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SOCI 11- Day One - Monday Afternoon - June 13, 2016

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Slide decks presented during Day One sessions of the 11th Annual Stewards of Change National Symposium at Johns Hopkins University.

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SOCI 11- Day One - Monday Afternoon - June 13, 2016

  1. 1. Innovation Spotlight: Employing Cognitive Computing to Advance Program Effectiveness o Martin Duggan o Director, Social Programs, IBM Watson Health o Vernon Brown o Chairman of the Board of Directors, Stewards of Change Institute; CEO, Aspiranet #SOCI16
  2. 2. Employing Cognitive Computing to Advance Program Effectiveness © 2016 IBM Corporation 4
  3. 3. Introducing Watson © 2016 IBM Corporation
  4. 4. Watson Health will serve as a catalyst to improve and save lives of people around the world, and lower health and human services costs through the power of cognitive insights.
  5. 5. © 2016 IBM Corporation 7 Cognitive systems democratize innovation by scaling knowledge Analytics Cognitive Information Knowledge Data Sensors
  6. 6. Common Sense Dilemmas Morals Compassion Imagination Dreaming Abstraction Generalization Natural Language Pattern Identification Locating Knowledge Machine Learning Eliminating Bias Endless Capacity Humans excel at: Cognitive systems excel at: A new partnership between humans and technology © 2016 IBM Corporation 8
  7. 7. Watson, a cognitive system Learns Decisions made by leading experts feed the engine. Watson learns & improves over time. Understands Watson can read & understand documents & data – both structured & unstructured – at a massive scale. Reasons Watson searches & analyzes data, returning evidence- based recommendations. © 2016 IBM Corporation 9
  8. 8. © 2016 IBM Corporation 10
  9. 9. Page 11 IBM Watson Health Using Cognitive to impact Healthcare Memorial Sloan Kettering Partners with Watson A team of physicians and researchers drew “from an impressive corpus of information, including MSK curated literature and rationales, as well as over 290 medical journals, over 200 textbooks, and 12 million pages of text,” so that Watson could understand the field of medicine generally, and oncology in particular. IBM and Boston Children’s Hospital are collaborating to apply IBM’s Watson cognitive platform to help clinicians identify possible options for the diagnosis and treatment of rare pediatric diseases. In an initial project focused on kidney disease, Watson will analyze the massive volumes of scientific literature and clinical databases on the Watson Health Cloud to match genetic mutations to diseases and help uncover insights that could help clinicians identify treatment options. Cleveland Clinic
  10. 10. HHS Programs have a clear set of processes Identify Assess Respond Manage Measure • Identify clients • Verify Identity • Provide information & options • Assess priority, complexity & risk • Consider social context • Identify optimal outcomes • Determine eligibility & entitlement • Identify benefits and services to meet outcomes • Create & manage outcome plan • Manage delivery of benefits and provider payments • Measure program success • Analyze future policy needs Cognitive capabilities can be applied at each process step to better engage, discover and decide © 2016 IBM Corporation 12
  11. 11. Aspiranet Continuum of Services Core Programs:  Adoption  Behavioral Health  Family and Community Services  Foster Care  Intensive Home-Based Services  Residential  Transitional-Aged Youth Client Base  22,000 Children, Youth, and Families Annually
  12. 12. Transitional-Aged Youth  Exiting Foster Care  Young Adults, 18-26  Collaborative Care Management  Housing  250 Apartments  Employment  Education  Life Skills  Family and Community Connection
  13. 13. Watson Care Management  Pilot Proof of Concept TAY  Integrated Care Management  Evolving Needs of Health and Human Service Programs  Collaborative Person-Centered  Replace Transactional Features of Existing Case Management  Cloud-Based Solution  Design and Functionality
  14. 14. Cognitive Care Management  Natural Language Inquiry of Unstructured Data  Lease and Rental Agreements  User Interface  Access to Analytics  Client Portal Access  HealthShack
  15. 15. Two Youth Ambassadors who participated in the Health Shack 2.0 Sustainability Project Melanie S., Age 21 Antoinetta B., Age 20 HealthShack
  16. 16. But of course, we will still need humans….. © 2016 IBM Corporation 21
