January 21, 2016
New York City
PAOP Presentation
Governance Structure
© Bronx Health Access 1
Bronx Lebanon Hospital Center
PPS Lead Entity
BHA PPS LLCGovernance Board
Committees
PMO
Cross-Functional Workgroups
Project Workgroups
Bronx Health Access PPS LLC
Governance Structure
© Bronx Health Access 2
BHA PPS LLCGovernance Board
5 BLHC Members
Governance Structure
© Bronx Health Access 3
BHA PPS LLCGovernance Board
5 BLHC MembersUrban Health
(FQHC)
Comunilife
(CBO)
VNSNY
(Home/Community HC)
Dominican Sisters
(Home/Community HC)
Hudson Heights IPA
(Physicians)
SEIU/1199
(Union)
Mt Sinai Hospital
(Hospital)
Governance Structure
© Bronx Health Access 4
Bronx Lebanon Hospital Center
PPS Lead Entity
BHA PPS LLCGovernance Board
ComplianceCommittee
PMO
WorkforceCommittee
StakeholderCommittee
Clinical Quality &PDI Committee
FinanceCommittee
ITCommittee
PAC
Governance Structure
© Bronx Health Access 5
Bronx Lebanon Hospital Center
PPS Lead Entity
BHA PPS LLCGovernance Board
PMO
Care CoordinationCross-Functional
PCMHCross-Functional
Cultural CompetencyCross-Functional
ComplianceCommittee
WorkforceCommittee
StakeholderCommittee
Clinical Quality &PDI Committee
FinanceCommittee
ITCommittee
PAC
Governance Structure
© Bronx Health Access 6
Bronx Lebanon Hospital Center
PPS Lead Entity
BHA PPS LLCGovernance Board
PMO
Care CoordinationCross-Functional
PCMHCross-Functional
2.b.i - Ambulatory ICU 3.a.i – Behavioral Hlth2.b.iv – Care Transition2.a.i - IDS 2.a.iii - HHAR
3.f.i – Maternal & Child 4.c.ii – HIV Care4.a.iii - MHSA3.c.i – Disease Mgmt 3.d.ii - Asthma
ComplianceCommittee
WorkforceCommittee
StakeholderCommittee
Clinical Quality &PDI Committee
FinanceCommittee
ITCommittee
Cultural CompetencyCross-Functional
PAC
© Bronx Health Access 7
Funds Flow
• Project Funding
– Budget expenditure to meet milestones
• Approvals by project committee, Finance and Board
• Approximately $4.4M budgeted for DY1
• Developed Performance Funds Flow
– Worked closely with KPMG
– Allocate Percent of “Importance” to Provider Type
• Project Level
• Input from project teams
• Input from partners
• Project Funding
– Budget expenditure to meet milestones
• Approvals by project committee, Finance and Board
• Approximately $4.4M budgeted for DY1
• Developed Performance Funds Flow
– Worked closely with an independent consulting firm
– Allocate Percentages to Provider Type
• Project Level
• Input from project teams
• Input from partners
© Bronx Health Access 8
Funds Flow
BHA Involved in Many Collaborations
© Bronx Health Access 9
Collaboration
Across Committees, Workgroups and Projects
• Collaboration across Committees, Workgroups and Projects
- Steering Board- Workforce Committee- Cultural Competency and Health Literacy Workgroup- All 10 projects
• Cross-PPS Collaboration
- HIV Coalition- Mental Health Substance Abuse Infrastructure- Consent Form- EIP Contracting
• Non-PPS and Inter-Agency Collaboration
- NYC Dept of Mental Health and Hygiene- NYC Dept of Education- BronxRHIO
BHA Involved in Many Collaborations
© Bronx Health Access 10
Collaboration
4.a.iii - MHSA
BHA Involved in Many Collaborations
© Bronx Health Access 11
Collaboration
4.a.iii - MHSA
Maimonides (Brooklyn)
Health & Hospitals (multi-borough)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
BHA Involved in Many Collaborations
© Bronx Health Access 12
Collaboration
4.a.iii - MHSA
Maimonides (Brooklyn)
Health & Hospitals (multi-borough)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
NYC Dept of Health and Hygiene
NYC Dept of Education
BHA Involved in Many Collaborations
© Bronx Health Access 13
Collaboration
4.a.iii - MHSA
Maimonides (Brooklyn)
Health & Hospitals (multi-borough)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
NYC Dept of Health and Hygiene
NYC Dept of Education
Jewish Board of Family & Children’s Services
NYAM
BHA Involved in Many Collaborations
© Bronx Health Access 14
Collaboration
4.a.iii - MHSA
Maimonides (Brooklyn)
Health & Hospitals (multi-borough)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
NYC Dept of Health and Hygiene
NYC Dept of Education
Jewish Board of Family & Children’s Services
Strengthen infrastructure used to promote Mental,
Emotional and Behavioral health.
