JULY 2008 ISSUE

Safety Net Working Group committee reports

The Safety Net Working Group and two of its committees (Access to Care and System Capacity) did not meet in July. Other committee reports:

The Provider Relations and Advocacy Committee met on July 10. Committee members discussed the input received from recent focus groups that were held to gain input from safety net providers regarding key elements that should be included in a message to educate legislators and other stakeholders about the safety net system. The committee agreed that the Safety Net message should focus on three main points: Need: The story of the uninsured, supported by data. Solution: The story, history and collaboration of the safety net clinics. Difficulties: The barriers associated with maintaining a high-quality safety net system. MARC staff agreed to draft a message which follows this format for the committee to review in August. Members of the committee discussed plans to get the message out to the region and key safety net stakeholders. An initial message should be ready for regional stakeholders by the end of August, and the final message should be completed by the end year. Committee members also reviewed a directory of safety net stakeholders compiled by MARC. It includes contact information for elected officials, foundations, hospitals, chambers of commerce and local media. The directory will be disseminated to all SNWG members in August.

The Health Information and Exchange Committee met on July 16. Committee members heard updates about several local health information technology initiatives: KC CareLink: Linda Davis, executive director of KC CareLink, announced that KC CareLink and a technical advisory group will move forward with a strategic plan to implement a new system to replace or upgrade the existing KC CareLink technology. The goal is to develop a system that will exchange health information more efficiently and provide enhanced services to safety net providers. KC CareLink will issue an RFP to local and national vendors by the end of July. The technical advisory group will review the proposals and meet with potential vendors. The KC CareLink advisory committee will select a vendor in August, and building of the system is expected to start in January 2009. Lafayette County: Toniann Richard, executive director of the Lafayette Health Care Coalition, updated committee members on a collaborative health information technology initiative in Lafayette County. The county is working with Gregg Smith & Associates to assess the technology infrastructure of local health clinics, hospitals and health providers, with an end goal of building a community portal to share health information. The initial assessment will focus on hardware and software interfaces. The second phase of the project will focus on e-prescribing and the final phase will focus on the development of a community network to share patient-level health information by April 2009. UAW Ford Community Health Initiative: Cathy Davis, executive director of the UAW-Ford Community Health Care Initiative, announced that UAW is working in conjunction with Browsersoft Inc. to develop a health information data exchange focused on sharing quality health indicators. The exchange will provide a method for doctors to report and review patient-level health outcome data. The project will have reporting capabilities so stakeholders can review the quality of care provided by doctors and other health providers in the community. The project is funded by the Robert Wood Johnson Foundation. Eventually, the project will have public reporting and include the safety net providers. The timeline for the plan will be announced after July 30, 2008. The next meeting of the committee will be held on August 20 from 8:30-11:00 a.m. at the MARC Conference Center. Representatives from the Kansas and Missouri primary care organizations will present information on state-level health technology initiatives and KC CareLink will present information from the vendors that responded to its RFP.

HMA awarded contract for behavioral health needs assessment

The technical advisory committee that oversees the Kansas City Behavioral Health Needs Assessment has awarded a contract for the project to Health Management Associates (HMA). The needs assessment will identify specific initiatives that can improve access to quality behavioral health care for members of the Kansas City community.

HMA is an independent national research and consulting firm that specializes in complex health care program and policy issues. It was founded in 1985 in Lansing, Mich., and it provides technical expertise to local, state and federal governmental agencies. HMA has nine offices throughout the U.S.

Karen Hale from the Austin, Texas, office will lead the behavioral health team that will work in Kansas City. She has more than 25 years of experience in developing and managing behavioral health, developmental disabilities and other social services programs. She will begin work on July 29 with an initial meeting with the technical advisory team. The project should be completed by the end of this year.

Regular reports regarding the needs assessment will be provided to the Metropolitan Mental Health Stakeholders and other interested stakeholder groups. Updates will also be included in future newsletters. Please contact Laura McCraryfor more information.

E-Library to be launched this fall

The Health Information and Exchange (HIE) committee is working to develop an e-library. An e-library is a electronic library that it is available to anyone with Internet access. Documents and links in the HIE e-library will focus on the needs of the safety net providers in Greater Kansas City and others interested in health information technology.

