Care Transformation Collaborative of Rhode Island News & Updates | March 2022

Earlier this month, pediatric practices across RI applied for funding made available by Governor McKee’s Rhode Island Rebounds proposal, passed by the General Assembly, which included $7.5 million in pediatric relief funding.

“The appropriation of these funds will allow pediatricians to strengthen their practices, improve immunization rates, and overcome COVID-19 related barriers to access,” said EOHHS Secretary Womazetta Jones. “The social and economic repercussions of the COVID-19 pandemic, and their corresponding effects on the physical and mental health of our state’s children, cannot be overstated. We need to ensure that our pediatricians are best positioned to support the needs of all children and families.”

PCMH Kids co-director Dr. Elizabeth B. Lange weighs in on how the state’s Pediatric Relief Initiative will help RI pediatric practices and their continued operation through and post-pandemic.

What unique financial challenges have pediatric practices experienced through this pandemic, and how may this impact their capacity? 
Like all medical offices focused on infectious disease safety in the pandemic, pediatric offices implemented reduced patient scheduling, closed waiting rooms, multiple new cleaning protocols, and staff wore personal protection equipment, all of which added tremendous cost to daily business. Since there is no COVID vaccine yet approved for children under 5 years old, pediatric practices must continue prudent infection control measures to keep our patients healthy. Also, the COVID-related increased unemployment rates meant more children became insured by Medicaid, the state’s lowest paying insurer.

How will these Pediatric Relief Funds help pediatric practices in Rhode Island? 
Pediatric practices have always operated on small margins, so the increased costs and diminished revenues experienced during the pandemic have stressed the pediatric healthcare system. The Pediatric Relief Funds provide much needed financial support to cover the gap. For some practices, these Rescue funds literally mean the pediatric office can keep their doors open.

What measures can help demonstrate our pediatric practices are being effectively supported? 
Thanks to support from the first pediatric relief funds in 2020, pediatric vaccination rates returned to pre-pandemic levels. Since these levels declined again in 2021, this program will measure well-child visits and, tangentially, vaccine rates to show improved access to pediatric care. For long-term sustainability, the insurance funding formulas that pay for children’s healthcare needs revamping statewide, but for now, pediatricians and family physicians are quite thankful for this Relief funding.

Pediatric primary care is the clinical setting where children receive critical preventive services which have been deferred by many families because of the COVID-19 public health emergency. Thanks to ARPA funding and support from EOHHS, 44 practices, providing primary care to RI Medicaid-covered children, successfully applied to the Medicaid Pediatric Healthcare Recovery Program and will receive payments based on the number of RI Medicaid-covered children served by the practice and contingent on demonstrating pay-for-reporting and performance improvement on child and adolescent well-child visits and for participation in technical assistance related to developmental, psychosocial, and behavioral health screening. An important component of well-child visits is immunizations and lead screening. Practice facilitators are available to guide practices on how to use KIDSNET data and well-child visit data to improve outcomes and well-child care for children and families. This support is critical so that primary care providers can ensure continued access to preventive care and support the staffing and infrastructure needed to rebound from COVID-19-related delays in care.

Meetings have been set up in April and May to address the technical assistance requirements of the Medicaid Pediatric Healthcare Recovery Program related to developmental, psychosocial, and behavioral health screening. Intended audience for these meetings, open to all of the CTC-RI community, include providers, nurse care managers, care coordinators, behavioral health clinicians, and other staff are welcome. Read more here.

CTC-RI / PCMH Kids is pleased to offer an opportunity to apply for funding that will assist practices with achieving NCQA Behavioral Health Distinction. This funding will be available to 5-8 primary care practices (child, family, and/or adult) that provide integrated behavioral health services within primary care. This 12-month learning collaborative will run from May 1, 2022 to April 30, 2023. 

Completed practice applications are due April 15, 2022 by midnight. For details on how to apply, along with requirements and timeline information, please refer to the full call for applications.

CTC-RI offered a Q&A session to interested parties on the morning of March 23. You can view the recording of the Q&A session here. Any additional questions can be directed to ssummers@ctc-ri.org.

CTC-RI is excited to announce that we will be supporting 11 RI behavioral health professionals to participate this spring in the UMass Chan Medical School Certificate Course in Primary Care Behavioral Health. This opportunity, made possible by funding from UnitedHealthcare, fits into a larger effort by CTC-RI to increase the number of integrated behavioral health (IBH) providers trained within the state.