NYAM
BHA Involved in Many Collaborations
© Bronx Health Access 15
Collaboration
4.c.ii – HIV Care
BHA Involved in Many Collaborations
© Bronx Health Access 16
Collaboration
4.a.iii - MHSA 4.c.ii – HIV Care
BHA Involved in Many Collaborations
© Bronx Health Access 17
Collaboration
4.c.ii – HIV Care
Mt Sinai Hospital(Manhattan)
Health & Hospitals (Multi-borough)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
NYU Lutheran(Brooklyn)
Maimonides(Brooklyn)
NY Hospital Queens(Queens)
Montefiore(Westchester)
NYC Dept of Health and Hygiene
BHA Involved in Many Collaborations
© Bronx Health Access 18
Collaboration
4.c.ii – HIV Care
Mt Sinai Hospital(Manhattan)
Health & Hospitals (Multi-borough)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
NYU Lutheran(Brooklyn)
Maimonides(Brooklyn)
NY Hospital Queens(Queens)
Montefiore(Westchester)
Reduce Barriers to Access and Retention of
HIV Care
NYC Dept of Health and Hygiene
BHA Involved in Many Collaborations
© Bronx Health Access 19
Collaboration
4.c.ii – HIV Care
Mt Sinai Hospital(Manhattan)
Health & Hospitals (Multi-borough)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
NYU Lutheran(Brooklyn)
Maimonides(Brooklyn)
NY Hospital Queens(Queens)
Montefiore(Westchester)
Reduce Barriers to Access and Retention of
HIV Care
Recent AccomplishmentsNYC Dept of Health and Hygiene
BHA Involved in Many Collaborations
© Bronx Health Access 20
Collaboration
4.c.ii – HIV Care
Mt Sinai Hospital(Manhattan)
Health & Hospitals (Multi-borough)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
NYU Lutheran(Brooklyn)
Maimonides(Brooklyn)
NY Hospital Queens(Queens)
Montefiore(Westchester)
Reduce Barriers to Access and Retention of
HIV Care
Launched Peer Intervention Pilot
Program
Approved HIV Coalition Bylaws
Recent AccomplishmentsNYC Dept of Health and Hygiene
BHA Involved in Many Collaborations
© Bronx Health Access 21
Collaboration
4.c.ii – HIV Care
Mt Sinai Hospital(Manhattan)
Health & Hospitals (Multi-borough)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
NYU Lutheran(Brooklyn)
Maimonides(Brooklyn)
NY Hospital Queens(Queens)
Montefiore(Westchester)
Reduce Barriers to Access and Retention of
HIV Care
Launched Peer Intervention Pilot
Program
Approved HIV Coalition Bylaws
Recent AccomplishmentsNYC Dept of Health and Hygiene
BHA Involved in Many Collaborations
© Bronx Health Access 22
Collaboration
4.a.iii - MHSA 4.c.ii – HIV Care 2.a.i – IDS
BHA Involved in Many Collaborations
© Bronx Health Access 23
Collaboration
ACP(City-wide)
NYC Health & Hospitals (Bronx)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
2.a.i – IDS
BHA Involved in Many Collaborations
© Bronx Health Access 24
Collaboration
ACP(City-wide)
NYC Health & Hospitals (Bronx)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
Consent FormIndividual vs Community
2.a.i – IDS
BHA Involved in Many Collaborations
© Bronx Health Access 25
Collaboration
ACP(City-wide)
NYC Health & Hospitals (Bronx)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
Bronx RHIOConsent Form
Individual vs Community
2.a.i – IDS
BHA Involved in Many Collaborations
© Bronx Health Access 26
Collaboration
ACP(City-wide)
NYC Health & Hospitals (Bronx)
St. Barnabas(Bronx)
Bronx-Lebanon(Bronx)
Bronx RHIOConsent Form
Individual vs Community
2.a.i – IDS
BHA Involved in Many Collaborations
© Bronx Health Access 27
Collaboration
