Division of Health Policy and Analytics MEDICAID ADVISORY COMMITTEE When: January 27, 2021, 9:00am-12:00pm Join on your computer or mobile app Click here to join the meeting Or call in (audio only) +1 971-277-2343,,924842358# United States, Portland Phone Conference ID: 924 842 358# When What Who Welcome and introductions; review Leslee Huggins and Jeremiah Rigsby, 9:00 and approve December minutes MAC Co-Chairs Anna Lansky, Deputy Director, Office of 9:10 DHS Agency Update Developmental Disability Services (DHS) David Inbody, CCO Operations Manager 9:25 OHA Agency Update (OHA) Jeff Scroggin, Sr. Policy Advisor, OHA 9:40 Legislative Update Government Relations Advancing Consumer Experience 10:10 Lavinia Goto, Subcommittee Chair Subcommittee Update 10:30 Break Health-related Services Spending Anona Gund, Transformation Analyst, OHA 10:40 Trend for CCOs Transformation Center 11:10 OHPB Retreat - Discussion Jeremiah Rigsby and Leslee Huggins 11:20 Public Comment 11:30 Wrap up / adjourn Next Meeting: February 24, 2021 9:00 am -12:00 TBD OREGON MEDICAID ADVISORY COMMITTEE (MAC) December 2, 2020 9:00 AM – 12:00 PM MEMBERS IN ATTENDANCE: Adrienne Daniels, Daniel Alrick, Dave Inbody, Jeremiah Rigsby, Karun Virtue, Lavinia Goto, Leslee Huggins, Tamara Bakewell, Brandy Charlan, Kevin Alfaro-Martinez MEMBERS ABSENT: Anna Lansky, Miguel Angel-Herrada Quorum? Yes PRESENTERS: Sarah Dobra, Lisa Bui, Veronica Guerra, Joelle Archibald, Lauren Kustudick, Oceana Gonzales, Sarah Dobra, Joell Archibald, Dustin Zimmerman STAFF: Jackie Wetzel, Tom Cogswell, Margie Fernando TOPIC Key Discussion Points Jeremiah Rigsby welcomed everyone to the meeting, and members introduced themselves. There was a motion to approve the minutes of 10/28/20; All votes were in favor of approval of the Welcome and Introductions 9/30/20 minutes. Chris DeMars shared the results of the Accountable Health Communities Study that was conducted. It is a national CMS study seeking to understand if screening for social needs, provision of community resource information, and help from a patient navigator to access resources improves health and reduces the cost of care for Medicaid and Medicare beneficiaries. The graphs show the health-related Social Needs of Medicaid and Medicare Beneficiaries before and during COVID-19. One big takeaway from this is that social needs increased amongst populations of color Accountable Health Communities and other communities because of COVID. Study Findings & Discussion: COVID-19 and Impact on Social In Oregon, $45 million of grants were awarded to address some of the unmet social needs. These grants Needs (Pages 5-8) went out both from Public Health Division and Office of Equity and Inclusion. Sarah Dobra shared the links where we can find the list of grants awarded: COVID-19 Funding for Community-Based Organizations COVID-19 Health Equity Grants Jackie asked the MAC if they would like to include this topic as a regular feature. Jeremiah agreed that it will be very useful to ask if CCOs can share how they are addressing health-related needs. 1 TOPIC Key Discussion Points Lisa Bui, Director of Quality Improvement and Veronica Guerra, Quality Assurance and Contract Oversight Manager, OHA. Lisa talked about the key areas of the Medicaid Quality Strategy: • CCO Transformation Quality Strategy (TQS) • Performance Improvement Projects • Network Adequacy • Complaints and Grievances Here is the link to the TQS page: https://www.oregon.gov/oha/HPA/dsi-tc/Pages/Transformation-Quality- Strategy.aspx MAC’s role in this Quality Strategy is to: • Inform the direction of the quality strategy updates Medicaid Quality Strategy • Inform the accountability methods for quality strategy implementation (Pages 9-46) Lisa also talked about Performance Improvement Projects (PIP). PIPs are a lever of quality to: • Improve quality of care • Improve in clinical and non-clinical areas • Follow quality improvement science Veronica Guerra followed up with a report on the Provider Networks. All CCOs and DCOs must submit an Annual Delivery System Network (DSN) Provider Narrative Report on or before September 1, 2020. The Report includes five specific categories: 1. Description of the Delivery Network and Adequacy 2. Description of Enrollees (Members) 3. Additional Analysis of the MCO’s Provider Network to Meet Enrollee (Member) Needs 4. Coordination of Care (CCO only) 5. Performance on Metrics (CCO only) 2 TOPIC Key Discussion Points In addition, Veronica added that all CCOs and DCOs are required to send out a notice to members for service denials. The review of these NOABDs started with the third quarter submission from CCOs and DCOs. Those were submitted September 2020. Jackie would like to ask Lisa Bui and Veronica Guerra to come back to the January meeting of