Health & Wellness
Alliance for Children
Common Agenda
What is The Alliance?
Who We Are
•
Coalition of community organizations established to improve the health and well being of
children in Dallas County
•
An organized & engaged group of community stakeholders aligned around a common agenda
for positive change in pediatric health (initially focusing on pediatric asthma)
•
Funded and supported by Children’s Medical Center
Who We Represent
•
The voice of children and their families
•
Social service organizations
•
Educators, universities, school districts & day care centers
•
Faith-based organizations
•
Hospitals and health clinics
•
Government entities
•
Donors
The Health and Wellness Alliance for Children – “It’s About the Kids”
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Challenges and Focus - Asthma
Why Focus on Children’s Health?
•
Dallas County has cutting edge medical facilities and a community dedicated to its
children, yet the current state of children’s health in Dallas County is not in line with
the community’s vision:
- 29% of our kids live in poverty
- 18% do not have health insurance
- 28% have inadequate food and nutrition
Why Initially Focus on Asthma?
•
60,000 children in Dallas have asthma, nearly 9% of all Dallas children
•
Asthma is a manageable condition, yet:
- In 2010, 3 children per day visited a Dallas County hospital for their asthma
- In Texas, 54% of children with asthma missed at least one school day per year
due to their condition
- The cost of unmanaged asthma in Dallas (to families and medical facilities) is estimated at $60M per year
•
We can apply what we learn about the social and environmental determinants of asthma to
address other conditions in the future
The Health and Wellness Alliance for Children – “It’s About the Kids”
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The Asthma Wellness Equation
The Health and Wellness Alliance for Children – “It’s About the Kids”
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The Alliance Goals - Asthma
EVERY child with asthma achieves their fullest health,
well-being and potential
•
The Alliance seeks to reduce or eliminate the burden that asthma places on children,
families and the community by developing strategies that address each of the components
of the asthma wellness equation.
•
Indicators that the Alliance is evaluating to track progress include the following:
1. Hospitalizations due to asthma
2. Emergency department visits due to asthma
3. Average asthma control test score
The Health and Wellness Alliance for Children – “It’s About the Kids”
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Approach to Achieving Our Goal:
Collective Impact
Five Conditions of Collective Impact
1. Common Agenda
• Common understanding of the problem
• Shared vision for change
2. Shared Measurement
• Collecting data and measuring results
• Focus on performance management
• Shared accountability
3. Mutually Reinforcing Activities
• Differentiated approaches
• Willingness to adapt individual activities
• Coordination through joint plan of action
4. Continuous Communication
• Consistent and open communication
• Focus on building trust
5. Backbone Support
• Separate organization(s) with staff
• Resources and skills to convene and coordinate participating organizations
The Health and Wellness Alliance for Children – “It’s About the Kids”
Structure of Work
EVERY child with asthma achieves their fullest health,
well-being and potential
Backbone Staff Support
Steering Committee provides guidance and oversight
Working groups of community partners plan and implement strategies
Asthma-Healthy Physical
Environments
High Quality Health Care
Improved Access to
Health Care
Equipping Children and
Families For Asthma Wellness
Connecting groups will support strategies across working groups
Policy Group
The Health and Wellness Alliance for Children – “It’s About the Kids”
Data Group
FSG.ORG
DRAFT
Strategy Indicators
DRAFT
Working Group Indicators
Working
Group Goal
Working
Group
Big Goal +
Indicator
Health and Wellness Alliance Goals & Indicators
Every child with asthma achieves their fullest health, well -being, and potential.
1. Child hospitalizations due to asthma in Dallas County
2. Child emergency department visits due to asthma in Dallas County
3. Asthma control test (ACT) scores for children in Dallas County
Equipping Children &
Families for Asthma
Wellness
Improved Access to
Health Care
Asthma-Healthy Physical
Environments
Create awareness and sense
of power among children and
families regarding asthma
management.
Remove barriers for families to
get the necessary care and
medications they need to
manage asthma.
Create safe places for children
to live, learn and play free from
asthma triggers.
Ensure that medical care
providers have accessible and
consistent information about
childhood asthma.
