REGION 15-REGIONAL HEALTHCARE PARTNERSHIP

Wednesday, September 24, 2014

1:00 p.m.

El Paso First Health Plans, Inc.

1145 Westmoreland Drive

El Paso, Texas 79925

PRESENT

/

PRESENT

Cathy Gibson, CCO, Chief Waiver Officer-UMC
Gina M. Palafox, UMC
David Smead, UMC
Gloria Vega, UMC
Lorrie Giessel, UMC
Joanne Bonilla, UMC
Moses Priego, UMC
Blas Meza, UMC
Javier Gonzalez, UMC
Yvonne Martinez, UMC
Rene Jasso, UMC
Diana Ramirez, UMC
Julie Gest, UMC
Cynthia Y. Martinez, UMC
Oscar Perez, TTUHSC
Virginia Herrera, TTUHSC
Rosario Reyes, TTUHSC
Veronica Candia-Conelley, UMC / Maria Teresa Ambat, MD, TTUHSC
Garrett Levin, MD, TTUHSC
Mateo DeLaRosa, TTUHSC
Norma C. Garcia, TTUHSC
Bruce Parsons, City of El Paso Health Department
Claudia Lozano, City of El Paso Health Department
Fernando Gonzalez, City of El Paso Health Department
Linda Lawson, Sierra Providence Health Network
Edward Pacheco, El Paso Children’s Hospital
Jesus Medrano, HCA
Cynthia Moreno, EHN
Ann Rodriguez-McConnell, TenderCare Home Health
Tom McConnell, TenderCare Home Health
Stacey Adams, TTUHSC
David M. Palafox, MD, El Paso County Med. Society
1. CALL TO ORDER & ROLL CALL

Ms. Gibson called the meeting to order at 1:05 p.m., and remarked that it is the last meeting of DY3. Monthly meetings will continue as Waiver implementation continues although most providers will no longer be submitting them in support of process measures. Ms. Gibson welcomed everyone and invited those present to introduce themselves for a roll call.

2. APPROVAL OF THE MINUTES FROM THE AUGUST 28, 2014 MEETING

There were no recommended changes and the minutes were adopted.

3. ANCHOR UPDATES

Ms. Gibson presented her overview of recent communication from HHSC as follows: She announced that HHSC will be providing October DY3 reporting webinars on October 1, 2014 from 9:30 am to 11:00 am (QPI), October 2, 2014 from 1:00 pm to 3:30 pm (Category 3 Baselines), and October 6, 2014 from 9:30 am to 11:30 am (Electronic Reporting Template). She also reported that HHSC has a risk adjustment guide and a FAQ document posted on their 1115 Waiver website.

Ms. Gibson also reported that HHSC recently announced that there is $345 million in left over DSRIP funds from DY2. Representative Coleman is leading efforts to solicit feedback from providers on interest in participating in additional DSRIP activities to pull down these funds. Rep. Coleman has identified a focus on mental health and veterans issues although others are being considered. HHSC representatives have indicated that a Waiver amendment would first be necessary to utilize the funding. Due to time constraints, HHSC is suggesting that adding metrics to current projects would likely be the best approach under the circumstances. Additional information will be forthcoming on this issue. If providers of region 15 are interested in participating in additional funding, they should also be prepared to have an IGT entity on board for the required match.

Ms. Gibson also reported that HHSC is soliciting feedback from anyone who attended the recent Statewide Learning Collaborative. An email will be sent with a link to an online survey and responses must be submitted by October 6, 2014. HHSC has also announced that it will soon be posting recordings of the presentations on their Waiver website.

Ms. Gibson also reported that activities are now underway regarding the mid-point assessment required by the terms of the program funding and mechanics protocol. Texas has an approximate total of 1,500 DSRIP projects underway. Approximately 700-800 projects across all regions were recently selected by Myers and Stauffer, third-party auditor, for a detailed desk audit. Selection was based upon random selection and a focus on particular project areas. Providers with projects under review may ultimately receive a letter or request for an onsite visit from field auditors. HHSC has indicated that it is hopeful to have the assessments completed sometime in December 2014.

Finally, Ms. Gibson also provided information regarding IGT payment dates for the next two years (See power point slides posted on the region 15 website or HHSC Waiver website for dates).

4. REGION 15 – DSRIP PROJECT PRESENTATIONS

a.  Improving Care and Outcomes of High Risk Newborns after NICU Discharge using the Patient Care Navigation Program – By Dr. Maria Teresa C. Ambat, TUHSC

Dr. Ambat gave a presentation of the NICU navigation project operated by Texas Tech University Health Sciences Center along with IGT by University Medical Center. This presentation included power point slides that will be publicly posted on the region’s website. The project establishes a patient care navigation program within the high risk clinic operated by the department of pediatrics of Texas Tech University Health Sciences Center in El Paso. Dr. Ambat explained that patient navigation is a process by which a patient navigator guides patients through and around barriers in the complex care system to help ensure that patients receive coordinated, timely, and site-appropriate health care services. The target population for this project are infants born at less than or equal to 32 weeks gestational age and/or infants whose birth weight was less than 1500 grams. These patients represent a cohort of high-risk patients discharged from the El Paso Children’s Hospital Neonatal Intensive Care Unit.

