California Community Care Coordination Collaborative - June 4, 2013


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The California Community Care Coordination Collaborative (5Cs) is a learning collaborative made up of six regional coalitions serving children with special health care needs (CSHCN) launched in April of 2013.

The Orange County Care Coordination Collaborative for Kids, led by Help Me Grow Orange County, is assessing CSHCN needs in the county and pilot testing a process to identify, track and review cases of families of CSHCN to help connect them to services and increase communication between providers.

The San Mateo County Care Coordination Learning Community, led by Community Gatepath, is developing care coordination policy and practice recommendations and working with First 5 San Mateo to expand care coordination services for a San Mateo County Health System Clinic.

The Seven Cs Project, under the direction of the Public Health Division of Contra Costa Health Services, is developing a proposed care coordination system for the county based on a needs assessment and analysis of current resources, as well as piloting a case review process.

The Rural Children’s Health Care Coalition, led by Rowell Family Empowerment of Northern California, is bringing together stakeholders in Shasta, Siskiyou and Trinity counties, to promote shared problem-solving and developing interagency agreements for dealing with shared clients.

Representatives from the Medically Vulnerable Care Coordination Project of Kern County and the Central California Care Coordination Project of Fresno County, led by Exceptional Parents Unlimited, are providing insights and lessons learned from their care coordination projects with the Learning Collaborative.

The 5Cs provides a structured opportunity for coalitions to learn from one another, identify areas of shared need, discuss emerging challenges and connect with others engaged in improving the quality of services for CSHCN. The collaborative has had an introductory webinar and recently came together at the Foundation for our first full-day meeting to discuss project progress and evaluation strategies.

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  • Parent involvement at all levels- family centered approach
  • COLLABORATIVE/LPFCH GOALS:- Brief Participant Survey: - Administered anonymously through SurveyMonkey (post-only – done in SEPTEMBER 2014)- Evaluate each TA Event immediately after using a short questionnaire- Process Measures: - Attendance/Participation (done through monitoring spreadsheet – Stacey) - Fidelity to original schedule of meeting events - Additional Technical Assistance offered as a result of coalition requests - Communications via Google Groups - Data from Interim and Final Reports  - Exit Interviews - Learning Collaborative Meeting Worksheet: To be done 4 times over the 18-month period – at the close of each meetingCOALITION GOALS:Process Measures:AttendanceCoalition members at regional meetingsParticipation levelInternal tracking system or data base used by organization - Fidelity to WorkplanIntermediate Outcomes:Data from Interim and Final Reports- Meeting Worksheet – to assess actions/take-aways as a result of work from each 5C’s in-person meetingCollaboration Checklist from Marc Thibault – how does group change over time?Administer in June 2013, December 2013, August 2014- Shared 5C’s outcome – same indicator across coalitions – to be determined collaboratively 
  • Measurement can be done in different ways - If so, you can show improvement, but you cannot compare across groupsDecide how it will be measured and emphasize need for baseline information in order to assess change over time
  • California Community Care Coordination Collaborative - June 4, 2013

    1. 1. Welcome to theCalifornia Community CareCoordination CollaborativeJune 4, 2013
    2. 2. • Introduction and Welcome• Icebreaker• Updates and Discussion– Contra Costa County – 7C’s– Orange County – OC C3 for Kids– Shasta, Siskiyou, Trinity Counties – Rural Children’s Special Health Coalition– San Mateo County – SMC Care Coordination Learning Community– Fresno County – Central California Care Coordination Project– Kern County – Medically Vulnerable Care Coordination Project• Evaluation• Learning Collaborative PlanningAGENDA
    3. 3. • Your name• Your organization and position• If you could spend a weekend anywhere inCalifornia, where would you go and why?ICEBREAKER
    4. 4. Contra Costa California Community CareCoordination Collaborative (7C’s)Barbara Sheehy, MSAdministratorCalifornia Childrens Services Contra Costa CountyUPDATE
    6. 6. Seven Cs Coalition Members California Children’s Services CARE Parent Network Regional Center of the East Bay First 5 Contra Costa Clinic Services/Public Health Nursing Contra Costa Behavioral/Mental Health Head Start/Early Head Start Children’s Hospital & Research Center Oakland Contra Costa Health Plan Early Childhood Mental Health West Contra Costa SELPA Contra Costa Regional Medical Center, Dept of Pediatrics Kern County Medically Vulnerable Care CoordinationProject Kaiser Permanente John Muir Health
    7. 7. Seven Cs Project Goals1. Determine the specific needs of CSHCN, birth to 5 years ofage, and their families, for the Seven Cs Project.2. Align the organizational structure to implement the SevenCs Project for CSHCN, birth to 5 years of age, and theirfamilies, providers and communities.3. Conduct a 3-month pilot program of the Seven Cs initiativeto work through and validate procedures, tools, costs andprocesses before full implementation.4. Create and implement a financial sustainability plan tosecure Care Coordination staff and other resources to fullyimplement the Seven Cs Project for CSHCN, birth to 5 yearsof age, their families, providers and communities.
