CACHI Accelerator Site Learning Lab

Kick Off Webinar July 13, 2017

Q&A Feature

Please submit questions via the Q&A Feature

Please submit questions to All Panelists

Polling Feature

Please

1. Choose your answer, then

2. Click Submit

Agenda

1. Welcome, Purpose and Agenda

2. Meet the PHI CACHI Team

3. What is an ACH?

• ACH purpose and aspiration

• CACHI Initiative and the 7 definitional elements

4. Accelerator Site Colleagues

5. Learning Lab Approach

6. Updates and CACHI Information

7. Q and A

8. Closing

Welcome

Accelerator Site Team

Sue Grinnell

Dana Pearlman

Suparna Ferreira

Christina Lane

Kyli Gallington

Suzanne Ryan Ibarra

Lisa Tadlock

Program Associate - TBD

Chat Box Question

Each Site type in your answer

What are you hoping to get out of the next 18

months? (Name your ACH)

Hussein and Collins. SSIR July 2016

How can the health system better address these factors in a coordinated and holistic manner?

What is Accountable Health?

• The health system is moving towards rewarding health

outcomes over volume; all factors affecting health must be

mobilized.

• Accountable care = holding provides responsible for better

management of clinical conditions in a patient population

• Requires link to community / social needs to prevent

readmission

• Accountable health = shared responsibility for the health of

a community or patient population across all the sectors

• Requires link across all sectors to improve health

Jeff Levi, George Washington University

CACHI

Community

Partners

6 Catalyst

sites

10 Accelerator

sites

Public Health Institute

California Accountable Community for Health Initiative

Introducing Accelerator Sites

1. Adventist Health Clearlake, Lake County

2. City of Long Beach, Department of Health & Human Services, LA

3. Fresno Metro Ministry, Fresno County

4. Health Education Council, Sacramento

5. LAC+USC Medical Center Foundation, Inc., Boyle Heights, L.A.

6. Napa County Health and Human Services Agency, P.Health Div.

7. North Coast Health Improvement and Information Network, Inc.,

Humboldt County

8. Public Health Foundation Enterprises, Inc., Riverside County

9. YMCA of Greater Whittier, Whittier, LA County

10.YWCA San Gabriel Valley

Adventist Health ClearLake Hope Rising

LA/USC Wellness Center

Shared vision and

goals

Partner- ships

Leadership Backbone

organi- zation

Data analytics

and sharing capacity

Wellness Fund

Portfolio of

interventions

Definitional Elements

Definitional Elements of an ACH

• Identification of and shared understanding of the health issue and commitment to addressing it together

Partnerships

• Collaboration is the heart of the ACH • Multi-sector partnerships that include health

care, public health, community organizations that engage residents, especially in underserved areas

Shared Vision and Goals

• Champions; Multiple organizations & multiple levels of organizations

• Governance

• Facilitator and convener • Provides overall guidance in support of

vision and strategy • Mobilizes funding

Leadership

Backbone Organization

• Data collection and analysis at multiple levels: population health, clinical care, and cost

• Infrastructure for data sharing between organizations

• Vehicle for attracting resources, braiding and financing innovation

• Support the ACH infrastructure and interventions for which few resources exist

Data Analytics and Sharing Capacity

Wellness Fund

Intervention/Program Time Frame (e.g. short, med, long)

Clinical services

Community programs & resources

Clinical-Community Linkages

Public Policy & Systems Changes

Environmental Changes

Portfolio of Interventions

Backbone Organization

Portfolio of mutually reinforcing interventions Clinical Community-Clinical Linkage Community Programs Policy & Systems Environment & Social Services

Timeframe of Intervention Short term Medium term Long term

Identify savings across providers, systems & sectors for potential reinvestment

Wellness Fund

Accountable Communities for Health

Selected Health Issue

Braiding funding & program interventions

Social Services

Labor & Business

Commun. agencies & residents

Educ. sector

Health care

sector

Public health

Other govt.

agency

Community Collaborative and Governance

Sustain- ability

Plan

CACHI Accelerator Learning Lab Objectives

● Increase participating CACHI Accelerator sites understanding of the 7

CA Accountable Communities for Health definitional elements

● Increase participating CACHI Accelerator sites readiness to operate

under the 7 CACHI definitional elements

● Increase participant’s capacity to navigate complex challenges and

co-create solutions with their ACH member teams

● Facilitate and broker opportunities for the CACHI Accelerator sites

focused on innovative and collaborative technologies and methods

that support the ACH shared vision and goals

● Facilitate and broker additional funding opportunities and other

methods that support sustainability of the ACH structures

● Increased capacity to engage and include community members,

incorporating perspectives in the design of ACH, governance and

portfolio of interventions

● Offer recommendations to the funders and state on policies and

guidance to move the ACH initiative forward.