The HIE e-library will have several sections:

• A list of practice management software and electronic medical record software currently used by area safety net providers. Local contact information for people who can share information about how each program is working will be included.
• Information on local and state health technology initiatives, with contact information.
• A list of electronic medical record software that meets the certification requirements from the Certification Commission for Healthcare Information Technology.
• Relevant health technology articles.

Additional information will be added in the future regarding the purchase and selection of an electronic medical record.

The e-library will be maintained by MARC staff and will be located on the Regional Heath Care Initiative web site at www.marc.org/healthinitiative.

Behavioral Health Initiative underway in St. Louis

Bethany Johnson from the St. Louis Regional Health Commission visited Kansas City on July 10. She shared information about the Eastern Region Behavioral Health Initiative with members of the Metropolitan Mental Health Stakeholders.

The goal of the initiative is to transform how behavioral health services, including mental health and substance abuse services, are provided to adults in St. Louis. Key components of the work include an integrated health care system that allows for easy entry, seamless navigation, effective case management, an array of treatment options, and recovery that balances independence and support.

Bethany said that the first step in the initiative was to determine the unmet need in St. Louis. Through a review of data, it was determined that 43 percent of the safety net population was in serious need of psychiatric services and 73 percent of the behavioral health providers in St. Louis had waiting lists. Additionally, primary and acute care providers identified mental health as a top unmet need in St. Louis.

To address these concerns a Behavioral Health Steering Committee was established to oversee work in three areas:  entry into the system, coordinating care for individuals with high utilization of the system and reducing stigma associated with mental illness.

• Improving entry into the system:  A standardized screening tool was developed and is currently being piloted in 16 behavioral health locations in St. Louis.
• Coordinating care for individuals with high system utilization: 19 organizations agreed to share patient-level data with the patient’s permission. Fifty individuals were identified as high-level users of the system. The total cost associated with their care for 2006 and 2007 was $6,439,294. The committee is working to provide comprehensive care coordination with a focus on cost reduction and improvements in access and quality of care provided.
• Reducing the stigma associated with mental illness: More than 18 organizations joined together to create a training program for mental health providers. The training program was developed in January-February 2008 and a full rollout began in June 2008. Over 70 individuals representing 40 health care organizations have attended the training.

For more information regarding the Eastern Region Behavioral Health Initiative, visit www.stlrhc.org.

Health Clinic South of 75th Street

A steering group established by the KCMO Health Department met on July 17 to explore the feasibility of establishing a health clinic south of 75th Street for uninsured and underinsured residents. The possibility of a school-based health clinic located in one of the Center School District buildings has been discussed for several years, but never implemented. Representatives from the KCMO Health Department, MARC, LINC, Center School District and KCATA attended, as well as Kansas City Councilmembers Cathy Jolly and John Sharp.

The group discussed input that was gained from the community about the need for health care in the area and reviewed visual information regarding potential locations for the clinic. One possible location is the Alternative Middle School located at 85th and Paseo. The Center School District is willing to partition off the building and provide two classrooms for the clinic.

Safety Net Profile: Duchesne Clinic

Duchesne Clinic 636 Tauromee Kansas City, KS 66101 913-321-2626

Duchesne Clinic is located in Kansas City, Kan., at 636 Tauromee. It is open Monday through Friday from 8:00-11:45 a.m. and 12:45 to 5:00 p.m. Duchesne Clinic provides quality primary healthcare for uninsured, low-income patients regardless of their ability to pay. The clinic is known for its commitment to the uninsured poor and for providing access to compassionate and trustworthy primary health care.

Duchesne Clinic was established in 1989 when Sister Rosalie Mahoney expressed concern that many low-income residents of Wyandotte County had no medical coverage or access to care. Duchesne Clinic in Kansas City and Saint Vincent Clinic in Leavenworth, Kan., comprise the Caritas Clinic, Inc., affiliates of the Sisters of Charity of Leavenworth Health System.

Duchesne Clinic provides health care for adults with incomes at or below 150 percent of the federal poverty guidelines, who have no health insurance and who live in Wyandotte County. Other services include medication assistance, chronic disease education and management, limited dental, optical and specialized medical care, and mental health services through a partnership with Wyandot Center for Behavioral Health care.

More than 28 volunteer physicians provide on-site services at the clinic and referral arrangements are made with many other medical and dental professionals throughout the community. During 2007 Duchesne provided over 11,000 patient visits.