Can I Sign Alaska Banking Word

Can i industry sign banking alaska word mobile

okay casey if you want to take us to the next slide i'll talk about um some of the reminders that we have so uh i think we're all probably used to the way that webinars are working during the pandemic um we're gonna do like many other webinars and have questions submitted in the chat and we will answer them throughout and as with as much time as we have at the end also take questions through the chat we are on twitter we hope you are too you can tag us at aligning for the number four health and we have a hashtag link for health and of course we would love um for you to say something on twitter um because we want the word to get out about this great legislation and some of what we're talking about here today the full recorded webinar will be on the aligning for health website um and that is aligning for health.org and we'll also have lots of information about the bill summary overview um things like that so we hope that you'll visit our website for more information next slide so today i'm going to just say a few words and then we're going to hear remarks from our bipartisan co-sponsors in the senate senator dan sullivan and chris murphy and then we're going to hear from some folks on the ground who are actually doing this work which is really important to illustrate why we're here and why we think this policy is the right policy to achieve the goals that we all want to achieve so we hope you can stay for the panel discussion and then if there's time left we'll have q a next slide please just to let you know uh the whole this webinar is aligning for health i am the co-chair along with melissa quick and we were started five four years ago we're a non-profit advocacy organization and we really grew out of the need for actionable policies we at the federal level we had gone to many panels and webinars and speeches about the importance of social factors in healthcare and we felt like the evidence was sinking in and the conventional wisdom was that there was a need for a more integrated approach so we started aligning for health we advocated last year for the social determinants accelerator act uh most of which ended up in the end of your package and so we're back again here with um with link and these are our members it's a broad range of healthcare organizations on our board and then we have a really robust advisory board of food housing public health mental health um advocates and one of the pieces of homework for today is to go meet someone outside your network i think one of the most rewarding things about being part of learning for health for me has been meeting people in the food housing public health transportation sectors um because we all think a little bit differently and we all have different networks and part of what we need to do in integrating care is to get to know each other so i know you didn't come accepting homework but i'm never afraid to assign homework um next slide please uh so we have there's a lot of um different phrases thrown around social factors social drivers health equity so we thought just very quickly to level set to to talk about what we think are social determinants of all of these things that you see here nutrition housing even life and energy subsidies all contribute to health and we have uh we do still use the social determinants um language and but it's very similar with social drivers and social factors next slide please and again this was this is the evidence that i think um melissa and i felt had really been established and was really taking hold in the healthcare world that healthcare the way that we talked about it previously was clinical care how many hospital beds do you have in a community and that is really only 10 of health care based on the really incredible work of the robert wood johnson foundation and others to really get to the bottom of why is it that we have health um challenges in some areas and so this is the kind of evidence that was driving our thinking around developing policy next slide please so one of the important aspects of what we did at the beginning of aligning for health was interview a lot of people on the ground um counties non-profits um state people and state government to find out why is it that we um are lacking in some areas on coordination around social services and healthcare and there were many reasons for it i think part of what i just said which is that you know the relationship piece of it um another is that the way we fund programs is vertical but the way people live is horizontal so if you think about it the federal government funds housing and then it comes down um and it's housing housing housing all the way down to the local level and the housing funding and the housing requirements are different from the healthcare or you know or food and nutrition requirements so you've got these silos if you think about what we need in terms of a whole person we need to integrate the silos but then we have all of these aspects outside that are so important in social services and so um thinking about both integrating the government programs and then how do you communicate externally with the social services that you need and the reason why link came about is because through all these conversations and investigations one of the very clear factors was the um the lack of of a more centralized way of communicating between social service organizations and healthcare organizations so this bill provides seed funding for states to facilitate cross-sector communication service coordination customer assistance referral referrals because i know that you know sometimes if you're a provider and you give a referral to a patient even just for like you know to go see a mental health provider or some social service in the community you don't actually know if they did it and you're not actually sure where to tell them to go um so managing that referral and then capacity management if you think about it a lot of community-based organizations don't have funding um and so um this bill will um sort of assist in a facilitation of that and then finally um outcome tracking i mean imagine a world where we actually tracked outcomes um so they can establish public private partnerships with this funding and also expand technology if we've got a common tech platform that people can communicate on we could have a unified um patient record so again you can find