% of children / families who
report asthma interfering with
home/work/school on the
Asthma Control Test
Medication possession ratio %
of children with asthma who
have had a preventive care
visit in the last 12 months
Prevalence of triggers in
targeted households
Controller to rescue
medication ratio
% of schools in Dallas County
who implement indoor airquality guidelines of Tools for
Schools program
% of children who visit hospital
or ER who have PCP follow
up within 14 days
Families perspective on
whether they can get the
primary care they need to
manage asthma
# alternative primary care
appointments created
# of navigation guides
distributed
.
# daycares implementing
indoor air quality guidelines
# of day cares or schools
implementing flag program
8
% of children who have had
ACT score recorded
% of children who have an
asthma action plan
ER & hospital repeat visit rates
# parents or # kids
participating in education
sessions
# community members trained
Knowledge change after
education
High-Quality Health Care
# of organizations who agree
to use universal AAP
# physicians participating in
asthma-specific training
© 2013 FSG
FSG.ORG
Working Group Strategies
Equipping Children and Families for Asthma Wellness
Testing a holistic approach in Jubilee Park to include:
• Screening for asthma (health fair-style) with information on
resources for medical care, insurance, and other items
• Parent/caregiver education class with opportunity for parent
to identify specific actions he/she can take
• Followup with parents to address challenges (phone and inperson)
Future strategies to include:
• Create peer groups (same age, older to younger kids) to
teach, support, and encourage children with asthma
• Deliver in-home education for parents/children
• Train community residents to serve as community health
workers OR other asthma health literacy educators from the
community to provide asthma education to families in their
neighborhoods in variety of settings
•
•
•
•
•
Asthma-Healthy Physical Environments
• Assess and identify schools with high levels of allergens
and implement EPA indoor air quality tools
DRAFT
Improved Access to Health Care
Make asthma medications more affordable by:
1.) Publishing guides for patients on how to get low-cost and
free medications 2.) Studying insurance coverage policies
and, if necessary, advocating for expanded coverage of
medications 3.) Working with pharmaceutical companies to
provide medications
Expand alternative forms of primary care such as shared
medical appointments, walk-in clinics for asthma patients
Create an asthma hotline or mobile app that families can
use to address questions and concerns about asthma 24/7
Create resources guides and/or navigational services to
help families identify free and low cost asthma-related health
care services and transportation
Increase the portion of physicians who will accept
Medicaid/CHIP patients by increasing the reimbursement
High-Quality Health Care
• Work towards universal usage of standardized asthma
action plans by all providers in Dallas. This involves
encouraging providers who don’t use a plan to do so,
recommending the use of standardized plan(s) by all
providers, and recommending that electronic health record
systems contain standard asthma plan components
• Train providers (MDs, PAs, NPs) on ERP-3 guidelines and
provide tools and techniques to have effective conversations
with patients about asthma management
• Identify key messages/education tools related to asthma
wellness for non-healthcare providers who may have contact
with children with asthma. Families WG will work to equip
those partners (i.e. coaches, daycare workers, teachers, faith
community)
• Partner with day cares to implement indoor air quality tools
• Work with city inspectors to add relevant environmental
questions to daycare checklists
• Targeted in-home environmental trigger identification
and interventions in areas of high distressed housing
• Enact anti-idling policies in areas frequented by
children/families
• Coordinate high-ozone day programs (flags, billboard
warnings) with clear messages for citizen action, using new
technology as possible
• Align with existing North Texas air quality initiatives
9
© 2013 FSG
HWAC Steering Committee Members
Steering Committee Members as of April 1, 2014
Ron J. Anderson, M.D., MACP
Retired President and CEO
Parkland Health & Hospital System
Julie Bagley
President Elect
Junior League of Dallas
Cheryl Boswell
VP, Community Health and Well-Being
YMCA of Dallas
Brent A. Brown
Director
bcWorkshop
Bill Dawkins
Chief Financial Officer
H.I.S. Bridgebuilders
Jennifer Edwards
UPSTREAM Population Health
Rebecca Gruchalla, M.D.
