Regional Health Improvement Plan Council October 16, 2018 Meeting - - PowerPoint PPT Presentation

Regional Health Improvement Plan Council

October 16, 2018

Meeting Objectives

• General SWACH Business
• Strategic Framework

Overview and Progress

• Decision Making Criteria
• 2019 Policy Priorities

Meeting Minutes

• Council Member Action:

Approve Meeting Minutes

Operations Dashboard

Key Strategies Major Milestones Target Date Success Metric Status Staffing

• Opioid Coordinator
• Equity Manager

August 2018 Positions Filled In Progress

• Review organizational roles and potential staffing models that support

function October 2018 Organizational structure to support 2019 Work In progress 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 Winter 2018/9 In progress Budget/Funds Flow

• Board approved operating budget

Winter 2018/9 Approved budget In progress

• New Opioid funding

September 2018 Grant approved Complete Internal Policies & Procedures

• Review policies and procedures for gaps and fill gaps

Fall 2018 Full policies and procedures In progress Reporting & Accountability

• SARs 100%
• Implementation Plan submitted

Healthy Living Collaborative Integration

• Integrate Healthy Living Collaborative programs, staffing, and services

into SWACH regional plan

• CHW Neighborhood Pilot Transition

Winter 2018/9 In Progress

Funds Flow Update

(REVIEW) Four High Level Funds Flow Categories

ACH Admin Community Resiliency Fund Regional Capacity Investments Transformation Plan Implementation

• Administrative operating

expenses of SWACH

• Legal
• Financial
• Facilities
• Equipment
• Funds for Pathways
• Funds for ACH to make

regional investments that support partners for specific purposes including workforce, health information, training, and other infrastructure funds.

• Funds will be used to promote

large scale transformation and sustainability across the region.

• Funds paid directly to partners

to plan for and achieve DSRIP goals and overall transformation.

• Assessments
• Transformation plans
• Implementation

support

• Investments impacting social

determinants of health and innovative solutions.

(REVIEW) How Many Dollars Are There?

$8.67M BH Integration $? Community Resiliency Fund

$721,217 – Year 1 (10%) $? – Year 2 $? – Year 3 $? – Year 4 $? – Year 5

DSRIP Incentives

$7.2M Year 1

$1.8M (25%)

$9.2M Year 2

$?

$7.8M Year 3

$?

$7.3M Year 4

$?

$5.9M Year 5

$? $4M (55%) $? $? $? $?

% to the Community Resiliency Fund

Regional Capacity Investments Partners Transformation Plans/Implementation

To support bi-directional integration across Clark, Skamania, and Klickitat Counties

ACH Admin Year 1 = $721,217 (10%)

(REVIEW) Year 1 Transformation Plan Implementation

$2.3M Binding Agreements

Binding 2019 agreements negotiated September through December These funds will combine with year 2 funds to support 2019 contracts Contracts will take into account Medicaid lives served and can support equity/anti- stigma work as well as partnerships needed to achieve transformation outcomes

$1.7M Planning

Health Information Assessment ($210,000) Clinical Assessment ($260,000) Transformation Plan Submission ($900,000) Non-Clinical Partner Engagement TBD ($330,000)

Year 1 Transformation Plan Implementation Budget vs. Actual

Actual

Spent: $172,500 Owed: $37,500 Spent: $220,000 Owed: $30,000 Spent: $0 (21 plans submitted so far) Spent: $0 (RFI is currently open)

Budgeted

Health Information Assessment ($210,000) Clinical Assessment ($260,000) Transformation Plan Submission ($900,000) Non-Clinical Partner Engagement TBD ($330,000)

Current Thinking/ Board of Trustees Decision in October

BH Integration

ACH Admin $0 Community Resiliency Fund $868K (10%) Regional Capacity Investment $2.2M (25.4%) Transformation Implementation $5.6M (64.6%)

DSRIP Incentives Year 1 thru 5

ACH Admin 10% (roughly $3.7M) Community Resiliency Fund 10% (roughly $3.7M) Regional Capacity Investment 25% (roughly $9.3M) Transformation Implementation 55% (roughly $20.5M)

Current Thinking/ Board of Trustees Decision in October

Total of DSRIP Incentives Year 1 thru 5 and BH Integration

ACH Admin 8.11% (roughly $3.7M) Community Resiliency Fund 10.00% (roughly $4.6M) Regional Capacity Investment 25.07% (roughly $11.5M) Transformation Implementation 56.82% (roughly $26.1M)

Thank you!

