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Innovator Agent Bulletin (2/25/22)

New items

A. Housing and health resources for payers

B. Environmental justice screening and mapping tool


Repeated items

A. (TC) Tales from the field: Family Connects Oregon early adopters share lessons learned March 11

B. (TC) Collaborative CHA/CHP learning collaborative Topics set; first session March 29

C. (TC) VBP pre-interview questionnaire, PCPCH and CDA data template Due May 6 and 7

D. (TC) Learning collaborative: Care coordination and intensive care coordination Third Thursday each month

E. (TC) SHARE, HRS and ILOS comparison Now available

F. (TC) Free, quick online tobacco cessation counseling training (with CME) On demand, 45 minutes

G. Webinar: Improving HPV vaccination in your health system through quality improvement March 3

H. OHA COVID-19 Hotline

I. Plain language incentive metric summaries Now available

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New items

A. Housing and health resources for payers

Request: Please share with CCO staff working on SDOH-E spending programs (if relevant).

The Oregon Rural Practice-based Research Network helped pull together the following list of national housing and health resources. These guides and articles may be helpful for CCOs in their housing work, including health-related services and the SHARE Initiative.

  • Health and Housing: Introduction to Cross-Sector Collaboration (National Academy for State Health Policy, 2021)

  • https://www.nashp.org/wp-content/uploads/2021/12/Health-Housing-Cross-Sector-Collaboration-NASHP-Dec-2021.pdf

  • Health System Investments in Housing: A Development Guide (Corporation for Supportive Housing, 2020)

  • https://www.csh.org/resources/health-system-investments-in-housing-a-development-guide/

  • “Payer Housing Programs Address Social Determinants of Health” (Health Payer Intelligence, 2017)

  • https://healthpayerintelligence.com/news/payer-housing-programs-address-social-determinants-of-health

  • “Housing and Health Partners Can Work Together to Close the Housing Affordability Gap” (Center on Budget and Policy Priorities, 2020)

  • https://www.cbpp.org/research/housing/housing-and-health-partners-can-work-together-to-close-the-housing-affordability

  • “Intermountain Healthcare & The Utah Housing Preservation Fund” (Build Health Places Network, 2021)

  • https://buildhealthyplaces.org/sharing-knowledge/publications/community-close-ups/intermountain-healthcare-the-utah-housing-preservation-fund/


B. Environmental justice screening and mapping tool

Request: Please share with CCOs if relevant to community health assessments or other initiatives.

The U.S. Environmental Protection Agency has updated and redesigned EJScreen, the agency’s environmental justice screening and mapping tool: https://www.epa.gov/ejscreen

The update features new indicators on environmental burdens, socioeconomic factors, climate change health, and critical service gaps, including the following:

  • Environmental and demographic information to identify areas overburdened by pollution

  • Unemployment

  • Food deserts, medically underserved areas, and broadband internet service

  • Life expectancy, asthma and heart disease at the census tract level

  • Drought and wildfire data (layers that build on the existing climate data)


Repeated items

A. (TC) Tales from the field: Family Connects Oregon early adopters share lessons learned March 11

Contact: Lashanda Friedrich (LASHANDA.N.FRIEDRICH@dhsoha.state.or.us), Tom Cogswell (thomas.cogswell@dhsoha.state.or.us)

Request: Please share with your CCOs.

Family Connects Oregon is a universally-offered home visiting service for newborns and their families. In addition to clinical services, FCO provides community alignment that connects families with services in their community. The scope of this presentation will be two early adopter sites sharing their implementation journeys thus far. We will present data on the following: number of families served, client satisfaction, partnerships with CCOs and community alignment work.


B. (TC) Collaborative CHA/CHP learning collaborative First session March 29

Contact: Tom Cogswell (Thomas.Cogswell@dhsoha.state.or.us)

Request: Please share with CACs and CCO staff working on CHAs and CHPs.

The OHA Transformation Center will be hosting a virtual community health assessment (CHA) and community health improvement plan (CHP) learning collaborative that will focus on the operations side of developing a collaborative CHA and CHP. This new peer-to-peer learning collaborative will be facilitated by the Providence Center for Outcomes Research and Education (CORE).


C. (TC) VBP pre-interview questionnaire, PCPCH and CDA data template Due May 6 and 7

Contact: Lisa Krois (Lisa.R.Krois@dhsoha.state.or.us)

Request: FYI (was shared with CCO VBP points of contact 2/4/22).


D. (TC) Learning collaborative: Care coordination and intensive care coordination Third Thursday each month

Request: Please share with CCOs planning or delivering CC/ICC.

