Health_Systems_Liaison_Requirements_Sheet.final.pdf

Health Systems Liaison RFP-23/24-0265 Specifications Sheet

Overview:

Access to high quality, culturally responsive health care and related social services for pregnant people and young children is an important protective factor. However, it is not enough that families have health insurance or receive a referral to a service. We know that barriers exist that make it difficult to successfully access care. As we look at issues like prenatal care, maternal morbidity and mortality, birth outcomes, well child checks, immunization rates, and access to medical, dental, and mental health services, the data indicates that we fall behind in many of these areas:

• From 2019-2021, 87.6% of pregnant people in Sacramento County received early prenatal care.

In addition, 73% of pregnant people had adequate prenatal care, falling short of the Healthy People 2030 goal of 80.5%1. This matters because babies born to pregnant people that do not receive prenatal care are three times more likely to be low birthweight and five times more likely to die than those born to people that had prenatal care2.

• According to the CDC, although it is estimated that 80% of pregnancy related deaths are preventable, the number of maternal deaths from 2018 to 2021 in the U.S. increased from 17.4 to 32.9 per 100,000 live births.3

• The maternal mortality rate for Black women in 2018 was 37.3 per 100,000 live births, and this climbed to 69.9 deaths per 100,000 live births by 2021. This number is 2.6 times the rate of White women, who experienced a maternal mortality rate of 26.6 per 100,000 live births in 20214.

• Less than 20% of women are screened for maternal mental health conditions, and less than 15% receive treatment for depression5.

• In Sacramento County 1 in 11 births was preterm, with the rate being highest for Black infants at 12.6%, compared to 7.9% for White infants6. 1 in 14 babies were born low birthweight in 2021, with Black babies being two times as likely to be born low birthweight than White babies (12.2%

vs. 5.4% respectively)7.

• Although 97.1% of children under the age of 19 are insured in Sacramento County8, utilization rates are low. In Sacramento County in 2021, only 41% of children with Medi-Cal received an annual preventive check-up9.

• In 2020, only 30% of children 0-5 in low income families saw a dentist in the last year10.

• Nationally, in 2019 it was estimated that 70.5% of children born in 2016 and 2017 had received the recommended vaccines, with only 65.8% of Black children and 65.7% of children covered by Medicaid being up to date11. It is important to note that these numbers were pre-pandemic.

• The COVID-19 pandemic had a significant impact on the delivery of care as agencies had to shift resources. 76% of local health departments reduced services for chronic disease prevention, and 60% reduced services for maternal and child health12.

1 Prenatal Care 2 Prenatal care | Office on Women's Health (womenshealth.gov) 3 Vital Signs: Maternity Care Experiences — United States, April 2023 | MMWR (cdc.gov) 4 Maternal Mortality Rates in the United States, 2021 (cdc.gov) 5 Fact+Sheet-Maternal+Mental+Health-Policy+Center+IB010-10.23.pdf (squarespace.com) 6 Distribution of gestational age categories: Sacramento county, 2021 | PeriStats | March of Dimes 7 Low birthweight: Sacramento county, 2011-2021 | PeriStats | March of Dimes 8 Sacramento :: Indicators :: Children with Health Insurance :: County : Sacramento (behealthysacramento.org) 9 Children Now Scorecard 10 Children Now Scorecard 11 Urgent Action Needed to Catch Up on Routine Childhood Vaccinations – Center For Children and Families (georgetown.edu) 12 A Snapshot of NACCHO's Forces of Change Survey https://www.cdph.ca.gov/Programs/CFH/DMCAH/surveillance/Pages/Prenatal-Care.aspx https://www.womenshealth.gov/a-z-topics/prenatal-care https://www.cdc.gov/mmwr/volumes/72/wr/mm7235e1.htm?s_cid=mm7235e1_w https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm https://static1.squarespace.com/static/56d5ca187da24ffed7378b40/t/6544556b540c655dcda074d5/1698977132743/Fact+Sheet-Maternal+Mental+Health-Policy+Center+IB010-10.23.pdf https://www.marchofdimes.org/peristats/state-summaries/california?top=3&lev=1&stop=55&reg=99&sreg=06&creg=06067&obj=3&slev=6 https://www.marchofdimes.org/peristats/state-summaries/california?top=4&lev=1&stop=43&reg=99&sreg=06&creg=06067&obj=1&slev=6 https://www.behealthysacramento.org/indicators/index/view?indicatorId=2732&localeId=271 https://scorecard.childrennow.org/?ind=preventive&yr=4 https://scorecard.childrennow.org/?ind=lowIncomeDental&cty=sacramento&yr=5 https://ccf.georgetown.edu/2021/07/15/urgent-action-needed-to-catch-up-on-routine-childhood-vaccinations/#heading-4 https://www.naccho.org/uploads/downloadable-resources/2020-Forces-of-Change-From-the-Frontline.pdf?utm_campaign=FOCinfographic

The data provided above is not an exhaustive list and does not fully reflect the challenges that families face with access to and utilization of critical prevention and early intervention services. It also does not reflect the impact of social determinants of health, the policies and practices that influence the quality of care, and the numerous systems that families must engage with. Rather than put the onus for care solely on families or assume a referral is enough, we also need to look upstream at the complex systems that families have to navigate.

