Medicaid Advisory Committee March 25, 2015 General Services - PowerPoint PPT Presentation

Medicaid Advisory Committee March 25, 2015 General Services Building Salem, Oregon

Time Item Presenter Opening Remarks - Introduction of new members 9:00 Co-Chairs - Committee memo, OHA Report on SB 1526 - Approval of minutes – January 2015 Bri a n Nieubuurt, OHA 9:15 2015 Legislative Update 9:20 OHA Ombuds Advisory Council: Update Ellen Pinney, OHA OHA Transformation Center Adrienne Mullock, OHA 9:35 - Update on CCO Community Advisory Councils (CACs) Tom Cogswell, OHA Health Share Community Advisory Council - Health Share’s CAC membership and community engagement Sandra Clark, staff; Amy 10:10 activities Anderson, member - Council priority areas and implementation activities outlined in the CHIP 10:40 BREAK Oregon Health Authority: Updates 10:50 - Oregon Health Plan (OHP) Enrollment and Redeterminations Rhonda Busek, OHA - Coordinated Care Organizations (CCOs) Committee Strategic Planning and Draft Work Plan - Review Committee Charter 11:00 Co-Chairs; staff - Proposed 2015 work plan & meeting calendar - Brainstorm future policy topics 11:30 Public Comment or Testimony Co-Chairs 11:35 Closing comments Co-Chairs; staff 11:40 Adjourn Co-Chairs; staff

2015 Legislative Update Brian Nieubuurt Legislative Coordinator for Health Care Programs, OHA

OHA Ombuds Advisory Council Update Ellen Pinney, OHA Ombudsperson

Community Advisory Council (CAC) Adrienne Paige Mullock, MPH, CHES, RYT Transformation Analyst 3/25/15

Agenda • Overview of the CACs • Summary of the CHPs • Senate Bill 436 • Focus for 2015 • CAC Summit 2015 3/24/2015 6

Total CACs Around the State = 36 • PrimaryHealth of Josephine • AllCare Health Plan: 3 County: 1 • Cascade Health Alliance: 1 • Trillium Community Health • Columbia Pacific CCO: 3 Plan: 2 • Eastern Oregon CCO: 13 • Umpqua Health Alliance: 1 • FamilyCare, Inc: 1 • Western Oregon Advanced • HealthShare of Oregon: 1 Health: 2 • Intercommunity Health • Willamette Valley Community Network: 3 Health: 1 • Jackson Care Connect: 1 • Yamhill County Care • PacificSource Central Organization: 1 Oregon: 1 • PacificSource Columbia Gorge: 1

Per ORS 414.627 CAC must: • “Include representatives of the community and of each county government served by the coordinated care organization, but consumer representatives must constitute a majority of the membership” • “Have its membership selected by a committee composed of equal numbers of county representatives from each county served by the coordinated care organization and members of the governing body of the coordinated care organization.” 3/24/2015 8

CAC Meetings • Meet at least once every three months. • Post a report of its meetings and discussions to the website of the coordinated care organization and other websites appropriate to keeping the community informed of the councils activities. Example: InterCommunity Health Network CCO CAC 3/24/2015 9

Community Advisory Councils (CACs) • Duties of the CAC include, but are not limited to: o Identifying and advocating for preventive care practices to be utilized by the CCO o Overseeing a community health assessment (CHA) and adopting a community health improvement plan (CHP) to serve as strategic guidance for the CCO to address health disparities and meet health needs for the communities in their service area o Annually publishing a report on the progress of the CHP

Community Health Improvement Plan (CHIP) The activities, services and responsibilities defined in the plan may include, but are not limited to: a) Analysis and development of public and private resources, capacities and metrics based on ongoing community health assessment activities and population health priorities; b) Health policy; c) System design; d) Outcome and quality improvement; e) Integration of service delivery; and f) Workforce development. 3/24/2015 11

Summary of CHIPs Implementation status: • Delivered June 30, 2014 • Yearly progress report due June 30, 2015 CCO Community Health Improvement Plans

CHIP: Priority Areas • Mental health integration (15 CCOs) • Maternal health, early childhood and youth (11 CCOs) • Access to care (8 CCOs) • Health equity and socioeconomic disparities (8 CCOs) • Oral health (8 CCOs)

CHIP: Implementation Strategies • Access to care (41 strategies) • Health equity (33 strategies) • Workforce development (32 strategies) • Integration of services (31 strategies) and care coordination (21 strategies) • Oral/dental health (28 strategies) • Substance abuse prevention/cessation (28 strategies) • Mental health (27 strategies)

Senate Bill (SB) 436 • Effective July 1, 2013, SB 436 highlighted issues related to children’s health care and established guidelines for Coordinated Care Organizations (CCOs) to focus on children’s health, to the extent possible, in the development and adoption of their required CCO community health improvement plans.

