Board of Trustees February 28, 2019 1 Board Agenda Introductions: - - PowerPoint PPT Presentation

Board of Trustees

February 28, 2019

1

Board Agenda

• Introductions: New Staff
• Consent Agenda
• Finance Committee Reports
• Board of Trustees
• CTP/CSO Contracts – Status Report

Introductions

• Jim Jensen, Opioid Collaborative Coordinator
• Sky Wilson, Equity Initiatives Manager
• Brandi Williams, Rose Village Community Health

Worker Team Lead and Educational Advocate

• Dominique Horn, Rose Village Community Health

Worker Team Lead and Educational Advocate

• Michelle Ahmed, Pathways HUB Coordinator

Consent Agenda

• December 2018 Board of Trustee Minutes
• SWACH Dash Board Report (Strategic

Framework)

Operations Dashboard

Key Strategies Major Milestones Target Date Success Metric Status Staffing

• Opioid Coordinator – Jim Jensen
• Equity Manager – Sky Wilson
• Pathways HUB Coordinator – Michelle Ahmed
• Accounting & Human Resources Coordinator
• Transformation Improvement Director

November 2018 December 2018 January 2019 Position Filled Position Filled Position Filled Two positions filled; applications being received for two positions

• Review organizational roles and potential staffing models that support

functions; implement changes to organizational structure October 2018 Organizational structure to support 2019 Work Finalized; Board reviewed 12.2018 Marketing & Communications

• Hired a Communications Director to develop a communications plan

August 2018 Position filled/Plan created Complete

• Communications Plan Launch and integration of Healthy Living

Collaborative

• Robert Wood Johnson Healthy Communities Application submitted
• ED participated on two community panels: Leadership Clark County

and Clark County Health Care Advisory Board

• ED spoke at Health Policy Conference on Future of ACH’s
• ED is representing the ACH-EDs on Washington State CHW Task Force
• Established regular meetings with Managed Care Plans

Winter 2018/2019 November 2018 December 2018 November 2018 April 2019 Ongoing Communications Plan; SWACH brochure/video. 2nd Round Approval. Participation complete. Panel participation. CHW Training Recommendations. Monthly-Quarterly meetings Brochure completed; 1st Round Approval; 2nd Round proposal submitted; Review of CHW trainings in multiple states.

Operations Dashboard (continued)

Key Strategies Major Milestones Target Date Success Metric Status Budget/Funds Flow/Personnel

• Board approved operating budget.
• Board approved five-year Funds Flow Allocations
• Board approved 2018 Pathways/HUB budget.
• New Financial Software Implemented.

Winter 2018/2019 Jan-Feb. 2019 Approved 2019 budget; Approved Multi-Year Funds Flow; Approved 2018 Pathways/HUB Budget. System Implemented. Multi-Year Funds Flow & 2018 Hub Budget approved; 2019 SWACH Budget approved. System being installed.

• Transition HR functions from Contractor to SWACH

December- March 2019 HR Functions internalized. Insurance transitioned Internal Policies & Procedures

• Review operational policies and procedures for gaps; prepare and

implement policies and procedures

• -Personnel Policy Manual
• -Financial Policy Manual
• -IT Policies

Fall 2018-Spring 2019 Completed operations policies and procedures Personnel Policy Manual approved. Reporting & Accountability

• SAR 100%; Implementation Plan submitted
• SAR 2.0: Implementation Plan submitted

Summer 2018 January 2019 SAR 100% SAR 100% Complete. Complete.

Operations Dashboard (continued)

Key Strategies Major Milestones Target Date Success Metric Status Board Governance/RHIP Council

• Bylaws Revised
• Board of Trustee Officers and Board Members Recommended.
• Executive & Finance Committee Accountabilities Defined
• Hosted a Social Determinants/Clinical Care Panel at RHIP.

December 2018 December 2018 February 2019 February 2019 January 2019 Bylaws approved Officers & Board Members approved Accountabilities approved. Successful Panel. Approved

• Dec. 2018

Approved

• Feb. 2019.

Panel completed.

Whole Person Integrated Care Dashboard

Key Strategies Major Milestones Target Date Success Metric Status Integrated Care Framework Development Co-Created Goals

• Integration of Physical and Behavioral Health
• Value Based Payment Goals Established
• Success Metrics Established
• Workforce Needs Established

October 2018 Implementation Plans submitted. Completed. Cohort of Providers for Clinical Transformation

• Clinical Partner Assessment
• Review Transformation Plan (CTP)

July 2018 Transformation Plan Developed Completed.

• Clinical Transformation Plan developed disseminated and returned

August 2018 Transformation Plan Completed Complete

• Clinical Transformation Plan review

October- early December 2018 Plans reviewed by Staff and External Reviewers. Completed.

