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“Empower ing our communi t i e s to a ch i eve the h ighes t s ta t e o f we l l -be ing .”

COHC Community Advisory Council

La Pine Community Center (Wickiup Room) Agenda 05-01-2014

Conference Line: 1.719.325.2630 Participant Code: 137417#

Time Topic Action 11:00-11:10 Welcome/Public Comment 11:10-11:40 Health Issues & Disparities in South County—Panel

1. Panel presentation 2. CAC Q & A 3. Information for Board and possible recommendations 4. General Information:

a. Population: 1,687 b. Median household income

i. La Pine: $23,334 ii. Oregon: $46,816

c. Estimated median house value: i. La Pine $101,548 ii. Oregon $232,900

d. People living below poverty level i. La Pine 18.4% ii. “Best” 50% quartile: 15.6% and lower iii. “Worst” 25% quartile: 19.8% and higher

Discussion & Create Deliverables

Action: If needed,

create recommendations for

the COHC

11:40-12:10 Health Equity Task Force (HETF)—Kate Wells/Sonya Littledeer-Evans

1. HETF Report 2. CAC info:

a. Offer any input they feel needs to be included from the consumer perspective before this report goes to COHC and Ops; including feedback on content.

Discussion & Endorsement

Action: Endorse report

content to move forward in COHC

process, specifically as it relates to Elements 6

and 7 12:10-12:40 School Based Health Centers—Panel

1. Panel presentation 2. CAC Q & A 3. Information for Board and possible recommendations

General Information: • Central Oregon School Based Health Centers

o Ensworth Elementary o Bend High School (2015) o Redmond High School o Lynch Elementary o La Pine Community Campus o Sisters High School o Gilchrist Schools o Crook County SHC

Discussion & Create Deliverables

Action: If needed,

create recommendations for

the COHC

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“Empower ing our communi t i e s to a ch i eve the h ighes t s ta t e o f we l l -be ing .”

12:40-1:00 CAC Committee Updates—Lindsey Hopper 1. Flex Funds Committee—Jeff White 2. Budget Committee—Jeff White/Suzanne Browning 3. CHA/CHIP—Jeff White 4. New Members—Linda McCoy

Discussion

Action: Approve endorsed CHA/CHIP process and use of the MAPP tool to achieve Transformation Plan

Element Future Meeting (6/5/14)

1. OHA CAC Conference May 2014—Angela Kimball 2. Meeting location: La Pine 3. Next panel: Dental Integration

Follow-up: Dental/South County/School Based Health Centers

Discussion

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COHC Community Advisory Council

COCC Open Campus (Prineville) 04-03-14

Present: Bruce Abernethy, Bend-LaPine School District Jeffrey White, Consumer Representative Julie Rychard, Full Access Ken Wilhelm, United Way of Deschutes County Linda McCoy, Chair Nicole Rodrigues, Consumer Representative Sean Ferrell, National Forest Service Suzanne Browning, Kemple Memorial Children’s Dental Clinic

Absent: Elaine Knobbs, Vice-Chair, Mosaic Medical Diane Fuller, Indian Health Services Michelle Nein, Consumer Representative

Present Staff/Guests: Angela Kimball, Oregon Health Authority Therese Madrigal, PacificSource Lindsey Hopper, JD, MPH, Central Oregon Health Council Kenny LaPoint, Housing Works Zach Pangares, Central Oregon Health Council Muriel DeLaVergne-Brown, Crook Co. Health Department Emma Reynolds, Crook Co. Health Department Kelly Fisher, Housing Works Absent Staff/Guests: Regina Sanchez, Crook Co. Health Department Public Comment

• Time was made for public comment. No public comment was had. Housing Panel

• Attached to the meeting minutes is the CAC Panel Report that highlights the findings of this month’s topic: Housing.

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• The following recommendations were made: • Request #1: Create a document summarizing the panel discussion and sharing the

PowerPoint displayed by Housing Works. • Request #2: Involve the document in the CHA/CHIP process and make it available within

the community to educate community partners.

