Tag: Social Determinants of Health

A Message from HWCLI’s Board Chair, Bob Detor

It is with mixed feelings that I write to announce Gwen O’Shea’s departure from the Health & Welfare Council of Long Island.

Fifteen years ago this month, Gwen O’Shea joined the Health & Welfare Council of Long Island. Ten years ago this year, she was selected as its President/CEO.  During her tenure, she expanded and diversified the organization’s revenue infrastructure.  She reshaped the organization’s governance structure, by-laws, and mission to achieve greater efficiency, transparency, and enhanced active community partnerships.

Gwen oversaw the establishment of the Unmet Needs Roundtable after the Economic Downturn in 2007/2008, Hurricane Irene and Superstorm Sandy.  This effort brought more than $10 million in financial support to Long Island individuals and families struggling with their disaster recovery.

During these responses and other initiatives, her work with community partners and government officials at the local, State and Federal level, ensured the voices and concerns of those most at-risk were heard.

I think anyone who has worked with Gwen has found her to be dedicated to the mission, professional and a tenacious advocate for Long Island’s most vulnerable and at-risk.

Gwen’s leadership has been a great benefit to this organization and, undeniably, she will be deeply missed here.

Gwen’s last day with the Health & Welfare Council of Long Island will be on Friday, March 24th.

We will begin the search for her replacement over the next few weeks. Please click here for a copy of the position profile.

On behalf of HWCLI’s Board of Directors, please join me in thanking Gwen for her caring service and wishing her all the best as she assumes her new position as President/CEO of CDCLI, a long-standing partner of HWCLI and a critical part of the Long Island community.

10/4- The Social Determinants of Health Workshop

The Association for Mental Health and Wellness is hosting a Social Determinant Workshop in honor of Mental Health Awareness Week. The workshop will take place on October 4th from 1-4 pm at the Huntington Hilton. Sponsored by the Suffolk Collaborative and the Nassau Queens Preforming Provider System, this free event will overview the social determinants of mental health, review the evidence of mental health inequities in the United States, and consider solutions to addressing the social determinants of mental health from a policy perspective. The presenter, Ruth Shim, MD, MPH is Vice Chair of Education and Faculty Development and Chief of Outpatient Psychiatry Services in the Department of Psychiatry at Lenox Hill Hospital in New York City, a division of Northwell Health. She is an Associate Professor in the Department of Psychiatry at Hofstra Northwell School of Medicine.

To register for this event, click here.

Or contact Alexis Rodgers, LMSW
Association for Mental Health and Wellness
631-471-7242 x1315


Attention HWCLI Members and Partners!

Critical Follow-up to the CBO Planning Grant Application

Thanks to those of you who were able to attend this week’s CBO planning grant follow-up meeting.  For those of you who were unable to attend, I am happy to have a follow-up conversation about the next steps.

HWCLI is applying to lead our regional application for the NYS CBO Planning grant. The state will award each of 3 regional Consortia $2,500,000 for a one year planning initiative to support CBO infrastructure and capacity building in order to participate in the State’s Delivery System Reform Incentive Plan (DSRIP).

Our region includes the Island and  7 counties in Hudson area.

CBO participation in DSRIP, and in the ultimately transformed healthcare delivery system, is critical to ensure input from various communities, to implement  strategies to improve population and community health, and to address the determinants that influence health.

The purpose of the CBO planning grant is the development of financially sustainable infrastructure within community based organizations for value based contracting with performing provider systems.

The grant may only target CBOs that:

  • Have an annual budget of less than $5 million
  • Are not billing Medicaid or planning to bill Medicaid,
  • Are not directly providing health care services, and
  • focus on services to address the social determinants of health for the Medicaid and Medicaid eligible populations

We need your help!!

We are seeking:  Consortium Members.

If you are interested in being part of the regional consortium, please sign the attached MOU agreement and complete the following survey:


THIS SURVEY IS CRITICAL. IT WILL HELP TO ESTABLISH THE GOALS AND OBJECTIVES for our region, based on the information that you share. 

Please note we anticipate this survey to take 20-30 minutes.

I apologize in advance for the short notice, but we really need the surveys back by Tuesday, July 26th.  THANK YOU FOR YOUR WILLINGNESS TO PARTICIPATE and for your quick response.

Finally: Please plan to join our orientation webinar on Tuesday, July 26 at 10:30 a.m.

No registration is necessary and we’ll follow this message with an Outlook invitation.

Join WebEx meeting

Meeting number: 735 402 299

Join by phone
1-877-668-4493 Call-in toll-free number (US/Canada)
1-650-479-3208 Call-in toll number (US/Canada)
Access code: 735 402 299
Toll-free calling restrictions

The webinar will be a fast paced and highly informative overview— easily understood, interesting, and accessible whether you are well versed in the state’s reform efforts or totally new to the dialogue. It will contextualize the CBO Planning Grant within the context of the State’s goals for achieving and sustaining a system of health care financed by value based payment.