  17. 17. Research Presentation: How New Technology Could Improve Child Welfare Outcomes o Daniel Stein, President, Stewards of Change Institute o Richard Gold, Senior Consultant, Stewards of Change Institute o Adam Pertman, Senior Consultant, Stewards of Change Institute o Alan Day, Senior Consultant, Stewards of Change Institute #SOCI16
  18. 18. Cognitive Computing for Child Welfare Agenda ■ Daniel Stein – Background, Overview of Research, Key Findings, Recommendations ■ Adam Pertman – Implications of “Within Our Reach: A National Strategy to Eliminate Child Abuse and Neglect Fatalities” Report ■ Richard Gold – A Practitioner’s Perspective On Cognitive Applications to Child Welfare ■ Alan Day – Broader System-wide Applications – Conclusions Stewards of Change Institute
  19. 19. Research Key Findings ■ Strong interest for new tools and technologies to improve access to information, and improve analytics to support case management and administration. ■ Lack of technologies and tools limit access or use of existing/new information e.g. more accurate risk assessments, case history mining, solution modeling, and pattern identification (fraud, abuse, neglect). ■ Lack of evidence-based approaches impacts worker effectiveness e.g. safety assessments, staff selection, matching children with families. ■ High caseloads and employee turnover limits knowledge regarding policies and best practices. ■ Administrative burden - and lack of automation tools - limits workers ability to interact most effectively with families. ■ Few opportunities exist to leverage subject matter experts for training new workers. Stewards of Change Institute
  20. 20. Recommendations 1. Public and nonprofit child welfare agencies should pilot ‘level 1’ cognitive tools to help solve immediate problems e.g. access to policies and procedures. 2. Public agency’s should incorporate cognitive computing tools into future procurements. 3. University and philanthropy consortiums should build scalable models to accelerate testing to benefit the child welfare community. 4. Federal officials, foundation leaders, academia and vendors should convene to shape how they will share responsibility for sponsoring and funding pilots, research and analysis. Stewards of Change Institute
  21. 21. Recommendations, cont’d 5. Similarly, they should outline procurement guidelines to ensure that new investments encourage the use of these tools. 6. Foundations, universities, government and vendor representatives should form a consortium to underwrite research on how best to use cognitive systems in child welfare. 7. HHS leaders should convene all partners to explore how cognitive computing could help advance the Social Determinants of Health and Wellness, especially as value-based pricing from healthcare accelerates. Stewards of Change Institute
  22. 22. Stewards of Change Institute
  23. 23. A Public Health Approach: ■ Leadership and Accountability: strong leaders at every level ■ Decisions Grounded in Better Data and Research: real-time sharing ■ Multidisciplinary Support for Families: cross-system prevention and intervention Principal Findings Include: ■ Four to eight children a day, every day, die of abuse or neglect ■ Some are seen not by child welfare, but healthcare, schools, courts, etc. ■ Access to real-time information about families is vital but not available ■ A lot is known, but there are few evidence-based or promising solutions Recommendations Include: ■ States should review the past five years of abuse/neglect data to identify circumstances that led to fatalities and to shape preventive policies and services ■ All relevant programs (Medicaid, etc.) should focus on reducing these fatalities ■ The administration should lead the drive for real-time sharing of information Stewards of Change Institute
  24. 24. What is the Wider Scope and Role of Cognitive for Social Determinants of Health? ■ Cognitive Analytics – Productive Patterns in Complex Information – Inform Key Child Welfare Decision Guidance – Identify Productive Coordinated Care Patterns Across Other Domains ■ CCWIS for Child Welfare, A-87, Medicaid Fund Matching & SDOH – All Push Data Sharing and Integrated Care – SDOH Seeks Lower Healthcare Costs by Better Social Services Engagement – All Need Effective Models For Using Shared Data to Work Together. ■ Needs Very Large Research/Analysis Investment – Payback Societal – Not Often Agency Internal – Investment From Societal Level Players ■ Government, Foundations, Investors (how to share benefits?) Stewards of Change Institute