OHP Expansion/Enrollment Follow-up • Dental deliverables will be distributed after the DCO contract has been signed • A focus will be on IHS patients as they had a large increase due to the expansion

Adolescent Well Child Check Deliverables Follow-up

• Handouts were provided to group members. o Most districts around the region do not pass out additional education info to

students and families o Most health related information comes from the health classes taught in school, with

material that comes from the state • Ops created several strategies that are being evaluated

o Work with The Center on getting patients well child checks at their sports physical event

o Create a social media campaign o Work the school districts to create educational material for families

! Each school district must approve any info before it can be dispersed

CAC Committee Updates • Flex Funds

o Committee had their first meeting and it was largely organizational o COHC/PS/OHA will be gathering materials from around the state/country to see

what other similar programs are taking place o PS will be the administrator for the flex funds

• Health Equity Task Force o HETF is finalizing their report o There is one meeting remaining o Have created a film that documents findings and highlights patient stories o

• Budget Committee o Monthly meeting is taking place next week

• CHA/CHIP o A draft process has been created and is being reviewed by community partners o The CHA/CHIP workgroup will be getting together to evaluate the process before

the next CAC meeting Future Meeting (5.1.14)

• The CAC Summit will be taking place May 29 and 30 in Eugene at the Hilton Hotel • Registration information will be emailed to CAC • No registration fee for CAC members • Information for travel assistance will be included in registration information

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• Travel assistance will include: o Hotel room o Mileage o Meal allowances o Child care assistance o Personal care assistance

• Next meeting is 05.01.14 in La Pine at the La Pine Community Health Center Adjournment The meeting was adjourned at 1pm PST. Respectfully submitted, _________________________________

The next meeting will be held on May 1, 2014 at La Pine Community Health Center (La

Pine)

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CAC PANEL REPORT TO COHC CAC Meeting Date: April 3, 2014 CAC Meeting Location: Prineville CAC Panel Focus: Housing Participants: CAC members Housing Works staff (see attached presentation materials) CAC Findings:

• Approximately 95% of the people served by Housing Works are on OHP. • There was less than 1% vacancy rate for rentals in 2013. Housing Works estimates (pending

new numbers) that the vacancy rate will be less than 0.5%. This rate represents approximately the time required for a landlord to clean out a unit between tenants.

• The housing burden in La Pine is the biggest burden in the region. • Health and housing are inextricably linked. Homeless and rent burdened people have poorer

health outcomes to begin with, and once they receive care, they do not recover. They come back to the ER with even worse conditions. We can spend a ton of dollars on their care and not make them any healthier.

• The information on rent burden in central Oregon is staggering. See the attached PowerPoint.

• Homeless youth need more resources for supportive housing in central Oregon. • The community needs to be educated on the housing crisis and the link between health and

housing. Summary of Panel Discussion:

• Housing Works offers a variety of housing assistance programs in central Oregon: homes for veterans, individuals with SPMI, special needs housing, disabled, and elderly

• Pay annually $8 million of housing in the region • The unmet housing needs and rent burdens in La Pine are larger than in any other community

in the region • The vacancy rate is so low that only 27% of people were able to use housing vouchers

awarded in October 2013. The normal rate is at 70%. • There is presently no requirement for a landlord to accept housing vouchers • However, starting July 1, 2014, that will become a fair housing violation. Landlords will

have to include the voucher as a part of the applicant’s income. • Without housing, dollars spent on care in the hospital are wasted. People do not recover and

they come back to the hospital in even worse condition. • Housing Works sees great value in case management and housing together to address this

issue. Regional Challenges

• While more housing is available in Prineville and Madras versus Bend, much of the housing in those areas does not meet the minimum requirements for housing vouchers. The houses are in poor condition and are not energy efficient.

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• There is very little multi-family housing available in Bend. • There is very little land available for building low-income housing in Bend. • There are no private incentives to build low-income housing. • Unless Housing Works can obtain funds to offset mortgage payments, it cannot keep rent

payments low enough to be helpful. Housing Works applies for grants every year to offset costs, but there is not enough money to go around to all applicants in the region.

How Can We Help Address the Housing Crisis?

• Funding (obviously) • Advocacy within the community to educate people about the shortage and need for housing.

Work to educate people on the link between health and housing. CAC Requests

• Request #1: Create a document summarizing the panel discussion and sharing the PowerPoint displayed by Housing Works.

• Request #2: Involve the document in the CHA/CHIP process and make it available within the community to educate community partners.

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1. Member Eng. & Communication (Tailored to Health Literacy, Cultural and Linguistic Needs of Members)

Complete written self-‐assessment to identify at least two (2) areas to improve Member communications with particular focus on Hispanic/Latino and Indian/Alaska Native (AI/AN) populations (CAC review and endorsement); Outline system requirements necessary to implement recommended changes (PS).

