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www.washtenawhealthinitiative.org May 24, 2012 1 Organizational Sustainability: Stories from the Field Ellen Rabinowitz May 24, 2012 Healthy Safety Net 2012: A Blues Symposium
www.washtenawhealthinitiative.org May 24, 2012 1
Organizational Sustainability: Stories from the Field
Ellen RabinowitzMay 24, 2012
Healthy Safety Net 2012: A Blues Symposium
www.washtenawhealthinitiative.org May 24, 2012 2
What is the WHI?
• Voluntary, community‐wide, multi‐sector collaboration
• Focus: increasing health care access and coordination for low‐income, Medicaid and uninsured
• Sponsors: St. Joseph Mercy Health System and the University of Michigan Health System
• Launched January 2011
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Why now?
• Stimulus of Affordable Care Act
• No other forums available
• Philanthropic nature of our community
• Learned from efforts in the past
• Readiness/timing/leadership ready to step up
• Community need/willingness
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Mission
• To help to improve the health of the low‐income, uninsured, and Medicaid recipients in Washtenaw County by bringing together organizations to:
– Coordinate and leverage resources
– Share information on gaps in care, opportunities to fill those gaps and organizational plans
– Consider opportunities to work together on specific projects and/or functions
– Generate innovative ideas, plans and implementation approaches to improve care and access in the county
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Brief History
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Who Participates in the WHI?
• Engaged leadership of key healthcare and community organizations, over 70 participants, 40organizations
• Key attributes:– Voluntary participation
– Focused on solving common problems
– All put aside competition in favor of collaboration
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Participating Organizations
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2012 Charter Signatories
• Ann Arbor Area Community Foundation • Ann Arbor/Ypsilanti Regional Chamber
• Arbor Hospice• Blue Cross Blue Shield of Michigan (includes Blue
Care Network)• Casa Latina• Catholic Social Services of Washtenaw County
• Center for Healthcare Research & Transformation• Corner Health Center
• Dawn Farm• Hope Clinic• Huron Valley Ambulance
• Integrated Health Associates • Jewish Family Services
• L & S Associates • Packard Health
• Planned Parenthood of Mid and South Michigan• Policy Initiatives Consulting Group• re:group
• Shelter Association of Washtenaw County
• St. Joseph Mercy Health System (includes Neighborhood Health Center)
• U‐M School of Dentistry
• U‐M School of Public Health
• University of Michigan Health System (includes Ypsilanti Family Medical Practice)
• United Way of Washtenaw County (includes Washtenaw Success by 6)
• VA Ann Arbor Healthcare System
• Washtenaw County Board of Commissioners
• Washtenaw Community Health Organization
• Washtenaw County Community Support and Treatment Services
• Washtenaw County Department of Human Services
• Washtenaw County Public Health Department
• Washtenaw Health Plan
• Women’s Center of Southeastern Michigan
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Structure
• Primary Care Capacity – Tom Biggs
• Care Navigation – Ellen Rabinowitz and Ruth Kraut
• Dental Acute Care Expansion – Bonita Neighbors
• Dental Reduced Fee Referral Program – Ruth Kraut
• Medicaid Enrollment – Renee Adorjan
• Community Outreach for Medicaid Enrollment –Kelly Stupple and Charo Ledón
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Washtenaw County
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Washtenaw County
• 344,971 residents
• 11.1% foreign born
• 14.1% speak a language other than English at home
• 4% Latino
Race Percent
White 74.5%
Black 12.7%
Asian 7.9%
American Indian or Alaskan Native
0.3%
Two or more races 3.4%
Source: U.S. Census, American Community Survey 2010
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Picture of Health Care in Washtenaw County ‐ Overall
• 983 primary care providers
• 5 safety net clinics
• No federally‐qualified health centers
• Estimated 53,239more primary care visits ‐ if health reform goes into effect
– Roughly a 9% increase over 2010
Sources: RWJF County Health Rankings 2010, WHI Primary Care Work Group Survey 2011
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Health Insurance Estimates in Washtenaw County, 2010
• 340,961 total non‐institutionalized civilian population
• 8.5% uninsured (28,864)
• 11.3% Medicaid (38,474)
– 2,719 residents estimated to be eligible for Medicaid today but are not enrolled
• 11.7% Medicare (39,740) (3,180 also have Medicaid)
• 69.9% privately insured (238,447)Source: U.S. Census, American Community Survey 2010Dual eligibles included in both Medicare and Medicaid
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Picture of Health in Washtenaw County – Behavioral Health Needs
• 22% of adults had a diagnosable mental disorder in 2010
• 2,700+ individuals with substance use disorders treated in emergency rooms in 2010
• Community mental health agency focuses on severely mentally ill
Sources: Washtenaw County Health Improvement Plan Survey 2010, WHI Mental Health Work Group Analysis 2010, US Health Resources and Services Administration 2010
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Picture of Health in Washtenaw County – Dental Care
• In 2007, only 15% of county dentists accepted Medicaid, and only 8% accepted new patients
• Nearly 4,700 dental‐related ED visits in 2007, 28admissions for dental disorders (~$19,000/visit!)
Sources: Washtenaw County Oral Health Task Force Dental Survey 2007, Michigan Oral Health Coalition Report 2011
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9 Initiatives Underway
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Improving Medicaid Enrollment: Department of Human Services Staff Working in the Community
• Problem: 2,800 people eligible for Medicaid but not enrolled
• Project: 2 DHS workers co‐located with enrollment staff and also visiting community sites to assist with enrollment and other services
• Outcomes: Over 900 people maintained or received new enrollment
• Lessons learned: – Success based on a strong relationship with local DHS
leadership
– Changing face of DHS in the community
www.washtenawhealthinitiative.org May 24, 2012 18
Improving Medicaid Enrollment: School visits by AmeriCorpsvolunteers
• Problem: finding the 2,800 who are eligible for Medicaid but not enrolled. Focus on middle school aged children.
• Project: conducting outreach with local school districts and assisting with enrollment
• Outcomes:
• Lessons Learned:
– Leverage existing community resources (AmeriCorps,
– Be open expanding partnerships across the community
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Adult Dental Access: reduced fees for the uninsured
• Problem: uninsured adults have limited access to acute and preventive dental services
• Project: create dental homes for people with dentists who will accept a sliding scale fee schedule
• Outcomes: 7 dentists participating, enrollment begins this month
• Lessons Learned:– Dig until reaching the roots of barriers and use that information to develop programs
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How can you get involved?
• Funding
• Collaborations
• Volunteers, staff
• Organizational support
• Networking opportunities
• Educate your constituents about the WHI
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The WHI is facilitated by the Center for Healthcare Research & Transformation (CHRT)
Ellen Rabinowitz, Executive Director, Washtenaw Health Plan
734‐544‐6858
Carrie Rheingans, CHRT WHI Project Manager
(734) 998‐7555
http://washtenawhealthinitiative.org
