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Strategies to Achieve Alignment, Collaboration, and Synergy across Delivery and Financing Systems
Testing a Shared Decision-Making Model for Health and Social Service Delivery in East Harlem
Research In Progress WebinarWednesday, April 25, 2018
12:00-1:00 pm ET/ 9:00 am-10:00 am PT
Funded by the Robert Wood Johnson Foundation
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AgendaModerator: CBMamaril,PhD
ResearchFaculty,RWJFSystemsforAction NationalCoordinatingCenterUniversityofKentuckyCollegeofPublicHealthanna.hoover@uky.edu
Presenters: CarlLetamendi,PhD,MBA,GStat RachelDannefer,MPH,MIADirectorofEvaluation&DivisionalSupport DirectorofResearchandEvaluationDivisionManagement HarlemNeighborhoodHealthActionCenterCenterforHealthEquity [email protected] @health.nyc.gov
CommentarySpeaker: Padmore John,MS
ManagerEastandCentralHarlemNeighborhoodHealthActionCenters
Q&A: ModeratedbyDr.CBMamaril
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Presenter
CarlLetamendi,PhD,MBA,GStatDirectorofEvaluation&DivisionalSupportDivisionManagement
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Presenter
RachelDannefer,MPH,MIADirectorofResearchandEvaluationHarlemNeighborhoodHealthActionCenter
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Commentary Speaker
Padmore John,MSManagerEastandCentralHarlemNeighborhoodHealthActionCenters
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TestingaSharedDecision-MakingModelforHealthandSocialServiceDeliveryinEastHarlem
ResearchinProgressWebinarApril25,2018
RachelDannefer,MPH,MIADirectorofResearchandEvaluationHarlemNeighborhoodHealthActionCenter
CarlLetamendi,PhD,MBA,GStatDirectorofEvaluation&DivisionalSupportDivisionManagement
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PEACH: PurposeandGoal
PartnershipstoEncourageActionableCulturesofHealth
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Purpose:Theprimaryaimofthismixed-methodsstudyistoprovidenewevidenceonhowaligningacityhealthdepartmentwithcross-sectorcommunitystakeholdersunderaplace-basedmodelcanimprovehealthandreduceinequitiesacrossneighborhoods.ThePEACHstudyfocusesprimarilyontheEastHarlemNeighborhoodHealthActionCenter.
Goal:Weexpecttocriticallyevaluatetheimpactofthesystemontheneighborhood,anddetailhowthisalignmentmaybescaledupinNewYorkCity(NYC)andreplicatedinotherU.S.cities.
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BuildingaCultureofHealthinEastHarlem
ActionArea2:Fosteringcross-sectorcollaborationtoimprovewell-being
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PEACHResearchTeam
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CarlLetamendi,PhD,MBA,GStatDirectorofEvaluation&DivisionalSupportDivisionManagement
RachelDannefer,MPH,MIADirectorofResearchandEvaluationHarlemNeighborhoodHealthActionCenter
JenniferPierre,DrPH,MPHDirectorofQualitativeResearchCenterforHealthEquity
LukeSleiter,MPHAssistantProjectDirector,PEACHCenterforHealthEquity
Presenter
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NeighborhoodSnapshot:EastHarlem
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NeighborhoodHealth:EastHarlem
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NeighborhoodHealth:EastHarlem
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NeighborhoodHealth:EastHarlem
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CausesofInequities
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PoliciesthatcreatedalltypesofsystemsofunbalancedpowerandprivilegeCausedbyhistoricalpracticeofexclusionanddiscriminationacrossthelifecourseLedtogeographicconcentrationofpovertyandhyper-segregation
Rootcausesofinequities
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RespondingtoInequities
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Aneighborhood’shealthresultsfromthehistorical,political,socialandphysicalforcesthataffectit.CertainNYCNeighborhoodshavebeendeprivedofsufficient
resourcesandattention.Inorderto“right”thisinjustice,wehaveneighborhoodofficesinareasthat
bearthehighestdiseaseburden.
Weinvestinkeyneighborhoods(place-based).
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NYCDOHMHCenterforHealthEquity
OurVision
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Acrossourcity,everyNewYorkerlivesinathrivingneighborhood,whereresourcesworkwellandsystemsareequitableinordertonurtureandsustainhealthyindividualsandcommunities.