    8. 8. Seven Cs Main Activities Convene monthly Seven Cs partner meetings to develop,pilot and support an county-wide CSHCN carecoordination system. Learn about the Kern County, MVCCP model, history,Acuity Form and tools. Compile and analyze Contra Costa CSHCN data toidentify projected population to be served by carecoordiation initiative. Develop a county-specific resource list of pediatric specialneeds services for families and providers. Develop and implement a county-wide outreach andeducation plan for families and providers. Create, implement, and monitor role of Care Coordinatorto support county-wide CSHCN care coordination system.
    9. 9. Seven Cs Anticipated Challenges Some partners have limited experienceworking together collaboratively. Assuring family centered care isinstitutionalized in care coordinationsystem.
    10. 10. Seven Cs Progress Hired excellent Facilitator and ProjectCoordinator. Honing in on our target population andcare coordination model. Added needed Project Partners.
    11. 11. Seven Cs Current Challenges Difficulty getting School/SpecialEducation Partner participation. May be difficult to develop twoadditional Round Table groups to fleshout County-wide care coordinationsystem.
    12. 12. Orange County Care CoordinationCollaborative for Kids(OC C3 For Kids)Rebecca Hernandez, MSEdProgram ManagerHelp Me Grow Orange CountyUPDATE
    13. 13. Key Coalition Partners:• American Academy of Pediatrics, CA Chapter 4• Children and Families Commission of Orange County• CHOC Childrens Foundation• Help Me Grow Orange County• Orangewood Children’s Foundation/Bridges NetworkCollaborative Participants:• California Children Services• Cal Optima (Orange County Medi-Cal agency)• Child Health and Disability Prevention Program• Comfort Connection Family Resource Center• County of Orange, Social Services Agency• CHOC Children’s Early Developmental Assessment Center• Family Support Network• Orange County Department of Education/Center for Healthy Kids and Schools• Public Community Health Nursing• Regional Center of Orange County• The Center for Autism and Neurodevelopmental Disorders of Southern CAOrange County Care CoordinationCollaborative for Kids
    14. 14. OC C3 For Kids GoalsOverarching goal: To improve overall care for children and families withspecial health care needs by creating a collaborative care coordinationsystem in Orange County.1. To identify the specific needs of the Orange County care coordinationcollaborative starting with children birth to 5 years of age who have specialhealth care needs (CSHCN) and their families.2. To determine the organizational structure of the Orange County carecoordination system for children birth to five years with special health careneeds (CSHCN) and their families.3. To conduct a pilot of the proposed Orange County Care Coordination modelto validate the efficacy and refine team based development of procedures,tools, costs and processes before full implementation.4. To create and implement a sustainability plan to secure resources toimplement a care coordination countywide system with scalability andpotential to expand to other age groups.
