PAOP Presentation
January 21, 2016
New York City
Governance Structure
PPS Lead Entity
Bronx Lebanon
Hospital Center
Bronx Health Access PPS LLC
PMO
Cross-Functional
Workgroups
BHA PPS LLC
Governance Board
Committees
Project Workgroups
© Bronx Health Access
1
Governance Structure
BHA PPS LLC
Governance Board
5 BLHC Members
© Bronx Health Access
2
Governance Structure
BHA PPS LLC
Governance Board
5 BLHC Members
Urban Health
(FQHC)
Comunilife
(CBO)
VNSNY
(Home/Community HC)
Dominican Sisters
(Home/Community HC)
Hudson Heights IPA
(Physicians)
SEIU/1199
(Union)
Mt Sinai Hospital
(Hospital)
© Bronx Health Access
3
Governance Structure
PPS Lead Entity
PMO
IT
Committee
© Bronx Health Access
Finance
Committee
Bronx Lebanon
Hospital Center
BHA PPS LLC
Governance Board
Clinical Quality &
PDI Committee
Stakeholder
Committee
PAC
Workforce
Committee
Compliance
Committee
4
Governance Structure
PPS Lead Entity
BHA PPS LLC
Governance Board
PMO
IT
Committee
PCMH
Cross-Functional
© Bronx Health Access
Finance
Committee
Bronx Lebanon
Hospital Center
Clinical Quality &
PDI Committee
Care Coordination
Cross-Functional
Stakeholder
Committee
PAC
Workforce
Committee
Compliance
Committee
Cultural Competency
Cross-Functional
5
Governance Structure
PPS Lead Entity
BHA PPS LLC
Governance Board
PMO
IT
Committee
Finance
Committee
Bronx Lebanon
Hospital Center
Clinical Quality &
PDI Committee
PAC
Stakeholder
Committee
Compliance
Committee
Workforce
Committee
PCMH
Cross-Functional
Care Coordination
Cross-Functional
2.a.i - IDS
2.a.iii - HHAR
2.b.i - Ambulatory ICU
2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
3.f.i – Maternal & Child
4.a.iii - MHSA
4.c.ii – HIV Care
© Bronx Health Access
Cultural Competency
Cross-Functional
6
Funds Flow
• Project Funding
– Budget expenditure to meet milestones
• Approvals by project committee, Finance and Board
• Approximately $4.4M budgeted for DY1
• Developed Performance Funds Flow
– Worked closely with KPMG
– Allocate Percent of “Importance” to Provider Type
• Project Level
• Input from project teams
• Input from partners
© Bronx Health Access
7
Funds Flow
• Project Funding
– Budget expenditure to meet milestones
• Approvals by project committee, Finance and Board
• Approximately $4.4M budgeted for DY1
• Developed Performance Funds Flow
– Worked closely with an independent consulting firm
– Allocate Percentages to Provider Type
• Project Level
• Input from project teams
• Input from partners
© Bronx Health Access
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Collaboration
BHA Involved in Many Collaborations
Across Committees, Workgroups and Projects
•
Collaboration across Committees, Workgroups and Projects
-
•
Cross-PPS Collaboration
-
•
Steering Board
Workforce Committee
Cultural Competency and Health Literacy Workgroup
All 10 projects
HIV Coalition
Mental Health Substance Abuse Infrastructure
Consent Form
EIP Contracting
Non-PPS and Inter-Agency Collaboration
- NYC Dept of Mental Health and Hygiene
- NYC Dept of Education
- BronxRHIO
© Bronx Health Access
9
Collaboration
BHA Involved in Many Collaborations
4.a.iii - MHSA
© Bronx Health Access
10
Collaboration
BHA Involved in Many Collaborations
4.a.iii - MHSA
Maimonides
(Brooklyn)
Health & Hospitals
(multi-borough)
St. Barnabas
(Bronx)
Bronx-Lebanon
(Bronx)
© Bronx Health Access
11
Collaboration
BHA Involved in Many Collaborations
4.a.iii - MHSA
Maimonides
(Brooklyn)
NYC Dept of Health
and Hygiene
Health & Hospitals
(multi-borough)
NYC Dept of
Education
St. Barnabas
(Bronx)
Bronx-Lebanon
(Bronx)
© Bronx Health Access
12
Collaboration
BHA Involved in Many Collaborations
4.a.iii - MHSA
Maimonides
(Brooklyn)
NYC Dept of Health
and Hygiene
Jewish Board of Family
& Children’s Services
Health & Hospitals
(multi-borough)
NYC Dept of
Education
NYAM
St. Barnabas
(Bronx)
Bronx-Lebanon
(Bronx)
© Bronx Health Access
13
Collaboration
BHA Involved in Many Collaborations
4.a.iii - MHSA
Maimonides
(Brooklyn)
NYC Dept of Health
and Hygiene
Jewish Board of Family
& Children’s Services
Health & Hospitals
(multi-borough)
NYC Dept of
Education
NYAM
St. Barnabas
(Bronx)
Strengthen
infrastructure used
to promote Mental,
Emotional and
Behavioral health.