• Established Cohort of Clinical Partners invited into a binding agreement to begin

workplan negotiations and Pay for Performance tied to transformation plans. January 2019 Binding Agreements In Process.

• Provider contracts/MOU executed

February 2019 Binding Agreements In Process. Learning Collaborative(s)

• Learning Collaborative (QI) process Identified for Integration Teams

March 2019 Collaboratives Developed Pending

Community Clinical Linkages Dashboard

Key Strategies Major Milestones Target Date Success Metric Status Engage Community Serving Organizations into Transformation

• Request for community serving organizations that support addressing the social

determinants of health to partner with clinical partners October 2018 RFI’s Received Complete

• Establish review and matchmaking process and criteria

November 2018 Process Developed Complete

• Invite Community Serving Organizations into a transformation Cohort; complete

Binding Agreements February 2019 CSO’s integrated with Clinical Teams In Process

• Current Project - SeaMar/CVAB Hep C CURES QI

Ongoing Improvement Cycle In Process

• New Opioid funding
• New Opioid Treatment Network Funding

September 2018 December 2018 Grant approved Funding Received Funding Approved . Healthy Living Collaborative Initiatives

• Promote and support CHW neighborhood teams in Clark, Cowlitz and Wahkiakum

counties; Select partner organizations for CHW teams. November 2018 Ongoing Ongoing MOUs completed Barriers identified Complete In Process

• Address barriers to school attendance at McLoughlin Middle School through the

Education Community Health worker initiative

• Support growth of CHAPS network (namely Advocates, Community Health Workers,

Certified Peers and their organizations) serving Southwest Washington, to improve holistic health outcomes for the Community

Community HUB Dashboard

Key Strategies Major Milestones Target Date Success Metric Status Community HUB

• Board adopts pathways

June 2018 Board Approval Complete

• CTPs identify Klickitat and Skamania interest in Pathways model (rural

engagement) September 2018 RFA released In progress

• Contract with CCS for HUB Technology and Technical Assistance
• Includes prelaunch support with Healthy Gen for CHW workforce development

September 2018 Contracts signed Complete

• Pathways HUB 2-Day Strategic Planning Meeting

September 2018 Implementation Tasks and Timeline developed Complete

• Rural CCAs announced: Skamania County Community Health & Washington

Gorge Action Program November 2018 Rural CCAs announced In progress

• HUB Advisory Committee formed

November 2018 First meetings scheduled Not complete

• All CCAs Trained

February 2019 Training completed In Process

• Community HUB Go Live!

March 2019 First person enrolled Planning

Collaborative Impact Dashboard

Strategy Key Milestones Target Date Success Metric Status Cross Sector Shared Learning

• Monthly Stakeholder Meetings Held
• Opioid Learning Sessions: Successful events for providers “The Uses of Suboxone in a

Practical Clinical Setting”; Events in Clark and Skamania Counties 9/2018 Minimum attendance

• f 40 Providers

Complete Community Engagement System

• Conduct an internal assessment of SWACH’s community engagement efforts, collate

community engagement knowledge, and refine and communicate community engagement strategy 1/2019 Assessment completed In progress

• Form local and regional community councils

3/2019 Councils formed In progress

• Host community engagement sessions

Ongoing Quarterly community engagement sessions

• Create a culture of community engagement within SWACH as an organization and within the

work groups and learning collaboratives it supports Ongoing Community Resiliency Funding

• MOU approved for Housing & Health Innovation Partnership (VHA; SWWCF; Clark County

Community Services & SWACH)

• VHA to dedicate up to 50% of vouchers to people enrolled in FCS housing support benefit

until total vouchers reaches 200.

• Elwood & Tenny Creek supportive housing funded with 9% tax credit allocation.

10/18 Partnership Agreement Approved. Additional funding for supportive housing approved. Ongoing

Collaborative Impact Dashboard Cont.

Strategy Key Milestones Target Date Success Metric Status Equity Planning

• Hire Equity Manager

12/18 Position Filled Complete

• Developed Equity Shared Learning Cohort and Curriculum

3/19 4/19 12/19

• ngoing

Curriculum developed Partners complete assessment and plans SWACH completes assessment and plan Trainings completed quarterly Steering committee met.

• Support partners to equity assessment and plans
• Complete an internal assessment and plan; convened equity collaborative steering

committee.

• Support equity, stigma reduction and trauma informed training and capacity building across

the region Platform for Policy and System Changes

• Conduct policy watch and analysis at the local regional, state and federal levels.

Ongoing

• Maintain a high functioning Policy committee.

Ongoing

• Develop a policy agenda that is community led and supported.

Ongoing

• Support advocacy at local, state, and federal levels, to include letter writing, direct outreach

to decision makers, and public testimony. Ongoing 12/18 Ongoing Policy Approved. Policy Approved by Board 12/18

• Develop a process for bridging SWACH and HLC policy agenda.
• Connect to organizational/system policy change and identify opportunities to influence by

bringing an equity, health and community lens. Evaluation

• Develop 3rd evaluation plan in partnership with CORE.