Contact: Jackie.Wetzel@dhsoha.state.or.us

The Oregon Health Authority Transformation Center is hosting a monthly virtual learning collaborative to support CCOs and other organizations that provide care coordination and intensive care coordination (CC/ICC) services to Oregon Health Plan members.

  • When: Third Thursday each month in 2022, noon–2 p.m.

  • Audience: Staff of CCOs, Kepro, and other organizations who are involved in planning or delivering CC/ICC to OHP members.

  • To sign up, please email Jackie Wetzel (Jackie.wetzel@dhsoha.state.or.us)


The year-long learning collaborative will provide support toward understanding and meeting CCO 2.0 care coordination requirements and facilitate sharing of CC/ICC best practices. Participants will hear from subject matter experts and peers on key topics such as:

• CCO contract requirements and OARs related to CC/ICC

• Best practices for:

o Interdisciplinary care team (ICT) meetings

o Sharing assessments and care plans

o CC/ICC staffing models

• CC/ICC reporting requirements/template

• Face-to-face requirements in rural/urban areas

• Prioritized populations

• Using data to support CC/ICC activities and workflows

• In lieu of services (ILOS) and care coordination


E. (TC) SHARE, HRS and ILOS comparison Now available

Contact: Anona Gund (Anona.E.Gund@dhsoha.state.or.us), Laura Kreger (Laura.E.Kreger@dhsoha.state.or.us)

Request: Please share with CCO staff working on HRS, SHARE and ILOS.

This new comparison of CCO spending programs provides an overview of health-related services, in lieu of services and the SHARE Initiative (Supporting Health for All through Reinvestment). The document includes examples of activities that could fall into each category. View the comparison here: https://www.oregon.gov/oha/HPA/dsi-tc/Documents/HRS-SHARE-ILOS-Comparison.pdf


F. (TC) Free, quick online tobacco cessation counseling training (with CME) On demand, 45 minutes

Contact: Anona Gund (Anona.E.Gund@dhsoha.state.or.us)

Request: Please share with CCO staff working on tobacco cessation.

This short online course will improve your care team’s ability to help patients quit tobacco. The course focuses on Brief Tobacco Intervention and Motivational Interviewing techniques.

  • Who: All members of the care team committed to supporting their patients quit tobacco.

  • When: The course is self-paced and takes approximately 45 minutes. The course can be started, paused and resumed later as needed.

  • CMEs: This training has been reviewed and is accepted for up to 1.0 prescribed credit from the American Academy of Family Physicians (AAFP). For other licensing boards that may not pre-approve continuing education credits (for example, the Board of Licensed Professional Counselors and Therapists), please submit the certificate of participation to your accrediting body.

  • Access the training: https://learn.optum.com/redeem/or


G. Webinar: Improving HPV vaccination in your health system through quality improvement March 3

Contact: Jmontgomer@samhealth.org

Request: Please share with CCO staff working on adolescent vaccinations.

Review evidence-based strategies to improve HPV vaccination rates, improve your ability to make HPV vaccination recommendations, and learn about resources for clinics. This webinar is hosted by the Oregon Pacific Area Health Education Center and Samaritan Health Services.


H. OHA COVID-19 Hotline

Contact: Laura Wendel, COVID-19 Case Investigation Unit Manager (laura.a.wendel@dhsoha.state.or.us)

Request: Please share with CCOs (to share with provider networks).

The OHA COVID-19 Hotline is a statewide resource for people who test positive for COVID-19. People with positive cases can call in whether or not they tested positive at home, in a lab, or to get guidance on a household case. People can call to receive quarantine and isolation guidance, how to inform close contacts, and connect with wraparound services in their county. The hotline is staffed by case investigators and previous contact tracers. On the hotline website, there is also a survey link where people can complete basic information about their case. That information is sent automatically to OHA.


See the “Did you test Positive for COVID?” page here: https://govstatus.egov.com/or-oha-covid-19-positive-test?utm_source=OHA&utm_medium=egov_redirect&utm_campaign=https%3A%2F%2Foregon.gov%2Fpositivecovidtest

Please share widely. OHA is especially wanting to make sure providers have this information.


I. Plain language incentive metric summaries Now available

Contact: metrics.questions@dhsoha.state.or.us

Request: Please share as needed (sent to Metrics TAG 1/31)

OHA has published a plain language summary of each of the 2022 CCO incentive measures for a non-technical audience: https://www.oregon.gov/oha/HPA/ANALYTICS/CCOMetrics/PlainLanguageIncentiveMeasures.pdf We invite you to share this document with your partners as a communication tool.


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