HMPRG Safety Net Initiative History- Lon Berkeley


Published on

PPT Setting the Stage for the Regional Health Care Safety Net in Northeastern Illinois. Presented at the Safety Net Summit, June 23, 2009, hosted by Health & Medicine Policy Research Group (HMPRG) and the U.S. Health Resources and Services Administration (HRSA)

Published in: Health & Medicine, Technology
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide
  • 1) This isn’t a recent development; this has not been easy… sometimes this hasn’t even been fun. 2) Ask people to stand if: a) attended kickoff April, 2006; b) served on a committee or attended a meeting; c) participated in key informant county meeting
  • How many of these groups have you heard about? Raise hand if could describe what ALL of them do Acronyms Danger (AWA=another weird acronym)? Bolded orgs were 7 of 8 original convenors in April 2006 when world was very different (including diff names for CMAP = NIPC, and different structures CCHHS = CCBHS). 4) Go back & ask to stand
  • Ask audience to suggest local models that they are familiar with (e.g. RTA, Waste Management, Water Reclamation, Disaster-relief??, N Suburban Library System).
  • How many people know where Kendall county is, or that it is the 6 th fastest growing county in country?
  • Ask audience to suggest local models that they are familiar with (e.g. RTA, Waste Management, Water Reclamation, Disaster-relief??, N Suburban Library System).
  • Ask audience to suggest local models that they are familiar with (e.g. RTA, Waste Management, Water Reclamation, Disaster-relief??, N Suburban Library System).
  • YMCA, pharmacies
  • “It is hoped that this consideration will enhance then integration of health and the regional planning agenda”;
  • e.g. “By 2015, a regional mechanism will be established to monitor Sentinel Events in each CMAP county using comparisons with Illinois rates and other targets.”
  • Ask audience to suggest local models that they are familiar with (e.g. RTA, Waste Management, Water Reclamation, Disaster-relief??, N Suburban Library System).
  • HMPRG Safety Net Initiative History- Lon Berkeley

    1. 1. “ 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
    2. 2. OVERVIEW <ul><li>Progress to Date/History of the Initiative </li></ul><ul><li>Key Assumptions & Terminology </li></ul><ul><li>Demographic Snapshot of Region </li></ul><ul><li>- Russell J. Pietrowiak, CMAP </li></ul><ul><li>On-going Efforts to Strengthen the Safety Net </li></ul><ul><li>Introduction to Preliminary Recommendations & Small Group Action Planning </li></ul>
    3. 3. “ MOVING THE BALL DOWN THE FIELD” <ul><li>Crisis in funding for Cook County Health Services </li></ul><ul><li>New Cook County Health & Hospitals Systems (CCHHS) Board created </li></ul><ul><li>CMAP (Chicago) Metropolitan Agency for Planning) begins “Go To 2040” plan </li></ul>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 <ul><li>Convene/organize the players </li></ul><ul><li>Define the Problem </li></ul><ul><li>Collect/analyze Data </li></ul><ul><li>Shape the scope </li></ul>Stage I (1/06-8/08) OTHER IMPORTANT DEVELOPMENTS METHODS & ACTIVITIES TASK PHASES  (TIMING)
    4. 4. Endorsements to Convene the Regional Health Care Safety Net Summit <ul><li>Alivio Medical Center </li></ul><ul><li>Chicago Department of Public Health (CDPH) </li></ul><ul><li>Chicago Hispanic Health Coalition (CHHC) </li></ul><ul><li>Chicago Metropolitan Agency for Planning (CMAP) </li></ul><ul><li>Chicago Partnership for Public Health </li></ul><ul><li>Community Nurse Health Association </li></ul><ul><li>Melanie Dreher, Dean, College of Nursing, Rush University Medical Center </li></ul><ul><li>William T. Foley, Chief Executive Officer, Cook County Health & Hospitals System </li></ul><ul><li>Patricia Gross, MSPH </li></ul><ul><li>Illinois Maternal and Child Health Coalition (IMCHC) </li></ul><ul><li>Illinois Public Health Institute (IPHI) </li></ul><ul><li>Institute of Medicine of Chicago (IOMC) </li></ul><ul><li>Latinos for a Healthy Illinois </li></ul><ul><li>Metropolitan Chicago Healthcare Council (MCHC) </li></ul><ul><li>Near North Health Services Corporation </li></ul><ul><li>Northern Illinois Public Health Consortium (NIPHC) </li></ul><ul><li>Alderman Toni Preckwinkle, 4th Ward, City of Chicago </li></ul><ul><li>Resurrection Health Care </li></ul><ul><li>UIC Latino Health Research, Training & Policy Center </li></ul>
    5. 5. “ MOVING THE BALL DOWN THE FIELD” <ul><li>New US President </li></ul><ul><li>New IL Governor </li></ul><ul><li>CCHHS initiates strategic planning </li></ul><ul><li>Economic crisis </li></ul><ul><li>Convene Pre-summit conference </li></ul><ul><li>Meetings of Summit Planning Committee </li></ul><ul><li>Solicit written feedback </li></ul><ul><li>Prepare “Call for Summit” </li></ul><ul><li>Prioritize Problems </li></ul><ul><li>Draft & Vet preliminary recommendations </li></ul><ul><li>Plan Summit </li></ul>Stage II (9/08-5/09) OTHER IMPORTANT DEVELOP-MENTS METHODS & ACTIVITIES TASK PHASES  (TIMING)
    6. 6. “ MOVING THE BALL DOWN THE FIELD” <ul><li>National Health Care Reform Deliberations </li></ul><ul><li>Federal stimulus funding for health information technology </li></ul><ul><li>Convene Summit Conference with HRSA co-sponsorship </li></ul><ul><li>Presentations on regional models </li></ul><ul><li>Endorse Regional Health Pact & Call to Leaders </li></ul><ul><li>Implement pilot project(s)? </li></ul><ul><li>“ Field trips” to other counties outside NE IL? </li></ul><ul><li>Finalize regional blueprint </li></ul><ul><li>Identify & engage additional implementers </li></ul><ul><li>To Do: Solicit funding & political support </li></ul><ul><li>To Do: Identify leadership for next steps </li></ul>Stage III (6/09 - ?) OTHER IMPORTANT DEVELOPMTS METHODS & ACTIVITIES TASK PHASES
    7. 7. KEY TERMINOLOGY OF INITIATIVE <ul><li>Health </li></ul><ul><li>Safety Net </li></ul><ul><li>Regional </li></ul><ul><li>Vulnerable Populations </li></ul>
    8. 8. KEY TERMS OF INITIATIVE <ul><li>Health is not merely the absence of illness or disability, but also the attainment of mental, physical, and spiritual or social well-being. (WHO) </li></ul><ul><ul><li>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. </li></ul></ul>
    11. 11. WHAT DO WE MEAN BY THE “HEALTH CARE SAFETY NET”? <ul><li>Providers that … </li></ul><ul><ul><li>organize and deliver a significant level of health care and other related services… </li></ul></ul><ul><ul><li>to uninsured, Medicaid, and other vulnerable populations (IOM), as well as other population-based health services. </li></ul></ul>
    13. 13. WHAT DO WE MEAN BY “Regional”? <ul><li>INCLUDES COUNTIES OF: </li></ul><ul><ul><li>> Cook > DuPage </li></ul></ul><ul><ul><li>> Kane > Kendall </li></ul></ul><ul><ul><li>> Lake > McHenry </li></ul></ul><ul><ul><li>> Wil l </li></ul></ul>
    14. 15. WHAT DO WE MEAN BY “Vulnerable Populations”? <ul><li>Residents who are vulnerable because health services are: </li></ul><ul><ul><ul><li>unavailable </li></ul></ul></ul><ul><ul><ul><li>inaccessible </li></ul></ul></ul><ul><ul><ul><li>under-subsidized or </li></ul></ul></ul><ul><ul><ul><li>not subsidized at all by public or private programs </li></ul></ul></ul><ul><li>Includes the uninsured, under-insured, and people on Medicaid </li></ul>
    15. 16. KEY ASSUMPTIONS OF INITIATIVE <ul><li>There is no mandate or requirement to pursue this regional approach. </li></ul><ul><ul><li>We don’t have to do this </li></ul></ul><ul><ul><li>There is no sponsor </li></ul></ul><ul><li>2) Planning that includes the public and private sector increases the probability of attaining our goals and desired outcomes. </li></ul>