Health Equity Task Force – Report & Recommendations May/June

HETF/PS

2. Diversity & Cultural Competency

Engage all appropriate and essential partners throughout CCO to organize a committee to review, define and set Community adopted standards to be established and approved by Central Oregon and Columbia Gorge Health Councils (COHC decision with Committee input).

Health Equity Task Force – Report & Recommendations to COHC May/June

HETF/CAC/PS

3. Q1 Plan to Reduce Disparities

Complete written self-‐assessment of system data gaps (PS); Ensure that at least 2 operational or system changes to improve granular data collection, reporting and analysis related to language, race and ethnicity are completed (PS – Complete). Quality Improvement Plan focused on eliminating racial, ethnic and linguistic disparities is adopted (PS Developing based on assessment and HETF findings – review with CAC, Ops/CAP before July 1).

PacificSource Quality Disparities Study; Report May; Plan finalized June

PS/HETF

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School-‐Based Health Centers: A Quick Overview

What is a SBHC?

•  A school-‐based health center (SBHC) is a high quality professionally staffed health center located on school grounds providing primary care, behavioral health, oral health and public health.

Principles for SBHC’s •  Responds to the community •  Focuses on the student •  Delivers comprehensive care •  Supports the school •  Advances health promoFon acFviFes •  Implements effecFve systems •  Provides leadership in adolescent and child health

How are SBHC Services decided?

• Services decided by community

• Care to students with consent

• Some centers provide adult care

• Care provided regardless of ability to pay

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Oregon SBHC’s (2011-‐2012 Service Year) •  Safety Net services for uninsured or under-‐insured •  63 Centers in 21 CounFes •  6 addiFonal sites planned •  23,502 clients served by Oregon SBHCs in 70,275 visits

•  52,429 students had access to a SBHC at their schools

Oregon SBHC OperaHons (2011-‐2012 Service Year) •  40 of the SBHC (63%) operated by Federally Qualified Health Centers (FQHC)

•  33 of the SBHC (52%) operated by local public health departments, 20 of which have FQHC status

•  29 of the 63 SBHCs (46%) recognized as PaFent-‐Centered Primary Care Homes

•  53 of the 63 SBHCs (84%) use electronic health records

Community Goals •  Better health, better care, less cost

–  (Central Oregon Health Council)

•  Partnership between public health and primary care –  (Central Oregon Health Council)

•  All high risk young children will read by the third grade –  (WEBCO and the Early Learning Leadership Council)

•  Right care, right time, right place –  (Better Together and CCO)

SBHC Support Children and Families By:

•  Providing health care in the most accessible locaFon for children, solving transportaFon issues which are barriers to care

•  Increase access to physical, dental health and behavioral health services

•  Strengthen the connecFon between the school and the family, and provide referrals

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Facts About Adolescents •  Less likely to have health insurance than any other age group.

•  Lowest uFlizaFon of health care services. •  Leading causes of death for adolescents have changed from natural causes (illness) to unintenFonal and intenFonal injuries.

•  Risky behaviors are the leading threat to adolescents.

SBHC’s Support EducaHon By:

•  Keeping students in school (demonstrated by research)

•  IdenFfying and counseling students at risk for physical illness and emoFonal or behavioral trouble

•  Responding in Fmes of school or community crisis

SBHC’s Support Businesses By:

•  Reducing parental work absences related to children’s health care needs; saving parents $

•  Keeping children out of emergency rooms •  DetecFng illness and risk early and reducing the need for expensive treatment later

Health Centers

•  A healthy child is a teachable child. •  Poor health has a direct and negaFve impact on student success.

•  SBHC’s address physical, emoFonal and behavioral health issues and foster learning readiness and academic achievement.

