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HomeMy WebLinkAboutDoc No 2014-451 Amendment to IGA between WEBCO and DCDeschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701-1960 (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.orq AGENDA REQUEST & STAFF REPORT For Board Business Meeting of ** Wednesday, August 27, 2014 DATE: August 15, 2014 FROM: David Doyle It County Counsel Phone: 388-6624 TITLE OF AGENDA ITEM: Consideration of Board Signature of Document #2014-451, Amendment #2 to the Intergovernmental Agreement between Wellness and Education Board of Central Oregon and Deschutes County Health Services (DCHS), Doc #2012-599 ("Original Agreement"). PUBLIC HEARING ON THIS DATE? No BACKGROUND AND POLICY IMPLICATIONS: The purpose of this Amendment #2 is to include Performance Measures into the Original Agreement. These performance measures were drafted with input from Deschutes County Behavioral Health and have been approved by Director Jane Smilie. This Amendment #2 is effective upon signature of all parties. All other terms and conditions of the Original Agreement and Amendment #1 (Doc. 2014-068) remain in full force and effect. The Central Oregon Health Board is a 190 organization formed by Crook County, Deschutes County and Jefferson County to improve health outcomes, increase satisfaction with the health systems and reduce healthcare costs. The goal of the Wellness and Education Board of Central Oregon (fka Central Oregon Health Board) is to manage resources efficiently and effectively, in collaboration with local and State Government, the hospital system, local providers, private insurers, health collaboratives, and most importantly the community and the people Deschutes County serves. A number of health organizations and interests in Central Oregon have been working to develop a structure and set of functions to improve the health of people in the Central Oregon region and the performance of the health care system in Crook, Deschutes and Jefferson Counties. Represented organizations include all three (3) counties (Boards of Commissioners), Deschutes County Health Services (DCHS), PacificSource, St. Charles Health System, HealthMatters, Volunteers in Medicine, Oregon Health Authority, BestCare Treatment Services, Lutheran Community Services NW and others. In July of 2010, the Boards of County Commissioners (Boards) in all three (3) counties agreed in concept that the region would benefit from a formal process for the aforementioned groups to work together more closely in adapting to health reform changes at the national, state and local levels. WEBCO contracts and administers contracts with the State of Oregon and any other public and private entity to provide or secure a wide range of health services including behavioral health, physical health and public health. In addition to the administration of contracts, the Board: a. Conducts a periodic regional health assessment to inform decision -makers on such matters as planning, policy development, system design and investments. b. Develops and establishes policies that support Deschutes County Health Services on behalf of the Central Oregon population. c. Improves the coordination of funding for Deschutes County Health Services among the counties and relevant stakeholders. This includes establishing financial systems, maintenance of financial reserve requirements, policies, and monitoring sub -capitated funds of the counties and other Health Service providers in Central Oregon. d. Develops and adopts a coordinated regional Health Improvement Plan to improve collaboration among health care providers. e. Collects and analyzes health system costs and outcome data to measure the quality and performance of the health system in order to lower costs, increase access, improve satisfaction and increase efficiency. This includes establishing management information systems to meet reporting requirements. f. Promotes evidence -based practices and prevention programs, including, but not limited to: quality assurance guidelines and oversight, utilization management for services both inpatient and outpatient, and providing member services including education and prevention activities. Promotes models of care that improve the provision of services for patients among various providers so that individuals can navigate service systems successfully. This includes the development and implementation of processes for hearing, monitoring and resolving complaints and grievances. h. Hire employees to perform administrative tasks and other duties as assigned or delegated by the Governing Board and Administrative Council. g. Through the formation of WEBCO, the counties are able to provide the best possible behavioral health, physical health and public health services to the client population of all three