    16. 17. KEY ASSUMPTIONS OF INITIATIVE <ul><li>3) Collective regional action will strengthen: </li></ul><ul><ul><ul><li>Planning </li></ul></ul></ul><ul><ul><ul><li>Resource sharing </li></ul></ul></ul><ul><ul><ul><li>Advocacy </li></ul></ul></ul><ul><ul><ul><li>Patient Referrals </li></ul></ul></ul><ul><ul><ul><li>Service Coordination, and </li></ul></ul></ul><ul><ul><ul><li>Research Opportunities. </li></ul></ul></ul><ul><li>Other successful regional efforts exist that have improved outcomes or operations </li></ul>
    17. 20. KEY ASSUMPTIONS OF INITIATIVE <ul><li>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). </li></ul>
    18. 21. 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
    19. 22. KEY ASSUMPTIONS OF INITIATIVE <ul><li>5) There is a continuum of health care services that can be categorized into both vertical and horizontal dimensions. </li></ul><ul><li>6) We accept the World Health Organization’s systems building blocks of a health system conceptual framework </li></ul><ul><li>7) We accept the Institute of Medicine’s </li></ul><ul><li>six specific aims for improving the health care system. </li></ul>
    20. 23. THE WHO Health System Conceptual Framework Source: WHO Health System Strengthening Strategy 2007
    21. 24. KEY ASSUMPTIONS OF INITIATIVE <ul><li>Six Aims for Improvement (Institute of Medicine) </li></ul><ul><li>Safe : avoiding injuries to patients from the care intended to help them. </li></ul><ul><li>Effective : providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit. </li></ul><ul><li>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. </li></ul><ul><li>Timely : reducing waits and sometimes harmful delays for both those who receive and those who give care. </li></ul><ul><li>Efficient : avoiding waste, including waste of equipment, supplies, ideas, and energy. </li></ul><ul><li>Equitable : providing care that doesn’t vary in quality due to personal characteristics such as gender, ethnicity, geographic location, & socioeconomic status. </li></ul>
    22. 25. KEY ASSUMPTIONS OF INITIATIVE <ul><li>8) Health & Medicine Policy Research Group’s (HMPRG) role is to facilitate the process only </li></ul><ul><li>- currently supported by one foundation grant and in-kind contributions </li></ul><ul><li>- similar to approach with other successful projects. </li></ul>
    23. 26. KEY ASSUMPTIONS OF INITIATIVE <ul><li>9) All problem statements, priorities, and recommendations, are “works-in-progress,” … </li></ul><ul><li>- with recognition and apologies to any overlooked organizations, projects, and people that are interested in contributing to this initiative. </li></ul>
    24. 27. A Demographic Snapshot of the Region Russell J. Pietrowiak Associate Planner Chicago Metropolitan Agency for Planning
    25. 28. 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%
    26. 31. Changing Demographics in Cook County
    27. 32. Constant growth over more than 3 decades (*6 counties)
    28. 33. Latinos have the highest rates of uninsured persons in Illinois
    29. 39. Ongoing Efforts to Strengthen the Safety Net <ul><li>HMPRG compiling a “Summary of Actions” </li></ul><ul><li>Federal & State Legislation re: </li></ul><ul><ul><li>Community Building/Coalitions for Safety Net Improvements </li></ul></ul><ul><ul><li>Workforce, IT, Financing </li></ul></ul><ul><li>Metro-area Initiatives </li></ul><ul><ul><li>The Chicago Access Puzzle: Fitting the Pieces Together </li></ul></ul><ul><ul><li>Healthy San Francisco Initiative </li></ul></ul><ul><ul><li>Detroit/Wayne County Health Authority </li></ul></ul><ul><ul><li>Mid-America Reg’l Council & KC Metro Health Access </li></ul></ul><ul><ul><li>Access DuPage </li></ul></ul><ul><ul><li>Access to Care </li></ul></ul>
