects Behavioral Health

  ACT for Residents of PSH

Prenatal Care & Family Health

Pre & Post Natal Program 

Prevention & Education

 Healthy Families Expansion Community Diabetes Project   Tobacco Program for 18-25 Year Olds Immunization to high risk adult populations www.CentralHealth.net

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Dell Childrens: 3 projects

   Care for Chronically Ill Children Family-centered Pediatric Obesity Project Counseling on AISD Campuses (AISD funded) www.CentralHealth.net

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UMC Brackenridge: 14 projects Behavioral Health

 Psychiatric Emergency Department   Post-Graduate Training for Psychiatric Specialties Psychiatric Telemedicine for Emergency Service  Substance Abuse Care Connection & Navigation 

Cancer Care

 Behavioral Health Care Connection & Navigation Women's Oncology Care Screening 

Chronic Disease Care

 Women’s Oncology Care Navigation Adult Diabetes Care  Chronic Care Management: Adults 

Patient Experience

 Care Transitions Language Access & Resource Center 

Palliative Care

  Culturally Competent Care Training Palliative Care Expansion

Prenatal Care

OB Navigator Project www.CentralHealth.net

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ATCIC: 9 projects

Crisis Services

 MCOT Expansion   MCOT Telepsychiatry Services Crisis Residential program  Community Behavior Support Team

Outpatient Community Based Services

  Integrated Medical & Behavioral Health Center in Dove Springs Chronic Disease Self Management  Whole Health Peer Support

Workforce Development

  Prescriber Expansion Mental Health First Aid & Suicide Prevention Training www.CentralHealth.net

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Community Care Collaborative: 14 projects Infrastructure

 Disease Management Registry  Patient Centered Medical Home Model 

Care Expansion: Primary, Specialty, Dental

 Chronic Disease Management Model Expanded Hours at Community Clinics   Mobile Care Vans Gastroenterology at Community Clinics   Musculoskeletal Care at Community Clinics Pulmonology at Community Clinics 

Behavioral Health

 Expanded Dental Services Integrated Behavioral Health for Diabetes 

Sexual Health

 Telepsychiatry at Community Clinics Pregnancy Reduction Program 

Patient Navigation

 STD/HIV Screening & Treatment Community Paramedic Navigation www.CentralHealth.net

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Community Care Collaborative: DSRIP Projects Overview

Presented to the Central Health Board of Managers January 9, 2012

Community Care Collaborative DSRIP Projects Category Description No. of Proj Valuation

1 2 3 4 Infrastructure Development Program Innovation & Redesign Quality Improvements-Outcomes Population Focused Improvements TOTAL 8 6 ALL ALL $95m $61m $61m $30m $237m

Category

1-2

Minimum

$3.4m

Maximum

$19.5m

www.CentralHealth.net

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Community Care Collaborative DSRIP Projects

 14 total projects    3 “infrastructure” projects Connection and standardization among safety net providers    11 care delivery projects Expand access to primary, specialty and dental services Access to appropriate care & treatment for chronic conditions Sexual health www.CentralHealth.net

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Every DSRIP Project

    Will impact all patients in Safety Net System – CCC, Medicaid, Uninsured, Others Has process measures & improvement measures, and outcome measures Payment based on performance; outcomes must be achieved Contains some element of Continuous Quality Improvement (CQI) 16 www.CentralHealth.net

Patient Centered Medical Home Model

 $25,001,546 proposed valuation  Intended to enhance shared care & data exchange between providers  Outcomes:   All safety net providers will share certain PCMH standards FQHCs get PCMH recognition/ certification 17 www.CentralHealth.net

Disease Management Registry

    $27,126,462 proposed valuation Intended to enhance Health Information Exchange analytic capabilities 90% of CCC providers use DMR through DY5 Outcome: better blood pressure control for enrolled hypertensives 18 www.CentralHealth.net

Chronic Disease Management Protocols

    $25,982,686 proposed valuation Will create treatment standards across CCC 12,000 patients enrolled in Multiple Chronic Condition treatment protocol through DY5 Outcomes:    better cholesterol control for patients with cardiovascular disease; better blood pressure control for diabetics; improved self-assessed functional status for patients with Multiple Chronic Conditions 19 www.CentralHealth.net