counties. FISCAL IMPLICATIONS: Maximum compensation is $0. RECOMMENDATION & ACTION REQUESTED: Behavioral Health requests approval and signature. ATTENDANCE: Consent Agenda DISTRIBUTION OF DOCUMENTS: Original to Deschutes County Clerk for recording, Scan copy to Colette Smith at: Colette.smith@webcohub.org, One copy to Nancy Mooney at Deschutes County Health Services DESCHUTES COUNTY DOCUMENT SUMMARY (NOTE: This form is required to be submitted with ALL contracts and other agreements, regardless of whether the document is to be on a Board agenda or can be signed by the County Administrator or Department Director. If the document is to be on a Board agenda, the Agenda Request Form is also required. If this form is not included with the document, the document will be retumed to the Department. Please submit documents to the Board Secretary for tracking purposes, and not directly to Legal Counsel, the County Administrator or the Commissioners. In addition to submitting this form with your documents, please submit this form electronically to the Board Secretary.) Date: (August 15, 2014 Department: Please complete all sections above the Official Review line. Health Services Contractor Name: Wellness and Education Board of Central Oregon (WEBCO) Contractor Contact: Jane Smilie Contractor Phone #: 541-322-7502 Type of Document: Amendment #2 to Intergovernmental Agreement (IGA) #2012-599 Goods and/or Services: The purpose of this Amendment #2 is to include Performance Measures into the Original Agreement. These performance measures were drafted with input from Deschutes County Behavioral Health and have been approved by Director Jane Smilie. This Amendment #2 is effective upon signature of all parties. All other terms and conditions of the Original Agreement and Amendment #1 (Doc. 2014-068) remain in full force and effect. Background & History: The Central Oregon Health Board is a 190 organization formed by Crook County, Deschutes County and Jefferson County to improve health outcomes, increase satisfaction with the health systems and reduce healthcare costs. The goal of the Wellness and Education Board of Central Oregon (fka Central Oregon Health Board) is to manage resources efficiently and effectively, in collaboration with local and State Government, the hospital system, local providers, private insurers, health collaboratives and most importantly the community and the people Deschutes County serves. A number of health organizations and interests in Central Oregon have been working to develop a structure and set of functions to improve the health of people in the Central Oregon region and the performance of the health care system in Crook, Deschutes and Jefferson Counties. Represented organizations include all three (3) counties (Boards of Commissioners), Deschutes County Health Services (DCHS), PacificSource, St. Charles Health System, HealthMatters, Volunteers in Medicine, Oregon Health Authority, BestCare Treatment Services, Lutheran Community Services NW and others. In July of 2010, the Boards of County Commissioners (Boards) in all three (3) counties agreed in concept that the region would benefit from a formal process for the aforementioned groups to work together more closely in adapting to health reform changes at the national, state and local levels. WEBCO contracts and administers contracts with the State of Oregon and any other public and private entity to provide or secure a wide range of health services including behavioral health, physical health and public health. In addition to the administration of contracts, the Board: 8/15/2014 a. Conducts a periodic regional health assessment to inform decision - makers on such matters as planning, policy development, system design and investments. b. Develops and establishes policies that support Deschutes County Health Services on behalf of the Central Oregon population. c. Improves the coordination of funding for Deschutes County Health Services among the counties and relevant stakeholders. This includes establishing financial systems, maintenance of financial reserve requirements, policies, and monitoring sub -capitated funds of the counties and other Health Service providers in Central Oregon. d. Develops and adopts a coordinated regional Health Improvement Pian to improve collaboration among health care providers. e. Collects and analyzes health system costs and outcome data to measure the quality and performance of the health system in order to lower costs, increase access, improve satisfaction and increase efficiency. This includes establishing management information systems to meet reporting requirements. f. Promotes evidence -based practices and prevention programs, including, but not limited to: quality assurance guidelines and oversight, utilization management for services both inpatient and outpatient, and