Care Transformation Collaborative of Rhode Island News & Updates | October 2020
CTC-RI / PCMH Kids Launch New Primary Care Telehealth Learning Collaborative
Designed for pediatric, adult, and family medicine practices, including Federally Qualified Health Centers, CTC-RI is accepting applications for a new 12-month pilot learning collaborative to test the use of telehealth technology to improve care for patients with a selected chronic condition. Practices will be provided with infrastructure and incentive funding payments ($22,000.00 per practice site), practice facilitation technical support, Northeast Telehealth Resource Center content expert support, and quarterly “best practice sharing” peer learning services. This pilot program is financed by UnitedHealthcare and authorized CARES Act funding.
Applications for Federal Phase 3 Provider Relief Funding Open Until Nov. 6
On Oct. 1, the U.S. Dept. of Health and Human Services announced $20 billion in new funding for providers on the frontlines of the COVID-19 pandemic. Under this Phase 3 General Distribution allocation, providers that have already received Provider Relief Fund payments are invited to apply for additional funding that considers financial losses and changes in operating expenses caused by the COVID-19. Previously ineligible providers, such as those who began practicing in 2020 are also invited to apply, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic are also eligible for relief payments. Providers must apply for funding by Nov. 6. Visit hhs.gov/providerrelief for details and updates on the Provider Relief Program.
Funding Opportunity for Practices Providing Prenatal and Postpartum Clinical Care
The RI Dept. of Health recently announced a funding opportunity/call for applications for practices providing prenatal and postpartum clinical care, helping practices optimize behavioral health screening/treatment (depression, anxiety, and substance use) of perinatal patients.

To help address the behavioral health needs of perinatal patients during COVID-19, the RI Dept. of Health and CTC-RI are pleased to offer practices providing prenatal and postpartum clinical care the opportunity to join the RI MomsPRN (RI Maternal Psychiatry Resource Network) perinatal behavioral health quality improvement initiative. The goal of the initiative is to improve screening rates of pregnant and postpartum patients for depression, anxiety, and substance use using evidence-based screening tools. Up to 6 prenatal care practices will be selected with project activities scheduled to begin in Jan. 2021 and continue for 15 months. Applications are due by Dec. 4.
CTC-RI Receives RI Pharmacy Association's 2020 Charles Hachadorian Award
On October 8, the RI Pharmacy Association presented CTC-RI with the 2020 Charles Hachadorian award. This award is presented annually to a non-pharmacist who has recognized the efforts that the profession of pharmacy has made to healthcare and has actively supported those efforts. While traditionally the RI Pharmacy Association selects an individual, this year, the decision was made to recognize CTC-RI because of the efforts and advocacy for pharmacy with implementation of the statewide pharmacy quality improvement project. This year the CTC-RI Pharmacy Initiative for Safe, Effective, and Efficient prescribing was funded by UnitedHealthcare.
CTC-RI Advances State's Effort to Provide COVID-19 Primary Care Provider-Focused Assistance
COVID-19 prevention measures have constrained health care provider capacity and resulted in significant business interruptions for health care providers, as well as created barriers for members of the public to access health care (e.g., transportation, perceptions of safety, the need to quarantine). These barriers are anticipated to persist as RI continues to respond and adapt to the pandemic.

As a leading voice in the primary care and healthcare community, CTC-RI has provided input to the Governor's COVID-19 Taskforce and the state as it works to identify and implement a number of projects to provide technical assistance concerning telemedicine, financial support and infrastructure support to health care providers, with a focus on primary care providers and community health teams, to address the health care needs of Rhode Islanders vulnerable for COVID-19 and to ensure that providers can continue to meet critical health care needs during the public health emergency. Following CTC-RI's recommendations to the Governor's COVID-19 Taskforce, the state has identified projects targeting primary care provider-focused assistance.

The identified projects include:
  1. Community Health Teams
  2. Well-Child Care
  3. Telemedicine Access and Payment
  4. Clinical Care Delivery Redesign Under Prospective Payment
Save the Date! December 11 Breakfast of Champions
Please save the date for the CTC-RI Quarterly Breakfast of Champions. All Clinical Practice Champions and practice site clinical and administrative leaders are expected to attend.