    15. 15. OC C3 For Kids Activities• Conduct a trend analyses of CSHCN in Orange County• Implement a monthly gathering of a diverse countywide collaborativeproviding CSHCN case reviews, open discussion and resolution ofchallenges• Develop a care coordination protocol to address system wide issues thataffect CSHCN and their families• Develop and promote common language via a county wide risk assessmentand referral form to enhance provider communication• Maximize staff time and resources by focusing on theefficiencies of care coordination• Create a sustainable care coordination entity in OC• Conduct final evaluation combining qualitativeand a quantitative assessments to identify strengthsand weaknesses of the project
    16. 16. 16Anticipated Orange County ChallengesAs our project was developed, the core planningteam identified several challenges that may beencountered. These include:• Time constraints of the current OC C3 forKids participants• Recruitment of additional organizations whoprovide services for CSHCN• Financial constraints as there has beentremendous cutbacks to organizationstherefore limited staff to participateThank youRebecca Hernandez, MSEdProject Director, OC C3 For
    17. 17. Progress Made To Date• Meaningful engagement of multiple stakeholders with commitment to aregular monthly meeting schedule• Hired facilitator for coordination of collaborative meetings and trendanalysis fulfillment• Identified trend analysis indicators• Initial understanding and standards in place for confidentiality• Initiation of case reviews intended to inform system gaps and barriers– Initial structure and template in place– Begun identification of system issues– Begun identification of opportunities for additional collaborativeefforts
    18. 18. Challenges Being Faced• Ensuring the right representatives from each agency are at the table• Engaging other payers beyond CalOptima• Missing representation from Public Health• Understanding how the system will function as the AffordableCare Act is implemented• Gathering the actual data from the identifiedagencies for the trend analysis• Encouraging appropriate participation byparent representatives while respectingtheir personal experiences
    19. 19. Rural Children’s Special Health CoalitionSiskiyou, Shasta and Trinity CountiesWendy LongwellParent Health ConsultantRowell Family Empowerment of Northern CaliforniaUPDATE
    20. 20. Rowell Family Empowermentof Northern CA. (RFENC)• The mission of RFENC is toempower people with diverseabilities, and their families, to liveas respected and valued membersthroughout their communities byproviding support, education andadvocacy services.• RFENC is a parent founded, parentrun agency that assists families innavigating systems, understandingthe laws and regulations thatgovern these systems, and providesparent to parent support.Rural Children’s SpecialHealth Coalition (RCSHC)• Key Coalition Members willinclude: CA. Children Services Far Northern Regional Center Community Health Centers Health and Human Services First 5 Dept. of Health and HumanServices 3-5 Family Members from Shasta,Siskiyou, and Trinity counties• RCSHC is dedicated to bringingfamilies and health professionalstogether to improve healthcoordination in Shasta, Siskiyou,and Trinity counties.
    21. 21. Rural Children’s Special HealthCoalition Goals!• Professionals are moreknowledgeable about communityservice systems and the familyperspective.• Family members are moreknowledgeable about communityservice systems and how to navigatethem.• All participants see increasedcollaboration and communicationamong agencies to solve problems.• All participants finds the trainingprovided has quality, isvaluable, relevant, and useful.• Problem solve any issues we findaround the transition to the newmanaged care Medi-Cal.• Improving and updating the MedicalHome Binder.• All participants believe relationshipshave been strengthened.
    22. 22. RCSHC Project Activities• Schedule 10 phone and/or face to face meetings per year• Create Methods to track changes in the systems• Develop a trainings needs plan and hire speakers and trainers to educateeveryone involved on improving care coordination and developing a clearerunderstanding of the transition to the new managed MediCal model• Coordinate regular convening of a broad range of stakeholders in the targeted 3counties to define issues, identify local unmet needs, explore resources, anddevelop action plans to solve problems• Work on plans and projects the coalition decide are areas we need to work on.
    23. 23. RCSHC Anticipated Challenges• To get all required coalition members to attend meetings from all three counties.Challenges we may face include: Distance to travel in unsafe weather conditions from the pioneer communities Time commitment, with travel, for professionals who may have a tight schedule• To keep coalition members focused on the goals and activities outlined in thegrant, staying true to the specific agenda• Finding professional guest speakers/trainers who are willing to travel to therural and pioneer communities to provide required educational topics that alignwith the RCSHC goals and objectives.• Keeping the training to be disseminated at a level that can be easily understoodby all. Such as keeping it at a 6th grade reading level
    24. 24. Accomplishments• Meetings held– 1 face to face meeting– 1 conference call– Next meeting: conference call• Members of coalition have attended Partnership Health Meetings and State-Level managed Care meetings.• Other meetings in the community helping spread information on the transition• Outreach– Poster distribution– Facebook– Email– Community partners- Head Start, Non-Profit Coalition, local businesses, Area 2Board, CCS, Far Northern Regional Center, Local Schools and School DistrictsHospital representatives, Community Health Representatives, Local Providers,Parents.
