Access to Care 5-Year Action Plan Sample



Deliverable Form D – 5-Year Action PlansAccess to Health, Dental, and Mental Care (For further instructions see separate document titled “Action Plan Guidelines”)MCAH SOW Goal X:Problem Category(ies)From Deliverable Form B of your Title V Needs Assessment.Problem Statement(s)From Deliverable Form B of your Title V Needs Assessment.Five Year Local Goal(s)Develop one or more five year local goal(s) that state the desired results of your interventions. Example: Increase access to health, dental and/or mental health care for women and children (specify type(s) of access).Risk/Contributing FactorsList LHJ specific contributing factors using a problem analysis. Examples: Difficulty in completing applications, cultural barriers, lack of knowledge/trust in the system, inefficient referral system among hospitals, providers and public health programs, lack of providers, and transportation issues.Best Practice Strategies/ InterventionsList best practice strategies and/or interventions to address your problems. Examples: Targeted outreach to MCAH population, case management services, simplify insurance application process, increase provider knowledge about public health programs, develop policies and procedures to implement a referral process, ensure client follow-up, enrollment in insurance product and appointment to see a provider, and timely access to a provider. Department of Managed Health Care: CA: Population(s)List the populations you will be intervening with for the next five years. Examples: Pregnant and parenting women, Women, Infants and Children (WIC) Program, MCAH and other public health programs, CPSP Providers, and hospital obstetric (OB) departments.Short and/or Intermediate Objective(s)1Inputs, including Community Partner InvolvementIntervention Activities to Meet Objectives Performance MeasuresShort and/or IntermediateProcess Description and Measure(s) including Data SourceOutcome Measure(s) including Data SourceFiscal Year 1 By June 30, 20XX, all WIC eligible women participating in public health programs will be linked to WICWICPublic health program staff that serve pregnant and parenting womenMCAH Staff, PHNs, case managers(Insert LHJ specific partners and resources, such as funding)Develop understanding of WIC eligibility, services, and local WIC hard-to-reach priority populations Develop relationships with WIC and other public health programs that serve WIC eligible clientsDevelop and implement policies, including referral systems, to ensure that women participating in public health programs will be referred to and enrolled in WICDevelop and implement a Continuous Quality Improvement/Quality Assurance (CQI/QA) process to monitor implementation of policies/processes, a regular feedback mechanism to continually improve the process and a plan to evaluate the impact List WIC hard-to-reach priority populations, including opportunities to overcome barriers, if applicable Briefly describe relationships developed with WIC and other public health programs that serve WIC eligible women Describe rationale for policies and referral systems developedBriefly describe the CQI/QA process developed Briefly describe barriers, challenges, and solutions to linkages to WICNumber of WIC eligible women participating in public health programs that are linked to WIC/all WIC eligible women participating in public health programsList policies developed and implementedDescribe referral system and submit referral form Describe the outcome of the CQI/QA process, including methods of measurements and resultsFiscal Year 2 By June 30, 20XX, all Medi-Cal eligible pregnant women and children (ages 0-5) who are clients in MCAH programs will be enrolled in Medi-Cal and have timely access to provider(s)Medi-CalProvidersMCAH Advisory BoardLocal MCAH program staff and field nursing staffMedi-Cal enrollment staffCommunity clinic staffCalifornia Immunization Branch(Insert LHJ specific partners and resources, such as funding)MCAH staff will:Assess each MCAH program client for eligibility for Medi-Cal:Refer to the Covered CA website: and the California Department of Health Care Services: Presumptive Eligibility for Pregnant Women: unenrolled but potentially eligible clients for application assistance or directly provide application assistanceFollow-up with referred clients to determine if they become enrolledEncourage enrolled clients to complete an appointment with a health, dental or mental health care provider and follow-up to assure completionEducate and assist parents to ensure that their children receive immunizations according to the recommended schedule. Refer to the California Department of Public Health/Immunization Branch: Develop and implement a CQI/QA process to monitor implementation of policies/processes, a regular feedback mechanism to continually improve the process, and a plan to evaluate the impactDescribe access to care issues identifiedDescribe rationale for interventions, recommendations and strategies developedBriefly describe barriers, challenges, and solutions to enrollment in Medi-Cal and follow-up to see a providerNumber of children (age 0-5) in MCAH Programs that received recommended immunizations Briefly describe the CQI/QA process developedNumber of pregnant women in MCAH Programs who enrolled in Medi-Cal/all pregnant women in MCAH programsNumber of children (ages 0-5) in MCAH Programs who enrolled in Medi-Cal /all children (age 0-5) in MCAH programsNumber of pregnant women newly enrolled in Medi-Cal who had timely access to needed provider(s) /Number who were referred to a provider (Specify type: health, dental or mental health care provider)Number of children (ages 0-5) newly enrolled in Medi-Cal who had timely access to needed provider(s) /Number who were referred (Specify type: health, dental or mental health care provider)Describe referral process developed and submit referral form Describe the outcome of the CQI/QA process including methods of measurements and resultsFiscal Year 3 By June 30, 20XX, all eligible women, children, and adolescents presenting at the public health department (PHD) will be enrolled in health insurance and will have timely access to needed provider(s) Front line staff at the public health departmentMCAH staff Public health program staffInsurance providers, including Medi-Cal and Medi-Cal Managed Care(Insert LHJ specific partners and resources, such as funding)MCAH