August 1, 2017 Jefferson County Public Health Lakewood, CO MFHCC Meeting August 1, 2017 Jefferson County Public Health Lakewood, CO

Welcome & Introductions Lisa

Agenda Arrive, sign in, grab lunch Welcome & Introductions – Lisa Review Previous Action Items – Janelle Agency Updates - All – Janelle North Central Region Healthcare Coalition (NCR HCC) Development Process – Suzanne Boccia and Karri Knight Review of Public Health Emergency Dispensing Exercise (PHED EX) - All Upcoming Training and Events – Lisa Member Agency Spotlight: FQHCs Review New Action Items – Janelle

Review previous action items Janelle

Review Previous Action Items Person responsible Deadline Contact Christine/Cali if interested in becoming a JCPH or Denver Closed POD. All On-going Member Spotlight - email Janelle and Lisa if you would like to be featured on the website. Share updates about HPP/HCC changes. Lisa and Janelle Contact Ginny Schwartzer if interested in participating in a Disaster Book Club. Ginny Schwartzer

Agency updates Janelle We have noticed that there have been fewer report outs during the agency update section of recent meetings. As a reminder, it is helpful to share updates about recent drills and exercises, lessons learned, available resources to share, job openings, staff changes or recognition, etc. Also, in an effort to save time, we are not going to call out various disciplines so people can respond at any time. Janelle

Agency Updates Please mention brief updates you would like to share with the entire group Include your name and agency name High level reports applicable to various agencies Updates requiring in depth discussions may transition into workgroups

Agency Updates Epidemiology Update Hospitals Public/Environmental Health EMS Provider Emergency Management Long Term Care Mental/Behavioral Health Outpatient Medical Services (Example: community health center, clinic, dialysis, etc.) Other HCC Partner (Example: education, private, federal entity, coroner, etc.).

North Central Region Healthcare Coalition (NCR HCC) Update Suzanne Boccia and Karri Knight

North Central Region Healthcare Coalition (NCR HCC) New NCR HCC page on the MFHCC website: https://metrofoothillshcc.com/north-central-region-healthcare-coalition-ncr-hcc/

North Central Region Healthcare Coalition (NCR HCC) Fiscal Agent – Trailhead Institute Completed first task of NCR HCC – to select a fiscal agent Completed CDPHE paperwork for Trailhead Institute to be NCR HCC fiscal agent NCR HCC funds will be sent by ASPR to Trailhead Institute Trailhead will be responsible for paying for vendors, exercises, potential staff member, meeting expenses, etc., according to process to be established by NCR HCC governance board Trailhead will provide regular fiscal reports to governance board Kickoff meeting with Trailhead and NCR HCC governance board representatives on 12 July The MFHCC has been well represented at the meetings to date. We want to thank our members who have volunteered to serve on the governance board and have been available to participate. The three existing healthcare coalitions will continue to meet and function as they have to date. 12 July – Kickoff meeting with Trailhead Institute (our fiscal agent) and NCR HCC Governance Board representatives Reviewed fiscal sponsorship agreement Discussed Trailhead expertise and what they can do for us. They have lots of experience and can offer past examples for how we can develop a process for spending our HCC funds based on our membership and deliverables. They have experience working with CDPHE, they can provide us with fiscal training and technical assistance, and will help us develop a payment request and approval process. They will provide us regular fiscal reports to help us manage our funds.

North Central Region Healthcare Coalition (NCR HCC) NCR HCC governance board is meeting monthly Establishing governance board leadership structure and associated governance documents (charter, leadership position descriptions) Workgroup reviewed Scope of Work (SOW) to draft ideas of how to complete deliverables Will document other desired work that would benefit the North Central Region (e.g. revised radio templates) Investigating the option of hiring a contractor or affiliated employee to coordinate all activities Beginning discussions for funds spending process and distribution NCR HCC Governance Board meeting (met May, June, July) Will be conducting board leadership elections in August. Will serve 90 days, then revisit. We are developing leadership position descriptions. Workgroup to draft governance board charter - Have examples from across US to use as templates We are developing a job description for the possibility of hiring someone to help complete all HCC work. Using examples from other HCCs across the state. Faster, less red tape process. Don’t need to release an RFP to get someone on board. We will begin development of the process to determine how NCR HCC funds will be spent. Looking at other HCC processes, and current NCR HLS grant project processes as examples

