MARCH 2008 ISSUE

Safety Net Working Group Update

The Safety Net Working Group (SNWG) met on March 25th to discuss initiative priorities for the upcoming year. Several areas of work continue to be important to members of the group. These include:

• an analysis of the capacity of the safety net system to meet the needs of the uninsured
• advocacy for the protection of Medicaid and funding
• support for recruiting and retaining health care providers for Safety Net programs
• continued support for working on care coordination and system navigation

Members of the SNWG noted that it would not be possible to focus on all of these issues in one year. To help prioritize, the SNWG directed its committees to meet during April and determine their number one and two priority areas. For each identified initiative, a high-level plan will be developed to outline how it will be accomplished. Committee chairs will present their recommendations to the full SNWG at the April 29th meeting. The SNWG expects to adopt a slate of priorities and a decision-making process at that meeting. Committees will then be charged with implementing their initiatives in the next year.

Behavioral Health Initiative

The staff of the Regional Health Care Initiative is working closely with behavioral health stakeholders in the Kansas City region to help identify opportunities to strengthen and more closely integrate mental health, substance abuse, correctional, developmental disability and physical health care services.

This effort is supported by the Missouri Mental Health Transformation Project, which focuses on implementing initiatives recommended by the President’s New Freedom Commission on Mental Health. The Commission recommended a fundamental transformation of the nation’s approach to mental health care. This transformation is designed to ensure that mental health services and supports actively facilitate recovery and build resilience to help people face life’s challenges.

The Missouri Mental Health Transformation project works with local communities to identify policies that could be implemented by federal, state and local governments to maximize existing resources, improve coordination of treatment and services, and promote successful community integration for adults with serious mental illnesses and children with serious emotional disturbances.

Capacity Study of the Safety Net System

The Mid-America Regional Council (MARC) is working with safety net providers, the Missouri Hospital Association and area Emergency Medical Service (EMS) agencies to assess the capacity of the existing safety net system in Kansas City to meet the health care needs of the uninsured and medically underserved.

To accomplish this, researchers at MARC are reviewing existing data regarding the number of uninsured people in Kansas City. This data will be compared to the number of patient visits reported by safety net providers, as well as the number of unduplicated patients that safety net providers see each year.

Zip code-level data will help identify how far patients travel for health care services. This will be analyzed to determine whether there are portions of the metropolitan area in need of more or fewer services. Data from the Missouri Hospital Association will provide additional information regarding the use of the emergency room for primary care or other non-emergency health care services. Transportation data from EMS providers and a transportation analysis of health care providers, overlaid with available transportation options, can provide insight into how patients get to the hospital. Additional data regarding clinic wait times will also be gathered.

KCHealthResource.org to launch April 28th

Beta testing was conducted on March 18th for the new GIS-based Web site that will provide free safety net system navigation. Representatives from United Way 211, the Salvation Army, El Centro and the Community Services League viewed the new site and provided input regarding changes that could make the site more user-friendly. Suggestions included adding emergency room information, listing required documents that patients must bring to appointments, and adding bus routes and other transportation options.

The final design phase will be completed during the next month. The site will be launched in conjunction with Cover the Uninsured Week, which begins April 27th. The new Health Resource Guide, a supplemental, hard-copy booklet that provides information about safety net providers in both English and Spanish, will also be available that week.

The Kansas City Quality Improvement Consortium

The Kansas City Quality Improvement Consortium (KCQIC) was formed in 2000 by the United Auto Workers—Ford Community Health Care Initiative and other community stakeholders to address health care quality in the Greater Kansas City area. The goals of KCQIC include:

• improving patient outcomes and health status
• fostering health care based on best practices
• establishment of a collaborative forum to develop and implement quality guidelines and measures

KCQIC membership includes physicians, health plans, and other community partners. Since 2002, KCQIC has provided local primary care physicians in the Greater Kansas City bistate area with consolidated feedback reports related to the care of individuals with diabetes and asthma. The measures used for these reports were based on the National Commission on Quality Assurance's (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS).

More than 655 physicians are participating in the project. Data regarding how physicians provide care to patients with asthma and diabetes is electronically gathered from claims data provided by local commercial and Medicaid health plans. This information is compiled into a format that shows each physician how he/she performed annually on identified quality measures. At this time, the data is used by the physicians to improve their own practices. At some point it may be made available to the public. (Physicians and clinics can also submit data.)

In 2007, KCQIC received a Robert Wood Johnson grant (Aligning Forces for Quality) to develop quality measures for physicians. Aligning Forces for Quality focused on public reporting of physician quality measures, quality improvement and consumer engagement in quality.

KCQIC is currently applying for an additional Robert Wood Johnson grant to build on the existing quality initiative and focus on a nurse-led quality project provided at the patient’s bedside. Participating hospitals include: Shawnee Mission Medical Center, Kansas University Medical Center, St. Mary’s, Truman Medical Center, Providence Medical Center, North Kansas City Hospital and Children’s Mercy Hospital. The site team from Robert Wood Johnson was in Kansas City on March 9th to meet with community and hospitalsrepresentatives. Final funding decisions will be made this spring. For more information, contact Cathy Davis.

Wellness Strategy Development Process

KC Consulting has received a contract to begin a strategy development process for the Kansas City Wellness Community. KC Consulting will survey the wellness community and conduct interviews with 25 to 30 agencies and businesses that have a strong focus on wellness. Through these interviews and surveys, KC Consulting will assess the current scope of work being done on the issue of wellness in the Kansas City community. They will also conduct a national scan to determine wellness trends in other communities and identify successful models.

The information will be compiled and analyzed to develop a draft strategy that will provide leadership and focus, and help determine opportunities for the wellness community to work together to improve the health of the Kansas City metropolitan area. The work should be completed by May 2008.

Worksite Wellness LA to visit Kansas City

Liz Torres, CEO of Worksite Wellness LA (WWLA) will visit Kansas City on April 21st to kick off Cover the Uninsured Week. Liz has developed a unique model for providing wellness care and education to a significant number of low-wage workers, mostly Latino, in Los Angeles. Liz notes that most of the businesses that WWLA works with are in light manufacturing industries that do not provide health benefits to their employees. As a result, many of the employees and their families are uninsured and have limited access to health care or health information.

WWLA’s model is unique in its efforts to bring basic health education and information to hard-to-reach individuals at their workplaces. Liz notes that worksites are an untapped venue for reaching a population that cannot afford to take off from work to seek health information and assistance. WWLA brings health education to target worksites in a variety of formats including health presentations, one-on-one education, health screenings and health fairs. WWLA currently works with 20 worksites that employ 3,750 low wage workers, and has provided 133 health education presentations during workers ‘lunch breaks.

 WWLA also provides enrollment assistance for employees and family members who may be eligible for Medicaid or SCHIP health coverage. During 2005-2006, WWLA enrolled a total of 431 children and 49 adults into state-sponsored health coverage programs. For more information about Liz’s visit to Kansas City, please contact Traci Rowland.