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HomeMy WebLinkAboutWEBCO Initiative Funding AgrmtINITIATIVE FUNDING AGREEMENT This Initiative Funding Agreement (this "Agreement") is entered into as of July 1, 2013 (the "Effective Date"), by and between Central Oregon Health Council ("COHC") and Central Oregon Health Board (together with COHC, the "Parties"). RECITALS A. COHC serves as the governance entity over Central Oregon's Coordinated Care Organization (the "CCO"). B. COHC voted to fund the Initiative (defined below) as submitted by COHB. C. COHB is an ORS Chapter 190 intergovernmental entity that has as one of its primary objectives to arrange for and facilitate the provision and delivery of physical and behavioral health services to persons enrolled in the CCO program and assigned to COHB or who are covered by intergovernmental agreements with COHB. D. COHC desires to fund the Initiative and COHB desires to carry out the Initiative on the terms and conditions set forth in this Agreement. AGREEMENT COHC and COHB agree as follows: 1. The Initiative. COHB will undertake and complete the Maternal Child Health Initiative as set forth in Exhibit A (the "Initiative"). COHB will coordinate the provision of the services required to carry out the Initiative (the "Services"). 2. Payment. 2.1. Subject to the terms and conditions of this Agreement, during the Initial Term of this Agreement, COHC agrees to pay COHB actual costs incurred in connection with the Initiative up to the budgeted amount of $180,212.00 (the "Initial Term Initiative Payment"). If this Agreement is renewed pursuant to Section 3.2 ("the "Renewal Term"), COHC and COHB will mutual agree upon the budget for the Renewal Term (the "Renewal Term Initiative Payment"). 2.2. The Initial Term Initiative Payment will be paid quarterly in installments (each an "Installment") on November 15, 2013, February 15, 2014, May 15, 2014, and August 15, 2014 (each a "Payment Date"). If the Agreement is renewed for an additional one-year term pursuant to Section 3.2, the Parties will establish Payment Dates for payment of the Renewal Term Initiative Payment in the written confirmation of the renewal. 2.3. The payment of each Installment is conditioned on: 2.3.1. COHB's timely submission of reports in the form set forth in Exhibit B (each a "Monthly Report"). Monthly Reports must be submitted on or before the 5th day of each month and must report on the Initiative activities of the previous month. 1 CORDOCS:60021535.5 Attachment 1 — Page 1 of 17 2.3.2. COHB's submission of quarterly reports (each a "Quarterly Report") addressing the Initiative activities of the immediately previous three months. Each Quarterly Report must contain the information specified in Exhibit C and be submitted not less than 15 days prior to a Payment Date. 2.3.3. COHB's submission of evidence of actual expenses incurred (each an "Expense Report") for the three-month period immediately prior to the relevant Payment Date. Each Expense Report must be submitted not less than 15 days prior to a Payment Date. 2.3.4. COHC's approval of the Monthly Reports, the Quarterly Report, and the Expense Report for the three-month period preceding the relevant Payment Date, which will not be unreasonably withheld or delayed. 3. Term. 3.1. Initial Term. The initial term of this Agreement will commence on the Effective Date and continue until August 16, 2014 (the "Initial Term"). COHB will confirm the launch of the Initiative in a written communication to the Executive Director of COHC. 3.2. Renewal. The Parties will meet to review this Agreement and the Initiative on or before March 1, 2014. During the review, the Parties will determine if this Agreement will be renewed for an additional one-year term. If the Parties mutually agree to renew this Agreement, such renewal must be set forth in a writing signed by both Parties. 4. Termination. 4.1. Either Party may terminate this Agreement after giving thirty (30) days' prior written notice to the other of intent to terminate without cause. The Parties shall deal with each other in good faith during the thirty (30) day period after notice of intent to terminate without cause has been given. 