Meeting Minutes October Consumer Engagement Workgroup Meeting 10/8/15 | 2:00-4:00 pm | HCPF Type of meeting

Consumer Engagement

Chair

Joe Sammen

Co-Chair

Kyle Brown

SIM Representative

Nicole King

Members in Attendance: Amy Board, Peter Dawson, Alison Laevey, Michael Lott-Marnier, Carol Meredith, Bethany Pray, Jenny Santos, Matt Sundeen, Antoinette Taranto, Jessica Wilbanks

Discussion Items: Charter 

The group discussed an updated draft of the charter, which was changed to reflect suggestions made at the previous workgroup meeting. Members suggested that final edits include: o Inclusion of language around “families and caretakers” instead of just consumers. o A broader goal of messaging around what SIM is and how it affects consumers. Joe Sammen will make final edits and return to the group.

SIM Office Update 

Nicole King provided an update on other major activities throughout SIM. o Practice Transformation  Practice RFP released – University of Colorado currently accepting applications to join the first cohort of 100 SIM practices. o Population Health RFPs  Joint RFP between the Colorado Department of Public Health and Environment and The Denver Foundation (Colorado Health Access Fund) was released to fund Population Health Transformation Collaboratives. Groups of three or more organizations working on behavioral health prevention at a community level can apply for funds.  SIM LPHA RFP will be released on October 19th. This opportunity is available to Local Public Health Agencies that seek funding to conduct community outreach and education regarding behavioral health, such as stigma reduction campaigns. o Evaluation RFP  RFP to select an external evaluator, who will evaluate the process and outcomes of SIM.  Deadline for proposals is November 10, anticipated to be on-board by February 1

The Project described was supported by Funding Opportunity Number CMS -1G1-14-001 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services.

Meeting Minutes 

Soliciting recommendations for measuring consumer experience

SIM Evaluation 

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CAHPs: SIM Evaluation Specialist, Ellen Kaufmann, presented on requests from the SIM Evaluation workgroup related to Consumer Engagement. Workgroup members were asked to consider the CAHPS survey, which is collected by payers to gauge patient experience. The workgroup was asked to select a few key questions to consider, since the SIM office must report a statewide measure of patient satisfaction. Recommendations will be taken to the Payment Reform Workgroup to validate what questions can be used. This data will mainly be used to meet federal CMS reporting requirements. The workgroup recommended: o Including at least one of questions 18-20, which all relate to whether providers talked to patients about behavioral health. o Including question 32, which relates to follow-up reminders (especially important for behavioral health). o Including question 13 and 20 on the adult survey, which relate to continuity of care. o Including question 17, which relates to social determinants of health. ECHO: The group also recommended potentially using the ECHO survey. The survey had not previously been considered because it is only of Medicaid/CHP+ clients and therefore was not as broad as the CAHPs. However, because ECHO is focused on behavioral health, some of these questions should be considered by the evaluator. Ellen to see how feasible this suggestion may be to implement. Group discussed need to distinguish between patient satisfaction and consumer engagement. A patient can be “satisfied” without being “engaged” in his/her care.

Consumer Engagement Priorities 

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Workgroup members were asked to identify major elements/priorities related to Consumer Engagement that they would like the external evaluator to evaluate (when hired). The evaluator will then decide on the best methodology for collecting this information (e.g. focus groups, versus patient survey). The workgroup identified the following priority areas. Members had been sent literature about consumer engagement surveys from other states and studies and were asked to identify priorities based on these as well as their own expertise. Access to care o Availability without requirement of psych diagnosis o Language o Provider availability o Cost – separate, part of payment reform to remove cost as barrier o Payer fragmentation Effectiveness of care o Continuity of care

The Project described was supported by Funding Opportunity Number CMS -1G1-14-001 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services.

Meeting Minutes Can encompass feeling of being informed (streamlined) Safety Family involvement Treating the whole person, person-centered Careful with whole person language - including dental Patient activation  Decision aids, shared decision making  Whole health action management tool – distribute within primary care Valued/feeling respected o Type of language used - respectful, person first language Privacy/confidentiality o Ability to access your information/share your information o Not sharing with unwanted parties o Sharing with all caregivers o Careful with sharing behavioral health information – stigma  Concern about bending 42 CFR Part 2 as far as we can  Update from Policy Workgroup? Might be a bigger conversation, make sure everyone know what’s being shared, what’s required to be shared by the state  Data sharing for evaluation purposes (aggregated, blinded) to help measure, report out  Bring someone outside of CORHIO to SIM process – restrictions, values for consumers, advocate for both consumer and provider voice The group also suggested speaking with the Practice Transformation workgroups in order to get a better understanding for how integration is defined and measured. o o o o o o

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Leveraging Other Consumer Groups 

Nicole King proposed that while the SIM Consumer Engagement workgroup will likely not engage consumers directly, the group can leverage other consumer groups throughout the state to solicit feedback directly from consumers. The following were discussed as potential avenues for engagement: o HCPF – Person-Centered Advisory Council o CDPHE – Family Leadership Program o 500 graduates, interested in public policy issues, advocacy o LinkedIn platform, looking for consumer feedback o Others? o Chronic care collaborative – can convene a group of consumers and patients o Numerous listservs, email weekly updates (The Arc of Arapahoe and Douglas, advocacy)  Parent groups, online discussion forums o Membership organizations – particularly provider organizations, can talk to networks, direct link to those they are providing services to, communicate SIM o At the end of each Workgroup meeting, the group will discuss questions to pose to consumer groups. The following were offered as potential questions:

The Project described was supported by Funding Opportunity Number CMS -1G1-14-001 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services.

Meeting Minutes o o o

Is there value in integrating primary and behavioral health care? What concerns do you have? Given the opportunity to consent, how would you feel about your various providers sharing information with each other?

Public Comment No public comment.

Action Items: Topic

Responsible Party

Update SIM Charter.

Deadline

Joe Sammen

11/3/2015

Schedule ongoing meetings.

Nicole King

10/20/2015

Ask Policy and/or Practice Transformation workgroups to present at next workgroup meeting.

Nicole King

10/30/2015

Bring CAHPS and evaluation recommendations to Evaluation and Payment Reform workgroups.

Nicole King

10/30/2015

The Project described was supported by Funding Opportunity Number CMS -1G1-14-001 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services.