CDPH Role in Health Care Reform and Uninsured in Chicago
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The Chicago Board of Health Meeting, Wednesday, September 28, 2013 presentation on Enroll Chicago.
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CDPH Role in Health Care Reform and Uninsured in Chicago
- 1. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel Enroll Chicago: The Role of CDPH in Health Care Reform Implementation September 18, 2013 Erica Salem, MPH Deputy Commissioner Chicago Department of Public Health @chipublichealth #HealthyChicago
- 3. Supporting Enrollment Efforts 506,340 Uninsured Adults •33,415 Disabled Persons •145,171 SNAP Recipients •7,288 Seniors 40,161 Children & Youth
- 4. Community-Based Enrollment Support In-Person Assisters (IDPH) •$12.4 Million •24 grantees, several consortia Federal Navigators (CMMS) •$2.3M •7 grantees Health Center Outreach & Enrollment (HRSA) •$2.5M •16 grantees
- 5. • Information sharing • Facilitate coordination • Identify and address barriers • Maximize enrollment efforts Community-Based Enrollment Support
- 6. Enroll Chicago! Children’s Initiative
- 7. Enroll Chicago! Children’s Initiative Illinois All Kids program •Children (≤18 years old, ≤ 300% poverty) qualify for Medicaid and can receive comprehensive care. ?
- 8. CDPH to fund a Lead Agency to coordinate outreach & application completion for at least 5,000 CPS students. > Grant period: Oct. 2013 – Sept. 2015 > Funding available: $350,000-$1,050,000 Enroll Chicago! Children’s Initiative Communities with High Density of Uninsured CPS Students Community Area Elementary High School Total Albany Park 600 200 800 Archer Heights 500 --- 500 Ashburn 800 300 1,100 Austin 400 --- 400 Belmont Cragin 1,400 800 2,200 Chatham 200 --- 200 Gage Park 1,000 --- 1,000 South Lawndale 1,000 200 1,200 West Ridge 900 200 1,100 Chicago Lawn 500 --- 500 Logan Square 700 --- 700 Portage Park 600 200 800
- 9. Enroll Chicago! Small Business Initiative
- 10. • ACA requires large employers to pay shared responsibility fee if they don’t provide affordable coverage. • Defined as 60% of health care expenses. • Large employers = >50 employees • This mandate affects just 6% of Chicago businesses. Enroll Chicago! Small Business Initiative
- 12. ACA Requirements for Non- Profit Hospitals Establish financial assistance and emergency medical care policies Limit charges for medically necessary care Reasonable efforts before engaging in extraordinary collection actions Conduct a community health needs assessment (CHNA) and adopt an implementation strategy Conducted once every 3 years Posted on hospital website Public health involvement Deadlines vary depending on tax year. Hospitals not completing CHNA could lose tax-exempt status
- 13. Charitable Contributions from Chicago Hospitals, 2011
- 14. Hospital Community Health Needs Assessments (posted as of September 1, 2013) Ann & Robert H. Lurie Children’s Hospital of Chicago Holy Cross Hospital Mercy Hospital and Medical Center Mount Sinai Hospital Northwestern Memorial Hospital Presence - Our Lady of Resurrection Medical Center Presence - Resurrection Medical Center Presence - Saint Joseph Hospital- Chicago Presence - Saints Mary & Elizabeth Medical Center Rehabilitation Institute of Chicago RML Specialty Hospital – Chicago Rush University Medical Center Saint Anthony Hospital Schwab Rehabilitation Hospital University of Chicago Medical Center University of Illinois Hospital and Health Sciences System
- 16. COMMUNITY HEALTH NEEDS ASSESSMENTS: KEY PRIORITIES Selected Chicago Hospitals Hospital Mental Health Obesity Access to Care Diabetes Heart Health Chronic Disease Respir. Health Violence Social Determinants Cancer Women's Health Stroke Other Holy Cross Hospital √ √ √ √ √ √ √ Lurie Children's Hospital √ √ √ √ √ Mercy Hospital and Med Ctr. √ √ √ √ √ Mount Sinai Hospital √ √ √ √ √ Northwestern Memorial Hospital √ √ √ √ √ Our Lady of Resurrection Medical Center √ √ √ √ Rehabilitation Institute of Chicago √ Resurrection Medical Center √ √ √ √ RML Specialty Hospital √ Rush University Medical Center √ √ √ √ √ √ √ Saint Anthony Hospital √ √ √ √ √ √ √ √ √ Saint Joseph Hospital √ √ √ √ Saints Mary & Elizabeth Med Ctr. √ √ √ √ √ √ Schwab Rehabilitation Hospital √ √ √ √ University of Chicago Med Ctr. √ √ √ √ √ University of Illinois Hospital and Health Sciences System √ √ √ √ √ √ √ √ CHNA Key Priority Areas
