Proposal to Host the 2019 CFHA Conference in

Denver, Colorado

Proposed Co-Chairs:

▪ Randall Reitz PhD LMFT has filled numerous roles with CFHA including current board member, current section editor for CFHA’s journal, and Health, past executive director, previous conference co-chair, and previous director of social media. He is the Director of Behavioral Medicine at the St Mary’s Family Medicine Residency in Grand Junction, CO.

▪ Lucy Graham, PhD RN is an Assistant Professor in the Colorado Mesa University School of Nursing. Before joining academia, she had a 15-year career nursing in an integrated HIV clinic. She co-presented a plenary session at the 2015 CFHA conference. She has a PhD in Nursing from University of Colorado.

▪ Alexandra Schmidt PhD LMFT will be the early career co-chair. In 2016 she completed her PhD in Marriage and Family Therapy from Texas Tech University and her pre-doctoral internship in Medical Family Therapy at the University of Colorado / St Mary’s Family Medicine Residency Fellowship. She is the Integrated Behavioral Health Advisor for Rocky Mountain Health Plans.

Other Local Planning Committee Members (See attached letters of support):

▪ Shi Coleman, Program Manager for Workforce and Population Health with Colorado’s State Innovation Model;

▪ Laurie Ivey, Director of Behavioral Health with Swedish Family Medicine Residency;

▪ Kim Marvel, Executive Director of Colorado Association of Family Medicine Residencies;

▪ Alex Reed, Director of Behavioral Health Education with University of Colorado;

▪ Janet Steinkamp, Colorado Office of Behavioral Health, State Innovation Model Project Manager;

▪ Michael Talamantes, Associate Professor in Social Work with University of Denver, Workforce Committee Co-Chair with Colorado’s State Innovation Model.

Why Denver? As the cultural and political hub of Colorado, Denver represents the ideal location for the 2019 CFHA conference. In recognition of the need for healthcare innovation, Governor John Hickenlooper announced a plan in 2013 to make Colorado the healthiest state in the nation by 2023. Key aspects of this plan include expanding public and private insurance coverage, closing gaps in access to primary care, and strengthening Colorado’s health workforce.

The State of Health Scorecard released in July 2017 showed that the state is making excellent progress towards this goal, having achieved 11 of 15 initial goals. Highlights include:

• More than 4 million people covered by a Health Information Exchange (HIE) to support care coordination across the medical neighborhood,

• Colorado Medicaid and six private health insurers committed to supporting value-based payments for healthcare through payment reform initiatives,

• Medicaid savings of nearly $280 million since 2013, • Funding increase of $10 million to support loan repayment programs for providers working in

rural and underserved communities, and • Development of a statewide crisis service system with a 24/7mental health crisis hotline.

State Participation in Healthcare Innovation

Colorado was an early adopter of the patient-centered medical home (PCMH) model of care delivery. The state has a long history of participating in innovative programs, including the Colorado Beacon Consortium, Advancing Care Together, and Sustaining Healthcare across Integrated Primary Care Efforts, to name a few. Although each program maintained specific focus areas, these initiatives largely concentrated on strengthening the infrastructure of healthcare to improve the quality and efficiency of whole-person care. Analysis of these programs revealed the importance of team-based, collaborative care as an essential element of providing comprehensive, patient-centered care. Several current initiatives continue to build upon the learning points gained from these prior programs and fuel the changes needed to improve the health of Coloradans.

Comprehensive Primary Care (CPC) Initiative Colorado was one of seven regions across the United States that participated in the Comprehensive Primary Care (CPC) initiative from 2012-2016.This multipayer initiative aimed to offer population-based care management fees and shared savings opportunities to participating primary care practices to support the provision of five comprehensive primary care functions: (1) risk-stratified care management, (2) access and continuity, (3) planned care for chronic conditions and preventive care, (4) patient and caregiver engagement, and (5) coordination of care across the medical neighborhood. The insights gained through CPC led to refinements in the organization of five core functions of comprehensive primary care and the development of the CPC+ initiative. CPC+ launched in 14 regions, including Colorado, in January 2017. Over 200 primary care practices are actively engaged in the CPC+ program working towards improved care, better health for populations, and lower health care costs through meaningful quality improvement.

