california community care coordination collaborative ii - june 2015
TRANSCRIPT
Welcome to the California Community
Care Coordination Collaborative
June 2, 2015
• Introductions and Welcome• Icebreaker• Project Updates
– San Joaquin County – SJC 5Cs Project– San Mateo County – SMC Care Coordination Learning Community
• Project Leadership Family Advocacy Training– Family Voices of California – Allison Gray and Pip Marks– A Parent’s Perspective – Michele Byrnes
• Lunch
MORNING AGENDA
• Project Updates
– Ventura County – VC-Pact
– Orange County – OCC3 for Kids
• Using kidsdata.org
• Project Updates– Alameda County – CCS Mental Health Initiative
– Contra Costa County – 7 Cs
• Discussion of System Issues
• Meeting Evaluation and Wrap-Up
AFTERNOON AGENDA
• Women’s Bathroom Code: 421
• Men’s Bathroom Code: 543
• Wireless Password: Being passed around
LOGISTICS
ICEBREAKER
• Your name
• Your organization and position
• What’s your favorite thing to do during the summer?
San Joaquin County 5Cs Project
Ann Ciremele
Executive Director
Family Resource Network
1. Planning and Development Committee meeting monthly.
2. Collaborative meeting monthly.
a. Alternating agency presentations and case sharing each month.
3. MOU deliverable completed by 5/30 date.
4. First Fact Sheet almost completed, due 6/30.
5. Adopting a local version of San Mateo’s Map of Agencies to our deliverables to share information on agency eligibility and services.
PROJECT PROGRESS
• Agency presentation talking points include “Where’s the front door?” and “What is a major myth or misunderstanding about your organization?” which are providing great info.
• CCS shared wonderful CHDP resources that were not known by all 5Cs agencies.
• Health Plan of San Joaquin is actively participating in this collaborative, facilitating the link between early intervention and the county’s primary managed health care program.
ACCOMPLISHMENTS
• Appealing to more agencies to participate in monthly meetings.
• Finding a “virus free” way to share documents.
• Determining the role of 5Cs San Joaquin County within other collaborative structures that exist in the county.
CHALLENGES
• Has a collaborative or agency used the 2-1-1 iCarol system to store and manage health care specialist information for agencies and families?
• Are other collaboratives having difficulty finding
providers for out-of-county transportation to hospitals or medical centers, especially for children receiving Medi-Cal i.e. are the fixed reimbursement rates affecting vendors’ willingness to travel out of county?
DISCUSSION QUESTIONS
San Mateo County Care Coordination Learning Community
Cheryl Oku
Program Manager
Community Gatepath
• Professional Development Workgroup organizing a training event for medical professionals on screening/ assessment, referrals and care coordination planned for August in collaboration with Stanford Children’s Health: Lucile Packard Children’s Hospital Developmental Behavioral Pediatrics and Watch Me Grow
• Incorporating the San Mateo 5Cs Learning Community into the First 5 San Mateo Integrated Systems for Children with Special Needs and their Families (Watch Me Grow) to provide focus and sustainability
PROJECT PROGRESS
• Care coordination focus in Watch Me Grow: First 5 San Mateo Integrated Systems of Care for Children With Special Needs and their Families (2015-2018)
• New 0.5 FTE care coordinator position in one primary care pediatric clinic and continuation in 3 additional clinics
• Training event for medical professionals on screening/ assessment, referrals and care coordination planned for August.
ACCOMPLISHMENTS
• Staff and partners’ availability and capacity
• Maintaining focus and continuity in a shifting landscape of local funding and services
CHALLENGES
• How has your coalition used local data to improve care coordination systems?
• What might we do in order to encourage and maintain family participation in our collaborative?
• How has your coalition addressed identified systems gaps and barriers and elevated the discussion to promote systems change and advocate for local, regional or statewide changes?
DISCUSSION QUESTIONS
Project Leadership Family Advocacy Training
Allison Gray
Pip Marks
Family Voices of California
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.
- Margaret Mead Public Policy Advocacy: A Grassroots Guide, The Statewide Parent
Advocacy Network, [email protected]
The voice of families
The vision of quality health care
The future for children and youth with special health care needs
To increase the ability of families to advocate for the needs of children and youth with special health care
needs, and to encourage more families to take on leadership roles.
