Communities of Care NASCSP Conference Marisue Garganta Director, Community Health Integration Dignity Health, St. Joseph’s Hospital and Medical Center September 11, 2013
Jan 04, 2016
Communities of CareNASCSP Conference
Marisue GargantaDirector, 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
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St. Joseph’s Hospital and Medical Center
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Hospital’s Roles and Responsibilities
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•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 Assessments5
Two thirds of the uninsured live in 13 states
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Uninsured by State
<230K 230K - 600K
600K - 1.1M
1.1M+
Number of Uninsured
67% of uninsured live in 13 states
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
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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 BenefitsAll Qualified Health Plans Will Cover These Essential Health Benefits
04/20/23 The Health Insurance Marketplace 101 8
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care
1. Ambulatory patient services
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and substance use disorder services, including behavioral health treatment
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
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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
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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
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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
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Investing in the Community
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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
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www.HealthCare.govwww.HealthCare.gov
04/20/23 The Health Insurance Marketplace 101 15
Starting October 1, 2013, you will be able to apply
through this site
Now - Sign up for Email and Text Alerts
and Get Ready
Marketplace.cms.govMarketplace.cms.gov
04/20/23 The Health Insurance Marketplace 101 16
Get the latest resources to help people
apply, enroll, and get
coverage in 2014
QUESTIONS?Thanks for all you do and for taking the time to be here today!
Marisue Garganta
Director of Community Health Integration
602.406.6580