Strong Start for Mother and Newborns - HealthInsightPlease see the Executive Summary, which has been submitted with this Progress Report as a separate Microsoft Word document. SECTION

Strong Start for Mother and Newborns

Program Progress Report: Year 1 Quarter 3 - July 1, 2013 through September 30, 2013

Report Due: October 30, 2013

Federal Agency and Organization Element to Which Report is Submitted:

Centers for Medicare & Medicaid Services – Center for Medicare & Medicaid Innovation

Federal Grant Number Assigned by Federal Agency:

CMS Awardee Number (1D1CMS33####) 1D1CMS331136-01-00

Recipient Organization Name:

HealthInsight of Nevada

2 | P a g e

SECTION 1: EXECUTIVE SUMMARY Please see the Executive Summary, which has been submitted with this Progress Report as a separate Microsoft Word document.

SECTION 2: STAFFING AND TRAINING Strong Start Current Staffing Table

Staffing: Strong Start Position Title

Staff Member's

Name

Credentials of Staff

Start Date

% Time on Strong

Start Renown Pregnancy Center: Program Director

Jennifer Holcombe

07/01/13 10%

Renown Pregnancy Center: Sr. Medical Assistant/Centering Coordinator

Katrina Adamson

Medical Assistant

07/01/13 50%

Renown Pregnancy Center: Nurse Coordinator

Rebecca Rudd CNM 07/01/13 10%

Renown Pregnancy Center: Lead Midwife

Jessica Goods CNM 07/01/13 10%

Women's Speciality WellHealth: Centering Coordinator

Michelle Vargas

Medical Assistant

08/27/13 100.00%

Women's Speciality WellHealth: Executive Director of Clinical Care

Tina Phyfer APN 07/01/13 10.00%

Women's Speciality WellHealth: Nurse Midwife

Marsha Brown

CNM 08/26/13 2.00%

Women's Speciality WellHealth:Nurse Midwife

Patty Waters CNM 08/26/13 2.00%


Charlene Hanna-Manful

CNM 08/26/13 2.00%


Angela Detie CNM 08/26/13 1.00%

Women's Speciality WellHealth:OB GYN Tammy Kelly MD 08/26/13 5.00%

Women's Speciality WellHealth: Marketing Coordinator

Meghan Bailey

07/01/13 15.00%

Women's Speciality WellHealth: President of Network Development and

Steve Keltie 07/01/13 10.00%

3 | P a g e

Staffing: Strong Start Position Title

Marketing

Staff Member's

Name

Credentials of Staff

Start Date

% Time on Strong

Start

Women's Speciality WellHealth: Director of Clinical Operations

Kevin Andrada

08/26/13 1.00%

Women's Speciality WellHealth: Chief Financial Officer

Debbie Blanchard

07/01/13 3.00%

Women's Speciality WellHealth: Controller

Chris Christiensen

07/01/13 3.00%

HealthInsight of Nevada: Administrative Assistant

Cheri Crosby 07/01/13 2.5%

HealthInsight of Nevada: Project Coordinator

Alison Shipley BA 07/01/13 2.00%

HealthInsight of Nevada: Project Manager

Sabrina Drass BA 07/01/13 54.90%

HealthInsight of Nevada: Project Director

Leslie Johnstone

MBA 07/01/13 6.60%

HealthInsight of Nevada: Medical Director

Jerry Reeves MD 07/01/13 4.40%

HealthInsight of Nevada: Communication Specialist

Kymberlie Roundtree

BA 07/01/13 2.30%

HealthInsight of Nevada: Communications Director

Dana Hawes BA 07/01/13 2.00%

HealthInsight of Nevada: Specialist Marcia Warner

BA 07/01/13 4.00%

HealthInsight of Nevada: Health Care Analyst

Andrea Romero

07/01/13 5.00%

HealthInsight of Nevada: Health Care Analyst

Emily Sim MS 07/01/13 4.00%

Total Number of Strong Start Staff: 26

Strong Start Vacant Positions Table

4 | P a g e

Staffing: Vacant Strong Start Position Titles

Number of Vacant

Positions

Expected Credentials

% Time on Strong Start

Total Number of Vacant Positions:

Strong Start Training Table

Training: Type of Training No. of Staff trained

Length of Training

Date Completed

5 | P a g e

SECTION 3: PARTICIPANT DEMOGRAPHICS Question YES NO

Has your Organization begun providing Strong Start Services? Yes

Site Name (list all sites that are providing Strong Start Services); add rows as necessary

Date of First Service

Renown Pregnancy Center 9/10/2013

Basic Participant Questions

No. of Participants

Total Number of Strong Start Participants (enrolled between February 15, 2013 and September 30, 2013)

20

Of this total enrollment:

Number of Participants Newly Enrolled in Strong Start This Quarter (enrolled July 01 - September 30, 2013)

20

Number of currently enrolled Strong Start Medicaid Participants

20

Number of currently enrolled Strong Start CHIP Participants 0

Strong Start participants who stopped receiving Strong Start

services this quarter (prior to delivery), due to loss of Medicaid/CHIP eligibility

0

Former Strong Start participants who stopped receiveing Strong Start services (prior to delivery) for any reason othan than loss of Medicaid/CHIP eligibility

0

Live Births (July 01, 2013 - September 30, 2013) 0 Stillbirths (July 01, 2013 - September 30, 2013) 0 Pregnancy terminations (including miscarriage) for any reason (July 01, 2013 - September 30, 2013)

0

6 | P a g e

Race or Ethnicity

Number Newly Enrolled this quarter (July 01, 2013 - September 30, 2013)

Total Participants (enrolled February 15, 2013 - September 30, 2013)

White 14 14

Black or African American 1 1

American Indian or Alaska Native 2 2

Asian Indian 0 0

Chinese 0 0

Filipino 0 0

Japanese 0 0

Korean 0 0

Vietnamese 0 0

Other Asian 0 0

Native Hawaiian 0 0

Guamanian or Chamorro 0 0

Samoan 0 0

Other Pacific Islander 0 0

Hispanic, Latina, or Spanish Origin

1 1

Mexican, Mexican American, Chicana

2 2

Puerto Rican 0 0

Cuban 0 0

Other Hispanic, Latina, or Spanish Origin

0 0

Mixed Race 0 0

Other 0 0

Not Disclosed 0 0

7 | P a g e

Start Participant Age (at Strong

enrollment)

Number Newly Enrolled (July 01, 2013 - September 30, 2013)


Less than 13 years of age 0 0

13 - 17 years of age 0 0

18 - 19 years of age 5 5

20 -24 years of age 4 4

25 -34 years of age 10 10

Greater than 35 years of age 1 1

Gestational age of woman at Strong Start enrollment

Number Newly Enrolled (July 01, 2013 - September 30, 2013)


Less than 10 weeks gestation

0 0

10 - 14 weeks gestation 14 14



25 -28 weeks gestation 1 1

Gestational age of infant at birth Number of births2013 -

(July 01, September 30, 2013)

Preterm: ≤ 36 weeks, 6 days 0

Early Term: 37 weeks, 0 days – 38 weeks, 6 days 0

Term: 39 weeks, 0 days – 40 weeks 6 days 0

Late Term: 41 weeks, 0 days – 41 weeks, 6 days 0

Post Term: 42 weeks, 0 days and beyond 0

8 | P a g e

SECTION 4: MILESTONE PROGRESS UPDATE See Milestone Progress Table beginning on page 9.

9 | P a g e

Quarter Goal

(Section2.4 Summary of Project Goals and 2.5 Driver Diagram of the Operational Plan)

Milestones/Activities (Informed by Section 3.0 Project Start-Up Priorities and Section 4.0 Work plan of the

Operational Plan)

Starting Quarter/

Year

Ending Quarter

/Year Lead Staff Lead Staff

Organization Key Partners Status Actual Date

of Completion

Q3 2013 Establish and sustain viable CenteringPregnancy prenatal care programs in 3 sites.

Hire and orient new staff to administer CenteringPregnancy program at each site.

Q3 2012 Q3 2013 Tina Phyfer and Jennifer Holcomb

WellHealth and Renown

On Track 8/27/2013

Comments: Both sites have hired and oriented their Strong Start staff. Q3 2013 Establish and sustain viable

CenteringPregnancy prenatal care programs in 3 sites.