4.2. With reasonable cause, either Party may terminate this Agreement effective immediately if the cause is not cured within thirty (30) days after written notice of such cause. Reasonable cause shall include material violation of this Agreement or any act exposing the other Party to liability to others for personal injury or property damage. 4.3. Notwithstanding any other provision of this Agreement, COHB shall not be obligated under any provision of this Agreement during any fiscal year following the Renewal Term unless and until COHB and COHC appropriate funds for this Agreement for such future fiscal year. In the event that funds are not appropriated for this Agreement, then this Agreement shall terminate automatically as of June 30 of the last fiscal year for which funds were appropriated. 5. Joint Management Agreement. COHB has read and understands the Joint Management Agreement (the "JMA") dated July 25, 2012 by and between PacificSource Community Solutions, Inc. and COHB. COHB agrees: (i) to comply at all times with the JMA in connection with its obligations under this Agreement, (ii) to perform its obligations under this Agreement in such a manner as to further the goals of the JMA, and (iii) to alert COHC immediately upon becoming aware of any violation of the JMA by either party thereto or COHB. 2 CORDOCS:60021535.5 Attachment 1 — Page 2 of 17 6. Protected Health Information. COHB will not include any protected health information ("PHI") in any report submitted to COHC. In addition, COHB will not release or otherwise disclose PHI to COHC. If COHB obtains any PHI related to this Agreement, COHB agrees to provide appropriate safeguards to protect the confidentiality of this information. COHB shall provide appropriate safeguards by meeting or exceeding the requirements stated in ORS §646A.622. 7. Compliance with Laws. In connection with this Agreement and the Services, COHB and COHC will comply with Title VI of the Civil Rights Act of 1964, and all applicable federal, state and local laws and regulations. 8. Indemnification. 8.1. COHB acknowledges that COHC has no control over the operations, acts, or omissions of COHB. COHB will indemnify, defend, and hold harmless COHC and its directors, officers, employees, and agents from and against any claim, liability, loss, damages, fines, penalties, and expenses (including but not limited to reasonable legal fees and costs) (collectively, "Losses") arising out of a third party claim to the extent related to (i) COHB 's material breach of this Agreement or (ii) any act or omission of COHB, its officers, employees and agents in connection with COHB's performance of, or failure to perform, the Services. 8.2. COHC will indemnify, defend, and hold harmless COHB and its directors, officers, employees, and agents from and against Losses arising out of a third party claim to the extent related to (i) COHC's material breach of this Agreement or (ii) any act or omission of COHC, its officers, employees and agents in connection with this Agreement. 9. Miscellaneous. 9.1. Relationship of the Parties. The relationship of the parties is not that of principal and agent, nor of joint venturers nor of partners, but is that of independent contractors. Neither Party shall be deemed to be the legal representative of the other. It is expressly agreed that this Agreement and the relationship between COHC and COHB hereby established does not constitute a partnership, joint venture, agency or contract of employment between them. 9.2. Confidentiality. To the extent allowed under Oregon Public Records Law, ORS 192.410. 192.505, neither COHC nor COHB shall use, publish, or otherwise disclose, without specific written permission from the other Party, any information (in any form) concerning the other Party, including its organization, personnel, business activities, or policies as a result of or in connection with the performance of the Agreement; nor shall either Party use said information in any way which might be injurious to the interests of the other Party or its employees. 