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HomeMy WebLinkAbout2022_02_17_Packet CHIP Overview and Proposal to BOH January 2022 Developed by Lori Fleming, CHIP /BHC; Apple Martine, JCPH BeHealthyJefferson.com 1 of 11 CHIP OVERVIEW AND PROPOSAL PRESENTED TO JEFFERSON COUNTY BOARD OF HEALTH BACKGROUND The original Community Health Improvement Plan (CHIP) partnership, an innovative collaboration between Jefferson Healthcare (JCH), the City of Port Townsend and Jefferson County Public Health (JCPH), has been devoted to identifying the most pressing health priorities and actions leading to health improvements for individuals, families, and communities across Jefferson County. This partnership recognizes that community health improvement is not a one- time effort, but an ongoing process that looks broadly at factors impacting our population’s health and uses the community health assessment (CHA) data to identify priority issues, develop and implement strategies for action, and establish accountability to ensure measurable health improvement. 2016-2019 CHIP partnership focused on four Jefferson County health priorities, which were identified through a rigorous community data assessment study completed in 2014, and ranked at data assessment meetings in 2015-2016. The four health priorities are: ▪ Access to care ▪ Access to mental health and substance abuse services ▪ Immunizations ▪ Healthy eating, active living and chronic disease prevention The hiring of two .5 FTE Co-Executive Directors for CHIP, to direct and manage this work, was approved by the Joint Board (the Board of County Commissioners and the Board of Public Hospital District #2). Co-Executive Directors Lori Fleming and John Nowak, with funding from JCPH and JHC respectively, were aligned to build and facilitate four workgroups focusing on the four priority areas. The workgroups included stakeholder and interested parties who collaboratively developed each workgroup’s purpose statement, goals, objectives, and strategies. This effort resulted in the writing of the first CHIP which was adopted by both the Board of Health and the Board of Public Hospital District 2 in October 2016. This CHIP is the current Plan that exists today. In 2019 a new Community Health Assessment (CHA) was conducted and another community stakeholder group was assembled to thoroughly vet the data. After several meetings, the priorities were established based on the group’s recommendation to form age-bands delineated into Youth Age, Working Age, and Older Age. These age-band teams are populated by relevant agency, organization and community stakeholders and advocates. These groups have developed strategic frameworks, that when completed/approved, will serve as a roadmap to improve the health of the community members represented in the focus of each age band. (See pages 4-9 for more detail.) Prior to his retirement, Co-Executive Director Nowak was focused on developing content for the 2021 CHIP update. He and Fleming met monthly from January to August 2021 with the three age-band teams that were developed to address the 2019 Community Health Assessment (CHA) results. CHIP Overview and Proposal to BOH January 2022 Developed by Lori Fleming, CHIP /BHC; Apple Martine, JCPH BeHealthyJefferson.com 2 of 11 Concurrent with the age-band work, and in an ongoing effort to secure additional funding to address Jefferson County’s health priorities, CHIP pursued and was awarded $3M in HRSA Planning Grants and, in 2020, the $1M HRSA RCORP-Implementation grant. This latest grant specifically focuses on improving access to Substance Use Disorder (SUD) and Mental Health (MH) services. The RCORP-I grant’s performance period ends in August 2023. Fleming has focused on the grant-funded role of Behavioral Health Consortium (BHC) Director, productively serving CHIP’s mission as convener, multiplier and amplifier of efforts at the intersection of CHIP’s community health improvement mission and the RCORP-Implementation (RCORP-I) Grant. The Behavioral Health Consortium’s (BHC) over-arching mission is to improve Jefferson County’s behavioral health system and increase access to services throughout the County. In Fleming’s role as the RCORP-I grant’s Project Director, she:  Leads monthly BHC meetings with the 10 Consortium agencies and stakeholders, along with a robust cadre of ad hoc members who compose a broad-based team of decision-makers who are involved with the county’s behavioral health system.  