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December 12-13, 2019 Addressing Social Determinants to Improve Overall Health in Tennessee | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | TAMHO 2019 Annual ConferenceSOCIAL DETERMINANTS OF HEALTH | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
IT’S CALLED POVERTY: GETTING BEYOND THE SOCIAL
DETERMINANTS OF HEALTH HYPE
Erine Gray, MPA, Founder & CEO, Aunt Bertha, Austin, Texas
Building Model CommunitiesHow do we design interventions that empower people to own their own path, and where organizations work better together?
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Disclosures
Founder of Aunt Bertha, a Public Benefit Corporation focused on connecting people in need to available services in the United States.
My desire is to share some of the strategies and thoughts currently used throughout the United States.
Broken Social Care System
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Seeker
[see-ker]Someone who is in need of services.Or, everyone, at some point in their lives.
It’s too hard to navigate the system.
Seeker Programs
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Seeker Things!
How it usually works… (other sectors)
Search
$ Buy SomethingProblem
SeekerSocialServices
It should work like this...
Search
Connect!Problem
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Solving One Problem: Finding Help
37067
The ideal workflow would be (simple)...
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In-House Data Operations Team
The ideal solution would have an in-house data quality team that is responsible for making sure the network is up to date and as accurate as possible.
In-House Data Operations
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AB Data Operations Team
Community Organizations
Platform Users
Automated Processes
The in-house data team would be responsible for validating social care data and keeping the information current and up to date.
They would be an extension of your care team.
Data Maintenance Strategy
Search Trends
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Ideally...Policy Makers have more data...Ideally...Policy Makers have more data...
34,000usersTennessee Activity
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880usersWilliamson County, TN
The Reach
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The Reach of… Your Care Team
Staff beyond your Care Team
Community OrganizationsHospitals, Social Services Providers, K-12 Schools, Prisons, Community Colleges, Insurers, Religious Organizations...
Seekers and their families when they can also self-serve
An example of an effective collaboration… 99% Closed Loop Rate
An example of an effective collaboration… 99% Closed Loop Rate
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Data Trends
Texas
328k #3 Dental Careusers
Regional Trends
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California
125k #17 Dental Careusers
Regional Trends
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Tennessee
34,000 users #2 Dental Care
Regional Trends
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Meeting People Where They Are
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LinkNYC
LinkNYC
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LinkPHL
LinkPHL
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LinkPHL
Wine!6:41PM
Alexa, you there?
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AARP’s Connected Communities
https://www.youtube.com/watch?v=8k2QvVwoIJY
Alexa, Help me find...
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Health Information Exchange
Vs.
Community Information Exchange
If I have a rare disease, then I *probably* want anybody with access to an HIE to know about my rare condition.
Health Information Exchange
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This information is accessed by any person with access to the system across most medical entities...
Health Information Exchange
Idea: Let a broad network *know* about social issues:
- Short on rent?- Fighting an addiction?- Literacy levels?
Community Information Exchange
Should these temporary things of a social nature, stay with you forever?
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211 Partnership: United Way Austin
United Way for Greater Austin in 2018 created a unique partnership with a technology partner to connect onlinesearchers to their call center.
Dynamic Criteria:
● Location;● Time of Day; and● Search Terms.
211 Partnerships
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Prompted w/ Call Option
7,420Clicked to Call
1.5%However, for those that do need to speak to someone, the intervention could be huge both to the person in need and to the overall health system.
Comfort w/ Self Service Program Discovery
More and more people facing difficult circumstances are comfortable using a computer or mobile device.
An Alternative:The Model Community Approach
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The Model Community
AISD(School District)
FQHCs Funders(MSDF)
University(U. Texas)
Call Center
81,000users
What could a connected “model” community look like?
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Context: Location
Context...
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More Context...
“Just so you know, we have folks on the phone that might be able to help. Just call or chat us by pressing this button when you’re ready.”
Nudge?
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We must increase the supply of free or reduced cost services available?
Healthcare executives addressing the Social Determinants of Health held out a hope that existing non-profits could solve the problem (poverty).
This is misguided.
A Lack of Supply
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There is simply not enough supply of help out there.
This is Misguided Thinking
Just Buy Stuff for People
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Path:Anonymous Search —> Fulfillment
Care Manager Programs
search referral and Vendors
order
Seeker
Has a NeedDecides to Search(anonymously)
Charity 1
Charity 2
Charity 3
Needs: the courage to speak to someone...
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SeekerCharity 1
Charity 2
Charity 3
Needs: the courage to speak to someone...
“No!”
“Maybe...paperwork.”
“No!”
“Why did I bother?”
SeekerCharity 1
Charity 2
Charity 3
“No!”
“Maybe...paperwork.”
“No!”
Just buy them stuff... {Reimbursable “Non-Medical” Services
Medicaid: Flex Services (Mass)
Direct Philanthropy
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Changing Reimbursement In 2020, in an attempt to address social determinants of health, CMS will start reimbursing Medicare Advantage plans for non-medical services.
© Aunt Bertha, a PBC — Proprietary & Confidential — 59
© Aunt Bertha, a PBC — Proprietary & Confidential — 60
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We’re all Seekers, eventually.
[see-ker]Someone who is in need of services.Or, everyone, at some point in their lives.
Questions?
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More InformationName: Erine GrayEmail: [email protected]: 512-795-4864
December 12-13, 2019 Addressing Social Determinants to Improve Overall Health in Tennessee | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | TAMHO 2019 Annual ConferenceSOCIAL DETERMINANTS OF HEALTH | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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