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HomeMy WebLinkAbout10-2020 OCTOBER 28 PHAB Minutes Deschutes County Health Services Public Health Advisory Board MINUTES MINUTES October 28, 2020 12:00 p.m. - 1:30 p.m. via Zoom videoconferencing Facilitator Keith Winsor, Chair Staff Coordinator Tom Kuhn, Community Health Manager Scribe Lisa Michael Next Meeting December 9, 2020, via Zoom Topic and Lead Introductions and Approval of September Meeting Minutes Tom Kuhn asked Lindsay Seibel to introduce herself to the Board as the new PHAB scribe. Dr. Robert Ross motioned to approve the minutes as submitted, which were seconded by Steve Strang. The Board was unanimous in their approval of the submitted minutes. Updates and Unfinished Business No updates from any board members were reported. Traditional Health Work Expansion in Central Oregon (THW) Tanya Nayson gave an overview of the types of traditional health workers and Gretchen Horton-Dunbar spoke about the changes to the billing models. Traditional Health Workers (THW) are experts in connecting people with resources in finding health care that fits their needs. They share socioeconomic ties and lived experience with the health plan members. They advocate for patients and support adherence to care and treatment while empowering the individual to be in charge of improving their own health. There are seven types of traditional health workers: 1. Community Health Workers (CHW) help patients navigate the social systems in and out of clinic settings by finding resources to health care. 2. Peer Support Specialists (PSS) provide services to patients who share similar life experiences whether it be addiction, a mental health illness, or family members with these conditions. 3. Peer Wellness Specialists (PWS) are individuals who have experienced psychiatric conditions, and who have intensive training. These specialists work as part of a person- driven, health home team that integrate behavioral health and primary care in helping a patient achieve well-being. 4. Youth Support Specialists (YSS) can be Peer Support Specialists or Peer Wellness Specialists that provide supportive services to those under 30 who are current or former consumers of mental health or addiction treatment, or are facing difficulties in accessing education, health and wellness services due to mental health barriers. 5. Family Support Specialists (FSS) provide support services to a child who is facing addiction or mental health issues or is struggling to access education, health and wellness services due to mental or behavioral health barriers. “To promote and protect the health and safety of our community.” Updated 1/26/21 6. Doulas are birth companions who provide personal nonmedical support to pregnant women and their families during childbirth and those experiencing post-partum. Tanya noted there has been an uptick in home births. 7. Personal Health Navigators (PHN) provide information, support and tools to enable patients to make the best health choices regardless of their needs, lifestyle, combination of conditions and desired outcomes. They coordinate with providers and insurance and follow-up on a patient’s care. The benefits of using a THW includes reducing health inequities, building trust between patient and provider, improving health outcomes, and advancing the Quadruple Aim to better health, better care, lower costs, and less provider burden. THWs are a covered benefit with PacificSource Community Solutions/OHP plans. Tanya explained that PHN’s and CHW’s are basically the same, except a CHW does work in the community and has relatable life experience, while a PHN works in a clinic setting only and has no relatable life experience. Tanya said there is a big change in the CCO 2.0 regarding case management and social determinants of health. Services can now be billed directly to Medicaid unlike before. PacificSource has been working with the state on this since January. Tanya has been spending most of her time searching for candidates that fall in these seven categories and getting them trained and certified. Training is expensive, so she is trying to help lessen the cost. Alison chimed in and said they are getting lots of requests from veterans who are interested in becoming certified. Gretchen spoke about direct billing practices for contracted providers and groups. Providers must have a certified and registered THW on staff and services may be billed FFS or through value based arrangements. Providers are also eligible for one year of Community Health Excellence (CHE) grant funds in order to add a THW position starting in 2021. Affiliation agreements also require providers to retain a certified THW on staff and are eligible for the CHE grant funding; however, services billed FFS or through value based arrangements must be billed by the clinical supervisor/billing provider. PHAB 2020 Priorities Work Group Discussion Keith Winsor went over the 2020 priorities and the Board decided to make a few changes for 2021 but continue working to finalize the list. A shortened draft version of the 2021 priorities are as follows: 1. COVID 19 Considerations A. Mask Usage B. Health Screenings and Care during COVID. 2. Immunizations, including COVID Vaccine and Vaccine avoidance. 