hmprg safety net initiative history- lon berkeley
DESCRIPTION
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)TRANSCRIPT
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“Setting the Stage: The Case for Regional Action to
Strengthen the Safety Net”
Lon M. BerkeleyHealth & Medicine Policy Research GroupRegional Health Care Safety Net Summit
June 23, 2009
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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
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PHASES (TIMING)
TASK METHODS &ACTIVITIES
OTHERIMPORTANT
DEVELOPMENTS
Stage I(1/06-8/08)
Convene/organize the players
Define the Problem
Collect/analyze Data
Shape the scope
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
o Crisis in funding for Cook County Health Services
o New Cook County Health & Hospitals Systems (CCHHS) Board created
o CMAP (Chicago) Metropolitan Agency for Planning) begins “Go To 2040” plan
“MOVING THE BALL DOWN THE FIELD”
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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
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PHASES (TIMING)
TASK METHODS & ACTIVITIES
OTHER IMPORTANT DEVELOP-
MENTS
Stage II(9/08-5/09)
Prioritize Problems
Draft & Vet preliminary recommendations
Plan Summit
1) Convene Pre-summit conference
2) Meetings of Summit Planning Committee
3) Solicit written feedback
4) Prepare “Call for Summit”
o New US President
o New IL Governor
o CCHHS initiates strategic planning
o Economic crisis
“MOVING THE BALL DOWN THE FIELD”
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PHASES
TASK METHODS & ACTIVITIES OTHER IMPORTANT DEVELOPMTS
Stage III(6/09 - ?)
Finalize regional blueprint
Identify & engage additional implementers
To Do: Solicit funding & political support
To Do: Identify leadership for next steps
1) Convene Summit Conference with HRSA co-sponsorship
2) Presentations on regional models
3) Endorse Regional Health Pact & Call to Leaders
4) Implement pilot project(s)?
5) “Field trips” to other counties outside NE IL?
o National Health Care Reform Deliberations
o Federal stimulus funding for health information technology
“MOVING THE BALL DOWN THE FIELD”
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KEY TERMINOLOGY OF INITIATIVE
Health
Safety Net
Regional
Vulnerable Populations
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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.
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WHAT DO WE NOT MEAN BY THE “HEALTH CARE SAFETY NET”?
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WHAT DO WE NOT MEAN BY THE “HEALTH CARE SAFETY NET”?
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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.
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WHAT DO WE MEAN BY THE “HEALTH CARE SAFETY NET”?
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WHAT DO WE MEAN BY “Regional”?
• INCLUDES COUNTIES OF:> Cook > DuPage
> Kane > Kendall
> Lake > McHenry
> Will
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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
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KEY ASSUMPTIONS OF INITIATIVE
1) 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.
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KEY ASSUMPTIONS OF INITIATIVE
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
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KEY ASSUMPTIONS OF INITIATIVE
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).
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Other Sectors:Housing, EducationTranportation, 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
Who Takes Care of Your Health?
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KEY ASSUMPTIONS OF INITIATIVE
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.
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THE WHO Health System Conceptual Framework
Source: WHO Health System Strengthening Strategy 2007
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KEY ASSUMPTIONS OF INITIATIVE
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.
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KEY ASSUMPTIONS OF INITIATIVE
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.
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KEY ASSUMPTIONS OF INITIATIVE
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.
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A Demographic Snapshot of the Region
Russell J. PietrowiakAssociate Planner
Chicago Metropolitan Agency for Planning
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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%
Total Population Change by County from 1990 - 2006
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Changing Demographics in Cook County
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Constant growth over more than 3 decades(*6 counties)
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Latinos have the highest rates of uninsured persons in Illinois
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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
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CMAP GoTo 2040: The Plan For Health
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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.
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CMAP GoTo 2040: The Plan For Health
• 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.
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CMAP GoTo 2040: The Plan For Health
4 Recommended Strategies:1. Integrated prevention and health promotion
strategy that will integrate the regional planning agenda with health policy issues and integrate the participants in the process.
2. Move toward an all data-real time concept that builds on electronic medical records.
3. Address workforce concerns.
4. Strengthen the public health infrastructure in response to early signs of deterioration.
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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
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BUILDING A BETTER WORLD
• CURRENT STATE
TRANSITIONAL STATE
IMPROVED STATE
DESIRED STATE
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Moving Recommendations to Action
• Preliminary Recommendation Categories– Data/IT– Workforce– Access– Health Equity– Finance– Planning Approaches
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Moving Recommendations to Action
• 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
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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.
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Japanese Proverb
“Vision without action is a daydream …..
…action without vision is a nightmare.”