Community-Centered
Health Homes
Demonstration Project
Introductory Webinar
Friday, October 17, 2014
12:00 – 1:30 PM CST
Agenda
Welcome
Dr . Eric Baumgartner, Community Health Strategist, LPHI
Introduction to Community Prevention and the
Community-Centered Health Home Model
Rea Pañares, Senior Advisor, Prevention Institute
Community-Centered Health Home Demonstration Project
Jaymee L. Lewis, CCHH Program Manager, LPHI
Questions and Answers
2
Gulf Region Health Outreach Program:
Primary Care Capacity Project
Dr. Eric T. Baumgartner
3
Gulf Region Health Outreach
Program (GRHOP)
Series of five integrated projects over five years extending from 2012 2017.
•
•
•
•
•
Primary Care Capacity Project (PCCP)
Mental and Behavioral Health Capacity Project (MBHCP)
Environmental Health Capacity and Literacy Project (EHCLP)
Community Health Workers Training Project (CHWTP)
Community Involvement
Developed jointly by BP and the Plaintiff Steering committee as part of
the Deepwater Horizon Medical Benefits Class Action Settlement.
Supervised by the Federal Court and the GRHOP Coordinating
committee.
4
Gulf Region Health Outreach
Program (GRHOP)
5
Target Beneficiaries of GRHOP
GRHOP target beneficiaries are residents, especially the uninsured and
medically underserved, of 17 coastal counties and parishes.
Florida
•
•
•
•
•
Escambia
Santa Rosa
Walton
Okaloosa
Bay
Alabama
• Mobile
• Baldwin
Mississippi
• Hancock
• Harrison
• Jackson
Louisiana
•
•
•
•
•
•
•
Orleans
Jefferson
Plaquemines
St. Bernard
Terrebonne
Lafourche
Cameron
6
Primary Care Capacity Project
(PCCP)
Seeks to improve access to high quality, integrated, patientcentered care in the 17 designate GRHOP parishes/ counties in
support of sustainability and resilience of the Central Gulf Coast.
Guiding Principles
• Commitments to communities we serve to be transparent,
responsive, and respectful
• Creating lasting community benefit
• Supporting the alignment of community assets that support
high-quality primary care services
• Drawing from the evidence based practices when designing
interventions
• Working collaboratively to advance the PCCP mission
7
PCCP Strategies
I.
“Direct focal” funding to some clinics – already implemented per
settlement terms and priorities, no new clinics planned
II. Technical Assistance and Regional Care Collaborative peer
exchange
III. “Systems” investments in support of multiple clinics
in quality and systems of care
• AL – electronic health systems interfaces to support
behavioral health integration (pending)
• MS – C-Change – community cancer outreach and access (under way)
• MS-HIN – HIE ability to provide ADT notification to coastal CHC (pending)
• LA – GNOHIE (already in play), 504HN (already in play), Quality
initiative in support of GNOCHC (pending)
• 4 States: Community-Centered
Health Home
Demonstration Project – the purpose of this
informational webinar
Primary Care Capacity Project
Community-Centered Health
Home Demo Project
The Community-Centered Health Home (CCHH)
Demonstration Projection a part of the PCCP of the
GRHOP aims to advance health equity and community
resiliency by enhancing the capacity of selected
health center sites to take the next step beyond the
patient-centered medical home model and serve as
trusted, effective partners in community prevention.
9
Community Prevention and the
Community-Centered Health Home
Rea Pañares, MHS
10
Community-Centered
Health Home Model:
An Overview
Webinar
Louisiana Public Health Institute
October 17, 2014
Rea Pañares, MHS
Senior Advisor
a systematic process that reduces the frequency and/or
severity of illness or injury.
Promotes healthy environments and behaviors to prevent
problems from occurring before the onset of symptoms