    30. 40. CMAP GoTo 2040 : The Plan For Health
    31. 41. CMAP GoTo 2040 : The Plan For Health <ul><li>The GoTo 2040 Plan is a comprehensive plan for the seven county region of the Chicago Metropolitan Agency for Planning (CMAP). [1] </li></ul><ul><li>This report presents the plan for health. </li></ul><ul><li>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.” </li></ul><ul><li>[1] The Illinois counties of Cook, DuPage, Kane, Kendall, Lake, McHenry, and Will. </li></ul>
    32. 42. CMAP GoTo 2040 : The Plan For Health <ul><li>The scope of the plan was guided by: </li></ul><ul><ul><li>3 decade planning horizon </li></ul></ul><ul><ul><li>Limitation of no more than 15 indicators </li></ul></ul><ul><ul><li>Emphasis on the determinants of health </li></ul></ul><ul><ul><li>Unsustainable cost and quality of life burden of chronic disease; and </li></ul></ul><ul><ul><li>Focus on what can be accomplished in the region to improve health and not on those factors that are beyond regional control. </li></ul></ul>
    33. 43. CMAP GoTo 2040 : The Plan For Health <ul><li>4 Recommended Strategies: </li></ul><ul><ul><li>Integrated prevention and health promotion strategy that will integrate the regional planning agenda with health policy issues and integrate the participants in the process. </li></ul></ul><ul><ul><li>Move toward an all data-real time concept that builds on electronic medical records. </li></ul></ul><ul><ul><li>Address workforce concerns. </li></ul></ul><ul><ul><li>Strengthen the public health infrastructure in response to early signs of deterioration. </li></ul></ul>
    34. 44. KEY TERMINOLOGY FOR SUMMIT <ul><li>Preliminary Recommendations </li></ul><ul><ul><ul><li>May not be complete or the best </li></ul></ul></ul><ul><li>Blueprint </li></ul><ul><ul><ul><li>Vision with guidelines </li></ul></ul></ul><ul><li>Strengthening </li></ul><ul><ul><ul><li>Existing services need support </li></ul></ul></ul><ul><li>Moving Recommendations to Action </li></ul><ul><ul><ul><li>Building on past progress </li></ul></ul></ul>
    35. 45. BUILDING A BETTER WORLD <ul><li>CURRENT STATE </li></ul><ul><li>TRANSITIONAL STATE </li></ul><ul><li>IMPROVED STATE </li></ul><ul><li>DESIRED STATE </li></ul>
    36. 46. Moving Recommendations to Action <ul><li>Preliminary Recommendation Categories </li></ul><ul><ul><li>Data/IT </li></ul></ul><ul><ul><li>Workforce </li></ul></ul><ul><ul><li>Access </li></ul></ul><ul><ul><li>Health Equity </li></ul></ul><ul><ul><li>Finance </li></ul></ul><ul><ul><li>Planning Approaches </li></ul></ul>
    37. 47. Moving Recommendations to Action <ul><li>Preliminary Recommendation Format </li></ul><ul><ul><li>Problem Statement </li></ul></ul><ul><ul><li>Vision </li></ul></ul><ul><ul><li>Recommendation </li></ul></ul><ul><ul><li>Local/Regional Examples </li></ul></ul><ul><ul><li>Rate Level of Support </li></ul></ul><ul><ul><li>Your Role in Implementing the Recommendation </li></ul></ul><ul><ul><ul><li>> Leadership > Participant </li></ul></ul></ul><ul><ul><ul><li>> Resource > Stay Informed >Not Interested </li></ul></ul></ul>
    38. 48. RECAP <ul><li>We are not waiting to be told that we can strengthen the health care safety net by working across geographic boundaries. </li></ul><ul><li>As we continue to “move the ball down the field” we hope to gain some momentum from today’s efforts. </li></ul><ul><li>We need you to weigh in with your comments, ideas, energy, and action to help implement this vision. </li></ul>
    39. 49. Japanese Proverb <ul><li>“ Vision without action is a daydream ….. </li></ul><ul><li>… action without vision is a nightmare.” </li></ul>