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Research shows: •  Improvement in children’s health status •  Reduce ER visits •  Increases access to mental health care •  Keeps students in school and learning •  SBHC’s reduce absenteeism •  Keeps parents from missing work

Documented Impact

•  Increased access to primary, behavioral health, and oral health care

•  Improved immunizaFon rates •  Reduced emergency room visits, costs for health care

•  Reduced birthrates

Central Oregon SBHCs Bend Deschutes Health grantee •  Ensworth Elementary (Mosaic Medical medical sponsor) •  Planned for 2015: Bend High School (Mosaic Medical medical sponsor) Redmond Deschutes Health grantee •  Redmond High School (St.Charles medical sponsor) •  Lynch Elementary School (Mosaic Medical medical

sponsor)

La Pine Deschutes Health grantee •  La Pine Community Campus (La Pine Community Clinic medical sponsor)

Sisters Deschutes Health grantee •  Sisters High School (St.Charles medical sponsor) Gilchrest Klamath Health grantee with sub-contract to Deschutes •  Gilchrist Schools (La Pine Community Clinic medical sponsor) Prineville Crook Health grantee •  Crooked River Elementary School (Mosaic

Medical medical sponsor)

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National Vision SBHCs are supported by… •  American Academy of Pediatrics

•  American Psychiatric Association

•  National Association of School Nurses

•  Affordable Care Act

•  HRSA

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Community Assessment Model Prepared by: Muriel DeLaVergne-‐Brown, RN, MPH (4-‐23-‐14) Page 1

Central Oregon Community Health Assessment

Prepared by Muriel DeLaVergne-‐Brown, RN, MPH Crook County Health Department, WEBCO representative

Purpose The purpose is to develop and maintain the Central Oregon Community Health Assessment and update the Community Health Improvement Plan consistent with SB1580 (2012), Section 13. (Attachment #1 – Partner’s Needs/Requirements) Deschutes, Crook, and Jefferson County Public Health and Mental Health along with partners completed the initial Community Health Assessment and Community Health Improvement Plan in April of 2012. This document describes the process for updating the initial assessment and plan for July 1, 2015 in accordance with the Oregon Health Authority CCO requirements. Pacific Source CCO Transformation Plan Statement The Central Oregon Health Council designated it’s county public health and mental health authorities through their partnership in WEBCO (an intergovernmental entity between Crook, Deschutes, and Jefferson Counties) to lead the maintenance and status of the CHA and CHIP process going forward, in partnership with the CCO’s and other stakeholder entities. (See Attachment #2 – Improvement Measures and Methods) Framework and Process Overview This framework provides guidance for the process of designing and documenting the CCO’s community health assessment and community health improvement plan update for 2015. As background, the Oregon Health Authority created the Oregon Community Health Assessment and Community Health Improvement Plan (CHA/CHIP) Alignment Workgroup including representatives from local public health, mental health, nonprofit hospitals, Coordinated Care Organizations (CCOs), education system partners and the Oregon Health Authority to identify ways to better align timelines and processes across local entities with a CHA/CHIP requirements. The following process was recommended for CCO requirements: 1. Ensure appropriate resources are dedicated to the CHA/CHIP development process. 2. Engage local partners. 3. Identify a lead organization to manage the CHA/CHIP process. 4. Meaningfully engage community members and other stakeholders throughout the CHA/CHIP development process. 5. Organize one comprehensive CHA that fulfills each of the partner organizations’ CHA requirements. 6. Ensure that all subsequent CHIPs reference the comprehensive community CHA.

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FRAMEWORK FOR THE CENTRAL OREGON PROCESS

PHASE 1: Organize (By August 2014) 1. Recruit and create a planning team to include data analysts and partners within the tri-‐county region. 2. Partners to include: key Public Health staff, COHC Executive Director, Pacific Source staff, St. Charles staff, (CAC) Citizens Advisory Council, Early Learning staff, Behavioral Health staff, non-‐profits, businesses and others as identified. 3. The guidance from Oregon Health Authority on Community Health Assessments is based on the National Association of county and City Health Officials community-‐driven strategic planning process for improving community health called the Mobilizing for Action through Planning and Partnerships (MAPP) process. This process is named as a National Standard for assessment and it is required that a best practice model is used. The Central Oregon Health Council and Wellness and Education Board of Central Oregon -‐ WEBCO will use a modified MAPP process with a timeline of July 2014-‐June 2015. (Attachment #3 – MAPP) 4. Identify who needs and who wants to be involved. Make sure the role for partnership members is clearly communicated. The Community Health Assessment partnership will reflect the community, and will include representatives of:

• Counties • COHC staff • Hospital • School Districts • Health Care Providers • Special Populations (racial and ethnic groups; age groups; persons with disabilities) • CAC

Organize

• Create a planning team and select an assessment/planning process.

• Idenafy who needs and wants to be involved; hospitals, health plans, public health departments, behavioral health, health care providers, comunity members.

• Set meeang dates/ames and create communicaaons plan.

Plan Assessment in Partnership

• Agree on leadership and decision-‐making processes.

