JANUARY 2010 ISSUE

Safety Net Capacity Expansion Project

In August 2009, the REACH Healthcare Foundation and the Health Care Foundation of Greater Kansas City awarded a combined grant of $700,000 to a consortium of Kansas City-area safety net clinics. The purpose was to expand the capacity of the clinics to provide care to more patients during evening and weekend hours.

The safety net clinics include: Swope Health Services–Main Campus, Southwest Boulevard Family Health Care–Quindaro, Health Partnership of Johnson County, Kansas City Free Health Clinic and Samuel U. Rodgers–Crestview Clinic. These clinics were selected because they provide care in geographically dispersed portions of the region.

The clinics worked together during the fall of 2009 to define outcomes and hire staff. Most are now providing direct services during evening hours, and planning is underway for added weekend hours. The clinics are open during the evening hours listed in the table below.

For more information on clinic appointment availability please contact each clinic directly.

Children’s Enhancement Project ready to begin services

On Dec. 30, 2009, Kansas City stakeholders received a contract with the Missouri Department of Mental Health Services (DMH) in the amount of $565,250 to begin transforming mental health services for the most severely mentally ill children in the northwest region of Missouri. The contract is for the six-month period beginning in January 2010. Full funding for the project in the amount of $1.2 million annually is expected in the future.

For the last year, northwest Missouri stakeholders interested in behavioral health services for children have been discussing a new system of care to help extremely challenging children stay in their homes. The project, fully described in previous newsletters, focuses on keeping children out of state mental health hospitals and in their communities. The impetus for the project was the closure of the children’s unit at Western Missouri Mental Health Center, now the Center for Behavioral Medicine.

Stakeholders in northwest Missouri worked together to develop a project with resources and supports that will allow the community to provide an acute level of services rather than requiring a hospital setting. The new funding will cover costs not billable through traditional funding sources and will include such activities as intensive training for family members and staff, specialists to work directly with the children for extended periods of time, and the recruitment, training and oversight of intensive-treatment family homes.

CommCare is currently hiring a coordinator for the program. Funding for an outside evaluation is being sought and the formation of a Steering Committee and an intensive staffing team will begin in January 2010. For more information, contact Laura McCrary.

KCBHIE accepting nominations for Formational Board of Directors.

The selection committee of the Kansas City Bistate Health Information Exchange met on Jan. 11, 2010, to discuss the process to select a Formational Board of Directors for the health information exchange being developed in the Kansas City region. David Warm, executive director of the Mid-America Regional Council, will lead the process as a non-voting member. The following individuals, nominated by interested stakeholders in the community, are voting members on the selection committee:

• Myra Christopher, CEO of Midwest Center for Bioethics
• William Bruning, CEO of Mid-America Coalition on Healthcare
• Sandra Lawrence, CFO of Children’s Mercy Hospitals
• Jeff Ellis, Attorney at Lathrop and Gage
• Bridget McCandless MD, CEO of Jackson County Free Health Clinic
• John Wade, President of J.C. Wade & Associates

The guiding governance principles for the new Formational Board will provide the basic structure for the new board. The board will be in place by early 2010 and will comprise nine to 11 people who will serve for 12–18 months until a permanent Board of Directors is named.

If you are interested in nominating yourself or others for the KCBHIE Formational Board of Directors please fill out the nomination form and return it to David Warm by 5:00 p.m. on Jan. 25, 2010.

KCBHIE sponsors vendor demonstrations

In December, KCBHIE stakeholders sponsored vendor demonstrations for five health-information exchange vendors that submitted proposals for the project — Axoltol, Cerner & Browsersoft, Informatics Corporation of America (ICA), Medicity and RelayHealth.

The demonstrations were held at the Town Pavilion conference facility and any interested stakeholder was invited to participate. Each vendor had three hours to demonstrate the functionality of its electronic medical record and health information exchange and answer questions from the audience.

Members of the audience completed reaction evaluations that provided input to the KCBHIE vendor selection committee. The vendor selection committee used this information, along with evaluations of the written proposals, to narrow the vendors to three: Axoltol, Informatics of America (ICA) and Medicity.

Prior to making its final recommendation, the vendor selection committee will continue to gather information about the remaining vendors through in-depth pricing meetings, reference checks, direct observations of the EMR and HIE functioning in a community, and webinars for hospitals and physicians. If you are interested in participating in the process, please contact Sonya Wills for more information.

State Health Information Exchange processes move forward

The development of statewide Health Information Exchanges in both Kansas and Missouri has gained momentum over the last few months. The primary goal of HIEs is to allow health care providers and stakeholders to share data for coordinating patient care and to support public entities in understanding and improving health goals for the entire population. Every state will receive funding from the U.S. Department of Health and Human Services to help achieve the national goal of having an electronic health record for every American by 2014.

