TRI-COUNTY
COMMUNITIES in CHARGE
MULTNOMAH COUNTY HEALTH DEPARTMENT
Portland,
OR
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Objectives
The
goal and objective for Phase Two has been developed with input provided by
community leaders involved in the Phase One planning process. These goals
and objectives are intended to address the themes (i.e., improving the efficient
use of existing resources, and expanding resources) established by consensus at
the conclusion of the Phase One process.
The
Goal of Phase Two is to: "Implement Phase Two of a collaborative
process designed to establish and implement a new system for delivering and
financing high quality, affordable, culturally competent healthcare for the
medically uninsured and underserved population of Multnomah, Washington, and
Clackamas Counties."
Objectives:
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Within
12 months of receiving Phase Two funding, make recommendations for
establishing a "safety net authority" as a new mechanism to ensure
the availability of healthcare for the medically uninsured and underserved
residents. This work will be carried out by a Blue Ribbon Panel
commissioned by the county boards of the Tri-County metropolitan region.
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Within
12 months of receiving Phase Two funding, evaluate and recommend changes to
the community benefits policies of local non-profit hospitals to enhance
access to healthcare among uninsured and underserved residents.
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Within
12 months, access, develop, and implement outreach, education and enrollment
mechanisms to improve access to health insurance and care for the uninsured
and underserved residents.
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Within
24 months, develop and implement a safety net health information system in
conjunction with the Oregon Community Health Information Network.
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Program Design
The
Tri-County Communities in Charge Initiative is designed as a collaborative
process to evaluate the needs of the uninsure and vulnerable populations and the
resources currently used to meet them; identify and evaluate existing healthcare
financing and delivery models that could be adopted to better serve the needs of
the uninsured; and to conduct initial steps needed to implement a new healthcare
financing and delivery system.
From
the data and community input of Phase One, it is clear there is a critical need
to address the issues of healthcare access for the uninsured. It is also
clear the improvements in access cannot come from one portion of the community,
it must be a shared responsibility with shared risk, shared benefits, and shared
commitment. In addition, the community consensus of Phase One generated
themes to guide effective system-oriented approaches to providing financing
healthcare to the uninsured:
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Refine
and restructure the safety net system to better capture existing resources
through improved efficiency and economies of scale; and
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Develop
increased resources to improve access for defined populations through
implementing service delivery and financing strategies based on rigorous
assessment and business planning methods.
Financing
& Outreach Strategies
In
Clackamas, Multnomah, and Washington County, Oregon Region (Tri-County) there
are no dedicated long-term revenue sources to ensure that healthcare services
for the uninsured are available from year to year, and safety net providers have
experienced threats to their financial stability in recent years. To
address the challenges faced by the local safety net providers, and to avoid
healthcare crisis among the uninsured population the goal of Multnomah County,
Tri-County Communities in Charge Initiative is...To implement a collaborative
process designed to establish and implement a new system for delivering and
financing high quality, affordable, culturally competent healthcare for
medically uninsured and underserved populations of Multnomah, Washington, and
Clackamas Counties.
Financing
Strategy
With
the creation of the Healthcare Safety Net Authority, we will have the capacity
to fund care and care support services through creative use o the federal
qualified health center status, improved federal financial participation
strategies, potential for new Medicaid waivers and dedicated local general
funds. Further, we anticipate increased community participation in the
funding of care and the potential for recouping funds through integration of
duplicative services cross-organizationally.
Outreach
Strategy
Outreach
strategies to community partners and beyond the Healthcare Safety Net are in the
testing and implementation process. Collaborations with community action
agencies, school districts and other social support and minority agencies are
being initiated. This work is currently targeting those eligible for state
sponsored programs and providing information about accessing care within the
safety net. As the system integration continues among the Healthcare
Safety Net providers and funding is stabilized and increased, more outreach for
these services will commence.
Delivery
System
The
delivery system consists of count and non-profit clinics and providers who offer
full service primary and preventive care or some subset of it. Currently
the Healthcare Safety Net is loosely connected through partnership and shared
mission. The Tri-County Communities in Charge project will design and
implement a regional framework to coordinate the provision of health services to
uninsured and low-income residents. The intended outcome is increased
access achieved through improved funding, better matching of resources with
need, shared services, economy of scale and reduced duplication.
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Accomplishments to Date
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Completed
a high level Blue Ribbon Process to create a Healthcare Safety Net Authority
whose purpose is to build and maintain access to basic health services for
those under 200% of the federal poverty level.
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Completed
a Hospital Charity Care access and application process that is now
consistent across the region's 10 health systems and hospitals.
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Implemented
several new outreach and education programs targeting minority populations.
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The
Tri-County region's three largest community health centers have all gone
"live" on the OCHIN system.
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Challenges
The
Tri-County Region has a healthcare safety net that consists of clinics operated
by Health Departments, nonprofit organizations and private providers.
These systems have a history of mission support and riche services but have
never been interdependent in the ways described. Approaching each entity
and allowing them to continue to do what they do best with minor changes and
additions will be difficult. Finally, making sure that the Healthcare Safety
Net Authority is developed with the power to act regionally and to assure
funding, by whatever means, will also challenge this project.
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Contact
Us
Tom
Fronk
Director
Tri-County Health Care Safety Net Enterprise
110 SW Yamhill, Suite 300
Portland, OR 97204
Phone: (503) 241-3087
E-mail:
tom@tcsne.org
Website:
http://www.mchealth.org/cic
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