9.3. Severability. In case any one or more of the provisions or parts of a provision contained in this Agreement shall, for any reason, be held to be invalid, illegal or unenforceable in any respect in any jurisdiction, such invalidity, illegality or unenforceability shall not affect any other provision or part of a provision of this Agreement or any other jurisdiction, but this Agreement shall be reformed and construed in any such jurisdiction as if such invalid or illegal or unenforceable provision or part of a provision had never been contained 3 CORDOCS:60021535.5 Attachment 1 — Page 3 of 17 herein and such provision or part shall be reformed so that it would be valid, legal and enforceable to the maximum extent permitted in such jurisdiction. 9.4. Non -Assignment. This Agreement is personal to the Parties and cannot be assigned by either Party without the prior written consent of the other Party. The foregoing notwithstanding, this Agreement will be binding on, and will inure to the benefit of, the Parties and their respective successors and permitted assigns. The Parties recognize that COHB is entering into arrangements with certain partners to fulfill the objections of the Initiative and that those arrangements do not constitute an assignment for purposes of this Section 9.4. 9.5. Entire Agreement. Except as otherwise provided in this Agreement, the Parties agree that this Agreement, including the exhibits hereto, constitutes the entire agreement and understanding between them and that any and all prior agreements are superseded by this Agreement. The Parties further agree that this Agreement can only be amended or revised by a written document signed by both Parties. 9.6. Waiver. The failure of either Party at any time or from time to time to enforce any of the terms of this Agreement shall not be construed to be a waiver of such term or of such Party's right to thereafter enforce each and every provision of the Agreement. 9.7. No Third -Party Beneficiaries. Nothing in this Agreement, express or implied, is intended or will be construed to confer on any person, other than the Parties, any right, remedy, or claim under or with respect to this Agreement. 9.8. Notices. All notices and other communications under this Agreement must be in writing and will be deemed to have been given if delivered personally, sent by facsimile (with confirmation), mailed by certified mail, or delivered by an overnight delivery service (with confirmation). All notices to COHB must be addressed to the Executive Director or the Board Chair at the address or facsimile number noted below the Parties' signatures (or at such other address or facsimile number as COHB may designate by like notice to COHC). All notices to COHC must be addressed to the Executive Director at the address or facsimile number noted below the Parties' signatures (or at such other address or facsimile number as COHC may designate by like notice to COHB). Any notice or other communication will be deemed to be given (a) on the date of personal delivery, (b) at the expiration of the third (3rd) day after the date of deposit in the United States mail, or (c) on the date of confirmed delivery by facsimile or overnight delivery service. 9.9. Governing Law. This Agreement shall be governed by and construed and enforced in accordance with the laws of the State of Oregon (regardless of that jurisdiction's or any other jurisdiction's choice of law principles). 9.10. Counterparts. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. [Remainder ofpage intentionally left blank.] 4 CORDOCS:60021535.5 Attachment 1 — Page 4 of 17 IN WITNESS WHEREOF, the Parties enter into this Agreement as of the Effective Date. CENTRAL OREGON HEALTH COUNCIL CENTRAL OREGON HEALTH BOARD By: 1 „ Name: '1.1 : aney Title: President Address: Fax: By: Name ch Pangare Title. ' Secretary B Name: Damien Sands Title: Executive Director Address: 200 S.E. Combs Flat Road Prineville, Oregon 97754 Fax: Commissioner Mike Ahern, Jefferson County Commissioner Tammy B w y, Deschutes County Commissioner Ke ahlgren, Crook County CORDOCS:60021535.5 -Attachment 1 — Page 5 of 17 CENTRAL OREGON HEALTH COUNCIL Domain: Prevention and Population Health - Focused Primary Care/Public Health