The information below is a synopsis of what is happening in each state. However, much more information is available on the Missouri and Kansas HIE websites.

Kansas HIE progress:

The Kansas Department of Health and Environment (KDHE) is the state designee for health information technology (HIT) for the state of Kansas. KDHE provides leadership and staff support to the e-Health Advisory Council. The e-Health Advisory Council is a group of health-care stakeholders guiding the planning and HIE implementation process in Kansas. The e-Health Advisory Council has been meeting in work groups which focus on facets of the project including governance, technology, business operations, finance and legal.

In January 2010, the e-Health Advisory Council will begin consolidating the efforts of the work groups into a strategic plan for Kansas. Throughout 2010, the Council will focus on creating the operational and strategic plans. The next meeting of the e-Health Advisory Council is Feb. 9, 2010. The committee meets monthly and meetings are open to the public. 2010 meeting schedule>

The e-Health Advisory Council in Kansas has established a “Skunk Works” team to fast track HIE for providers who are ready to connect to an exchange in 2010. Further information regarding the Skunk Works process will be discussed at the January 14 meeting.

The Kansas Foundation for Medical Care was asked by the Office of the National Coordinator (ONC) to submit a full proposal to establish a Regional Center for Health Information Technology. The goal of the regional center will be to provide support to primary-care providers across the state in the implementation of an electronic medical record system and connection to an HIE. Michael Aldridge has been hired to lead the Regional Extension Center for Kansas. Notification of funding is expected in January 2010.

Missouri HIE progress:

On Nov. 4, 2009, Governor Jay Nixon signed Executive Order 09-27 which created the Missouri Office of Health Information Technology (MO-HITECH) which is assigned to the Department of Social Services. MO-HITECH will promote the development and application of an effective HIT/HIE infrastructure for the state of Missouri. The MO-HITECH office is led by Department of Social Services Director Ronald Levy. A statewide advisory board was also created. The advisory board is responsible for advising the state’s strategic and operational plan for establishing a statewide HIE. The advisory board has 20 members appointed by the governor. For the list of members please refer to the state website. Work groups focusing upon governance, finance, privacy and security, and technology have also been established. Work groups are open to the public and a list of the work groups and meeting dates are also listed on the website.

While Missouri was not asked to submit a full proposal in the first round for a regional center, the Center for Health Policy Management at the University of Missouri has submitted a Regional Center application in the second round. More information regarding the regional centers will be available from the ONC in January 2010.

Both Kansas and Missouri have submitted HIE applications/grants to the ONC for statewide HIE planning funds. Funding from the planning grants will assist both states in development of statewide HIE implementation plans. The implementation plans must be submitted to the ONC and once they are approved the states will beeligible for implementation funding. For more information regarding the HIT/HIE process in both Kansas and Missouri please refer to the websites linked above.

Kansas City C.A.R.E. Clinic provides care to over 2,000 uninsured people

On December 9 and 10 hundreds of volunteers provided free health care, dental care and behavioral health services to over 2,000 uninsured people at Bartle Hall amid frigid temperatures, ice and snow. Patients were encouraged to make appointments but many patients simply stood in line to receive health care.

The patients had a wide variety of health care needs. Approximately 38 percent of the patients needed dental care, including many who needed multiple extractions. Nearly 30 percent of the patients reported general pain and 20 percent of the patients had hypertension. Vaccinations were provided to the patients, including 679 seasonal flu injections and 719 H1N1 injections.

Patients were asked where they had received their health care in the past. A large number — 36 percent — of the patients indicated they did not go anywhere for health care and 6 percent indicated they had not received health care in over 10 years. Hospital emergency departments were the health care provider of choice for 26 percent of the patients, while 25 percent noted that they went to a clinic.
Demographic data indicated that most of the patients were Caucasian (43 percent) or African American (41 percent). Asians comprised 11 percent of those seen, 3 percent were other races, and 2 percent were multi-racial. Age ranges included 39 to 58 years of age (50 percent), 19–38 years of age (36 percent), under age 18 (7 percent) and over age 59 (7 percent).

The C.A.R.E Clinic received media coverge from MSNBC, which broadcast live from Bartle Hall. A wide variety of follow-up mentions of the clinic have appeared in other media, including The Wall Street Journal, NPR, BBC and others.

Special recognition goes to CEO Sheri Wood and the staff of the Kansas City Free Health Clinic who provided the local organization necessary to ensure the clinic's success.