Hire and orient new staff needed to administer Strong Start Project



On Track 8/27/2013

Comments: Both sites have hired and oriented their Strong Start staff. Q3 2013 Establish and sustain viable


Hire new Strong Start Program Manager at Women’s Specialty Wellhealth

Q3 2012 Q3 2013 Tina Phyfer WellHealth On Track 8/27/2013

Comments: The new WellHealth Strong Start coordintator was hired and began on August 27, 2013. Q3 2013 Establish and sustain viable


Women’s Specialty WellHealth’s new Program Coordinator Training

Q3 2013 Q3 2013 Tina Phyfer WellHealth HealthInsight On Track 9/30/2013

Comments: The new WellHealth Strong Start Coordinator has been trained. Q3 2013 Establish and sustain viable


CHI onsite basic training for The Pregnancy Center new staff

Q3 2013 Q3 2013 Jennifer Holcomb

Renown Centering Health Institute (CHI)

On Track 8/22/2013

Comments: The Basic CHI trianing occurred on August 21 and August 22, 2013. Q3 2013 Recruit and retain at-risk pregnant

women into the CenteringPregnancy prenatal care program and Increase timely initiation of prenatal care and referral to program sites

Prepare Strong Start promotional materials, flyers and patient handouts with Strong Start logo

Q2 2013 Q3 2013 HealthInsight Team, Tina Phyfer and Jennifer Holcomb

HealthInsight, WellHealth and Renown

On Track

Comments: This is an ongoing effort. More materials are created as needs are identified.

10 | P a g e

Quarter Goal


Milestones/Activities (Informed by Section 3.0 Project Start-Up Priorities and Section 4.0 Work plan of the Operational Plan)

Starting Quarter/

Year

Ending Quarter



of Completion

Q3 2013 Recruit and retain at-risk pregnant women into the CenteringPregnancy prenatal care program and Increase timely initiation of prenatal care and referral to program sites

Distribute program promotional materials to religious organizations, county health district service sites, community center, emergency departments, WIC program sites, Medicaid managed care organization customer service sites and other sites frequented by Medicaid beneficiaries

Q3 2013 Ongoing HealthInsight Team, Tina Phyfer and Jennifer Holcomb


Community Partner Organizations

On Track

Comments: Outreach and program information is ongoing. Q3 2013 Recruit and retain at-risk pregnant

women into the CenteringPregnancy prenatal care program and Increase timely initiation of prenatal care and referral to program sites

Begin Social Media campaign on the web sites of the participating providers, Facebook and Twitter.



On Track

Comments: Each site has updated their website with the program informaiton as well as social media outlets.

Q3 2013 Recruit and retain at-risk pregnant women into the CenteringPregnancy prenatal care program and Increase timely initiation of prenatal care and referral to program sites

NV Medicaid managed care organizations (Health Plan of NV and Amerigroup) distribute promotional materials, flyers and patient handouts with Strong Start logo to enrollees regarding program



Nevada Managed Care Organizations

Off Track but Mitigation in Process

Comments: Outreach and program information is ongoing. Q3 2013 Recruit and retain at-risk pregnant

women into the CenteringPregnancy prenatal care program

WellHealth Screening for Medicaid eligibility and risk factors

Q3 2013 Q4 2013 Tina Phyfer WellHealth On Track

Comments: Screening for elgiability is ongoing. Q3 2013 Recruit and retain at-risk pregnant


Renown Screening for Medicaid eligibility and risk factors

Q3 2013 Q4 2013 Jennifer Holcomb

Renown On Track

Comments: Screening for elgiability is ongoing. Q3 2013 Recruit and retain at-risk pregnant


WellHealth Scheduling patients for group sessions

Q3 2013 Q4 2013 Tina Phyfer WellHealth On Track

Comments: Scheduling for group sessions is ongoing.