Implementation of the project began with development of a protocol or roadmap that includes specific steps to navigate to improve care and outcomes of the target patient population. Dr. Ambat explained the development process and provided a status of current activities underway in the project. In addition to improving patient care, the project also will focus upon outreach with patient families to promote retention. The project provides information to help families understand the importance of follow-up programs and their impact on long-term outcomes to encourage compliance. The navigation process will help ensure that patients’ receive culturally competent care that is also confidential, respectful, compassionate and mindful of patient’s safety. Patient navigators participate in the discharge process at El Paso Children’s Hospital NICU and help the NICU team prepare families for the next phase of care. Two weeks afterwards, navigators conduct follow-up phone calls and repeat the contact after every clinic visit. Navigators provide a helpful resource to assist when parents encounter barriers to care such as lack of transportation, health insurance complications, daycare needs, and other circumstances.

Project data to date demonstrates that the project has surpassed its initial QPI goal for DY3 with enrollment of 50 patients. Based on this success, plan modifications were submitted to increase QPI goals for DY4 and DY5 respectively. The category 3 quality measures include IT 8.21 developmental screening in the first 3 years of life, IT 9.9 transition record with specified elements received by discharged patients, and IT 8.25 sudden infant death syndrome counseling.

b.  Community Health Atlas – By Fernando Gonzalez, Lead Epidemiologist, City of El Paso Department of Public Health

Fernando Gonzalez, Lead Epidemiologist, City of El Paso Department of Public Health, gave a presentation on the City’s Community Health Atlas project. His presentation also included power point slides that will be publicly posted on the region’s website. This project is a four year developmental effort to capture disease and health condition data from existing and supplemental databases then map the data for informing of policymakers, planners, researchers and interested members of the public. There are several participating institutions including the department of public health, the City’s Fire/EMS department, area academic institutions, hospital and health centers, and the Paso del Norte Health Information Exchange, among others. The project will be able to display and layer real data at zip code level for informing policymakers and health advocates of the area. Data may help identify data repository participants and extended family members in need of preventive health services, e.g. breast and cervical cancer screening, and refer to medical home and other follow up providers for additional care and/or immunizations.

The project is informed by the ATLAS Healthcare Mapping Model developed in 1993 from the Dartmouth Institute for Health Policy and Clinical Practice. It provides national reporting of health system performance over time in utilization, cost, quality, and patient experience. Data is utilized to effect positive changes in the health care system.

Project milestones to date include determination of content for the data repository, engagement of Dartmouth Institute collaborators in a joint effort with Texas Tech University Health Sciences Center, development of a business plan for collection of biomarker data, and hiring of a database administrator. Progress reported to date includes agreements entered with area universities, scheduling of a UTEP and neighborhood fire station pilot on September 20th, collaboration with PdNHF Health Information Exchange, standardization of REAL data survey collection, distribution of vouchers for screening and immunizations, activities with the new mobile dental unit, and solicitation for preventive care services from local providers for mammography, pap testing, and FOBT.

5. Update on Regional Learning Collaborative – Diabetes, by Moses Priego, UMC

Moses Priego, Director of Region 15’s Learning Collaborative on Diabetes, presented an update on the activities of the regional collaborative. He reported that collaborative participants recently included a discussion regarding lessons learned to date and reassessment of the present breadth and scope of the regional collaborative. The primary question examined asked whether providers were satisfied that an impact on diabetes had been achieved within their clinics. The general consensus of the group was that the learning collaborative had not yet fully achieved its goals. Participants found it helpful and useful to continue meeting, sharing data, learning about quality improvement methodologies, and other discussions centered on the topic of providing care and improving outcomes for diabetic patients. Participants also determined that quarterly meetings would continue with data gathering and analysis between sessions. Collaborators continue to outreach with other providers in the region and are interested in wider inclusion.

Mr. Priego also described an opportunity exists to initiate additional collaboratives on other topics. Suggested ideas include mental health and reduction of readmission rates. EHN representatives present at the meeting said they would welcome an additional collaborative on the topic of mental health and would consider taking on a leadership role to develop and lunch a second collaborative.

6. ROUNDTABLE DISCUSSION OF PROJECTS OR ANY ISSUES OF CONCERN

Discussion was held among meeting participants regarding DSRIP issues of their own concern.

7. ADJOURNMENT

Ms. Gibson adjourned the meeting at 2:15 p.m.

Ms. Cathy Gibson, Chief Waiver Officer

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September 24, 2014