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where collaboration creates a healthier community


Projects
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End-of-life Care

 

In January 2011, Jefferson Regional Heath Alliance (JRHA) became the fiscal agent for an emerging community-based initiative for promoting conversations about end-of-life care, Choosing Options Honoring Options (COHO).  COHO envisions a collaborative community which values, respects, and honors conversations about end-of-life care, where each person facing the final stages of life does so with the greatest possible comfort and dignity.

 

COHO Goals:

 

Increase awareness and availability of palliative and hospice resources in the community.
Achieve greater than 80% prevalence of advanced directives by those who die.
Assist medical providers to be more comfortable with having end-of-life care conversations with patients.
Cultivate community acceptance of meaningful end-of-life care dialogue and advance care planning.

 

COHO exists to engage our entire community by providing education about options for end-of-life care, facilitating conversations for mutually respectful decision-making and empowering all parties to honor the letter and spirit of advance care planning to the greatest extent possible. By increasing the understanding of personal end-of-life options, the health of our community will improve and better align itself with the shifting cultural perspectives regarding end-of-life issues.

 

In the past three years, COHO has hosted 4 Public Forum lecture series about advance care planning (3 in Jackson County and 1 in Josephine County) with 47 sessions and 3,950 attendees. The Speakers Bureau has reached over 8,000 attendees, and COHO has established relationships with 25 local and state-wide organizations. COHO has certified 42 facilitators in advance care planning and 10 facilitators regarding conversations and planning with the POLST form through Respecting Choices ® and has trained 130 staff at 3 local nursing home facilities. With the completion of COHO’s Providence Medical Group pilot project (which embedded a palliative care/advance care planning nurse or LCSW in the primary care setting), POLST completion at Providence increased by 33.9% in 2012. 

 

In the past year, COHO has successfully completed many new and exciting activities:

 

Developed 10,000 and distributed 5,000 patient and healthcare provider targeted end-of-life brochures in the first 6 months of 2012 and outlined end-of-life options including the importance of conversation and steps for the POLST form and advanced directive completion.
Organized the second annual community series and workshops on end-of-life issues for over 900 participants.
Developed an active Speakers Bureau and presented 25 programs which connected with over 750 individuals in a one year period starting from September 2011.
Continued the development of the COHO website including the production of a 7 minute video (www.cohoroguevalley.org).
Enlarged our public profile with repeated recognition through media and local newspaper (See Links Page).
Created a one hour informational interview on Rogue Valley Television that plays continuously.
Interviewed with the Jefferson Exchange, a regional NPR affiliate.
Published three e-newsletters in 2012 which were distributed to 232 active web contacts.

 

Links and more information regarding End-of-Life Care

 
 


 

 

 

 

Health Care Reform

 

Coordinated Care Organizations

 

This initiative offered a local forum for dialogue on the transformation process for the Oregon Health Plan as it was being envisioned by the Oregon Health Authority. As the State became clearer on the model of Coordinated Care Organizations, JHRA facilitated conversations among the potential leaders regional CCO’s and their potential partners. In addition to facilitation of pre-CCO formation meetings over six months, JRHA specifically supported the development of the Community Advisory Council and Clinical Advisory Panel for the Jackson County Care Connect CCO.

 

The three CCOs in Jackson and Josephine County (Jackson Care Connect, AllCare, and PrimaryHealth of Josephine County) spent 2013 on a Community Health Assessment (CHA) to assist them and other organizations in planning and prioritizing efforts to fulfilling the triple aim of improving health outcomes, improving individual and community health, and reducing costs in the healthcare system. As part of their obligation to the state, the three CCOs are now working to complete their Community Health Improvement Plan by July 2014.

 

Links and more information regarding the Health Care Reform

 


 

 

 

 

Complex Care Project

 

JRHA fostered the formation and ongoing implementation of a collaborative pilot project to address the high utilization of emergency departments and recurrent hospitalization by a small sub-population of patients. Five organizations (La Clinica Del Valle, Community Health Center, Jackson County Mental Health, Addiction Recovery Center, and OnTrack) that spanned the continuum of care, integrating physical, mental health and addictions recovery, joined to create a new model of outreach care in order to support coordinated care and reduce system barriers for this sub-group of patients. The project was initally funded by the JRHA and CareOregon and now includes further support from Jackon Care Connect and AllCare CCOs.