4.a.iii - MHSA 4.c.ii – HIV Care 2.a.i – IDS EIP Contracting
BHA Involved in Many Collaborations
© Bronx Health Access 28
Collaboration
Maimonides (Brooklyn)
Mt. Sinai Hospital (Manhattan)
St. Barnabas(Bronx)
Montefiore(Westchester)
Bronx-Lebanon(Bronx)
EIP Contracting
BHA Involved in Many Collaborations
© Bronx Health Access 29
Collaboration
Maimonides (Brooklyn)
Mt. Sinai Hospital (Manhattan)
St. Barnabas(Bronx)
Montefiore(Westchester)
Bronx-Lebanon(Bronx)
Operational Workgroup
Legal
Workgroup
EIP Contracting
BHA Involved in Many Collaborations
© Bronx Health Access 30
Collaboration
Maimonides (Brooklyn)
Mt. Sinai Hospital (Manhattan)
St. Barnabas(Bronx)
Montefiore(Westchester)
Bronx-Lebanon(Bronx)
Operational Workgroup
Legal
Workgroup
EIP Contracting
BHA Involved in Many Collaborations
© Bronx Health Access 31
Collaboration
Maimonides (Brooklyn)
Mt. Sinai Hospital (Manhattan)
St. Barnabas(Bronx)
Montefiore(Westchester)
Bronx-Lebanon(Bronx)
Operational Workgroup
Legal
Workgroup
MCOs EIP Contract Signed and Executed
EIP Contracting
© Bronx Health Access 32
CBOs Involvement
Cultural CompetencyCross-Functional
© Bronx Health Access 33
CBOs Involvement
Cultural CompetencyCross-Functional
Community Health Care Network
(FQHC)
Health literacy training
Cross-Functional Workgroup touches all 10 projects
© Bronx Health Access 34
CBOs Involvement
Cultural CompetencyCross-Functional
Community Health Care Network
(FQHC)
Boom! Health
(CBO)Evidence-based interventions
Health literacy training
Cross-Functional Workgroup touches all 10 projects
© Bronx Health Access 35
CBOs Involvement
Cultural CompetencyCross-Functional
Community Health Care Network
(FQHC)
Boom! Health
(CBO)
Strive
(Vocational Services)
Evidence-based interventions
Health literacy training
Training andemployment
Cross-Functional Workgroup touches all 10 projects
Governance Structure
© Bronx Health Access 36
2.b.i - Ambulatory ICU 3.a.i – Behavioral Hlth2.b.iv – Care Transition2.a.i - IDS 2.a.iii - HHAR
3.f.i – Maternal & Child 4.c.ii – HIV Care4.a.iii - MHSA3.c.i – Disease Mgmt 3.d.ii - Asthma
© Bronx Health Access 37
2.b.i - Ambulatory ICU 3.a.i – Behavioral Hlth2.b.iv – Care Transition2.a.i - IDS 2.a.iii - HHAR
3.f.i – Maternal & Child 4.c.ii – HIV Care4.a.iii - MHSA3.c.i – Disease Mgmt 3.d.ii - Asthma
CBOs Involvement
2.a.iii - HHAR
NADAP
(Vocational Svs)
Health People
(Community Support)
© Bronx Health Access 38
2.b.i - Ambulatory ICU 3.a.i – Behavioral Hlth2.b.iv – Care Transition2.a.i - IDS 2.a.iii - HHAR
3.f.i – Maternal & Child 4.c.ii – HIV Care4.a.iii - MHSA3.c.i – Disease Mgmt 3.d.ii - Asthma
CBOs Involvement
2.a.iii - HHAR
NADAP
(Vocational Svs)
Health People
(Community Support)
2.b.i – Ambulatory ICU
CASES
(MH Services)
EAC
(MH Treatment)
© Bronx Health Access 39
CBOs Involvement
2.b.i - Ambulatory ICU 3.a.i – Behavioral Hlth2.b.iv – Care Transition2.a.i - IDS 2.a.iii - HHAR
3.f.i – Maternal & Child 4.c.ii – HIV Care4.a.iii - MHSA3.c.i – Disease Mgmt 3.d.ii - Asthma
2.a.iii - HHAR 2.b.iv – Care Transition
JASA
(Home/Comm Care)
NADAP
(Vocational Svs)
NADAP
(Vocational Svs)
God’s Love We Deliver
(Community Support)
Health People
(Community Support)
2.b.i – Ambulatory ICU
CASES
(MH Services)
EAC
(MH Treatment)
© Bronx Health Access 40
CBOs Involvement
2.b.i - Ambulatory ICU 3.a.i – Behavioral Hlth2.b.iv – Care Transition2.a.i - IDS 2.a.iii - HHAR
