Health Care Reform 2011-2012

Health reform encourages transformation of the health care system. This session will examine new models of care delivery promoted by the ACA and how they’re being developed in Alameda County. It will look at models trying to coordinate patient services along the continuum of care from prevention to specialty to care to acute care.

• Summary of Building Strong Linkages to Specialty Care Hearing (PDF – 92kb), by Sarah Arnquist, Harbage Consulting

Background

• At the Intersection of Health, Health Care and Policy (PDF – 229kb),
  by Katherine Neuhausen, Kevin Grumbach, Andrew Bazemore and Robert L. Phillips,
  Health Affairs, 31, no.8 (2012):1708-1716

Presentations

• Access to Specialty Care for Community Health Center Patients (PDF – 751kb),
  by Dr. Melissa Marshall, Chief Medical Officer, Community Health Center Network (CHCN)
• Health Reform Hearing/Specialty Care (PDF – 1184kb),
  by Kathleen Clanon, MD, Medical Director, HealthPAC and Interim Chief Medical Officer, ACMC and
  Evan Seevak, MD, Chair, Ambulatory and Preventive Medicine, ACMC
• The CAMINO DE SALUD NETWORK: eConsult Pilot (PDF – 690kb),
  by Charlene Chen, Director of Clinical Integration and Translational Research, COPE Health Solutions
• Alliance Programs and Specialty Care Services (PDF – 536kb), by Dr. Lily Boris, Chief Medical Officer, Alameda Alliance for Health

Health Information Exchanges will be a critical component of a health care system capable of providing coordinated care across the delivery system. This session will provide an overview of the national and statewide issues related to these exchanges, as well as an overview of Alameda County’s current status of electronic medical records and interoperability.

• Summary of Health Information Exchanges and Coordinating Care Delivery Hearing (PDF – 87kb), by Sarah Arnquist, Harbage Consulting

Presentations

• What is HIE? A Federal and State Perspective (PDF – 1619kb), by Lori Hack, CEO, Object Health
• HealthShare Bay Area (PDF – 997kb),
  by Arieh Rosenbaum, MD, Director of the Informatics Program, California Pacific Medical Center
  and Chairman of the Board of Directors, HealthShare Bay Area
• ACMC + CHCN: The Chocolate Peanut Butter Cup of Alameda County Healthcare (PDF – 510kb),
  by Howard M. Landa, M.D., Chief Medical Information Officer, Alameda County Medical Center
  and Ralph Silber, Executive Director, Alameda Health Consortium

Video

• Health Committee Board Meeting

Health reform means transformative changes to the health insurance market – from increased regulation of private insurers’ enrollment practices and profit to purchasing subsidies for individuals and families earning up to 400% FPL. This session will provide updates on the State Health Benefits Exchange and local insurers’ plans for recruitment and enrollment.

• Summary of Understanding Changes in the Health Insurance Market Hearing (PDF – 98kb), by Sarah Arnquist, Harbage Consulting

Background

• State Exchange Profiles: California – Kaiser Health Reform (PDF – 117kb)
• Flowchart: The Requirement to Buy Coverage Under the Affordable Care Act Beginning in 2014 (PDF – 117kb)
• Affordable Care Act Two-Year Report (PDF – 236kb)
• The Affordable Care Act: What Californians Should Know (PDF – 1622kb), California HealthCare Foundation

Presentations

• The Federal Health Law and Alameda County: What’s New, What’s Next, and What Do We Need to Do? (PDF – 87kb),
  by Anthony Wright, Executive Director, Health Access
• The ACA and California’s Health Benefit Exchange: An Update (PDF – 108kb),
  by Marian Mulkey, MPP, MPH, Director, Health Reform and Public Programs Initiative California HealthCare Foundation

Video

• Health Committee Board Meeting

Hearing Cancelled

This session will focus on new interests and opportunities related to integrating behavioral health and physical health services, with a specific focus on the work being done in this arena in Alameda County

