Meeting Minutes Population Health Workgroup 8/27/15 | 10:30-12:00 | CDPHE C1D Type of meeting

Population Health

Chair

Liz Whitley

Co-Chair

John Douglas

SIM Representative

Matthew Welchert

Members in Attendance: Neha Patel, Joshua Ewing, Tyler Payne, Allyson Gottsman, Kelley Vivian, Karen Koenemann, Barbara Becker, Tim Byers, Betsy Duckett, Margaret Tomcho, Jennifer Fanning,

Discussion Items: Item 1: Presentation on SIM Population Health Efforts 

Barbara Martin, CDPHE and HIT Workgroup, presented briefly on an update of SIM and more fully on the SIM specified Population Health efforts: o There are three funding opportunities available:  Regional Behavioral Health Collaboratives (RBHCs)  Regional Health Connectors (tentative name for Extension Agents)  Local Public Health Agency funding (LPHA’s) o RBHC’s  Many of these organizations exist in the State.  LPHA’s would be eligible to be a part of a collaborative.  The FRA will be released in collaboration with the Denver Foundation.  There exist four to five grant opportunities to disburse $2.2 million dollars over three years. o Regional Health Connectors (RHCs):  Gabriel Kaplan, CDPHE, spoke briefly regarding the RHCs.  RHC’s will be locally based and oriented and will be employed locally by the organizations that receive extension funding.  Main role will be to facilitate linkages among the various components of the health care delivery system. Assist with the acquisition of resources for practices seeking integration and other support.  Questions: The name has been evolving from Health Extension Agent, why?  The concept and literature on the subject is borrowed from agricultural health extension services however the name can have negative or confusion connotations. Rather, the RHC is not uniquely rural and won’t be providing extension from urban to rural but will

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 serve as a brokerage elements and connector of resources and practices within a specific locality. The name is still in fluid.  The Extension service is called out in the ACA, how many other states utilize extension agents? o AHRQ and other funding opportunities have been funding some moderate extension work, such as Colorado’s joint effort with New Mexico. o Currently, due to Colorado’s expertise on the matter other states are turning to us for technical assistance and in turn we have gathered many best practices. o Funding for Public Health:  Two funding opportunities for LPHA’s:  Behavioral health promotion and prevention  Increasing access to behavioral health prevention through partnerships and community and clinical linkages.  The focus is towards wellness and early intervention rather than towards treatment of mental illness.  Community education is an important element to reduce stigma, increase awareness, and outreach to stakeholders.  Provides an opportunity for time to build the capacity for whole-person mental and physical well-being.  $1.5 Million dollars over three years to four to six LPHA’s. o Will align with Regional Health Collaborative applications. o Maximizing Access to USPSTF A&B recommended preventive services and evidence-based preventive programs.  Called out in the SIM Narrative, question becomes how best to align efforts.  Identify need for behavioral health screenings looking across the life-course and align with the SIM clinical measures.  Cover evidence based prevention programing.  LPHA’s will be encouraged to form partnerships in their regions to share and review in order to best cover gaps and discover opportunities in the community.  $1.5 Million dollars over three years to four to six LPHA’s. o Further LPHA funding details:  The funding opportunities for LPHAs are targeted to those agencies that have identified behavioral health in their prioritization process  All agencies that identified Mental health, Substance Use Disorders or Obesity (for the Preventive Services funding) in the Community Needs Assessment can apply but would need to provide community data to support their application

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

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 An RFA process rather than contracting process will be used  Geographic Distribution will be a consideration Things to consider and general discussion: o How can we better understand all of these mechanisms, is there a roadmap or timeline to assist?  Timing seems to be an issue>  There is a need for orchestration of all these elements: The Denver Foundation funding, the public health grant funding, the extension service support, and the practice transformation support might be leveraged more efficiently if undertaken in unison.  For instance, it will be harder for the practice transformation cohort members to do the work required of them without the support of the extension services.  The Connectors work differently from the practice transformation coaches but may be able to work together to best assist a practice if we can provide that degree of cooperation. o Should we reconsider the buckets for population health funding, would it not be more useful to practices if the funding was from a larger lump sum with greater flexibility?  Not necessarily, for every element we are providing funding, practices will need assistance. It is part of a larger paradigm shift from looking exclusively at practice transformation and rather looking at community transformation with delivery as a piece. o There is concern that a practice in a smaller or rural area might be overlooked because while they may be well prepared to take on the elements required they will ultimately not affect as large a segment of the population. Nonetheless, such efforts can be transformational in smaller communities.  Geographic consideration will be an element and there will need to be a balance with dispersing the funds to urban and rural areas in proportions that are effective. o How might a community best leverage all of these may buckets of funding?  Practices applying to multiple grants will need to specify as such as well as provide an explanation of what they plan to do with each set of funding opportunities.  There is a balance which must be hit between leveraging funds to the greatest potential in a community while not duplicating efforts.  A roadmap may assist with how to best align these buckets. Perhaps each workgroup could prepare their own roadmap to assist with a more allencompassing one.

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

Conclusions:

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The orchestration of timing will need to be tackled to a larger degree outside of the Steering Committee level, but should likely be passed along to other relevant workgroups as well. Timing issues around the funding opportunities needs to be addressed to best ensure the funds are optimized. o Need to coordinate with Practice Transformation Workgroup around cohort support opportunities. o Need greater clarity regarding the distribution and use of the Regional Health Connectors. o Need to be clear with communications to practices regarding the funding opportunities that exist, what they mean to them, and the timeframe surrounding the applications. o Possible need for a roadmap focused on sequencing possibilities and which may incorporate the other workgroups’ roadmaps.

Action Items: Topic

Responsible Party

Deadline

Speak with a CMS representative and find out what federal regulations may impact a joint RFP process.

SIM Office, Nicole King

9/25/2015

Pass along Workgroup recommendations and questions to the SIM Office for further clarification and possible discussion at the Steering Committee.

Liz Whitley

9/25/2015

Population Health Workgroup

9/25/2015

Produce a draft roadmap to present to the Steering Committee

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.