In response to the 1115 Waiver proposed by New York State in 2022, the Community Care of Brooklyn Planning Collaborative submitted public comments to the State entitled, “Strategic Health Equity Reform Payment Arrangements: Making Targeted, Evidence-Based Investments to Address the Health Disparities Exacerbated by the COVID-19 Pandemic”. CCB’s Planning Collaborative is a group of CCB members that includes Chief Executive Officers, Executive Directors and assignees from community-based organizations, providers and payers.
Joint Brief on Health Coach Program
Our new brief, “The Win-Win-Win Health Coach Model: Improving patient engagement, clinical outcomes, and career advancement through the integration of an emerging occupation in New York City primary care settings”, was prepared in partnership with New York Alliance for Careers in Healthcare (NYACH) and explores innovative workforce solutions that address the challenges of patient engagement and help to improve clinical outcomes. This collaboration between NYACH and CCB led to the implementation of a customized Health Coach Model, an evidence-based approach in primary care to improve the experience, quality, and cost of care for patients most in need of extra support.
Testing Provider Partnership
In December 2020, The Maimonides Department of Population Health entered into a one-year grant from NYC DOHMH to expand and increase COVID-19 testing by 20% of the baseline period. This baseline period, June through November 2020 resulted in an average of 17,492 tests performed monthly, with a plan to increase to 20,990 COVID-19 tests performed per month.
Community Care of Brooklyn took a multipronged approach to accomplish this goal – incorporating vaccination promotion initiatives along with testing efforts wherever appropriate – grouped into three main levels of engagement: provider, community, and patient.
Building off of CCB’s existing partnerships, 47 provider organizations including hospitals, FQHCs and private practices agreed to engage in this work. 13 of these organizations had never performed tests before.
Projects Under DSRIP
Based on the Community Needs Assessment, Community Care of Brooklyn selected 10 DSRIP projects to better serve the Medicaid population of Brooklyn:
- Create Integrated Delivery Systems
- Health Home-At-Risk Intervention Program
- Emergency Department Care Triage
- Care Transitions to Reduce 30 Day Readmissions
- Integration of Primary Care Services and Behavioral Health
- Cardiovascular Disease: Evidence-based Strategies for Disease Management
- Asthma Medication: Expansion of Asthma Home-Based Self-Management Program
- Integration of Palliative Care into the PCMH Mode
Population-wide Strategy Implementation (The Prevention Agenda)
- Strengthen Mental Health and Substance Abuse Infrastructure
- Increase Early Access to, and Retention in, HIV Care
CCB has pursued a collaborative approach to DSRIP project selection and planning with OneCity Health, the New York City Health + Hospitals Corporation PPS to ensure that the needs of our communities are met through a coordinated approach