information on our website i hope that you will do so and without further ado i want to um have us all hear remarks from our incredible congressional champions who have been working on this bill for quite a while and um so we have um senator we're going to hear first from senator dan sullivan he's been in the senate representing alaska since 2015. he is on the commerce committee and the veterans affairs committee and he's been a long advocate of vulnerable populations in alaska and also a senator chris murphy from connecticut he's on the health committee which is where this bill will be referred he's before coming to the senate he was in the um house for three terms serving connecticut and has worked tirelessly um for homeless veterans health care expansion um so both of our sponsors are enthusiastic about the bill and really hope to get it passed with our help and all of your help so let's hear from senator dan solomon and senator chris murphy good afternoon and thank you to aligning for help for hosting this discussion and for being an important component of the piece of legislation that senator murphy and i recently introduced and are very very exciting about i know we have a lot of people joining us virtually so thank you very much for your participation we're going to learn a lot from this conference i want to give first a special shout out to sue brogan for the united way of uh of anchorage for representing alaska in this conference and on this panel and sharing her experiences on the 2-1-1 system she does great work and i'm sure you're going to hear a lot of great things from sue so let me let me begin by talking a little bit about the unique and wonderful state and people that i represent uh back home in alaska you know we're a big state i know you're hearing from senator murphy we're a little bit bigger than connecticut and with of course size comes challenges many unique challenges particularly as it relates to health care because although we're a big very expansive state we don't have a lot of population about 730 000 people so this creates huge problems of access for health care particularly in our smaller communities we have over 200 communities in alaska rural communities that are not connected by roads so access to just getting there is difficult and oftentimes these communities have very very limited health care none of them have hospitals small clinics small providers usually no doctors in entire communities so those are some of the big challenges that we certainly have in alaska we've certainly seen like other places across america how one zip code can impact one's access to health care shouldn't be that way but that's what we've seen throughout our country but alaska has a rich history of innovating because of these very significant challenges with regard to our health care so for example we're one of the first states in the country to implement a system of wrap around services on a statewide level very proud of that in our native community that's almost 20 percent of our population alaska natives a very innovative alaska native health system throughout the state that provides access to health care and we are also the first state under the affordable care act to implement and have accepted by the federal government what was called a 1332 waiver to help lower our health care costs on the individual market so we are proud of that innovation despite all of our challenges and this all brings me to today while we the legislation we are talking about the leveraging integrated networks to address social needs act the link act as we are calling it and i want to thank senator murphy as a friend and calling and partner where we're going to work together on this legislation to support states and communities as they work to bridge the gaps that exist between poor health care outcomes and the services that already exist in these communities bridging that outcome and service gap is a critical part of this legislation to make sure the ability for new wraparound services that can bridge this gap are part of what this legislation is all about you know this holistic approach to health will connect patients with networks of providers and social services that best fits their needs and one of the things that we want to make sure we focused on in this legislation is making sure that states and communities have the flexibility to address their own unique challenges one size does not fit all in america certainly doesn't fit all with american health care alaska and connecticut for example have many different challenges what our legislation does the linked act is recognize this but also enables states to address their unique challenges as unique states under an overall encompassing piece of legislation so i want to thank senator murphy again in the aligning for health again for their partnership members of my team sarah and aaron are certainly going to be listening in getting your good ideas as we move forward on what we think is a very innovative and important piece of legislation that of course already has bipartisan support in the senate we look forward to your feedback we know you're gonna have a great discussion thanks again for your great support hey it's u.s senator chris murphy here to talk about the link to address social needs act i'm really excited to be introducing this legislation with my friend dan sullivan of alaska and i'm grateful to the connecticut hospital association and many of your 211 partners uh for drawing attention to this really common sense objective which is making sure that we have health care providers uh linked with all sorts of other social service providers in the community what we know in connecticut is that there are all sorts of what we call social determinants of health your health is certainly dictated by your access to good health care professionals but it is also dictated by your access to housing your access to nutritious food uh it is connected to all sorts of other aspects of your life that maybe today we don't specifically categorize in the health care basket i remember early on in my senate career going to one of connecticut's inpatient child psych units these were kids with serious uh mental illness and i asked how many of the kids that were currently impatient when i was visiting also had trauma had trauma histories in their life connected you know for instance to uh something happening in their family or to a lack of housing and the