 

The goals for the future of this overall initiative include:


Acting as a conduit for Southern Oregon on health and healthcare delivery issues between the state legislators and the JRHA region.
Providing its leadership council members and the region as a whole with awareness of initiatives that are happening regionally and statewide which impact the health or healthcare resources of Southern Oregonians.
Supporting collaborative efforts in competitive healthcare environments.
Facilitating the testing of policy ideas aimed at improving health outcomes and cost reduction.

 

 

 

 

 

Mental Health and Primary Care Integration

 

 

This initiative was identified by JRHA as a critical component to fulfill
JRHA’s goal of an interconnected community promoting health in the broadest sense. JRHA places 
great importance on the awareness of mental health issues and increased mental health support 
within the primary care setting. Dr. Jim Shames, Medical Director for Jackson County Health & 
Human Services, serves as the champion for Oregon Pain Guidance, a forum created to elevate the 
issues surrounding narcotics use and its intersection with healthcare providers and the community 
systems as a whole, as well as to support patients and their providers in the appropriate 
management of chronic pain, narcotic use, and addiction treatment, which JRHA continues to

This initiative was identified by JRHA as a critical component to fulfill JRHA’s goal of an interconnected community promoting health in the broadest sense. JRHA places great importance on the awareness of mental health issues and increased mental health support within the primary care setting. Dr. Jim Shames, Medical Director for Jackson County Health & Human Services, serves as the champion for Oregon Pain Guidance, a forum created to elevate the issues surrounding narcotics use and its intersection with healthcare providers and the community systems as a whole, as well as to support patients and their providers in the appropriate management of chronic pain, narcotic use, and addiction treatment, which JRHA continues to support.

 

Links and more information regarding Mental Health and Primary Care Integration



 

 

 

 

Jefferson Health Information Exchange (JHIE)

 

JHIE is the secure, electronic exchange of health information endorsed by regional health care stakeholders – including private and non-profit health care providers and public health agencies. JHIE facilitates timely, effective, and patient-centered care by decreasing the inefficient use of existing patient data, fostering careful collaboration, and lowering administrative burden, resulting in markedly improved patient care and reduced costs. As a well-developed and supported health information exchange, JHIE revolutionizes patient care through the virtual breakdown of organizational silos, making information available to authorized providers when and where it is needed – quickly and securely. 

 

JRHA provides the necessary neutral role to bring together all the diverse interests and stakeholders to move toward these agreed goals:

 

Reduce over-utilization of costly medical test/technology.
Improve patient health outcome aligned with best practices.
Decrease utilization of Emergency Departments.

Augment chronic care management and patient medical home initiatives.

Support the alignment of stakeholders as new accountable care models emerge.
Utilize data for public health initiatives to improve overall community health outcomes.

 

Links and more information regarding the Jefferson Health Information Exchange


 


 

 


 

Behavioral Health Initiative (2006-2008)

In 2006, the Jefferson Health Alliance (JRHA) teamed up with Hank Collins, director of the Jackson County Health & Human Services who championed a community based effort to improve services for adults experiencing mental health crises. Over a three year period an extensive fact gathering process ensued that included interviews with clients and their families and mapping existing acute and community based mental health services. Numerous work groups were organized and met to create the structure and operational details of an integrated crisis response system.

 

These ongoing meetings with system-wide providers created transformational recommendations and goals for improving client outcomes and service delivery. The primary goal culled from these meetings was to create an integrated community based crisis and ongoing care site outside the acute hospital setting.

 

This Center-based Crisis Response Program (CCRP) was envisioned to assure timely and more effective service to persons in crisis. A site location was selected on Jackson County public property. Service delivery would be incorporated into a single facility and include the components essential to a fully operational adult crisis response system. A memorandum of understanding was reached by all parties in the process involving those from acute care and community based organizations.

 

Unfortunately this public-private partnership for the community good came to an abrupt halt when the Oregon economy tumbled in the fall of 2008. The formalized single facility project had to be shelved due to lack of investment funds by the State and County governments. Nevertheless, the earlier threads of thinking with regard to the creation of a clinic based social service and mental health supports were now integrated into medical practices and coordinated by La Clinica del Valle and Community Health Center through philanthropic support. This shift was embraced by the medical staff who felt their patients would attain the mental and social supports necessary to change their health status.

 

Links and more information regarding the Behavioral Health Initiative

 

 

 

 

 

 

 

When we no longer know what to do, we have come to our real work. And when we no longer know which way to go, we have begun our real journey. The mind that is not baffled is not employed. The impeded stream is the one that sings.


- Wendell Berry