providing member services including education and prevention activities. g. Promotes models of care that improve the provision of services for patients among various providers so that individuals can navigate service systems successfully. This includes the development and implementation of processes for hearing, monitoring and resolving complaints and grievances. h. Hire employees to perform administrative tasks and other duties as assigned or delegated by the Governing Board and Administrative Council. Through the formation of WEBCO, the counties are able to provide the best possible behavioral health, physical health and public health services to the client population of all three counties. Start Date: December 31, 2013 End Date: Until Terminated Annual Value or Total Payment: No fiscal implications. ® Insurance Certificate Received (check box) Insurance Expiration Date: N/A Check all that apply: ❑ RFP, Solicitation or Bid Process ❑ Informal quotes (<$150K) ® Exempt from RFP, Solicitation or Bid Process (specify — see DCC §2.37) 8/15/2014 Funding Source: (Included in current budget? ® Yes ❑ No If No, has budget amendment been submitted? ❑ Yes ® No Is this a Grant Agreement providing revenue to the County? ❑ Yes ® No Special conditions attached to this grant: Deadlines for reporting to the grantor: If a new FTE will be hired with grant funds, confirm that Personnel has been notified that it is a grant -funded position so that this will be noted in the offer letter: ❑ Yes ® No Contact information for the person responsible for grant compliance: Name: Phone #: Departmental Contact and Title: Jane Smilie Phone #: 541-322-7502 Department Director Approval: Signature Distribution of Document: Original to Deschutes County Clerk for recording, Scan copy to Colette Smith at: Colette.smithc webcohub.orq, One copy to Nancy Mooney at Deschutes County Health Services. Date Official Review: County Signature Required (check one): D BOCC Department Director (if <$25K) D Administrator (if >$25K but <$150K; if >$150K, BOCC Order No. Legal Review Oa, ‘4)1Y Date g'Lr..... ( (7 Document Number 2014-451 ) 8/15/2014 L. ft-MEWED ---21VAi LE19.S.:Alea AMENDMENT NO. 2 TO WELLNESS AND EDUCATION BOARD OREGON INTERGOVERNMENTAL AGREEMENT This Amendment No. 2 (Amendment) to the Wellness and Education Board of Central Oregon Intergovernmental Agreement (Agreement) is entered into as of the date of the last signature hereto. AGREEMENT A. An additional paragraph No. 30.0 is added to the original Agreement to read as follows: Performance Measures. The parties agree that the performance measures which are attached hereto as Exhibit "A" and incorporated herein by reference have been adopted by the respective parties and shall be adhered to by the parties in the future operations of Wellness and Education Board of Central Oregon (hereinafter WEBCO). The attached performance measures may be amended from time to time by the parties and such amendments shall be in writing, signed by both parties, and attached to this Amendment. Thereafter, such Amendment shall be deemed incorporated herein without necessity of further amendment to the original Agreement. B. Counterparts. This Amendment No. 2 may be executed simultaneously or in counterparts, each of which shall be deemed an original, but all of which together will constitute one and the same contract. C. Reaffirmation. Except as amended herein, all terms and conditions of the Agreement dated October 22, 2012, as amended by Amendment No. 1 which was executed on February 26, 2014, shall remain in full force and effect. D. Effective Date. The parties hereto agree that the effective date of this Amendment No. 2 shall be the date of the last signature to this document. IN WITNESS WHEREOF, the parties have read this Amendment No. 2 to the Agreement dated October 22, 2012 in its entirety, agree to it and hereby assert that they have the authority to bind the respective parties to it. DESCHUTES COUNTY WELLNESS AND EDUCATION BOARD BOARD OF COMMISSIONERS OF CENTRAL OREGON (WEBCO) Alan Unger, Commissioner Date Ken Fahlgren, Board Chair Date Crook County Commissioner Tammy Baney, Commissioner Date Mike Ahern Date Jefferson County Commissioner Anthony DeBone, Commissioner Date Tammy Baney Date Deschutes County Commissioner Page 1 of 1 — AMENDMENT NO. 2 TO WEBCO IGA John Rexford Date High Desert ESD Superintendent DC 2014-451 EXHIBIT A (to IGA Amendment No. 2) PERFORMANCE MEASURES PacificSource (PSCS) Contract Reporting 1. Contractor will provide WEBCO with the County template in the following ways: Provide on a quarterly basis 21 days after the end of the quarter (a) actual expenditures, (b) encounters, (c) number of service events, and (d) number of unique persons served regardless of payor source, and cost per person unique person served regardless