PROJECT LEADERSHIPPROJECT LEADERSHIP
Chapter 1: Knowing the Past to Change the Future: History and Purpose of Advocacy
Chapter 2: Rules of the Road: Systems, Laws, and Entitlements
Chapter 3: Becoming a Mover and Shaker: Working with Decision-Makers for Change
Chapter 4: Playing Well with Others: Enhancing Communication
Chapter 5: Telling Your Story: Developing and Presenting Stories to Others
Chapter 6: Ways You Can Serve: Participating on Decision Making Bodies
Chapter 7: Solidifying Partnerships: Connecting with Local Change Makers
TABLE OF CONTENTS
RECRUITMENT
Target Population: Caregivers of children with special health care needs, disabilities, or mental health / behavioral health issues
Outreach: Wide variety of agencies, organizations, and hospitals (e.g., Family Resource Centers, support groups, local California Children’s Services, and specialty care clinics)
RETENTION Incentives
• Food• Childcare• Stipends
Participation Agreement
Certificate of Completion
SCHEDULING
Seven 4-hour sessions
Accommodating familiesMeeting days / timesFlexibility to make up missed
session
STRUCTURE & STAFFING
FVCA Council Member Agencies
Project Director
Statewide Leadership Liaison
Host Site Trainer / Mentor
Host Site Support Staff
FACILITATION
Preparing local trainer / mentor
Facilitating dynamic / interactive sessions
Development of Action Plan
Completion of homework
MENTORING & SUPPORT
Individual Mentoring
Monthly Group Mentoring
Online Advocacy Community
Support from local Family Resource Center Staff
MENTORING CONT’D – DATABASES
Family Databases (Project Graduates)• Areas of expertise / experiences• Advocacy Interests• Advocacy Activities
Opportunity Database• Local• Regional• State
RESULTS – YEARS 1 AND 2
10 graduates – San Diego County
20 graduates – San Francisco
49 graduates – Alameda County
RESULTS – CONT’DGraduates are:
Serving on health care- / disability-related groups or decision-making bodies
Meeting with local and state policymakersProviding public testimonyTelling their stories to the media
PROJECT LEADERSHIP GRADUATES – EXAMPLES OF PARTICIPATION:
Alameda County Committee on Children with Special Needs CCS Alameda County Family Centered Care Committee Title V CCS Needs Assessment CCS Redesign Technical Work Groups Children’s Hospital Oakland Family Advisory Council Children’s Regional Integrated Service System San Diego Head Start Policy Committee Help Me Grow (Alameda and San Francisco) Kaiser Patient & Family Centered Care Advisory Council SF City & County Fatherhood Initiative Workgroup San Francisco Mental Health Board SELPA Community Advisory Committee (various counties) Support for Families Board Center for Youth Wellness Advisory Council UC Berkeley MCH CSHCN Conference – Parent Panel FVCA Health Summit & Legislative Day / Health Summit Advisory
Committee
EXTERNAL EVALUATION
Participants’ confidence in their ability to advocate, their leadership skills, and their experiences with advocacy showed significant improvement.
Participants showed significant, positive changes on measures of empowerment for accessing services for children.
Participants felt better prepared to continue to advocate for their children and for systems change.
LESSONS LEARNED Curriculum Revision (e.g., more attention to
cultural differences / learning styles of group, more about history / structure of CA health care system)
Flexible scheduling, childcare, and stipends
Long-term mentoring and facilitated peer support
Variety of means for communication, mentoring, and support
Educating others about importance of family participation
YEAR 3 – EXPANSION OF TRAININGS
Train the Trainers Workshop Two-day training in SF:
Curriculum content, best practices for recruitment and implementation, budget estimates, information on approaching local foundations / funders, Action Plan
Request for Applications: To be publicized through Family Resource Center Network of CA (FRCNCA), $500 stipend offered to offset costs of attending
YEAR 3 – EXPANSION OF TRAININGS
Implementation Guidelines:• Best practices and lessons learned related
to recruitment, retention, scheduling, staffing, etc.
Menu of Technical Assistance Options:• Online group for / scheduled conference
calls with Trainer / Mentors facilitated by State Liaison
• Problem solving with State Liaison via phone or email
• Site visit and in-person consultation with State Liaison
YEAR 3 – ALUMNI MENTORING
Statewide Online Advocacy Community Statewide monthly conference calls or
webinars
Statewide annual in-person meeting
YEAR 3 – UPDATES
Database maintenance
Curriculum updates
Curriculum translation
ALUMNI TESTIMONIES Project Leadership helped build my confidence to advocate for my child
and other children with health care needs. It also gave me the strength and confidence to continue pushing to get services and make sure programs continue happening for children.