  25. 25. Conclusions ■ The Child Welfare Field is maturing slowly, but it is in desperate need for better tools to leverage the data in hand to make more evidence based decisions. ■ Technologies and tools are able to handle the complexity and volume of information – both unstructured and structured ■ CCWIS enables bi-directional information flows, and will be a catalyst for next generation systems to support children and families ■ We owe it to our children and families to act local but think globally – and use the best tools available. Stewards of Change Institute
  26. 26. Case Study: Battling the Opioid/Heroin Epidemic with Better Information- Sharing and Interoperability Case Study Moderators: o Christopher Jones, Director, Division of Science Policy, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services (HHS) o Richard Gold, Senior Consultant, SOC Institute #SOCI16
  27. 27. A Brief Introduction to the Opioid Epidemic Christopher M. Jones, PharmD, MPH CDR, US Public Health Service Director, Division of Science Policy Office of the Assistant Secretary for Planning and Evaluation
  28. 28. Overview • Epidemiology crash course • Policy and information sharing
  29. 29. Source: CDC/NCHS, National Vital Statistics System, Mortality File. 0 5 10 15 20 25 1980 1985 1990 1995 2000 2005 2010 2014 Deathsper100,000population MV Traffic Drug Poisoning Age-adjusted death rates for Motor Vehicle Traffic and Drug Poisoning, United States,1980-2014
  30. 30. 2002 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  31. 31. 2003 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  32. 32. 2004 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  33. 33. 2005 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  34. 34. 2006 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  35. 35. 2007 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  36. 36. 2008 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  37. 37. 2009 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  38. 38. 2010 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  39. 39. 2011 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  40. 40. 2012 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  41. 41. 2013 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS
  42. 42. 2002 2013 Source: CDC, NVSS, Slide courtesy of M. Warner, CDC/NCHS 2013 2002
  43. 43. Rx opioids mostly commonly abused prescription drug, US, 2014 Source: SAMHSA National Survey on Drug Use and Health, 2014 0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 5,000 Rx Opioids Tranquilizers Stimulants Sedatives Numberofpeoplereportingbehavior(inthousands) Initiation Dependence or Abuse Past Month Nonmedical Use
  44. 44. Past year opioid use disorders, US, 2003-2014 53 0 500,000 1,000,000 1,500,000 2,000,000 2,500,000 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 NumberofIndividuals Any Opioid Use Disorder Prescription Opioid Use Disorder Heroin Use Disorder Source: SAMHSA, NSDUH 2003-2014 PUF
  45. 45. Opioid-related overdose deaths, US, 1999-2014 0 1 2 3 4 5 6 7 8 9 10 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 AgeAdjusted-Rateper100,000population All Opioids Heroin Natural/Semi-Sythetic Opioids Methadone Synthetic Opioids
  46. 46. Increases in Rx opioid prescribing coincide with increases in Rx opioid overdose deaths 0 1 2 3 4 5 6 7 8 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Rate Source: CDC/NVSS and DEA ARCOS. KG of morphine milligram equivalent per 10,000 population Opioid overdose deaths per 100,000 population
  47. 47. Primary care physician’s views on Rx opioids 0 10 20 30 40 50 60 No problem at all Small problem Moderate problem Big problem Percent Magnitude of Rx abuse in community 0 10 20 30 40 50 60 Strongly disagree Somewhat disagree Somewhat agree Strongly agree Percent Opioids overused for pain 0 10 20 30 40 50 60 Not at all Slightly Moderately Very Percent Confidence in clinical skills related to opioid prescribing 0 10 20 30 40 50 60 Not at all Slightly Moderately Very Percent Comfort in prescribing opioids for chronic noncancer pain Source: Hwang et al. Prescription drug abuse: a national survey of primary care physicians. JAMA 2015
  48. 48. Increase in opioid prescribing dose for same conditions over time Source: Wunsch et al. JAMA 2016
  49. 49. Changing demographics of heroin use Source: Jones CM et al. MMWR 2016; Cicero et al JAMA Psychiatry 2014.