MAC to create time for questions and discussion. These are the follow up topics that MAC can digest and have questions ready for the next meeting. • Metrics reports; impacts on OHP members • Complaints and Grievance data and interventions to address problems • Delivery System Network that gets to access discussions • CCO Transformation Quality Strategy outcomes and policy directions Tom Cogswell Project Coordinator, OHA Transformation Center presented on this topic. Tom introduced the panel who helped with the discussion. Tom gave a good overview of Community Advisory Councils. There are 36 CAC’s across the 16 CCOs. Lauren Kustudick, Central Oregon Health Council CAC. Lauren covers the rural areas of Central Oregon. Lauren discovered that most of the services being offered were in Bend but did not cover areas outside of this area. She helps to connect people outside of this area. CCO 2.0 and Community Oceana Gonzales, Eastern Oregon CCO Malheur LCAC. She and her children are OHP consumers. She has Engagement (Panel Discussion) been doing this for a year. She advocates for her community and brings her insight as an OHP member (Pages 5-8) and can reach out to her community. Karun Virtue, InterCommunity Health Network CCO CAC. Karun has been involved for the last 7 years. This group has been actively involved. Karun realized that although CCO2.0 has a long list of action goals; it does not really impact the members and the community. In addition, the Wildfires severely impacted housing and in the short term and there is a greater need for social determinants of health. The Learning Collaborative of the CAC will provide a peer-to peer sharing space and discuss best practices. It will be a space for sharing and learning for all members. 3 TOPIC Key Discussion Points How is the CAC trying to recruit new members? Tom explained that each local community tries to identify the needs of the local community. They have strategies and resources that are discussed at their monthly meetings. For rural communities, it is harder to access because of the lack of Wi-Fi connections. Sarah Dobra, Manager of the Ombuds Program and Innovator Agents, Joell England Archibald, RN, and Dustin Zimmerman gave an update on the Innovator Agents in the CCO’s. Joell Archibald gave a brief history of how the concept of the Innovator Agent program started. Dustin Zimmerman introduced the 6 Innovator Agents working across the CCOs in Oregon and the service areas they cover. Innovator Agents have been working since the beginning of the formation of CCOs over 8 years ago. They Innovator Agent Update (Pages have worked closely with the CCOs and have a tremendous wealth of community knowledge. Specifically, 47-57) they work to: • Support and participate in CCO Community Advisory Councils to amplify OHP member voice • Gauge the impact of transformation on community health and OHP member needs • Inform OHA of opportunities and obstacles • Identify system and/or policy solutions to support CCOs, community partners and OHP members • Build, support and participate in learning collaboratives at the community and state level • Regular connection between all IAs to discuss/learn/share…help good ideas travel faster • Share innovative and successful practices with other CCOs, with OHA and with national audiences. Dave Inbody gave a verbal update on OHA. The focus is on the planning and distribution of the COVID vaccine. The second is the Governor’s budget that was sent out. There will be challenges that will require ongoing work to address. CCO Deliverables: At the end of this year, each CCO is required to submit a Health Equity Plan. This plan Agency Updates, OHA & DHS will allow visibility into progress., impacts, and future plans for continued work. OHA also received the first submission on Language Access reporting. There is Legislative Concept coming up on this area. As we move into 2021, there will be additional contractual requirements placed on CCOs. One example is Intensive In-Home Behavioral Health Treatment (IIBHT program). OHA has met with CCOs to explain the 4 TOPIC Key Discussion Points program and how to work through the associated requirements. Another example is related to the CCOs new responsibility for individuals placed on the waitlist for the State Hospital. OHA has scheduled meetings to discuss this new responsibility with CCOs, as well as CMHPs and other providers. Anna Lansky was not available to present in person, but a written update was distributed prior to the meeting. Public Comment There was no public comment. The next meeting is January 27, 2021 via Microsoft Teams Closing Comments Next Meeting Wed Jan 27, 2021, 9am-noon Via Microsoft Teams 5 2021 Session Calendar JANUARY FEBRUARY SMTWTFS SMTWTFS 1 New Years 2 123456 Day 3 4 5 6 7