Transcript HEALTH ENTERPRISE ZONES: Baltimore City Public Forum Department of Health and Mental Hygiene Community Health Resources Commission July 19, 2012

HEALTH ENTERPRISE ZONES:
Baltimore City Public Forum
Department of Health and Mental Hygiene
Community Health Resources Commission
July 19, 2012
Maryland Health Improvement and
Disparities Reduction Act
• The Act emanated from the Maryland Health Quality and Cost
Council’s Health Disparities Work Group, established by Lt.
Governor Brown and led by Dean E. Albert Reece of the
University of Maryland School of Medicine.
• The Act was the first bill signed into law by the Governor on April
10, 2012 and its implementation is under the leadership of Lt.
Governor Brown.
• The FY 2013 budget provides $4 million in new funding to the
Community Health Resources Commission (CHRC) to fund Health
Enterprise Zones (HEZ). It is anticipated that this funding will
support two to four zones.
• The Administration appreciates the support of the Maryland
General Assembly in approving the Act.
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Maryland Health Improvement and
Disparities Reduction Act
• The analysis of the Health Disparities Work Group
focused on ways to address the root causes of health
disparities, as evidenced by higher rates of diseases and
illnesses such as:
– Asthma
– Diabetes
– Hypertension
– Other ambulatory care sensitive conditions
• The Work Group developed bold recommendations that
including the creation of HEZ to saturate underserved
communities with primary care providers and other
essential health care services.
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Main Components of the Act
• Health Enterprise Zones (HEZ)
• Promoting Cultural Competency
• Encouraging Reporting and Analysis
of Health Disparities Data
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Health Enterprise Zones
• The purpose of establishing HEZs is to target
State resources to:
– Reduce health disparities among racial and ethnic
groups and geographic areas;
– Improve health care access and health outcomes
in underserved communities; and
– Reduce healthcare costs and hospital
admissions/readmissions.
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Health Enterprise Zones
• Each HEZ will be a contiguous geographic area;
• Must have documented evidence of health
disparities, economic disadvantage and poor
health outcomes; and
• Small enough to allow incentives to have a
significant impact but large enough to track data
(population of at least 5,000).
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Eligible HEZ Applicants
• Non-profit community-based organizations and local
government agencies will be eligible to submit an
application for HEZ designation on behalf of an area or
community.
• The state is encouraging HEZ applications to reflect
inclusion, community participation, collaboration, and
support the priorities identified in the Local Health
Improvement Process.
• The application for HEZ designation will be combination of
both demonstrated need and intervention strategies to
improve health outcomes in the potential Zone.
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Health Care Practitioners Eligible
to Receive HEZ Incentives
• In order to receive incentives/benefits, health care
practitioners must provide services in the HEZ, be
licensed/certified, and provide health care in one of the
following areas:
– Primary care, including OB/GYN, pediatric and
geriatric services;
– Behavioral health, including mental health and
alcohol and substance use services; or
– Dental services.
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Implementation of the HEZs
• An internal steering committee led by Secretary Sharfstein,
comprised of DHMH, Lt. Governor and CHRC staff,
has been established to guide implementation of the HEZs
with assistance from the Health Disparities Collaborative.
• There will be three stages in the process to implement HEZs:
– Public Comment (June 15 - July 20, 2012)
– HEZ Selection Process (September – December 2012)
– Implementation & Evaluation Phase (December 2012 – beyond)
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Public Comment
 Feedback was requested on the following:
(1) Eligibility Criteria and Data;
(2) Proposed Principles for the Review of applications
for HEZs; and
(3) Potential Incentives and Benefits for the HEZ.
 Send public comments to
[email protected]
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Eligibility Criteria and Data
(1) An HEZ must be a community, or a contiguous cluster of
communities, defined by zip code boundaries (one or multiple
zip codes).
(2) An HEZ must have a resident population of at least 5,000 people.
(3) An HEZ must demonstrate economic disadvantage:
– Medicaid enrollment rate; or
– WIC participation rate.
(4) An HEZ must demonstrate poor health outcomes:
– A lower life expectancy; or
– Percentage of low birth weight infants.
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Eligibility Criteria and Data
• Based on these criteria DHMH developed dynamic
maps with data at the zip-code level.
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HEZ Selection Principles
•
Purpose: Describe how the proposal will reduce health disparities,
including racial/ethnic and geographic health disparities, in
Maryland.
•
Description of need: Describe the health needs specific to the
community.
•
Core disease targets: Identify specific diseases for improvement.
•
Goals: Propose measurable goals for health improvement in the
HEZ by January 2016.
•
Strategy: Propose strategies and interventions to meet the goals.
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HEZ Selection Principles
•
Cultural competence: Explain how the strategies will be
implemented in a culturally competent manner and designed to
be accessible to the target population.
•
Balance: Strategies should be balanced between communitybased approaches with primary care provider based incentives.
•
Coalition: The coalition should include a diverse array of health
and community partners, with specific roles and a clear
governance structure with a point of accountability.
•
Work-plan: Provide a detailed list of program activities,
measurable outputs, timelines, responsible entities and other
logistics that enable tracking of effort.
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HEZ Selection Principles
•
Program Management and Guidance: Include a plan for periodic
reporting to the State regarding progress and challenges on
implementation of the HEZ work-plan and interim values for the
evaluation metrics.
•
Sustainability: Develop a plan for sustainability and acquisition of
resources beyond State funding.
•
Evaluation: Propose an evaluation plan which tracks progress in
meeting the health goals for the Health Enterprise Zone.
•
Collaboration: Local health departments, hospitals, community
organizations, local health improvement coalitions, and other
stakeholders are encouraged to collaborate and produce a single
plan to reduce health disparities and improve health outcomes in
their area.
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Incentives and Benefits of
HEZ Designation
• Grant funding to implement the actions outlined in the HEZ
application to improve health outcomes and reduce health
disparities.
• Specific incentives for individual practitioners or practices that
provide primary care, behavioral health services, or dental
services in a HEZ:
– State income tax credits;
– Hiring tax credits;
– Loan repayment assistance;
– Priority to enter the Patient Centered Medical Home;
– Priority for electronic health records funding; and
– Grants for capital improvements and medical/dental equipment. 16
Promoting Cultural Competency
• The Act requires the Maryland Health Care Commission
(MHCC) to track efforts by health plans to provide
culturally appropriate educational materials for its
members.
• In addition, the Maryland Health Quality and Cost Council
(MHQCC) will recommend criteria for health care
providers to receive continuing education in multicultural
health care, including cultural competency and health
literacy training.
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Encouraging Reporting and Analysis of
Health Disparities Data
• MHCC and HSCRC will develop and incorporate standard
measures on racial and ethnic variations in quality and outcomes
and track health insurance carriers’ and hospitals’ efforts to
combat disparities.
• MHCC and HSCRC will develop recommendations for criteria and
standards to measure the impact of the Maryland Patient
Centered Medical Home on eliminating disparities in health care
outcomes.
• State institutions of higher education that train health care
professionals are required to report to the Governor and General
Assembly on their actions aimed at reducing health disparities.
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For more information:
http://dhmh.maryland.gov/healthenterprisezones/SitePages/Home.aspx
Send public comments and questions to:
[email protected]
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