Meeting Minutes
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Meeting #2
Date: August 19, 2015 1:00pm-4:00pm
Location: Albany School of Public Health, Massry Center 1 University Place, Rensselaer, NY 12144
Overview
This was the second meeting in a series of meetings for the Social Determinants of Health (SDH) and Community Based Organizations (CBO) Subcommittee (SC). The purpose of the meeting was to review the work that had been completed to date by a small Subgroup (Identifying Effective Interventions workgroup formed after Meeting #1) and discuss the outstanding Roadmap questions that still need to be answered. This meeting also served as a forum to discuss any questions and address concerns about the SC's scope of work.
The Agenda for this meeting included the following:
- Review of Roadmap Questions
- Identifying Effective Interventions Workgroup Findings and Discussion
- Guidelines for Providers and the State
- Housing Determinants
- Capturing Savings Across Public Spending
Key Discussion Points
1) Welcome and Overview
The co-chairs opened the meeting, noting that the "Identifying Effective Initiatives" Workgroup had made good progress since Meeting #1 and that there will be three additional Workgroups created to help address the remaining Roadmap questions. The agenda and timeline for the meeting was explained. Jason Helgerson, NY State Medicaid Director, spoke to the subcommittee. The charge of not only the SDH and CBO SC, but of all of the VBP SCs, is to make specific recommendations to the VBP workgroup that fit into one of three vehicles - change in state law, change in state regulation, or a change in the contract between the State and the Medicaid managed care providers. The SC members were encouraged to keep in mind the difference between a standard and a guideline and when it makes sense to use one over the other. The group was asked to hold providers accountable for improving deficits in the SDH, but to use caution and not to push too hard, too fast. Roles of providers must be thought about holistically based on the greater needs of the population when making decisions.
2) Agenda Items #1 - Review of Roadmap Questions (Reference slides 3-4)
Slide 3 illustrates the Roadmap questions answered by the Identifying Effective Interventions Subgroup, identified with a purple star. Slide 4 shows the remaining Roadmap questions to be answered by the SC.
3) Agenda Item #2- Subgroup Findings and Discussion (Reference slides 5-48)
The work completed by the subgroup was reviewed and it was noted that "Family" was added to the Social and Community SDH category, as seen on slide 6. The discussion addressed each key area listed on slide 6 and the disparities that the Subgroup identified for each one. The "menu" of interventions, and proposed framework created in Excel by the Subgroup, were also explained and displayed in the presentation. A discussion ensued regarding the Subgroup's findings, and comments, questions, and modifications were solicited by the co-chairs. Please refer to the appendix for the notes taken on the flip chart during this discussion.
4) Agenda Item #3 - Guidelines for Providers and the State (Reference slide 50)
The Roadmap questions pertaining to guidelines for providers and the State were addressed during this portion of the meeting. SC members brainstormed and offered insights to answer the questions: 1) What is the best way to incentivize providers to encourage development of SD initiatives and collaboration with CBOs? 2) What is the best method to measure the success of the programs? Please refer to the appendix for the notes taken on the flip chart during this discussion. The co-chairs asked for members of the SC to volunteer to be a part of a second Subgroup, called "Guidelines", that will meet over the next three weeks (prior to Meeting #3) to discuss, research, and generate recommendations on guidelines for providers and the State as related to SDH and CBOs.
5) Agenda Item #4 - Housing Determinants (Reference slide 51)
During this section of the meeting, the Roadmap questions "How do we address housing determinants and develop an action plan?" and "From where can money be leveraged to invest in housing issues?" was discussed. Please refer to the appendix for the notes taken on the flip chart during this discussion. The co- chairs asked for members of the SC to volunteer to be a part of a third Subgroup, called "Housing", that will also meet over the next three weeks (prior to Meeting #3) to discuss, research, and generate recommendations on housing determinants as related to SDH and CBOs.
6) Agenda Item #5 - Capturing Savings Across Public Spending (Reference slide 52)
Lastly, the Roadmap questions pertaining to capturing savings across public spending was introduced. The SC asked clarifying questions, brainstormed, and discussed several ideas around ROI and aligning short and long term goals of different participating entities. The notes from this brainstorming session can be found in the appendix. The co-chairs asked for members of the SC to volunteer to be a part of a fourth subgroup, called "Capture Savings", that will meet over the next three weeks (prior to Meeting #3) to discuss, research, and generate recommendations on capturing savings across public spending as related to SDH and CBOs.
Materials that were distributed prior to the meeting:
| # | Document | Description |
|---|---|---|
| 1 | SDH and CBO Meeting 2 Final | A PDF presentation of the slide deck created for Meeting #2, which included findings from the "Identifying Effective Interventions" Subgroup and the remaining unanswered Roadmap questions pertaining to SDH |
| 2 | Title-IV_E-Waiver-Interventions-Research-Brief | A brief from July 2015 summarizing interventions, with and without benefit-cost data, or that which do not yet have substantial evidence |
| 3 | Surprising Results from Pilot Program Aimed at Medi-Cal ´Super-Utilizers´ | An article from June 2015 providing information on the population with the highest health care bills in California based on the results of a pilot program. |
| 4 | Risk-Protective-Intervention-Social-Family-Cohesion | A page outlining risk and protective factors and detailing interventions for social, family, and community cohesion |
Key Decisions
In addition to the first Subgroup formed after Meeting #1 (now called Identifying Effective Interventions), members from the SC will form three additional Subgroups to address the remaining Roadmap questions. The new Subgroups are called 1) Guidelines 2) Housing and 3) Capturing Savings. The subgroups will meet, as needed, over the next three weeks in order to generate recommendations to bring back to the larger SC in Meeting #3, which will be held on September 9, 2015. The SC will then discuss the findings and formulate formal recommendations to the VBP Workgroup.
Action Items
- Please email Josh McCabe (joshuamccabe@kpmg.com) if you attended the meeting on the phone or did not sign the attendance sheet.
- Please email Josh McCabe if you would like to participate in one of the smaller Subgroups that will be conducting research and making recommendations for Identifying Effective Interventions, Guidelines, Housing, and/or Capturing Savings.
Conclusion
The next three weeks will be very intensive for the SC members, as they form three additional Subgroups to tackle the remaining Roadmap questions pertaining to SDH. In total, four subgroups will be meeting at least twice to formulate recommendations to bring back and present to the SC in Meeting #3.
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