atr care coordination traci kodeck, mph sadie smith, msw healthcare access maryland
TRANSCRIPT
ATR Care Coordination
Traci Kodeck, MPHSadie Smith, MSW
HealthCare Access Marylandwww.hcamaryland.org
Vision
We envision Maryland as a place where all people have equal access to health care and where there are no disparities in health outcomes based on income or race. HealthCare Access Maryland will be a state and national leader in reforming the healthcare system
Mission
We are making Maryland healthier by connecting residents to insurance and care, educating the community about healthier living and advocating for a more equitable healthcare system
HealthCare Access Maryland (HCAM)
Non-profit agency created in 1997 Formerly Baltimore HealthCare Access
(BHCA) Originally 2 Core Functions
– Eligibility – Ombudsman Services/Care Coordination
Four Areas of Expertise
Eligibility/Enrollment
System Navigation
Case Management/Care Coordination
Advocacy and Public Policy
Programs and Services
Eligibility Services
Maryland Children’s Health Insurance (MCHP) Program
Medical Assistance for Families (MA4F)
Primary Adult Care (PAC) Program
HCAM Hotline
Medicaid Outreach Services
Maternal and Child Health Immigrant Services Care Coordination Ombudsman Services MD Prenatal Risk Assessments
Homeless Services
Street and site based outreach to homeless or persons at risk for homelessness
HPRP: Homeless Prevention and Rapid Rehousing
Operation Care
Making all the Children Healthy (MATCH)
Collaborative program with Baltimore City DSS
Health care coordination and medical case management
Physical Health Behavioral Health Dental Health
Addiction Outreach Services
Baltimore Buprenorphine Initiative (BBI)
Information and Referral Line
Drug Treatment Court
HOPE
Special Initiatives
Second Chance Jail Project
Jurisdictional Care Coordination
Access to Recovery
Access to Recovery/ RecoveryNet
Presidential initiative that provides vouchers to individuals to purchase services and supports linked to their recovery from substance use disorders
Emphasizes client choice
Services: Care Coordination, Recovery Housing, Job Readiness Counseling, Transportation, Vital Records, Gap Services, Pastoral Counseling
HCAM’s Role in ATR
HCAM = Care Coordinators– Vital Records– Transportation
Public Transportation Cab Services
– Gap Services Dental Home Depot, stylist supplies, big and tall stores
Anne Arundel County & Baltimore City
Key Components of HCAM Care Coordination
Knowledge of the region - resources Familiarity with public benefits, eligibility and
enrollment Awareness of substance use disorders Community-based Cultural competency Partnerships with key providers Data driven – qualitative and quantitative A Flexible Structure Motivated employees
HCAM Model
Care Coordinators
Manage referrals Conduct Outreach
Home Visits Community Office
Caseloads 100-125 Work with clients 6-
8 months, longer if needed
Management
Maintain partnerships
Problem Solve Build Bridges Data and Billing
reports Support outreach
efforts
Administrative Support
Process referrals Manage
supplemental service requests and partners
Track insurance and medical appointments
Oversight
Manager
Support Open door policy Maintain caseload Communication Transparency Data tracking Training
Care Coordinators
Manage relationships with portals
Communication Bump it up Manage responsibilities
Management Ethics
1. My team is my biggest asset.2. Decision making should be inclusive not exclusive.3. Open the door.4. Respect and loyalty should be mutually given and earned.5. Focus on people’s strengths.6. Stay committed and focused.7. Set clear expectations. Everyone is different, manage them
as such.8. It’s my job to know my job. It’s their job to know their job.9. Ask questions, often.
ABCs of Care Coordination
ADAPATBILITY is a must. BELIEVE. CARE. DEMONSTRATE understanding. EVERYONE deserves a chance to change. FLEXIBILITY is key. GIVE love. HONESTY is the best policy, be trustworthy and reliable. IT’S all in the details. JUST breathe. KEEP things in perspective. LISTEN, actively. MEET people where they are. NEVER give up, persistence pays off. OPEN your mind. PAY attention. QUALITY control: Be well-prepared, detail-oriented, and organized. REMAIN calm. SOLVE problems. TEAMWORK makes the dream work. USE your resources. VIRTUE - patience is a virtue. WHEN in doubt, ask. EXHIBIT compassion. YOU are a motivator for yourself and everyone around you. Be Zealous.
ATR Challenges
Rapid roll-out High Caseloads Services at capacity
Administrative Procedures Implementation of supplemental services
Dueling Priorities Population
Lessons Learned
Teamwork Hard Work Overstaff Relationships/Partnerships are key You’re going to do things you didn’t think
possible
Questions?
Contact Information
Traci Kodeck [email protected]
410-649-0521
Sadie Smith [email protected]
410-649-0529