Convenes and facilitates multiple regular subgroup and one-on-one meetings to advance action and progress assessment on the BHC’s RCORP-I-funded strategic projects Current subgroups include: - South County Harm Reduction Workgroup - Pre-Hospital Behavioral Health Summit – Led by Dr. David Carlbom - BHC Data Collection and Analysis  Provides monthly progress presentations to grantor’s representatives in WA DC  Executes the significant quarterly reporting requirements for the RCORP-I grant. (See Pages 10-11 of this document for an update covering the first year of the BHC’s work.) ISSUE STATEMENT CHIP is in a time of transition. The Health Department, Hospital and City began a review of CHIP’s support structure as John Nowak retired from his role as CHIP Co-Executive Director in August of 2021. That structure was outlined in an Interlocal Agreement effective November 2017 through June 2019. The updated structure for CHIP’s governance, funding partnerships, executive lead role description and salary, are all elements in gestation. Broad strokes are emerging that include CHIP reporting to the Board of Health for Policy and Programmatic Oversight, along with securing funding partnerships with the City, Hospital District, County and State sources. Lori Fleming, who served as CHIP’s Co-Executive Director from 2018 to the present, looks forward to considering the next iteration of the CHIP lead role, once clarity emerges around the future governance, role description and reporting structure, and salary. CHIP Overview and Proposal to BOH January 2022 Developed by Lori Fleming, CHIP /BHC; Apple Martine, JCPH BeHealthyJefferson.com 3 of 11 CONSIDERATIONS ▪ CHIP consistently serves as the convener, multiplier, and amplifier of strategic action on important health issues. The organization’s credibility is underscored by the many community leaders and stakeholders who engage, and are committed to, supporting its continuance. ▪ CHIP has magnetized awards of over $1.3M in grant funding to address Behavioral Health priorities articulated in the last two CHA efforts ▪ Since 2018, the CHIP team advanced the 2016 CHIP, executed the 2019 CHA, and facilitated the development of strategic frameworks that, if approved, will comprise the 2022 Community Health Improvement Plan (CHIP) update – serving to continue the integration and advancement of stakeholder and advocate health efforts throughout our community. PROPOSAL Lori Fleming, CHIP’s past Co-Executive Director and current Director of the BHC, Dr. Allison Berry, Jefferson County’s Health Officer, and Apple Martine, Director of Jefferson County Public Health - are collectively requesting that the Board of Health (BoH) consider and agree to assume governance role in support of CHIP’s successful operation and growth as CHIP works to ensure the community reaps the intended benefits by fully implementing the Community Health Improvement Plan. In the proposed role, the BoH will provide cross-sector representation that is equipped to offer policy direction and governance of CHIP’s work. CHIP may report to the BOH at their scheduled meetings that includes representation from the County, the Hospital District, the City, and citizens. This structure will provide CHIP with governance primarily focused on policy direction. We propose that JCPH integrate the Community Health Assessment (CHA) and the CHIP process and provide general and operational structure. Lori’s work with the RCORP grant is a full-time commitment at this time. Until the question of on-going CHIP governance, role definition, reporting structure and salary is resolved, the work outlined in the strategic frameworks each Age Band has developed for the 2021 CHIP Update will be on hold, with the exception of the Youth Age-Band meeting. (Refer to page 4-5.) When the plan for how CHIP will move forward is completed, we envision the three age-band teams will begin to meet again. Each workgroup will complete a final review of the frameworks