Course participants will complete 12 weeks of asynchronous training developed by the UMass Center for Integrated Primary Care. After completion of the online courses, participants will have access to 1 hour of practice facilitation to support implementation of their learning in RI-based primary care settings. The course is designed to support behavioral health professionals skilled at practicing in specialty mental health as they transition into working in primary care. Some of the 11 participants in this spring’s group already practice in an IBH setting while others are looking to make the switch to primary care from specialty mental health. Read more.
Meet Michelle Mooney, MPA
As a Program Coordinator, Michelle supports CTC-RI with the care delivery design learning series, workforce development initiatives, and other meetings. She has a Masters in Public Administration with a minor in Non-Profit Management from Johnson & Wales University and was most recently a Lead Case Management Coordinator at ResCare Workforce Services.

“In my most recent role, I worked hand-in-hand with families who had been made vulnerable, and so access to health care as well as the cost was always a major concern of theirs,” said Michelle. “As I looked for the next steps in my career, I was excited about working at CTC-RI because it meant being able to take that experience, assist in the transformation work to lower those barriers to accessing healthcare, and create a more equitable environment for those who needed it most.” Read more.
Meet Kim Nguyen-Leite, MHA, CPHQ, PCMH CCE
As a CTC-RI Program Coordinator, Kim supports with a focus on pediatric work and practice facilitation projects. She is a healthcare quality professional with experience working in federally-qualified health centers. She is a certified professional in healthcare quality and a PCMH content expert. She received a BS in Biology from Bay Path College and a Masters in Healthcare Administration from Suffolk University.

“Having relocated back to the state after spending the past five years in CA, I was searching for an opportunity with an organization that allowed me to continue working towards a more equitable future that improves the health and wellness of the community in which I live. When meeting with CTC-RI staff and learning more about the organization, I was truly inspired by the passion that everyone brought to their work,” said Kim. “Not only was the work innovative and impactful, but the people doing the work truly cared. I feel lucky to have found CTC-RI during my search and I could not think of a better place to have ended up.” Read more.
Watch the Recording and Claim CME!

The February Clinical Strategy Committee (CSC) meeting featured presentations by 2 guests: Judith Steinberg, MD, MPH, Chief Medical Officer, Office of Infectious Disease and HIV/AIDS Policy, Office of the Assistant Secretary for Health on the Current Status of Primary Care Plan for Health and Human Services (HHS); and Craig Jones, MD, Partner, Capitol Health Associates, with reflections from Learning Action Network (LAN) work on alternative payments for primary care, Advancing Health Equity Through APMs: Guidance for Equity-Centered Design and Implementation. The two panelists reinforced the importance that HHS is placing on primary care investment and alternative payments to support and strengthen primary care. The HHS plan was stimulated as a response to the challenges posed in the May 2021 report on “Implementing High-Quality Primary Care” which had been discussed extensively at the July 2021 CSC meeting. The HHS plan is in formation and is expected to be presented to the Secretary in June 2022. The need for multi-payer alignment, including between Medicare and Medicaid, was one of the areas highlighted.
Watch the Recording and Claim CME!

In the groundbreaking March session, the Breakfast of Champions brought together nearly 80 health care leaders to share and learn about updated asthma guidelines, discuss practical considerations, and learn about specific projects to improve asthma care in children and families focused on a practice-based pharmacy led intervention, school-based training efforts and a collaborative effort to integrate clinical support, as well as impact upstream causes in a targeted zip code to reduce ED utilization in pediatric patients. This exciting event was moderated by Patricia Flanagan, MD, Hasbro Children’s Hospital, & Brown University pediatrics professor. Read more here.

As CTC-RI’s 4th round of the GLearn NCM/CC Core Curriculum program closes, the learners' post-program evaluations highlighted the most valuable program parts. Of the 40 respondents, 90% said that they improved their care/case manager skills, and 70% said that they gained greater disease-specific knowledge. The majority of respondents said that the program helped them apply their knowledge in their day-to-day role, better understand new concepts and reinforce old ones, as well as improved their effectiveness as a case/care manager.

When asked about their ongoing learning needs, the majority (60%) said that they would like training on how to better manage patients with BH/MH challenges, followed by overcoming barriers to care (55%). Read more.

Beginning this spring, the Rhode to Equity project has a new component: each of the 6 participating teams will be engaging up to 3 community health workers (CHWs) to support the work that they are doing to address health disparities rooted in systemic inequities. CTC-RI is also excited to bring Latino Health Access (LHA) into the project. LHA will work alongside Dr. Somava Saha and the WE Team to support CHW engagement, not only as an important component of the work, but also as change agents in addressing upstream causes of inequity. Founded in Santa Ana, CA, LHA has been implementing the Promotora model in their community for nearly 2 decades. Read more.
Rhode Island COVID Updates

Brown University's Dr. Ashish Jha Tapped to Lead President Biden's COVID Response
Last week, Dr. Ashish K. Jha, Dean of Brown University’s School of Public Health and a visible public health advocate during the pandemic, was tapped by President Joe Biden to lead his administration’s COVID response.