• Summary of Behavioral Health Hearing (PDF – 90kb), by Sarah Arnquist, Harbage Consulting

Background

• Care Integration in the Patient Protection and Affordable Care Act: Implications for Behavioral Health (PDF – 163kb), by Bevin Croft & Susan L. Parish
• Expansion of Substance Use Disorder Treatment Within Reach Through Health Care Reform (PDF – 3063kb), California Society of Addiction Medicine, April 2011
• Understanding Health Reform: Integrated Care and Why You Should Care (PDF – 346kb), SAMHSA, Substance Abuse and Mental Health Services Administration

Presentations

• Integrated Behavioral Health Capacity Building – Alameda County (PDF – 80kb), by Robert Ratner, MPH, MD, Housing Services Director Alameda County Behavioral Health Care Services & Aaron Chapman, MD, Medical Director, Alameda County Behavioral Health Care Services
• Behavioral Health Primary Care Integration Hearing (PDF – 189kb), by Sandra Naylor Goodwin, PhD, MSW, California Institute for Mental Health
• 1115 Wavier and Mental Health Services Act Strategies in Alameda County (PDF – 133kb), by Alex Briscoe, Alameda County Health Care Services Agency

With an additional 150,000 people insured in 2014, additional workforce will be needed to ensure all Alameda County residents have adequate access to care. This session will provide an overview of projected workforce needs, and an update on local efforts to develop tomorrow’s diverse and capable health care workforce.

• Summary of Building a Strong Workforce Hearing (PDF – 87kb), by Sarah Arnquist, Harbage Consulting

Background

• California’s Health Care Workforce-Are We Ready for the ACA (PDF – 227kb), by Center for the Health Professions at UCSF
• Health Reform Health Care Workforce (PDF – 520kb), by the Baker Institute

Presentations

• Health Workforce Challenges and Opportunities (PDF – 600kb), by Ed O’ Neil, Ph.D, MPA, FAAN, Professor at University of California, San Francisco
• Alameda County Health Pipeline Partnership (PDF – 510kb), by Jocelyn Freeman Garrick, MD, Director, Alameda County Health Pipeline Project
• Health Care Reform and the Health Care Workforce (PDF – 316kb), by Michael Kushner, Director of Training, SEIU UHW-West and Joint Employer Education Fund

In contrast to the current system, health reform prioritizes prevention of disease. Additionally, providers are leveraging grants to work on improving integration of physical, mental health and substance use services. This session will look at new funding and initiatives available and what Alameda County is doing locally in these key areas.

• Summary of Innovations in Prevention Hearing (PDF – 88kb), by Sarah Arnquist, Harbage Consulting

Background

• Health Policy Brief: The Prevention and Public Health Fund (PDF – 146kb), by Jennifer Haberkorn
• The Prevention and Public Health Fund: Backgrounder and Fact Sheet (PDF – 176kb), by Trust for America’s Health
• The Affordable Care Act’s Prevention and Public Health Fund in California (PDF – 37kb), by HealthCare.org

Presentations

• Prevention and Healthcare Reform: Why It’s Important for Alameda County (PDF – 497kb), by Mary Pittman, DrPH President and CEO of the Public Health Institute
• Innovations in Prevention (PDF – 214kb), by Ellen Wu, MPH, Executive Director of the California Pan-Ethnic Health Network
• Improving Community Health: A Framework for Achieving Health Equity (PDF – 1516kb), by Muntu Davis, MD, MPH, County Health Officer, Alameda County Public Health Department
• Street Level Health Project (PDF – 747kb), by Laura Elizabeth Lopez, Executive Director of the Street Level Health Project

Roughly 56,000 Alameda County residents will be eligible for the Medi-Cal expansion. The County will be responsible for enrolling them using new, simplified tools. This session will focus on ways to promote enrollment, needed cooperation with local unions, and the development of California’s Health Benefits Exchange that will help people purchase private insurance coverage starting in 2014.