3.f.i – Maternal & Child 4.c.ii – HIV Care4.a.iii - MHSA3.c.i – Disease Mgmt 3.d.ii - Asthma
2.a.iii - HHAR 2.b.iv – Care Transition 3.a.i – Behavioral Hlth
JASA
(Home/Comm Care)
NADAP
(Vocational Svs)
Unique People Services
(Care Coordination)
St. Christopher’s Inn
(Health Care Svs)
Catholic Charities
(Residential Svs)
Comunilife
(CBO)
Salvation Army
(Comm Support)
Three Graces Medical
(Med Group)
JASA
(Home/Comm Care)
NADAP
(Vocational Svs)
God’s Love We Deliver
(Community Support)
Health People
(Community Support)
2.b.i – Ambulatory ICU
CASES
(MH Services)
EAC
(MH Treatment)
© Bronx Health Access 41
CBOs Involvement
2.b.i - Ambulatory ICU 3.a.i – Behavioral Hlth2.b.iv – Care Transition2.a.i - IDS 2.a.iii - HHAR
3.f.i – Maternal & Child 4.c.ii – HIV Care4.a.iii - MHSA3.c.i – Disease Mgmt 3.d.ii - Asthma
2.a.iii - HHAR 2.b.iv – Care Transition 3.a.i – Behavioral Hlth 3.c.i – Disease Mgmt
JASA
(Home/Comm Care)
NADAP
(Vocational Svs)
Unique People Services
(Care Coordination)
St. Christopher’s Inn
(Health Care Svs)
Catholic Charities
(Residential Svs)
Comunilife
(CBO)
Salvation Army
(Comm Support)
Three Graces Medical
(Med Group)
JASA
(Home/Comm Care)
Health People
(Comm Support)
EAC
(MH Treatment)
God’s Love We Deliver
(Community Support)
NADAP
(Vocational Svs)
God’s Love We Deliver
(Community Support)
Health People
(Community Support)
2.b.i – Ambulatory ICU
CASES
(MH Services)
EAC
(MH Treatment)
© Bronx Health Access 42
CBOs Involvement
2.b.i - Ambulatory ICU 3.a.i – Behavioral Hlth2.b.iv – Care Transition2.a.i - IDS 2.a.iii - HHAR
3.f.i – Maternal & Child 4.c.ii – HIV Care4.a.iii - MHSA3.c.i – Disease Mgmt 3.d.ii - Asthma
2.a.iii - HHAR 2.b.iv – Care Transition 3.a.i – Behavioral Hlth 3.c.i – Disease Mgmt 3.d.ii - Asthma
Bronx Works
(Settlement House)
EAC
(MH Treatment)
Pioneer Home Care
(Home Care)
JASA
(Home/Comm Care)
NADAP
(Vocational Svs)
Unique People Services
(Care Coordination)
St. Christopher’s Inn
(Health Care Svs)
Catholic Charities
(Residential Svs)
Comunilife
(CBO)
Salvation Army
(Comm Support)
Three Graces Medical
(Med Group)
JASA
(Home/Comm Care)
Health People
(Comm Support)
EAC
(MH Treatment)
God’s Love We Deliver
(Community Support)
NADAP
(Vocational Svs)
God’s Love We Deliver
(Community Support)
Health People
(Community Support)
2.b.i – Ambulatory ICU
CASES
(MH Services)
EAC
(MH Treatment)
© Bronx Health Access 43
CBOs Involvement
2.a.iii - HHAR 2.b.iv – Care Transition 3.a.i – Behavioral Hlth 3.c.i – Disease Mgmt 3.d.ii - Asthma 3.f.i – Maternal & Child
Pioneer Home Care
(Home Care)
SKIP of New York
(Disabled Children Care)
2.b.i - Ambulatory ICU 3.a.i – Behavioral Hlth2.b.iv – Care Transition2.a.i - IDS 2.a.iii - HHAR
3.f.i – Maternal & Child 4.c.ii – HIV Care4.a.iii - MHSA3.c.i – Disease Mgmt 3.d.ii - Asthma
Bronx Works
(Settlement House)
EAC
(MH Treatment)
Pioneer Home Care
(Home Care)
JASA
(Home/Comm Care)
NADAP
(Vocational Svs)
Unique People Services
(Care Coordination)
St. Christopher’s Inn
(Health Care Svs)
Catholic Charities
(Residential Svs)
Comunilife
(CBO)
Salvation Army
(Comm Support)
Three Graces Medical
(Med Group)
JASA
(Home/Comm Care)
Health People
(Comm Support)
EAC
(MH Treatment)
God’s Love We Deliver
(Community Support)
NADAP
(Vocational Svs)
God’s Love We Deliver
(Community Support)
Health People
(Community Support)
2.b.i – Ambulatory ICU
CASES
