COMMUNITY HEALTH IMPROVEMENT: AS hare Goal

							HEALTH ENTERPRISE ZONES:
Prince George’s County Public Forum

     Department of Health and Mental Hygiene
     Community Health Resources Commission
                 August 2, 2012
      Maryland Health Improvement and
          Disparities Reduction Act
• The Act emanated from the Maryland Health Quality and Cost
  Council’s Health Disparities Work Group, established by Lt.
  Governor Brown and led by Dean E. Albert Reece of the
  University of Maryland School of Medicine.
• The Act was the first bill signed into law by the Governor on April
  10, 2012 and its implementation is under the leadership of Lt.
  Governor Brown.
• The FY 2013 budget provides $4 million in new funding to the
  Community Health Resources Commission (CHRC) to fund Health
  Enterprise Zones (HEZ). It is anticipated that this funding will
  support two to four zones.
• The Administration appreciates the support of the Maryland
  General Assembly in approving the Act.
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    Maryland Health Improvement and
        Disparities Reduction Act
• The analysis of the Health Disparities Work Group
  focused on ways to address the root causes of health
  disparities, as evidenced by higher rates of diseases and
  illnesses such as:
   – Asthma       – Hypertension
   – Diabetes     – Other ambulatory care sensitive conditions


• The Work Group developed bold recommendations that
  including the creation of HEZ to saturate underserved
  communities with primary care providers and other
  essential health care services.
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 Main Components of the Act
• Health Enterprise Zones (HEZ)

• Promoting Cultural Competency

• Encouraging Reporting and Analysis
  of Health Disparities Data
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     Health Enterprise Zones
• The purpose of establishing HEZs is to target
  State resources to:
  – Reduce health disparities among racial and ethnic
    groups and geographic areas;

  – Improve health care access and health outcomes
    in underserved communities; and

  – Reduce healthcare costs and hospital
    admissions/readmissions.
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     Health Enterprise Zones
• Each HEZ will be a contiguous geographic area;

• Must have documented evidence of health
  disparities, economic disadvantage and poor
  health outcomes; and

• Small enough to allow incentives to have a
  significant impact but large enough to track data
  (population of at least 5,000).

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            Eligible HEZ Applicants
• Non-profit community-based organizations and local
  government agencies will be eligible to submit an
  application for HEZ designation on behalf of an area or
  community.

• The state is encouraging HEZ applications to reflect
  inclusion, community participation, collaboration, and
  support the priorities identified in the Local Health
  Improvement Process.

• The application for HEZ designation will be combination of
  both demonstrated need and intervention strategies to
  improve health outcomes in the potential Zone.
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  Health Care Practitioners Eligible
     to Receive HEZ Incentives
• In order to receive incentives/benefits, health care
  practitioners must provide services in the HEZ, be
  licensed/certified, and provide health care in one of the
  following areas:
   – Primary care, including OB/GYN, pediatric and
      geriatric services;

   – Behavioral health, including mental health and
     alcohol and substance use services; or

   – Dental services.
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   Implementation of the HEZs
• An internal steering committee led by Secretary Sharfstein,
  comprised of DHMH, Lt. Governor and CHRC staff,
  has been established to guide implementation of the HEZs
  with assistance from the Health Disparities Collaborative.

• There will be three stages in the process to implement HEZs:
   – Public Comment (June 15 - July 20, 2012)
   – HEZ Selection Process (September – December 2012)
   – Implementation & Evaluation Phase (December 2012 – beyond)


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Public Comment and Public Forums
 Feedback was requested on the following:
    (1) Eligibility Criteria and Data;
    (2) Proposed Principles for the Review of Applications for HEZs;
    and
    (3) Potential Incentives and Benefits for the HEZ.
•   Public comments on these three documents was
    closed on July 20.
•   Public Forums
    –   Southern Maryland, Wednesday, July 11
    –   Baltimore City, Thursday, July 19
    –   Montgomery County, Thursday, July 26
    –   Prince George’s County, August 2
    –   Eastern Shore, August (TBD)
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    –   Western Maryland, August (TBD)
     Eligibility Criteria and Data
(1) An HEZ must be a community, or a contiguous cluster of
    communities, defined by zip code boundaries (one or multiple
    zip codes).

(2) An HEZ must have a resident population of at least 5,000 people.

(3) An HEZ must demonstrate economic disadvantage:
    – Medicaid enrollment rate; or
    – WIC participation rate.

(4) An HEZ must demonstrate poor health outcomes:
    – A lower life expectancy; or
    – Percentage of low birth weight infants.
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    Eligibility Criteria and Data
• Based on these criteria DHMH developed dynamic
  maps with data at the zip-code level.




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           HEZ Selection Principles
1. Purpose                8. Coalition

2. Description of need    9. Work-plan.

3. Core disease targets   10. Program Management and
                              Guidance
4. Goals
                          11. Sustainability
5. Strategy
                          12. Evaluation

6. Cultural competence    13. Collaboration

7. Balance
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            Incentives and Benefits of
                HEZ Designation
• Grant funding to implement the actions outlined in the HEZ
  application to improve health outcomes and reduce health
  disparities.
• Specific incentives for individual practitioners or practices that
  provide primary care, behavioral health services, or dental
  services in a HEZ:
   – State income tax credits;
   – Hiring tax credits;
   – Loan repayment assistance;
   – Priority to enter the Patient Centered Medical Home;
   – Priority for electronic health records funding; and
   – Grants for capital improvements and medical/dental equipment. 14
                 For more information:
http://dhmh.maryland.gov/healthenterprisezones/SitePages/Home.aspx

    Send public comments and questions to:
           dhmh.hez@maryland.gov




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