OurMissionTostrengthenandamplifytheHealth
Department'sworktoeliminatehealthinequities,whicharerootedinhistoricalandcontemporaryinjusticesanddiscrimination,includingracism.
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NeighborhoodHealthActionCenters
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ActionCenters:BriefHistoryandOverview
13DistrictHealthCenters
1920s
DistrictPublicHealthOffices(DPHOs)
2003
NeighborhoodHealthActionCenters
2017
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ActionCenterLocations
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NewYorkState
NewYorkCity
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ActionCenterStrategies
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CollectiveActionandImpact
InnovationinPrograms&Policy
Co-locationandReferrals
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Clinicalandprogrammaticproviders
Kitchensandgardens
Navigatorsandreferral
specialists
Neighborhoodconveningspace
TheFamilyWellnessSuite
Amultipurposeroomprovidesa
spaceforneighborhoodpartnersandresidents,and
spaceforphysicalactivity andevents
Co-locatedservicesprovidedirectclinicalandsocialservices,
whileallowingforplace-basedplanningandcoordination
TheFamilyWellnessSuiteprovidesa
lactationlounge,children’snookandtargetedprogramming
Somewillfeatureateaching
kitchenaswellasagardenforgrowingfruitsandvegetables
Throughreferralsystems,
residentsaresupportedingettingtheservicesthey
need
ActionCenters:WhatWeOffer
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ActionCenterCo-LocatedPartnersinEastHarlem
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v HarlemHealthAdvocacyPartners
v EastHarlemAsthmaCenterofExcellence
v NewbornHomeVisitingv EHACEChefsv FreshFoodBoxv ShapeUpv EastHarlemCommunity
WalkingTrailv FamilyWellnessSuite
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PEACH Objectives
Determinehowaligningthecityhealthdepartment,clinicalandnonclinicalpartners,internalandexternalfrontlinestaffinacollectivegovernancestructure withintheEastHarlemActionCenterbuildsacultureofhealth.
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Theobjectives guidingthestudyseekto:
DeterminewhethertheuseofNowPowbyActionCenterstakeholdersfostersacross-sectorcollaborationtoimprovehealth&well-beingintheneighborhood.
EvaluatetheimpactthattheActionCenterhasonthehealthoftheEastHarlemcommunity.
TodevelopafinalreportwhichdetailshowthisalignmentmaybescaledupinNewYorkCityandreplicatedinotherU.S.cities.
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PEACHDataSources
• GovernanceCouncilInterviews
• EastHarlemActionCenterStaffInterviews
• NowPowreferralandtrackingsystem
• VisitorSatisfactionSurveys
• ActionCenterMonitoring&TrackingData
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GovernanceCouncilInterviewsGovernanceCouncilPurpose• Promotetransparency• Supportcohesionandcollaboration• Addressbuildingmanagementissues• Ensurecustomerrelationsareofthehighestpossiblestandardsandrespondtocommunityneeds• Strategicplanning
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MonthlyGovernanceCouncilMeeting• Includesrepresentativesfromeachco-locatedpartner
• Supportscoordinationofservicesandplanningatthebuildinglevel
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GovernanceCouncilBaselineInterviewsAnticipatedbenefitstoorganizationsforbeingpartoftheActionCenter
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Membersdescribedexpectationsandoutlinedgoalsforthecouncilitself,fortheirorganizations,andfortheActionCenter.
• CollaborationwithActionCenterstaffandpartners• Connectprogramsforcollaborativeinitiatives• Acceptreferralsandwarmhandoffsfrompartners• Sharestaffandresources• Increasedcapacityandabilitytooffernewservices• Expandedprogramreach
CollaborationandReach • Goodlocation• Morespace• Attractivespacewithartdisplaysinbuilding
Building
• Fillservicegaps• Raiseawarenessofhealthissuesinthecommunity• Promoteawarenessofprograms• Improvehealthoutcomesintheneighborhood
Community
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ActionCenter KeyPlayerInterviews
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NavigatorWelcomesneighborhoodresidents,orientsvisitorstotheActionCenterservices,andfacilitatescoordinationofservicedelivery.