(MH Services)
EAC
(MH Treatment)
Preparing for Workforce Future State
© Bronx Health Access 44
■ Identify training needs and gaps
■ Assess workforce skill development needs for clinical staff redeploying
■ Survey partners to identify and leverage training resources
■ Analyze PPS infrastructure changes to develop Leadership & HIT Training Programs
Future State Training
■ Leverage current & new curriculum to enhance workforce skills
■ Evaluate new skills and credentials needed to support advanced Information Technology
■ Focus on diversity in recruitment strategies
Assessing Skill
Development Needs
■ Evaluate Partner & Practitioner Engagement needs
■ Project workgroups design standards of care by project
■ Focus on Partner understanding, awareness, and buy-in of the DSRIP transformation
■ Developing Employee Engagement Plans that help align partners and facilitate adoption of the changes
■ Partners will be involved in designing project workflows & workforce competencies needed for the Six HEDIS® Hybrid Measures
■ Evidence-based Guidelines and Processes are being integrated into the standards of care for each project
■ Target training and development programs in alignment with both specific job category needs and DSRIP business imperatives
Linking Training to
PerformancePartner Engagement
and Input
Care Coordination Functional Workgroup
© Bronx Health Access 45
Care Coordination
Cross-Functional
Workgroup
2.a.i
2.a.iii
2.b.i
2.b.iv
3.a.i
3.c.i
3.d.ii
3.f.i
4.a.ii
4.c.ii
Care Coordination Functional Workgroup
© Bronx Health Access 46
Improve Synergy between Projects and Organizational Work Streams
All 10 Projects Must Structure and Deploy Care Coordination Services
The Care Coordination Cross-Functional Workgroup Responsible for Developing Care Coordination Standards and Protocols
Care Coordination Functional Workgroup
© Bronx Health Access 47
Improve Synergy between Projects and Organizational Work Streams
All 10 Projects Must Structure and Deploy Care Coordination Services
The Care Coordination Cross-Functional Workgroup Responsible for Developing Care Coordination Standards and Protocols
Four-Step Process
Care Coordination Functional Workgroup
© Bronx Health Access 48
PatientEncounter
Care Coordination Functional Workgroup
© Bronx Health Access 49
Process Patient
Care Coordination Functional Workgroup
© Bronx Health Access 50
Assignment and Alert
Care Coordination Functional Workgroup
© Bronx Health Access 51
Care Coordination
Care Coordination Functional Workgroup
© Bronx Health Access 52
Care Coordination Functional Workgroup
© Bronx Health Access 53
2.b.ivCare Transitions
© Bronx Health Access 54
2biv Care Transitions
Clearinghouse
Admitted Patient
Clearinghouse Functionality
- Risk Stratification- Continuity by Provider/Care Management Agency- Clinical Integration of Psychosocial Drivers of Health
Primary CareCare CoordinationEnabling Services Specialty Care
© Bronx Health Access 55
2biv Care Transitions
Clearinghouse
Ambulatory Patient
Clearinghouse Functionality
- RHIO Data- Outcomes Driven- 7-Day appointments- HEDIS Measures- Engagement Metrics
Primary CareCare CoordinationEnabling Services Specialty Care
PMO Staff
© Bronx Health Access 56
PMO
KathyAlexis
KathleenCraig
DuaneGranston
SteveMaggio
GaryRosario
VirgilinaGonzalez
Dr. IsaacDapkins
JessicaColon
Bronx-Lebanon Hospital Center PPS, LLC