A Summary of the January 21

Steering Committee Meeting

We are enthusiastic about the insights and solutions developed during our January 21st Steering Committee meeting. Below is a summary of our progress and next steps as we prepare for our third Leadership Forum meeting, coming up in March. We will have another Steering Committee meeting in mid-February prior to the Leadership Forum.

idea-512Big ideas:
Collective Vision => Action Areas => Action Teams
The model and survey have helped us interpret the collective vision of the Leadership Forum. Our current work is to define that vision and frame it into action areas where action teams will be able to develop action plans. That vision includes the following:

1. Supporting education and income pathways is essential to addressing the social determinants of health. We will need action around coordination with Collective Impact organizations working in income and education in order to maximize success in any health and health care improvement effort.

2. We will need action around supporting healthy behaviors in order to improve health in our region.

3. We will need action around a set of care delivery improvements that include care coordination, self-care, Patient-Centered Medical Homes, and primary care efficiency in order to improve health care in our region.

4. We will need action around payment in order to leverage the benefits of improved health and health care so as to generate savings that can reinvested or otherwise create economic benefit for our region.

CONCLUSION: Four Action Areas = Pathways to Equity/Healthy Behaviors/Care Delivery/Payment and Financing

Mental Health
We grappled with the issue of how to incorporate mental health into the community agenda. The model showed treatment of the severely mentally ill to be a high cost initiative that performed poorly in reducing overall costs. The Steering Committee committed to a position of defining health to be inclusive of mental health for two reasons: i. to signal that our community vision is to de-stigmatize mental health as a self-inflicted or shameful affliction; ii. to leverage the power of work in healthy behaviors, and care delivery/coordination to improve mental health.

CONCLUSION: Our community’s definition of health will be holistic and inclusive of mental health.

Assuring That Vulnerable Populations See Action
We examined how to create accountability around assuring that community initiatives address the special needs of vulnerable populations. The discussion centered on the recognition that barriers to health and health care are very different for people with insufficient income, education, or other socioeconomic challenges. The Steering Committee discussed having a separate action area accountable for equity, but that thought evolved into a discussion of including an equity strategy within each of the action areas that would be supported by the structure and formation of the action teams working in each action area. Additionally, the Steering Committee structure “2.0” would remain in such a fashion as to hold each action team accountable for a sufficient plan for vulnerable populations.

CONCLUSION: Responsibility for plans to address the needs of vulnerable populations will be implicit in action team directives and the Steering Committee will be responsible for holding them accountable.

Action Team Formation
The Steering Committee reviewed a draft charter for the action teams. The draft was deemed to be directionally correct but in need of fine tuning. The discussion centered on how to coordinate action teams with an alignment and accountability structure such as an executive committee. The Steering Committee discussed different options as well as evolving the existing Steering Committee to serve that role. Staff will work on revisions to reflect that co-chairs from action teams will be added to the existing Steering Committee. Those co-chairs will ideally be existing Steering Committee or Leadership Forum members. The newly constituted Steering Committee will be accountable for alignment, equity, and other issues.

CONCLUSION: Action teams will be balanced and accountable to the Steering Committee. Action team co-chairs will become members of the Steering Committee moving forward. 

Guiding Principles and Values
The Steering Committee reviewed a draft of guiding principles and decisions. The draft was well received with suggestions for key changes and additions that reflected the decisions reached in the day’s previous discussions. The staff will incorporate the changes for confirmation at the next Steering Committee meeting.

Next Steps
Discussions will continue offline to determine the details of action team formation, such as whether Patient-Centered Medical Homes and primary care effectiveness might be distinct areas from care coordination and self-care, or if they should remain bundled together. We’re also considering issues such as how to garner the support of local governments and community leaders; how to communicate effectively with the larger community; and how to coordinate ongoing engagement with the Leadership Forum members in a manner that both assures transparency and credibility, and supports consensus.