staff develops and implements policies to:Assess each pregnant and parenting woman presenting at the PHD to determine if they are enrolled in health insuranceRefer unenrolled, but potentially eligible pregnant and parenting woman for application assistance or directly provide application assistance for appropriate insurance typeRefer to the Medi-Cal Eligibility website: Covered CA website: Department of Health Care Services: Presumptive Eligibility for Pregnant Women: with referred pregnant and parenting woman to determine if they become enrolledEncourage enrolled pregnant and parenting woman to complete an appointment with needed provider(s) and follow-up to assure completionDevelop and implement a CQI/QA process to monitor implementation of policies/processes, a regular feedback mechanism to continually improve the process and a plan to evaluate the impactDescribe access to care issues identifiedDescribe rationale for interventions, recommendations, and strategies/policies developedBriefly describe referral process developed and implementedBriefly describe the CQI/QA process developedNumber of eligible women, children, and adolescents presenting at the PHD who enroll in health insurance/all eligible women, children and adolescents presenting at the PHD Number of women, children, and adolescents newly enrolled in insurance who had timely access to needed provider(s)/Number who were referred (Specify type: health, dental or mental health care provider)Describe policies implementedDescribe the outcome of the CQI/QA process including methods of measurements and results, if availableFiscal Year 4 By June 30, 20XX, X/X CPSP providers will develop protocols/policies to refer their eligible high risk pregnant and postpartum (PP) women to the public health department to ensure that these women are enrolled in the public health program or have timely access to a provider that best meets their needs(This objective could be used for multiple years depending on the number of providers you are trying to reach and your capacity)(If no CPSP providers in your LHJ, develop an objective targeting OB providers, and/or other provider types, e.g., pediatricians, PCPs, NPs, hospitals, clinics)MCAH DirectorPerinatal Services Coordinator (PSC) CPSP ProvidersPerinatal care roundtable membersLocal Public Health or Social Services DepartmentProviders or organizations that provide care for pregnant and PP women(Insert LHJ specific partners and resources, such as funding)MCAH staff will perform the following activities: Engage existing community partners/collaborativesMeet with CPSP providers and staff Inform CPSP providers and staff of the family benefits of involvement in MCAH or other public health programs Educate providers and staff on how to make referrals to the public health program that best meets client needsAssist providers to develop and implement referral protocols/policies for their high risk pregnant and PP women to the appropriate public health programProvide technical assistance and ongoing contact with the providers to ensure that referral system is implementedDevelop and implement a CQI/QA process to monitor implementation of policies/processes, a regular feedback mechanism to continually improve the process, and a plan to evaluate the impactMCAH staff number of visits/contacts with CPSP providers. Briefly list common outcomes.Number of referrals to public health programs by CPSP providers Briefly describe referral process developed and implementedBriefly describe the technical assistance provided to the providersBriefly describe the CQI/QA process developedNumber of CPSP providers who develop and implement protocols/policies to refer eligible high risk pregnant and PP women to the public health program that best meets their needs/XNumber of eligible high risk pregnant and PP women referred who enter into public health programs or have timely access to a provider/number referred (Specify type: health, dental or mental health care provider)Briefly describe protocols/ policies developed and implemented Describe the outcome of the CQI/QA process including methods of measurements and resultsFiscal Year 5 By June 30, 20XX, all eligible PP moms in need of further services from X hospital(s) OB department will be referred to the public health program that best meets their needs (If none or inaccessible birthing hospitals in your LHJ, develop your objective targeting referral processes with neighboring birthing hospital(s))OB department hospital staffProvidersMCAH DirectorPSCPublic health program managersProviders or organizations that provide care for pregnant and PP women(Insert LHJ specific partners and resources, such as funding)MCAH staff will perform the following activities:Engage existing community partners/collaborativesMeet with hospital OB staff Inform hospital OB staff of the family benefits of involvement in MCAH or other public health programsEducate hospital OB staff on how to make referrals to the public health program that best meets client needsAssist hospitals to develop and implement referral policies for their high risk pregnant and PP women to the appropriate public health programProvide technical assistance and ongoing contact with the hospital OB staff to ensure that referral system is implementedDevelop and implement a CQI/QA process to monitor implementation of policies/processes, a regular feedback mechanism to continually improve the process and a plan to evaluate the impactMCAH staff number of visits to hospital OB staffBriefly list common outcomes from hospital visitsNumber of referrals to public health programs by hospital OB staffBriefly describe referral process developed and implementedBriefly describe the technical assistance provided to the hospital OB staffBriefly describe the CQI/QA process developedNumber of PP women referred to the public health program that best meets their needs/all PP women in need of further services after hospital discharge (Specify type: health, dental or mental health care)Number of PP women enrolled in public health programs as a result of referral from hospital OB department/number of PP women referred from the hospital OB department (Specify type: health, dental or mental health care)Briefly describe policies developed and implemented Describe the outcome of the CQI/QA process including methods of measurements and results ................
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