Bronx-Lebanon
(Bronx)
© Bronx Health Access
14
Collaboration
BHA Involved in Many Collaborations
4.c.ii – HIV Care
© Bronx Health Access
15
Collaboration
BHA Involved in Many Collaborations
4.a.iii - MHSA
© Bronx Health Access
4.c.ii – HIV Care
16
Collaboration
BHA Involved in Many Collaborations
4.c.ii – HIV Care
NYC Dept of Health
and Hygiene
Mt Sinai Hospital
(Manhattan)
Health & Hospitals
(Multi-borough)
St. Barnabas
(Bronx)
Bronx-Lebanon
(Bronx)
NYU Lutheran
(Brooklyn)
Maimonides
(Brooklyn)
NY Hospital Queens
(Queens)
Montefiore
(Westchester)
© Bronx Health Access
17
Collaboration
BHA Involved in Many Collaborations
4.c.ii – HIV Care
NYC Dept of Health
and Hygiene
Mt Sinai Hospital
(Manhattan)
Health & Hospitals
(Multi-borough)
St. Barnabas
(Bronx)
Bronx-Lebanon
(Bronx)
NYU Lutheran
(Brooklyn)
Reduce
Barriers to
Access and
Retention of
HIV Care
Maimonides
(Brooklyn)
NY Hospital Queens
(Queens)
Montefiore
(Westchester)
© Bronx Health Access
18
Collaboration
BHA Involved in Many Collaborations
4.c.ii – HIV Care
NYC Dept of Health
and Hygiene
Recent Accomplishments
Mt Sinai Hospital
(Manhattan)
Health & Hospitals
(Multi-borough)
St. Barnabas
(Bronx)
Bronx-Lebanon
(Bronx)
NYU Lutheran
(Brooklyn)
Reduce
Barriers to
Access and
Retention of
HIV Care
Maimonides
(Brooklyn)
NY Hospital Queens
(Queens)
Montefiore
(Westchester)
© Bronx Health Access
19
Collaboration
BHA Involved in Many Collaborations
4.c.ii – HIV Care
NYC Dept of Health
and Hygiene
Recent Accomplishments
Mt Sinai Hospital
(Manhattan)
Health & Hospitals
(Multi-borough)
St. Barnabas
(Bronx)
Bronx-Lebanon
(Bronx)
NYU Lutheran
(Brooklyn)
Maimonides
(Brooklyn)
Reduce
Barriers to
Access and
Retention of
HIV Care
Launched Peer
Intervention Pilot
Program
Approved HIV
Coalition Bylaws
NY Hospital Queens
(Queens)
Montefiore
(Westchester)
© Bronx Health Access
20
Collaboration
BHA Involved in Many Collaborations
4.c.ii – HIV Care
NYC Dept of Health
and Hygiene
Recent Accomplishments
Mt Sinai Hospital
(Manhattan)
Health & Hospitals
(Multi-borough)
St. Barnabas
(Bronx)
Bronx-Lebanon
(Bronx)
NYU Lutheran
(Brooklyn)
Maimonides
(Brooklyn)
Reduce
Barriers to
Access and
Retention of
HIV Care
Launched Peer
Intervention Pilot
Program
Approved HIV
Coalition Bylaws
NY Hospital Queens
(Queens)
Montefiore
(Westchester)
© Bronx Health Access
21
Collaboration
BHA Involved in Many Collaborations
4.a.iii - MHSA
© Bronx Health Access
4.c.ii – HIV Care
2.a.i – IDS
22
Collaboration
BHA Involved in Many Collaborations
2.a.i – IDS
ACP
(City-wide)
NYC Health &
Hospitals (Bronx)
St. Barnabas
(Bronx)
Bronx-Lebanon
(Bronx)
© Bronx Health Access
23
Collaboration
BHA Involved in Many Collaborations
2.a.i – IDS
ACP
(City-wide)
NYC Health &
Hospitals (Bronx)
St. Barnabas
(Bronx)
Consent Form
Individual vs Community
Bronx-Lebanon
(Bronx)
© Bronx Health Access
24
Collaboration
BHA Involved in Many Collaborations
2.a.i – IDS
ACP
(City-wide)
NYC Health &
Hospitals (Bronx)
St. Barnabas
(Bronx)
Consent Form
Individual vs Community
Bronx RHIO
Bronx-Lebanon
(Bronx)
© Bronx Health Access
25
Collaboration
BHA Involved in Many Collaborations
2.a.i – IDS
ACP
(City-wide)
NYC Health &
Hospitals (Bronx)
St. Barnabas
(Bronx)
Consent Form
Individual vs Community
Bronx RHIO
Bronx-Lebanon
(Bronx)
© Bronx Health Access
26
Collaboration