Partnership Strategic Initiative: Maternal Child Health (MCH) Contact: maggi.machala(i)deschutes.org PROBLEM STATEMENT: Research shows that prenatal and early childhood wellness (physical, behavioral, social, emotional and cognitive) can positively impact life-long health and learning. A key barrier to wellness in Central Oregon is inadequate coordination between primary care, public health and other prevention services. GOAL: Improve prenatal and early childhood wellness through a MCH care coordination system that empowers low-income families and optimizes their use of primary care, oral health, behavioral health, prevention, family support, early learning services and other CCO initiatives. ACCOUNTABLE COORDINATORS: Central Oregon Health Board, PacificSource PARTICIPATING PARTNERS: Central Oregon Pediatric Associates (COPA), East Cascades Women's Group (ECWG), Advantage Dental, Pacific Source, St. Charles Health System, Mosaic Medical, La Pine Community Health Center, Central Oregon Early Childhood Councils and partners WHAT: Develop a regional MCH care coordination system incorporating: 1) Expansion of RN Care Coordinator/community health worker model for high utilizers into ECWG. 2) Extension of care coordination into the home by expanding nurse home visiting programs (i.e., Cacoon, Maternity Case Management and Nurse Family Partnership programs). To assure system continuity, connection with prevention services, and experienced home visitors, RN care coordinators and community health workers will be hired by public health agencies. • Deschutes County: Hire 2 RNs and 1 community health worker. RN 1 will support ECWG and provide Maternity Case Management home visiting. She will also give oversight to a bilingual community health worker who will be certified to provide WIC and Oregon Mother's Care. RN 2 will develop primary care liaison role and provide CaCoon home visiting services for special -needs children. • Jefferson and Crook Counties: Hire .5 RN FTE each to provide similar care coordination and home visiting services with primary care practices in their counties. RN care coordinators: promote integration of prevention services and other CCO initiatives into the practices and bring the primary care perspective back to public health. EXHIBIT A Attachment 1 — Page 6 of 17 WIC certifiers/nurse expanders: work in enhanced role to include assessment, screening and referral to required services and outreach to primary care practices as well as family education and advocacy. Nurse Family Partnership (NFP): Deschutes County will expand the evidenced -based home visiting program, NFP, by hiring 1 additional bilingual/bicultural RN to help serve the tri - county's Hispanic CCO members and provide back-up for the other NFP nurses. (Currently, NFP is only able to serve 50% of eligible referrals). WHEN: July 1, 2013- June 30, 2014 **Based on program outcomes/resources, services may be expanded to other practices in the region. METRICS: see Exhibit C CCO REQUIREMENTS ADDRESSED: low birth -weight, tobacco use, alcohol use, dental visits, screening/referral for depression, developmental screening by 36 months, ED utilization, and effective contraceptive use REGIONAL HEALTH IMPROVEMENT PLAN GOALS ADDRESSED: 1) Health Disparities, 2) Access to Resources and Quality Services 3) Early Childhood Wellness, 4) Safety Crime and Violence 5) Preventive Care and Services, 6) Chronic Disease Prevention, 7) Alcohol, Drug, Tobacco Use, 8) Behavioral Health and Suicide Prevention, 9) Oral Health, Improve dental health of children/youth/adults, 9) Promote best practices in the community HEALTH DISPARITIES AND INEQUITIES ADDRESSED: This initiative will address disparities/inequities for our Hispanic population through use of bilingual/bicultural staff. It also address disparities among the rural poor and those with limited transportation by serving clients in their homes, connecting services in their primary care site, and through one-stop clinics in WIC where they already participate—right care, right place, right time. COST VS RETURN ON INVESTMENT (ROI): See Budget ROI—Rand Corporation analysis found a net savings of $34,148 for every