Friday, December 11, 7:30-9:00am

Planned agenda and topics to include:
  • Current COVID Pandemic Challenges for Practices
  • Review of Pediatric Immunization and Medicaid Access Efforts
  • Updates on “Care Delivery Design for Pediatric Practices to Maximize Success in Comprehensive Primary Care Capitation” (Adult Design on December 18 CTC-RI Clinical Strategy Committee agenda.)
CTC-RI Provides Input on Medicaid Accountable Entity Roadmap and Sustainability Plan
CTC-RI recently submitted public comment to the Executive Office of Health and Human Services to share input on the Accountable Entity Roadmap and Sustainability Plan.

Improving Reporting, Transformation, and Access to Wellness
CTC-RI / PCMH Kids has been working to support practices that provide care for children and adolescents so that children can obtain well-child care (including immunizations/screenings) within the context of patient-centered medical home. Especially important this year is for children and adolescents to obtain the influenza vaccine. At this month's Practice Reporting and Best Practice Sharing meeting, Janet Limoges, KIDSNET Provider Relations Representative, provided information on how practices can identify children due for vaccine #1 and how to identify children in need of vaccine #2. Reports include information when immunizations have been given in non-primary care settings. Cameron Condry, Network Engagement Manager, BCBSRI provided an update on the Nurse Care Manager Care Management program including reporting options. Practice performance on immunization, lead screening and access to well-child care was shared and well as applications open for Learning Collaboratives (RI MomsPRN and Telehealth Using Technology to Improve Care for Patients with Chronic Conditions).

Practices continue to demonstrate steady improvement in providing families with access to well-child care as summarized below.
CTC-RI Seeking Participation in National Primary Care Survey
CTC-RI is still encouraging RI provider participation in the Larry A. Green Center / Primary Care Collaborative 3-minute clinician surveys to better understand the response and capacity of the US primary care practices through COVID-19, with the next survey release on Nov. 13, with plans to continue these surveys through 2020 or beyond.

Key messages found in survey results from RI clinicians fielded Oct. 16-19 include:

  • Over half of RI providers that responded to the survey reported that they were experiencing high to severe strain on their practice (56%)
  • Stressors: In the past 4 weeks, RI providers responded to the survey that:
  • Mental health of patients has decreased during the pandemic (88%)
  • There’s a rise of COVID-19 illness in the community (56%)
  • Patients are getting tested for COVID-19 but results take more than 2 days to receive (56%)
  • Telehealth: RI providers responded to the survey that:
  • Telehealth is being used to screen sick patients to prevent unnecessary exposure within the practice (75%)
  • They started to increase use of telehealth as part of plan for flu season (63%)
  • Telehealth has been important for their capacity to see patients (63%)
Update: Nurse Care Manager/Care Coordinator Best Practice Sharing Meeting
Over 50 NCM/CC joined the October 20 Nurse Care Manger/Care Coordinator Best Practice Sharing Meeting and heard from Jenn Kaufman, M.Ed., Chief, Family Health System, EOHHS on how to make referrals to Early Intervention during COVID-19 and how those services are being provided. Kayland Arrington, MPH, RIDOH Epidemiologist COVID-19 Operations discussed “Voices from the Field: Patient Needs and Services Identified through Call Center and Contract Tracing." Liz Cantor, Ph.D. led a discussion on working with parents/children/families in stressful times and mental health resources were shared.
Update: PCMH Kids Stakeholder Meeting
On October 4, CTC-RI / PCMH Kids hosted another virtual PCMH Kids Stakeholder meeting. Drs. Flanagan and Lange provided an update on the Pediatric Relief Fund and Pediatric Advisory Board activities. As of September 15, Kindergarten Readiness and Kindergarteners with 2 MMR Immunization status are surpassing last year’s September immunization rates, and immunization and lead screening rates among 7th graders have significantly improved since July 15, 2020. The group applauded PCMH Kids Cohort 3 for achieving their immunization target. Drs. Flanagan and Lange provided an update on how school reopening plans were progressing and opened up the discussion for best practice sharing. The meeting wrapped up with a review of upcoming programs that pediatric practices might be interested in.
In the News
Center for Health Care Strategies, Inc.
The Center for Health Care Strategies, Inc. recently highlighted the work that RI is doing to improve pediatric immunization rates through its cross-agency strategy. 

