leveraging o&e assisters in community health centerschamps/cchn 2017 outreach and enrollment...
TRANSCRIPT
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CHAMPS/CCHN 2017 Outreach and Enrollment Distance Learning Series
Leveraging O&E Assisters in Community Health Centers
July 27, 2017
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Presented By: Ted Henson, National Association of Community Health Centers,
Jaspreet Malhotra, MPH, Michigan Primary Care Association, and Cherise Fowler, Alaska Primary Care Association
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Community Health Association of Mountain/Plains States (CHAMPS)
Member Benefits
• Two seats on the CHAMPS Board of Directors
• Free access to online CHAMPS Live and Archived Distance Learning Events
• Two free copies of the 2017-2018 CHAMPS Region VIII Health Center Directory
• Discounted registration for CHAMPS face-to-face trainings plus opportunities for registration and clinical travel reimbursement
• Access to the Members Only section of the CHAMPS Website
• Direct advertising of newly active Job Opportunities Bank (JOB) postings to job seekers
• And much more
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Colorado Community Health Network (CCHN)
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2017 O&E Distance Learning Series
Upcoming Events
• Leveraging O&E Assisters in Community Health Centers– July 27, 2017
• Strengthening Your Compassion Resiliency Toolkit– August 24, 2017
• Preparing for OE5: Addressing Changes in the Marketplace– September 21, 2017
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Presented by:
TED HENSON Director/Health Center Growth & Innovation, NACHC [email protected] www.nachc.com
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Health Center Footprint
1,300+
# of health
centers
reporting on
O&E
18 million
# of assists
into
coverage
since 2013
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Federal Expectations around Outreach and
Enrollment
Health Center O&E Activities
• O&E funding is part of health center base
grant funding
• Expectations around O&E activities are the
same!
• Changes in Reporting Transitioning from
QPRs to UDS reporting
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Federal Expectations around Outreach and
Enrollment
1:1
customizable
education
sessions
Securing access
to Medicaid, CHIP
and other
available health,
social service,
pharmacy and
other assistance
programs;
SEPs
Conduct
targeted
outreach
File appeals/
exemptions
Planning &
Maintaining
Partnerships to
reach the
uninsured
Conduct
in-reach Assist with
understanding
coverage /
Health
Insurance
Literacy
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Continuing, Enhancing O&E in
Times of Uncertainty
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Demonstrate Value of O&E
NACHC’s Outreach and Enrollment Case Studies
Goal: Demonstrate the impact that investing in outreach and enrollment
activities has on a health center’s finances, operations, and
patient/community health.
• Borinquen Medical Centers of Miami-Dade, Miami, FL
• Partnership Community Health Center, Appleton, WI
• Mountain Comprehensive Health Corporation, Whitesburg, KY
http://www.nachc.org/health-center-issues/outreach-and-
enrollment/information-and-resources/
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Social Determinants of Health (SDOH)
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Tackling SDOH in Health Centers
• Addressing social determinants through providing
enabling services
• Enabling services are defined as:
“Non-clinical services that aim to increase access to
healthcare and improve health outcomes”
• Examples: health education, interpretation, and case
management
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Work Force
• Workforce:
– UDS collects data on 7 categories of enabling
services personnel
– 89% of FTEs come from 4 categories:
• case managers
• eligibility assistance workers
• outreach workers
• patient/community education specialists
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PRAPARE
• The Protocol for Responding to and Assessing
Patients’ Assets, Risks, and Experiences
(PRAPARE)
• National effort to help health centers and other
providers collect and apply the data they need to
better understand their patients’ social
determinants of health
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Future of the O&E, Assister Workforce
• Enrollment assisters play
an important, growing role
at health centers
• Assisters address many
social determinants of
health
• Investing in the
cross-training of
CACs/Navigators
provides multiple upsides
for health centers and
patients:
• CHWs
• Patient Navigators
• VITA Volunteers
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Presented by:
JASPREET MALHOTRA, MPH, Enabling Services Manager, Michigan Primary Care Association
[email protected] www.mpca.net
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Integrating CHWs and Enrollment Roles
Community Health Workers
Outreach and
Enrollment Assisters
Experts in System Navigation, Education, and Advocacy
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Getting Started
Cross-train!