professionals i were there with i remember them kind of smirking when i asked the question um and they looked at me and they said all of them every single one of these kids has both a trauma history uh and a mental illness which brings them here today which again is just a reminder of how you can't separate separate out access to healthcare with access to all of the other building blocks uh of a decent uh humane and full life so what we're doing here with this bill is putting up some federal dollars to incentivize social service providers and healthcare providers to get together now we do that pretty well in connecticut but it doesn't get reimbursed by medicaid or medicare or most private insurers and so this will provide some federal grants um to substitute for that lack of reimbursement and in the end it'll frankly save taxpayers a whole lot of money because if you're spending a little bit of money you know making it easier for somebody who shows up in the emergency room with a health diagnosis but who is also homeless to go out and get access to housing that person will be much less likely to show back up in that emergency room very difficult to be healthy if you're also homeless just one example of how these dollars can help create these partnerships incentivize these kind of collaborations and i'm really glad to be working with all of you and with senator sullivan to try to push this forward over the course of 2021. great i want to turn it over now to my co-chair melissa quick um she's going to introduce our panel and talk more but i want to just say that melissa has worked tirelessly to understand the problem work with policy makers on what a good policy solution would be building the coalition of supporters of this bill and working with the policy makers on capitol hill along with our very capable colleagues chris adamec and casey osgood so thanks to melissa for all her work and um i'll turn it over great thanks krista um so i just want to give a quick reminder before i talk a little bit about the bill if folks have any questions about the bill itself or for our panelists as they speak if you could just please enter any questions that you have in the q a and we'll try to get to as many q a questions as we can during this time um so as chris mentioned hi everyone um my name is melissa i'm not going to give too much more detail about uh the link to address social media back chris did a wonderful job talking about it before but just want to mention that it would provide um funding to states to facilitate cross-sector referral and capacity management solutions there's more information about the legislation on our website and we will be sharing it with participants today so that you can learn more and help us to support its advancement in congress next slide and next slide so with that i'm i'm happy and excited to turn it over to our panel who will discuss their own experiences in coordinating health and social services and how they believe that the link to address social needs act can help regions from coast to coast including areas as senators poland mentioned as distinct as alaska kansas and connecticut first we'll hear from sue brogan of united way of anchorage followed by virginia barnes from blue cross and blue shield of kansas finally we'll hear from anne diamond of yale new haven health system and bridgeport hospital and mark shaffer who is representing the connecticut hospitalis speech next slide so we'll start with sue sue is the chief operating officer at united way of anchorage sioux formulates policies ensures effective and efficient daily operations leads the work of community investment and engagement advocacy and volunteerism all in support of community impact goals in education health and financial stability having worked in the nonprofit sector for 35 years sue has been with the united way of anchorage for 25 years and just briefly i just wanted to fly that in 2005 sue was asked to trailblaze and launch alaska 211 the one-stop statewide information referral system for health and social services she worked with the telecommunications industry regulatory commission for the state of alaska and local government to negotiate a partnership and co-location of the service within the anchorage emergency operations center sue continues to oversee technology and network administration statewide operations stakeholder relations marketing communications and media relations in support of alaska's two-on-ones commitment to being the first most essential resource to any alaskan who needs help sue good morning everyone i'm so happy to be here i want to thank senator sullivan and his staff and the team from aligning for health for the invitation to share a little bit about alaska with you today this is anchorage it's bordered on the east by the mountains and the west by cook inlet it's our largest city in our state with a population of 294 000 our state population is 730 000. as senator sullivan mentioned the majority of alaska is accessible by water or air travel only this presents an incredible challenge when it comes to accessing community resources many communities are very small and isolated and rely on services provided within their communities challenges arise when community members need to travel to a larger community or a hub anchorage is the largest community in the state with the highest concentration of health and social service organizations navigating between these systems of service is complex and that's where a single network system like 2-1-1 can add value next slide please 211 is foundational to work that goes far beyond just healthcare we have had businesses contacted contact us wanting to partner as part of their hr departments and we use 2-1-1 in schools to connect students and families with community supports we also work with law enforcement across alaska to make sure that they're aware of the system and how they can help spread the word alaska 211 works on behalf of and in partnership with many organizations non-profits for-profits government tribal entities located in communities all across the state our service providers make up the heart of the 2-1-1 system we launched in 2007 and have a current database size of 980 provider organizations which equates to 8 700 individual services available for referral we're very proud to be part of a larger national effort of more than 200 211s across the nation the data on this slide represents connections with