Post on 30-Aug-2020
Cascade Pacific Action Alliance
Maternal/Child Health Workgroup
October 25, 2017
Welcome & Introductions
Introduce yourself: Name, county, organization
Agenda for Today
Overall Plan
Discuss Draft Application & Address Gaps
Discuss Workplan & Address Gaps
Next Steps
Section I (ACH) Project Update
Finance Committee has been meeting and made recommendations to the Council and Board about funding allocations
Last week Council and Board met- decided to move forward on 6 projects and approved funding flows.
Section II (Project Specific Workgroup Activities)
August/September
• Identified target populations
• Discussed engaged providers via RFQ and high-volume Medicaid providers
• Identified Domain 1 assets and challenges (for Section I)
• Developing proposals- HMA and CPAA
October:
• Reviewing Draft Applications and Addressing Gaps
• Reviewing Draft Workplans and Addressing Gaps
• Refining proposals
November: Review project proposals
Draft Project Application: Gaps to be Addressed
How this project will support sustainable health system transformation for the target population
How ACH will ensure each project coordinates with and doesn’t duplicate existing efforts
Identifying the anticipated target population (specific numbers, which CPAA will develop)
Assets and challenges
Gaps to be Addressed: Lasting Impacts for Medicaid Beyond the Target Population
Increasing the capacity of providers to provide better sexual and reproductive health services is more easily sustainable as contraceptive care and sexual health screenings are already Medicaid-covered benefits.
We will work with the state and MCOs on how sexual and reproductive health care can be included in value-based payment contracts between a MCO and a provider.
We will also need to explore what types of providers patients are going to receive sexual and reproductive health care. If those patients seek these services from providers other than PCPs, we need to determine how easily those providers can enter into VBP contracts.
Because we will need to be creative in how we expand provider establishment and capacity, especially in rural areas, we will need to be creative in determining how these providers can be paid. Telehealth services, in particular, will present challenges related to PCP assignment and attribution of risk that we will need to try and overcome in 2018 or 2019 to be successful in investing in that type of capacity-building.
Gaps to be Addressed: How ACH will ensure each project coordinates with and doesn’t duplicate
An environmental scan to gather the existing MCH home visiting programs in all seven counties and barriers/challenges to expanding. In that scan, we also gathered information on referral pathways into home visiting programs to understand how clients get access to certain programs. This will help us determine improvement strategies for referrals.
What did the scan say?
Existing RMCH Projects from the RFQOrg Target Pop. Project Description
Arcora People at high risk for oral
disease, maternal/child health,
chronic disease (estimated #)
Integrate aspects of oral health into most MTD
projects where appropriate
Child &
Adolescent
Clinic
Children birth to 20 (estimated #) Add Behavioral Health Specialist to integrated
care team and continue collaboration with other
community partners
Child Care
Action Council
Pregnant mothers not eligible
for NFP, with risk factors
Expand existing home visiting services for
Parents As Teachers model
Nisqually
Tribal Health
Department
PMG clinical population
w/chronic disease
Improve overall health management and patient
engagement with care coordination. Specific
interest in partnering to improve Maternal Child
Health.
Providence
Medical Group
PMG clinical population
w/chronic disease
Improve overall health management and patient
engagement with care coordination. Specific
interest in partnering to improve Maternal Child
Health.
Existing Projects from the RFQOrganization Target Population Project Description
Sea Mar
Community
Health Centers
Sea Mar patients Provide integrated care and implement the Pathways care
coordination model
Health &
Social
Services in
Thurston,
Lewis and
Mason
First time mothers Expand available slots for NFP across three counties
Youth and
Family LINK
Mothers w/SUD,
other Maternal
Child Health
Referral hotline, Community Health Workers providing care
coordination, linkage with multiple care providers
Thurston
County Health
and Social
Services
South and NW areas
of county (estimated
#)
Expand geographic reach and hours of operation for SEP (need
to be clear about what is happening here- expanding primary
care and treating those engaged)?
Assets and Challenges
What are the assets the region brings to the project?
What are the challenges?
How do we address those challenges?
Assets
PTCPI Grant: child & adolescent clinic. Grant $
Some of the community colleges provider health care profession training
Surveys: BRFFS and Healthy Youth surveys
Depression screens
WAIIS – immunization registry. Child Profile.
OTHER ASSETS?
•
•
•
Challenges & Mitigation StrategiesChallenge Mitigation Strategy
Assuring metrics for well-child visits are
included in contracts
Training practices on revenue cycle
changes
Shortages of certain professions -
especially in rural areas
Incentives such a loan forgiveness or conditional scholarship
Family planning training, including LARC
Need more patient registriesStandardize EHRs
Nurse family partnerships and Home
Visiting data are not readily available.
Workplan Review
Visually Displaying the Work
Application must include logic model that depicts the work and tells our story
Medicaid Demonstration is only Part of the CPAA Work
Medicaid Demo Project
All Other CPAAProjects
Maternal and Child Health & Reproductive Health 10 Recommendations to Improve
Women’s HealthHome Visiting Program
Bright Futures
Bi-Directional Integration of Care & Primary Care Transformation
Collaborative Care Model
Medicaid Projects & Strategies
Chronic Disease Prevention and Control Chronic Care Model
Addressing the Opioid Use Public Health Crisis
Prevention, Treatment, Overdose Prevention, Recovery
Transitional CareINTERACT 4.0
Transitional Care ModelThe Care Transitions Intervention
Community Based Care CoordinationPathways Community HUB
Target Pop (Medicaid Clts) Project Outcomes
↓ util. (ED, I/P, readmits)
↑ opioid care (hi-dosetherapy, MAT)
↑ BH care & follow-up (post ED, post I/P)
↓ homelessness
↑ access – pediatric care/screenings
↑ chronic disease screenings
(diabetes, depression, asthma)
↑ maternal & reproductive screenings and care
↑ diabetic care (eyes, HbA1C, nephropathy)
CPAA Medicaid Demo Project Logic Model - Option 1
Having or at-risk for behavioral health conditions
In transition from intensive settings of care or institutional settings
Having or at risk for, arthritis, cancer, chronic respiratory disease, diabetes, heart disease, obesity and stroke
Women of reproductive age, pregnant women, mothers
Youth and adults who use, misuse, or abuse, prescription opioids and/or heroin
One or more chronic disease or condition and at least one risk factor
↑ MH or SUD screenings
↑ Rx management (anti-depressant, asthma, statin)
Next Steps
Next Meeting: November 29th, 2017
• Mother Joseph Conference Room, Providence Centralia
• 914 S. Scheuber Rd, Centralia, WA 98531
HMA and CPAA Staff working on Project Drafts
Posted in November for Review/Comment
Final Project Application to Council & Board for approval