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Communities of Care NASCSP Conference. Marisue Garganta Director, Community Health Integration Dignity Health, St. Joseph’s Hospital and Medical Center September 11, 2013. Setting the Stage. Who is your hospital partner? Understanding Hospital's responsibilities
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Communities of CareNASCSP Conference • Marisue Garganta • Director, Community Health IntegrationDignity Health, St. Joseph’s Hospital and Medical Center • September 11, 2013
Setting the Stage • Who is your hospital partner? • Understanding Hospital's responsibilities • The Affordable Healthcare Act • Responding to the mission and law • Creating Communities of Care • Resources
Hospital’s Roles and Responsibilities • Nonprofit Requirements • Internal Revenue Services – IRS – Form 990 Schedule H • 3 year Community Health Needs Assessment • 3 year Community Benefit Plan • Mission to serve the community • Affordable Healthcare Act • Investment in community
Affordable Health Care Act • Health Coverage • Medicare • Medicaid • Subsidies - Assistance • Preventive Services • Hospital and Providers • Community Health Assessments
Two thirds of the uninsured live in 13 states Uninsured by State 67% of uninsured live in 13 states Number of Uninsured <230K 230K - 600K 600K - 1.1M 1.1M+ Source: Census Bureau, Current Population Survey, March 2011 and 2012
One fifth of the uninsured live in the top 13 counties and half live in the top 114 counties Uninsured by County 10% of the uninsured live in just 4 counties (LA, Harris, Cook, Miami) 20% of the uninsured live in top 13 counties (Top 4 + Next 9) 50% live in the top 114 counties (3.8% of total counties in the US)
All Qualified Health Plans Will Cover These Essential Health Benefits • Ambulatory patient services • Emergency services • Hospitalization • Maternity and newborn care • Mental health and substance use disorder services, including behavioral health treatment • Prescription drugs • Rehabilitative and habilitative services and devices • Laboratory services • Preventive and wellness services and chronic disease management • Pediatric services, including oral and vision care The Health Insurance Marketplace 101
The Beginning of the Shared Vision and Need“Creating a Healthier and Connected Community” • Healthy and Safe Community Environments • Clinical and Community Preventive Services • Empowered People • Elimination of Health Disparities National Prevention Strategy America’s Plan for Better Health and Wellness” (http://www.healthcare.gov/center/councils/nphpphc). • Prevention Strategy Diagram
10 Responding to the mission and law • Requirements within Community Benefit • Reporting “good works” for IRS Form 990 – Schedule H • Improving the health of the community • Community Grants • Community Investments
Connecting the Community Health Needs Assessment • Identify key areas in Community Health Needs Assessment • Review, identify assets and gaps • Create initiative to meet your greatest area of need • Identify zip codes with Community Needs Index and/or other identified data of greatest need • Identify “key” groups of need • Identify service areas, departments and/or hospital’s in and outpatient services to be “champions” for work • Create a Community of Care
Grant’s Program as Solution • Use grant’s program as a “solution” • Filling the gap in services • Creating networks of care • Integrating best practices in community and hospital • Education opportunities – teaching, learning, growing • Answering Schedule H – Questions • Did you meet the needs within Community Health Needs Assessment? • If no, than how did you meet it and with whom? • Changing the paradigm of care • Foundation for the Affordable Healthcare Act
RESOURCES • Affordable Healthcare Act • www.Healthcare.gov • www.Marketplace.cms.gov • http://www.healthcare.gov/center/councils/nphpphc Dignity Health • www.DignityHealth.org/CommunityInvestments • National Organizations • www.chausa.org • www.communityhlth.org • Healthy Communities • http://www.healthycommunitiesinstitute.com • Collective Impact • http://www.fsg.org/OurApproach/CollectiveImpact.aspx
www.HealthCare.gov Now - Sign up for Email and Text Alerts and Get Ready Starting October 1, 2013, you will be able to apply through this site The Health Insurance Marketplace 101
Marketplace.cms.gov Get the latest resources to help people apply, enroll, and get coverage in 2014 The Health Insurance Marketplace 101
Thanks for all you do and for taking the time to be here today! Marisue Garganta Director of Community Health Integration 602.406.6580 Marisue.Garganta@DignityHealth.org QUESTIONS?