    25. 25. Future Activities• Next Face to Face meeting guest speakers:– Partnership Health Representative– Lucille Packard Representative– State Department of Health and Human Services Representative• Wendy Longwell will be joining the Partnership Health CommunityRepresentative Body– Also will be applying to become a Partnership Health Board Member• Additional informational materials will be distributed as they become available.– Ex: input from community of information that Partnership Health should include intheir documents• State of California has been updated on the developments and issues that ariseas we go through the transition.
    26. 26. MediCal TransitionAnticipated Challenges• State of CA not giving Partnership Health the MediCal recipients name prior totransition.• Misinformation presented by Partnership Health to the community.• Partnership Health does not have a local office or Executive Director and arenot planning to have either until August.• Partnership Health does not have information for our area on their website andis not expected to have such information until July.• Primary Care Providers will be assigned by Partnership Health and recipientsmust be informed that they must fill out a form to switch back to their originalPrimary Care Provider.– Recipients must contact their PCP to submit form.– Changes will only happen at the first of the month. Recipients who submit the formafter the first of the month will not be able to see their PCP until the followingmonth.– Can cause recipients to wait to see the doctor and could end up in the emergencyroom.• Healthy Families transition confusion.• Lack of language access.
    27. 27. Possible Solutions• What worked for your counties?• What strategies did you use to combat these issues?• Any ideas???All input greatly appreciated!
    28. 28. • Orzo pasta with spinach, feta cheese, kalmata olives, redonion and toasted pine nuts in balsamic vinaigrette• Fresh mixed greens topped with crumbled bluecheese, dried cranberries, spiced nuts and balsamicvinaigrette• Mediterranean platter of hummus, dolmas, tabbouleh, fetacheese, olives and pita• Grilled squash (vegan), shrimp, and chicken skewers• Beverages and CookiesLUNCH
    29. 29. San Mateo County Care CoordinationLearning CommunityCheryl OkuProgram ManagerWatch Me Grow Demonstration SiteCommunity GatepathUPDATE
    30. 30. • Community Gatepath• First 5 San Mateo County• Golden Gate Regional Center• Lucile Packard Children’s Hospital• San Mateo Co. Community College District• San Mateo County Office of Education• San Mateo Medical System: CCS, MCH, Clinics,Family Health ServicesPARTNERS
    31. 31. • Children Now• Child Care Coordinating Council• Fair Oaks Children’s Clinic• IHSD: Head Start/Early Head Start• Legal Aid Society• Lifesteps Foundation• Parca• Ravenswood Family Health Center• Silicon Valley Community Foundation• StarVistaPARTICIPANTS
    32. 32. • Strengthen the existing system of care coordinationfor CSHCN through a collaborative learningcommunity• Increase access to coordinated, effective, family-centered services for CSHCN within the medicalhome• Develop a model of care coordination for CSHCN inthe medical home that is replicable and sustainablePROJECT GOALS
    33. 33. • Policy Group• Mapping care coordination resources• Assessment and referral protocol• Policy recommendations• Practitioner Group• Best practices for care coordination• Care coordinator handbook or toolMAIN PROJECT ACTIVITIES
    34. 34. • Integrating care coordination models and informationacross different systems• Changing availability of community resources forprovision of care coordination• Co-location of community care coordinator in themedical homeMAJOR CHALLENGES ANTICIPATED
    35. 35. • Leveraged technical assistance from LPFCH toobtain additional funding to continue the work ofthe learning community• Convened 2 meetings focused on developing ashared understanding of the system of carecoordination and needs in San Mateo County• Began mapping local care coordination resourcesand services for CSHCNPROGRESS MADE TO DATE
    36. 36. • Uncovering gaps in the local system of care thatneed to be addressed to create a system ofcoordinated care• Addressing a wide range, intensity and diversity ofcare coordination needs of CSHCN• Establishing protocols for co-location of carecoordination services in the medical homeCHALLENGES
    37. 37. Central California Care Coordination ProjectMarion KarianExecutive DirectorExceptional Parents Unlimited Children’s CenterUPDATE
    38. 38. Central California CareCoordination ProjectEPU Children’s CenterFresno, California