individual callers to the two-on-one call center it's really a bellwether of community conditions and you'll note in the healthcare you'll note the healthcare explosion and calls from 2019 to 2020. those are coveted 19 related calls specifically many individuals seeking insurance options because they were laid off or they lost their job callers looking for you know interpreting travel mandates testing and vaccination sites you can also see the incredible increase in calls for housing supports from 19 to 20. the dramatic increase in these requests certainly is not unique to alaska next slide please you can go ahead and advance please to there you go thank you food insecurity is a challenge that many are facing and next to our request for rental and utility assistance the calls for food assistance rank in the top three requests and this has been consistent since 2007. the reason i pulled this slide um i was asked to talk a little bit about challenges and opportunities um so the reason i pulled this particular slide is that working in the social services sector assumptions are often made that everyone knows the difference between say a food bank and a food pantry or a mobile food pantry and home delivered meals versus congregate meals and soup kitchens you can go and donate non-perishables to a food bank but you can't pick up food there so you can see how it gets very confusing and you know to the in to an end user all they want to do is find food for their families so linking into a single network like 2-1-1 can provide clarity in a search for help next slide please prior to the launch of 2-1-1 this is what it might have looked like to a family who was looking for help the strength of a 2-1-1 system is that it provides navigation support a resource database base that is curated and managed and maintained and an expansive data repository on social needs within a community and most importantly trained staff who listen care and are knowledgeable and good at their jobs next slide please 211 is an easy number to remember but if a consumer is already in a place where their healthcare issues are being addressed it makes sense that more information should be available to that provider so to make it excuse me a seamless connection to help better alignment means that capacity can be managed in both directions using technology leveraging software capabilities and a database that is structured to allow for flexible use we face the challenge of individuals not being aware of community resources that might be available to address their social needs and then we find that health care providers may not be aware of those resources either so they cannot make a referral for that patient first and foremost our direct service work has shown that people need navigation assistance we also know that many social problems cannot be solved by a single organization next slide please this is recover alaska it's our first innovation partner you can see their vision and their mission there but i want to point out what is at the bottom of that screenshot it's circle get help now next slide please we worked in partnership with recover alaska to provide access into the 211 database to populate the search option on their website we were able to make this happen using technology data agreements and a standardized approach to the cost of data purchase recover alaska was able to maintain their branding provide the resource to their website users and receive data usage reports from 2-1-1 this is an example of how to use the 2-1-1 tool we're very happy to say that this partnership is one of our greatest success stories next slide please in a white paper released in november 2020 which was produced by the national 211 steering committee it states 211 has been engaged in social determinants of health work since its inception and continues to be a vital service in communities across the country because of our intimate knowledge of resources and our ability to provide a center point of access to social determinants of health referrals 2-1-1 is uniquely positioned to be a key partner with health care to provide whole person care we look forward to the passage of this bill to be able to carry forward the work of 2-1-1 fortifying the provider relationships and continuing to connect individuals with resources that they are needed so by so many right now thank you for the work that you are doing and we look forward to the partnership thank you so much sue um and just a reminder if you have any questions either for sue or about the legislation please feel free to drop it in the q a we will try to get to as many as possible if not we will follow up and try to post responses to some of the q a on our website as well so now turning to virginia virginia barn or two virginia barns rather virginia joined blue cross and blue shield of kansas in october 2015 as director of blue help initiatives as director of virginia is responsible for investing in communities to create sustainable healthy places for kansas live work and play in ways that improve the quality of their lives virginia brings to her role at blue cross a strong background in public health having spent more than eight years at the kansas department of health and environment in a variety of roles virginia thank you melissa and thank you for allowing for help for inviting me to present so again i am director of blue health initiatives and blue cross blue shield of kansas is a mutual not-for-profit insurance company that serves 103 out of the 105 counties in kansas so glad to be representing the midwest in this presentation today uh blue health initiatives has been a commitment from blue cross uh to really expand how we address social determinants of health and how we understand community and population health in kansas and next slime and so we started in 2016 uh through identifying in northeast kansas the need for a risk a social risk referral network and through a community needs assessment and community health improvement plan both with community partners and with stormont bail health which is the large regional health care system in that area and when we recognize that this was a need we also understood that we would need to build a network that bridged that healthcare and social service organization gap to really understand how we could serve across the community and so we did establish the northeast kansas community network i will say we naively started this in 2016 