I really believe this experience is life-changing for the unexpected role I’ve found myself in of a mother of a special needs daughter. …I am proud to be a Project Leadership alum and am excited to see what we all do with our empowered voices.
Project Leadership Training has allowed me to further build my confidence as an advocate. I have progressively taken on the role as an advocate for her special health care needs but always felt ‘stuck’ when it came to further advancing. This training has given me the tools, information, and necessary leadership skills to further my advocacy voice for my daughter and other families.
I feel so empowered and inspired to take my advocacy work to the next level. Project Leadership graciously provided me with the tools and strategies to tailor my story to a specific issue and how to be an effective communicator using a balance of emotion and objectivity.
A Parent’s Perspective on the Project Leadership Family Advocacy Training
Michele Byrnes
Alameda County
• Professional background in policy and advocacy, but not based on personal experience
• Classes provided strong basis of knowledge on how to translate personal advocacy to systems advocacy
• Created strong, diverse community of parents
• Ongoing mentorship and support essential for continued advocacy
BENEFITS OF PROJECT LEADERSHIP
Thanks to preparation and mentoring offered through Project Leadership:
• Understood steps necessary to join a family board; joined Family Advisory Council at UCSF Benioff Children’s Hospital Oakland; participated as Family Partner in Kaizen Weeks
• Invited to present a web seminar on pediatric feeding tubes; co-presented with Dr. William Berquist, Gastroenterologist at Lucile Packard Children’s Hospital
• Participated on Family Voices of California Health Summit Advisory Committee; collaborated with FVCA to create and present a web seminar to prepare parent advocates for Advocacy Day
ACCOMPLISHMENTS
• Invited to provide testimony at the Senate Committee on Health Informational Hearing: Making Health Care Affordable: The Impact on Consumers
• Presented at UC Berkeley MCH Roundtable: The Changing Landscape for CYSHCN
• Presented to Gastroenterology team at California Pacific Medical Center about therapeutic benefits of SOS feeding therapy for children with G-tubes
ACCOMPLISHMENTS
THANK YOU
• Orzo pasta with spinach, feta cheese, kalamata olives, red onion and toasted pine nuts in balsamic vinaigrette
• Fresh mixed greens topped with crumbled blue cheese, dried cranberries, spiced nuts and balsamic vinaigrette
• Mediterranean platter of hummus, dolmas, tabbouleh, feta cheese, olives and pita
• Grilled squash (vegan), shrimp, and chicken skewers
• Beverages and cookies
LUNCH
Ventura County
(VC-Pact)
Myra Medina, DPT
Supervising Therapist, Conejo Medical Therapy Unit
California Children’s Services, Ventura County
• Initial Trend Report submitted, revised version to be submitted with additional data on coalition members’ perceived gaps
• Acuity Tool with operational definitions developed and piloted
• Coalition Case Admission Review Panel selected
• First case presented
PROJECT PROGRESS
• Accomplishment 1: Monthly meeting established successfully
4th Tuesday of every month; 15 to 25 participants
• Accomplishment 2Excellent involvement of coalition members
Bring new agencies to the table and spread the word in the community
• Accomplishment 3Excitement in the community regarding the project and
acknowledged as valuable
ACCOMPLISHMENTS
• Challenge 1Maintaining coalition members regular participation
Number of members is significant but not all are present at all meetings
• Challenge 2Time to work on the project while actively involved in
other job duties
• Challenge 3Maintaining uniqueness of this coalition in comparison
to other existing ones
CHALLENGES
• Are any of the existing coalitions using by-laws?
• How do other coalitions involve members to promote participation at every meeting (at least one agency representative)?
• Has anyone secured funding (outside of LPFCH) and what are some of the strategies to secure funding?