of payor source. This data broken into the following categories: • Crisis services. • Services to adults with severe and persistent mental illness. • Adult outpatient counseling. • Intensive child treatment services. • Outpatient Substance Use Disorder (SUD) services. Report Quarterly: • Actual expenditures for PSCS and Non-PSCS services. • Encounterable and non-encounterable shall be by usual and customary rates. Both will include calculations for services that were delivered with co -facilitators and provider activity services. • Cost per person served (PSCS and Non-PSCS) is number of publicly funded persons served. • Capitation Utilization % is the percentage of the OHP sub -capitation that is accounted for through encounters, non-encounterable services, co -provided services and provider activity services. 2. Children in DHS custody will have a mental health evaluation conducted within 60 days of CCO notification that a CCO member has entered child welfare custody. 3. Assure that CCO members with applicable mental health disorders receive an eligible behavioral health service within seven days of discharge from a mental health hospitalization. 4. Assure that 75% of SUD capitation is committed to SUD services in 2014 and 85% in 2015 through a written plan submitted to PSCS/WEBCO. 5. CMHP will submit State Hospital and Civil Commitment application documentation to the appropriate entity within one (1) business day following receipt from St Charles. 6. CMHP will assure that clients will receive access to: • Within 48 hours for urgent care, and • Seen for an intake assessment with two (2) weeks of the date of request for non -urgent mental health or chemical dependency treatment. Exhibit A — Performance Measures 1. Updated 8-12-14 EXHIBIT A (to IGA Amendment No. 2) WEBCO Contract Requirements 1. Complete and submit to WEBCO an annual UCR of mental health and substance abuse rates by June 30 of each fiscal year. WEBCO will submit information to PSCS. 2. Have a clinician or supervisor participate in a clinical record review of the other two counties twice a year. 3. Participate in a clinical record review once per year of your own CMHP. 4. Provide annual provider roster which will include credentialing information to WEBCO on the designated form which will in turn be shared with PSCS. 5. CMHP will submit new staff credentials, on WEBCO form, prior to formally having the person start work. WEBCO will review all credentialing information on clinical site reviews to determine that all required documentation is there. 6. A process for the dispersal of any unspent funds will be developed and presented to the WEBCO Board by November 2014. 7. If WEBCO does not meet its performance objective and one or more counties are not meeting the objective, then a conversation must occur about how to help make adjustments to meet the objective. 8. Maintain a local quality management committee which meets at least quarterly and to participate in the WEBCO Regional Quality Management Committee. 9. Counties shall adhere to the Federal Terms and Conditions (Exhibit 4) as stipulated in the PSCS/WEBCO contract (effective April 1, 2014). OHA Young Adult Hub Program (YAHP) Reporting 1. Within 30 days of the end of a quarter, County shall submit to WEBCO: • Number of young adults served and their demographic information. • Staffing, credentials and ability to meet the needs of specialized populations. • Measure outcomes on the young adults prior to admission in the YAHP, quarterly and upon discharge in order to determine whether there is an increase in: (a) Employment and education opportunities (b) Housing stability; and (c) Reduction in acute care services 2. By June 15, 2015, County will provide to WEBCO a summary of the above for the entire period of this special project. 3. Each County will develop and implement a County -specific YAHP implementation strategy by July 1, 2014. 4. All individuals will be enrolled in either the CPMS or the MOTS. Exhibit A — Performance Measures 2. Updated 8-12-14 EXHIBIT A (to IGA Amendment No. 2) MATERNAL CHILD HEALTH REQUIREMENTS Section 1. Services In consideration of the compensation to be paid under the Agreement (effective July 1, 2014), Partner will provide the following services: Enhance and Institutionalize MCH Initiative Phase I with the following components: • Work with tri -county health departments, WEBCO and CCO to institutionalize service provision, supervision, data collection and reporting of expanded nurse home visiting services (Nurse Family Partnership, Maternity Case Management, CaCoon). • Work with the CCO to identify Tong -term, sustainable funding strategies and/or payment methodologies through transition of Medicaid Targeted Case Management and Maternity Case Management funds. • Partner with other community home visiting