thinking uh we can put a platform in place will allow for those resources and referrals and if you build it they will come and truly the the journey has been a bit longer than that uh so in 2019 uh we reassessed what we were trying to build really engaged strongly with united way who was already a great partner with blue cross blue shield and dug deeper into what do our community-based organizations need to create a referral network how do we align with sale um to engage the healthcare and the social organizations more strongly and how do we really utilize um the platform in this case healthify is our platform and so that we're serving that whole person here and really addressing the needs of the population next one so as i said uh 2019 we strongly engaged with our community partners we actually started off with just two or three of the partners listed here on this slide and began bringing them together to understand what is their workflow and why is a referral network important to them and actually recognize that a lot of them haven't had those conversations within the community and across partners and often time you start with your service and you kind of get a head down silent approach and don't have that bigger picture so it's a really wonderful opportunity to build this network out by starting with those conversations with partners in 2020 we did integrate helpify into um this vermont vale emr and that allowed us to launch the full network this past august so it's a pretty new network but we feel like there's been a lot of lessons learned along the way and we will say that because of koga 19 the pandemic we saw that having this network started also allowed us to expand quickly and go from some of the i think we had three or four uh initial partners to the 13 we have um now in the network and we are continuing to expand uh in relation to the needs that we are seeing in the community next slide and the great part about that approach is that we have been able to to take those organizations and not only recognize who are the partners our healthcare system already understands that they need um but as you bring partners in who are they partnering with and who else should be in the network and then taking that and looking at a network adequacy so across the region that we serve what are the types of referrals that we're seeing that are important where do we have gaps within the network of partners that can do a bi-directional referral and how do we look at our data to understand how we fill in those gaps and who we invite to join the network so we're trying to take a very intentional approach to how we build this out next one and now that we have been able to build the network uh really we've just begun so with the organizations that are on board we have begun to not only have the pieces where we can assess risk and build out those referrals um but to come together regularly and look at the data so the great thing about having that platform is that anecdotally most of our partners could have told you that financial support was going to be a big problem or food security was going to be a big problem in the community but now um we have those metrics and those datas that we can start to build out on um especially in communities in kansas uh when you have a rural community and a lot of times the data that you're looking for doesn't show up in those large data sets that people usually reference when we're talking about social services it can be very difficult to really wrap your head around what your community needs and be able to provide that data back to a large healthcare organization or a payer or your government entity to say this is what our community needs and so we are able to take that really understand what are those social services that are either being addressed or frankly not being addressed by the network they either don't exist or they don't have capacity and now we can have those big bigger social determinant conversations and not just the anecdotal social media conversations so that's been a real bonus of starting this network and i just listed a couple of the types of measures um that we are starting to look at that look both at the capacity of the network but also um how how are we seeing those services um again on the referral and the actual offering side too so a little bit of both in terms of capacity um and services being measured and we look forward to really building that out over the next year as we get on our feed address with the network next slide so why is the link act important uh we think that there are a lot of challenges like i said we actually started this work almost five years ago and had to recognize a lot of our assumptions were not accurate uh so when you are building a network based on uh historically disconnected systems that we all have that value of you want to help our member or our client we have that number one value that is the same but past that the value systems can be dramatically different in terms of how we do service and so um being able to begin those conversations was really critical and continues to be critical when we talk about uh thinking about a statewide networker or nationally uh and and that first point i sort of skipped over but this does take time it's a lot of time and a lot of effort and a lot of really good people trying to change a system uh so that's a huge challenge that we see um in this this particular line of work and then interoperability which is probably a dreaded word in healthcare but realistically um blue cross and blue shield of hands as i mentioned we serve 105 103 of the 100 105 um counties in our state so we don't serve kansas city so we recognize automatically that despite building a system in northeast kansas we know there has to be that bigger conversation and interoperability because we can't um we can't serve kansas city to full capacity we have to have partnerships we have to be able to network and i mentioned again rural readiness having urban and rural areas we know that the rural areas can't be left out can't be left behind we need to be able to tackle their needs as well which can be very different when it comes to access and finally sustainability a huge part of the conversation that we think act will help with as well and so we see those challenges but we're ready to meet them um and i believe that is my last slide so thank you again for having me present great thank you so much virginia all