Our speaker, Josh Rubin from Health Management Associates, will:

  • address the national trend toward healthcare financing based on value and quality instead of volume (i.e. value based payment) and provide an overview of the goals for reform, nationally and within NYS
  • address the main elements of “accountable care” delivery and funding that underlie many NYS state initiatives, including the Delivery System Reform Incentive Plan (DSRIP) and explain what is behind changes to Medicaid funding
  • discuss how the resulting flexibility in addressing people’s needs can include flexibility to pay for CBO interventions and programs
  • describe the progression of options for healthcare financing that incentivize systems, like our Performing Provider Systems, to “do better more rapidly, in less traditional ways” and the potential for CBOs to contract directly with managed care providers as well as PPSs and others to do the kinds of things that are currently either under-resourced, lacking in the system, or available only where grants or contracts permit.
  • outline the core challenges faced by human service providers/CBOs in a value based payment system (i.e. the importance of knowing who is being served by the organization, being able to demonstrate need and document services, the importance of demonstrating evidence of CBO effectiveness, the capacity to support the cost of providing care, ability to understand and negotiate contracts, manage fiscal reporting, etc.)

We look forward to hearing from you via the survey and talking with you during the Q and A on Tuesday morning’s webinar.

We look forward to hearing from you!  Please contact us if you have any questions about this exciting opportunity to support our region’s most vulnerable communities.



Gwen O’Shea


Report Proposes VBP model for Children in Medicaid

The Schuyler Center, together with United Hospital Fund, recently released a new report: Value-Based Payment Models for Medicaid Child Health Services, that proposes a new, child-centered approach to value-based payment in Medicaid. The researchers conclude that because of the significant differences in children’s health care utilization compared to adults, a payment model should be used that promotes—and pays for—screening and effective interventions to address psycho-social risks that are not currently widespread in primary care. The report notes that, “Given the increased recognition of how profoundly social determinants of health (including Adverse Childhood Experiences) affect childhood development and adulthood health and social productivity, payment models need to consider how to motivate and support attention in this area.”

Click here for the full report

Providers Screen For Exposure to Trauma

Twenty years ago, the Adverse Childhood Experiences study established the association between traumatic childhood experiences and the leading causes of morbidity and mortality in the U.S. Researchers from Kaiser Permanente and the Centers for Disease Control and Prevention found a direct relationship between instances of trauma (defined in the study as sexual, emotional, or physical abuse as well as being raised in neglectful or dangerous households) and rates of chronic obstructive lung disease, lung cancer, heart disease, and liver disease as well as depression, substance abuse, suicide, and risky behaviors.

While traumatic experiences can affect the entire population regardless of income level or insurance status, certain groups of vulnerable patients, such as the poor, are more likely to experience trauma. The Medicaid program in Oregon found that more than half of its high utilizing patients had experienced trauma and a third suffered from PTSD. Patients that have experienced trauma can be difficult to engage in their healthcare and frequently are labeled as “difficult” or “non-compliant.”

Trauma informed care offers providers a new lens through which to view these patients that have been labeled as “difficult.” To help patients overcome this barrier to their own healthcare, providers work to identify the trauma and the parts of medical exams that may trigger anxiety or fear. Some practices utilize social workers or peer counselors to work with patients and help streamline the referral process for other services. Because trauma informed care is relatively new, it will take evidence to establish the effectiveness of trauma focused care. Some of these efforts are supported by The Robert Wood Johnson Foundation and led by the Center for Health Care Strategies, which launched a multi-site demonstration to test whether use of trauma-informed practice improves patient engagement, enhances outcomes, and reduces costs. One of its grantees, Bronx based Montefiore Medical Group is training all staff at its 22 ambulatory care clinics in approaches to trauma-informed care. The clinics already have behavioral health specialists working alongside primary care clinicians, helping to serve residents of the nation’s poorest congressional district. For more information about trauma focused care initiatives visit  http://www.commonwealthfund.org/publications/newsletters/transforming-care/2016/june/in-focus


Reimbursing important conversations

Having conversations with your doctor can help them understand how your life outside of her office impacts your health.  Doctors’ time is often limited and the types of questions they ask might not only depend on what is most important, but what they can bill for.

End of life discussions are thought to be essential by most doctors, but they rarely have them, for a variety of reasons. In January, Medicare began reimbursing providers for end of life discussions in the hope that this type of planning would become more common place.

Growing evidence suggests that screening for poverty and connecting patients to community resources can have positive impacts on health.  Would doctors be more likely to screen for these risk factors if they were getting paid? We think so!  In a poll, 75% of doctors said Medicare’s new policy makes it more likely that they will engage patients in these conversations.

Reimbursing is a great first step to encourage providers to start having these types of discussions with patients. However, more training, engagement with community based organizations, and clinical infrastructure are likely needed to integrate this type of screening into regular practice.