  50. 50. Multiple facets of the opioid epidemic
  51. 51.  Demographics  Men  35-54 year olds (deaths)  18-35 (abuse)  Whites  American Indians/Alaska Natives  Socioeconomics and Geography  Medicaid, uninsured  Rural  Clinical Characteristics  Chronic pain  Substance abuse  Mental health  Nonmedical use  Multiple prescriptions  Multiple prescribers  High daily dosage  Combination of opioids and benzodiazepines Risk factors for Rx opioid abuse and overdose
  52. 52. Use data to identify patients in need of treatment and improve continuity of information across information systems • PDMPs – Key piece of information in the clinical work flow – Starting point for a conversation with patients • EHRs – Like PDMPs, could provide full visibility on prior drug and treatment exposure, clinical conditions, risk factors – Clinical decision support can facilitate screening, assessment, intervention, and monitoring – Incorporate guidelines on appropriate prescribing for both acute and chronic pain conditions • Insurer/PBM data/Claims data – Examine utilization patterns to identify patients at risk or abusing substances – Academic detailing, alerts to providers, alters to patients, connection with employee assistance programs, etc. • Connection with other information systems such as human and social services, inpatient systems, etc., is needed
  53. 53. HHS Opioid Initiative • Launched by Secretary Burwell in March 2015 • Three focus areas – Improve opioid prescribing – Increase use of naloxone to reverse opioid overdose – Expand use of Medication- Assisted Treatment (MAT) for opioid use disorders
  55. 55. Interoperability in Action: Advancing Cross- System Information-Sharing at Scale Moderator: o Wade Horn, Managing Director, Deloitte Presenters: o Nick Lyon, Director, Michigan Department of Human Services o Sean Pearson, Deputy Cabinet Secretary, New Mexico Human Services Department
  56. 56. Michigan Department of Health & Human Services P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e . I n t e g r a t e d S e r v i c e D e l i v e r y
  57. 57. Where We Stand: Today’s Complex System P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .
  58. 58. The Challenge Before Us: Integrating Programs We’ve tried to solve problems by creating new programs and adding layers of government. Each program focuses on a specific piece of someone’s life without looking at the whole person and understanding what’s holding them back... government keeps getting bigger, the root of someone’s problem isn’t solved, and people are maintained in a status quo. “ “ P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .
  59. 59. The Merger: A Starting Point for Transformation • Separately, the Departments managed hundreds of unique programs that customers interacted with in many ways • Through the merger, we’re looking at every program we offer to see how we can achieve more person-centric flexibility • The combined MDHHS is charged with reforming how we interface with our customers through technology and making the service delivery system more focused on customers’ needs + = P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .
  60. 60. MDHHS Programs 21st CenturyCommunity LearningCenters Dental Services: SEAL! Michigan Program Immunization Native American Affairs Specialized Action Center 24/7 After Hours On-Call Program Epidemiology Dental Workforce Development Infant Death Prevention,Autopsy And Bereavement Support Newborn ScreeningProgram State Disability Assistance Access Services Developmental Disabilities Council Infant Mortality Reduction NurseFamily Partnership State Disability AssistanceProgram SubstanceAbuse Services Additional Community-Based Programs Diabetes Prevention And Control Program In-Home Help Program (Medicaid) Nursing Facility Transition Services State Emergency Relief Program Adoption Services Program Disability Determination Services In-Home Services Nursing Home Pre-Admission Screening And Resident Review/OminbusReconciliation Act (OBRA) State Psychiatric Hospitals And CentersFor Persons With Developmental Disabilities Adoption Subsidy Donated Dental Program HIV/AIDS InsuranceAssistance Program Obesity Prevention In Early LearningAnd Development Programs Utilizing NAP SACC State Psychiatric In-Patient Services Adult Community Placement MI Health Link Michigan HIV/AIDS Drug Assistance Program Office Of InspectorGeneral State Supplemental Security Income Supplementation Program Adult Protective Services Early ChildhoodComprehensiveSystems Grant InternationalMedical GraduateProgram Oral Health Initiative STD Control And Prevention Aging & Disability ResourceCollaboration Early Hearing Detection And Intervention Program Jail Diversion Oral Health Program SubstanceAbuse Treatment: Designated Women'S Programs (Federal Block Grant Above And Beyond Medicaid/CMH Funds) Alzheimer's Disease SupportiveServices Program Early On Program Jail Diversion Mental Health Services (Non-CMH) PA 161: Public Dental Disease Prevention Program SubstanceUse And Addiction Services Arthritis Program Education and Training Voucher Juvenile Justice Detention/SupportServices Partnership. Accountability. Training. Hope. SuddenUnexplained Infant Death Autism Services Elder Abuse PreventionProgram Juvenile Programs Partnershipfor Health & Disability Supplemental Security Income Birth Defects Education and OutreachProgram Employment And Training Program For FAP Recipients Legal Services Pathways to Potential Taking Pride In Prevention Breast And Cervical Cancer Prevention And Treatment Program Employment And Training Program: Employment-Support Activities Local Health Services Perinatal and Infant Oral Health Teen PregnancyPrevention Initiave BreastfeedingInitiative Empowering Older Adults Local Maternal & Child Health Program Perinatal Care System The Emergency Food AssistanceProgram Cancer Prevention & Control Program Essential Local Public Health Services Local Maternal Child Block Grant Pharmacy Management TuberculosisControl Program Cardiovascular Disease Prevention And Control Family Center For Children And Youth With Special Health Care Needs Long Term Care And Services Pre/Inter-Conception Health Programming For Would-Be Mothers University Workforce Development Care Management Program Family IndependenceProgram Long Term Care Ombudsman Prenatal Smoking Cessation Program VARNISH! Michigan Program Carry-Over NWD No Wrong Door Michigan Family PlanningProgram Long Term Care Services (NursingHome) Prevention Direct Services: Child Care Expulsion Prevention Program Vaccines for Children Program Center For Forensic Psychiatry Family Preservation And Family Support: Families First Low-Income Home Energy AssistanceProgram Prevention Direct Services: Infant Mental Health Vital Records And Health Statistics Child & Adolescent Health Center Program Family Preservation And Family Support: Family Reunification Program Maternal & Child Health Medicaid Outreach Preventive Services Vocational Rehabilitation Child Welfare Licensing Family Preservation And Family Support: StrongFamilies/Safe Children Maternal & Child HIV/AIDS Program PREVNT grant Weatherizationassistance Child InjuryPrevention (Michigan Safe Kids Program) Family Support SubsidyProgram Maternal Infant Early Childhood Home Visitation Initiative Program for All-Inclusive Care for Elderly WIC Project FRESH Child Support Administration Federal Community Mental Health Services Block Grant Maternal Infant Health Program Project LAUNCH WISEWOMAN Program ChildhoodLead Poisoning Prevention Program Fetal Alcohol SpectrumDisorder (FASD) Program MaternityOutpatient Medical Services Promoting School Health Women, Infants, And Children (WIC) Special Supplemental Nutrition Program Children With Serious Emotional Disturbance Home & Community Based Services Waiver Food AssistanceProgram Medicaid Protection And Advocacy Services Youth-In-Transition & Education & Training VoucherProgram Children with Special Needs Fund Foster Care Guardianship AssistanceProgram Medicaid SubstanceAbuse Services Protect MiFamily Children’sFoster Care Foster Grandparent Program Medical/Psychiatric Evaluations Public