State Innovation Model (SIM) In 2015, the state of Colorado was awarded a $65 million from the Center for Medicare and Medicaid Innovation (CCMI) to implement and test its four-year State Innovation Model (SIM) program. Colorado’s SIM initiative aims to provide access to integrated physical and behavioral health care services in coordinated community systems, with value-based payment structures, for 80 percent of Colorado residents by 2019. SIM aims to accomplish this goal by engaging 400 practices in three cohorts in practice transformation coaching with support from health information technology (HIT) coaches. Milestones within the program include high-value primary care activities such as team-based care, care management and coordination, data-driven improvement, and integration of behavioral health. Beyond practice-level support, SIM also provides funding to strengthen partnerships between individual practices, community resource organizations, payers, and local public health agencies. The first cohort launched with nearly 100 practices in February 2016, and preliminary data shows that practices are progressing along the spectrum of integrated care and improving their ability to report clinical quality

measures. The second cohort of 164 practices begins work in the fall of 2017. By 2019, cohorts two and three will be completing their work towards SIM milestones and creating plans for sustaining the changes they have implemented in their practice, and additional data will be available to be presented at the conference and the policy summit.

Transforming Clinical Practice Initiative (TCPi) The Transforming Clinical Practice Initiative (TCPi) is a federally funded support network designed to help specialty and primary care practices navigate provider compensation changes on the horizon as a result of the Medicare Quality Payment Program (MACRA) and increased emphasis on value-based payment with commercial payers. The program is open to clinicians in all 50 states, and nearly 2000 clinicians in independent and system-owned practices in Colorado are currently receiving technical assistance and peer support. The five stages of the program include (1) setting aims and developing basic capabilities, (2) reporting and using data to generate improvements, (3) achieving aims of lower costs, better care, and better health, (4) getting to benchmark status, and (5) demonstrating capability to generate better care and better health at lower cost. One key element particularly relevant to the mission of CFHA is the focus on strengthening communication between primary and specialty care providers, which serves to improve patients’ outcomes and experiences within the health system. Focus Areas for the Policy Summit These national and statewide initiatives have led to the identification of several key areas for discussion during the policy summit:

• Successes and challenges learned through initiatives such as SIM, CPC+, and TCPi • Workforce development efforts to support collaborative care teams prepared to deliver

effective, patient- and family-centered care • Payment models designed to support the integration of medical and behavioral health services • Policies and licensing regulations that help or hinder the provision of integrated care • Collaborative treatment for substance use disorders and responsible prescribing of opioids for

pain management Travel Attractions in Colorado Hosting the conference in the mountain west will provide excellent geographic diversity to CFHA’s conference-goers. The conference hasn’t been held west of the Mississippi since the 2013, when Colorado last hosted the conference. The full conference experience goes beyond the sessions offered. As the sixth busiest airport in the nation sustained by 25 commercial airlines, Denver International Airport offers non-stop flights to and from 188 domestic destinations, supporting its attractiveness as a travel destination. Denver, also known as The Mile High City, and its surrounding areas are well known as a magnet for those who seek the thrill of adventure, connection with nature, and engagement with arts and culture. For every year of the last decade, Denver’s population has grown at a rate of at least 2% every year. This long-sustained growth powers a thriving art and theatre scene, multiple professional sports teams, various live music options, an amusement park with 48 rides, a mile-long outdoor mall, over 11,000 diverse restaurants that feature locally sourced foods and flavorful combinations, and 70 craft breweries. For those seeking fun outside the city, Denver is just a short car ride from the Rocky Mountains, where attendees can enjoy hiking, biking, rafting, kayaking, and rock climbing, and more. Denver enjoys over 300 days of sunshine a year. With over 200 city parks and 20,000 acres of parks in the surrounding mountains, the possibilities for adventure are endless!

