Download the report

Download the report

 

A word from our co-chairs…

February 2015

Dear Community Partner,

It is our privilege to share with you the 2014 Washtenaw Health Initiative Annual Report to the Community, chronicling our accomplishments over the past year. This year’s report explores the WHI’s impact in two key areas: increasing the number of community members with health insurance coverage, and improving access to coordinated primary, dental, and mental health care for our community’s most vulnerable populations.

The WHI is unique. What we have accomplished together—voluntarily and collaboratively—is unparalleled in our state. As of December 2014, over 180 people participated in our working groups and 16 community-based projects. In one project, we brought together law enforcement, public health, community mental health, care providers, and health plans to create a community-wide plan to address opioid use and related overdoses in our county. Another impact is that now Packard Health Clinic uses the same electronic medical record system as the Corner Health Center, allowing for easier referrals of patients between the two community-based clinics. Together, we dedicated hundreds of hours in 2014 across the county, from safety net medical and dental clinics to community outreach locations.

The WHI has worked to leverage and coordinate financial and human resources throughout this community to support the various initiatives. We thank our numerous funders, and especially our two major sponsors: St. Joseph Mercy Health System and the University of Michigan Health System. We are also grateful for the facilitation and research support provided by the Center for Healthcare Research & Transformation.

Now, we’re entering a new era. What began as a focused effort to build relationships and prepare for the full implementation of the Affordable Care Act is shifting. Over the course of 2014, the WHI entered its second phase, which improves coordination across the community, while maintaining the focus on the low-income, under- and uninsured in our community.

To define this second phase of our work, the WHI leadership examined our role in the community and gathered input from key stakeholders: Our members. We also sought feedback from other community leaders, such as representatives from the Coordinated Funders, the VA Ann Arbor Healthcare System, and the Washtenaw Health Plan. Using this feedback, we developed a three-year plan that outlines the WHI’s structure, leadership, and funding processes through the end of 2017.

Next year’s work will continue to build on the great work done in the first four years of the WHI. Thank you for your participation and support of the Washtenaw Health Initiative. We look forward to working with you to continue these successes in 2015 and beyond!

Sincerely,

Robert Guenzel                                                           Norman Herbert

WHI Co-Chair                                                             WHI Co-Chair

Thank you to Maddie Zavala at  re:group, inc. for the wonderful design of this annual report!

Who We Are

The Washtenaw Health Initiative (WHI) originated in 2010 when local community leaders convened to prepare health services within the county for the full implementation of the Patient Protection and Affordable Care Act (ACA) and improve integration and coordination of services for the low income and uninsured populations in Washtenaw County. A steering committee was formed to clarify the initiative’s goals and scope, and to identify organizations and individuals to participate. Since that time, the WHI has grown into a county-wide collaboration of more than 70 provider, payer, safety net, and service organizations that have come together to improve the health of the low-income, uninsured, and Medicaid recipients in Washtenaw County, Michigan. This voluntary, non-governmental collaborative is sustained through the dedicated work of more than 180 members who are focused on identifying community health needs, emphasizing primary care over emergency care, and increasing communication in order to improve access to—and the quality of—care in the county.

For the first phase of the WHI (2011-2014), the goals of the WHI were to:

  1. Increase and maintain insurance coverage;
  2. Improve access to coordinated, integrated care, and;
  3. Become a model and resource for other communities considering how best to serve the needs of their most vulnerable citizens.

The WHI ended 2014 with 16 community-based projects designed to help achieve these goals.   The Steering Committee and Stakeholders group also concluded the year recommitting to the work of the WHI and revising the mission and goals for the upcoming three years.

The following are accomplishments from November 2013 through December 2014, organized by the goals during the first phase of the WHI.

Increase and maintain insurance coverage

Over the course of the past year, the WHI coordinated efforts across the county to help reduce the numbers of individuals who were uninsured.  The ACA insurance marketplace took effect starting January 1, 2014 and the Healthy Michigan program (Medicaid expansion) took effect in Michigan on April 1, 2014. During the first open enrollment period, from October 2013 – March 2014, approximately 10,700 people in Washtenaw County selected a plan through the Health Insurance Marketplace. Between April and December 2014, 12,423 Washtenaw residents enrolled in the Healthy Michigan Plan. WHI participants worked together to maximize the impact of these two new coverage options. Specifically:

  • In advance of and during the first-ever open enrollment period for the new Health Insurance Marketplace, the WHI’s Community Outreach & Education Project convened more than 40 organizations and agencies to coordinate community-wide outreach and training of enrollment staff. This effort was led by the Washtenaw Health Plan, the staff of which also provided extensive technical support to member organizations.
  • In addition, the WHI Community Outreach & Education Project enlisted and trained more than 90 U-M graduate students and community members to conduct community outreach in 2014. These volunteers gave nine presentations and hosted thirteen additional outreach events about enrolling in new types of health care coverage, reaching 283 community members.
  • The WHI’s Enrollment Coordination Project assisted 10 agencies to become designated or redesignated by the federal government to provide hands-on enrollment assistance for consumers newly enrolling in health care coverage. This has yielded approximately 76 individuals who are trained and designated to do enrollment county-wide.
  • During 2014, the WHI’s Co-Located Department of Human Services Worker project supported 500 county residents to renew or enroll in state assistance programs, such as: food assistance, Medicaid, child care assistance, state emergency relief, and cash assistance.

Improve access to coordinated, integrated care

The WHI is committed to increasing the integration and coordination of health care in the county, particularly within the areas of mental health, substance use disorders, primary care, and dental services. More than 30 WHI participating organizations worked together on these issues over the past year.  Specifically:

  • The Safety Net Clinic Coordination Project team assisted with discussions between Packard Health Clinic and the Corner Health Center so that both now use the same electronic health record system. In addition, the Regional Alliance for Healthy Schools (RAHS, school-based health centers) is also in the early stages of implementing this electronic health record.
  • The Primary Care Capacity Project team facilitated the hiring of two new primary care practitioners in safety net clinics in anticipation of increased demand for primary care due to health insurance coverage expansions.
  • The Tailored Mental Health Management Support for Primary Care (TaMMS) team implemented a mental health management support pilot program in two primary care safety net clinics, with two pilot sites anticipated to begin in early 2015. The program is based at the University of Michigan Department of Psychiatry, and served 88 patients in 2014. The TaMMS project team secured funding from a variety of funders: the University of Michigan Health System, Michigan Department of Community Health, and the Blue Cross Blue Shield of Michigan Foundation.
  • The WHI adopted a new community-based program that provides supportive housing for homeless people who are frequent users of local emergency departments. By December, 2014, the Frequent Users Systems Engagement (FUSE) project has placed 78 people in permanent supportive housing. The program is based at Catholic Social Services, and is fully funded through the Corporation for Supportive Housing.
  • The Reduced Fee Dental Initiative enrolled 15 additional patients into a reduced fee dental program, bringing the program total to 103 patients. In this program, patients directly pay dentists in the program a reduced fee, based on the patients’ income. The program was administered by Washtenaw Health Plan staff.
  • The Acute Dental Care Referral Program employed a new referral process from each local emergency department to the Community Dental Center to provide patients with treatment for dental abscesses. In 2014, 107 patients received treatment for abscesses, and about half were referred for additional services.
  • The CareNet Project Team, based at the Washtenaw Health Plan, strengthened the CareNet, which is a group of more than 340 care managers in settings across the community. In 2013 and 2014, CareNet provided over 10 trainings—in particular, on helping people apply for Medicaid and the Marketplace, and three trainings for new case/care managers.
  • A pilot program called the Blue Cross Complete Pilot Project used three health advocates (CHAs) from the Washtenaw County Health Department to assist newly enrolled BCC members in making their first primary care appointment and address gaps in care for more than 200 patients at Packard Health Clinic. Gaps such as overdue mammograms were identified by Blue Cross Complete, and the CHAs then reached out to welcome new Blue Cross Complete members and help members with identified care gaps and make appointments. The project was funded by Blue Cross Blue Shield of Michigan.
  • The Opioid Project, a WHI project formed in 2014, laid the groundwork for a multi-faceted, county-wide approach to address opioid-related overdoses in the community. Five evidence-based interventions will be implemented in the community in 2015:
    • Provider education about prescribing opioid-based pain medications
    • Naloxone access for first responders
    • Substance abuse treatment center protocols
    • Community engagement to promote recovery from opioid use
    • Primary prevention among youth

Become a model and resource for other communities

The WHI has also participated in significant statewide initiatives.  In 2014, the WHI:

  • Provided input to the Michigan Department of Community Health that was used in their state-wide Blueprint for Health Innovation, which was funded for $70 million by the Centers for Medicare and Medicaid Innovation in December, 2014.
  • Shared learning and recommendations at state-wide conferences and individually with communities across the state about coordinating outreach and enrollment for new health insurance options.
  • Provided input to the VA Ann Arbor Healthcare System about opportunities to serve the families of veterans at the VAAHS’ annual mental health summit.