• Review background document; etablish common ground.

• Create a work plan and ameline.

Gather and Analyze Assessment Data

• Compile data from a variety of sources.

• Summarize and analye data to answer iniaal quesaons raised in the assessment.

• Refer to partners and staff to add meaning to the data.

• Ask addiaonal quesaons and gather addiaonal data (as needed).

• Evaluate data as compared to the previous CHA.

• Evaluate current top prioriaes and evaluate based on data.

Document and Communicate Findings

• Prepare print and/or web-‐based documentaaon of CHA findings.

• Share key findings with decision makers and the public.

• Deliver to Central Oregon Health Council the top Community Health Issues.

• Update Community Health Improvement Plan.

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• Business Community • Community Non-‐Profits • Behavioral Health • COHC -‐ Coordinated Care Organization • Early Learning partners

PHASE 2: Plan the Assessment in Partnership (August 2014) 1. Diverse community engagement and partnership development are an essential first (and ongoing) phase of the assessment and health improvement plan. This phase identifies who should be involved in the process and how the partnership will approach and organize the process. 2. WEBCO – The 2012 Community Health Assessment and Community Health Improvement Plan was created by Local Public Health and partners. The Central Oregon Health Council designated it’s county public health and mental health authorities through their partnership in WEBCO (an intergovernmental entity between Crook, Deschutes, and Jefferson Counties) to lead the maintenance and status of the CHA and CHIP process going forward, in partnership with the CCO’s and other stakeholder entities. The goal is that all required planning processes for community assessment can be coordinated into one document. 3. Develop a Vision and Charter for the group: The members will need to determine together how decisions will be made throughout the assessment and planning process. This group will serve as the planning and guidance team for completion of the Community Health Assessment (CHA) and the Community Health Improvement Plan (CHIP). The team will:

• Explain the process for identifying (including members engaged) the CCO health assessment and improvement plan’s vision and values.

• Complete a Vision and Values statement for the work. 4. The team will design the assessment and planning process. 5. Documentation for this process:

• Demographic summary of the assessment and health improvement planning partners. • Demographic summary of community members engaged as participants in the assessment and

health improvement planning process. • Decision-‐making process – identifying who has final authority to approve the assessment and

adopt the plan. • Identify CCO framework for embedding health equity and the elimination of health disparities in

the Health Improvement. • Document use of OHA data. • Identify the mechanism for on-‐going dialogue and community engagement throughout the

Community Health Assessment, Community Health Improvement Plan, and ongoing assessment/future plan updates.

Develop Communications Plan 1. A Communication Plan will be created to keep the assessment and planning processes on track and keep the Central Oregon Health Council, the planning team and partnerships engaged. The plan will determine the communication needs of all those involved in the process.

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PHASE 3: Assessment and Analysis Process (September 2014 – January 2015) 1. The assessment phase will provide a comprehensive update to the current Community Health Assessment and the Community Health Improvement Plan. (Attachment #4 – Plan Areas Of Focus) The assessment will use multiple data sources including:

• Census tract data aligned with the CCO service area with demographic breakdown of specific issues.

• Quantitative data on a broad array of health indicators, including quality of life, behavioral risk factors, and other social determinant of health measures that reflect a board definition of health across the dimensions of diversity identified above.

• Qualitative information on now communities perceives their health and quality of life concerns as well as their knowledge of community resources and assets.

• DHS, School, and Community Justice Information. • Measure how well public health and health system partners collaborate. • Examination of the health status and health needs of diverse populations such as racial and

ethnic communities, tribal members, the aged, people of disabilities, LGBT populations, and uninsured.

• Conduct an environmental scan of positive and negative external forces that impact the promotion and protection of the public’s health.

PROCESS ACTIVITIES DOCUMENTATION Primary Data Collection to update current plan Identify additional community assessment Secondary quantitative data collection

-‐Web-‐based search for data -‐Key-‐informant interviews -‐CAC reports and interviews -‐Completed by assigned staff.

Assessment Plan – explanation of criteria used for selected data. Summary of the demographics of the CCO service area at a granular level sufficient to represent community diversity.

Analysis of current chosen categories to compare current additional data

-‐Review by CHA Team and CAC representatives.