“States may consider looking to RI, which implemented a number of strategies to boost immunization rates and increase pediatric primary care engagement.”

RI’s efforts to boost immunization rates include: (1) Governor Gina Raimondo’s establishment of a COVID-19 Pediatric Advisory Council to encourage stakeholder engagement and create shared priorities across the state; (2) a requirement that the state’s MCOs submit plans for improving immunization rates and biweekly data reports; and (3) an immunization learning collaborative, offered by the Care Transformation Collaborative of RI and financed by the Rhode Island Foundation's COVID-19 Response Fund and Blue Cross and Blue Shield of Rhode Island.
Update: Clinical Strategy Committee
Ongoing Clinical Strategy Committee (CSC) discussions occurred on October 16 around pandemic-related challenges and progress continued with creating a consensus document outlining core aspects of care delivery design to maximize success under comprehensive primary care capitation under Total Cost of Care risk. Improvement is also being made on a practice/SOC self-assessment that we hope will be helpful as practices and SOC continue to prioritize their practice QI work. CTC-RI does envision this as a longer-term effort as well. Additional CSC priorities to reduce low-value care (and increase high-value care) as well as PCP/specialist collaboration are areas CTC-RI hopes to expand upon in 2021.
CTC-RI Launches New Telehealth Webinar Series Beginning Nov. 19
CTC-RI / PCMH Kids is launching a telehealth webinar series, "Advancing Team-Based Telehealth in RI," made possible by authorized CARES Act and UnitedHealthcare funding. The first webinar, “RI Telehealth Sustainability Strategies – Coding and Billing,” will take place Nov. 19 at 12p. Register now.

In the Nov. 19 webinar, learn strategies to optimize coding and billing for telehealth services in RI. What are the necessary steps and best practices that will help you get paid for your telehealth services in RI? Learn from experts as they discuss what is needed to get full reimbursement from Medicare, Medicaid and Commercial payers. Representatives from the payers, including UnitedHealthcare, Blue Cross & Blue Shield of Rhode Island, Neighborhood Health Plan, and Tufts Health Plan, have been invited to help answer your questions along with our expert panelists. 
Postponed: CTC-RI 2020 Annual Conference
The CTC-RI 2020 Annual Conference has been officially postponed and rescheduled to take place on November 4, 2021. The 2021 keynote speaker will be Ann C. Greiner, President and CEO, Primary Care Collaborative. Stay tuned for more updates!
Practice Resources
Today at 3pm: Collaboratives in Action: Responding to COVID-19
Nelly Burdette, Psy.D., Senior IBH Program Leader, and Liz Cantor, PhD, Pediatric IBH Practice Facilitator, will present “Integrated Behavioral Health 2.0 - How Primary Care Practices in Rhode Island Deliver Services During a Pandemic” to the Network for Regional Healthcare Improvement Oct. 29 at 3pm. On behalf of CTC-RI, they will review how adult and pediatric primary care practices have created the new normal for integrated behavioral health (IBH); discuss how data comparing pre-COVID to post-COVID for IBH and Social Determinants of Health has impacted decision-making; and analyze how staffing and burnout has impacted Rhode Island primary care practices with IBH.

CTC-RI List of Resources for Community, Fitness, Counseling Support, Stress Management, Volunteering, and More
Please reference CTC-RI's growing list of resources throughout the community.

Free Learning Collaborative for Health Centers on Comprehensive Care
This 4-month participatory learning experience offered by the National Health Center Training and Technical Assistance Partners provides Federally Qualified Health Centers beginning or restarting their move to high performance team-based comprehensive primary care with knowledge about the basic principles and best practices of care and the strategies to plan for implementation. Applications are open until Nov. 16.

Bradley Learning Exchange Offers Virtual Professional Development Trainings
Over the past months in response to the pandemic, Bradley Learning Exchange clinicians have created a series of staff development trainings via Zoom, available to provide to primary care practice staff, with a wide-range of topics. Email elizabeth.defreitas@lifespan.org for details and rates.