Next Steps Elect New Hospital Representative Need to appoint a new hospital representative from the MFHCC to the governance board Proposal for Hiring Staff Person Statement of Work group will put together a proposed job description and interview questions, and then will decide what % of staff person time the NCR HCC needs to support the projects Board Leadership Position Descriptions A group is developing leadership position descriptions for review Board Leadership Elections Electing 2 Co-Chairs, Treasurer, and Secretary for 90 day term, then re-visit the need for new elections

Review of Public Health emergency Dispensing Exercise (PHED EX) Lisa and Janelle

PHED EX Public Health Emergency Dispensing Exercise (PHED EX) – June 15-17, 2017 MFHCC tested resource ordering and information sharing

PHED EX Here are some photos of Denver County’s Point of Dispensing (POD) which was managed collaboratively by Denver Public Health and Denver Environmental Health.

Here are some photos the Jefferson County Emergency Operations Center (EOC) and Regional Transfer Point (RTP).

Here are some photos the PODs in Floyd Hill, Idaho Springs and Georgetown.

MFHCC Participation Summary – PHED EX Janelle

Janelle

Janelle

PHED EX Discuss successes and lessons learned for all MFHCC agencies during PHED EX Take 1-2 minutes to briefly share 1-2 successes and lessons learned from your agency’s participation Lisa

PHED EX Debrief MFHCC Information Sharing and review communication survey feedback JCPH EOC & DPH DOC Experience Survey & Discussion 31 survey respondents Lisa (summarize feedback for each question) Q6 (not graph or comments, only #s) (summarize feedback for each question) Q7 (graph only) (summarize feedback for each question) Q8 (just numbers) (summarize feedback for each question) Q12 (use graph, #’s) include Other categories (summarize feedback for each question)

Lisa

Janelle -

Janelle

Upcoming Trainings and Events Lisa

MFHCC Website - 2017 Training and Exercise Opportunities in our Community Aug 11 - MHCD – Need volunteers to participate in Active Shooter Exercise (contact Melissa Zotara) Aug. 12 – Emergency Preparedness Training for Transition-aged Youth (14-25) with Development Disabilities (Aurora) Aug 21-24 –National EMS Safety Summit Aug 22-23 – Cyber Exercise for Everyone Sept. 19-20 - Pediatric Disaster Response and Emergency Preparedness Sept. 28 – TB Update and Tuberculin Skin Testing Practicum for Health Care Providers Lisa - Visit the MFHCC website for details about all of the events listed. All of the listings in red are new offerings. The TB and pediatric topics have been specifically requested by MFHCC members in the past. Please send us training opportunities so we can share them with members on our website.

Member Agency Spotlight – Federally Qualified Health Centers Paula Davis, Jeremiah Jones, James Munford

Community Health Centers, MCPN, and Our Patients

Partner with the community to provide excellent, Mission: Partner with the community to provide excellent, culturally-sensitive health services to meet the needs of each individual Every Touch, Every Time. Vision: Individuals empowered to live the lives they want through personalized, compassionate healthcare.

MCPN Family Health Centers Chain of Support and Responsibility OPC&OPA 330/340B MCPN Family Health Centers

Federally Qualified Health Center Designation received under Section 330 of the Public Health Service Act under Health Resources and Services Administration (HRSA) or designated by approval of the Secretary of Health and Human Services

Community Health Centers (CHCs): Non-profit or public providers of high-quality, affordable primary and preventive care serving low-income and medically underserved communities. CHCs accept patients who are uninsured, self-paying, on Medicaid, Medicare, or CHP+, who have private insurance, or who are eligible for other programs (In Colorado, this includes the Colorado Indigent Care Program). In the United States, there are 1,400 CHCs delivering care at 9,000 service delivery sites. $24 billion is saved annually, through decreased ER, hospital, and specialty care costs.

Colorado’s CHCs And Who They Care For Over 93% of patients at Colorado CHCs have family incomes below 200% of the Federal Poverty Level ($48,600 per year for a family of four in 2016). CHCs cared for 25% of Colorado’s Medicaid enrollees and 25% of Colorado’s Child Health Plan Plus (CHP+) enrollees.

In Colorado: 20 Community Health Centers The CHCs operate 186 sites in 39 Colorado counties, serving people in 61 counties. In 2015: 700,000 patients (1/8 of the state of Colorado population) seen in the CHCs 94% had incomes below 200% of the Federal Poverty Level. Over 90% were uninsured or enrolled in Medicaid, Medicare, or CHP+.