Child Restraint and Safety Belt Use

Smoking Prevention

Minimum Drinking Age Laws

Childhood Immunizations

Motorcycle and Bicycle Helmet Laws

Reduced Lead Levels in Children
The Triple Aim
Influencing Policy & Legislation
Changing Organizational Practices
Fostering Coalitions & Networks
Educating Providers
Promoting Community Education
Strengthening Individual Knowledge & Skills
IHI Triple Aim image courtesy of Northern New England Accountable Care Collaborative: http://nneacc.com/
The Spectrum of Prevention
Influencing Policy & Legislation
Changing Organizational Practices
Fostering Coalitions & Networks
Educating Providers
Promoting Community Education
Strengthening Individual Knowledge & Skills
Swift & Cohen. Injury Prevention (1999)
Community-Centered
Health Homes
Community-Centered
Health Homes
Patient-Centered
Medical Homes
Medical
Homes
A Different Way
to Think about Health Care
Photo Credit: Daniel Bernstein
“The last time
we looked in the
book, the
specific therapy
for malnutrition
was food.”
- Jack Geiger, MD
Take 2
Steps to
Prevention
Environment
Exposures &
Behaviors
Medical
Services
st
1
The
step ...
Environment
Exposures &
Behaviors
Medical
Services
Let’s take
another
step ...
Environment
Exposures &
Behaviors
Medical
Services
What’s Sold and Promoted
Elements of Community Health
EQUITABLE
OPPORTUNITY
HEALTH CARE SERVICES

Racial justice

Preventative services

Jobs & local ownership

Access

Education

PLACE

What’s sold & how it’s
promoted
Treatment quality, disease
management, in-patient services,
& alternative medicine

Cultural competence

Emergency response
PEOPLE

Look, feel & safety

Parks & open space


Getting around


Housing

Air, water, soil

Arts & culture

Social networks & trust
Participation & willingness to act
for the common good
Norms/Costumbres
“
It is unreasonable to expect
that people will change their
behavior easily when so many
forces in the social, cultural,
and physical environment
”
conspire against such change.
- Institute of Medicine
Source: Institute of Medicine. (2000). Promoting health: Intervention strategies from social and
behavioral research (B. D. Smedley & L. S. Syme, Eds.). Washington, DC: National Academies Press.
Existing Clinician Skills
PATIENT
INTAKE
DIAGNOSIS
TREATMENT
Transferable to Community Prevention
INQUIRY
ANALYSIS
ACTION
Capture and
identify
population
level health
trends
Analyze and
prioritize
relevant
community
conditions
Engage in
advocacy and
translate clinic
priorities into
action
Inquiry
EQUITABLE
OPPORTUNITY


HEALTH CARE SERVICES

Preventative services
Education

Access
Living wages & local
wealth

PLACE

What’s sold & how it’s
promoted

Look, feel & safety

Parks & open space

Getting
around/transportation

Housing

Air, water, soil

Arts & cultural
expression
Treatment quality, disease
management, in-patient services,
& alternative medicine

Cultural competence

Emergency response
PEOPLE



Social networks & trust
Participation & willingness to act
for the common good
Norms & Culture
Analysis
Analysis
“ I also believed…
because of
experience with
my family, that
rural low income
people had capacity to plan and change… ”
- Dr. John Hatch
Action
Asian Health
Services
From Pedestrian Safety …
Photo courtesy of: Asian Health Services, http://www.ahschc.org/safety.htm
… to Policy, Systems, &
Environmental Change
Photo Credit: http://metes.wordpress.com/2009/01/25/diagonal-crosswalks/
Moving More Upstream,
Identifying Priorities
 Community groups
Priority 1: economic development
and economic equity
 Business owners
Priority 2: physical development
in surrounding communities
 OCCC
 City planning agencies
Led by AHS
Legal Action
Priority 3: current state of
transportation development
Revive Chinatown!
Catalyst for Change
“ An ecological system approach can more
effectively address a chronic public health
problem…health centers can function as
catalysts of community and economic
development. ”
- Liou and Hirota on the Revive Chinatown! campaign,
as described in From Pedestrian Safety to Environmental Justice:
The Evolution of a Chinatown Community Campaign
Spring 2005
“ We are bringing together the health and
human rights voices in south LA and beyond
to discuss the healthcare crisis and how we
build a movement for the right to health. ”
- Jim Mangia, CEO, St. John’s Well Child
Inquiry
Image Credit: User Thester11, Wikimedia Commons
Inquiry:
Housing Questionnaire
Analysis:
Partnership to Assess Housing
Conditions
St. John’s Well Child &
Family Center
Esperanza Community
Housing Corporation
Strategic Actions for a Just
Economy
Los Angeles Community
Action Network
Action:
Policies that Improve Health
Community
Engagement
Outcomes
Medical Care
Health
Action
Education
Advocacy
Litigation
POLICIES:
LA City Attorney’s
Office; LA County
Department of Public
Health
Landlord Compliance
Action:
Advocacy for Change
Success:
Improved Health Outcomes
4 out of 5 residents with anxiety related specifically to
substandard housing conditions reported health
improvements
 Among residents with more than 2-5 health conditions, 93%
reported significant improvements in health