The first phase of the WHI, from 2011 – 2014, was focused on addressing gaps in existing health care delivery as well as preparing for the Affordable Care Act  coverage expansions in 2014. Over the course of 2014, the WHI leadership solicited feedback and guidance about the future direction including mission, scope, and goals of the WHI from WHI member organizations. Entering 2015, the WHI will maintain a primary focus on the low income population in Washtenaw County and go deeper into key areas such as mental health as well as broaden its work to help further the integration of community needs assessment efforts occurring throughout the county.  Most of the existing projects will continue and grow as well over the next three years to further access to coverage and care in the county. The strength of the WHI is in its members and the continued enthusiasm and hard work they bring to this voluntary effort to do better for those they all serve in Washtenaw County.

Participating Organizations (*Charter Members)

1)     Acción Buenos Vecinos Action 28)  Grace Clinic 55)    St. Joseph Mercy – Ann Arbor*
2)     Aid in Milan 29)  Hamilton Crossing 56)    St. Mary’s Student Parish
3)     Alpha House 30)  Health Policy Student Association 57)    U-M Institute for Healthcare Policy and Innovation
4)     Ann Arbor City Council* 31)  HIV/AIDS Resource Center (HARC)* 58)    U-M School of Dentistry*
5)     Ann Arbor Area Community Foundation* 32)  Home of New Vision 59)    U-M School of Public Health*
6)     Ann Arbor Housing Commission* 33)  Hope Medical Clinic, Inc.* 60)    U-M University Health Service
7)     Ann Arbor / Ypsilanti Regional Chamber* 34)  Huron Valley Ambulance* 61)    UMHS Community Health Assessment and Community Benefit*
8)     Arbor Hospice* 35)  Integrated Health Associates* 62)    United Way of Washtenaw County*
9)     Avalon Housing 36)  Jewish Family Services of Washtenaw County* 63)    University of Michigan Health System*
10)  Blue Cross Blue Shield of Michigan* 37)  Livingston and Washtenaw Narcotic Enforcement Team (LAWNET) 64)    University of Michigan Health System Department of Psychiatry*
11)  Casa Latina* 38)  Legal Services of Southeastern Michigan 65)    VA Ann Arbor Healthcare System*
12)  Catholic Social Services of Washtenaw County* 39)  Manchester Community Resource Center 66)    Washtenaw Association for Community Advocacy
13)  Center for Family Health 40)  Michigan Community Health Worker Alliance 67)    Washtenaw Community College
14)  Center for Healthcare Research & Transformation* 41)  Michigan Consumers for Healthcare 68)    Washtenaw Community Health Organization *
15)  Center for Independent Living 42)  Michigan Health & Hospital Association 69)    Washtenaw County Department of Human Services*
16)  City of Saline* 43)  Michigan State University Extension – Washtenaw County 70)    Washtenaw County Medical Society
17)  City of Saline Police Department* 44)  National Alliance on Mental Illness – Washtenaw 71)    Washtenaw County Michigan Works
18)  Community Action Network* 45)  Neighborhood Family Health Center* 72)    Washtenaw County Public Health*
19)  Community Alliance 46)  Packard Health* 73)    Washtenaw County Sheriff’s Office*
20)  Community Dental Center* 47)  Planned Parenthood of Mid and South Michigan* 74)    Washtenaw Health Plan*
21)  Community Support and Treatment Services* 48)  POWER, Inc. 75)    Washtenaw Intermediate School District Head Start
22)  Corner Health Center* 49)  Regional Alliance for Healthy Schools* 76)    Washtenaw Success by 6*
23)  Dawn Farm* 50)  re:group* 77)    Women’s Center of Southeastern Michigan*
24)  Detroit Regional Chamber 51)  Shelter Association of Washtenaw County* 78)    Ypsilanti City Council*
25)  DHS – Michigan Rehabilitation Services 52)  SOS Community Services 79)    Ypsilanti Community High School
26)  EMU Snow Health Center 53)  St. John Providence Treatment Center 80)    Ypsilanti Housing Commission*
27)  Faith in Action 54)  St. Joseph Mercy – Chelsea*


Washtenaw Health Initiative Funding Supporters

  • Ann Arbor Area Community Foundation
  • Blue Cross Blue Shield of Michigan
  • Blue Cross Blue Shield of Michigan Foundation
  • City of Ann Arbor
  • City of Saline
  • City of Ypsilanti
  • Corporation for Supportive Housing
  • Michigan Department of Community Health
  • St. Joseph Mercy Health System
  • United Way of Washtenaw County
  • University of Michigan Health System
  • Washtenaw County
  • Washtenaw Health Plan