right so now we'll turn to ann diamond and mark shaffer from connecticut so ann is the president of bridgeport hospital and executive vice president at yale new haven health system she's been in healthcare for over 30 years and has held many positions in her career starting as a nuclear medicine technologist radiation saf ty officer and researcher moving through the leadership ranks of hospitals to the cc and was recognized by the american hospital association at the 2020 grassroots as the 2020 grassroots champion in recognition for her exceptional leadership in advocating for patients and hospital priorities she is an active and engaged advocate leading the connecticut hospital association's statewide asthma initiative to improve patient care and access and to design new models of care to transform community partner and hospital relationships her community sorry her leadership on asthma highlighted the dual challenges of health disparities in social determinants of health which led her to establish and chair the connecticut hospital association's health equity advisory council and uh dr mark schaefer mark is a clinical psychologist and the vice president for system innovation and financing at the connecticut hospital association dr previously served as a state's medicaid director at the department of social services and subsequently as the state's director of healthcare information he led the state's five-year multi-payer state innovation model initiative overseeing a wide range of payment care delivery and insurance reforms and launching connecticut's first quality scorecard health score ct in his current role with the cha connecticut hospital association he is working to advance a sustainable healthcare delivery and financing system that fosters innovation provides optimal health for connecticut communities they're turning it over to you both all right good afternoon and thank you melissa thank you to aligning for health for bringing us together in this webinar it's uh it's an honor to be here today let's dig right in and go to the next slide all right so this is uh connecticut we may be small but we are mighty um and you can see all of the h's there that represent the 31 hospitals within the state and bridgeport is the red star down there towards the bottom so a few years ago uh back in 2018 the connecticut hospital association which really is a an excellent statewide facilitator of important health care issues brought together all of those ages that you see 31 hospitals and as part of our strategy planning effort reaffirmed our commitment to the communities that we serve specifically addressing the social determinants of health now this came out of that shared recognition and the increasing side scientific evidence that health is more than just the health care that we provide and we've heard this from many of the other presenters uh this afternoon that the social determinants of health specifically those social and environmental factors are vital components really in that holistic approach to the individual's health and well-being you can see the um the three phases as i said we started in 2018 really focusing on process on data education and architecture development we're currently in phase two and i have to admit that covet has slowed us down a little bit but we are still forging ahead uh looking towards 2022 as we move into our third phase and i'll discuss a little later in more detail what that looks like let's move on to the next slide so i i love this quote this is by dr mafuze hawk dr hawk is our medical director of population health our primary care strategy where we serve the majority of our low-income patients and of course complex diseases and i'm not going to read the the whole quote but i i think there's a few important phrases here no one should fall between the cracks and that patients returning patients to environments that negatively impact their health just perpetuates an unhealthy cycle and that platforms like unite us really create an integrated health and social service approach where a person can recover to their fullest uh extent which of course is is what we want so the more that we can help an individual successfully meet their social determinant of health needs the more likely we are to be uh healthy and active successful outcomes uh after the patient leaves the hospital so whether they're recovering from an acute illness or the management of a chronic illness it's really putting that center in the patient the the patient in the center uh of all of those other uh social determinants that really helps improve next slide please all right so let's take a look at some of the challenges that we have here in the greater bridgeport connecticut area we can see clearly that the impact of the lack of inadequate social determinants of health in our community has so according to the bridge board hospital's latest community health needs assessment we found that 28 of bridgeport residents do not have enough food to feed their families each month and 43 percent of bridgeport residents only have two months or less of savings to help support them if they were to lose their jobs on the left hand side of the slide you can see the greater bridgeport area and i call out two life expectancy data points in bridgeport it is now 77.6 years but if you go a little bit to the to the south and west in westport the the life expectancy is 85.4 years that's 7.8 year difference in only 12 miles so clearly within the 26 towns in our greater region we have some work to we have some work to do next slide please all right so health equity is absolutely vital to addressing the needs of our community improving the overall health and well-being so each person has significant and unique um social determinants of health needs and all of these are different you know one size does does not fit all and we see the impact on our patients when their non-medical needs are not met so for example the asthma patients in our community suffer when they live in substandard houses that have mold pests rodents etc diabetic patients suffer when they don't have access to fresh produce and other kinds of healthy foods um our heart patients suffer when they don't have safe neighborhoods or local parks where they can walk exercise uh and and get out there and of course our behavioral health patients suffer when there isn't access to transportation to get them to and from uh support groups and therapy uh