    39. 39. Level 1: BasicInformation and Outside Referral- 2-year-old child with expressive and receptive language delays- Referral sent to the Central Valley Regional CenterLevel 2: ModerateCare Coordination and Multi Agency Involvement- 3- year old child referred for behavioral and developmental concerns-OCK staff ,with the family, creates a care plan with referrals-Referral to ACC /CSC and Family Resources CenterLevel 3: IntensiveComplex /Multi Agency -Care Coordination including Special Health Care Needs- 3-year-old girl has cerebral palsy, a seizure disorder, and is dependent on G-tube feedings,as well as having significant developmental and educational needs.- Complex Care plan must meet her various medical , developmental and educational needs includingreferrals to specialists at community-based agencies and tertiary care settings. Long term coordination.- Referral to the Central California Care Coordination Team/Care Coordinator
    40. 40. Fresno County Department of Social ServicesFresno County Department of Behavioral HealthFresno County Department of Public Health—Public Health Nursing,Children’s Medical ServicesCentral Valley Regional CenterFresno Unified School DistrictFirst 5 FresnoChildren’s Hospital Central CaliforniaCASAChildren’s Services NetworkExceptional Parents UnlimitedCal VivaMarjaree Mason Center (Domestic Violence Shelter)SMART Model of Care PartnerOversight Committee Members
    41. 41. To establish an active, interdisciplinary multi-agencyteam to receive referrals and coordinate the care ofchildren with special health care needs.To provide outreach and information regarding carecoordination to hospital discharge planning/carecoordination staff, NICU discharge staff, privatepediatricians, and Federally Qualified Health Clinics.Project Goals
    42. 42. Convene the Care Coordination Planning Team includingrepresentatives from:California Children’s ServicesCentral Valley Regional CenterChildren’s Hospital—specialty primary care clinicChildren’s Hospital—High Risk Newborn Follow UpEPU Children’s CenterParentsConducting Outreach to various providersAttending the SMART—MOCPOCVisiting Kern Medically Vulnerable ProjectStudying models of care coordinationMain Project Activities
    43. 43. The complexities of the reimbursement systemsThe vast-ness of the medical systemsThe fragmentation and super-specialization ofmedical careFocusing our efforts on the ways in which we canhave the greatest impactDetermining how the Care Coordination Project canfit into the existing SMART Model of CareChallenges
    44. 44. Difficulties working with collaborative partnersComplexity of eligibility requirementsPrivate insurance limitationsInter-agency consentsMore Challenges
    45. 45. Care Coordination Team has been meeting monthlyReferral procedures are in placeCase presentation format has been establishedA complex case has been presentedBeginning outreach presentationso Children’s Hospital “Charlie Mitchell Clinic”o CVRC Baby Clinico Children’s Hospital High Risk Infant Follow-up ProgramProgress
    46. 46. Kern County Medically VulnerableCare Coordination ProjectMarc Thibault, MAProject DirectorUPDATE
    47. 47. Kern County Medically Vulnerable Care Coordination ProjectMission Use enhanced coordination of existing case management services tomeasurably improve long term outcomes for children, birth to 5 years of age, who areat risk of costly, lifelong medical and developmental issues.Background Since 2008, the Kern County Medically Vulnerable (MV) Workgroup of40+ partner organizations has met monthly at First 5 Kern to address the needs ofCSHCN, their families, providers, and communities.Partners California Children’s Services; Clinics; Family Resource Centers; First 5 Kern;Foundations; Hospitals; Insurers; Kern County Departments of HumanServices, Mental Health, Public Health Services; Kern Regional Center; School Districts;Special Care Centers; Local Agencies, Community Organizations and Institutions.
    48. 48. MVCCP ObjectivesKey Components of the Care Coordination Process• Use an accepted Acuity Form to quickly identify and treat moreconditions earlier to make a measurable difference in a child’s life.• Support local services that already exist.• Focus on individual cases, working together through a Case ReviewCommittee, to develop best practices of care coordination.• Streamline access to, and maintenance of, health insurance and amedical home, to reduce unnecessary ER visits and hospitalizations.• Build strong, long-term provider partnerships to sustain asystem of care coordination that is practical, affordable, and responsiveto changing conditions.• Use longitudinal data to document results.• Conduct Cost Benefit Analyses to demonstrate savings on at-riskinfants and children to better serve all children in the county.
    49. 49. The LPFCH grant to MVCCP provides free technical assistance in2013 and 2014 to help implement care coordination in 3 counties by:• facilitating a series of face to face and webinar meetings to assistlocal care coordination collaboratives• sharing the MVCCP Acuity Scale Form to quickly help identify andrefer Children with Special Health Care Needs (CSHCN)• implementing a process for jointly addressing CSHCN cases• working together, through a locally selected Care Coordinator• finding local solutions and resolving care coordination barriers• using evaluation results from the Kern County MVCCP• developing best practices, learned in all four counties, and• jointly addressing the overall system of health care for CSHCN inthese counties.
