Minutes from Aurora Health Access December quarterly meeting

Aurora Health Access met at 2PM on Wednesday, December 14th at St. Therese in Aurora.

Over 20 organizations and 40 individuals attended the meeting. Rich McLean, a leader with St. Therese FAMILY, opened the meeting with our mission statement: Aurora Health Access is working to build a community health system in Aurora that meet the needs of all residents.

Welcome from Mayor Steve Hogan

After introductions of those present, Aurora Mayor Steve Hogan introduced himself and offered his support to Aurora Health Access moving forward. Mayor Hogan stated that he would love to attend a future AHA meeting.

Health Care Innovation Challenge

The Colorado Health Institute estimates that Colorado needs an additional 200 primary care providers (doctors, Nurse Practitioners, and Physician Assistants) presently to bring the state up to par. We will need an additional 141 primary care providers as 510,000 new people get health insurance through the Affordable Care Act (ACA).  AHA asked, how does Aurora help meet this need? Communities must take the initiative, using the tools the ACA gives them, if the challenge of affordable, accessible health care is going to be met.

On November 14, 2011, the Department of Health and Human Services released a funding opportunity announcement for the Health Care Innovation Challenge.  Under this Challenge, up to $1 billion dollars will be awarded to innovative projects across the country that test creative ways to deliver high-quality health care services at lower costs.

• Priority will be give to projects that demonstrate cost savings, workforce development and deployment, rapid implementation, and model sustainability post funding.

Within the AHA Care Coordination Workgroup meeting several important discussion topics arose:

1. It seems advantageous to pursue the grant application under Colorado Access.
   1. Although the final decision was not made, the group made efforts to specifically define the relationship between CO Access and AHA and establish a governance structure.
   2. CO Access would pair with a community-based organization in each of its Regional Care Collaborative Organization (RCCO) Regions. Aurora is in Region 3 composed of Adams, Arapahoe, Douglas counties.
   3. As a payer, CO Access has the means to track cost-savings.
2. The group asked if focusing on reducing per member per month was the best metric for cost savings.
3. The group discussed who the most expensive patients were in the area and how to define our target population.
   1. For the first year of the grant, it seems logical to start with a broad population within the three Aurora zip codes (80010, 80011, 80012).  These zip codes have the highest levels of poverty in the community and have the highest ER utilization at University and Children’s Hospitals.
   2. In following years it could be possible to target more specific populations (mental health patients, frail/elderly, young women likely to have unplanned pregnancy… etc)
4. Based on the review of other successful community health initiatives, AHA hopes to develop a three pronged approach in the community to improve care and lower cost for high risk/high opportunity patients.
   1. Build a network of trained community health workers that live in the community and can provide valuable health information and support to residents
   2. Develop and deploy a new kind of trained and paid “Case Manager/Patient Navigator/Community Health Liaison” health care worker that can operate in multiple settings across the community and serve as a bridge between the larger health care system and the individual patient.
      • Currently, Medicaid does not pay for health care navigation services.
      • The larger AHA group emphasized the importance of defining the “patient navigator” goals and metrics.
      • The group also recommended pairing with the Community College of Denver and Community College of Aurora to develop sustainable curriculum  for this “patient navigator.”  Currently, the Colorado School of Public Health has a pilot program, but their patient navigator model focuses mostly around cancer.  There is the possibility to expand this role as well.
   3. Expand and strengthen relationships and care compacts between health care providers in the community.
5. It was important to note that Colorado has many excellent existing resources and we shouldn’t abandon these simply to “chase the money.”  AHA wants to remain true to its roots and values within this grant application process.

During the larger discussion, the question was asked, “Can we re train and re deploy our current workforce?”

• The group emphasized the importance of preventative care within the grant proposal.

Important Deadlines

1. Non-binding Letter of Intent: December 19, 2011
2. Application Due: January 27, 2012
3. Anticipated Award Date: March 30, 2012

Next meeting: Early January.  Please contact Joe Campe at Joe.Campe@ccmu.org with questions and comments or if you are interested in joining the working committee for this opportunity.

Thanks to the following organizations who attended:

Alternative Pregnancy Center, Arapahoe County Commissioner, Arapahoe Early Childhood Council, Arapahoe House, Aurora Adams County Medical Society, Aurora Chamber of Commerce, Aurora Mental Health Center, Aurora Public School, Aurora Residents for Recreation, Bacchus/Tobacco Free Aurora, Children’s Hospital Colorado, City of Aurora, Colorado Access, Colorado Childrens Healthcare Access Program, Colorado Coalition for the Medically Underserved, Department of Health Care Policy and Finance, Colorado Regional Health Information Organization, Colorado School of Public Health, Colorado Tobacco Education and Prevention Alliance, Denver Health, Governor’s Office, HCAC, Kaiser Permanente, Mayor of Aurora, Metro Organizations for People, residents of Aurora, Senator Morgan Carroll’s office, St. Therese Catholic Church, The Medical Center of Aurora, and Tri-County Health Department