Partnership Agreements Please see the attached letters of support from the local planning committee. Each of the committee members has committed to bringing administrative and/or financial support from their employers and administrative systems. As the conference is over 2 years away, many of them won’t be able to finalize a specific financial commitment until the budget cycle of the conference. Our team is very well connected with Colorado’s health foundations and we have no concerns of meeting or exceeding the expectation of raising $60,000 to $80,000 in sponsorships.

Grand Junction Headquarters 2775 Crossroads Blvd. Grand Junction, CO 81506 970-244-7760 rmhp.org

Denver 6251 Greenwood Plaza Blvd.

Suite 300 Greenwood Village, CO 80111

303-689-7367

August 3, 2017 CFHA Conference Site Review Committee: It is my pleasure to support the proposal to host the 2019 CFHA Annual Conference in Denver, CO. On behalf of Rocky Mountain Health Plans (RMHP), I would like to offer my support for this application. Rocky Mountain Health Plans is a recognized leader in the healthcare system in Colorado. Our commitment to providing innovative, high-quality, whole-person health coverage sets us apart and drives us forward. We serve members with commercial, Medicaid, and Medicare coverage, and we have developed various Practice Transformation programs to support primary care and specialty practices in evolving to meet the healthcare needs of Coloradans and preparing for payment reform. Some examples of these programs include our partnership with federally funded programs such as Colorado’s State Innovation Model (SIM) program with a focus on integrated behavioral health, the Comprehensive Primary Care (CPC+) initiative, and the Transforming Clinical Practice initiative (TCPi). The 2019 conference showcases an ideal time to highlight the efforts that the state of Colorado has made in preparing a trained workforce to meet the comprehensive health needs of patients and their families and developing an infrastructure to support collaborative care. Hundreds of primary care and specialty practices across the state are actively involved in sustaining team-based, comprehensive care, and a 2019 conference in Denver would present an excellent learning and networking opportunity for providers from various specialties. We anticipate that the conference would be well supported by healthcare professionals from a variety of professional backgrounds and geographical regions from across Colorado and in the surrounding states. If the Denver 2019 proposal is accepted, RMHP would be willing to support the success of this conference through providing input in the planning process, marketing the conference to providers, and potentially offering financial support through sponsorship of this annual conference. We encourage you to strongly consider and accept this proposal. Signed,

Laurel D. Walters Chief Operating Officer

August 3, 2017 CFHA Conference Site Review Committee: Colorado Mesa University’s Department of Health Sciences enthusiastically supports the proposal to host the 2019 CFHA Annual Conference in Denver, Colorado. Colorado Mesa University, located in Grand Junction, Colorado in the western part of the state, has a 90-year history educating students. Today more than 10,000 students are working towards 70 undergraduate degrees. Hundreds more are working towards graduate degrees in education, business, and nursing. Colorado Mesa University has the only doctoral program in western Colorado and eastern Utah, the Doctorate in Nursing Practice (DNP). The DNP program trains nurses to be Family Nurse Practitioners, nurse leaders, and vital partners to health care teams. Collaborative, integrated care comes naturally to nurses whose training focuses on biopsychosocial health. In fact, faculty seek out opportunities to educate nursing students in integrated care. Fortunately, Grand Junction and the state of Colorado have led the charge in collaborative, integrated care and our students have the ability to learn from the experts; there is much to share about the innovative work being done statewide by teams of interdisciplinary providers and in workforce development. A conference in Denver would allow a variety of statewide care providers to share expertise with national colleagues. If the Denver 2019 proposal is accepted, Colorado Mesa University’s Department of Health Sciences would be willing to support the success of the conference by providing faculty and, if appropriate, graduate student support, along with marketing CFHA and the conference to the general Colorado Mesa University campus and the Department of Health Sciences clinical partners. I hope you will consider and accept this proposal. Please free to contact me via email at snadelson@coloradomesa.edu or by phone at 970-248-1675. Respectfully,

Dr. Sandie Nadelson, RN, MSN, MSEd, CNE Director of Health Sciences

The project descr ibed was supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). The Colorado State Innovation Model (SIM), a four -year initiative, is funded by up to $65 million from CMS. The content pro-

vided is solely the responsibility of the authors and does not necessarily represent the off icia l views of HHS or any of its agencies.

