The Haitian American Cultural and Social Organization Inc. (HACSO Community Center Inc.)

Rockland County has approximately 10,000 Haitian residents, most of whom reside in Spring Valley, a village in the town of Ramapo.

In the aftermath of the devastating earthquake that struck the Haitian capital of Port au Prince in January 2010, the Haitian American Cultural and Social Organization Inc. (HACSO) experienced an influx of Haitian immigrants and local Haitian residents who need assistance with social and health care services. In response to this catastrophe and the needs of New York Haitian communities, NYHealth developed a three-part response strategy. The Foundation participated in two separate funding collaboratives led by Brooklyn Community Foundation (BCF) and Long Island Community Foundation (LICF). NYHealth also provided a grant to Haitian American Cultural and Social Organization (HACSO). NYHealth provided grants totaling $150,000 to support these organizations’ efforts to address the needs of Haitian communities in three areas of the State.

With NYHealth support, HACSO hired a case manager to coordinate access to preventive care and mental health services to members of the Haitian community affected by the earthquake, manage the increasing caseload, and link clients to linguistic and culturally competent mental health professionals. In addition, the case manager reached out to the community’s partners, such as schools, day care centers, and local health providers, to raise awareness within the Haitian community about mental health issues and available social and health care services.

In Rockland County, most of the local support following the earthquake was provided as in-kind services from State and local government agencies and nonprofit organizations. NYHealth’s contribution filled a more acute monetary need for direct services.

Joseph P. Addabbo Family Health Center, Inc.

South Ozone Park, Queens is a low-income, medically underserved community.

The shortage of primary care options has been exacerbated by the recent closure of three local hospitals where many of the area’s uninsured residents sought routine care. The Joseph P. Addabbo Family Health Center, Inc. (Addabbo) is establishing a new site for primary care in South Ozone Park as a part of its network of Federally Qualified Health Centers.

The identified South Ozone Park facility has the capacity to serve 15,000 patients annually. With NYHealth support, Addabbo will renovate the site, consolidate primary care services, and ultimately operate the facility at full capacity. Addabbo anticipates operating at 50% capacity in the first year of operation, reaching maximum patient volume by the fourth year.

Taconic Health Information Network and Community, Inc. (THINC)

Current health care reimbursement structures generally reward volume rather than value, and do not encourage coordination or collaboration across unaffiliated organizations.

A promising, but new and largely untested, model called accountable care organizations (ACOs) has emerged as a way to slow rising health care costs and improve quality. An ACO formally brings together a set of non-affiliated providers, and holds them accountable for the cost and quality of care delivered to a defined population of patients. The Taconic Health Information Network and Community, Inc. (THINC) brought payers and providers to the table in a joint pursuit of models that would benefit both communities in the Hudson Valley region. The New York Health Foundation funded THINC to facilitate a planning process among payers, providers, and other key stakeholders.

The planning process has three components: (1) bringing together health care providers and payers to explore the ACO model and develop common principles; (2) providing training and technical assistance on the “nuts and bolts” of ACOs (including financial modeling, legal considerations, quality measurement, and management and leadership); and (3) populating a communitywide data set across multiple payers and years to enable quality and cost outcome analysis.

Read the report associated with this grant, “Building ACOs and Outcome-Based Contracted in the Commercial Market: Provider and Payor Prespective.”

Northeast Health, Inc./Home Aide Service of Eastern New York, Inc. (The Eddy)

Seventy-five percent of the nation’s health care spending is spent on patients with chronic conditions.

Providing care for these patients at home can reduce these costs, but has proven to be a logistical challenge. One model of care, developed in Arkansas, shows promise—Baptist Health’s Home-based Chronic Care Model improved outcomes and quality of care while cutting back on costs and staff member turnover. The Home-based Chronic Care model focuses on patient empowerment, theory-based behavioral interventions, and care coordination, and incorporates telemedicine and depression screening into current models of home-based care. The Eddy Visiting Center is the largest home health care agency in the greater Capital Region. Serving more than 5,000 patients in both urban and rural communities, it is well positioned to pilot this model of care in New York State. In November 2010, the New York Health Foundation (NYHealth) awarded a grant to the Eddy Visiting Nurse Association to implement the Baptist Health Home-based Chronic Care Model and evaluate its capacity to transform home health care in New York State.

This grant allows the Eddy to hire two additional clinical nurse specialists in the areas of diabetes and pulmonary care. These specialists are incorporating evidence-based care plans into an electronic medical record; training frontline home care workers; monitoring and improving agency-wide quality indicators; discussing care plan recommendations with physicians; and serving as consultants in the care of the most complex patients. Current clinicians and nurse practitioners are being trained and will receive certification in chronic care management.

Manatt Health Solutions

Federal health reform offers an opportunity to expand health insurance coverage, strengthen safety net providers, and reform our payment and delivery systems.

Turning the promise of federal reform into reality and implementing an enormous and complex bill will fall largely on the States; States are charged with implementing the Medicaid expansion, creating Insurance Exchanges, and implementing a wide range of insurance law reforms to commercial markets. With support from NYHealth, Manatt Health Solutions will develop a road map which will help identify specific tasks, decisions and considerations for implementing provisions that have the greatest impact on New York and its residents.

Manatt Health Solutions, a policy consulting firm based in New York City, is uniquely qualified to conduct this work because they have already been commissioned by the California HealthCare Foundation to prepare a similar document for California. Manatt will develop a Strategy Road Map that will summarize each reform provision and why it is important to New York; detail the timetable for implementation; analyze fiscal and other implementation implications for the state and/or key stakeholders; and analyze the key issues and decisions that public policy makers will need to address in order to ensure New York maximizes the benefits of federal reform in the State. The final report will help inform the Foundation’s strategic thinking and will aid NYHealth in determining which issues would most benefit from the application of its resources.

Read the report associated with this grant, “Implementing Federal Health Care Reform: A Roadmap for New York State”.

Greater New York Hospital Association Foundation

Hospital-sponsored ambulatory clinics and outpatient departments are a major component of the primary care delivery system in the New York metropolitan region.

These clinics are training sites for thousands of physician residents in primary care specialties and serve a large number of the uninsured and Medicaid enrollees. Although medical residents gain useful experience, they are also a discontinuous workforce—requiring them to rotate through different departments and assignments, which in turn results in discontinuity of care for patients. In 2010, NYHealth awarded a planning grant to the Greater New York Hospital Association Foundation (GNYHA Foundation) to identify ways for improving quality and continuity of patient care while adequately training medical residents.

While hospital-sponsored outpatient clinics strive to improve the continuity of care they provide, they confront a unique structural difficulty because they serve as training sites for thousands of physician residents in primary care specialties. Each resident individually serves as a “discontinuous” member of the workforce and is required to be exposed to varying experiences, resulting in discontinuity for patients.

This planning grant reconciled two important missions: improving quality and continuity of care for patients while adequately training the next generation of physicians. Greater New York Hospital Association Foundation accomplished the following:

  • Convened hospital administrators, ambulatory care directors, and residency program directors to assess the meaning of care management in the context of ambulatory teaching sites;
  • Reviewed and evaluated compliance with accreditation requirements that impact care management;
  • Identified opportunties to modify resident curriculm structures; and
  • Identified the barriers to such modifications so that they can be overcome.
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