Documentation of discussion and meeting decisions

Collection of primary data Collection of qualitative data Collect qualitative data Assessment of local health status, community strengths assessment of forces of change assessment

-‐Community Focus groups, surveys Key-‐informant interviews -‐Analysis by CHA/CHIP Team and assigned staff members -‐Input from CAC, Ops, PEP -‐There will be a request presented to COHC for support in-‐kind and financial to assist this process to completion by October 2014.

Document sources of data chosen for analysis Qualitative clinical and community health data sources chosen for analysis. Data sources (qualitative and quantitative) that delineate the health inequities experienced by diverse populations in the CCO service area, such as racial

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and ethnic communities, tribal members, the aged, people with disabilities, LGBT populations, and the currently uninsured and underinsured Document process for conducting environmental scans (community members).

Final Analysis of data Review by CHA/CHIP Team and CAC representatives COHC Exec. Director

Documentation of discussion and meeting decisions Summarize findings from qualitative and quantitative data that informs the strategic clinical and community heath priorities. Explain the process for (including community members engaged in) narrowing data findings into strategic priorities. Explain the process for (including community members engaged in) identifying priority community health disparities Provide brief analysis of key finds that relate to strategic priorities for promoting both community health and health equity as compared to the 2012 CHA

Update Central Oregon Community Health Assessment

WEBCO – Public Health Staff Completed CHA – May 2015 for COHC June 2015 Approval Submit to OHA by June 30, 2015

Update Central Oregon Community Health Improvement Plan

WEBCO – Public Health Staff Completed CHIP – May 2015 for COHC June 2015 Approval Submit to OHA by June 30, 2015

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PHASE 4: Document into the Updated CHA/CHIP and Communicate Findings April 2015 – for CAC and COHC Approval Process The Community Health Assessment and Community Health Improvement Plan will be updated based on new data, discussion, and decision-‐making. Documentation

• Updated Community Health Assessment Completed. • Explanation of the process for (including community member engagement) identifying priority

community health improvement strategies. • Explanation of goals, objectives, strategies, and leadership for each of the strategic health

improvement priorities identified. • Identification of how health improvement strategies have been tailored to respond to priority

health inequities in the region. • Plan for addressing clinical aspects of community health improvement with clinical partners.

CONTINUING ASSESSMENT AND QUALITY IMPROVEMENT

• The Central Oregon Health Council in coordination with WEBCO will maintain and deepen diverse community engagement in the CHA and the CHIP over time.

• List qualitative and quantitative data sources to be developed for future community health assessment.

• Identify plans for collecting more data over time, with the goal of devising solutions to the health problems impacting each of the diverse populations in the CCO service area.

• Incorporate the work into the HCI website, along with initiatives and strategies. • Annual report and update of WEBCO/COHC CHA/CHIP.

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Attachment #1

PLANS AND PROCESSES REQUIRING COMMUNITY HEALTH ASSESSMENT

• Required by Oregon Health Authority • Purpose is to assess enare community served by the CCO, not just the Medicaid populaaon. Tied to responsibility of CCO in creaang the Triple Aim: Beker care, beker health and reduced costs • Led by WEBCO/Public Health in coordinaaon with CAC and COHC partners • Every three years

CCO Requirements

• Required by IRS (Hospitals) • Focus is to idenafy and assess access and needs of the community the hospital is serving in a wriken report. • Led by St. Charles Healthcare

CHNA Requirements

(IRS 990)

• Required by Oregon Health Authority and Public Health Accreditaaon Standards and Measures Board (PHAB) • Collaboraave process resulang in a comprehensive community health assessment • Led by the Tri-‐County Public Health • Every 3 years in coordinaaon with CCO

PH Accreditaaon Board

Requirements

• Required by Oregon Health Authority • Collaboraave process resulang in a comprehensive community health assessment • Led by the Tri-‐County Mental Health in coordinaaon with Public Health

AMH BIP Requirements

COORDINATED COMMUNITY HEALTH ASSESSMENT

COORDINATED COMMUNITY HEALTH IMPROVEMENT PLAN

KEY: PHAB Public Health Accreditation Board CHNA Community Health Needs Assessment CHIP Community Health Improvement Plan CMHP Community Mental Health Program CHA Community Health Assessment LHD Local Health Department

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Attachment #2

PACIFICSOURCE CCO TRANSFORMATION PLAN 2013-‐2015 CHA/CHIP IMPROVEMENT MEASURES AND METHODS

Benchmark 4co Activity Central Oregon How benchmark will be measured (Baseline to July 1, 2015)

Activity 4.2co: Develop systematic methodology for CHA. -‐Support COHB (WEBCO) in identification and adoption of methodology for CHA (e.g. MAPP, CHANGE, etc.) -‐Dedicate PSCS staff to support community as needed to provide data and information that establishes a connection between the CCO population health needs and disparities.