• Summary of Laying the Foundation of Strong Eligibility and Enrollment Systems Hearing (PDF – 90kb), by Sarah Arnquist, Harbage Consulting

Background

• An Enrollment Checklist (PDF – 352kb), by Jennifer Sullivan, Enroll America
• Enrollment Checklist by Enroll America  (PDF – 110kb)
• Communicating with Plain Language (PDF – 141kb), Nicole Donnelly, Penny Lane, and Joan Winchester, Enroll America
• An Introduction to Health Literacy and Enrollment (PDF – 175kb), by Nicole Donnelly, Penny Lane, Joan Winchester, and Christina Powell, Enroll America
• Ideal Application Process (PDF – 251kb), by Elisabeth Rodman, Enroll America
• Building a Consumer-Driven Eligibility, Enrollment, and Renewal System: Essential Design Features for Effective Health Reform in California (PDF – 58kb), by Dawn Horner and Beth Morrow
• Under Pressure: Front-Line Experiences of Medi-Cal Eligibility Workers (PDF – 460kb), by The California HealthCare Foundation
• Health-e-App Public Access: A New Online Path to Children’s Health Care Coverage in California: An Overview of the First Year (PDF – 142kb), by Leslie Foster
• Enrolling in Medi-Cal: The Consumer Experience (PDF – 1045kb), Michael Perry, Mary Slosar, Phd, Naomi Mulligan, Lake Research Partners, California HealthCare Foundation and California Endowment

Presentations

• Getting Ready for Enrollment in 2013 (PDF – 758kb), Rachel Klein, Executive Director, Enroll America (EA Alameda County)
• Laying the Foundation of Strong Eligibility and Enrollment Systems (PDF – 387kb), Catherine Teare, MPP, Senior Program Office, California HealthCare Foundation
• Health Care Reform: Implications and Opportunities for Counties (PDF – 60kb), Cathy Senderling-McDonald, Deputy Executive Director, County Welfare Directors Association of California
• Eligibility, Enrollment, Renewal (PDF – 302kb), Lori Jones, Agency Director, and Randy Morris, Assistant Agency Director, Alameda County Social Services Agency

Access to primary care will be an ongoing issue as more people gain health coverage. This session will discuss new models for delivering primary care, such as patient centered medical homes and new competition for patients among providers.

• Summary of Primary Care System Hearing (PDF – 91kb), by Sarah Arnquist, Harbage Consulting

Background

• In Massachusetts, Universal Coverage Strains Care (PDF – 37kb), by Kevin Sack, The New York Times
• The Primary Care Physician and Health Care Reform (PDF – 54kb), by Robert H. Brook, MD, ScD and Roy T. Young, MD, The Journal of the American Medical Association
• The Teamlet Model of Primary Care (PDF – 95kb), by Thomas Bodenheimer, MD and Brian Yoshio Laing, BS, Annals of Family Medicine
• Lessons from the Trenches — A High-Functioning Primary Care Clinic (PDF – 267kb), by Thomas Bodenheimer, M.D., The New England Journal of Medicine
• Care Management of Patients with Complex Health Care Needs (PDF – kb), by Sarah Goodell, M.A., Thomas Bodenheimer, M.D., M.P.H., and Rachel Berry-Millet, B.A.
• Alameda Health Consortium Health Centers 2010  (PDF – 87kb)

Presentations

• The Building Blocks of High-Performing Primary Care (PDF – 2275kb), Tom Bodenheimer, M.D., Center for Excellence in Primary Care, UCSF
• Healthy San Francisco Overview: Preparing the Primary Care System for Health Reform (PDF – 220kb), by Tangerine Brigham, San Francisco Department of Public Health
• Preparing the Primary Care System for Health Care Reform (PDF – 730kb), by Ralph Silber, Executive Director, Alameda Health Consortium, and Sherry Hirota, Chief Executive Officer, Asian Health Services
• Addendum to Alameda Health Consortium Presentation (PDF – 87kb), by Sherry Hirota, Chief Executive Officer, Asian Health Services
• La Clinica de la Raza (PDF – 520kb), by Patricia Zayas, M.D., Chief Medical Officer

Dual Eligibles are individuals who receive both Medicare and Medi-Cal benefits. Most have multiple chronic conditions that make them among the most vulnerable and expensive patients in the system. California is developing new models of coordinated care delivery for dual eligibles. This conversation will examine the opportunities and challenges with this proposal statewide and locally.

