Healthcare Equity Plan: Building a Better Safety-net Healthcare System

People with low-income face many inequities that prevent them from living healthier lives. This month, we hosted three Community Conversations across Travis County about Central Health’s recently adopted Healthcare Equity Plan.

More than 130 community members in-person and online joined us to learn how Central Health is already addressing health care gaps identified in this plan while working toward developing a comprehensive healthcare system for Travis County residents with low income. When populations with low income don't have equitable access to quality healthcare, it affects everyone.

In addition, participants were able to ask Central Health staff members questions and offer their own insights as to what potential shortcomings still need to be addressed. Central Health staff members will use the information they gathered to help put together the Fiscal Year 2023 budget.

(Austin) – The Central Health board of managers voted Wednesday to adopt an Equity-focused Service Delivery Strategic Plan, which will guide the immediate and long-term work of the healthcare district to improve health and reduce inequities for Travis County’s low-income population.

Central Health patients face extreme poverty, higher unemployment, and severe social inequities that prevent them from living healthier. The new strategic plan identifies opportunities for Central Health to continue to expand its reach and strengthen the impact on the health and wellness of Travis County’s most marginalized populations – especially communities of color.

“The board adoption of our Equity-focused Service Delivery Strategic Plan will, near-term and over time, improve the lives of the patients Central Health serves,” Central Health President & CEO Mike Geeslin said. “The effects of this work will be felt for years to come as we now have the framework in place to identify where the most significant gaps in care exist, and what needs to be done to eliminate the inequities that hamper our safety-net health care system. This plan represents a monumental achievement for Central Health, and we are excited to get to work.”

In 2020 the Central Health Board of Managers adopted a strategic priority to improve access to care for people with low income by building an equity-focused, comprehensive, high-functioning, and affordable healthcare system. The Episcopal Health Foundation provided Central Health with a $600,000 grant in June to support the first phase of this work

This funding allowed Central Health to hire Guidehouse, Inc. as a consultant to assist in the developing the service delivery plan, which is based upon three assessments:

· A community health needs assessment (CHNA) focusing on the needs of the Travis County population with annual household incomes less than 200% FPIL ($27,180 for an individual or $55,500 for a family of four);

· An extensive community engagement initiative involving patients, patient-serving advocacy groups and Central Health partners;

· And an analysis of safety-net health care system’s capacity and gaps.

“As a community we can all be proud of this plan,” Dr. Charles Bell, chairperson of the Central Health board of managers said. “For the first time in Central Health’s 18-year history, we have a health needs assessment focusing specifically on the population we serve. And we created a long-range strategic plan that merges robust community input with expert third party consultation from a national leader in this type of work.”

Central Health prioritized community engagement throughout the development

of the plan. Through a combination of focus groups, one-on-one interviews, surveys and community conversations, Central Health gathered input from 320 residents. This included patients with experience navigating the safety-net health care system, residents from low-income communities and advocates for hard-to-reach populations such as those experiencing homelessness or formerly incarcerated individuals.

Download the Voice of the Community Report.

The adopted goal of the plan is to develop an equitable system of care that is comprehensive and accountable, while optimizing the collective use of capabilities and resources to serve residents with low incomes. The plan identifies four strategic imperatives:

• Access and capacity – increasing the number of providers and care teams
• Care coordination – optimizing how patients transition between care settings (e.g. hospital to home)
• Member engagement – enhancing engagement for Central Health Medical Access Program (MAP) enrollees and expanding enrollment in high-need regions
• System of care – joint service-delivery planning and timely sharing of health care data.

Central Health is now preparing to enter the next phase of its equity-based systems planning – developing an implementation plan with financially sustainable operations plan.

Download the Safety-Net Community Health Needs Assessment Report.

Download the Equity-focused Service Delivery Strategic Plan.

Is an equitable health care system possible? Central Health seeks to create a high-functioning health care system that provides more opportunities for Travis County residents to have access to care – particularly those who are uninsured or underinsured. In 2020, Central Health launched a systems planning initiative to create a high-functioning, patient- and equity-focused health care system that will improve the health of people living in Travis County. In the initial phase of the project, the organization carefully studied changing demographics and gaps in the system to begin identifying the needs of residents.

In October 2021, we launched Voice of the Community – an initiative to understand factors that influence patient access, connectedness, continuity, and trust - and improve health equity among some of our most vulnerable populations. The initiative started with focus groups dedicated to understanding the needs of the people.

Since then, Central Health has

• Held focus groups with advocacy groups, people with low income, and institutions;

• Met with community advocacy groups to share information about the initiative;

• And conducted one-on-one interviews with people experiencing homelessness.

Our community engagement efforts have been focused around capturing the voices of people with low income and partnering with community organizations and advocacy groups to help us connect with people who are hard to reach.

Below are examples of ways Central Health has connected with the community:

1. Listening to patients - Staff and vendors invited residents with low income to a community dinner at Dobie Early College Prep Academy and to a community lunch at the Central Health Southeast Health & Wellness Center to hear about their experiences with the health care system over a catered meal. We offered transportation to and from these events for MAP/MAP-Basic members. We also offered children activities so parents could bring their children and feel comfortable participating. People representing a total of 84 households participated. Each household received an H-E-B gift card in appreciation for their time.

2. Talking to people that are often overlooked - Sunrise Community Church opened their doors and allowed us to use their space for one-on-one conversations with those experiencing homelessness. Thirty participants received a Target or H-E-B gift card in appreciation for their time.

3. Understanding how organizations help connect patients to better care - Central Health met with advocates and members of community agencies like Austin Asian Community Health Initiative, Community Coalition for Health, Latino Healthcare Forum, Caritas of Austin, Casa Marianella, and many others (The Community Engagement Report, which will be published in January 2022, will include the complete list).

4. Asking the people of Travis County to get involved - In addition, Central Health has been sharing information on this initiative and ways to get involved during community meetings like the Colony Park Neighborhood Association, the Anti-Poverty Community Advisory Committee, the Del Valle Community Coalition, the Central Health Equity Policy Council, and many others (The Community Engagement Report, which will be published in January 2022, will include the complete list).
   
   

Next Steps:

In the next few weeks, we are continuing to work diligently to elevate the voice of the community. Currently, our staff is calling MAP/MAP-Basic members directly to conduct a survey focused on ways we can improve the health care system for Travis County residents with low income. We want to hear from as many people as possible so that the decisions made out of this process are based on a diverse and broad set of voices of people around Travis County.

For those who have not had the opportunity to participate, we also have an online survey: tinyurl.com/CHVOC.

These efforts are taking place both in Spanish and in English. Staff and vendors have been offering accommodations for speakers of other languages upon request. For language accommodations, please email: communications@centralhealth.net.

Additionally, Central Health plans to host a Facebook Live Community Conversation on Thursday, December 16 from 11:30 a.m. - 12:30 p.m. in English and 1 - 2 p.m. in Spanish to share with the public information about the initiative and ways to get involved.

RSVP: https://www.eventbrite.com/e/204125263157