SE Washington ACH Project Planning 4-28-17 Process for Optional Medicaid Transformation Demonstration Project Selection – Greater Columbia ACH SE Washington ACH Project Planning 4-28-17

Leadership Council’s Role per GCACH Bylaws, adopted 2/18/16 “General members participate in the GCACH through the Leadership Council. The Leadership Council is a permanent advisory committee to represent the community in the work of the Board, act in an advisory capacity to the Board, and serve as advocates for priorities in the communities from which the members come. In addition to tasks assigned to them by the Board, the Leadership Council: Develops a list of priority issues to be addressed by the GCACH. Develops strategies to address priority issues; Monitors indicators of population health in the regional services area; and Monitors the performance of regional healthcare delivery systems. Leadership Council members may serve on workgroups established to address the priority issues identified by the GCACH.”

Proposed “Re-Formation” of Priority Work Groups Project Teams GCACH Priority Work Group MTP Project Team Project Behavioral Health Bi-Direction Integration of Care & Primary Care Transformation 2A Addressing Opioid Use Public Health Crisis 3A Care Coordination Care Coordination (Pathways Hub) 2B Transitional Care & Diversion Interventions Transitional Care and Diversion Interventions 2C 2D Healthy Youth & Equitable Communities Reproductive and Maternal/Child Health 3B Oral Health Access to Oral Health Services 3C Diabetes/Obesity Chronic Disease Prevention and Control 3D

Suggested Project Teams’ Role Act as Advisory to the Board Represent Subject Matter Expertise Bring in Subject Matter Expertise Review Data & Evidence-Based Studies in the MTD Project Toolkit Determine Community Strengths and Gaps Represent Sectors Find Connections between Approaches Make Recommendations to Board

Project Objective/Goal MTP Project Team Project Project Objective/Goal MTP Weight Bi-Direction Integration of Care & Primary Care Transformation Example: Team Based model that adds a behavioral health care manager and a psychiatric consultant to support the primary care provider’s mgmt. of individual patients’ behavioral health needs 2A Project Objective: Through a whole‐person approach to care, address physical and behavioral health needs in one system through an integrated network of providers, offering better coordinated care for patients and more seamless access to the services they need. This project will support and advance Healthier Washington’s initiative to bring together the financing and delivery of physical and behavioral health services, through MCOs, for people enrolled in Medicaid. Required 32% Addressing Opioid Use Public Health Crisis Example: AMDG’s Interagency Guideline on Prescribing Opioids for Pain, CDC Guideline for Prescribing Opioids for Chronic Pain, Substance Use during Pregnancy: Guideline for Screening and Management 3A Overarching Goal: Support the achievement of the state’s goals to reduce opioid‐related morbidity and mortality through strategies that target prevention, treatment, and recovery supports. 4% Care Coordination (Pathways Hub) https://innovations.ahrq.gov/sites/default/files/Guides/CommunityHubManual.pdf 2B Project Objective: Promote care coordination across the continuum of health for Medicaid beneficiaries, ensuring those with complex health needs are connected to the interventions and services needed to improve and manage their health. Optional 22% Transitional Care Example: A nurse led model of transitional care for high-risk older adults that provides comprehensive in-hospital planning and home follow-up Diversion Interventions Example: A systematic approach to re-directing and managing persons who present at the ED nor non-emergency conditions, which may be oral health, general physical health, and/or behavioral health conditions. 2C 2D Overarching goals: Improve transitional care services to reduce avoidable hospital utilization and ensure beneficiaries are getting the right care in the right place. Overarching Goal: Implement diversion strategies to promote more appropriate use of emergency care services and person‐centered care through increased access to primary care and social services, especially for medically underserved populations. 13% Reproductive and Maternal/Child Health Example: Nurse Family Partnership, Early Head Start 3B Overarching goal: Ensure that women have access to high quality reproductive health care throughout their lives and promote the health and safety of Washington’s children. 5% Access to Oral Health Services Example: Mobile/Portable Dental Care 3C Overarching goal: Increase access to oral health services to prevent or control the progression of oral disease and ensure that oral health is recognized as a fundamental component of whole‐person care. 3% Chronic Disease Prevention and Control Example: Stanford Chronic Disease Self-Mgmt Program 3D Overarching Goal: Integrate health system and community approaches to improve chronic disease management and control. 8%

