Albany Medical Center Hospital PPS Collaboration & Networking - PowerPoint PPT Presentation

Albany Medical Center Hospital PPS Collaboration & Networking September 19, 2016

This WebEx Meeting is being recorded

Meeting Attendance Please email confirmation of your participation in today’s meeting to DSRIP@mail.amc.edu Name and Organization is required within 24 hours

Today’s Presentations: 1. Alliance for Positive Health 2. Catholic Charities 3. Center for Disability Services 4. Community Caregivers 5. Community Health Center 6. Healthy Capital District Initiative 7. In Our Own Voices 8. NY StateWide Senior Action Council 9. The Healthcare Consortium 10. Trinity Alliance

Project ID Metric ID Metric Type Contract Metric PPS Responsibility Partner Responsibility Supporting Documentation Provide list of identified CBOs/external stakeholders for Identify key CBOs/external List of identified CBOs/other external Facilitate relationships and future partnerships and stakeholders to develop stakeholders to develop collaborations provide networking collaborations. Hold at least one 2.a.iii 2.a.iii_P6 Performance collaborations and with; meeting agenda, attendees list, and opportunities to bring partnerships to meet goals minutes from initial meeting held to meeting to discuss future providers and CBOs together. of project 2.a.iii discuss partnership goals and strategies partnership goals and strategies for success of the project. Provide list of identified CBOs/external stakeholders for Identify key CBOs/external List of identified CBOs/other external Facilitate relationships and future partnerships and stakeholders to develop stakeholders to develop collaborations provide networking collaborations. Hold at least one 2.b.iii 2.b.iii_P3 Performance collaborations and with; meeting agenda, attendees list, and opportunities to bring partnerships to meet goals minutes from initial meeting held to meeting to discuss future providers and CBOs together. of project 2.b.iii discuss partnership goals and strategies partnership goals and strategies for success of the project. Provide list of identified CBOs/external stakeholders for Identify key CBOs/external List of identified CBOs/other external Facilitate relationships and future partnerships and stakeholders to develop stakeholders to develop collaborations provide networking collaborations. Hold at least one 3.b.i 3.b.i_P1 Performance collaborations and with; meeting agenda, attendees list, and opportunities to bring partnerships to meet goals minutes from initial meeting held to meeting to discuss future providers and CBOs together. of project 3.b.i discuss partnership goals and strategies partnership goals and strategies for success of the project. Provide list of identified CBOs/external stakeholders for Identify key CBOs/external List of identified CBOs/other external Facilitate relationships and future partnerships and stakeholders to develop stakeholders to develop collaborations provide networking collaborations. Hold at least one 3.d.iii 3.d.iii_P1 Performance collaborations and with; meeting agenda, attendees list, and opportunities to bring partnerships to meet goals minutes from initial meeting held to meeting to discuss future providers and CBOs together. of project 3.d.iii discuss partnership goals and strategies partnership goals and strategies for success of the project.

Please feel free to use Organization Name an approved slide background from Location(s): your organization. Counties served: Key services •  Please list key services and any details you would like to share focusing on those relevant to the following four projects (Health Home At-Risk Intervention, ED Care Triage, Cardiovascular, and Asthma) Service 1 – Service 2 – Service 3, etc. – Contact Information • Please list name, position, email and/or phone number for other – partners to connect with after the webinar Website, if applicable. –

Alliance for Positive Health Location(s): Albany, Schenectady, Plattsburgh, Hudson Falls, Hudson Counties served: Albany, Clinton, Columbia, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington The Alliance for Positive Health is a Health Home provider for adults with chronic illnesses, including cardiovascular disease, asthma, HIV, substance use disorders, mental illness, etc. Care managers work with clients in their homes, accompany them to medical appointments, and coordinate ER and hospital discharges. The Alliance provides linkage and navigation services, coordination of medical services, assistance with maintaining benefits, education regarding managing chronic illnesses, referrals to social services, harm and risk reduction counseling, and limited financial assistance for emergencies. In addition to the Health Home program, the Alliance offers a wide array of services for individuals with HIV, at risk for HIV, individuals with mental illness, substance use disorders, the LGBTQ community, and individuals with chronic illnesses. Contact Information • Laurie Lanphear, Director of Health Homes and DSRIP, – llanphear@alliancefph.org, 518-434-4686, ext. 2228 www.allianceforpositivehealth.org –

Catholic Charities Of the Diocese of Albany Location(s): Albany, Catskill, Glens Falls, Hudson, Saratoga Springs Counties served: Albany, Columbia, Greene, Saratoga, Warren Key services Behavioral Health/Counseling • Case Management/Service Coordination/Health Homes • Children and Youth Services • Adolescent pregnancy and parenting – Supervised Visitation – Parent Education – Kinship Care – Youth Mentoring – Developmental Disabilities Services • Emergency Assistance around Basic Needs • Food Services • Housing Services • WIC Services • Contact Information Further program and contact information for all 12 Catholic Charities’ Agencies can be located at – www.ccrcda.org Theresa Lux, Executive Director – Columbia/Greene: tlux@cathcharcg.org; 518-828-8660 –

Center for Disability Services Location(s): Albany , Clifton Park & Queensbury Counties served: Greater Capital Region including AMC PPS Footprint Key services •  Please list key services and any details you would like to share focusing on those relevant to the following four projects (Health Home At-Risk Intervention, ED Care Triage, Cardiovascular, and Asthma) Article 28 D&TC providing PC, Dental, Neuro, Behavioral Health Services, other Med – Specialties and Outpatient Therapies; services are designed to accommodate the needs of individuals with physical/cognitive/behavioral challenges however most practices, excluding behavioral health, are open to the general public. Heart Disease is one of the leading causes of death in individuals with IDD. Lead Partner with CNYHHN’s Children’s Health Home – Pediatric SNF – St. Margaret’s Center for Children – Accessible Transportation Services including VIA Specialized Transportation (similar – to CDTA STAR) Contact Information • Lori Kearsing – kearsing@cfdsny.org – 518-944-2106 – www.cfdsny.org –

Community Caregivers, Inc. 2120 Western Avenue, Albany, NY 12203 (518) 456-2898 Serving: City of Albany, Towns of Guilderland, Bethlehem, Knox, Berne, New Scotland Key services  Recruits and trains volunteers to provide clients of all ages with non-medical services at no charge, including transportation, shopping, light chores, visits and re-assurance phone calls. 150 volunteers serving over 300 families and caregivers Provides support group for Alzheimers caregivers – Conducts education programs on important health and human services – Registered nurse is Client Intake Coordinator making home assessment and – visits; Transportation Coordinator arranges for actual delivery of services; Program Coordinator recruits and trains volunteers and conducts community outreach and education programs. Contact Information Linda Miller, Program Coordinator, linda@communitycaregivers.org – www.communitycaregivers.org –

Community Health Center Location(s):Johnstown, Herkimer, Galway Counties served: Montgomery, Fulton, Schoharie, Herkimer, Hamliton, Saratoga and Warren Key services • Certified Home Healthcare Agency providing skilled nursing, physical , – occupational, speech and respiratory therapies, medical social work, palliative care, asthma certified clinicians, wound care, diabetes education (fully servicing all areas) Care transition coaching – Telehealth – Contact Information • Cynthia Lockrow LMSW Director of Homecare Marketing – clockrow@chchomecare.org – Website: www.chchomecare.org –