1. Unit-Based Teams as an Engine of System Transformation Saving the Safety Net With Small Tests of Change:

2. Why did we fight for it? Did we win? HEALTH CARE REFORM

3. The Four Main Areas of Reform 1.Insurance Reform 2.Coverage Expansion 3.Health Care Delivery System Redesign 4.Payment Reform THE AFFORDABLE CARE ACT

4. 2. COVERAGE EXPANSION Children can remain on their parents’ insurance plans up to the age of 26 Individuals who earn incomes up to 133% of the federal poverty level will be Medicaid (Medi-Cal) eligible Individuals who earn up to 400% of the Federal Poverty Level will be eligible for a government subsidy to purchase insurance through the exchanges.

5. TIMELINE FOR IMPLEMENTATION 2017-2018 S tates begin to pay small share of Medicaid expansion E xcise tax kicks in 2014 M edicaid expands E xchange begins I ndividual and employer mandates in effect 2010-2011 S ome insurance reforms begin S ome tax breaks kick in S tates must begin enacting legislation This is how much time we have to change.

6. HCR Safety Net Expand More patients covered Generate economic activity Save $$$ Create more FTE jobs Expand healthcare coverage Improve Quality/reduce cost $ 124 Billion to CA in 10 years $11 Billion to FQHCs 2015 Private Sector BUT!!! WHAT CAN HEALTHCARE REFORM DO FOR OUR SAFETY NET?

7. Private Sector THE PREGNANT LADIES CAUTIONARY TALE…

8. TIMELINE FOR IMPLEMENTATION 2017-2018 S tates begin to pay small share of Medicaid expansion E xcise tax kicks in 2014 M edicaid expands E xchange begins I ndividual and employer mandates in effect 2010-2011 S ome insurance reforms begin S ome tax breaks kick in S tates must begin enacting legislation UNIT BASED TEAMS – Improving Patient Experience on the Front Lines!

9. WHAT IS A UNIT-BASED TEAM?

10. A PROVEN MODEL

11. MEMBERS OF A UBT WORK COLLABORATIVELY AS PARTNERS AND PARTICIPATE IN:

12. PURPOSE UBTs work on:UBTs DO NOT work on: Day to day operations Work environment Improving performance Initiatives such as workplace safety Work flows and design Changing DHS’s strategic direction Scope of practice Labor relations or contractual issues Legal or regulatory issues

13. INITIATE THE 8! UBTS IN DHS

14. NEXT STEPS…