family served in Nurse Family Partnership or $5.70 return for every dollar invested. (Secondary to program outcomes including: 79% fewer preterm births, 69% reduction in tobacco use, 56% fewer child ED visits.) For every dollar spent on a pregnant woman in WIC, up to $4.21 is saved in Medicaid for her and her infant because WIC decreases risk for preterm birth by 25% and low -birth -weight by 44%. (It's estimated that the project will pay for itself by reducing the number of preterm births/year by 4 ($46,000 each). Short term cost reduction should also be realized through fewer avoidable ED visits by the target population. Prevention impact is difficult to measure, especially in the short term. Anecdotal or case studies will help to demonstrate positive impact of the initiative on risk factors that lead to preterm birth and other costly health outcomes. EXHIBIT A Attachment 1 — Page 7 of 17 EVIDENCE BASE FOR PRACTICE: Early Childhood Experiences Affect Health Over the Life Course. (Rethinking MCH: The Life Course Model as an Organizing Framework, US Dept. of Human Services, HRSA, Maternal Child Bureau, November 2011 Karoly, LA et.al. Early Childhood Interventions: Proven Results, Future Promise, RAND Corporation 2005 Kitzman, H, Olds DL et.al, Effect of Prenatal and Infancy Home Visitation by Nurses on Pregnancy Outcomes, Childhood Injuries, and Repeated Childbearing, a Randomized Controlled Trial JAMA 1997:278 (8) Bitler M., Currie J. 2005. Does WIC Work? The Effects of WIC on Pregnancy and Birth Outcomes, Journal of Policy Analysis and Management 24 (1): 73-91 EXHE IC: ETA Attachment 1 — Page 8 of 17 Exhibit B BUDGET AND COMPENSTATION Wellness and Education Board of Central Oregon (WEBCO) will: 1. Pay Quarterly to each of the three counties a percentage of $45,053 not to total more than for $180,212 for the length of the contract. The percentage breakdown is as follows: a. Jefferson 12% b. Crook 12% c. Deschutes 76% 2. Please see attached spreadsheet for full breakdown of total project cost — both WEBCO (CCO) and other funding. 3. Payment will be reconciled based upon Crook check run dates on a bi-weekly basis. EXHIBIT B Attachment 1 — Page 9 of 17 $ :ODJ of JeBop iad tso) N io N LT N w !,1-1 m � A V N Or m N 2 N 9 x a 2 m 01 'A A 3 3 C n O 0 0 z 2 ti 3 3 0 O_ 3 0 t/r Vr N 3 N m a: D 01O N P. O O O V ~ m V1 h N ti 2 O 2 2 W 2 O V. 3 3 0 O_ 3 N N ti 3 Nth VT N Lr III, N yw O x 9 x LI n n x 3 s A n O 1 N N O 0' Junowy sa2pna SHoo/43unf n 01 n v Ip n 0 8 3 2 EXHIBIT B 8 Remodel ECWG Aircards x 3 (PHN) Travel x 3 (PHN) 11.aptops x 3 (PHN) Furniture/Office Space (2.5 NFP) 0.05 FTE Admin. Secretary (Data Support) Salary & Benefits Cell Phones x 3 (NFP) 3.0 FTE PHN II Step 1 (ECWG, NFP, CaCoon) Salary & Benefits 0.15 FTE Supv. For NFP nurses Salary & Benefits 0.5 FTE Initiative Coord./PHN Supv. Salary & Benefits m 2 July 2013 -June 2014 July 2013 -June 2014 July 2013 July 2013 -June 2014 July 2013 -June 2014 July 2013 -June 2014 A July 2013 -June 2014 IJuly 2013 -June 2014 3 il 3 t+ N N N N N N N N N O 3 0 N O LT VN m AO W N In. 0Ww i1 O N N W m m 0 0p 000 A y1 Monthly amount . N NJ O O LI. IA lOw o L O O Vr N 00 r+ v. W N O 1.4 V1 r W 0p1. J E 8 $ 233,299 to V ., N w In r O 5 co 0. D O » W ti O m o COM O Pn' Payment Source Launch/DCHS 1 JCPH 1 CCPH 1 5t. Charles 1 Billing Revenue 1 CCO in O oO $ 2,000 $ 1,440 5 3.000 . lop N P to Attachment 1 — Page 10 of 17 $ :OBJ of iepop Jad Iso O CY 01 H 4. 4. co N 0 A O N O C f1 D H `n LO V O Nn A n -13 N W cri S N rt A it N A W V 01 7 00 CDCD N CD COT 0 EXHIBIT B $ O)) of Jellap Jad ;so) O 3D N N N 3 W A • E W A rn qW 0 rs n a r, ry m5. rt 0 a 3 2,33 ,3. 0 n N 0 0 D n Laptops x 1 (WIC Certifier) Furniture/Office Space (1.0 WIC) 0 c N m A 1.0 FTE WIC Certifier (nurse extender) Salary & BeneFits n 2 ilo 0 December 2013 Jan 2014 -June 2014 0 Jan 2014 -June 2014 Time Frame A A o 0 A a 0 3 0 T m m.+m m A Monthly amount A N $ 240 N N N N Budget Amount G '..:,1 N. J O O W N O DD a .