Weekly Brown Lecture Series: Decoding Disparities: Community Conversations to Decode Health Inequities
The goal of the lecture series is to describe problems of health disparities and the data supporting them and to open a conversation regarding solutions. Lectures will be held on Mondays from 4-5pm through Zoom.

November Webinar Series by Alzheimer's Association and RI Geriatric Education Center
The organizations are offering November webinars including Understanding Alzheimer's and Dementia (Nov. 5, 12-1pm), Understanding and Responding to Dementia Related Behavior (Nov. 12, 12-1pm), and Effective Communication Strategies (Nov. 19, 12-1pm)

Psychotherapy for Children with Developmental Disabilities and Their Families
This Bradley Conference presentation is being held virtually Nov. 10 from 8am-11:15am and will focus on addressing the therapeutic needs of children with developmental disabilities and their families. 

Rhode Island Foundation Offers "Paths to Recovery" Fall Panel Series
“Paths to Recovery: Strategies for Getting Back to Work and to a Better Future,” includes free events on Nov. 10 and Dec. 9 open to the public. Registration is required. 

Embracing a Continuum of Care: Trauma and Grief in the Age of a Pandemic
Join Friends Way for its annual professional development conference via Zoom on Nov. 20 from 9am-12pm, focused on adapting services based on what is known about risk factors, post-disaster pathways for mental health, and best practices for coping.

PCC 2020 Virtual Annual Conference
The Primary Care 2020 Virtual Annual Conference is being held Nov. 30-Dec. 1. Join hundreds of other primary care leaders online from wherever you are for this highly interactive virtual conference! It's an opportunity to hear from experts, including Dr. Kimberly Townsend from Pediatric Associates here in Rhode Island, and thought leaders who are drawn from a range of topics within primary care. There will also be many opportunities to connect with other attendees.

Earn $2,000 Stipend to Join RI Interprofessional Community Preceptor Institute (RI-ICPI)
Agency stipends of $2,000 per person to send clinical staff to participate in the RI-ICPI are available. The goal is for participating clinical staff to also create interprofessional teams of healthcare and allied health students from URI, RIC, CCRI, and/or the Warren Alpert Medical School. Information sessions will be held on Dec. 16 at 9am and Dec. 17 at 1pm. Applications are due Dec. 18.

Job Opportunity: Pediatric Integrated Behavioral Health Clinician
Coastal Medical is in search of a Pediatric Behavioral Health Integration Clinician who will be embedded in the pediatric primary care practice, working directly with care teams to assess children and adolescents with behavioral health and/or substance use concerns.

Job Opportunity: COVID-19 Unit Hiring Case Investigators
Temporary staff members are being hired to assist with RI Dept. of Health COVID-19 case investigation and contact tracing. Clinical experience is not required and all information necessary to conduct the interviews will be provided during the training period.

Job Opportunity: Program Director of Food Strategy, Rhode Island Commerce Corp.
Commerce Corp. seeks an experienced professional with strong business development skills and deep knowledge of the food economy to lead the state's implementation of Relish Rhody and deliver on the state's food and beverage business attraction, expansion, and retention goals.

Practice Tool: Safely Resuming and Promoting Cancer Screening
The American Cancer Society has developed a report to summarize the current state and to provide guidance on how public health agencies, health care providers, and screening advocates across the nation can promote and deliver cancer screening appropriately, safely, and equitably during the COVID-19 pandemic.
Upcoming Meetings (for CTC-RI members)
  • November 05, 07:30-08:00AM - Virtual Coffee Break with Dr Pat Flanagan & Dr Beth Lange
  • November 13, 09:30-11:00AM - Community Health Team Best Practice Meeting
  • November 17, 08:00-09:30AM - Care Manager/Coordinator Best Practice Sharing Meeting
  • November 19, 07:30-09:00AM - Pharmacy QI Initiative- Learning Network
  • November 19, 12:00-01:00PM - Advancing Team-Based Telehealth in Rhode Island Webinar
  • November 20, 07:30-09:30AM - Clinical Strategy Committee Meeting
  • November 25, 08:00-09:30AM - Practice Reporting/Practice Transformation Committee Meeting
Care Transformation Collaborative of RI | ctc-ri@ctc-ri.org | ctc-ri.org