Findings From SB 436 Com m unity Health I m provem ent Plan Strategy and Plan for Collaboration w ith Child Health Partners 100% 8 1 % 8 1 % 80% Early Learning Council 60% Youth Development Council School health providers 3 8 % 40% 20% 0%

Findings from SB 436 cont. Com m unity Health I m provem ent Plan Strategy and Plan for Coordinating Health Care Delivery to Children and Adolescents 100% 9 4 % 8 8 % 80% Effective and efficient delivery of health care to 60% children Effective and efficient delivery of health care to 40% adolescents 20% 0%

Findings from SB 436 cont.

Findings from SB 436 cont.

Focus for 2015 CAC Leadership Development • Monthly leadership calls – Chairs/Co-Chairs • Bi-monthly leadership calls – Coordinators • Bi-monthly leaderships calls – Steering Committee Resource Library Development • Motivational Interviewing • Logic Models: From Goals to Outcomes • Collaborative Problem Solving

Community Advisory Councils: Engaged & Active Summit 2015 June 3-4 in Sunriver, OR The summit will include: • Opportunities to connect with and learn from other CAC members • Strategies for effective member engagement • A forum for sharing CAC activities and overcoming challenges • A time to celebrate and recognize the amazing work accomplished to date

Questions? Adrienne Paige Mullock adrienne.p.mullock@state.or.us www.transformationcenter.org 3/24/2015

Goal in hearing from CACs: • Learn about the role of CCO CACs including membership, diversity, and community engagement activities • Current focus and priority areas as highlighted in the CACs’ community health improvement plans • Challenges and opportunities to improve from the perspective of CACs • Future focus areas related to implementation activities as outlined in CAC CHIPs • Other? 23

Health Share of Oregon CAC involvement in Community Health Needs Assessment & Community Health Improvement Plan Presentation to OHA Medicaid Advisory Committee Meeting March 25, 2015

Health Share of Oregon Mission: to develop an integrated community health system that achieves better care, better health and lower costs for the Medicaid population and the Tri- County community More simply: to create a regional system of care that improves outcomes for the population we serve

Who is a Health Share Member? 236,874 members 23% of our members select language other than English 18,778 African American and African 50,119 Hispanic/Latino 15,376 Asian & Pacific Islander 1,857 Native American

Health Share’s Community Advisory Council (CAC)

CCOs conduct a Community Health Needs Assessment every three years, and update a Community Health Improvement Plan yearly. Health Share’s CAC involvement is extensive: • A chartered CHNA/CHP Committee with CAC members, a Board Member, and community stakeholders meets monthly • The CAC approves and adopts the CHNA and CHP and ensures that contractual obligations to OHA are met or exceeded. Assessment/Improvement Plans are intended to: • Identify priority health needs through data gathering and analysis • Identify and address gaps in available data • Reduce health disparities and promote health equity • Improve overall population health

CAC’s role in developing the CHNA and CHP in 2013-2014 CHNA Committee’s tremendous volunteer investment: They met 3 hours every other week for almost two years – a tremendous investment of time and energy by volunteer CAC members! That’s more than hours!

How are CCO Community Health Needs Assessments different? Many health assessments focus on epidemiological data from the region as a whole. Our assessment comes from the perspective of Oregon Health Plan members.

Foundation for Assessment is Healthy Columbia Willamette Collaborative www.healthycolumbiawillamette.org

Healthy Columbia Willamette Collaborative • Fourteen hospitals • Four local public health departments • Two coordinated care organizations (Health Share & FamilyCare) • Four-county region (Clackamas, Clark, Multnomah & Washington) Improvement for new 2014-2016 CHNA Cycle: • Community Engagement Workgroup includes CAC members from Health Share and FamilyCare • CCO & Hospital Data Workgroup will use additional data available to identify drivers and indicators of health needs, with emphasis on disparities and on vulnerable populations