they have developed, and make any changes needed. Then the Plan will be presented for approval by the appropriate governing body, and once approved, each group will begin the work of implementing the strategies and activities outlined in the approved 2021 CHIP Plan. CHIP Overview and Proposal to BOH January 2022 20220120F_CHIPBHC2022_OvrvwBOH Developed by Lori Fleming, CHIP /BHC and Apple Martine, JCPH 4 of 11 CHA TO CHIP PROCESS: AGE-BAND TEAM UPDATES CHIP Youth Age Band Workgroup – (YAB) The YAB team met every three weeks from Jan - Aug ‘2021, and is the only CHIP subgroup Lori is facilitating during CHIP’s gestation period. These meetings now occur on an every-other-month basis. In addition to the development of the framework, the YAB team has been working to develop a few quick-hit solutions that will improve Adolescent Behavioral Health in our community and reviewing the evidence-based solutions for reducing teen suicide and collectively developing relationships to distribute consistent, evidence-based education and awareness throughout our county’s school districts and communities. We invite you to visit this link for the YAB meeting videos, notes and successive drafts of the strategic framework. Team members include: Kate Dean Jefferson County BOCC Kees Kolff Jefferson Healthcare Commissioner Cynthia Osterman Benji Project Denise Banker Jefferson County Public Health Apple Martine Jefferson County Public Health Jim Novelli DBH Ciela Meyer OESD, Chimacum Schools Jean Scarboro Jumping Mouse Trish Beathard Brinnon Schools Julie Canterbury MCS Counseling Dr Molly Parker Jefferson Healthcare Alexandra Murphy Community Therapist Jenny Vervynck PTSD Julie Canterbury MCS Counseling Dr Molly Parker Jefferson Healthcare Alexandra Murphy Community Therapist Anne Koomen Jefferson Healthcare John Nowak Jefferson County CHIP Lori Fleming Jefferson County CHIP CHIP Overview and Proposal to BOH January 2022 20220120F_CHIPBHC2022_OvrvwBOH Developed by Lori Fleming, CHIP /BHC and Apple Martine, JCPH 5 of 11 CHIP Youth Age Band Group – (YAB) – Example of Strategic Framework CHIP Overview and Proposal to BOH January 2022 20220120F_CHIPBHC2022_OvrvwBOH Developed by Lori Fleming, CHIP /BHC and Apple Martine, JCPH 6 of 11 CHIP Working Age Band Group – (WAG) The issues for the working age members of our community were closely aligned with work already going on at the (BHC). This team has developed a framework draft for this age band. We invite you to visit this link for the Working Age Group meeting videos, notes and successive drafts of the strategic framework. Team members include: Sheriff Joe Nole Jefferson County Sheriff Jolene Kron SBH-ASO Peggy Webster Affordable Housing Chief Tim McKern Quilcene Fire Dept Milena Stott Fletcher Group Apple Martine Jefferson County Public Health Dir. Jim Novelli DBH Dunia Faulx JHC Patrick Johnson NAMI Greg Brotherton Jefferson County Commissioner CHIP Overview and Proposal to BOH January 2022 20220120F_CHIPBHC2022_OvrvwBOH Developed by Lori Fleming, CHIP /BHC and Apple Martine, JCPH 7 of 11 CHIP Working Age Group – (WAG) – Example of Strategic Framework CHIP Overview and Proposal to BOH January 2022 20220120F_CHIPBHC2022_OvrvwBOH Developed by Lori Fleming, CHIP /BHC and Apple Martine, JCPH 8 of 11 CHIP Senior Age Band Workgroup The demographics of Jefferson County underscore this workgroup’s critical role. And, because Olympic Area Agency on Aging and Jefferson Healthcare have taken such active roles in this work historically, Lori engaged in multiple individual meetings with stakeholders to help refine the framework. We invite you to visit this link for the Senior Age Group meeting videos, notes and successive drafts of the strategic framework. Laura Cepoi OAAA Sheriff Joe Nole Sheriff’s office Dunia Faulx JHC Mary Winters Avamere Nursing Home Nancy McGonagle SHIBA Jim Novelli DBH Kees Kolff Jefferson County Commissioner Heidi Eisenhour County BOCC Heather Freund Dove House’s (Vulnerable Adult Taskforce) Miranda Nash Transit Sheriff Joe Nole Jefferson County Sheriff Jolene Kron SBH-ASO Chief Tim McKern Quilcene Fire Dept Milena Stott Fletcher Group Apple Martine Jefferson County Public Health, Director Chief Bret Black EJFR Jim Novelli