    50. 50. MVCCP Replication Process and Potential ChallengesReplication Process• MVCCP implemented a “first come, first served” approach, to engage withearly adopter counties.• Two counties – Contra Costa and Orange – have been actively engaged,learning about MVCCP Replication, and building their local collaboratives.• A third county is still in the process of being selected, with outreach occurringwith several counties through the MVCCP Advisory Committee.Challenges• Counties understand how big an undertaking it is to take on care coordinationfor CSHCN. Budgetary constraints and uncertainties due to local, state andfederal policy and funding changes can affect the level of commitment.• Must always remain aware of, and sensitive to, the political and historicaldynamics that can differentiate each county in the implementation process.• Previous or ongoing local collaboration efforts can impact the vision and thecommitment to cooperation, especially depending how competitive theatmosphere is among potential partner organizations.• A local governance plan must reflect the collaborative nature of the initiative,provide accountability and transparency to its work, and result in an inclusivedecision-making process to achieve optimum results.
    51. 51. Kern County MVCCP Developments• MVCCP’s first Care Coordinator, Gail Davidson, has retired.• In the last 27 months, she managed over 500 referrals to the project.• Gail was an RN for 34 years, (a nursing professor for 10 years); starting her career inthe NICU and finishing it helping to change the system of care in Kern County!• Another PHN will assume the duties of the Care Coordinator in June.• Also, our county Director of Public Health Nursing, Lucinda Wasson, is retiring atthe end of June, after 35 years. A strong partner and advocate for care coordination,Cindy will be missed!• Transitions like this must be as seamless as possible to sustain our progress!
    52. 52. MVCCP Replication Process and ChallengesReplication Process• Two counties – Contra Costa and Orange – are up and running!• A third county is doing an internal review among its agency and providerpartners prior to hosting a full presentation and broader planning discussion.Challenges• “I think we are doing that already.” Distinguish in early discussions betweencase management (individual level) and care coordination (system level).• “ I didn’t know about that.” Scheduled presentations from a variety localproviders, addressing their eligibility criteria, funding, and staffing, help buildout the level of system, and strengthen the connectedness among partners tocoordinate care, especially for complex cases.• “How are we going to keep this going?” Financial sustainability requiresresearching, building up, and maintaining relationships with key localfoundations and grant makers.MVCCP invites you to itsAnnual ConferenceThursday, November 7, 2013 in BakersfieldThe theme is:Reducing Premature Births Through Coordinated CommunityStrategies
    53. 53. • Goals:– Assess the function of the Collaborative– Identify whether LPFCH goals were met– Identify whether coalition goals were met– Evaluate the RFP processEVALUATION
    54. 54. • Users and Dissemination:– Programs and Partnerships Staff– 5C’s Participants– Abridged results to LPFCH Board– Abridged results to others interested in developinga learning collaborative around care coordinationor related areaEVALUATION
    55. 55. • What are the top two outcomes of your project?• Where do you see commonalities across projects?• How will we measure it?• Can we look at change over time by measuring it at thebeginning of the project and again at the end?• The goal is improvement, not competition!SHARED OUTCOME MEASURE
    58. 58. • Are there technical assistance needs we have notdiscussed yet today?• What is the best form for this technical assistance to take(i.e. site visit, webinar, in-person, phone call, outsideexpert, training)?TECHNICAL ASSISTANCE
    59. 59. • Use of Google Groups for communication• Use of Doodle Polls for event scheduling• What would be good to do the next time we meet?• Reimbursement Procedure for travel expenses– Submit original receipts by mail or scanned copies via email:Holly Henry400 Hamilton Ave. Suite 340Palo Alto, CA 94301holly.henry@lpfch.orgLOGISTICS
    60. 60. • Technical Assistance Webinar - August 13th at 11:00am• Webinar – TBD October 2013 at 11:00am• Check-in Calls – July, November, and December 2013• In-Person Meeting – TBD January 2014UPCOMING 5C’S EVENTS
    61. 61. Thank you for attending andsharing your thoughts and experiences!