• Andy Silver

Our Vision

A healthy southwest Washington region where all people have equitable access to quality whole person care and live in connected and thriving communities without barriers to wellness

Our Strategy Snapshot & Dashboards

COMMUNITY HUB

Care Traffic Control

WHOLE PERSON CARE

Clinical Transformation

COMMUNITY CLINICAL LINKAGES

Integration of Social Determinants into Clinical Transformation

COLLABORATIVE IMPACT

Learning, Action, Equity, and Sustainability

VISION Partnering to build a healthier future in Southwest Washington – for everyone

WHOLE PERSON CARE

Clinical Transformation

VISION Partnering to build a healthier future in Southwest Washington – for everyone CLINICAL PARTNERS

• Clinical Improvement (Target Populations/issues)
• Clinical Integration (BH/PH)
• Participate in Targeted Learning Collaboratives
• Integrated Managed Care - Klickitat

STAKEHOLDER ENGAGEMENT SYSTEM: Clinical Transformation Workgroup; Clinical Community Opioid T.F.; Integrated Managed Care CORE (Klickitat); Pre-Managed Learning Collaborative: Tribal Partners SWACH ROLE

• Support for Value Based Payment, Workforce Development,

Health Information Exchange/Technology, Equity and quality improvements supports and evidenced based interventions towards integrated care for target populations (opioid, chronic disease, behavioral health)

• Technical assistance and learning collaboratives

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 Plan Complete In Process Cohort of Providers for Clinical Transformation

• Clinical Partner Assessment
• Review Transformation Plan (TP)

July 2018 Transformation Plan Developed Complete

• Clinical Transformation Plan developed disseminated and returned

August 2018 Transformation Plan Completed Complete

• Clinical Transformation Plan review

October- November 2018 Transformation Plan Mapping file In Process

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

begin workplan negotiations and Pay for Performance tied to transformation plans. December- January 2018 Binding Agreements Pending

• Provider contracts/MOU executed

January 2018 Binding Agreements Pending

• TA plan developed for each participating provider
• Capacity to deliver TA Secure

December- January 2018 Binding Agreements Pending Learning Collaborative(s)

• Learning Collaborative process and curriculum developed

January-March 2019 Collaboratives Developed Pending

Partner Clinical Transformation Process & Timeline

• October: Finalize process and decision making criteria tools based on

stakeholder feedback

• Late October: Recruit Review Team Members (give them tools and plans to

review)

• November: Convene Review Team for Plan review
• December: Recommend partners to move forward into a binding agreement
• January: Board Approval

WHOLE PERSON CARE

Clinical Transformation

COMMUNITY CLINICAL LINKAGES

Integration of Social Determinants into Clinical Transformation

VISION Partnering to build a healthier future in Southwest Washington – for everyone INDIVIDUAL TRANSFORMATION PARTNER ROLE

• Complete a Community Serving Organization Request for Information

(RFI)

• Cross-sector regional opioid response plan
• Promote and support CHW neighborhood teams in Clark, Cowlitz and

Wahkiakum counties

• Address barriers to school attendance at McLoughlin Middle School

through the Education Community Health worker initiative STAKEHOLDER ENGAGEMENT SYSTEM: Community Health Advocates and Peer Supports Network CHAPS/HLC; Community Councils; Behavioral Health Advisory Board; Healthy Living Collaborative Committee SWACH Role

• Matchmaking of Community Serving Organizations to connect social

determinants into clinical transformation efforts

• Support prioritized initiatives with a target population of opioid,

chronic disease, and behavioral health

• Continue to support the HLC Community Health Worker Initiatives

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 In process

• Establish review and matchmaking process and criteria

November 2018 Process Developed Pending

• Invite Community Serving Organizations into a transformation Cohort

February 2019 Cross-Setting collaboratives Planning Stage

• Current Project - SeaMar/CVAB Hep C CURES QI)

