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Community-Based Strategies to Integrate and Coordinate Care for Underserved Populations
Tuesday, November 18, 2014: 8:30 AM - 10:00 AM
The passage of the ACA has stimulated a surge in transformation efforts seeking to integrate and coordinate primary care and behavioral health services as strategies for supporting the Triple Aim - reduce costs, improve quality of services, and improve health outcomes for clients. These transformation efforts include the development of health homes and other approaches to system redesign.
This session addresses a challenge that policy makers, health plan administrators and providers face as they move forward with integrated and coordinated primary care/ behavioral health. The Medicaid population includes individuals whose health challenges are often complicated by social determinants of health such as extreme poverty, violence, refugee status, limited English proficiency, and stigma. While integrated and coordinated health care is likely to improve the effectiveness of the overall health care delivery system, conventional integration models typically do not include strategies to address the social determinants of health. Failure to effectively address social determinants limits health care providers’ capacity to successfully engage clients in services and produce positive health outcomes. Since the social determinants have a disproportionate negative impact on low income ethnic and racial populations, significant challenges will remain in our ability to reduce disparities in health status and the burden of disease for these populations.
Session presenters will discuss transformation initiatives in California that have intentionally sought to address the social determinants and meet the needs of the unserved and hard to serve.
The California Institute for Behavioral Health Solutions initiated a year long learning collaborative in which participants’ integration efforts included partnerships between behavioral health providers, health centers, community-based social service providers, and culturally-specific navigators. Participants also incorporated strategies to link individual services to community level primary prevention.
California’s Health Home Innovation Fund funded 8 multi-stakeholder, regional collaboratives across California to improve care coordination and integration among safety net institutions and providers to better serve patients, particularly those with complex needs. The regional collaboratives fostered strong cross-sector partnerships in the community to serve complex populations.
Lessons learned from these efforts provide valuable knowledge to the nation regarding how to ensure the benefits of health reform have the broadest reach.
Session Objectives: Discuss the benefits of expanding health integration and coordination efforts to include community-based social service providers.
Identify concrete strategies to support the development of safety net Person Centered Health Homes.
Formulate strategies for helping direct service providers identify key opportunities to promote health and wellness at the population level.
See individual abstracts for presenting author's disclosure statement and author's information.
Organized by: Mental Health
Endorsed by: Medical Care Section, Public Health Social Work, Caucus on Homelessness, Community Health Planning and Policy Development, Community Health Workers
Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)
Masters Certified Health Education Specialist (MCHES)