Title: Setting the Stage: The Case for Regional Action to Strengthen the Safety Net
1Setting the Stage The Case for Regional Action
to Strengthen the Safety Net
- Lon M. Berkeley
- Health Medicine Policy Research Group
- Regional Health Care Safety Net Summit
- June 23, 2009
2OVERVIEW
- Progress to Date/History of the Initiative
- Key Assumptions Terminology
- Demographic Snapshot of Region
- - Russell J. Pietrowiak, CMAP
- On-going Efforts to Strengthen the Safety Net
- Introduction to Preliminary Recommendations
Small Group Action Planning
3MOVING THE BALL DOWN THE FIELD
4Endorsements to Convene the Regional Health Care
Safety Net Summit
- Alivio Medical Center
- Chicago Department of Public Health (CDPH)
- Chicago Hispanic Health Coalition (CHHC)
- Chicago Metropolitan Agency for Planning (CMAP)
- Chicago Partnership for Public Health
- Community Nurse Health Association
- Melanie Dreher, Dean, College of Nursing, Rush
University Medical Center - William T. Foley, Chief Executive Officer, Cook
County Health Hospitals System - Patricia Gross, MSPH
- Illinois Maternal and Child Health Coalition
(IMCHC) - Illinois Public Health Institute (IPHI)
- Institute of Medicine of Chicago (IOMC)
- Latinos for a Healthy Illinois
- Metropolitan Chicago Healthcare Council (MCHC)
- Near North Health Services Corporation
- Northern Illinois Public Health Consortium
(NIPHC) - Alderman Toni Preckwinkle, 4th Ward, City of
Chicago - Resurrection Health Care
5MOVING THE BALL DOWN THE FIELD
6MOVING THE BALL DOWN THE FIELD
7KEY TERMINOLOGY OF INITIATIVE
- Health
- Safety Net
- Regional
- Vulnerable Populations
-
8KEY TERMS OF INITIATIVE
- Health is not merely the absence of illness or
disability, but also the attainment of mental,
physical, and spiritual or social well-being.
(WHO) - It is a fundamental human right and that the
attainment of the highest possible level of
health is a most important world-wide social goal
whose realization requires the action of many
other social and economic sectors in addition to
the health sector.
9WHAT DO WE NOT MEAN BY THE HEALTH CARE SAFETY
NET?
10WHAT DO WE NOT MEAN BY THE HEALTH CARE SAFETY
NET?
11WHAT DO WE MEAN BY THE HEALTH CARE SAFETY NET?
- Providers that
- organize and deliver a significant level of
health care and other related services - to uninsured, Medicaid, and other vulnerable
populations (IOM), as well as other
population-based health services.
12WHAT DO WE MEAN BY THE HEALTH CARE SAFETY NET?
13WHAT DO WE MEAN BY Regional?
- INCLUDES COUNTIES OF
- gt Cook gt DuPage
- gt Kane gt Kendall
- gt Lake gt McHenry
- gt Will
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15WHAT DO WE MEAN BY Vulnerable Populations?
- Residents who are vulnerable because health
services are - unavailable
- inaccessible
- under-subsidized or
- not subsidized at all by public or private
programs - Includes the uninsured, under-insured, and people
on Medicaid
16KEY ASSUMPTIONS OF INITIATIVE
- There is no mandate or requirement to pursue this
regional approach. - We dont have to do this
- There is no sponsor
- 2) Planning that includes the public and
private sector increases the probability of
attaining our goals and desired outcomes.
17KEY ASSUMPTIONS OF INITIATIVE
- 3) Collective regional action will strengthen
- Planning
- Resource sharing
- Advocacy
- Patient Referrals
- Service Coordination, and
- Research Opportunities.
- Other successful regional efforts exist that have
improved outcomes or operations
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20KEY ASSUMPTIONS OF INITIATIVE
- 4) Improving health status and quality of life
requires a multi-sectoral approach that extends
beyond the multiple layers of traditional medical
care and public health (see Who Takes Care of
Your Health? diagram below).
21Who Takes Care of Your Health?
22KEY ASSUMPTIONS OF INITIATIVE
- 5) There is a continuum of health care services
that can be categorized into both vertical and
horizontal dimensions. - 6) We accept the World Health Organizations
systems building blocks of a health system
conceptual framework - 7) We accept the Institute of Medicines
- six specific aims for improving the health care
system.
