Stewardship Group

June 11, 2019 - Stewardship Group Meeting Summary

June 11, 2019 at 01:00 pm

Stewardship Group Meeting Summary

Welcome and Introductions
Kitty Bailey welcomed the Stewardship Group and attendees introduced themselves. The group reviewed the previous meeting summary and it was unanimously approved without changes as the final version to be posted on the ACH website.

CACHI Updates
CACHI Survey
Kitty shared results of the survey conducted earlier this year by the CACHI evaluation team. Out of 104 potential respondents, 26% (n=27) stakeholders responded. Survey highlights and comments include:
  • 56% of respondents have been involved with SD ACH for two or more years, which demonstrates long-term commitment and engagement.
  • San Diego scored higher than other CACHI catalyst sites on progress toward creating a shared vision and tracking data.
  • San Diego scored lower than other CACHI catalyst sites on actions toward development of a portfolio of interventions (POI). The group discussed factors that may have contributed to the low score: the survey was conducted during early stages of the Collective Action Workgroup’s North County POI pilot, which is currently underway; POI development takes a great deal of time; and the size of San Diego County is greater than other CACHI sites. Despite the low score, survey respondents supported the more focused POI approach, starting in a smaller community, and developing/testing a model that can be replicated in other areas.
  • San Diego had lower scores than several other sites for active community engagement, however respondents recognized the good work of the Community Resident Engagement Workgroup (CREW) and that more time and resources are needed to improve its effectiveness.
  • Respondents felt that SD ACH gets a lot done, but recognized that additional capacity and resources will be needed to achieve all intended goals.
  • Respondents recognized that SD ACH strongly demonstrates equity, diversity, and
  • inclusion (EDI) in its work. The group pointed to several possible reasons including the two-day EDI training conducted for stakeholders and the ongoing work of CREW in creating an equity discussion guide for use by all SD ACH workgroups.
  • Open-ended survey responses highlight SD ACH’s value to the community in the areas of convening cross-sector partners, alignment of vision and activities, community voice and empowerment, and partnership and collaboration. Respondents recognized the importance of SD ACH creating opportunities for conversations that aren’t happening elsewhere in the County.
  • Specific accomplishments mentioned include partner convening and trust building, collective accountability, data sharing and defining metrics, community engagement and equity, and working toward development of a wellness fund and sustainability.
  • Identified priorities for the coming year include developing a strategy for financial sustainability, implementing the POI, and increasing community awareness (same priorities as in 2018).

CACHI Renewal Application and Years 4-5 Milestones

Christy announced that an application for a two-year CACHI extension is due on July 1, for which SD ACH will apply. Funds are available in the amount $100k per year for two years for each site selected. (This amount is one-third of the current funding amount.)

CACHI has developed milestones for extended contract years four and five. The group discussed milestone #1: Solidify ACH infrastructure and its relationships to other initiatives and/or collaboratives. The group mentioned the importance of aligning similar initiatives in San Diego County. Measuring SD ACH partner organizations’ contributions (e.g., staff, time, and effort) as well as demonstrating how their organizational agendas align with those of the SD ACH, could also be powerful in demonstrating overall impact.

Action Item: Given time constraints, Stewardship Group members were asked to review the remaining years four and five CACHI milestones for discussion at the next meeting.

Neighborhood Networks Update

Kitty gave an update and led a discussion on the status of Neighborhood Networks. Discussion highlights include:

  • NN is a system of care that will utilize trained Neighborhood Navigators who serve as peer advocates to address individuals’ self-identified unmet health related social needs. Neighborhood Navigators are from the communities they serve, are known and trusted,  and have a clear understanding of the available resources, assets and barriers to health in each community.
  • Addressing needs that arise from the social determinants of health is a “hot topic” now among healthcare organizations, although they recognize that they might not be best suited to address these needs in community settings. Healthcare organizations will ideally achieve risk mitigation by addressing and integrating health and social needs.
  • Funding resources are needed to support these activities.
  • Recent discussions have resulted in interest by Health Net (for its MediCal population) and UCSD (for its Medicare population) in participating in a Neighborhood Networks (NN) pilot based on the Pathways Community HUB model. The pilot will be a “proof of concept” that will allow testing of how well the model works in San Diego (e.g., optimal case loads and capacity, time needed to resolve various social needs). In addition, the pilot will allow us to test a payment model that would include a base payment as well as payment for completed pathways.
  • Neighborhood Navigators will work closely with the Community Information Exchange (CIE) to better serve clients. NN differs from CIE in that Neighborhood Navigators work directly with clients in their homes or community settings.
  • NN could become a flagship program and economic driver of the SD ACH, with profits going into the wellness fund to address identified capacity needs in communities and SD ACH workgroups serving as advisors. NN could also inform the POI.
  • It will be important to build in effective evaluation, as the HUB could provide valuable information to communities about demonstrated social needs and availability—or lack of—resources. NN could support community-based organizations by making the case for increased funding and helping build capacity where needed.
  • Effective “branding” and promotion of NN will be important, with different messaging needed for varying audiences.
  • Kitty will be presenting an update on Neighborhood Networks (NN) to the Alliance Healthcare Foundation’s (AHF) advisory committee on June 14. AHF is looking for a financial investment into NN by health plans.

Action Item: Kitty will update the Stewardship Group as to the outcome of the AHF advisory committee meeting to discuss next steps. If AHF determines not to fund the NN pilot, additional fundraising will be necessary.

Equity Guide Discussion

This discussion was tabled until the next meeting.

Date and Time

June 11, 2019 01:00 pm
June 11, 2019 02:00 pm

ACHs build on prior efforts to coordinate and integrate various organizations, programs and services by linking their activities together in a coherent and reinforcing portfolio of interventions across five key domains.