3. Sexually Transmitted Disease/Infection (including Harm Reduction Strategies) 4. Teen Pregnancy/Reproductive Health Access “To promote and protect the health and safety of our community.” Updated 1/26/21 Exploratory Issues/Educational Areas 1. Veteran Homelessness & Health 2. Unintentional Injuries 3. Emerging PH Threats Dave Huntley mentioned PHAB needs to support the BOCC and be more active around COVID issues. PH is doing a great job and is knee deep in cases; however, from what he has witnessed, there is not a lot of mask compliance going on around the community like there should be. Dave thought the board should underscore proper mask use and also send messaging that standard health care should not be dropped by community members because they are afraid to see a doctor or dentist during these times. Jim Powell piggybacked off Dave’s comments by noting that the messaging should also include the three W’s – Wash your hands, Wear a mask and Wait at least 6 feet apart from others. He asked if there was a way to tie individual actions to overall community economic recovery. Keith wants to spend more time on expanding or refining the topics through the workgroup to bring back to the entire board for discussion and finalization. The finalized priorities can then be presented to the BOCC. Tom asked the board to send any ideas within the next week to him to bring to the workgroup. Tom will email the priorities to the board for their review. Public Health Strategic Planning Channa Lindsay gave a PowerPoint presentation and explained that DCHS follows a best practices procedure and the first step in the planning process is to assess and get feedback. The assessments come from the RHA/RHIP, the BAR HII and SWOT, which create the plan (goals, metrics and priorities). Everyone’s work is a priority and everyone has a plan. The plan is set for three years with annual updates and will include PH specific goals and metrics. Channa will continue to gather staff and community feedback throughout the process. The next steps at a department level are to improve outcomes, assure quality and increase sustainability. The Assessments Summary is a high level summary that will focus on top opportunities for improvement, not successes. It will also include workforce development issues and technology. Based on the recommendations provided by Oregon’s Public Health Advisory Board, investments in 2021-23 will focus on:  Recommendations for funding  Enhancing equity  CD and EH programs related to equity  EH regulatory requirements  Promotion of natural resources, land use and built environment policies and programs that support health.  Climate change  Emergency Preparedness Despite overall progress, DCPH still scores low (20-40% capacity or expertise) for the following:  Promotion of land use planning  Identify and prevent environmental health hazards  Improve oral health  Reduce accident rates  Financial management, contracts and procurement services, and facilities operations.  Communicate and engage inclusively “To promote and protect the health and safety of our community.” Updated 1/26/21 The CDC recommended a 15-minute Sustainability Assessment Summary for each program with a highest possible score of 7. DCPH averaged a score of 4.7 with funding stability believed to be the primary factor for the lower score as there is no control over that. If we align our work with the RHIP, we will collectively have a greater impact on the six priority areas. Channa spoke briefly about those six priority areas and considerations and noted that there have been huge equity issues, particularly in rural areas. She also mentioned that 74% of staff are currently satisfied with the technology we have; however, we could lose up to $300k a year trying to make our technology work up to par. Continuous quality improvement work is being done on internal workforce development. Deschutes County grew by 18.5% from 2010 to 2017 and 90% of the overall DCHS workforce and 98% of leadership staff identify as white or Caucasian. DCPH would like to improve in areas of community cultural, language and literacy needs. Other areas of improvement needed include equitable recruitment, hiring, retention and promotion practices. Channa asked PHAB to consider Public Health’s role and our collaborative work with partners and provide feedback on our services to be discussed at the December meeting. What things should we be focusing on? Channa will send out a survey and provide the PH priorities and metrics for the board to review and comment on. Adjourn at 1:30 p.m. Action Items:  Send out 2021 priorities to PHAB for review  Once edits are made, send priorities out to PHAB for final approval  Send out Strategic Plan info from Channa prior to December meeting Board Members Present: Keith Winsor, Rebeckah Berry, Rob Ross, Jim Powell, Steve Strang, Charla DeHate, Dave Huntley, Sharity Ludwig, Tami Pike, Tanya Nason and Alison Perry Staff Members Present: Tom Kuhn, Lisa Michael, Lindsay Seibel Guest Presenters: Tanya Nason (PHAB Board Member/PacificSource), Gretchen Horton Dunbar (PacificSource), Channa Lindsay (staff) PHAB – Public Health Advisory Board THW – Traditional Health Worker CHW – Community Health Worker PSS – Peer Support Specialist PWS – Peer Wellness Specialist YSS – Youth Support Specialist FSS – Family Support Specialist PHN – Personal Health Navigator OHP – Oregon Health Plan FFS – Free For Service CHE – Community Health Excellence BOCC – Board of County Commissioners PH – Public Health DCHS – Deschutes County Health Services RHA – Regional Health Authority RHIP – Regional Health Improvement Plan BAR HII – Bay Area Regional Health Inequities Initiative SWOT – Strengths, Weaknesses, Opportunities & Threats CD – Communicable Disease EH – Environmental Health DCPH – Deschutes County Public Health CDC – Center for Disease Control “To promote and protect the health and safety of our community.” Updated 1/26/21