Outcomes

• Identified successful methods, practices, and tools that support

collaboration in an improved health system

• Increased number of sites in California that operate effectively as

an ACH structure and contribute to impacts in health in their

communities

• Exploration of applying a business model to the ACH structure, with

identified value propositions that contribute to sustainability

methods and revenue generating models

• Curriculum and Playbook for ACH sites as they consider new and

emerging public health roles and capacity to provide foundational

public health services

• A published summary report and related materials for wide

dissemination and replication across public health systems

Scope of Work • Identify a lead staff to serve as point of contact /lead site facilitator

• Identify a core leadership team (subset of the larger ACH membership) to participate in the 18 month initiative

• Develop a work plan; to include:

– Identify a minimum of 2 CACHI definitional elements to focus on during the 18 month initiative

– Select a geographic area to focus. Population size should be no larger than 200,000 residents

– Select an identified focus area health need, chronic condition, or set of related conditions and or community conditions to focus the ACH efforts on for the geographic area

• Participate in Accelerator site convenings; 2 CACHI site members to 2 joint convenings

• Participate in Kick off Webinar

• Participate in webinars, individual coaching calls as relevant to site needs

Shared Design Challenge

How might we deepen our

understanding to effectively act

as an Accountable Community

for Health - generating value,

community health and well-

being?

Theories in our Approach

Theory U: Is a methodology, a framework and a way of being identifies how

transformation takes place at a systems level (change management). Theory U

relates that the quality of a social system (i.e. Health System) is the results of

the quality of awareness, attention and consciousness of the people (leaders)

co-creating the that system. Otto Scharmer, MIT Professor + Researcher

Art of Hosting: An approach to leadership that scales from the personal

to the systemic using personal practice, dialogue, facilitation and the co

creation of innovation to address complex challenges and opportunities. Global

Community of Practice

Systems Thinking: A holistic approach, that calls us to move away from

silos, to see the bigger picture and interconnections within a system, and in our

case see how health is interrelated to many domains and the need to partner

with those other domains to make a meaningful impact.

Key Concepts of the Learning Lab

Pivoting: being entrepreneurial in your approach; willingness to let go of what

is not working to find something that might work - building the bridge as you go,

pivot when needed!

Peeling back the layers: Being an investigator- seeing through someone

else's eyes and beyond our own limited thinking/lens, takes some humility! Identify

blind spots in your perspectives and actively working to address them.

Participation: we will model many of the methods and practices you can

replicate in your communities for community engagement.

Local Facilitators, Design Team, Curriculum + Playbook

Systems Thinking Concepts

Cross Cutting: working across multiple domains (i.e.. sectors) and

recognizing that parts within and across a systems are interconnected and affect

one another - whether it is apparent or not. (i.e.. fixing transportation issues -

transport experts, city planners, those using the transport, etc.).

Root causes: the fundamental reason for the occurrence of a problem. (i.e..

Diabetes - causes could be food deserts, lifestyle choices, genetics, smoking, no

sidewalks for exercise).

Leverage Points: places within a complex system (a corporation, an

economy, a living body, a city, an ecosystem) where a small shift in one thing can

produce big changes in everything - Donella Meadows. (i.e.. making it illegal to

drive without a seatbelt).

Poll

Are you familiar with Systems Thinking approaches?

• Yes

• No

• Not sure

SHARED INTENT

SYSTEMS PERSPECTIVE

MAKE MEANING PROTOTYPE SCALE

SHARED INTENT SYSTEMS PERSPECTIVE MAKE MEANING PROTOTYPE SCALE

• Discover the need + shared purpose you are addressing

• Create a preliminary vision of the future you want to enact

• Build a strong core team to address the need

• Observe + engage the greater system - impacts, challenges, opportunities, leverage points, gaps and blind spots

• Engage stakeholders

in the system to increase your understanding

• Map out the system and ask stakeholders "what's missing from my map"

• Reflect, individually and collectively

• Make meaning of what you are learning with your team + co-create

• Uncover blind spots, test your preliminary vision

• Integrate your current level of understanding

• Brainstorm or ideate potential solutions (services, products, processes)

• Build a prototype

• Test -> Feedback -> Test

• Go back to the drawing board if a prototype fails and repeat until you reach a scalable prototype

• Scale what is working

• Plan

• Implement

• Test

DEFI

NITI

ONAL

EL

EMEN

T KE

Y ST

EPS

Shared Vision and Goals Partnership and Leadership

Backbone Organization and Data Analytics

Wellness Fund and Portfolio of Interventions

All

Learning Lab Process

Next Steps

• Complete contract process

– Once contract is executed submit invoice for first 20K

• CACHI Announcement of funding • Need a pithy sentence that describes your ACH for CACHI website

• Entering Phase 1 in the process – Shared Intent – Form your Core Team

– Shared Intent and Focus (clarify if needed)

– Shared Vision and Goals (clarify or create)

•see curriculum + playbook

– Identify your site Design Challenge

• Complete work plan by September 1, submit to Sue Grinnell

Next Steps with your ACH

• ACH site Leads (Design Team) regular calls

• Webinars - dates TBD

–What does it take to lead in complex times? –Martin Kalungu-Banda

–Kitty Bailey from San Diego ACH

• October 3 - 4, 2017 Convening

–Pasadena; CACHI will pay for up to 2 members

–Registration information to follow soon

Chat Box

Q&A

Thank you!

We look forward to working together!