BHA Involved in Many Collaborations
4.a.iii - MHSA
© Bronx Health Access
4.c.ii – HIV Care
2.a.i – IDS
EIP Contracting
27
Collaboration
BHA Involved in Many Collaborations
EIP Contracting
Maimonides
(Brooklyn)
Mt. Sinai Hospital
(Manhattan)
St. Barnabas
(Bronx)
Montefiore
(Westchester)
Bronx-Lebanon
(Bronx)
© Bronx Health Access
28
Collaboration
BHA Involved in Many Collaborations
EIP Contracting
Maimonides
(Brooklyn)
Mt. Sinai Hospital
(Manhattan)
Operational
Workgroup
St. Barnabas
(Bronx)
Montefiore
(Westchester)
Bronx-Lebanon
(Bronx)
© Bronx Health Access
Legal
Workgroup
29
Collaboration
BHA Involved in Many Collaborations
EIP Contracting
Maimonides
(Brooklyn)
Mt. Sinai Hospital
(Manhattan)
Operational
Workgroup
St. Barnabas
(Bronx)
Montefiore
(Westchester)
Bronx-Lebanon
(Bronx)
© Bronx Health Access
Legal
Workgroup
30
Collaboration
BHA Involved in Many Collaborations
EIP Contracting
Maimonides
(Brooklyn)
Mt. Sinai Hospital
(Manhattan)
Operational
Workgroup
St. Barnabas
(Bronx)
Montefiore
(Westchester)
Bronx-Lebanon
(Bronx)
© Bronx Health Access
MCOs
EIP Contract
Signed and
Executed
Legal
Workgroup
31
CBOs Involvement
Cultural Competency
Cross-Functional
© Bronx Health Access
32
CBOs Involvement
Cross-Functional Workgroup
touches all 10 projects
Community Health
Care Network
(FQHC)
Health literacy training
Cultural Competency
Cross-Functional
© Bronx Health Access
33
CBOs Involvement
Cross-Functional Workgroup
touches all 10 projects
Community Health
Care Network
(FQHC)
Health literacy training
Boom! Health
(CBO)
Evidence-based
interventions
Cultural Competency
Cross-Functional
© Bronx Health Access
34
CBOs Involvement
Cross-Functional Workgroup
touches all 10 projects
Community Health
Care Network
(FQHC)
Health literacy training
Boom! Health
(CBO)
Evidence-based
interventions
Cultural Competency
Cross-Functional
Strive
(Vocational Services)
© Bronx Health Access
Training and
employment
35
Governance Structure
© Bronx Health Access
2.a.i - IDS
2.a.iii - HHAR
2.b.i - Ambulatory ICU
2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
3.f.i – Maternal & Child
4.a.iii - MHSA
4.c.ii – HIV Care
36
CBOs Involvement
2.a.iii - HHAR
Health People
(Community Support)
NADAP
(Vocational Svs)
© Bronx Health Access
2.a.i - IDS
2.a.iii - HHAR
2.b.i - Ambulatory ICU
2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
3.f.i – Maternal & Child
4.a.iii - MHSA
4.c.ii – HIV Care
37
CBOs Involvement
2.a.iii - HHAR
2.b.i – Ambulatory ICU
Health People
EAC
(Community Support)
(MH Treatment)
NADAP
CASES
(Vocational Svs)
(MH Services)
© Bronx Health Access
2.a.i - IDS
2.a.iii - HHAR
2.b.i - Ambulatory ICU
2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
3.f.i – Maternal & Child
4.a.iii - MHSA
4.c.ii – HIV Care
38
CBOs Involvement
2.a.iii - HHAR
2.b.i – Ambulatory ICU 2.b.iv – Care Transition
Health People
EAC
God’s Love We Deliver
(Community Support)
(MH Treatment)
(Community Support)
NADAP
CASES
JASA
(Vocational Svs)
(MH Services)
(Home/Comm Care)
NADAP
(Vocational Svs)
© Bronx Health Access
2.a.i - IDS
2.a.iii - HHAR
2.b.i - Ambulatory ICU
2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
3.f.i – Maternal & Child
4.a.iii - MHSA
4.c.ii – HIV Care
39
CBOs Involvement
2.a.iii - HHAR
2.b.i – Ambulatory ICU 2.b.iv – Care Transition
3.a.i – Behavioral Hlth