July 31, 2017

CFHA Conference Site Review Committee:

I am pleased to convey strong support for the application that St. Mary's Family Medicine Residency

submitted to host the 2019 Collaborative Family Healthcare Association conference in Denver.

The Colorado State Innovation Model (SIM) is helping 400 primary care practice sites and four

community mental health centers in Colorado integrate behavioral and physical health during its four-

year time frame. Our team would be interested in participating on the planning committee for the

policy summit or conference if Denver is selected as the 2019 site, and will dedicate a point-person on

the SIM leadership team to spearhead those efforts.

The state of Colorado has been heralded as a national leader in practice transformation efforts, which

is one reason why Denver would be an ideal place to host the 2019 conference, and the SIM team is

well positioned to help design content.

SIM is funded by the Center for Medicare & Medicaid Services and based out of the Office of Governor

John Hickenlooper. The team collaborates with state health departments and thousands of

stakeholders, including representatives from health plans, hospitals, local, state and federal

government agencies, consumer advocacy groups, health information technology organizations, local

public health agencies as well as healthcare providers and office administrators.

The team works with these stakeholders to ensure the sustained success of integration efforts across

the state, and would welcome a chance to contribute to your conference design.

The St. Mary’s Family Residency bid to host the 2019 Collaborative Family Healthcare Association

conference in Denver comes with the SIM team’s highest recommendation and commitment to help

ensure its success.

Please let me know if I can answer any questions or provide additional information, and I will look

forward to future communication.

Sincerely,

Barbara Martin, RN, MSN, ACNP-BC, MPH

Colorado State Innovation Model Office Director

July 31, 2017 CFHA Conference Site Review Committee, I am submitting this letter to strongly support your consideration of Colorado as the site to host the 2019 conference. The Colorado Association of Family Medicine Residencies (CAFMR) builds and maintains collaborative relationships among the 11 residency programs in the state. The overall goal of the organization is to maintain high-quality training programs by encouraging the sharing of best practices and resources. In this important segment of workforce development, all of the programs have a long-standing commitment to integrated healthcare. The recent addition of large grants, such as the State Innovation Model, have furthered the practice of integrated care in the residencies. With a rich tradition of integrated care, CAFMR offers its support for the application to host the CFHA conference. If Colorado is selected as the 2019 site, CAFMR can offer specific areas of support for the conference. A representative from CAFMR can serve on the Planning Committee for either the Policy Summit or Conference. The central office of CAFMR can serve as a liaison to distribute conference information to the residency programs and recruit residents and faculty to participate. Additionally, some of the residency programs can share strategies and stories of success in their approaches to teaching resident physicians to work collaboratively with behavioral health providers. Thanks for considering Colorado for the next CFHA conference site. Please do not hesitate to contact me if you have any questions about CAFMR or if I can provide additional information. Sincerely,

Kim Marvel, Ph.D. Executive Director Colorado Association of Family Medicine Residencies

