HMPRG Safety Net Initiative History- Lon Berkeley.

“ Setting the Stage: The Case for Regional Action to Strengthen the Safety Net” Lon M. Berkeley Health & Medicine Policy Research Group Regional Health Care Safety Net Summit June 23, 2009

OVERVIEW
Progress to Date/History of the Initiative
Key Assumptions & Terminology
Demographic Snapshot of Region
- Russell J. Pietrowiak, CMAP
On-going Efforts to Strengthen the Safety Net
Introduction to Preliminary Recommendations & Small Group Action Planning

“ MOVING THE BALL DOWN THE FIELD”
Crisis in funding for Cook County Health Services
New Cook County Health & Hospitals Systems (CCHHS) Board created
CMAP (Chicago) Metropolitan Agency for Planning) begins “Go To 2040” plan
1) Plan & Convene initial meeting 2) Draft “Roadmap” 3) Steering Committee & 6 committees meet 4) Conduct key informant county meetings 5) Assemble County Profiles 6) Research other county models & approaches 7) Research local activities
Convene/organize the players
Define the Problem
Collect/analyze Data
Shape the scope
Stage I (1/06-8/08) OTHER IMPORTANT DEVELOPMENTS METHODS & ACTIVITIES TASK PHASES (TIMING)

Endorsements to Convene the Regional Health Care Safety Net Summit
Alivio Medical Center
Chicago Department of Public Health (CDPH)
Chicago Hispanic Health Coalition (CHHC)
Chicago Metropolitan Agency for Planning (CMAP)
Chicago Partnership for Public Health
Community Nurse Health Association
Melanie Dreher, Dean, College of Nursing, Rush University Medical Center
William T. Foley, Chief Executive Officer, Cook County Health & Hospitals System
Patricia Gross, MSPH
Illinois Maternal and Child Health Coalition (IMCHC)
Illinois Public Health Institute (IPHI)
Institute of Medicine of Chicago (IOMC)
Latinos for a Healthy Illinois
Metropolitan Chicago Healthcare Council (MCHC)
Near North Health Services Corporation
Northern Illinois Public Health Consortium (NIPHC)
Alderman Toni Preckwinkle, 4th Ward, City of Chicago
Resurrection Health Care
UIC Latino Health Research, Training & Policy Center

New US President
New IL Governor
CCHHS initiates strategic planning
Economic crisis
Convene Pre-summit conference
Meetings of Summit Planning Committee
Solicit written feedback
Prepare “Call for Summit”
Prioritize Problems
Draft & Vet preliminary recommendations
Plan Summit
Stage II (9/08-5/09) OTHER IMPORTANT DEVELOP-MENTS METHODS & ACTIVITIES TASK PHASES (TIMING)

National Health Care Reform Deliberations
Federal stimulus funding for health information technology
Convene Summit Conference with HRSA co-sponsorship
Presentations on regional models
Endorse Regional Health Pact & Call to Leaders
Implement pilot project(s)?
“ Field trips” to other counties outside NE IL?
Finalize regional blueprint
Identify & engage additional implementers
To Do: Solicit funding & political support
To Do: Identify leadership for next steps
Stage III (6/09 - ?) OTHER IMPORTANT DEVELOPMTS METHODS & ACTIVITIES TASK PHASES

KEY TERMINOLOGY OF INITIATIVE
Health
Safety Net
Regional
Vulnerable Populations

KEY TERMS OF INITIATIVE
Health is not merely the absence of illness or disability, but also the attainment of mental, physical, and spiritual or social well-being. (WHO)
It is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector.

WHAT DO WE NOT MEAN BY THE “HEALTH CARE SAFETY NET”?

WHAT DO WE MEAN BY THE “HEALTH CARE SAFETY NET”?
Providers that …
organize and deliver a significant level of health care and other related services…
to uninsured, Medicaid, and other vulnerable populations (IOM), as well as other population-based health services.

WHAT DO WE MEAN BY THE “HEALTH CARE SAFETY NET”?

WHAT DO WE MEAN BY “Regional”?
INCLUDES COUNTIES OF:
> Cook > DuPage
> Kane > Kendall
> Lake > McHenry
> Wil l

WHAT DO WE MEAN BY “Vulnerable Populations”?
Residents who are vulnerable because health services are:
unavailable
inaccessible
under-subsidized or
not subsidized at all by public or private programs
Includes the uninsured, under-insured, and people on Medicaid

KEY ASSUMPTIONS OF INITIATIVE
There is no mandate or requirement to pursue this regional approach.
We don’t have to do this
There is no sponsor
2) Planning that includes the public and private sector increases the probability of attaining our goals and desired outcomes.

3) Collective regional action will strengthen:
Planning
Resource sharing
Advocacy
Patient Referrals
Service Coordination, and
Research Opportunities.
Other successful regional efforts exist that have improved outcomes or operations

4) Improving health status and quality of life requires a multi-sectoral approach that extends beyond the multiple layers of traditional medical care and public health (see “Who Takes Care of Your Health?” diagram below).

