CHAMPS/CCHN 2017 Outreach and Enrollment Distance Learning Series

Leveraging O&E Assisters in Community Health Centers

July 27, 2017

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Presented By: Ted Henson, National Association of Community Health Centers,

Jaspreet Malhotra, MPH, Michigan Primary Care Association, and Cherise Fowler, Alaska Primary Care Association

Community Health Association of Mountain/Plains States (CHAMPS)

Member Benefits

• Two seats on the CHAMPS Board of Directors

• Free access to online CHAMPS Live and Archived Distance Learning Events

• Two free copies of the 2017-2018 CHAMPS Region VIII Health Center Directory

• Discounted registration for CHAMPS face-to-face trainings plus opportunities for registration and clinical travel reimbursement

• Access to the Members Only section of the CHAMPS Website

• Direct advertising of newly active Job Opportunities Bank (JOB) postings to job seekers

• And much more

Colorado Community Health Network (CCHN)

2017 O&E Distance Learning Series

Upcoming Events

• Leveraging O&E Assisters in Community Health Centers– July 27, 2017

• Strengthening Your Compassion Resiliency Toolkit– August 24, 2017

• Preparing for OE5: Addressing Changes in the Marketplace– September 21, 2017

Presented by:

TED HENSON Director/Health Center Growth & Innovation, NACHC thenson@nachc.com www.nachc.com

Health Center Footprint

1,300+

# of health

centers

reporting on

O&E

18 million

# of assists

into

coverage

since 2013

Federal Expectations around Outreach and

Enrollment

Health Center O&E Activities

• O&E funding is part of health center base

grant funding

• Expectations around O&E activities are the

same!

• Changes in Reporting Transitioning from

QPRs to UDS reporting

Federal Expectations around Outreach and

Enrollment

1:1

customizable

education

sessions

Securing access

to Medicaid, CHIP

and other

available health,

social service,

pharmacy and

other assistance

programs;

SEPs

Conduct

targeted

outreach

File appeals/

exemptions

Planning &

Maintaining

Partnerships to

reach the

uninsured

Conduct

in-reach Assist with

understanding

coverage /

Health

Insurance

Literacy

Continuing, Enhancing O&E in

Times of Uncertainty

Demonstrate Value of O&E

NACHC’s Outreach and Enrollment Case Studies

Goal: Demonstrate the impact that investing in outreach and enrollment

activities has on a health center’s finances, operations, and

patient/community health.

• Borinquen Medical Centers of Miami-Dade, Miami, FL

• Partnership Community Health Center, Appleton, WI

• Mountain Comprehensive Health Corporation, Whitesburg, KY

http://www.nachc.org/health-center-issues/outreach-and-

enrollment/information-and-resources/

Social Determinants of Health (SDOH)

Tackling SDOH in Health Centers

• Addressing social determinants through providing

enabling services

• Enabling services are defined as:

“Non-clinical services that aim to increase access to

healthcare and improve health outcomes”

• Examples: health education, interpretation, and case

management

Work Force

• Workforce:

– UDS collects data on 7 categories of enabling

services personnel

– 89% of FTEs come from 4 categories:

• case managers

• eligibility assistance workers

• outreach workers

• patient/community education specialists

PRAPARE

• The Protocol for Responding to and Assessing

Patients’ Assets, Risks, and Experiences

(PRAPARE)

• National effort to help health centers and other

providers collect and apply the data they need to

better understand their patients’ social

determinants of health

Future of the O&E, Assister Workforce

• Enrollment assisters play

an important, growing role

at health centers

• Assisters address many

social determinants of

health

• Investing in the

cross-training of

CACs/Navigators

provides multiple upsides

for health centers and

patients:

• CHWs

• Patient Navigators

• VITA Volunteers

Presented by:

JASPREET MALHOTRA, MPH, Enabling Services Manager, Michigan Primary Care Association

jmalhotra@mpca.net www.mpca.net

Integrating the

Enrollment Assister

and Community

Health Worker

(CHW) Roles

Integrating CHWs and Enrollment Roles

Community Health Workers

Outreach and

Enrollment Assisters

Experts in System Navigation, Education, and Advocacy

Getting Started

Cross-train!

CHW core competencies

Health coverage enrollment training

Integrate health coverage outreach, education, and enrollment into all services delivered

Shared Roles

Communication Coaching & Social

Supports

Service Coordination &

Navigation

Capacity Building Advocacy

Culturally Appropriate Education & Mediation

Individual & Community Assessment

Outreach Participation and

Research

Enrollment Assister and CHW

Models

Ingham Community Health Centers

Lansing, MI

Great Lakes Bay Health Centers

Saginaw, MI

Mercy Health-St. Mary’s Community Health Centers

Grand Rapids, MI

Work as a Team

Cross training both CHWs and

O/E staff

Make referrals and connecting to

community based resources

Use daily huddles to debrief, share

resources, troubleshoot

issues

O/E Staff and CHW work with

each other to prioritize and

respond

Work as a Team

Example Approach 1:

Cross training both CHWs and

O/E staff

Make referrals and connecting to

community based resources

Use daily huddles to debrief, share

resources, troubleshoot

issues

O/E Staff and CHW work with

each other to prioritize and

respond

Work as a Team

Example Approach 2:

Redefine the roles and

responsibilities

Cross train staff to combine the two roles – “no wrong door” approach

Monthly meetings to

debrief

CHW works with patients to prioritize

and respond

Impact on Patient Outcomes

Community based supports can improve health1

Health insurance related to improved

management and control of chronic conditions2

Increased rates of care3

Increased rates of diabetes and cholesterol

diagnoses3

1. Financing Community Health Workers: Why and How. (2007, January 2). Retrieved from

http://www.publicsectorconsultants.com/wp-

content/uploads/2017/01/ColumbiaUniv_Financing_CommHealthWrkrs_PolicyBrief.pdf

2. Hogan, D. R., Danaei, G., Ezzati, M., Clarke, P. M., Jha, A. K., & Salomon, J. A. (2015, September). Estimating The Potential

Impact Of Insurance Expansion On Undiagnosed And Uncontrolled Chronic Conditions. Retrieved from

http://content.healthaffairs.org/content/34/9/1554.full

3. Rivero, E. (2016, April 18). Medicaid expansion significantly boosts insurance coverage among low-income adults.

Retrieved from http://newsroom.ucla.edu/releases/medicaid-expansion-significantly-boosts-insurance-coverage-among-

low-income-adults

Resources:

NACHC Issue Brief: Expanding the Role of the

Enrollment Assister at Community Health

Centers

Michigan PCA’s CHW Toolkit

Michigan PCA’s O/E Toolkit

Presented by:

CHERISE FOWLER Apprenticeship Training Coordinator, Alaska Primary Care Association

cherisef@alaskapca.org www.apcaapprentice.com

Introduction

Have you wondered how

you can increase your

capacity as an enrollment

assister, NOW?

With all the news and

changes to the ACA

underway we need to stay

the course and keep helping

people in our communities

that need our help!

1

Alaska’s CHW Apprenticeship Program

1 year program

Ideal candidates work in health centers as O&E

Assisters or Navigators for the ACA

Meet one hour weekly for one hour distance delivered

training

Funding for program provided by Alaska Department

of Labor

All training and final exam is distance delivered.

Apprentices will not leave their community to gain

certification.

2

Why the Need?

There are many barriers to health care including:

• Access to the Health Care System

• Lack of Understanding of how to navigate the health care

system

• Uninsured/Underinsured/Underserved

• Transportation

• Access to Primary Provider

• Access to Medications

• Health Literacy

• Education on Illness

• Communication

• Social Determinants of Health

3

Why You?

You’re ALREADY a trusted

member in the community

You have established relationships

You have links to various agencies

You already have the skills it takes

You can help people manage their

health

4

Improving Health Outcomes

You can help people navigate

the healthcare system, serve

as a health coach and help

others surmount barriers. You

can also connect your clients

to resources they may not

have known about.

5

Care Coordination Stages

Complete an initial assessment

Identify Goals

Develop a care plan with clients

Implement plan

Refer as needed

Follow up

Monitor outcomes

Advocate

Celebrate reached goals and improved

outcomes

6

Sample Intake Form

7

Date:

Client Name:

Client ID:

CHW Name:

Clients Primary Goal(s):

1.

2.

Actions to take to reach the health

goal are: _______________________

Will do this _____ times/week for____

One a scale of 1-10, confidence

completing this plan is ______

Resources (internal and

external) that will help to reach

the goal are:

Challenges that may get in the

way are:

Ways to overcome or resist these

challenges are:

Referrals Provided:

Next Meeting:

Sample Progress Notes

8

Date:

Progress Notes (document the client’s progress in implementing their Action Plan,

including successes and challenges)

The client made the following progress in implementing their Action Plan (include

actions taken, when and where)

The client faced the following challenges:

The client wants to make the following changes to their action plan:

Referrals provided:

On a scale from 0-10 the client rates their confidence for moving forward with their

Action Plan at______

Other Notes:

Referrals are Gold!

9

Sample Resource Form

10

O&E Best Practices

Continue to provide your clients enrollment and

re-enrollment support

Help people navigate the healthcare system and

utilize their coverage

Storybank whenever possible

Continue to stay informed about news in relation to

the ACA

11

Expanding Your Role

12

What can you do now?

Enhance your screening and initial intake processes

Educate yourself and learn more about the needs of

your community, clients and health center. Where are

the gaps?

Build relationships with local social service agencies

Build a strong referral network and resource list

Connect clients with additional support services:

• Food Stamps

• WIC

• Housing Assistance

• Temporary Assistance

• Job Centers 13

QUESTIONS? Type any questions into the chat box at the bottom of the screen.

2017 O&E Distance Learning Series

Upcoming Events

• Strengthening Your Compassion Resiliency Toolkit– August 24, 2017

• Preparing for OE5: Addressing Changes in the Marketplace– September 21, 2017

CHAMPS/CCHN 2017 Outreach and Enrollment Distance Learning Series

Thank You

“Everyone can be great because anyone can serve. You don’t have to have a college degree

to serve. You don’t even have to make your subject and your verb agree to serve… You only need a heart full of grace, a soul generated by

love.”

Dr. Martin Luther King, Jr.

www.champsonline.org www.cchn.org