etc uh next slide so so how are we going to address this well you know we need to move to a patient-centered referral system we've long recognized that the importance of integrating uh the screens for social determinants of health into the patient care environment so that these needs are identified referrals can be uh made and facilitated and the needs addressed so um you know we also recognize that hospitals really did not have an efficient way to make these referrals uh and communicate seamlessly between the hospitals and the community organizations in the traditional system and you see that on the left-hand side part of the slide you know that's really where all the hospitals and the community organizations were really moving kind of in parallel we didn't take that holistic view of an individual's complete needs the care was fragmented at best and it left patients to really kind of navigate on their own their needs and in this siloed approach we saw that there was none to very limited uh real-time communication between the community the government and and the health care so um you know the health and social providers also lost visibility after the patients were discharged we had no way of knowing whether you know we made a connection um did they get connected did the problems get solved um and and it was really just not very uh not very efficient so um you know this all contributed to the poor outcomes that our patients are are experiencing their care plans were not getting uh completed effectively we found that it just was ineffective and quite frankly we were seeing our patients returning uh to the emergency department and then being admitted and and some of these admissions may have been avoidable so if you look on the right side you see the client the patient right in the very center and you know this enables us to work through a managed network solution that makes screening and referrals easy for my staff the hospital staff to the community organizations to accept referrals and receive and pass back information and the two one one system that sue spoke of is also here implemented in in connecticut let's go to the next slide all right so um let me tell you a little bit about the bridgeport and connecticut experience so as the connecticut hospital association organized this statewide hospital approach to improve the hospital and community organization referral process through the implementation of a cloud-based electronic referral system unite us really bringing us together with the community organizations and bridgeport hospital became the first pilot within our health system to use this coordinated effort and so through the collaboration with our partners the health improvement alliance and the other community organizations we developed a really strong referral network within the greater bridgeport area and that's enabled us to change the way the referral system works we're able to make electronic referrals securely share client information track outcomes together and inform community-wide uh discussion so unite us currently has 200 organizations in its network of which the largest percentage are right here in the greater bridgeport area food housing benefit assistance and utilities have been the top four needs that we have addressed for our clients i just want to share a patient's story um just to kind of illustrate how effective this really was um we had a 49 year old woman um i'll call her peggy that's not a real name she recently had a heart attack and she was unable to continue to work so right around thanksgiving of 2020 she came to us for asymptomatic covet testing and while she was there we screened her for social determinants of health and we found out that um peggy was positive in that screening for needs uh related to food insecurity and utility assistance so during the initial intake the patient shared that she was a daycare provider she had been furloughed as a result of the pandemic and that she also had utility payments as a priority so through unite us the united the patient was referred to alliance for community empowerment and the initial referral turns out was denied and so advocacy jumps in helps peggy we clarified why she was denied and supported in recon completing the application the good news is peggy was successful uh in receiving utility assistance uh through this effort and then with subsequent conversations with peggy we found out that she exhausted her unemployment benefits and now she has a significant health concern so again advocacy jumps in and through the community health worker uh we were we found out she is able to receive support through the pandem excuse me pandemic unemployment assistance um through the department of labor and so again the um the community health worker helps her complete the application peggy receives this and now when you talk to her peggy's like so grateful for all of the help that she was able to receive and really able to focus on her health and recovery instead of worrying about the social determinants that impacted her let's move on to the last slide so again using a coordinated approach we were able to holistically focus on peggy and our other patients enabling them to achieve better health and well-being we're able to extend technology platforms able to extend networking to behavioral health providers enhance the analytics so we can actually understand and be predictive about which of our patients would benefit from the from the united platform create that interoperability uh solutions um you know so there's more than one platform in each state or service area and then of course expand um the medical records uh integration so we're all talking to each other so additional funding from the federal government under link would help us to expand these networks create more providers and community organizations particularly in our underserved areas and overall just basically improve our ability to achieve health equity for our patients thank you thank you anne um so now we'll open it up for a q a um recognizing that we only have a few minutes left um we'll try to get to as many questions as possible um and for any other questions that we have received through the q a we'll either try to answer uh live you via the q a box or um our panelists have generously offered uh to help us put together kind of a written response to some of the the questions that we don't have time to get through today we'll post that on our