Medicaid Transformation Project Certification & Application process for ACHs March RHNI Data Provided and HW Data Website Created STATE/PARTNERS ACH/REGIONAL March Certification Requirements Complete March/April VBP Taskforce July Project Application Template April DSRIP TA Starts May Certified Phase 1 Aug Certified Phase 2 Aug Dec 2017 Applications Approved Dec March Apr May June July Oct Jan March ACH Transition Plan in Place May 15th Certification Phase 1 Due June 30th Update SIM Budget Aug 14th Certification Phase 2 Due Jan Project Implementation Oct Oct 31st SIM Narrative Report Project Plan Applications Due Project Plan Development Q1 2017 Q2 2017 Q3 2017 Q4 2017 Jan 2018

Project Selection Process Timeline Project Selection Process April 20 Leadership Council Meeting Re-form 5 Priority Work Groups into 7 Project Teams Review MTP Approaches Assess Subject Matter Expertise on Team Review Data, Community Asset Inventory Select Project Team Facilitator May 4 Conference Call Project Team Facilitators Discuss Areas of Commonality between Projects May 18 Receive Report from Project Facilitators on Common Ground Receive Regional Survey Results Review Project Approaches Assess Community Readiness & Capacity Recommend Project Approaches June 15 Leadership Council Meeting Project Team Facilitators Select Project Approaches June 30-July 14 Public Input on Project Approaches July 18 Evaluation Team Recommends Projects for Board Consideration July 20 Board Meeting Project Selection by Board of Directors July 21-Oct 21 Project Plan Development

Project Selection Process (Revised April 26, 2017) Timeline Project Selection Process (Revised April 26, 2017) April 20 – May 3 Leadership Council Meeting Re-form 5 Priority Work Groups into 7 Project Teams Confirm/Select Project Team Facilitator Review MTD Approaches/Strategies Review Data Community Asset Inventory Assess Subject Matter Expertise on Team May 4 - 11 Conference Call Project Team Facilitators (PTF) Data Objective Gap Analysis ID Problem Areas Focus on Approaches Discuss Common Measures between projects (Wes’ MTD Toolkit Measure Set) Determine 2-3 Approaches/Strategies Criteria for Program Selection: Health Equity, Scalability, Evidence Based, # Impacted, ROI May 18 Receive Regional Survey Results Receive Report from Project Facilitators Breakout into Project Teams to determine 2 Project Approaches/Strategies to scale up Develops/Modifies Evaluation Criteria for program selection May 18 Board of Directors Approves Project approaches/Strategies from Project Teams May 19 - June 15 (PTF) Finalizes evaluation criteria for scoring final projects May 22 – June 16 World Cafés to showcase local programs to Public June 22 Project Team Facilitators recommend projects for full application process Leadership Council recommends application template for approval Leadership Council recommends projects to Board June 22 Board of Directors Board approves projects to move to full application process Board approves application template July ? Letters of Application Due July 20 Board Meeting Board approves final projects for Project Plan Application July - October Obtain attestations with organization, Write Project Plan Application

MTP Team recommends Approach(es) to Optional Projects Recommendation will be based on data, community asset inventory, Regional Survey results, consumer input, community impact Recommendation will consider community capacity and readiness Recommendation will incorporate the guiding principles from GCACH Regional Health Improvement Plan

MTP Team Facilitators Form Facilitators Council Charge of the Facilitators Council: Meet between Leadership Council Meetings Find areas of Commonality between Projects Study Data and Develop Narratives Bring in other Subject Matter Experts as needed Provide Bi-directional communication between Board and Leadership Council

For more information: Carol Moser cmoser@greatercolumbiaach For more information: Carol Moser cmoser@greatercolumbiaach.org Wes Luckey Wluckey@greatercolumbiaach.org Aisling Fernandez Afernandez@greatercolumbiaach.org Website: www.greatercolumbiaach.org Thank you for the opportunity to discuss Healthier WA with you today, and we look forward to a continued partnership as Healthier WA further develops throughout the state. Thank you!