July 24, 2017 CFHA Conference Site Review Committee Email address: info@cfha.net Dear Site Review Committee, As a former Co-chair and Program chair for the Denver 2013 CFHA conference and a Denver 2008 conference committee member (Program Chair) I am very excited about the possibility of bringing CFHA 2019 back to Denver. We had a fantastic time planning the event in 2013 and received excellent feedback about its engaging plenary sessions and creative didactics. People left energized and renewed, which was our goal. Besides, Denver is a great place to visit, and with its new airport to downtown rail system, has become an easy place for conference attendees to navigate. I am a psychologist by training with a specialty in residency education and integrated primary care. I have been a member of CFHA since 2007. CFHA is my professional home and I am very willing to support planning efforts for this conference and contribute my knowledge and time in helping craft an excellent curriculum for the conference. The team that Dr. Reitz is bringing together will have broad representation and expertise to create another unique experience for the conference attendees. I strongly encourage the Collaborative Family Healthcare Association to consider Randall Reitz’s application to host the 2019 Conference in Denver. If I can answer any questions or provide additional information, please do not hesitate to contact me at Laurie.Ivey@healthonecares.com. Sincerely,

Laurie C. Ivey

Laurie C. Ivey, Psy.D. Director of Behavioral Health, Swedish Family Medicine Integrated Primary Care Fellowship Director, The Colorado health Foundation

July 24, 2017 To The CFHA Board of Directors: I am writing this letter of support for the Denver 2019 proposal to host the 2019 Collaborative Family Healthcare Association’s Annual Conference. The state of Colorado has been major force in integrated care through the Colorado State Innovation Model (SIM), a project funded by the Centers for Medicare and Medicaid Services that is focused on helping primary care practices integrate behavioral health and testing alternate payment models. Furthermore, there have been statewide efforts to help develop, train and strengthen the workforce needed for these integration efforts. This letter is to confirm my support in the development of this conference. It is my understanding that my participation will include providing leadership on the conference committee and assisting in marketing and recruiting for this conference. The many integration efforts occurring in Colorado makes this a timely opportunity to host the 2019 CFHA Conference. I am confident there will be outstanding opportunities for conference attendees and participants to learn and collaborate while visiting a truly beautiful city and state. I very much admire the work and mission of the CFHA and I am pleased to be supporting the Denver 2019 proposal. Please let me know if I can answer any questions or be of further assistance. Sincerely. _________________________ Alex J. Reed, PsyD, MPH Director of Behavioral Health Education University of Colorado Family Medicine Residency Assistant Professor Department of Family Medicine University of Colorado School of Medicine

August 3, 2017 CFHA Conference Site Review Committee: I offer my strong support and my willingness to collaborate with Dr. Randall Reitz and the Denver team to host the 2019 CFHA conference. I strongly believe that the Denver Proposal 2019 will offer CFHA the strongest opportunity for a successful and inspirational annual conference. As a Clinical Associate Professor at the Graduate School of Social Work at the University of Denver, I currently work with numerous CFHA members in order to promote interdisciplinary comprehensive models of healthcare that integrate holistic care for the patient, family, team and community. In addition to my teaching responsibilities for MSW graduate students, I am actively involved in the Colorado State Innovation Model (SIM) as this initiative within our state is working to achieve integrated health services for all Coloradans. I serve as the co-chair of the workforce workgroup and we lead the efforts in the state to ensure that the behavioral health workforce is in place and appropriately trained to provide these essential services. The timing of the 2019 CFHA conference is perfect, as SIM will be completing the implementation of the initiative in the summer of 2019. We are more than happy to share our successes, as well as our lessons learned, in our quest to maximize pipeline and workforce efforts in our state. I enthusiastically commit to leadership on the planning committee and sharing my expertise and community contacts so that we can mobilize an interdisciplinary event that showcases not only the mission of CFHA, but also of the SIM of Colorado. Further, I pledge to assist in marketing and recruitment efforts so that we can optimize the chances of recruiting a true diverse interdisciplinary representation of professionals who are doing this work of integrated care in our state. In summary, I agree to collaborate with Dr. Reitz and the rest of the planning team. I believe that Denver, Colorado would be an optimal site to host the CFHA conference in 2019. Please feel free to contact me if you have any questions at 303/906-7324. Sincerely, Michael Talamantes, LCSW Clinical Associate Professor University of Denver-Graduate School of Social Work