HEALTH ENTERPRISE ZONES: Eastern Shore Public Forum Wor-Wic Community College Department of Health and Mental Hygiene Community Health Resources Commission September 13, 2012

2 Main Components of the Act Health Enterprise Zones (HEZ) Promoting Cultural Competency Encouraging Reporting and Analysis of Health Disparities Data

3 Health Enterprise Zones The purpose of establishing HEZs is to target State resources to: –Reduce health disparities among racial and ethnic groups and geographic areas; –Improve health care access and health outcomes in underserved communities; and –Reduce healthcare costs and hospital admissions/readmissions.

4 Health Enterprise Zones Each HEZ will be a contiguous geographic area; Must have documented evidence of health disparities, economic disadvantage and poor health outcomes; and Small enough to allow incentives to have a significant impact but large enough to track data (population of at least 5,000).

5 Eligible HEZ Applicants Non-profit community-based organizations and local government agencies will be eligible to submit an application for HEZ designation on behalf of an area or community. The state is encouraging HEZ applications to reflect inclusion, community participation, collaboration, and support the priorities identified in the Local Health Improvement Process. The application for HEZ designation will be combination of both demonstrated need and intervention strategies to improve health outcomes in the potential Zone.

6 Health Care Practitioners Eligible to Receive HEZ Incentives In order to receive incentives/benefits, health care practitioners must provide services in the HEZ, be licensed/certified, and provide health care in one of the following areas: –Primary care, including OB/GYN, pediatric and geriatric services; –Behavioral health, including mental health and alcohol and substance use services; or –Dental services.

7 HEZ Implementation An internal steering committee led by Secretary Sharfstein, comprised of DHMH, Lt. Governor and CHRC staff, has been established to guide implementation of the HEZs. Assistance has been provided by the Health Disparities Collaborative. There will be three stages in the process to implement HEZs: –Public Comment (June 15 - July 20, 2012) –HEZ Selection Process (September – December 2012) –Implementation & Evaluation Phase (December 2012 – beyond)

8 Public Comment & Public Forums  Feedback was requested on the following: (1) Eligibility Criteria and Data; (2) Proposed Principles for the Review of Applications for HEZs; (3) Potential Incentives and Benefits for the HEZ. Public comment on these three areas closed on July 20 and was included in a Joint Chairmen’s Report submitted in mid-August. Public forums held around the state: – Southern Maryland, Wednesday, July 11 – Baltimore City, Thursday, July 19 – Montgomery County, Thursday, July 26 – Prince George’s County, August 2 – Eastern Shore, September 13 – Western Maryland, September 25

9 HEZ Call for Proposals The public comments received earlier this summer were summarized in a Joint Chairmen’s Report (JCR) submitted to the legislature in mid-August. Following the 45-day legislative review, the CHRC will issue a Call for Proposal in early October. The CHRC and DHMH will host a public conference call in early October, several days after the Call for Proposals is released. Applicants will be given the opportunity to ask questions about the HEZ application process.

10 Eligibility Criteria and Data (1)An HEZ must be a community, or a contiguous cluster of communities, defined by zip code boundaries (one or multiple zip codes). (2) An HEZ must have a resident population of at least 5,000 people. (3) An HEZ must demonstrate economic disadvantage: –Medicaid enrollment rate; or –WIC participation rate. (4) An HEZ must demonstrate poor health outcomes: –A lower life expectancy; or –Percentage of low birth weight infants.

11 Eligibility Criteria and Data Based on these criteria DHMH developed dynamic maps with data at the zip-code level.

12 Incentives and Benefits of HEZ Designation Grant funding to implement the actions outlined in the HEZ application to improve health outcomes and reduce health disparities. Specific incentives for individual practitioners or practices that provide primary care, behavioral health services, or dental services in a HEZ: –State income and hiring tax credits; –Grant funding from the CHRC; –Loan repayment assistance; –Priority to enter the Patient Centered Medical Home; –Priority for electronic health records funding; and –Grants for capital improvements and medical/dental equipment.

13 HEZ Selection Principles 1.Purpose 2.Description of need 3.Core disease targets 4.Goals 5.Strategies 6.Cultural, linguistic and health literacy competence 7.Balance 8.Contributions from local partners 9.Coalition 10.Work-plan 11.Program management and guidance 12.Sustainability 13.Internal evaluation and progress monitoring

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