- w w Payment Source launch/DCHS 1 JCPH 1 CCPH 1 St. Charles 1 Billing Revenue 1 CCO �o2 O A o S inn A N pw Attachment 1 — Page 11 of 17 Initiative Status Report [Select] Project Name: [Project Name] 'Select Darcj Status Code Legend • On Track: Project is on schedule • I ligh Risk: \t risk, with a high risk of going off track • .1t Risk: Milestones missed but date intact • ( )ff Track: Date will be missed if action not taken The project is [SELECT] the month of [Select Start Date] - [Select End Date], due to the following: Issues/ Problems: Action items accomplished the month of [Select Start Date] - [Select End Date]: Action items planned this month, but not achieved: Action items planned for next month: Areas/questions for discussion: Other. Overall Status: • [To add a bullet for any status, on the Home tab, in the Styles gallery, click the name of the status of you need.] Insert brief update in this box • [Issue No. 1] • [Issue No. 2] • [Issue No. 3] • (Action item 1) • (Actions item 2) • (Action item 3) (Action item 1) (Action item 2) (Action item 3) • (Action item 1) • (Action item 2) • (Action item 3) Questions/discussion topics here. (:t•utra1 Orr[zam filth c .tams i1 B-2 EXHIBIT B CORDOCS:60021535.5 Attachment 1 — Page 12 of 17 Contact Information (Workgroup Leader Info.) Office: [Office Phone] Mobile: [Cell Phone] Email: [Email address] Initiative Abstract Summary of Initiative can be copy and pasted here. B-3 EXHIBIT B Attachment 1 — Page 13 of 17 Exhibit C STATEMENT OF WORK AND COMPENSATION Wellness and Education Board of Central Oregon (WEBCO) will: 4. Serve as fiscal agent for the MCH Initiative serving Central Oregon tri - counties (Deschutes, Jefferson and Crook). 5. Summarize quarterly program data submitted by the counties into required reports for PacificSource and Central Oregon Health Council. 6. Promote and advocate for Initiative success 7. Provide a point of contact for the MCH Initiative Coordinator and arrange quarterly face to face meetings to assure communication and cooperation. 8. Look for funding opportunities to sustain the Initiative and expand it to include Phase II Deschutes County Health Services will: 1. Provide a .5 FTE ( 86.33 hr./month) Coordinator to serve as point of contact with WEBCO for the MCH Initiative 2. Assure Coordinator attends quarterly Initiative meetings with WEB -co and other meetings as required. 3. Assure Coordinator communicates at least monthly with Jefferson and Crook County Initiative PHNs and Administrators as needed. 4. Assures Coordinator convenes quarterly meetings for the Initiative Workgroup. 5. Assure Coordinator provides required Initiative data quarterly to WEB -CO. 6. Hire, train and supervise a 1 FTE (172.67 hr./month) Spanish-speaking public health nurse (PHN) to provide Nurse Family Partnership services for a maximum caseload of 25 families in the tri -county area. 7. Hire, train and supervise a 1 FTE (172.67 hr./month) PHN to promote prevention integration in East Cascades Women's Group and Maternal Case Management services through a minimum of 2 home visits per day (average 500/yr.). 8. Hire, train and supervise a 1 FTE (172.67 hr./month) PHN to promote prevention integration in Deschutes County primary care practices and provide CaCoon services (for children with special health care needs) through at least 2 home visits/day (average 500/yr.) 9. Provide initiative staff office space, furniture, phone, IT equipment/support, medical equipment and supplies, materials and promotion 10. Provide ownership -custody of medical records. 11. Promote and advocate for Initiative success Jefferson County Public Health Department will: 1. Hire, train and supervise a .5 FTE e6.33 hr./month) PHN to promote prevention integration in Jefferson County primary care practices and provide Maternal Case EXHIBIT C Attachment 1 — Page 14 of 17 Management and CaCoon services through at least 1 home visit/day (average 250/yr.) 2. Provide initiative staff office space, furniture, phone, IT equipment/support, medical equipment and supplies, materials and promotion 3. Provide ownership -custody of medical records. 