Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.

City of ChicagoMayor Rahm Emanuel

Enroll Chicago: The Role of CDPH in Health Care Reform Implementation

September 18, 2013

Erica Salem, MPHDeputy Commissioner

Chicago Department of Public Health@chipublichealth#HealthyChicago

Presentation Outline

Supporting Enrollment Efforts

506,340 Uninsured Adults

•33,415 Disabled Persons

•145,171 SNAP Recipients

•7,288 Seniors

40,161 Children & Youth

Community-Based Enrollment Support

In-Person Assisters (IDPH)•$12.4 Million•24 grantees, several consortia

Federal Navigators (CMMS)•$2.3M •7 grantees

Health Center Outreach & Enrollment (HRSA)•$2.5M•16 grantees

• Information sharing

• Facilitate coordination

• Identify and address barriers

• Maximize enrollment efforts

Community-Based Enrollment Support

Enroll Chicago! Children’s Initiative

Enroll Chicago! Children’s Initiative

Illinois All Kids program

•Children (≤18 years old, ≤ 300% poverty) qualify for Medicaid and can receive comprehensive care.?

CDPH to fund a Lead Agency to coordinate outreach & application completion for at least 5,000 CPS students.

> Grant period: Oct. 2013 – Sept. 2015

> Funding available: $350,000-$1,050,000

Enroll Chicago! Children’s Initiative

Communities with High Density of Uninsured CPS Students

Community Area Elementary High

School Total

Albany Park 600 200 800

Archer Heights 500 --- 500

Ashburn 800 300 1,100

Austin 400 --- 400

Belmont Cragin 1,400 800 2,200

Chatham 200 --- 200

Gage Park 1,000 --- 1,000

South Lawndale 1,000 200 1,200

West Ridge 900 200 1,100

Chicago Lawn 500 --- 500

Logan Square 700 --- 700

Portage Park 600 200 800

Enroll Chicago! Small Business Initiative

• ACA requires large employers to pay shared responsibility fee if they don’t provide affordable coverage.

• Defined as 60% of health care expenses.

• Large employers = >50 employees

• This mandate affects just 6% of Chicago businesses.

Enroll Chicago! Small Business Initiative

Enroll Chicago! Hospital Partnerships

ACA Requirements for Non-Profit Hospitals

Establish financial assistance and emergency medical care policies

Limit charges for medically necessary care

Reasonable efforts before engaging in extraordinary collection actions

Conduct a community health needs assessment (CHNA) and adopt an implementation strategy

Conducted once every 3 years

Posted on hospital website

Public health involvement

Deadlines vary depending on tax year.

Hospitals not completing CHNA could lose tax-exempt status

Charitable Contributions from Chicago Hospitals, 2011

Hospital Community Health Needs Assessments(posted as of September 1, 2013)

Ann & Robert H. Lurie Children’s Hospital of Chicago Holy Cross HospitalMercy Hospital and Medical CenterMount Sinai HospitalNorthwestern Memorial HospitalPresence - Our Lady of Resurrection Medical CenterPresence - Resurrection Medical CenterPresence - Saint Joseph Hospital- ChicagoPresence - Saints Mary & Elizabeth Medical CenterRehabilitation Institute of ChicagoRML Specialty Hospital – ChicagoRush University Medical CenterSaint Anthony HospitalSchwab Rehabilitation HospitalUniversity of Chicago Medical CenterUniversity of Illinois Hospital and Health Sciences System

COMMUNITY HEALTH NEEDS ASSESSMENTS: KEY PRIORITIESSelected Chicago Hospitals

HospitalMental Health Obesity

Access to Care Diabetes

Heart Health

Chronic Disease

Respir. Health Violence

Social Determinants Cancer

Women's Health Stroke Other

Holy Cross Hospital √ √ √ √ √ √ √

Lurie Children's Hospital √ √ √ √ √

Mercy Hospital and Med Ctr. √ √ √ √ √

Mount Sinai Hospital √ √ √ √ √

Northwestern Memorial Hospital √ √ √ √ √ Our Lady of Resurrection Medical Center √ √ √ √

Rehabilitation Institute of Chicago √

Resurrection Medical Center √ √ √ √

RML Specialty Hospital √

Rush University Medical Center √ √ √ √ √ √ √

Saint Anthony Hospital √ √ √ √ √ √ √ √ √

Saint Joseph Hospital √ √ √ √

Saints Mary & Elizabeth Med Ctr. √ √ √ √ √ √

Schwab Rehabilitation Hospital √ √ √ √

University of Chicago Med Ctr. √ √ √ √ √

University of Illinois Hospital and Health Sciences System √ √ √ √ √ √ √ √

CHNA Key Priority Areas

The Guide to Community Preventive Services

OBESITY PREVENTION AND CONTROLINTERVENTIONS IN COMMUNITY SETTINGS

Interventions to Reduce Screen TimeBehavioral interventions to reduce screen time RecommendedMass media intervention to reduce screen time RecommendedTechnology-Supported InterventionsMulticomponent coaching or counseling interventions to: - Reduce weight Recommended - Maintain weight loss RecommendedInterventions in Specific SettingsWorksite programs RecommendedSchool-based Programs Insufficient Evidence

PROVIDER-ORIENTED INTERVENTIONSProvider education Insufficient EvidenceProvider feedback Insufficient EvidenceProvider reminders Insufficient EvidenceProvider education with a client intervention Insufficient EvidenceMulticomponent provider interventions Insufficient EvidenceMulticomponent provider interventions with client interventions Insufficient Evidence

Findings available at http://www.thecommunityguide.org/obesity/index.html

Other Related Initiatives

• County Care

• Starting Strong Collaborative

• Illinois Alliance for Health

• Health Care Task Force, Illinois Workforce Development Board

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