23THE WHO Health System Conceptual Framework
Source WHO Health System Strengthening Strategy
2007
24KEY ASSUMPTIONS OF INITIATIVE
- Six Aims for Improvement (Institute of Medicine)
- Safe avoiding injuries to patients from the care
intended to help them. -
- Effective providing services based on scientific
knowledge to all who could benefit, and
refraining from providing services to those not
likely to benefit. - Patient-centered providing care that is
respectful of and responsive to individual
patient preferences, needs, and values, and
ensuring that patient values guide all clinical
decisions. -
- Timely reducing waits and sometimes harmful
delays for both those who receive and those who
give care. -
- Efficient avoiding waste, including waste of
equipment, supplies, ideas, and energy. - Equitable providing care that doesnt vary in
quality due to personal characteristics such as
gender, ethnicity, geographic location,
socioeconomic status.
25KEY ASSUMPTIONS OF INITIATIVE
- 8) Health Medicine Policy Research Groups
(HMPRG) role is to facilitate the process only - - currently supported by one foundation grant
and in-kind contributions - - similar to approach with other successful
projects.
26KEY ASSUMPTIONS OF INITIATIVE
- 9) All problem statements, priorities, and
recommendations, are works-in-progress, - - with recognition and apologies to any
overlooked organizations, projects, and people
that are interested in contributing to this
initiative.
27 A Demographic Snapshot of the Region Russell
J. PietrowiakAssociate PlannerChicago
Metropolitan Agency for Planning
28Total Population Change by County from 1990 - 2006
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31Changing Demographics in Cook County
32Constant growth over more than 3 decades(6
counties)
33Latinos have the highest rates of uninsured
persons in Illinois
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39Ongoing Efforts to Strengthen the Safety Net
- HMPRG compiling a Summary of Actions
- Federal State Legislation re
- Community Building/Coalitions for Safety Net
Improvements - Workforce, IT, Financing
- Metro-area Initiatives
- The Chicago Access Puzzle Fitting the Pieces
Together - Healthy San Francisco Initiative
- Detroit/Wayne County Health Authority
- Mid-America Regl Council KC Metro Health
Access - Access DuPage
- Access to Care
40CMAP GoTo 2040 The Plan For Health
41CMAP GoTo 2040 The Plan For Health
- The GoTo 2040 Plan is a comprehensive plan for
the seven county region of the Chicago
Metropolitan Agency for Planning (CMAP).1 - This report presents the plan for health.
- Purpose To position the region to be
competitive in a global economy and create an
environment in which all diverse residents will
benefit from, and contribute to, the vitality of
the region. - 1 The Illinois counties of Cook, DuPage, Kane,
Kendall, Lake, McHenry, and Will.
42CMAP GoTo 2040 The Plan For Health
- The scope of the plan was guided by
- 3 decade planning horizon
- Limitation of no more than 15 indicators
- Emphasis on the determinants of health
- Unsustainable cost and quality of life burden of
chronic disease and - Focus on what can be accomplished in the region
to improve health and not on those factors that
are beyond regional control. -
43CMAP GoTo 2040 The Plan For Health
- 4 Recommended Strategies
- Integrated prevention and health promotion
strategy that will integrate the regional
planning agenda with health policy issues and
integrate the participants in the process. - Move toward an all data-real time concept that
builds on electronic medical records. - Address workforce concerns.
- Strengthen the public health infrastructure in
response to early signs of deterioration.
44KEY TERMINOLOGY FOR SUMMIT
- Preliminary Recommendations
- May not be complete or the best
- Blueprint
- Vision with guidelines
- Strengthening
- Existing services need support
- Moving Recommendations to Action
- Building on past progress
-
45BUILDING A BETTER WORLD
- CURRENT STATE
- TRANSITIONAL STATE
- IMPROVED STATE
- DESIRED STATE
46Moving Recommendations to Action
- Preliminary Recommendation Categories
- Data/IT
- Workforce
- Access
- Health Equity
- Finance
- Planning Approaches
47Moving Recommendations to Action
- Preliminary Recommendation Format
- Problem Statement
- Vision
- Recommendation
- Local/Regional Examples
- Rate Level of Support
- Your Role in Implementing the Recommendation
- gt Leadership gt Participant
- gt Resource gt Stay Informed gtNot Interested
48RECAP
- We are not waiting to be told that we can
strengthen the health care safety net by working
across geographic boundaries. - As we continue to move the ball down the field
we hope to gain some momentum from todays
efforts. - We need you to weigh in with your comments,
ideas, energy, and action to help implement this
vision.
49Japanese Proverb
- Vision without action is a daydream ..
- action without vision is a nightmare.
-