Unique People
Services
Health People
EAC
God’s Love We Deliver
(Community Support)
(MH Treatment)
(Community Support)
NADAP
CASES
JASA
St. Christopher’s Inn
(Vocational Svs)
(MH Services)
(Home/Comm Care)
(Health Care Svs)
NADAP
Catholic Charities
(Vocational Svs)
(Residential Svs)
(Care Coordination)
Comunilife
(CBO)
Salvation Army
(Comm Support)
Three Graces
Medical
(Med Group)
JASA
(Home/Comm Care)
© Bronx Health Access
2.a.i - IDS
2.a.iii - HHAR
2.b.i - Ambulatory ICU
2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
3.f.i – Maternal & Child
4.a.iii - MHSA
4.c.ii – HIV Care
40
CBOs Involvement
2.a.iii - HHAR
2.b.i – Ambulatory ICU 2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
Unique People
Services
Health People
Health People
EAC
God’s Love We Deliver
(Community Support)
(MH Treatment)
(Community Support)
NADAP
CASES
JASA
St. Christopher’s Inn
EAC
(Vocational Svs)
(MH Services)
(Home/Comm Care)
(Health Care Svs)
(MH Treatment)
NADAP
Catholic Charities
God’s Love We Deliver
(Vocational Svs)
(Residential Svs)
(Community Support)
(Care Coordination)
(Comm Support)
Comunilife
(CBO)
Salvation Army
(Comm Support)
Three Graces
Medical
(Med Group)
JASA
(Home/Comm Care)
© Bronx Health Access
2.a.i - IDS
2.a.iii - HHAR
2.b.i - Ambulatory ICU
2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
3.f.i – Maternal & Child
4.a.iii - MHSA
4.c.ii – HIV Care
41
CBOs Involvement
2.a.iii - HHAR
2.b.i – Ambulatory ICU 2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
Unique People
Services
Health People
Bronx Works
(Comm Support)
(Settlement House)
Health People
EAC
God’s Love We Deliver
(Community Support)
(MH Treatment)
(Community Support)
NADAP
CASES
JASA
St. Christopher’s Inn
EAC
EAC
(Vocational Svs)
(MH Services)
(Home/Comm Care)
(Health Care Svs)
(MH Treatment)
(MH Treatment)
NADAP
Catholic Charities
God’s Love We Deliver
Pioneer Home Care
(Vocational Svs)
(Residential Svs)
(Community Support)
(Home Care)
(Care Coordination)
Comunilife
(CBO)
Salvation Army
(Comm Support)
Three Graces
Medical
(Med Group)
JASA
(Home/Comm Care)
© Bronx Health Access
2.a.i - IDS
2.a.iii - HHAR
2.b.i - Ambulatory ICU
2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
3.f.i – Maternal & Child
4.a.iii - MHSA
4.c.ii – HIV Care
42
CBOs Involvement
2.a.iii - HHAR
2.b.i – Ambulatory ICU 2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
3.f.i – Maternal & Child
Unique People
Services
Health People
Bronx Works
SKIP of New York
(Comm Support)
(Settlement House)
(Disabled Children Care)
Health People
EAC
God’s Love We Deliver
(Community Support)
(MH Treatment)
(Community Support)
NADAP
CASES
JASA
St. Christopher’s Inn
EAC
EAC
Pioneer Home Care
(Vocational Svs)
(MH Services)
(Home/Comm Care)
(Health Care Svs)
(MH Treatment)
(MH Treatment)
(Home Care)
NADAP
Catholic Charities
God’s Love We Deliver
Pioneer Home Care
(Vocational Svs)
(Residential Svs)
(Community Support)
(Home Care)
(Care Coordination)
Comunilife
(CBO)
Salvation Army
(Comm Support)
Three Graces
Medical
(Med Group)
JASA
(Home/Comm Care)
© Bronx Health Access
2.a.i - IDS
2.a.iii - HHAR
2.b.i - Ambulatory ICU
2.b.iv – Care Transition
3.a.i – Behavioral Hlth
3.c.i – Disease Mgmt
3.d.ii - Asthma
3.f.i – Maternal & Child
4.a.iii - MHSA
4.c.ii – HIV Care
43
Preparing for Workforce Future State