CHW core competencies
Health coverage enrollment training
Integrate health coverage outreach, education, and enrollment into all services delivered
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Shared Roles
Communication Coaching & Social
Supports
Service Coordination &
Navigation
Capacity Building Advocacy
Culturally Appropriate Education & Mediation
Individual & Community Assessment
Outreach Participation and
Research
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Enrollment Assister and CHW
Models
Ingham Community Health Centers
Lansing, MI
Great Lakes Bay Health Centers
Saginaw, MI
Mercy Health-St. Mary’s Community Health Centers
Grand Rapids, MI
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Work as a Team
Cross training both CHWs and
O/E staff
Make referrals and connecting to
community based resources
Use daily huddles to debrief, share
resources, troubleshoot
issues
O/E Staff and CHW work with
each other to prioritize and
respond
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Work as a Team
Example Approach 1:
Cross training both CHWs and
O/E staff
Make referrals and connecting to
community based resources
Use daily huddles to debrief, share
resources, troubleshoot
issues
O/E Staff and CHW work with
each other to prioritize and
respond
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Work as a Team
Example Approach 2:
Redefine the roles and
responsibilities
Cross train staff to combine the two roles – “no wrong door” approach
Monthly meetings to
debrief
CHW works with patients to prioritize
and respond
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Impact on Patient Outcomes
Community based supports can improve health1
Health insurance related to improved
management and control of chronic conditions2
Increased rates of care3
Increased rates of diabetes and cholesterol
diagnoses3
1. Financing Community Health Workers: Why and How. (2007, January 2). Retrieved from
http://www.publicsectorconsultants.com/wp-
content/uploads/2017/01/ColumbiaUniv_Financing_CommHealthWrkrs_PolicyBrief.pdf
2. Hogan, D. R., Danaei, G., Ezzati, M., Clarke, P. M., Jha, A. K., & Salomon, J. A. (2015, September). Estimating The Potential
Impact Of Insurance Expansion On Undiagnosed And Uncontrolled Chronic Conditions. Retrieved from
http://content.healthaffairs.org/content/34/9/1554.full
3. Rivero, E. (2016, April 18). Medicaid expansion significantly boosts insurance coverage among low-income adults.
Retrieved from http://newsroom.ucla.edu/releases/medicaid-expansion-significantly-boosts-insurance-coverage-among-
low-income-adults
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Resources:
NACHC Issue Brief: Expanding the Role of the
Enrollment Assister at Community Health
Centers
Michigan PCA’s CHW Toolkit
Michigan PCA’s O/E Toolkit
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Presented by:
CHERISE FOWLER Apprenticeship Training Coordinator, Alaska Primary Care Association
[email protected] www.apcaapprentice.com
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Introduction
Have you wondered how
you can increase your
capacity as an enrollment
assister, NOW?
With all the news and
changes to the ACA
underway we need to stay
the course and keep helping
people in our communities
that need our help!
1
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Alaska’s CHW Apprenticeship Program
1 year program
Ideal candidates work in health centers as O&E
Assisters or Navigators for the ACA
Meet one hour weekly for one hour distance delivered
training
Funding for program provided by Alaska Department
of Labor
All training and final exam is distance delivered.
Apprentices will not leave their community to gain
certification.
2
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Why the Need?
There are many barriers to health care including:
• Access to the Health Care System
• Lack of Understanding of how to navigate the health care
system
• Uninsured/Underinsured/Underserved
• Transportation
• Access to Primary Provider
• Access to Medications
• Health Literacy
• Education on Illness
• Communication
• Social Determinants of Health
3
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Why You?
You’re ALREADY a trusted
member in the community
You have established relationships
You have links to various agencies
You already have the skills it takes
You can help people manage their
health
4
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Improving Health Outcomes
You can help people navigate
the healthcare system, serve
as a health coach and help
others surmount barriers. You
can also connect your clients
to resources they may not
have known about.
5
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Care Coordination Stages
Complete an initial assessment
Identify Goals
Develop a care plan with clients
Implement plan
Refer as needed
Follow up
Monitor outcomes
Advocate
Celebrate reached goals and improved
outcomes
6
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Sample Intake Form
7
Date:
Client Name:
Client ID:
CHW Name:
Clients Primary Goal(s):
1.
2.
Actions to take to reach the health
goal are: _______________________
Will do this _____ times/week for____
One a scale of 1-10, confidence
completing this plan is ______
Resources (internal and
external) that will help to reach
the goal are:
Challenges that may get in the
way are:
Ways to overcome or resist these
challenges are:
Referrals Provided:
Next Meeting:
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Sample Progress Notes
8
Date:
Progress Notes (document the client’s progress in implementing their Action Plan,
including successes and challenges)
The client made the following progress in implementing their Action Plan (include
actions taken, when and where)
The client faced the following challenges:
The client wants to make the following changes to their action plan:
Referrals provided:
On a scale from 0-10 the client rates their confidence for moving forward with their
Action Plan at______
Other Notes:
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Referrals are Gold!
9
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Sample Resource Form
10
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O&E Best Practices
Continue to provide your clients enrollment and
re-enrollment support
Help people navigate the healthcare system and
utilize their coverage
Storybank whenever possible
Continue to stay informed about news in relation to
the ACA
11
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Expanding Your Role
12
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What can you do now?
Enhance your screening and initial intake processes
Educate yourself and learn more about the needs of
your community, clients and health center. Where are
the gaps?
Build relationships with local social service agencies
Build a strong referral network and resource list
Connect clients with additional support services:
• Food Stamps
• WIC
• Housing Assistance
• Temporary Assistance
• Job Centers 13
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QUESTIONS? Type any questions into the chat box at the bottom of the screen.
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2017 O&E Distance Learning Series
Upcoming Events
• Strengthening Your Compassion Resiliency Toolkit– August 24, 2017
• Preparing for OE5: Addressing Changes in the Marketplace– September 21, 2017
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CHAMPS/CCHN 2017 Outreach and Enrollment Distance Learning Series
Thank You
“Everyone can be great because anyone can serve. You don’t have to have a college degree
to serve. You don’t even have to make your subject and your verb agree to serve… You only need a heart full of grace, a soul generated by
love.”
Dr. Martin Luther King, Jr.
www.champsonline.org www.cchn.org