Who is MCPN? MCPN's current service area encompasses Adams, Arapahoe, Douglas, Jefferson, and Park Counties. From a single clinic in 1989, MCPN has grown into a large, integrated health care delivery system with 25 health center locations, including two School Based Health Centers (SBHCs), providing primary medical care, dental care, pharmacies, social work, and behavioral health services. The mobile dental van provides oral health services to Jefferson County Public Schools. Six of MCPN's health centers are co-located within our community partners offering behavioral health services. In 2016, MCPN served 50,502 patients through 286,165 service encounters.

MCPN Service Area In 2016, MCPN added 3 new health center locations- 2 in Aurora and 1 in Lakewood

MCPN Services – Medical Family Practice Pediatrics Obstetrics Internal Medicine Geriatrics Specialized Primary Care Services- Disabilities(Physical or Intellectual), Down Syndrome, Women’s Wellness, Multiple Sclerosis, HIV, Adolescent Medicine, Refugee Health X-ray, Ultrasound, and Pharmacy

MCPN Services –Behavioral Health Outreach activities- MCPN has partnered with local community mental health centers in their catchment areas to provide short-term behavioral health services in most of the clinics to individuals of all ages. Whole Person Care - This type of care model is focused on the whole person and integrates with all service areas of the health centers. Short Term Therapy Options- Individual therapy, group therapy, family therapy, assessments, case management, crisis interventions, phone consultations and home visits. Areas of Specialty- Adult ADHD, alcohol use, anger, anxiety, trauma, trauma, diabetes, grief, job loss, loneliness, memory issues, mood swings, new diagnosis, pain, parenting, post-partum, sadness, self-esteem, smoking, depression, chronic illness, substance use and any other area of struggle.

MCPN Services - Dental Outreach activities- Oral health assessments, fluoride, and sealants in public schools, Public Health, and community events and health fairs. Comprehensive Dentistry- Fillings, extractions, root canals, crowns, bridges, partials, dentures. Oral Health- Prevention services (exams, cleanings, fluoride, sealants), periodontal treatment, and oral health education. Pediatric Dentistry- Pediatric care and service; to include oral surgery. Medical Dental Integration- Integrate oral health assessments and treatment within the medical clinic and refugee services.

MCPN Services – Outreach and Enrollment Outreach activities- Attending local community partner events, libraries and food pantries to speak to families and individuals about MCPN and the medical assistance programs we could potentially help them enroll in. Enrollments- Educating the community abut MCPN Discounts, CICP, Medicaid/CHP+ and Connect For Health Colorado. Service- Fostering and building relationship with many collaborative partners, acting as liaison between clinics, programs and clients; screening clients for eligibility for CICP, Medicaid/CHP+, MCPN Sliding Fee Discount Program, and Connect For Health Colorado.

MCPN Services – Community Services Care Coordination- MCPN care coordination provides assessments, referrals, community resources, coaching, and support to MCPN patients proactively by assisting in managing the patients healthcare needs. Service: Accountable Care- The Accountable Care Collaborative (ACC) is a new Medicaid program to improve clients’ health and reduce costs through decreased ER utilization. Service: Bridges to Care- Bridges To Care (B2C) is a program designed to reduce ER visits and inpatient hospitalizations and improve access to care for complicated patients.  Our interdisciplinary team provides intensive services in patients' homes or in the community.  Homeless Services- Serves patients in clinic as well as in the community whom are experiencing or at risk of homelessness. Elmira Refugee Health Center- Supports newly arriving refugees, asylees and other eligible individuals resettling in the State of Colorado with their medical screening, health education and establishing a medical home.

MCPN Services – Community Services (cont.) Service: Patient Navigation- Patient Navigation services are available for patients who require or request further support during or following their medical visit. Patient Navigators are available to help the patient complete referrals, follow up on doctors orders, and address psychosocial concerns that do not require full case management. Service: Health Education- Individual appointments and group classes offered by Health Educators and Dieticians to support patients looking to address and manage their diabetes, pre-diabetes, gestational diabetes, high blood pressure, high cholesterol, and/or to work on individual weight management goals. Service: Sexual Health- Empowering patients to make the best decisions for their sexual/reproductive health through health education support in the form of individual and group visits focused on: contraceptive counseling, STD testing and treatment, Ryan White HIV clinic, adolescent sexual health and decision-making, healthy pregnancy, childbirth, breastfeeding, and newborn health education.

Thank you for your interest Thank you for your interest. Now go out and spread the word on who we are and what we provide! .

Review New Action Items Janelle

Thank you and Networking!