DBH Dunia Faulx JHC Patrick Johnson NAMI Greg Brotherton Jefferson County Commissioner CHIP Overview and Proposal to BOH January 2022 20220120F_CHIPBHC2022_OvrvwBOH Developed by Lori Fleming, CHIP /BHC and Apple Martine, JCPH 9 of 11 CHIP Senior Age Band – Example of Strategic Framework CHIP Overview and Proposal to BOH January 2022 Developed by Lori Fleming, CHIP /BHC and Apple Martine, JCPH 10 of 11 Behavioral Health Consortium (BHC) FIRST YEAR PROGRESS UPDATES FOR BHC STRATEGIES DEVELOPED TO PURSUE RCORP-I FUNDING ▪ Increase Integration of Behavioral Health Therapy Provider and MAT Prescription: Underway: Discovery Behavioral Health (DBH) and Safe Harbor (SH) have collaborated to integrate DBH’s MAT Perscription and SH’s SUD Counseling services. They began integrating relevant clients in June 2021. In Development. Quantifying impacts of provider/prescriber integration. ▪ Explore Crisis Stabilization Center Feasibility: Not feasible at this time due to certification and regulation requirements that are antithetical to a local, sustainable mental health and Substance Use Disorder (SUD) Crisis Stabilization Facility. The BHC, with endorsement from HRSA’s RCORP-I Tech Assistant Team, approved the projects below to move the county’s behavioral health-related interactions to ever earlier interception points, ideally to reduce the number of County residents needing local crisis stabilization services. ▪ Ongoing Multi-Agency Behavioral Health Data Collection and Analysis across BHC Members to generate system-wide insights on which to base next steps to improve access to County behavioral health services. ▪ Develop/maintain online/printed Resource Directory: Completed. Resources linked here. ▪ Improve Jail-to-Community service connection: Underway. The Sheriff’s office procured funding for a Residential Substance Abuse Treatment (RSAT) project that includes a Jail-to- Community Transition service component, managed by Believe in Recovery, a BHC Member. ▪ Fund Recovery Café for peer network development and recovery/prevention environment: Underway. $35k/Year funding is under contract for September 2020 – August 2023 ▪ Extend Harm Reduction Services into South County (SCHR): In Development. Local stakeholder involvement is solid. Naloxone hosting/distribution logistic are awaiting clarity on JHC’s Quilcene clinic staffing. Fortuitiously, CHIP’s South County meeting table is also serving to connect local leadership and Fire/Law Enforcement in conversations that have led to key positive brainstorming and action. Next steps are underway to address the challenges presented by HB1310 and State v. Blake Decision, and how these agencies collaborate to deliver our residents timely connection to care and services needed. See SCHR meeting videos/meeting materials. ▪ Execute communication/education/integration to address regional stigma. Underway. ▪ Coordinate and optimize navigator and care coordination services: In Development. ▪ Initiate collective case management for high utilizers of law enforcement/EMS services. On Hold as WA State’s approach becomes clear. Next steps on bi-directional, closed loop CHIP Overview and Proposal to BOH January 2022 Developed by Lori Fleming, CHIP /BHC and Apple Martine, JCPH 11 of 11 communication systems are being considered by County players through the Olympic Communities of Health (OCH). ▪ New projects: In January 2022, the BHC Membership approved RCORP-I grant funds to support the Pfeiffer House in their proposed effort to offer wrap around services for the 18-24 y.o. clients they house. (These funds were made available after a budgeted grant coordinator role wasn’t filled during the grant’s first year.) ▪ Pre-Hospital Behavioral Health Summits – Began in October 2021; continues on a bi-monthly or Quarterly cadence. CHIP collaborates with Dr. David Carlbom, Medical Program Director, Jefferson County EMS, to convene leadership reps from EMS, Law Enforcement, Dispatch, and Behavioral Health Providers to learn of each other's expertise, discuss opportunities and challenges, and to develop a shared mental model of how we collaborate to provide the best care to patients suffering Behavioral Health Crisis. BH Summit resources/meeting materials.