Prof. of Medicine & Pediatrics, UTSW
Div. Dir. Allergy & Immunology
Children’s Medical Center of Dallas
Holly Hassmann
Vice President and Executive Director
Health and Wellness Alliance for Children
Susan Hoff
Chief Strategy Officer
United Way of Metropolitan Dallas
Larry James
President and CEO
CitySquare
Suzanne Kubelka
Director, Health Services
DISD
Tori Mannes
President and CEO
Child Care Group
Leonor Marquez
Chief Executive Officer
Los Barrios Unidos Comm. Clinic
Julie Martellini, PhD
Epidemiology Program Planner
Dallas County Health & Human Services
John Martinez
President
Regional Hispanic Contractors Assoc.
Cynthia Mickens
Founder and CEO
Cynthia Mickens Ministries
Sue Pickens
Director, Population Medicine
Parkland Health & Hospital System
Peter Roberts**
EVP, Population Health and Network Dev.
Children’s Medical Center of Dallas
Michael Samuelson
Sr. Consultant Population Health
Samuelson Health and Wellness Solutions
The Health and Wellness Alliance for Children – “It’s About the Kids”
Eduardo Sanchez, M.D.**
Deputy CMO
American Heart Association
Paula Selzer
Regional Coordinator
Children’s Environmental Health
US Environmental Protection Agency Reg. 6
John Siburt
Vice President of Programs
CitySquare
Joyce Tapley
Chief Executive Officer
The Martin Luther King, Jr. Family Clinic
Anne Thomas
Executive Director
AVANCE Dallas
Candace M. Thompson
Community Outreach Manager
Jubilee Park & Community Center
Larry Tubb
Sr. Vice President, System Planning
Cook Children’s Medical Center
Rhonda L. Walton, M.D.
Pediatrician
CitySquare Community Health Services
Keith Zimmerman
Chief Executive Officer
Medical City Children’s Hospital
**Steering Committee Co-Chair
HWAC Working Group Members
Working Group Members as of April 1, 2014
Asthma Healthy Physical Environments
Equipping Children and Families for Asthma Wellness
Brent Brown, bcWorkshop (Co-chair)
Cheryl Boswell, YMCA of Metropolitan Dallas (Co-chair)
Paula Selzer, EPA (Co-chair)
Anne Crowther, Children’s Medical Center (Co-chair)
Brooke Etie, LMSW, Dallas Housing Association
Bonner Allen, Junior League of Dallas
Loletha Horton, YMCA of Metropolitan Dallas
Lisa Bracken, Educational Consultant and Project Management
Nick Kunz, bcWorkshop
Nathan Edgerton, United Way
John Martinez, Regional Hispanic Contractors Association
Phyllis Kane, MyChildren’s
Mindy Mize, North Texas Council of Governments
Cynthia Mickens, Methodist Health Center
Kathryn McCartney, Head Start of Greater Dallas
Lister Robinson, Children’s Medical Center
Susan Spalding, M.D., Parkland
David Thomas, Bryan’s House
Whitney Vandiver, North Texas Council of Governments
Candace Thompson, Jubilee Park and Community Center
Danielle Wesley, Children’s Medical Center
Improved Access to Health Care
High Quality Health Care
Anne Thomas, AVANCE Care (Co-chair)
Leann Kridelbaugh, M.D., MyChildren’s (Co-chair)
Lois Trammell, Children’s Medical Center (Co-chair)
Joyce Tapley, The Martin Luther King, Jr. Family Clinic (Co-chair)
Valerie Bradley, City of Mesquite
Beth Dittman, Mesquite ISD, Health Services
Bill Dawkins, H.I.S. Builders
Barry Lachman, M.D., Parkland Community Health Plan/Asthma Action
Coalition
Bob English, DART
Tori Mannes, Child Care Group
Anthony Luedicke, R.Ph., Walgreen’s Pharmacy
Lori Millner, Texas Area Health Education Center East, UT Southwestern
Donna Persaud, M.D., Parkland
Veronica Moore, Health and Human Services
Hernan Reyes, M.D., HRSA
Cassandra Singleton, PediPlace
Larry Robins, PediPlace
Jill Strachan-Batson, M.D., Parkland Youth Family Centers
Martha Rodriguez, Health and Human Services
Suzanne Kubelka, Dallas Independent School District
John Siburt, CitySquare
Joanne Tenery, Parkland Community Health Plan
Matthew Thieman, PharmD, Walgreen’s Pharmacy
Ray Tsai, M.D., MyChildren’s
The Health and Wellness Alliance for Children – “It’s About the Kids”
**Steering Committee Co-Chair