Each of Oregon's 16 coordinated care organizations has been tasked with the creation of a community health improvement plan – and the draft plan presented before FamilyCare's community advisory council last week focused on improving the health of “transition-age” youth – usually defined as youth who are too old for child services, but not old enough for adult services, including young people who are aging out of foster care.
“We came up with two different aspects of the Ccommunity Health Improvement Plan – that we think we want to focus on. One of them was really more of a long-term impact,” said council member Alicia Atalla-Mei at the community advisory council meeting last week.
First, the health improvement plan workgroup outlined what the target population looks like: youth between the ages of 15 and 26, including youth of color, youth with substance abuse issues and others belonging to high-risk or high-need populations. The second part of the plan involves using community health workers and peer advocates to reach out to people who may not be experienced or comfortable interacting with the healthcare system.
“One of the things we talked about was that health literacy is so important,” said Carmen Cordis, adding that the workgroup would like suggestions for community organizations FamilyCare could partner with in order to identify and work with transition-age youth.
Consumer member Duane Westfall asked why the plan was focused on youth up to age 26, since young people in their late 20s – such as those leaving the corrections system – may be in need of outreach and assistance as well.
The state requires CCOs to (https://cco.health.oregon.gov/Documents/resources/CHA-guidance.pdf) identify health disparities associated with race, ethnicity, language, health literacy, age, disability, gender, sexual orientation, geography, occupation or other factors in its geographical areas – develop baseline date on those disparities and identify ways to overcome them.
“We had to take what can we do in a year and how far can we get in a year,” said consumer member Kyna Harris, adding that many agencies have been created to work with underserved populations specifically targeting youth between age 15 and 25. “We had to have a piece that we can submit to the state for the health improvement plan. We know these are two pieces that are priorities.”
Noting that many youth lose access to their parents' insurance around age 26, the council discussed expanding the age parameters, but didn’t reach any conclusions and instead decided to continue hammering out the details through other discussion channels – such as email – before its next meeting in March. CEO Jeff Heatherington pointed out that the plan should not just be guided through the availability of existing resources and data,
“The role of the council is to make decisions as to what the Child Health Improvement Plan looks like and set the parameters. The role of staff is to implement it. I would not want you to make a decision based on what we think are our parameters,” said Heatherington. “I would say you know your decision is open to what you really want to measure, not any limitations on the part of the company.”
Mary Nolan, vice president of business and community development, also talked about FamilyCare's innovation projects – including a culturally appropriate outreach care project with the Asian Health and Service Center – which will be making welcome calls to new members, particularly those identified as Asian immigrants who need translation services – as part of a larger project of doing outreach to non-English-speaking populations.
“We reserve the right to get smarter about it and you will help us do that,” Nolan said.
Dr. Daniel Roth also showed a video about FamilyCare's efforts to be more flexible in covering care, featuring an adult patient who had been diagnosed as schizophrenic and who had attempted suicide. The patient also had severe acne, which caused him physical as well as social discomfort – Roth said his acne would bleed onto his clothing, making him reluctant to go outside – so FamilyCare authorized the use of acne medication, above and beyond what Medicaid typically authorizes. The patient and his mother were both featured in the video talking about how the drug helped him emotionally as well as physically.
“We're small enough to make sure we can adapt to needs of our members and providers and we're innovative,” Roth said.
Christen can be reached at [email protected].