Future State Training
■ Identify training needs and
gaps
■ Assess workforce skill
development needs for
clinical staff redeploying
■ Survey partners to identify
and leverage training
resources
■ Analyze PPS infrastructure
changes to develop
Leadership & HIT Training
Programs
© Bronx Health Access
Assessing Skill
Development Needs
■ Leverage current & new
curriculum to enhance
workforce skills
■ Evaluate new skills and
credentials needed to
support advanced
Information Technology
■ Focus on diversity in
recruitment strategies
Partner Engagement
and Input
■ Evaluate Partner &
Practitioner Engagement
needs
■ Project workgroups design
standards of care by
project
■ Focus on Partner
understanding,
awareness, and buy-in of
the DSRIP transformation
■ Developing Employee
Engagement Plans that
help align partners and
facilitate adoption of the
changes
Linking Training to
Performance
■ Partners will be involved in
designing project workflows
& workforce competencies
needed for the Six HEDIS®
Hybrid Measures
■ Evidence-based Guidelines
and Processes are being
integrated into the
standards of care for each
project
■ Target training and
development programs in
alignment with both specific
job category needs and
DSRIP business imperatives
44
Care Coordination Functional Workgroup
2.a.i
4.c.ii
2.a.iii
4.a.ii
2.b.i
Care Coordination
Cross-Functional
Workgroup
2.b.iv
3.f.i
3.a.i
3.d.ii
3.c.i
© Bronx Health Access
45
Care Coordination Functional Workgroup
Improve Synergy between Projects and Organizational Work Streams
All 10 Projects Must Structure and Deploy Care Coordination Services
The Care Coordination Cross-Functional Workgroup Responsible for
Developing Care Coordination Standards and Protocols
© Bronx Health Access
46
Care Coordination Functional Workgroup
Improve Synergy between Projects and Organizational Work Streams
All 10 Projects Must Structure and Deploy Care Coordination Services
The Care Coordination Cross-Functional Workgroup Responsible for
Developing Care Coordination Standards and Protocols
Four-Step Process
© Bronx Health Access
47
Care Coordination Functional Workgroup
Patient
Encounter
© Bronx Health Access
48
Care Coordination Functional Workgroup
Process Patient
© Bronx Health Access
49
Care Coordination Functional Workgroup
Assignment and
Alert
© Bronx Health Access
50
Care Coordination Functional Workgroup
Care Coordination
© Bronx Health Access
51
Care Coordination Functional Workgroup
© Bronx Health Access
52
Care Coordination Functional Workgroup
2.b.iv
Care Transitions
© Bronx Health Access
53
2biv Care Transitions
Clearinghouse Functionality
- Risk Stratification
- Continuity by Provider/Care
Management Agency
- Clinical Integration of
Psychosocial Drivers of Health
Admitted Patient
Clearinghouse
Enabling Services
© Bronx Health Access
Care Coordination
Primary Care
Specialty Care
54
2biv Care Transitions
Clearinghouse Functionality
-
Enabling Services
Care Coordination
Primary Care
RHIO Data
Outcomes Driven
7-Day appointments
HEDIS Measures
Engagement Metrics
Specialty Care
Clearinghouse
Ambulatory Patient
© Bronx Health Access
55
PMO Staff
Dr. Isaac
Dapkins
Kathy
Alexis
Kathleen
Craig
Jessica
Colon
PMO
Duane
Granston
Virgilina
Gonzalez
Gary
Rosario
© Bronx Health Access
Steve
Maggio
56
Bronx-Lebanon Hospital Center PPS, LLC