DISCUSSION QUESTIONS
Orange County Care Coordination Collaborative for Kids
(OCC3 For Kids)
Rebecca Hernandez, MSEd
Program Manager
Help Me Grow Orange County
OCC3 for Kids progress to date on strengthening communication & collaboration among agencies providing services to CSHCN and implementation of system-level care coordination:• System Level Care Coordinator engaged as part of Public Health
Nursing (PHN) and OCC3 for Kids• Leadership team expanded to include PHN Program Manager
and System Level Care Coordinator • Federal Financial Participation as funding source continues to
move forward with commitment from CHOC and PHN• Two subcommittees (Communication & Best Practices) are
established and meeting regularly
PROJECT PROGRESS
• Evaluation Plan that includes inputs, activities, outputs and outcomes has been completed and submitted to LPFCH
• Acuity Tool finalized with plan to launch at CA Children's Services, Public Health Nursing and CHOC Children’s NICU discharge clinic
• Decision Tree finalized for the implementation of a process to improve dialogue and coordination among agencies when a specific need for a higher level of care coordination is identified
ACCOMPLISHMENTS
• The use of the term “delay of care” was found to be a problem if we expected the health care providers and health plans to utilize the acuity tool
• Although we have verbal commitment from health plans, they have not regularly participated in OCC3 for Kids
• It is uncertain if the subcommittee structure is effective since it is a challenge for people to commit to additional meetings
CHALLENGES
• How are others addressing system level issues and barriers once they are identified at the county level?
• Have we identified any common issues among
the 5Cs participants that can be addressed at the state level?
• What strategies do others have to engage and encourage & retain participation by health plans?
DISCUSSION QUESTIONS
Alameda County CCS/Behavioral Health Services Integrated Care Coordination Project
Katie Schlageter, MS-HCA
Administrator, California Children’s Services
Deputy Division Director, Family Health Services
Alameda County Public Health Department
• Alameda County CCS Mental Health Initiative has convened a large Steering Committee.
• Formed a Planning Committee to assist CCS staff with Steering Committee meeting and project planning.
• Have begun conducting key stakeholder interviews to build relationships and gain insight into mental health service system issues.
PROJECT PROGRESS
1. Developed and categorized Service System Issues List.
2. Created draft Vision and Values Statements.
3. Created draft Needs Assessment.
ACCOMPLISHMENTS
1. Engaging and keeping key stakeholders engaged.
2. Significant time commitment for core group.
3. Mental Health Service System is complex. State CCS policies related to mental health are outdated.
CHALLENGES
1. How are other projects keeping busy stakeholders engaged?
2. What types of data are others collecting?
3. Based on others’ experience is the CCS Mental Health Initiative “on track” in terms of progress and timeframe?
DISCUSSION QUESTIONS
Contra Costa California Community Care
Coordination Collaborative (7 Cs)
Hannah Michaelsen and Vi Ibarra
CARE Parent Network
Contra Costa County
• Completed Family Experience Outline: This details how families of kids with special health care needs will share their experience with 7 Cs partners in order to move our system to a family experience focus.
• Added new school district partner: Mt Diablo Unified, one of our county’s largest districts. Two enthusiastic program specialists have been attending our monthly meetings.
PROJECT PROGRESS
• Completed draft of a brochure that discusses the importance of our Roundtable meetings that can be shared with agency staff and providers.
• Continue to have consistent participation at monthly 7 Cs partner meetings.
• Role of Children’s Service Systems Coordinator: She is beginning to collect data about Roundtable meetings, promote Roundtable meetings, and share information across participants at 7 Cs and Roundtable.
ACCOMPLISHMENTS
• Sustainability of the project. Grant funding for Children’s Service Systems Coordinator runs out at year end. Also looking for sustainability funding for 7 Cs beyond June 2016. Recently formed a small workgroup to work on identifying funding.
• Consistent participation in Central/East County Roundtable. Waiting for some personnel changes in one agency. Only one partner consistently brings cases to discuss.
CHALLENGES
• How do we sustain our project efforts? What are other counties doing both with personnel and funding?
• Have other counties experienced a “roadblock” personality in their collaborative, and if so, what was their response?
• How can we increase participation of reluctant Roundtable/coalition members?
DISCUSSION QUESTIONS
COLLABORATIVE CHECKLIST
• Summer Site Visits – San Mateo, Ventura
• Webinar – September 1, 2015
• Fall Site Visits – Contra Costa, Orange
• Check-in Calls – October and November 2015
• In-Person Meeting – December 1, 2015
UPCOMING ACTIVITIES
• Please complete your meeting evaluation and leave it on the corner table.
MEETING EVALUATION
Thank you for attending and sharing your thoughts and experiences!