programs (Healthy Families, etc.) to coordinate services and improve continuum of care. • Continue care integration efforts between public health, East Cascade Women's Group and other primary care practices in the region. • Embedded .5 FTE bi-lingual (Spanish) WIC certifier at ECWG. • Partner with OSU/CORC on initiative evaluation. • Research existing models for Maternal/Child Wellness Home. • Work with existing and new partners (including non -profits) to develop MCWH concept and expand initiative advisory work group as needed. • Incorporate resources and lessons learned from LAUNCH (PCIT expansion, year-round parenting education, Maternal Mental Health Initiative, early childhood wellness PR campaign, trauma informed practice, etc.). • Assure integration with patient centered primary care homes and existing CHW models. • Work with OHA, EL HUB and COHC to explore common data collection models (e.g. Vista Logic). Timeline: • Ongoing: Hold Quarterly Advisory Work Group meetings and expand representation to meet needs of Phase II planning. • Q2 2014: Hire .5 WIC bilingual certifier/CHW at ECWG and pilot as expanded CHW role in practice under direction of RN Care Coordinator/WIC Supervisor. • Ongoing: Work with EL HUB, CCO, Mosaic and OHA Transformation innovator to identify role of certifier/CHW in system and identify a sustainable funding source. • Q3 — Q4 2014: Supervision, data collection, and reporting for embedded public health nurse services in tri -county PH departments is institutionalized. • Q4 2014: Screening/referral for maternal depression/anxiety, substance abuse, and oral health at East Cascades Women's Group (ECWG) is institutionalized. Exhibit A — Performance Measures 3. Updated 8-12-14 EXHIBIT A (to IGA Amendment No. 2) Section 2. Compensation PSCS will pay Partner compensation in the amount of $120,000 according to a payment schedule that aligns with the required OHA reporting cycles. Personnel $ Comments: Total Salary $71,457.83 Public Health Nurse new functions around system integration work: regular meetings with primary care providers, case consults, developing workflows and processes, increased communication and alignment with PCPs, etc.) Total Fringe $48,543 Travel $ Material & Supplies $ Contracts $ Equipment $ Other $ Indirect $0 Total $120,000 The project is exclusively supported by Transformation Funds provided by the Oregon Health Authority to the CCO. (Variances to approved expenses by 10% need to be approved by OHA) Subject to other provisions in the Agreement, the funds described below will be provided on the following schedule: o 20% at contract execution. o Two (2) quarterly payments of 40%. o All disbursements will be provided within 14 days of the receipt of funds from OHA, which are expected to be received on September 31, 2014 and December 31, 2014. o Payments will be made using Electronic Funds Transfer (EFT). ■ If any changes occur to the EFT information, a new Direct Deposit form must be provided within 10 business days of the change. Section 3. Data Sharing PSCS will provide the following data, in a format determined by PSCS's systems capabilities and reasonably acceptable to Partner: • PacificSource claims data corresponding to target population. Partner is required to enter into a Business Associate Agreement with PSCS. In addition, Partner may require or be required by other participating partners to enter into additional data sharing agreements to comply with HIPAA and other laws and regulations Section 4. Reporting Provide written reports on grant activities, budget changes and expenditures using the Required Progress Report Template. Reports will be provided on the following schedule: Reporting Period Partner submits report to PSCS March 1, 2014—June 30, 2014 July 1, 2014 July 1, 2014 — December 31, 2014 January 1, 2015 Final Report (entire grant period) July 15, 2015 Exhibit A — Performance Measures 4. Updated 8-12-14 EXHIBIT A (to IGA Amendment No. 2) Required Progress Report Template Date: Name of CCO: Reporting Period: Contact person for this report: Contact information: Please provide a brief update on your Transformation Grant activities for this reporting period. Be sure to highlight your successes. Please describe each project you have undertaken in this reporting period individually. For each project, please identify the following: • Activities/progress made to date. • Outcomes/successes to date. • Outcome/Success impact on Quality Incentive Metrics or Transformation Plan Elements using the template below: *Quality Incentive Measures (QIM): 1. Adolescent Well Care Visits Ambulatory Care: Outpatient Visits (per 1,000 members months); 2. Ambulatory Care: Emergency Department Visits (per 1,000 members months); 3. Screening, Brief intervention and Referral to Treatment; 4. Colorectal Cancer Screening (per 1,000 