Newsletter (September 2019)
In This Issue:
Executive Director UpdateStephanie Salazar-Rodríguez receives an award
Community Engagement Work
All Things Census
Mile High Specialty Care Network
Prime Health
New Initiative: Budtenders Program
Home Equity Report
Access Monitoring Review Plan Comments Due October 4th
On September 5th, the Department of Health Care Policy and Financing released a draft of the 2019 Access Monitoring Review Plan, triggering a 30-day comment period. The AMRP reports on whether access to care is sufficient for Medicaid-holders in five categories:
- Primary Care
- Specialty Care
- Behavioral Health Fee-For-Service
- Home Health Services
- Pre-Natal including Labor and Delivery
The Centers for Medicaid/Medicare Services requires every state Medicaid office to submit the AMRP every three years. “Sufficient” for Medicaid-holders is defined by CMS as equivalent to access by people with commercial insurance. For many rural geographies, as well as urban and suburban areas, this means that access to care is sufficient even though no one can get the care they need.
The 2016 AMRP and the 2019 draft AMRP both conclude that access to care is sufficient for Medicaid-holders in all categories. These findings by HCFP are incongruent with a report released in June by the Colorado Health Institute, which estimates that Medicaid patients forgo 486,000 specialty care appointments every year. That’s roughly 87 appointments annually for each specialty care physician in Colorado.
The Merrick Hawkins 2017 Survey of Physicians Wait Times and Medicaid-Medicare Acceptance reports that even though physician-to-population ratios are at a historic high, in the Denver metro area the wait time for dermatology can be as much as 365 days.
Comments on the AMRP are due on Friday, October 4th. Please, if you can, provide feedback regarding your experiences and challenges with access to care for Medicaid holders – qualitative or quantitative – to amrp@state.co.us.
Thanks so much.
Director of Community Engagement/Regional Health Connector is honored at the Public Health in the Rockies Conference
On August 27, 2019, Stephanie Salazar-Rodríguez received a prestigious “General Recognition” award at the annual Public Health in the Rockies (PHiR) conference. The award recognized her contributions to public health through her commitment to improving overall health outcomes for residents in Denver.
Community Engagement Work
On June 30, 2019, Stephanie Salazar-Rodríguez’s primary role as the Regional Health Connector (RHC) concluded, as the State Innovation Model (SIM) funding sunsetted. In the final RHC Social Network Analysis for Region 20, 55 survey respondents reported that the “new and strengthened relationships, facilitated by the RHCs were more valuable than pre-existing relationships in terms of the time commitment, resources contribution, and influence offered by new or strengthened partnerships. They also reported higher levels of trust among the new and strengthened relationships,” while 100% of survey respondents stated they believe that the role of an RHC is imperative to a stronger community health system in Denver.
Source:
2018, Colorado Health Institute, a Social Network Analysis of Region 20
Stephanie’s work continues as the Director of Community Engagement/RHC. The most recent priorities of the Director of Community Engagement are working with the Latino Age Wage in Montbello, Phase III of the Immigrant Drop-Off the Medical/Legal Partnership and promoting the importance of a complete count in the 2020 Census.
Stephanie’s community engagement work in Southwest Denver remains a priority. On August 6, 2019, Stephanie and Karen attended the Southwest Denver National Night Out event. They hosted a resources table where they provided information on the healthcare focus for the Census 2020. The MHHA staff, conducted an informal poll that revealed nearly everyone who participated in the poll, plan to respond to the upcoming Census. Denver’s Mayor, Michael Hancock stopped by the MHHA table to congratulate us on our commitment to the Census work.
Additionally, as part of the work in Montbello, on August 17, 2019, MHHA (Karen Trautman and Vicente Cardona) participated in a Wellness Fair held at the Montbello Recreation Center. There were approximately 200 individuals in attendance, including 40 people from the Latino Age Wave, who received health screening services through the CREA Results Mobile Health Van and the distribution of 10 home monitoring blood pressure cuffs.
All Things Census
Ignite at Public Health in the Rockies
Earlier this month, Dede de Percin, our executive director, presented an Ignite Talk at Public Health in the Rockies. Her five-minute presentation featured 20 slides highlighting the importance of the census for Coloradans, as well as why folks in the room should pay attention and take action. We should mention, she did this all while sporting fashion-forward “Star-Spangled Leggings.”
Census Grants
Department of Local Affairs
The Mile High Health Alliance recently submitted a proposal to support 2020 Census outreach, education, and promotion to the Department of Local Affairs for state funding appropriated by HB16-1239. We will be notified by November 1st whether we are successful.
Together We Count
Together We Count has opened an RFP for additional census outreach funding. MHHA plans to submit a proposal for this grant as well – every little bit helps! Click here for more information.
What the Census Tells Us: Health Insurance Coverage Edition
The Census recently released an extensive report on health insurance coverage. The percentage of insured individuals in Colorado held steady, despite the national downward trend. The number of individuals enrolled collectively, in both public and private insurance, remains equivalent to previous years.