October 2018 Improvement Cycle In Process 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 In Process In Process 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

Care Traffic Control

WHOLE PERSON CARE

Clinical Transformation

COMMUNITY CLINICAL LINKAGES

Integration of Social Determinants into Clinical Transformation

PARTNER ROLE:

• Become a Care Coordination Agency or Referral Agency for a specific pilot population that uses the Pathways model

and technology for care coordination, Community Health Workers, and pay for performance. SWACH ROLE

• Provide a Care Traffic Control System by building a Community HUB that uses health exchange technology to support

community based care coordination with a pay for performance mechanism to connect individuals and families to community supports and care teams

• STAKEHOLDER ENGAGEMENT SYSTEM: Pathways Community HUB Advisory Committee; Care Coordination Agencies

VISION Partnering to build a healthier future in Southwest Washington – for everyone

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

• Recruiting Rural CCAs through RFA, Scoring Committee and Selection

November 2018 Rural CCAs announced In progress

• Implementation Team and HUB Advisory Committee formed

November 2018 First meetings scheduled Planning

• All CCAs Trained

February 2018 Training completed Planning

• Community HUB Go Live!

March 2018 First person enrolled Planning

WHOLE PERSON CARE

Clinical Transformation

COMMUNITY CLINICAL LINKAGES

Integration of Social Determinants into Clinical Transformation

COLLABORATIVE IMPACT

Learning, Action, Equity, and Sustainability

VISION Partnering to build a healthier future in Southwest Washington – for everyone

PARTNER ROLE:

• Participate in regional shared learning; Identify policy barriers to whole person care.

SWACH ROLE

• Assess community needs and map assets
• Collaborative Impact: Neutral convener of diverse partners (stakeholder and community engagement system to include Tribal partners)
• Sustainability & Equity: Community Resiliency Fund to invest in Social Determination of Health
• Policy & Action: Prioritized regional policy issues that respond to community needs
• Equity & Inclusion planning (organizational and regionwide)
• Shared Learning & Sustainability:
• Regional Training & Skills Building and Knowledge on key regional topics (I.e. Equity, HLC Quarterly Convenings)
• Monitoring & Evaluation (Transformation Dashboards)
• Community Connections (Cross Sector Data Sharing)
• STAKEHOLDER ENGAGEMENT SYSTEM: RHIP Council; Policy Committee (HLC); Data Workgroup; Healthy Living Collaborative Stakeholders

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 On 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

Collaborative Impact Dashboard Cont.

Strategy Key Milestones Target Date Success Metric Status Equity Planning

• Hire Equity Manager and Equity Consultant team

12/18

• 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

• Support partners to equity assessment and plans
• Complete an internal assessment and plan
• 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
• utreach to decision makers, and public testimony

Ongoing

• 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

• Developing 3rd evaluation plan in partnership with CORE

Community Resiliency Funding

Policy Priorities

2019 Policy Priorities Criteria for Setting Our Policy Agenda:

• Are other entities better positioned to tackle this issue?
• Is there a point organization ready to play the lead role?
• What is the reach and scale of this issue?
• Is the strategy self-sustaining or does it require ongoing resources (implementation, enforcement)?
• Does this issue fall into our mission and scope of work?
• Who is most impacted? And are they part of our conversations?
• Do we expect these outcomes to decrease or increase racial inequities?
• Do we expect these outcomes to decrease or increase other forms of inequities?
• Gender
• Age
• Geography
• Disability
• Class – Socio Economic Status.
• What are potential unintended outcomes?

2019 Policy Priorities

• RHIP Council Discussion

Shared Learning Regional Topics

Council Members Action: Brainstorm and Prioritize Meaningful Regional Learning Topics and RHIP Specific Shared Learning Topics

COMMUNITY HUB

Care Traffic Control

WHOLE PERSON CARE

Clinical Transformation

COMMUNITY CLINICAL LINKAGES

Integration of Social Determinants into Clinical Transformation

COLLABORATIVE IMPACT

Learning, Action, Equity, and Sustainability

VISION Partnering to build a healthier future in Southwest Washington – for everyone

Thank You!