4. Promote and advocate for Initiative success Crook County Public Health Department will: 1. Hire, train and supervise a .5 FTE (s 6.3 3hr./month) PHN to promote prevention integration in Crook County primary care practices and provide Maternal Case Management and CaCoon services through at least 1 home visit/day (average 250/yr.) 2. Provide Initiative staff office space, furniture, phone, IT equipment/support, medical equipment and supplies, materials and promotion 3. Provide ownership -custody of medical records. 4. Promote and advocate for Initiative success EXHIBIT C Attachment 1 — Page 15 of 17 Deschutes County Health Services 6/5/2013 1) Expansion of RN Care Coordinator/CHW Model into East Cascade Women's Clinic 2) Expansion of CaCoon, MCM and NFP Home Visiting Models amseaw cutolooDuj =stow d1N1 Dfl X X X X Data Source Qualitative and Quantitative methods (TBD) C%] = • �4U c4 0 ms O c.) ORCHIDS- MCM ORCHIDS- MCM Target and Baseline MCH initiative Baseline followed by six month time series Baseline: = 160 Point in time measure 4/30/2013 NFP: DC 70, CC 8, JC 9 Total =87 CaCoon: DC 47, CC 11, JC 11 Total = 69 MCM: DC0,CC0,JC4 Total=4: Target = 333 NFP: 87 (current) + 25 (new) = 112 CaCoon: 69 (current) + 74 new (50 DC, 12 CC, 12 JC) = 143 MCM: 4 (current) + 74 new (50 DC, 12 CC, 12 JC)=78 All programs: 333 Counties =DC -Deschutes, CC -Crook, JC -Jefferson Baseline = 0 Target = 99 new NFP (25) + new MCM (74) Baseline = 87 (current NFP) Target = 186 (current NFP + new NFP (25) + new MCM (74) 1 o E °�.°C.�c) H R m U v cix,2, N W E (- 2 afgz�unoaay =xx V a. U a1tiL) xxx U A U Latif) xxx U t U CI xxx U a taj 12tiO food a3vanegj X X amseays anuuaori X X CCO Measure Alcohol or other substance misuse (SBIRT) Screening for clinical depression and follow-up plan (NQF 0418) Outcome Strengthen inter -organizational relationships, interactions, and practice. (Modifications in practice may include system level changes in screening/referral or data tracking. These will be captured quantitatively.) Increase # served (pregnant women receiving Maternity Case Management and children receiving CaCoon HV) * Increase # of pregnant women screened/referred for substance abuse (SBIRT) * 4 Increase # of pregnant and postpartum women screened/referred for depression/anxiety (Edinburgh Postnatal Depression Scale) * r- N rn EXHIBIT C 0 0 0 0 0 U x «� ▪ R @ c y U xv U -i+ 0. 0 cr C 0 O G u y E O ti O xb a� 4) X U .y 55 o a.▪ 3 G O O C UUVi � h C "C y E E N O a � {2... W U QU a.. raR u W C ~O av y wd h H Z, dl. a w R zca, O 0 0. ti.. 0 E N R R U � y d W II � 3� U� W ^, E ° 22 au m C caE E R • y U 'O N r0 R it II t U u • u0 _ T �G a Attachment 1 — Page 16 of 17 Deschutes County Health Services 6/5/2013 1) Expansion of RN Care Coordinator/CHW Model into East Cascade Women's Clinic 2) Expansion of CaCoon, MCM and NFP Home Visiting Models a USJAZ ddtd/Qoo3EJ X X amseayi ddtd/NIDN X X X X Data Source V] Q = O UU O C) ECWG data ORCHIDS/ MCM ECWG data ORCHIDS- MCM ORCHIDS- CaCoon Target and Baseline MCH initiative Baseline = 85 NFP: DC 70, CC 8, JC 9 =87, screened = 46 CaCoon: DC 47, CC 11, JC 11 = 69. screened=37 MCM: DC 0, CC 0, JC 4 =4, screened = 2 *Used 53% as percent screened, based on DC MCM & CaCoon data Target =333 NFP: 87 (current enrollment) + 25 (new DC) = 112 CaCoon: 69 (current) + 74 new (50 DC, 12 CC, 12 JC) = 143 MCM: 4 (current) + 74 new (50 DC, 12 CC, 12 JC) =78 Counties =DC -Deschutes, CC -Crook, JC -Jefferson Baseline = 0 Target =360 (tot — 60/mos tot w/prenatal care — 50% OHP) Baseline = 0 Target =99 Baseline = Establish Target = baseline + 99 74 new MCM (50 DC, 12 CC, 12 JC) and 25 new NFP (DC) * Will be established Q1 Baseline = Establish Target = baseline + 54 74 new CaCoon (50 DC, 12 CC, 12 JC) * Will be established Q1 o°5o'o 'C U H`6 oU W E 'o ma' �Qq �;1da'EF o ?+ 0 o en4 aigzlun000y a. a s Attu {7 a 3 AW a a a a a a AtiUAtiU a a a AtiU rood o5uatlE43 X amseaysl OARuaaul 'X X CCO Measure 0 - E 2 0 a, CU U U 4) 1 E t o a • a w Prenatal and postpartum care: Timeliness of Prenatal Care Outcome • Increase # of families referred to a medical home by NFP, CaCoon, and MCM Increase # of pregnant women coded for first prenatal visit at ECWG Increase # of postpartum OB/GYN check- ups (21-56 days postpartum) * Increase # of pregnant women receiving oral health exam during pregnancy * Increase # of children with a dental home v, \o \o n EXHIBIT C Attachment 1 — Page 17 of 17