MINUTES KDHE-KALHD P Public H Heal alth a h and nd M Medicai aid A Advisor ory G Group oup November 20, 2 r 20, 2015 015, 10: , 10:00a 00am – 3: 3:00p 00pm Top opeka P Public L Library, M Menning nger R Roo oom 1515 SW 1515 SW 10 10 th Avenu nue Topeka, K KS Attendees: Cristi Cain, Michelle Ponce, Ed Kalas, Fern Hess, Sonja Armbruster, Katie Mahuron, Nick Baldetti Anno nounc ncement The Wichita State University Center for Community Support and Research is now the Community Engagement Institute. The Community Engagement Institute has six centers; one of these centers is the Center for Public Health Initiatives. Additionally, the Center for Public Health Initiatives (and the Community Engagement Institute) has moved to Old Town on 258 N. Mead St. Current Syst stems I s Issu ssues a s and Updates • Foundational Public Health Services and Capabilities – Discussion was held regarding the new model that has been introduced. Michelle provided the group with a brief background on how the model was adopted. Public Health Systems Group – Michelle provided an overview of the most recent decisions, including a breakdown of the four workgroups of the Public Health Systems Group: Finance Workgroup: Lead by Kansas University. They will look at the financial issues related to the model. It is likely they will look at research that has already been completed by other states and organizations, such as the work of University of Kentucky. Legal Workgroup: KPHA will lead the group; they will review current statutes and potential options for future legislative activity. Will be trying to answer the question as to whether the current statutes support FPHSC model or if could they potentially hinder the work. Policy Workgroup: KALHD will lead group. Group will look at other states to see how they have incorporated the model. They will look at possible governance models, how multijurisdictional sharing might be a strategy, and other key policy areas. Assessment & Performance Management Workgroup: KHI will lead this group. They will be conducting systems assessment. The Center for Shared Public Health Services that is housed in KHI has already completed a lot of this work (e.g. what the definitions would be for an assessment). This group will identify performance measurements to be used in future. Coordination of these four workgroups and the process: To be led by KALHD & CPHI • Development of high level advisory group to meet 4 times/yr. - Want to engage some state and local policy makers (Hoping to make champions) • Summit to be held in conjunction with 2017 KAC conference to present the findings of the 4 workgroups. • Other Items Discussed: ♦ May look at sharing/cross-jurisdictional sharing/multidistrict sharing as a part of delivering foundational public health services and capabilities. ♦ RWJ has competitive funding to be released related to states focusing on foundational public health services and capabilities. Kansas may be able to compete for some of this funding since the model has been adopted • Current Issues local/state health department(s) are facing School inspections – Four to six weeks ago there was a lot of activity related to this issue on the KALHD listserv. LHDs were asking if they were required to do school inspections and asking their peers if this was something they were already doing. Some counties are doing school inspections and some are not doing them. There are few LHDs that have local ordinances that they will not do school inspections (e.g. Harvey and possibly Sedgwick County). The question of the statutory requirements of the LHD in relation to school inspections was sent to the KDHE legal department for review and interpretation. The initial interpretation was that KDHE no requirement to assist, and that LHDs could meet this need through MOUs with organizations already going into the schools. • LHDs could have a lot of liability if they are not following the statute. If they do inspections, they would be covered from liability. Through the KALHD Listserv the LHDs were asking: What are the checklist one uses to do a school inspection?
• Is there a requirement for swimming pool inspections? • There is an EPA tool that can be adapted for the county’s use. There was discussion of how often this responsibility ends up falling in the Planning and Public Works Department of local governments. Getting rid of the responsibility for the inspections takes away from public health. Some of this work has already been done. KEHA has done 3-4 sessions on this with a panel of people that do inspections • Hospital Closures/Medicaid Expansion Sunflower Foundation taking it on; trying to reengage former coalition members KHF taking a lead role also Community H Health W Workers • Insights and innovations from APHA were shared. Sonja shared some of the chief challenges identified by several CHW programs in other states as presented at APHA. One of the key challenges identified at APHA was the difficulty in integrating CHWs into the health care team. There was discussion around the need for a defined scope of practice to ensure that other professionals were allies rather than roadblocks. The potential for LHDs to house CHWs was discussed. CHWs can be practical navigators and promote existing LHD programs. They can provide access to care links – this is a foundational service found in the new model. Sonja shared her recent discussion with Kansas Health Institute and the proposal she presented to them for support funding. Communities o of P Prac actice • Health Homes An update was provided on the project, including the success of the in-person Community of Practice that was held in August through a two-day conference in Wichita. Discussion was held around the current legislative threat to the continuance of Health Homes. They are getting ready to move to regular Medicaid match level rather than the first year Medicaid match (90% federal, 10% state). Additionally, the legislative pause that was put on the health homes for asthma and chronic conditions was discussed (until 2017). The question of who will advocate for this program was discussed. The potential for the mental health associations to advocate was discussed. There was some fear that the issue would be bulked together with Medicaid expansion and the decision to continue Health Homes would be affected by that association. • KARP Successes shared included: individualized, in-person trainings at Riley County and Butler County, annual conference in September, and webinars. It was suggested that the issue of accreditation has fallen off the radar for some LHDs. There is confusion as to whether it is no longer important, especially with the shift in focus to the foundational services. LHDs may be asking if we are doing this instead of accreditation. There was discussion about the impact of turnover on the accreditation process: Shawnee corporate compliance person has left. Trai aining ngs • Billing Training – Business Process Informatics: Trends, data to watch, denial rate, turnaround time Thinking about what needed for billing piece: Fern wanted to emphasize the importance of this work. She recently lost a biller and knows that several other counties are in the midst of hiring new billers as well (e.g. Butler). • She had been hoping to look at billing through the lens of multijurisdictional sharing, but she does not have the time to explore that concept now since her biller retired earlier than expected. There was discussion of the difference between a biller (or coder) vs. an auditor. The auditor provides a secondary level of scrubbing; they are a system administrator for billing side of the EHR (when there is already autocoding/billing). Discussion was also held surrounding the differences between EHRs and KIPHS. • KHI is the license holder of KIPHS and has made a huge investment in the system. Nick shared Reno County’s current bid process for a new billing system. • The new position they are hiring will look over denials and be a health information position. Ed shared that Shawnee County has two accountants and he thinks they are probably already doing some of this work.
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