2/19 Evaluation Plan completed Pending

Finance Committee Report

• Financial Report – FY 2018

January 2019

Board of Trustees

• Committee Framework
• Trustee Recruitment
• Board Meeting Frequency
• Board Retreat
• SWACH Personnel Policy Manual

Clinical Transformation Plan (CTP) and Community Serving Organization (CSO) Plan and Contract Update

CTP/CSO Status Report

• 21 Clinical Transformation Plans

Funding Range: $300,000-$450,000

• 9 Community Organizations

Funding Range: $50,000-$150,000

Objective

• Use Guiding Principles to endorse the final

partner placement recommendations and ensure a balanced portfolio of Initiatives across our region.

Guiding Principles to ensure we have a balanced portfolio:

• Maximize the number of clinical organizations engaged with SWACH
• Align SWACH level of engagement with partners readiness for transformation
• Ensure rural community representation
• Balance support between short-term and long-term transformation activities
• Promote long-term sustainability by looking for opportunities in system

change

• Foster partnerships between clinical & community serving organizations to

increase effectiveness of transformational activities

• Promote awareness and reduction of inequities in delivery of whole person

care

• Have impact in both physical and behavioral health in all communities

Partner Requests

• Requested clinical partners to submit high-level clinical Medicaid

transformation plans (CTPs) for integrated whole person care with target populations of behavioral health, opioid, chronic disease, and those in need of care coordination.

• Requested community serving organizations (CSOs) to submit a

proposal (RFI) for partnership linkage opportunities with Medicaid transformation efforts and clinical partners to include target populations of behavioral health, chronic disease, opioid prevention and mitigation, and in need of care coordination.

As of December 31, 2018, 19 clinical partners were approved by SWACH Board of Trustees, as recommended by SWACH staff & Community Review Team. Cowlitz Tribe and Yakama Nation plans are in process.

• Child & Adolescent Clinic
• Children’s Center
• Children’s Home Society
• Columbia River Mental Health
• Community Services NW
• Comprehensive Healthcare
• Family Solutions
• Kaiser Permanente
• Klickitat Valley Health
• Legacy Health
• Lifeline
• Lutheran Community Services NW
• North Shore Medical Group
• PeaceHealth Southwest
• Providence Health
• Rose Medical Clinics
• Sea Mar Community Health Centers
• Skamania County Community Health
• Skyline Primary Care

Clinical Transformation Partners

Urban, 15 Rural, 6

Where are Partners Located?

Vancouver Portland Seattle Brush Prairie Goldendale Stevenson White Salmon Yakima

Statement of Work: Projects

• Bi-Directional Integration
• Care Coordination
• Clinical-Community Linkages, i.e., housing
• Opioid Services

As of December 31, 2018, nine community serving organizations were approved by SWACH Board of Trustees, as recommended by SWACH staff & Community Review Team. The majority of these organizations have indicated an interest in partnering with a clinical organization. 56% Urban; 44% Rural

Community Serving Organizations (n=9)

• Area Agency on Aging & Disabilities of SW Washington
• Clark County Fire & Rescue
• Council for the Homeless
• CVAB
• Share
• Vancouver Housing Authority
• White Salmon Valley Education Foundation
• Woodland Action Center
• WSU Extension Clark County

Community Serving Partners

Community Organization Projects

Care Coordination - Housing Partners Care Coordination-Fire & Rescue Units Mobile health services Behavioral Health – Schools Nutrition Education

Contracting Process-January 2019

• Notified approved partners
• Developed tools for partner meetings
• Developed template project
• Scheduled partner meetings (1-3 partners)
• Initiated scope of work

Finalizing Partner Contracts-February 2019

• Statement of work submitted
• Partner Matching
• Equity Collaborative
• Final Funding Allocations
• Contract signed
• Budgets completed

SWACH-Alignment of Support

• Skill Identification
• Re-evaluate Organization Structure
• Implement Learning Collaborative for

behavioral health & primary care

Transformation Implementation Funds Flow Years 1 & 2-

Confidential DSRIP & BH Integration Incentives Available $9.7M

Transformation Implementation Year 1 (January 2019)

$8M

Transformation Implementation Year 2 (January 2020)

$8M

Potential Additional Earning Pool or Emerging Partner Investments Needed for Transformation (Note: This pool could increase based on Statement of Work Negotiations) $1.7M

• Internal Plan

Review

• External Plan

Review

• Board Review

December

• Partner Invited into

Contracting Process

• Partner Statement of

Work (SOW) Sessions

January

• Finalize SOW, funding

formula & reporting requirements for each partner

• Partner Contracts

February

Contracting Timeline

Thank you!