Interestingly, Colorado’s Medicaid-insured numbers are down, consistent with the national trend reported in Census data. Theories about the reason for the decline include the impact of the “chilling effect” of Public Charge and other federal policies. Colorado has apparently been able to maintain our percentage of insured because of an uptick in commercial insurance enrollment. Click here for more information.
Mile High Specialty Care Network
The Mile High Specialty Care Network has been active in its new role within the Kaiser Cohort. Mile High Health Alliance is leading the conversation about our system change goals and focusing our efforts by utilizing various levers to ensure impactful change towards better access to specialty care.
During our cohort meetings, there have been discussions around system change and how the cohort can make a significant impact within Colorado. Mile High Health Alliance has taken the lead to focus on four system change goals that can make a considerable impact in accessing specialty care. The goals that we will be focusing on are: tracking current policy opportunities, UC Health participation with Health First Colorado, Health First Colorado provider enrollment, and e-consult reimbursement. Though the tasks are ambitious, we feel we are up to the challenge.
For those who might not be aware, Mile High Health Alliance has been focusing on Track II of its Specialty Care Network. Track II looks at finding specialists within Denver who are accepting new Medicaid patients. We then reach out to clinics or referralists seeking assistance and provide information most suitable to their patients. If you need information about Medicaid accepting specialists in your area, please contact us at Vicente@milehighhealthalliance.org.
Prime Health
Within the past several months, Mile High Health Alliance has had the privilege to participate as judges for the 2019 Prime Health Challenge. We have used our knowledge and resources from our network to ensure that each company concept embodied innovation, community, and was equitable for all. As the Prime Challenge comes to an end, only seven companies remain. To learn more about the dates and the seven finalists click here.
On October 23, at the Asterisk Event Center in Denver, Prime Health will be hosting a live “Shark Tank” style event. Seven finalists will pitch their product for an opportunity to win a portion of $150,000 provided by the Colorado Health Foundation. The seven companies that will be participating will be Babyscripts, Manatee, Meru Health, phas3, Moving Analytics, Care Cognitics, and STREAMD. If you haven’t already registered, click here to get your tickets to the main event.
New Initiative: Budtenders Program
We have a very exciting update on a new strategic initiative that MHHA has been working hard on – Budtenders Program. This project came out of a male mental health crisis. In Denver, suicides disproportionately affect men, which has a ripple effect throughout the whole community. There have been many efforts to address mental health and specifically male mental health in Denver, but MHHA’s strategy is a bit different. We’re interested in meeting people where they are with information, messaging, and resources to improve health. In this case, we’re interested in meeting people at cannabis retailers. Similar models have been used at gun ranges and gun stores to provide education and resources on suicide prevention.
In collaboration with Native Roots Dispensary and Mental Health Center of Denver, MHHA has put Colorado Crisis materials on the counters of dispensaries throughout the metro area. Although some teams were apprehensive at first to engage their guests with these materials, they soon warmed up to the idea once it was clarified that they should only engage if they feel comfortable and feel that the situation called for it. In one month, 57 cards and 14 flyers were handed out. We’re keeping track of the numbers over the next few months to see if the number of cards and flyers taken stays steady or increases as the teams become more comfortable with the materials.
Home Equity Report
A new analysis of housing trends in Colorado reveals that the health of Coloradans is closely tied to access to affordable, stable, accessible and quality housing. Residents across the state have been harmed by the rapid increase in housing costs, and that pinch has been acute for seven distinct demographic groups, the report found.
The report details how housing instability has a direct negative effect on the health and well-being of people of color, Coloradans with low incomes, families with children, people in rural areas, people with disabilities, immigrants without documentation and Coloradans experiencing homelessness. The report, “Home Equity: A Vision of Housing Security, Health and Opportunity” was produced by the Colorado Health Institute in partnership with a cohort of 18 Colorado nonprofit organizations. The average Colorado home price increased 77 percent in the past decade, researchers found, yet the state’s median income increased just 4.5 percent.
To improve housing opportunities throughout the state, the report outlines 11 promising policy ideas created in partnership with affected communities that state and local policymakers should consider. They range from local to state-level solutions and include ways to correct historic and current policies that have created today’s inequitable systems.
One of the policy ideas promoted in this report on page 32, is “Promote Medical-Legal Partnerships.” MHHA belongs to a Medical-Legal Partnership (MLP) partnership. Starting with two Denver Health Clinics, Intensive Outpatient and Westside Pediatrics, 186 patients were screened for legal needs such as housing and utilities, education, benefits, and safety and stability. Patients were then referred to one of our three legal partners; Colorado Legal Services, Colorado Poverty Law Project, and DU Sturm College of Law. We have since received funding to expand the MLP to two additional clinics, focused on aging adults 50+.