ReferralSpecialistConnectsneighborhoodresidentswithserviceprovidersinsideandoutsidethebuildingtopreventgapsinaccesstocare.
HealthPromoterIdentifiesanddevelopsrelationshipswithneighborhoodassetsandfacilitateshealthpromotionactivities.
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NowPow
thatallowscommunitymemberstofindhealthcare,socialservices,andpublichealthprograms,whileconnectingtheprovidernetworktofacilitatereferrals.
Coresystemfunctionsinclude• Acomprehensiveandregularlyupdatedresourcedirectory• Socialneedsscreening• Bi-directionalreferralmanagement• Aclient-centeredactionplanwithremindertools• Populationmanagementdashboardsforeachorganization
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NowPow isaresourcedirectoryandreferralsystem
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NowPow Cont’d
Benefits&Opportunities• Numberofsuccessfulreferrals• Identificationofservicegaps• Facilitateswithneedsanalyses• Helpsidentifysocialdeterminants
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VisitorSatisfactionSurveys
• Visitorswillbesurveyedtoassessperceptionsandexperiencesaround:• Physicalspace• Customerserviceandoverallexperience• Qualityofcare• AbilityofActionCentertomeetneeds• Socialcohesion
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EastHarlemActionCenterVisitors
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1065
1301
15371397
1212 1239 1252
1514 1474
1673 1720
1178
1336
1101
0
200
400
600
800
1000
1200
1400
1600
1800
2000
NUMBE
ROFVISITO
RS
TotalNumberofVisitorsEnteringEastHarlemActionCenterbyMonth
2017 2018
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EastHarlemActionCenterReferrals
27
4337
49 51
31
74
53
76
51
34 34 34
15
36
0
10
20
30
40
50
60
70
80
90
100
NUMBE
ROFRE
FERR
ALS
TotalNumberofReferralsMadebyMonth
2017 2018
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EastHarlemActionCenterReferrals,Cont’d
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TopReferralCategories
1. Sexualhealthservices2. ESLclasses3. Completephysical
82
270
261
Co-located
External
DOHMH
0 50 100 150 200 250 300
TypesofReferrals(January2017– February2018)
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NextSteps
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Activity Phase StartTimeGovernanceCouncilMemberInterviews Follow-Up Spring2018
Dôr FootTrafficCounters Implementation Spring2018
NowPow Utilization Implementation Spring2018
EastHarlemKeyPlayerInterviews Baseline Summer2018
EastHarlemVisitorSatisfactionSurveys Follow-Up/RoundTwo Summer2018
EvaluateActionCenterImpactonEastHarlemCommunity
Baseline Fall2018
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ThankYou!
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Questions?Comments?Conversation?
[email protected]
[email protected]
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Upcoming Webinars
Archives http://systemsforaction.org/research-progress-webinars
UpcomingWednesday, May 9, 2018 12-1pm ET/ 9-10am PTUNCOMPENSATED CARE PROVISION AND THE IMPLEMENTATION OF POPULATION HEALTH IMPROVEMENT STRATEGIESSystems for Action National Program Office, University of Kentucky College of Public HealthPrincipal Investigator: CB Mamaril, PhD
Wednesday, May 23, 2018 12-1pm ET/ 9-10am PTINTEGRATING CROSS-SECTORAL HEALTH AND SOCIAL SERVICES FOR THE HOMELESSUniversity of Utah and University of North TexasPrincipal Investigators: Jesus Valero, PhD, and Hee Soun Jang, PhD
Wednesday, June 6, 2018 12-1pm ET/ 9-10am PTLINKING EDUCATION AND HEALTH DATA TO IMPROVE ADOLESCENT HEALTH IN LOS ANGELESUniversity of California, Los AngelesPrincipal Investigators: Sheryl Kataoka, MD, MS, and Rebecca Dudovitz, MD, MS
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Acknowledgements
Systems for Action is a National Program Office of the Robert WoodJohnson Foundation and a collaborative effort of the Center for Public HealthSystems and Services Research in the College of Public Health, and theCenter for Poverty Research in the Gatton College of Business and Economics,administered by the University of Kentucky, Lexington, Ky.
and
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Questions?
www.systemsforaction.org