A Medical Home System

1

• A Medical Home System
• Supporting
• Individual Health Care Practices to
• Provide a Medical Home Approach

2
Objectives

• Understand Colorados Medical Home Initiative
  (CMHI), Vision and Guiding Principles
• Understand Colorados strategies to involve
  families in Medical Home efforts at national,
  state and local level
• Explore the successful steps of integrating
  Colorados legislation with goals of the CMHI
• Share Colorados Medical Home Standards and
  approach to implementation
• Understand the role of Public Health in building
  a Medical Home System

3
Colorado Medical Home Initiative

• Incremental Steps included
• Responding to the Title V National Outcome
  Measure (2001)
• Commitment to diverse perspective
• Hired a Developmental Pediatrician
• Established relationship with local AAP
• Defined Medical Home - Approach
• Participated in the NICHQ learning collaborative
• Ceased direct services
• Reframed goals of local/regional offices

4
Colorados Medical Home Initiative

• The Colorado Medical Home Initiative is a
  statewide effort to build systems of quality
  health care for all children in Colorado while
  increasing the capacity of providers to deliver
  care to kids in our state.

5
(No Transcript)
6
Community Resources
Primary Care
Recreational Services
Social Services
Patient Family
Mental Health
Specialty Care
Vocational Services
Oral Health
Educational Services
7
Core Medical Home Components

• Accessible support of primary and specialty
  care capacity, insurance eligibility, advocacy
• Family Centered support of families as
  advocates, participants in community planning
• Continuous linking community resources, support
  of medical information transfer
• Comprehensive linking medical, mental health
  and dental providers to ensure global thinking
  about the total child and family

8
Core Medical Home Components

• Coordinated working with medical components
  (inpatient and outpatient), educational and
  community resources to ensure efficiency
• Compassionate community resources include
  provision for respite care, linking to faith
  communities, and behavioral/mental health
• Culturally Responsive culturally sensitive
  partners are recognized and linked to families

9
Guiding Principles

• Title V is a facilitator in shifting the paradigm
  of health care delivery in response to changes in
  the traditional PCP model
• The concept of the health care team
• Increasing educational opportunities for families
  to assure authentic partnerships
• Medical, Mental and Oral health providers are
  equal partners

10
Families as Partners

• Embracing families as a resource not simply as a
  consumer of services
• Integrating the core concept that CYSHCN are not
  asking to be fixed
• Understanding the difference between family
  representatives and family leaders
• Invest in family leadership development and
  utilization thereof
• Respect the process of leadership development

11
 
12
Examples of Integrating Family Leaders into
Medical Home efforts

• Understanding families are a valuable resource
  and human capital
• Supporting emerging family leaders to attend
  national and state conferences
• Equitable compensation
• Systems approach to leadership development

13
Colorados Medical Home Legislation

• Concerning Medical Homes for Children (SB-07-130)
• Integration of efforts
• Collaboration with Title V
• Increasing access to Medicaid providers
• Developing standards

14
Colorados Medical Home Definition per
Legislation

• An appropriately qualified medical specialty,
  developmental, therapeutic, or mental health care
  practice that verifiably ensures continuous,
  accessible, and comprehensive access to and
  coordination of community-based medical care,
  mental health care, oral health care and related
  services for a child. ..If a childs medical home
  is not a primary medical care provider, the child
  MUST have a primary medical care provider to
  ensure that a childs primary medical care needs
  are appropriately addressed.

15
Colorado Medical Home Standards

• Developed by the Evaluation Task Force
• Based on Quality Components
• Developed by key stakeholders
• Statewide consciousness
• Assurances

16
What we learned

• Providers articulated technical assistance needs
• Families were eager for partnerships
• Providers had a format to express fears and
  concerns
• Revived commitment Medical Home Learning
  Collaborative - NICHQ model

17
From Policy to Practice

• Moving the Medical Home Nirvana to the impact
  on individual families
• Preserving the integrity of our commitment to
  supporting our provider communities

18
What is a Medical Home System?
  The state and local personnel, processes,
individuals, procedures, materials that support
providers to implement the practice-level medical
home standards. Often there are local and state
systemic issues such as lack of specialists,
access to insurance, and uncertainty of local
resources that prohibit providers from providing
a medical home approach. A state and local
infrastructure to overcome these barriers and to
provide technical assistance to providers is
called a medical home system.
19
What Role Does Local Public Health Play?

• Support of a Medical Home System
• Identification of barriers
• Technical assistance to providers
• Convening key stakeholders
• Data collection
• Gap filling services
• Communication of legislation
• Support of outreach clinics

20
Develop policies plans that support individual
and community health efforts
Monitor health status to identify community
health problems
Inform, educate, and empower people about health
issues
Assessment
Mobilize community partnerships to identify
solve health problems
Diagnose investigate health problems and health
hazards in the community
Core Public Health
Assurance
Policy Development
Enforce laws regulations that protect health
ensure safety
Research for new insights innovative
solutions to health problems
Assure a competent public health personal
health care work force
Evaluate effectiveness, accessibility, quality
of personal population-based health services
Link people to needed personal health services
assure the provision of health care
when otherwise unavailable
21
What Role Could Local Public Health Play?

• If/When we establish Consistent and Coordinated
  services throughout the state
• Mobilize community partnerships
• Efficient local policy development
• Long term planning
• Empowerment of community family and professional
  leaders
• Advocacy for underserved populations
• Intentionally connecting infrastructure of public
  health with the personal health care system

22

• Unprecedented Opportunities

23
Responding to Opportunities

• Passage of legislation to expand Public Health
  functions
• Positive health care reform activities
• Early Childhood Comprehensive Systems grant

24
Why Medical Home now?

• The concept and definition are rapidly evolving
  as the pressures of our national health care
  crisis become increasingly evident.
• Ultimately the intent is to improve care.
• Revived commitment to community-based,
  family-centered care.

25
Colorado Childrens Health Access Project
(CCHAP) Increase Medicaid, S-CHP in Private
PracticeAAFPMental HealthOral Health
Provider Connections
26
Medical Home Systems Building Projects

• Assuring Better Child Development (ABCD)
• Linking and Aligning
• Medical Home Action Guide
• Re-framed our regional structure to address MH
• Evident in assessment and planning
• Colorado Childrens Health Access Project (CCHAP)
  
• Integrated Systems Grant
• Family Leadership Training Institute
• School Based Health Clinics

27
Helpful Resources/References

• American Academy of Pediatrics, National Center
  of Medical Home Initiatives for Children with
  Special Needs www.medicalhomeinfo.org
• Center for Medical Home Improvement,
  www.medicalhomeimprovement.org
• National Initiative for Childrens Health
  Quality, www.NICHQ.org
• American Academy of Family Physicians,
  www.futurefamilymed.org
• American College of Physicians,
  www.acponline.org/advocacy/?hp
• Health Care Program for Children with Special
  Needs www.hcpcolorado.org
• Colorado Childrens Health Access Project
• www.cchap.org

28

• Contact Info
• Kathy.Watters_at_state.co.us
• Eileen.Forlenza_at_state.co.us
• 303-692-2370