members months); 5. Developmental Screening 0-36 Months; 6. Follow-up after Hospitalization for Mental Illness (7 day); 7. Follow-up Care for Children Prescribed ADHD Medication (Initiation); 8. Electronic Health Record Adoption; 9. Patient Centered Primary Care Home Enrollment; 10. All -cause Readmission; 11. PQI (01, 05, 08, and 15) Events per 100,000 Member Years; 12. Early Elective Delivery; 13. Well-child Visits in the First 15 Months of Life; 14. Comprehensive Diabetes Care: Hemoglobin A1c Testing; 15. Comprehensive Diabetes Care: LDL -C Screening; 16. Cervical Cancer Screening; 17. Chlamydia Screening in Women; 18. Testing for Children with Pharyngitis; **Transformation Plan Elements: 1. Integration of Physical & Behavioral Health; 2. Implementation and development of Patient -Centered Primary Care Home (PCPCH); 3. Implementing consistent Alternative Payment Methodologies that align payment with health outcomes; 4. Conducting a Community Health Assessment and adopting an annual Community Health Improvement Plan; 5. Develop a plan for encouraging Electronic Health Records, health information exchange, and meaningful use; 6. Assuring communications, Outreach, Member engagement, and services are tailored to cultural, health literacy, and linguistic needs; 7. Assuring that the culturally diverse needs of Members are met (Cultural Competence training, provider composition reflects Member diversity, non-traditional health care workers composition reflects Member diversity); 8. Developing a QI plan focused on eliminating racial, ethnic and linguistic disparities in access, quality, experience and outcomes. • Challenges/barriers. • What have you shared about your projects with other CCOs and what would you like to share? Exhibit A— Performance Measures 5. Updated 8-12-14 Baseline Current Performance *Impacted QIM(s) **Impacted Transformation Plan Element(s) Outcome/Success #1 Outcome /Success #2 Add rows as necessary *Quality Incentive Measures (QIM): 1. Adolescent Well Care Visits Ambulatory Care: Outpatient Visits (per 1,000 members months); 2. Ambulatory Care: Emergency Department Visits (per 1,000 members months); 3. Screening, Brief intervention and Referral to Treatment; 4. Colorectal Cancer Screening (per 1,000 members months); 5. Developmental Screening 0-36 Months; 6. Follow-up after Hospitalization for Mental Illness (7 day); 7. Follow-up Care for Children Prescribed ADHD Medication (Initiation); 8. Electronic Health Record Adoption; 9. Patient Centered Primary Care Home Enrollment; 10. All -cause Readmission; 11. PQI (01, 05, 08, and 15) Events per 100,000 Member Years; 12. Early Elective Delivery; 13. Well-child Visits in the First 15 Months of Life; 14. Comprehensive Diabetes Care: Hemoglobin A1c Testing; 15. Comprehensive Diabetes Care: LDL -C Screening; 16. Cervical Cancer Screening; 17. Chlamydia Screening in Women; 18. Testing for Children with Pharyngitis; **Transformation Plan Elements: 1. Integration of Physical & Behavioral Health; 2. Implementation and development of Patient -Centered Primary Care Home (PCPCH); 3. Implementing consistent Alternative Payment Methodologies that align payment with health outcomes; 4. Conducting a Community Health Assessment and adopting an annual Community Health Improvement Plan; 5. Develop a plan for encouraging Electronic Health Records, health information exchange, and meaningful use; 6. Assuring communications, Outreach, Member engagement, and services are tailored to cultural, health literacy, and linguistic needs; 7. Assuring that the culturally diverse needs of Members are met (Cultural Competence training, provider composition reflects Member diversity, non-traditional health care workers composition reflects Member diversity); 8. Developing a QI plan focused on eliminating racial, ethnic and linguistic disparities in access, quality, experience and outcomes. • Challenges/barriers. • What have you shared about your projects with other CCOs and what would you like to share? Exhibit A— Performance Measures 5. Updated 8-12-14 EXHIBIT A (to IGA Amendment No. 2) • Any technical assistance you would like to receive to support your project, and how would you like to receive this assistance (e.g., site visit, conference call, webinar, or another form of support). • Describe any changes to budget allocations impacting the following: Personnel Expenses, Travel Expenses, Indirect/Administrative Expenses. • Account for all expenditures in the following expense categories: Personnel Expenses, Travel Expenses, Indirect/Administrative Expenses using the template below: [Project Name] 1/1/14 — 6/30/14 7/1/14 —12/31/14 1/1/15 — 6/30/15 Cumulative TOTAL Personnel Total Salary Total Fringe Travel Supplies Contracts Equipment Other Indirect Reporting Period TOTALS Exhibit A— Performance Measures 6. Updated 8-12-14