Who Takes Care of Your Health? Other Sectors: Housing, Education Tranportation, etc Public Health Services : Environmental, Prevention, Disaster Preparedness, etc Health Care Services: Dental, Behavioral, Home Care, etc Medical Care: Primary Care, Specialist, Acute, Rehab, etc Family Self-Care

5) There is a continuum of health care services that can be categorized into both vertical and horizontal dimensions.
6) We accept the World Health Organization’s systems building blocks of a health system conceptual framework
7) We accept the Institute of Medicine’s
six specific aims for improving the health care system.

THE WHO Health System Conceptual Framework Source: WHO Health System Strengthening Strategy 2007

Six Aims for Improvement (Institute of Medicine)
Safe : avoiding injuries to patients from the care intended to help them.
Effective : providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit.
Patient-centered : providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.
Timely : reducing waits and sometimes harmful delays for both those who receive and those who give care.
Efficient : avoiding waste, including waste of equipment, supplies, ideas, and energy.
Equitable : providing care that doesn’t vary in quality due to personal characteristics such as gender, ethnicity, geographic location, & socioeconomic status.

8) Health & Medicine Policy Research Group’s (HMPRG) role is to facilitate the process only
- currently supported by one foundation grant and in-kind contributions
- similar to approach with other successful projects.

9) All problem statements, priorities, and recommendations, are “works-in-progress,” …
- with recognition and apologies to any overlooked organizations, projects, and people that are interested in contributing to this initiative.

A Demographic Snapshot of the Region Russell J. Pietrowiak Associate Planner Chicago Metropolitan Agency for Planning

Total Population Change by County from 1990 - 2006 County 1990 2000 2006 Net Change Pct. Change Cook 5,105,067 5,376,741 5,288,655 +183,588 4% DuPage 781,666 904,161 932,670 +151,004 19% Kane 317,471 404,119 493,735 +176,264 56% Kendall 39,413 54,544 88,158 +48,745 124% Lake 516,418 644,356 713,076 +196,658 38% McHenry 183,241 260,077 312,373 +129,132 70% Will 357,313 502,266 668,217 +310,904 87% Region 7,300,589 8,146,264 8,496,884 +1,196,295 16%

Changing Demographics in Cook County

Constant growth over more than 3 decades (*6 counties)

Latinos have the highest rates of uninsured persons in Illinois

Ongoing Efforts to Strengthen the Safety Net
HMPRG compiling a “Summary of Actions”
Federal & State Legislation re:
Community Building/Coalitions for Safety Net Improvements
Workforce, IT, Financing
Metro-area Initiatives
The Chicago Access Puzzle: Fitting the Pieces Together
Healthy San Francisco Initiative
Detroit/Wayne County Health Authority
Mid-America Reg’l Council & KC Metro Health Access
Access DuPage
Access to Care

CMAP GoTo 2040 : The Plan For Health

The GoTo 2040 Plan is a comprehensive plan for the seven county region of the Chicago Metropolitan Agency for Planning (CMAP). [1]
This report presents the plan for health.
Purpose: “To position the region to be competitive in a global economy and create an environment in which all diverse residents will benefit from, and contribute to, the vitality of the region.”
[1] The Illinois counties of Cook, DuPage, Kane, Kendall, Lake, McHenry, and Will.

The scope of the plan was guided by:
3 decade planning horizon
Limitation of no more than 15 indicators
Emphasis on the determinants of health
Unsustainable cost and quality of life burden of chronic disease; and
Focus on what can be accomplished in the region to improve health and not on those factors that are beyond regional control.

4 Recommended Strategies:
Integrated prevention and health promotion strategy that will integrate the regional planning agenda with health policy issues and integrate the participants in the process.
Move toward an all data-real time concept that builds on electronic medical records.
Address workforce concerns.
Strengthen the public health infrastructure in response to early signs of deterioration.

KEY TERMINOLOGY FOR SUMMIT
Preliminary Recommendations
May not be complete or the best
Blueprint
Vision with guidelines
Strengthening
Existing services need support
Moving Recommendations to Action
Building on past progress

BUILDING A BETTER WORLD
CURRENT STATE
TRANSITIONAL STATE
IMPROVED STATE
DESIRED STATE

Preliminary Recommendation Categories
Data/IT
Workforce
Access
Health Equity
Finance
Planning Approaches

Preliminary Recommendation Format
Problem Statement
Vision
Recommendation
Local/Regional Examples
Rate Level of Support
Your Role in Implementing the Recommendation
> Leadership > Participant
> Resource > Stay Informed >Not Interested

RECAP
We are not waiting to be told that we can strengthen the health care safety net by working across geographic boundaries.
As we continue to “move the ball down the field” we hope to gain some momentum from today’s efforts.
We need you to weigh in with your comments, ideas, energy, and action to help implement this vision.

Japanese Proverb
“ Vision without action is a daydream …..
… action without vision is a nightmare.”

HMPRG Safety Net Initiative History- Lon Berkeley.

by Health & Medicine Policy Research Group on Jun 26, 2009

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HMPRG Safety Net Initiative History- Lon Berkeley. — Presentation Transcript