• Summary of Improving Care Delivery for Dual Eligibles Hearing (PDF – 98kb), by Sarah Arnquist, Harbage Consulting

Background

• Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries (PDF – 228kb), Kaiser Commission on Medicaid and the Uninsured (May 2011)
• Summary of Focus Groups Conducted With Medicare-Medicaid Beneficiaries in California, Oakland and Riverside (PDF – 161kb), Centers for Medicare and Medicaid Services (December 2011)
• Overview of California’s Duals Demonstration (PDF – 150kb), Harbage Consulting (October 2011)
• Medicare and Medicaid Alignment: Challenges and Opportunities for Serving Dual Eligibles (PDF – 400kb), National Senior Citizens Law Center (August 20)

Presentations

• Coordinating Care for Dual Eligibles: California’s Demonstration Project (PDF – 1008kb), by Sarah Arnquist, Harbage Consulting
• Linking Medical Care and Long-Term Services and Supports: Issues, Implications, & Opportunities (PDF – 500kb), by Sarah Steenhausen, SCAN Foundation
• PACE : Program of All-inclusive Care for the Elderly (PDF – 1039kb), by Peter Szutu, Center for Elders’ Independence
• Reforming the Delivery of Medical, Behavioral, and Long Term Services for People with Disabilities and the Elderly (PDF – 44kb), by Gary Passmore, Congress of California Seniors

The ACA includes provisions that will impact hospital service delivery, including the increased number of people with insurance who now will be able to choose where they receive care. New financial reimbursement structures encourage hospitals to become part of larger coordinated networks of care and improve patient transitions back to the community. This hearing provided an overview of these provisions and perspectives from local hospital directors about a post-reform care delivery system.

• Summary of Acute Care Hearing (PDF – 61kb)

Background

• ACMC DSRIP Proposal (PDF – 431kb)
• ACMC Reform Preparations (PDF – 301kb)
• Patients Grades to Affect Hospitals Medicare Reimbursements (PDF – 113kb)
• RWFJ Reform impact on Hospitals (PDF – 210kb)

Presentations

• Alameda County Acute Care Facilities Utilization 2010 (PDF – 1443kb), by Alex Briscoe, Alameda County Health Care Services Agency
• Total Volume table AB (PDF – 33kb), by Alex Briscoe, Alameda County Health Care Services Agency
• Weinberg Alameda 121211 (PDF – 1227kb), by Micah Weinberg, Bay Area Council
• HCR and Alameda County (PDF – 458kb), by Rebecca Rozen, Hospital Council of Northern and Central California
• Health Committee Presentation BHM (PDF – 1093kb), by Bill Manns, Chief Operating Officer, Alameda County Medical Center

This kick-off session provided an introduction to the Affordable Care Act (ACA) and summary of issues that may impact Alameda County.

• Summary of Overview of the Affordable Care Act Hearing (PDF – 174kb), by Sarah Arnquist, Harbage Consulting

• Projecting the Impact of the Affordable Care Act on California (PDF – 963kb), by Peter Long and Jonathan Gruber
• Lessons for Counties in Preparing for Health Reform (PDF – 621kb), by Richard Thomason, Blue Shield of California Foundation
• State and Federal Health Care Reform in Alameda County (PDF – 668kb)
• Alameda Hearing Session 1 ACA Overview (PDF – 114kb), by Sarah Arnquist, Harbage Consulting