11 | P a g e

Quarter

Q3 2013

Q3 2013

Q3 2013

Q3 2013

Q3 2013

Q3 2013

Q3 2013

Goal Milestones/Activities Starting Ending Actual Date Lead Staff (Section2.4 Summary of Project Goals and 2.5 (Informed by Section 3.0 Project Start-Up Priorities Quarter/ Quarter Lead Staff Key Partners Status of Organization Driver Diagram of the Operational Plan) and Section 4.0 Work plan of the Operational Plan) Year /Year Completion

Recruit and retain at-risk pregnant Renown Scheduling patients for group sessions Q3 2013 Q4 2013 Jennifer Renown On Track women into the CenteringPregnancy Holcomb prenatal care program

Comments: Scheduling for group sessions is ongoing. Recruit and retain at-risk pregnant Women's Specialty Care Prepare space and Q3 2013 Q3 2013 Tina Phyfer WellHealth On Track 9/15/2013 women into the CenteringPregnancy materials prenatal care program Comments: Space was prepared and groups were started October 3, 2013. Recruit and retain at-risk pregnant Renown Pregnancy Center Prepare space and Q3 2013 Q3 2013 Jennifer Renown On Track 8/31/2013 women into the CenteringPregnancy materials Holcomb prenatal care program Comments: Space was prepared and groups were started September 10, 2013. Recruit and retain at-risk pregnant Renown Pregnancy Center First Group Session Q3 2013 Q4 2013 Jennifer Renown On Track 9/10/2013 women into the CenteringPregnancy Begins Holcomb prenatal care program Comments: The first group session occurred Recruit and retain at-risk pregnant Renown Subsequent Group Sessions Begin Q3 2013 Q4 2013 Jennifer Renown On Track 9/11/2013 women into the CenteringPregnancy Holcomb prenatal care program Comments: Subsequent groups have been occuring. Recruit and retain at-risk pregnant Renown Recruitment Goal: YR 1/Q3 100 Q3 2013 Q3 2013 Jennifer Renown Off Track but women into the CenteringPregnancy Holcomb Mitigation in prenatal care program Process Comments: Renown has been recruiting patients daily. Many patients they have recruited are pending Medicaid approval due to the long process of obtaining approval and are therefore not counted in the total number. They have recurited a total of 62 women. Of those, only 20 are currently enrolled in Medicaid. The remaining 42 are pending Medicaid. New Medicaid eligibility rules effective January 1, 2014 should greatly improve this situation. Establish and sustain viable Review recruitment progress, site preparations, Q2 2013 Q1 2016 HealthInsight HealthInsight WellHealth On Track CenteringPregnancy prenatal care participant satisfaction surveys, participation Team and Renown programs in 3 sites. data, successes and challenges, monitoring, data

collection, and continuous quality improvement. Comments: This is an ongoing activity that occurs during the monthly phone calls on the last Monday of the month.

12 | P a g e

Quarter Goal


Milestones/Activities (Informed by Section 3.0 Project Start-Up Priorities and Section 4.0 Work plan of the Operational Plan)

Starting Quarter/

Year

Ending Quarter



of Completion

Q3 2013 Establish and sustain viable CenteringPregnancy prenatal care programs in 3 sites.

Site visit to review site issues, clinician and patient challenges, successes and continuous quality improvement.

Q2 2013 Q1 2016 HealthInsight Team

HealthInsight WellHealth and Renown

On Track

Comments: This is an ongoing activity that occurs once a quarter. Renown's site visit occurred July 22, 2013 and WellHealth's site visit occurred on July 29, 2013. Q3 2013 Establish and sustain viable


Providers send reports on enrollment, Medicaid verification, group schedules and data collection



HealthInsight On Track

Comments: Each provider provides monthly administrative data on the 15th of the month to HealthInsight. De-Identified participant data will be collected and submitted on the 15th of the month once the evaluation requirements are finalized. Q3 2013 Establish and sustain viable


Send quarterly reports to CMMI Q1 2013 Q1 2016 HealthInsight Team


Comments: This is an ongoing goal that occurs quarterly. Q3 2013 Establish and sustain viable


Teleconference with CMMI Project Officer Q1 2013 Q1 2016 HealthInsight Team


Comments: This is an ongoing goal that occurs bi-weekly.

Enrollment Goals

Quarter Enrollment Goal (Section 4.1 of the

Operational Plan) Actual Number enrolled Q1 2013 (February 15 - March 30, 2013) N/A N/A Q2 2013 (March 31 -June 30, 2013) N/A N/A Q3 2013 (July 01 - September 30, 2013) Renown Pregnancy Center Y1Q3= 100 20

Documents

Strong Start for Mother and Newborns - HealthInsightPlease see the Executive Summary, which has been submitted with this Progress Report as a separate Microsoft Word document. SECTION