First Community Health Assessment (CHA) and Community Health Improvement Plan (CHIP) have been completed; assess use of Mobilizing for Action through Planning and Partnerships (MAPP) tool for adoption and use for CHA and CHIP ongoing.

Milestone to be achieved as of July 1, 2014

Activity 4.3co: Implement the web-‐based Healthy Communities Institute Tool (HCI) to support ongoing CHA needs and support broader community engagement and collaboration to eliminate health disparities. Allow indicators that reflect leading drivers of health costs, utilization and health disparities to be accessible to CCO stakeholders, the public and community organizations (see healthysonoma.org for an example) Provides ability to obtain community feedback.

Contractor standardizes CHA and CHIP updates considering the community partners’ agencies’ community health Assessment and plan needs.

Benchmark to be achieved as of July 1, 2015

Contractor ensures that annual update of CHA and CHIP are completed on an ongoing basis.

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Attachment #3

MAPP OVERVIEW

Mobilizing for Action through Planning and Partnerships, or MAPP, is a community driven process that results in engagement of new stakeholders and providers a broad understanding of community health issues. MAPP enables enhanced understanding of the complex influences on community health, through thoughtful and deliberate data collection and analysis. The process was developed through collaboration between NACCHO (National Association of County and City Health Officials) and CDC (Center for Disease Control and Prevention). (http://www.naccho.org/topics/infrastructure/mapp/index.cfm) MAPP is: a community-‐wide strategic planning tool for improving public health, a method to help communities prioritize public health issues, identify resources for addressing them, and take action. The key phases of the MAPP process include:

• Organizing for action and developing partnerships • Visioning • Conducting the four MAPP assessments • Identifying strategic issues • Formulate goals and strategies • Take action (planning, implementation, evaluation)

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The Action Cycle At-‐A-‐Glance

The action cycle is the final phase of MAPP and the Central Oregon CHA committee, along with COHC Operations Committee will oversee the implementation of the Community Health Improvement Plan.

Planning

• Organize for action by establishing an oversight committee for implementation activities, and preparing for implementation.

• Develop realistic and measurable objectives related to each strategic goal and establish accountability by identifying responsible parties.

• Develop action plans aimed at achieving the outcome objectives and addressing the selected strategies.

Implementation

• Review action plans for opportunities for coordinating and combining resources for maximum efficiency and effectiveness.

• Implement and monitor the progress of the action plans. Evaluation

• Prepare for evaluation by engaging the stakeholders and describing the activities to be evaluated.

• Focus the evaluation design by selecting evaluation questions, the process for answering these questions, the methodology and plan for carrying out the valuation, and a strategy for reporting results.

• Gather credible evidence that answers the evaluation questions. Justify the conclusions. • Ensure the results of the valuations are used and shared with others.

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Attachment #4

2012 AREAS OF FOCUS

Community Health Assessment (CHA) 2012 Focus Areas based on Data Analysis • Health Disparity and Inequiaes • Access to Resources and Quality Services • Early Childhood Wellness • Safety, Crime and Violence • Prevenave Care and Services • Chronic Disease Prevenaon • Alcohol, Drug and Tobacco Use • Behavioral Health and Suicide Prevenaon • Oral Health • Healthy Environments

Community Health Improvement Plan (CHIP) Framework – Nine Strategies • Improve health equity and access to care and services • Improve health • Improve health care and service delivery • Reduce cost and increase effecaveness • Strengthen health integraaon and system collaboraaon • Pursue excellence in health care and service delivery • Promote regional efforts • Strengthen health service organizaaons • Promote sound health policy

Coordinated Care Organiza`on Transforma`on Plan Nine Strategies/Elements • Integrated Primary Care Model • Paaent-‐Centered Primary Care Homes (PCPCH) • Alternaave Payment Methodologies • Contractor's Commuity Health Assessment and Annual Plan • Electronic Health Records and Health Informaaon Exchange • Tailoring Communicaaons and Services to Cultural, Health, Literacy and Linguisac Needs • Diversity and Cultural Competence • Quality Improvement Plan • Primary Care Public Health Partnership to Improve Populaaon Health

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