- 18. The Guide to Community Preventive Services OBESITY PREVENTION AND CONTROL INTERVENTIONS IN COMMUNITY SETTINGS Interventions to Reduce Screen Time Behavioral interventions to reduce screen time Recommended Mass media intervention to reduce screen time Recommended Technology-Supported Interventions Multicomponent coaching or counseling interventions to: - Reduce weight Recommended - Maintain weight loss Recommended Interventions in Specific Settings Worksite programs Recommended School-based Programs Insufficient Evidence PROVIDER-ORIENTED INTERVENTIONS Provider education Insufficient Evidence Provider feedback Insufficient Evidence Provider reminders Insufficient Evidence Provider education with a client intervention Insufficient Evidence Multicomponent provider interventions Insufficient Evidence Multicomponent provider interventions with client interventions Insufficient Evidence Findings available at http://www.thecommunityguide.org/obesity/index.html
- 19. Other Related Initiatives • County Care • Starting Strong Collaborative • Illinois Alliance for Health • Health Care Task Force, Illinois Workforce Development Board
Notas do Editor
- $17.2 million in recent grants, 41 agencies
- Another way CDPH is promoting enrollment is by focusing on children and implementing a Medicaid enrollment program. Through the All Kids program, Illinois children (≤18 years old, ≤ 300% poverty) qualify for Medicaid and can receive comprehensive care. Including: physician visits, hospital stays, prescription drugs, vision care, dental care and medical devices (e.g. glasses, asthma inhalers). However, up to 50,000 CPS students are still uninsured despite CPS efforts. To reach these children, CDPH issued a Request for Proposals (RFP), which will fund a Lead Organization to coordinate outreach and application completion for at least 5,000 CPS students, which wall lead to enrollment in All Kids. The LO will work with community-based organizations to reach these students. Grant period: October 2013 – September 2015 Funding available: $350,000-$1,050,000
- This means that the vast majority of Chicago businesses will be exempt from having to pay a penalty for not providing healthcare.
- As part of the ACA, new requirements are in place for non-profit hospitals to continue to be awarded tax-exempt status. These include developing policies on financial assistance and emergency medical care. These policies are required to limit amounts charged to individuals eligible for financial aid and also to stop extraordinary collection actions to these individuals. In addition, non-profit hospitals are not required to conduct a community health needs assessment and adopt an implementation strategy at least once every three years.
- CDPH has been involved with several hospitals and their CHNAs: Provided public health data Served on their assessment committees Provided technical assistance/guidance on planning process However, these represent only the minority of hospitals that contacted CDPH outright. Nonetheless, hospitals have identified priority areas in their CHNA. To assist their efforts and ensure funding is spent on effective strategies and programming, CDPH will soon issue a report sharing effective community preventive strategies for the priority areas mentioned in the CHNAs of Chicago non-profit hospitals. This chart shows the hospitals that are required to complete the CHNA. Hospital Community Health Needs Assessments (posted as of September 1, 2013) Ann & Robert H. Lurie Children ’s Hospital of Chicago Holy Cross Hospital Mercy Hospital and Medical Center Mount Sinai Hospital Northwestern Memorial Hospital Presence - Our lady of Resurrection Medical Center Presence - Resurrection Medical Center Presence - Saint Joseph Hospital- Chicago Presence - Saints Mary & Elizabeth Medical Center Rehabilitation Institute of Chicago RML Specialty Hospital – Chicago Rush University Medical Center Saint Anthony Hospital Schwab Rehabilitation Hospital University of Chicago Medical Center University of Illinois Hospital and Health Sciences System
- Here is a table of the key priority area from the 16 CHNAs that have been posted already. You can see the health issues that many of them are addressing….