COVID Data
COVID cases have declined significantly since the surge in January 2022. As of March 22, Rhode Island saw 113 new cases per 100,000 persons, and a 2.6% positive rate.

Vaccines
As of March 23, 1,017,593 people (96.3%) are partially vaccinated in Rhode Island, 858,946 (81.3%) have completed their primary vaccine series, and 415,937 (39.4%) have received a booster dose.
Practice Resources
Project ECHO® - on Cognitive Impairment: Innovative Strategies and Perspectives
The ECHO model uses a virtual case-based approach to learning, amplifying the capacity of providers to deliver best practice care to their patients. Participants can share their patient cases for review and feedback from other participating sites and a multidisciplinary team of experts. Learn about upcoming lectures here.

PediPRN Intensive Program Kick-off on Saturday, March 26
This program provides in-depth training for pediatric primary care practitioners in child/adolescent mental health, from safety assessment and crisis management to gender identity and collaboration with schools. The program starts with a morning half-day kick-off on March 26 which serves as an introductory session for participants to learn more about the PIP curriculum and mental health services for youth in RI. The remaining 9 sessions are approximately monthly on Wednesdays. Learn more. 

CMS Innovation Center Webinar: ACO REACH Financial Methodology Webinar
This March 28 webinar from 4-5pm will focus on the new financial policies featured in the ACO REACH webinar. For more information on the financial methodology for the ACO REACH Model that will be transitioned from the Global and Professional Direct Contracting (GPDC) Model, please refer to prior released financial webinars available on the GPDC Model Website.

Annual Thewlis Lecture on Gerontology and Geriatrics: Ageism and You: Why It Matters
Attend this virtual presentation on April 6 from 7-8pm. This lecture will summarize scientific evidence and share stories that illustrate how many health problems as we grow older are influenced by ageist beliefs. Dr. Becca Levy will share techniques for improving one’s own aging process and confronting structural ageism to create an age-just society.

RI Geriatric Education Series: Neurologic Music Therapy: Community and Clinical Care for the Aging
This webinar on April 21 from 12-1pm will allow participants to understand the role of music in aging, specifically pertaining to memory, recognize the difference between neurologic music therapy and music making, and to when each would be applicable in treatment, and more.

Bradley Hospital Resource: Learning About Grief and Loss
COVID-19 developments are happening quickly and Bradley Hospital's physicians and clinicians are working hand-in-hand to provide parents, caregivers and educators resources to help families and kids navigate these uncertain times. Check out their resources here, from a Grief and Loss Coloring Book to coping tips for parents and caregivers.
Job Opportunities
RIHCA: Outreach and Enrollment Program Manager/Trainer
The Rhode Island Health Center Association (RIHCA), under a contract with HealthSource RI, manages the Outreach and Enrollment Support Program. Under this program RIHCA manages a state-wide network of in-person assister and navigator agencies to assist Rhode Islanders with enrollment in health care coverage. Learn more.
Upcoming CTC-RI Committee Meetings and Workgroups
  • March 25, 07:30-08:45AM – Board of Directors
  • April 07, 07:30-08:30AM – Quarterly PCMH-Kids Stakeholder Meeting: Brief Intervention Training for Pediatric Staff
  • April 14, 07:30-09:00AM – Quarterly Pediatric IBH Meeting
  • April 15, 07:30-09:00AM – Clinical Strategy Committee
  • April 19, 08:00-09:30AM – Care Manager/Coordinator Best Practice Sharing: Impact of COVID on Children's Social-Emotional Development
  • April 21, 08:00-09:30AM – Community Health Team Expansion Best Practice Sharing
  • April 22, 07:30-08:45AM – Board of Directors
Upcoming Learning Collaboratives and Professional Development
  • March 24, 07:30-09:00AM – Pharmacy Quarterly Learning Collaborative: Reducing Preventable Hospitalizations and ED Usage
  • March 24, 10:30-12:00PM – Rhode to Equity Momentum Session
  • March 29, 07:30-09:00AM – SBIRT & Brief Negotiated Interview (BNI) Training- RI MomsPRN
  • April 06, 07:30-09:00AM – Healthcare Transfer of Care Quality Improvement Quarterly Learning Collaborative
  • April 20, 03:00-04:00PM – Pharmacy QI Initiative Planning Committee- Reducing Preventable Hospitalizations & ED Visits
  • April 26, 07:30-09:00AM – Final RI MomsPRN Learning Collaborative
  • April 27, 07:30-09:00AM – Telehealth Learning Collaborative Cohort 2 Final Quarterly Meeting
  • April 28, 08:00-09:00AM – CTC-RI Tele-IBH/NCQA BH Distinction Learning Collaborative
Care Transformation Collaborative of RI | ctc-ri@ctc-ri.org | ctc-ri.org