Health and Early On Children’sProtective Services Gambling Disorder Services Medicare Buy-In/Savings Program Public Water Supply Children’sTrust Fund Gettingto the Heart of the Matter in Michigan Program Mental Health Services For Special Populations Purchase of Medical Services For ResidentsOf Hospitals And Centers Children'sSpecial Health Care Services Great Start Trauma-Informed System Mi Choice Race to the Top Early LearningChallenge Children'sWaiver Program (CWP) Habilitation SupportsWaiver Michigan AbstinenceProgram Rape Prevention and Education Program Chronic Disease And Injury Prevention Health Disparities and Minority Health Michigan Adolescent Pregnant & ParentingTeen Program Recoupment And Reconciliation Chronic Kidney Disease Prevention Health Disparities Reduction - Maternal Child Health (MCH) Michigan Asthma Program Refugee Assistance Program Colorectal Cancer Early Detection Program Healthy Homes/Home Lead Abatement And Other Environmental Services Michigan Community Service Commission Refugee Grant Community Mental Health Medicaid Services Healthy Kids Program Michigan Domestic And Sexual Violence Prevention And Treatment Board Retired and Senior VolunteerProgram Community Mental Health -Non-MedicaidServices Healthy Michigan Plan Michigan Essential Health Provider Program Runaway And Homeless Youth Services Community Mental Health Services Programs Hearing And Vision ScreeningAnd Services Michigan Fetal Infant Mortality Review Program Safe Delivery Community Residential and Support Services Perinatal HepatitisB PreventionUnit Michigan Health and Wellness 4x4 Initiative Safe Sleep Community Resource Program HIV/AIDS Prevention And Testing Program Michigan HIV Dental Program School Wellness Community Services HIV/AIDS Care Michigan Maternal Mortality Surveillance Program School-Based Services Community Services Block Grant HIV/Aids Support Services Michigan Million Hearts Initiative Senior Centers Community SubstanceUse Prevention,Treatment And Recovery Programs Home And Community-Based Waiver For Children With Serious Emotional Disturbances Michigan Medicare/Medicaid AssistanceProgram Senior Community Service and Employment Program Community Ventures Home Help Services Michigan Model For Health ComprehensiveSchool Health Education Senior Companion Program CoordinatedSchool Health Home Visiting Initiative Michigan Rehabilitative Services Senior NutritionProgram Crime Victim Assistance Program Homeless Assistance Programs Michigan Tobacco Control Program Senior Respite Care Crime Victim Rights Services Program Homes for the Aged Michigan Youth OpportunitiesInitiative Senior VolunteerServices Crime Victims Compensation Hospice MIChild Sexual Assault Forensic Exam (SAFE) Program Dental Programs For PersonsWith developmental Disabilities HousingAnd Support Services Migrant Affairs Sexually Transmitted Disease Dental Services: Healthy Kids Dental IDEA, Federal Special Education National Family Caregiver Support Program ShapingPositive Lifestyles And AttitudesThrough School Health FTE’s- 15,576.5 Gross- $24,841,836,800 GF - $4,374,548,300 Federal - $17,880,902,200 Other - $2,586,386,300
  61. 61. A Vision for Integrated Service Delivery P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e . Today: Program Focus Limited supports that focus on a finite segment Siloed service delivery that does not solve the root problem Program focus Tomorrow: Person Focus Providing well-rounded, localized and targeted support to maximize results Transactional and enrollment focused Government and communities collaborating to serve customers better Person focus Holistic, proactive, and preventative approach focused on outcomes Overloaded case workers Case workers focusing on people to improve outcomes Manual processes that add layers of duplication Highly automated, streamlined with self-service capabilities
  62. 62. Integrated Service Delivery Strategy MDHHS’ Integrated Service Delivery strategy includes five major components, each contributing to the overarching vision. • Integrated Service Delivery Portal – Goal: Bring a diverse set of supports, services and benefits together in a unified customer experience. • Person-Centric Services Modules – Goal: Develop shared technology modules that can be used across systems and processes. • Universal Caseload Management – Goal: Manage casework more efficiently based on function, helping local office staff members achieve a more balanced, manageable workload. • Contact Center Development – Goal: Employ a new customer engagement and contact approach tasked with reducing calls to caseworkers through automated systems, providing information and resolving case issues in real time. • Technology Infrastructure Modernization – Goal: Consolidate and improve a number of critical technology components that facilitate more responsive experiences for caseworkers and customers in addition to better connections between systems. P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .
  63. 63. Integrated Service Delivery Concepts Core Components • Customer Dashboard • Holistic Needs Assessment • Supports and Resources Engine • Success Plan • Holistic Intake and Application • Service Approach Segmentation • Coach/Partner Customer Management P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e . Core Concepts • Outcome Orientation • Single Point of Contact • Customer Empowerment • Improved Customer Experience • Cohesive Connections • Analytical Insights • Partner Collaboration • The integrated service delivery portal will bring a diverse set of services and benefits together in a unified customer experience • The portal will include services provided directly by MDHHS in addition to those offered by community organizations • The portal will be built on top of and across MDHHS’ large core systems to bring now disparate information and processes together in a streamlined platform • The portal will guide customers through a holistic process which assesses needs, connects the customer with supports that address those needs and develops a plan aimed at improving a customer’s overall stability
  64. 64. Blueprint For Health • Michigan received a State Innovation Model cooperative agreement from CMS to test delivery and payment system changes • Michigan’s State Innovation Model is a simultaneous effort on two fronts: – Implementing payment policies, innovative models, infrastructure improvements and information technology investments – Developing coordinated communication and stakeholder engagement processes that assesses these policies and investments to determine effectiveness and scale up what works • Michigan’s State Innovation Model (SIM) strategies include: – Patient Centered Medical Home – Accountable Systems of Care – Community Health Innovation Region – Health Information Exchange / Health Information Technology – Collaborative Learning Network – Stakeholder Engagement Committee Structure P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .
  65. 65. Data Share – Template & Automation Data Security – Classification & Business Glossary 360 Degree View of Citizen – Identify & Location Decision Support & Analytics Open Data & Transparency Departmental Data Management Translating ED 2013-1 into actionable objectives Enterprise Information Management Elements EIM - Program Overview – Background and Objectives Core Directive Attributes • Organizational Processes • Data Sharing • Business Glossary • Identity Master • Location Master • Analytics P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .
  66. 66. EIM Program Elements There are 6 key elements, or work-streams, that guide the EIM program. ORGANIZATIONAL PROCESSES • Key roles (Chief Data Steward) • Responsibilities • Org Model and Principles DATA SHARING • Secure environment to deliver a “share first” capability across the enterprise BUSINESS GLOSSARY • Creation and management of enterprise business vocabulary • Speaking the same language IDENTITY MASTER • Centralized service for the identification of individuals across state interactions LOCATION MASTER • Centralized service for location data that leverages addresses and geographical information ANALYTICS • Skills, processes, and tools to enable data-driven insights and decision making. P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .
  67. 67. Examples of Data Sharing Initiatives  Care Connect 360  Michigan Care Improvement Registry  Health Information Exchange  Pathway – MDHHS Success coaches in schools  Child Welfare case management with State Courts Administrative Office  Early Childhood Data Governance  Behavioral Health Consent Form P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e .
  68. 68. Where We Stand: Today’s Complex System P u t t i n g p e o p l e f i r s t , w i t h t h e g o a l o f h e l p i n g a l l M i c h i g a n d e r s l e a d h e a l t h i e r a n d m o r e p r o d u c t i v e l i v e s , n o m a t t e r t h e i r s t a g e i n l i f e . 77
  70. 70. NEW MEXICO 2.09 million population 860,000 on Medicaid 521,000 on SNAP Record Enrollment In Public Assistance Programs 79 today
  72. 72. 81
  74. 74. RINSE AND REPEAT Public assistance programs aren’t designed to ensure programs and services address beneficiaries’ barriers to self-sufficiency. 83
  75. 75. by 2020 on a public assistance program in New Mexico Over 50% 84 tomorrow
  76. 76. HHS 2020 The Roadmap to the Future of Health and Human Services in New Mexico 85
  81. 81. 90