website along with other um materials uh including uh the slides and the recording uh from today's webinar as well as all of the other information about the link to address social needs act um for your perusal uh so to start i just want to i know a couple of the panelists uh mentioned this in in your remarks but you know reflecting um the elephant in the room which is covid19 um i'm curious you know from your experience over the past year how has the kobit 19 pandemic affected your networks um uh and have there been any specific challenges or opportunities that the pandemic has provided or has put in the way for you and then i know anne provided a really good example or anecdote of you know how the uh how the establishment of this kind of referral network can kind of help um address certain social needs and identify things in real time especially during um a pandemic in times of existence but curious others have other um examples that they would like to share so this is mark and i'd like to just comment on on that there is another way that hospitals have used the screening process and that is to align it with the cobot 19 testing so that when somebody test positive and you're trying to support quarantine and isolation you have the ability to uh solve timely for the uh kinds of uh basically uh social needs that might otherwise interfere with somebody's ability to do that and the same is true as you identify folks with whom they've had contact and supporting that as well anybody else want to add on i think just from you know our experience here in connecticut um you know we have we have uh cared for close to 3 000 coveted patients just at bridgeport hospital and certainly we're seeing a a shift to more self-pay meaning they're losing their job they're losing their benefits uh and also a shift to government payers uh specifically medicaid so you know the um the needs for a link and unite us is just becoming even more and more important i'll just add that here in alaska we partner with our department of health and social services and they had a group of volunteers that were all licensed medical practice folks and uh two one one was used as a screening mechanism to transfer you know calls to that group because what we found was our social service providers many of them were not open they were not in operation so we were spending an awful lot of time trying to figure out you know who was working who wasn't working so again um we are fully behind creation of a network uh a more holistic network no you know no matter what tools that we use because we could have been um you know triaging and using different mechanisms had all of those things been in place and if i could just add on to what sue just shared you know during covid many of our community organizations really closed down so this really enabled us to continue making the referrals and particularly our patients where english was their second language having that community health worker help them with all of the different applications really was just made all the difference in the world you know and one other add-on i would just say that it has other applications not just in a pandemic situation we saw the same thing in 2018 when we had an earthquake here in alaska um you know the same the same kind of thing was happening where providers were not open and we were spending a lot of time trying to figure out how to connect folks to pharmacies and things that they were in immediate need for so you know disaster non-disaster this network approach has a lot of a lot of value great thank you um so just to answer a couple of the questions um that we received in the chat specific to the l gislation so one of the questions was uh related to whether or not the intent of the funding or the uh technology platform that might be funded through the funding that would be made available through the legislation whether it's um intended to be kind of uh created at a single federal level or more as state and local levels and just to clarify so the funding would go to states uh uh through public-private partnerships that the states would partner with um to kind of build out either statewide or regional approaches uh to connecting health and social services organizations so it would not be a federal or nationwide structure but uh rather you know as senators holden mentioned in his remarks um really um trying to cater to the unique needs of giving communities or states to make sure that they are able to kind of knit together the different resources um that are available within their areas a second question is how will states and municipalities be able to access the federal funding so just a note this is a legislation that is being introduced as we speak so this is kind of the very start of the process we are very hopeful that we will be able to get this legislation enacted um and the funding will be made available to states um but it is a uh it takes a village and so we are hopeful on that uh through efforts uh and through you know the help of many of you on this webinar we will be able to kind of marshall support and push for the enactment of this legislation to be able to make that funding available uh to build these types of networks and recognizing we're at time i just want to casey if you could flip to the next slide and we'll try to get to as many of these as i mentioned as many of these questions as possible um on our website we'll provide answers uh but just to make a request if anybody on the call is your organizations are interested in endorsing the legislation and helping to get out the word please please let us know we are looking for any and all um endorsers who can show their support for what this bill can catalyze at the state and local level next slide and then as i mentioned there is information available on our website including one pagers faqs the bill text and a link to endorse the link legislation so please um you know find us at aligningforhealth.org and we would be happy um to answer any additional questions that you have next slide uh so with that i just want to thank everybody for joining this has been a wonderful very quick hour um i especially want to extend my thank you to our panel uh for your time and for your wonderful remarks here we really really appreciate it and again if anybody here has any but any questions for us you can read up that info at aligningforhealth.org and we will try to be in touch thank you very much