Photo credit: The Shame of the City: Slum Housing and the Critical Threat to the Health of L.A.
Children and Families, (Los Angeles: Strategic Actions for a Just Economy, April 2007).
“You can do more than
bail out these medical
disasters after they have
occurred… go upstream
from medical care to forge
instruments of social
change that will prevent
such disasters from
occurring in the first
place.”
- Jack Geiger, MD
Photo Credit: Daniel Bernstein
www.preventioninstitute.org
221 Oak Street
Oakland, CA 94607
Tel: (510) 444-7738
Sign up for our media alerts:
http://www.preventioninstitute.org/alerts
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PCCP: Community-Centered Health
Home Demonstration Project
Jaymee L. Lewis, MS
54
Project Overview
The Community-Centered Health Home (CCHH)
Demonstration Project a part of the PCCP of the GRHOP
aims to advance health equity and community resiliency by
enhancing the capacity of selected health center sites to
take the next step beyond the patient-centered medical
home model and serve as trusted, effective partners in
community prevention.
55
Eligible Entities
Only operational sites of Federally Qualified Health Centers (FQHC's)
or Look-Alikes in the 17 eligible GRHOP counties and parishes of the
central Gulf Coast are eligible to compete for this award.
Florida
•
•
•
•
•
Escambia
Santa Rosa
Walton
Okaloosa
Bay
Alabama
• Mobile
• Baldwin
Mississippi
• Hancock
• Harrison
• Jackson
Louisiana
•
•
•
•
•
•
•
Orleans
Jefferson
Plaquemines
St. Bernard
Terrebonne
Lafourche
Cameron
56
Award Information
• Maximum of 1 award in Florida, 1 in Alabama, 1 in
Mississippi and a maximum of 2 awards in Louisiana
• Applicants may request up 250,000 for the two-year
project period
57
Use of Funding
Funding may
be used
for…
• Personnel
• Training
• CCHH Oriented Systems
Changes
• Sustainability Considerations
Funding may
NOT be
used for…
• Funding of medical services
that are reimbursable
• Subcontracting with LPHI
• Construction costs of brand
new building structure.
58
Application Process
• Application Instructions are listed on pages 16-20 of the RFP.
• Interested parties should submit all elements listed in the
Application Checklist (Attachment B) to: jlewis@lphi.org no
later than Friday, November 21, 2014 at 5:00 pm CST.
• All questions regarding the RFP should be e-mailed to:
Jlewis@lphi.org.
59
Selection Process
Clinics are competing against two thresholds:
• Capacity and Readiness to implement the proposed project
• Superiority to other applications submitted within the state.
All applications will be reviewed by a panel comprised of internal staff,
field experts, and GRHOP partners.
Applications will be placed in 1 of 4 Categories
• Funded without condition or comment
• Funded with condition or comment
• Not funded but invited for resubmission with improvements
• Not funded
60
Selection Process
The offering of this funding opportunity does not guarantee that
awards will be made. If a highly qualified applicant is not identified
in any or all states, LPHI and the PCCP CCHH Demonstration
Project reserve the right to not make any awards. (please to
refer pg. 9 of the RFP for further guidance)
61
Timeline
Dates
Milestones
October 14, 2014
RFP Release
October 17, 2014
Technical Assistance Webinar
November 21, 2014
Submission Deadline
By January 31, 2015
Award Notifications
*February 2015
Project Period Begins
62
Questions and Answers
Jaymee L. Lewis, MS
Program Manager, LPHI
Community-Centered Health Homes
jlewis@lphi.org
504.301.9811
63
PCCP: Direct Focal Funding
• PCCP 2-3 years of direct funding in GRHOP eligible
counties/parishes to sole or prioritized FQHC, Look Alike or other
community clinic, (Port Sulphur, Cameron).
• To support direct operational costs of advancing capacity, quality,
transitions of care, sustainability
• Already committed - no new clinics to be added
• For Orleans Parish, the settlement prioritized NOELA.
• For Jefferson Parish, the settlement prioritized the Jean Lafitte
community which selected Jefferson Community Health Care
Centers