Expanded Hours at Community Clinics

     $21,106,982 proposed valuation Patients currently use ED for conditions that could be treated at clinics Expands hours at 3 centers to 8pm, including SE Hub; pilot one site to 11pm 49,000 additional visits serving 16,000 patients by DY5 Outcome: fewer ED visits for those using services 20 www.CentralHealth.net

Mobile Clinics to Underserved Areas

    $6,025,279 proposed valuation Brings care to underserved areas of Travis County Three vans; 4800 annual appointments slots and 1600 patients served by DY5 Outcome: improved patient satisfaction scores for those using vans 21 www.CentralHealth.net

Dental Care Expansion

      $17,912,179 proposed valuation To increase access to dental services Expands hours & capacity at clinics 12,000 annual visits for 4500 patients Focus on pregnant women (450 by DY5) & those with chronic conditions (3050) Outcome: More pregnant women get recommended preventive dental care www.CentralHealth.net

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Musculoskeletal Care in Community Clinics

 $17,864,274 proposed valuation   To address ortho wait times and provide appropriate level of care 2 rotating specialists, including SE Hub   Serves 1800 patients by DY5 Outcome: patients report improved quality of life 23 www.CentralHealth.net

Gastroenterology Care Expansion

     $15,781,027 proposed valuation Reduce wait time for GI visits & offer preventive colorectal cancer screenings Adds 1 specialist at North Central; 1 rotating specialist, including SE Hub Serves 1800 patients through DY5 Outcomes:    Reduced time to 3 rd next available appointment Ensures adherence to HCV regimen, including depression medication Increases colorectal cancer screening rate 24 www.CentralHealth.net

Pulmonology in Community Clinics

     $14,260,001 proposed valuation Wait time currently 4 months, with a 2 month lacuna in services 2 rotating specialists, including SE hub Serves 2400 patients through DY5 Outcome: reduces COPD admissions rate for population receiving services 25 www.CentralHealth.net

Integrated Behavioral Health for Diabetics

     $13,509,644 proposed valuation Depression co-occurs with diabetes & affects ability to self-manage condition Offers care team management of diabetics with depression 1500 enrolled through DY5 Outcomes: depression remission at 12 months & good A1c control 26 www.CentralHealth.net

Telepsychiatry in Community Clinics

 $11,110,177 proposed valuation    Smaller sites currently lack psychiatric services & health counselors Offers consultation for PCPs & direct treatment for patients via “telemental” service 3500 patients served through DY5  Outcomes: Depression &/or anxiety remission at 12 months www.CentralHealth.net

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STD/HIV Screening & Treatment

    $4,698,966 proposed valuation Climbing rates of infection, particularly among young adults Total of 7500 patient visits and 750 treatment courses/referrals through DY5 Outcomes: increased rates of gonorrhea, chlamydia, and HIV testing & treatment 28 www.CentralHealth.net

Adolescent & Young Adult Pregnancy Prevention

     $6,511,842 proposed valuation High birth rate for women under 20 in Travis County 1550 patient visits through DY5 Provides contraception education and counseling, including long acting reversible contraception (LARC) counseling Outcome: lowers pregnancy rate of those under 25 who receive services 29 www.CentralHealth.net

Community Paramedic Navigator Project

     $9,319,427 proposed valuation High rates of repeat EMS & ED utilization Adds 3 paramedic navigator staff for in home services & development of patient care plan Serves 900 patients through DY5 Outcome: Reduced inappropriate ED utilization www.CentralHealth.net

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DSRIP Project Timeline

Dec 2011 – Sept 2012 Preliminary Oct 2012 – Sept 2013 Planning Oct 2013 – Sept 2014 Implement Oct 2014 – Sept 2015 Outcomes

HHSC/CMS Timelines

RHP Plan Submittal to HHSC – December 31, 2012 RHP Plan Submittal to CMS – February 2013 CMS Approval of RHP Plan – May 2013 Oct 2015 – Sept 2016 Outcomes www.CentralHealth.net

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Questions or Comments

11/9/2012 www.CentralHealth.net

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Information, Questions, Comments:

www.texasregion7rhp.net

[email protected]

512-978-8195 www.centralhealth.net