Cross-Systems Care Integration: Increasing Access to Culturally Competent Care for Persons with Intellectual and Developmental Disabilities

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Interview with Ryan Kerner, Health Integration Manager and Project Manager for the CSCI Replication and Spread Project Funded by Colorado Springs Health Foundation 
 
Since January 2019, The Resource Exchange (TRE) has worked with HealthTeamWorks to develop a strategy, refine tactics and round-out a business plan to effectively replicate and spread a Cross-Systems Care Integration (CSCI) model supporting the health of people with intellectual and developmental disabilities. We interviewed Ryan Kerner, Health Integration Manager and Project Manager at TRE about the CSCI model and  the current project to expand access to culturally competent care for individuals with IDD.
 
Tell us a little bit about TRE and the organization’s history?
Through the efforts of parents and professionals, The Resource Exchange (TRE) was incorporated in 1964. Currently TRE has just under 300 employees, and an operating budget of about $17.5 million. We serve individuals and families in communities throughout El Paso, Park, Pueblo and Teller counties, with a mission to build independence for people with intellectual and developmental disabilities (IDD).
The Resource Exchange is a “Community Centered Board.” For more than four decades, Community Centered Boards (CCBs) have managed and delivered services to children and adults with developmental disabilities. Currently there are twenty Community Centered Boards serving approximately 19,000 individuals and their families throughout Colorado.
CCBs continue to lead the nation in supporting the independence, productivity, and integration of the people we serve. CCBs enable them to exercise their rights to live, learn, play and work in their home communities with dignity, abundant choices, opportunities and responsibilities accorded to all citizens. Above all, CCBs believe that all people have the inherent value and the right to exert control and responsibility over their own lives.
What is Cross-Systems Care Integration?
Cross-systems care integration (CSCI) brings the healthcare system, long term services and supports system, and a person’s community of naturally occurring social and developmental supports into common purpose in supporting the health of people with IDD.
How long has TRE been working on Cross-Systems Care Integration?
In 2007, with supports provided by the Coleman Institute for Cognitive Disabilities, Colorado Health Foundation, JFK Partners–University Center of Excellence in Developmental Disabilities of the University of Colorado, and University of Colorado at Colorado Springs, TRE engaged numerous community agencies and national leaders in disability and healthcare who shared an interest in improved healthcare service models for people with IDD. By 2009, five Colorado Springs-based organizations combined to establish an integrated, collaborative, and interdisciplinary healthcare model that addressed primary, mental, and behavioral health, health promotion and wellness, and health education, all designed with and around the needs of people with IDD. Two years later, in 2011, these partners opened a thriving health center providing care based on this model. Today, TRE is working with support from the Colorado Springs Health Foundation to replicate and spread the model to increase access to Culturally Competent care for individuals with IDD in Park, Teller, El Paso and Pueblo counties.

 

Tell us more about your current project to expand Access to Culturally Competent Care in your Region?
To begin this project TRE conducted a Community Health Needs Assessment to answer the question “What does culturally competent healthcare mean for people with intellectual and developmental disabilities (IDD)?”. Focusing on El Paso , Park, Pueblo and Teller counties we explored:
Upon completion, we presented the themes that emerged during interviews and focus groups, the results of the surveys gathered from community members and healthcare providers, and offered recommendations to enhance the healthcare experience for people with IDD and their healthcare providers. Those recommendations were integrated into our refined Cross-Systems Care Integration model. Since in January 2019, TRE has worked with HealthTeamWorks to develop a strategy, refine tactics and round-out a business plan to effectively replicate and spread the CSCI model. In addition to observing workflows in practice and further clarifying recommended efficiencies within the model, we have finalized a strategic plan and began operationalizing the plan and developing the business case for various methods of expanding the reach of the model.

 

"Since in January 2019, TRE has worked with HealthTeamWorks to develop a strategy, refine tactics and round-out a business plan to effectively replicate and spread the CSCI model. In addition to observing workflows in practice and further clarifying recommended efficiencies within the model, we have finalized a strategic plan and began operationalizing the plan and developing the business case for various methods of expanding the reach of the model."

We documented and refined the key workflows for CSCI and formally captured best practices and implementation tips. Most recently we have completed the development of a change package to serve as the implementation road map for new primary care partners.
 

"We know the CSCI model leads to improved clinical outcomes and health related quality of life. Translating the model into one that is financially sustainable will require shifts from fee-for-service models to value driven reimbursement. This will allow for more options for access to culturally competent care and more individuals whose clinical needs are fully met."

What value does a Care integration Specialist bring to patient lives and practice care teams?
The Care Integration Specialist serves as a trusted, informed, and empowered advocate for patients’ health and well-being. They offer coordinated Cross-Systems Care Integration, management of population-level data, advocacy and health promotion, multi-disciplinary team communication, promotion of facilitators of care and maintenance of a strong primary care partnership.
What do you look forward to as a result of your work to expand CSCI across Park, Teller, El Paso and Pueblo counties?
Principally, we strive to see every person with IDD gain superb access to high-quality culturally competent health care – with all of their natural, and long term services and supports working in concert. We know the CSCI model leads to improved clinical outcomes and health related quality of life. Translating the model into one that is financially sustainable will require shifts from fee-for-service models to value driven reimbursement. This will allow for more options for access to culturally competent care and more individuals whose clinical needs are fully met.

This interview was conducted by Cecilia L. Saffold, COO, HealthTeamWorks

TRE is conducting a survey of practices serving people with intellectual and developmental disabilities across El Paso, Teller, Park and Pueblo counties in Colorado. The aim is to understand the care coordination needs of those practices and to determine how TRE may best provide services to address those needs. If you provide care in those Counties, you are invited to complete the survey, and to state whether you are willing to be contacted by TRE for additional conversations around providing access to the highest quality care for people with IDD. For questions, contact Ryan Kerner at (719) 380-1100 or rkerner@tre.org.

Link to Survey: https://www.surveymonkey.com/r/7JQS3P2