Frequently Asked Questions (FAQ) About Our New Strategic Plan

September 23, 2013

Today’s post was written by Kelly Rago, program associate at the Connecticut Health Foundation.

You may recall that the Connecticut Health Foundation (CT Health) hosted a series of roadshows across the state about our new strategic plan. We compiled all of your questions and identified themes, which led to the creation of this Frequently Asked Questions (FAQ) about our new strategic direction. Thank you to everyone who attended our roadshows and asked us the hard questions about what we’re doing, why we’re doing it, and how we can work together.

If you have a question that’s not answered here, we encourage you to leave your question in the comments because others may have that question too.

What is CT Health’s timeline for phasing out children’s mental health?

We will continue to fund work in children’s mental health through the end of 2014. As we have seen, however, this issue when not addressed contributes significantly to health inequities. Starting in 2015, we will address both children’s and adult mental health through our health equity work and through our integration of health care work.

What is CT Health’s vision for integrated health care?

We believe that an integrated health care system provides better quality care and ultimately, better health outcomes. An integrated health care system is one in which health care professionals consider all health conditions – be they mental, oral, or physical – at the same time.[1]  An integrated health care system is more inclusive of safety net providers so that, for examples, referrals to specialists who take publicly-funded health insurance are easily made. Our vision is that consumers, with providers coordinating their care, can get the care they need in the right place at the right time.

Integration is a theme in our new strategic plan. We want the issue of health equity integrated into all major health care, public health, and health policy initiatives in the state.

What can be done to address early childhood traumas and mitigate the effects these have on children’s mental and physical health?

In the past, we have made investments into developing approaches to trauma-informed care, with a focus on integrating trauma-informed care into primary care for children. As we exit children’s mental health as a standalone priority area at the end of 2014, we step back where others have emerged as leaders. Trauma-informed care is a growing field in Connecticut that we’re proud to have invested in, but we’re confident our partners will advance the work. Advocates are currently working to implement policies for early behavioral health screening around early-life trauma.

Some groups, such as undocumented immigrants, are going to be left out of health care reform.  How can we engage these populations and ensure that they have access to quality health care?

Even with 100% success of implementation of the Affordable Care Act (ACA), many still will not have access.  An estimated 65,000 undocumented immigrants in the state will not be eligible for private insurance subsidies or the Medicaid expansion, but undocumented immigrants will still need health care.  This is why one of new strategic objectives involves keeping our health care safety net strong.  Policy possibilities are difficult given the how this issue is playing out nationally, but   we continue to track immigration reform and its implications for health care.

How is CT Health working to improve quality of care?

To us, health equity involves systematically helping more people gain access to better care.  Access is on the forefront of our minds as we begin open enrollment begins under health reform; as such, we have an emphasis on access to coverage for first 2 years of our new plan.

The “better care” side of our definition is where quality comes into play, and we are taking a systematic approach there as well.  Two strong forces for change are increased accountability in the health care system and shifting the state from an acute care model to one that prioritizes preventative care. We’re funding grants and developing effective policies to support these opportunities to advance health equity, as well: culturally and linguistically competent care, workforce sustainability, the role of community health workers, and navigation of health care systems.

We also look to our partners to tell us what quality improvement initiatives will be scalable, sustainable, and ultimately result in better care as experienced by diverse consumers and patients.

While access to and navigation of the healthcare system are important, a vast majority of what influences health happens outside of the doctor’s office.  What work is CT Health doing aside from this?

We recognize that 60-70% of what causes health disparities and inequities occurs before one enters the system.[2] We have chosen, however, to seize the once-in-a-lifetime opportunity of the Affordable Care Act to reform access and delivery systems to deliver more equitable care. Many of our partners have undertaken or are involved in a number of health equity initiatives in the state that focus on public health and the social determinants of health.  Both work streams are critical to ending disparities, and yet we need to divide and conquer, and come together and bridge where it makes sense.   Not one of us can do this alone and ultimately going to take real collaboration to move that needle.

With a limited amount of resources going into the in-person-assister and navigator programs, how can we ensure that they are successful?

The CT Health has taken steps to ensure the Navigators and In-Person Assisters (NIPA) are effective. We have to date provided support in the form of grant-making and participation at various policy tables in an advisory capacity.

At the same time, the program is time limited and the need for NIPA will continue when funds expire. CT Health will be involved in conversations about what happens next and how we can partner with others to fill the need.

How can the faith-based communities partner with CT Health?

Faith organizations are tremendously important to the health equity agenda.  We challenge faith organizations to think beyond health education, screening, and programs.  We are interested in faith based organizations that have moved into systems change and advocacy – both on the local and state public policy side as well as on the health care consumer side.  While the moral case for health equity isn’t the message that all leaders should adopt, it’s a perfect message for faith leaders to bring to decision makers in the state in order to ensure that it is a priority for Connecticut.

How do we enable services that go toward better outcomes for patients?

Our theory of change is that we can have the greatest impact through systems change. We know quality of care has improved for communities of color nationally, but we want to ensure that improved care has actually led to better health for people of color.

To that end, we seek to transform the health care delivery system and the systems that touch it. We work to ensure that health care delivery is defined as more than just medical care. We believe in researching and implementing financing mechanisms that drive and reward positive health outcomes. Health care service providers, including community health workers and navigators, can inform our systems work.

 

 


[1] http://www.samhsa.gov/healthReform/docs/ConsumerTipSheet_IntegrationImportance.pdf

[2] www.nejm.org/doi/full/10.1056/nejmsa073350, see Figure 1.

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