The Commission is not the only one looking at systems change – there are newer policies being put in place and organizations like the Department of Health Care Services (DHCS) that are trying to improve access to equitable and culturally responsive care. As the landscape for health and social services changes, the Commission is seeking a consultant to serve as a Health Systems Liaison that will help develop connections to other family serving organizations and systems, create strategies to increase collaboration and support closed loop referrals. The Commission is also seeking opportunities to innovate, leverage, and help partners diversify funding sources with an eye towards equity, sustainability, and systems change.

Focus of Funding:

Proposers should review the Priority 5: Systems Improvement Summary Sheet of the 2024 Implementation Plan. Specifically:

Strategy 2: Health Systems Liaison A consultant to serve as the Commission’s liaison to local health plans and family service organizations to improve referrals and access to services for families. The Systems Liaison will participate in partner advisory groups/committees, maintain knowledge of pathways to access services, advocate for services, and help support some work of Sac Family Connect (www.sacfamilyconnect.com). Convened by the Commission, Sac Family Connect is a collaborative network of over 30 home visiting and family service agencies in Sacramento County. The collaborative works to create and support a coordinated, culturally responsive, and equitable system of high-quality care that best meets families’ needs.

Primary Population:

Health plans, health systems, and local organizations that focus on and/or provide services to pregnant women and their children through five years of age.

Requirements:

The goal of this RFP is to seek out a qualified and experienced consultant that will work collaboratively with Commission staff to develop a plan and implement activities that will help further develop the local infrastructure for an improved system of care. That coordinated system should promote improved access, closed loop referrals, and utilization of culturally responsive health and family support services. The efforts are aimed to facilitate increased connection between local health plans, health systems, family service organizations, and families with children 0-5 that need the services. The Health Systems Liaison should meet the following criteria and be able to carry out the following tasks during the three-year period:

Experience/Knowledge:

• Knowledge of how health systems (i.e. hospitals, clinics/FQHCs) and health plans operate and the services available to families with children prenatal through age five

• Knowledge of GMC health and dental plans serving Sacramento County

• Knowledge of existing and upcoming health care and social service initiatives and benefits that can improve health and wellbeing for families with young children, such as, but not limited to: the Affordable Care Act, Dignity in Pregnancy and Childbirth Act, Medi-Cal improvements and expansion (including DHCS Bold Goals 50x2025), and California Advancing and Innovating Medi- Cal (CalAIM) (specifically Populations of Focus (PoF) and Enhanced Care Management (ECM) http://www.sacfamilyconnect.com/

• Experience convening community collaboratives

• Experience with gathering and interpreting quantitative and qualitative data, and utilizing that information to generate reports and recommendations

• Strong verbal and written communication skills; ability to facilitate meetings with diverse groups, organize and synthesize information, and create written documents and reports

Core Areas of Work / Minimum Services:

The Health Systems Liaison should be prepared to work with Commission staff and Sac Family Connect over the three-year period. Core areas of activities may include but are not limited to:

Assess the Environment:

• Within the first 6 months of the contract, conduct an environmental scan / community assessment to determine needs, opportunities, potential for partnerships, and areas for improvement for connection to services (particularly those provided through health systems and health plans).

• Work with Commission staff to develop and implement avenues to gather information to determine families’ needs of culturally responsive health and social services, barriers to accessing services, recommendations to improve access.

• Gather feedback from partners and systems around training or other needs to improve outreach and connection to community in order to facilitate improved use of services by families.

Develop Partnerships / Find Champions:

• Identify, establish, and maintain relationships with champion(s) at the local health plans, health systems and family service organizations to improve closed loop referral and access pathways to culturally responsive services for families with children 0-5.

• Gather information about services, as well as key points of contact/pathways, strengths and barriers/limitations to services.

• Participate in health plan or other family service organization advisory groups and advocate for access to quality services.

Advise and Strategize:

• Review Commission’s direct service and systems improvement efforts related to health and equity. Work with staff to research and prioritize initiatives and benefits that can impact either the quality of, access to, cultural responsiveness of, or sustainability of services. For example, Birthing Friendly Hospital Designation; Momnimbus; and CalAIM reimbursement for doulas and community health workers. How can the Commission and its partners engage in systems work on some of these issues? What can we realistically work on to have the deepest impact?

• Research opportunities to leverage funding, such as health plan funding and CalAIM, and work with staff to strategize how to connect Commission initiatives and funded partners to these opportunities.

• Serve as a knowledgeable bridge that works with organizations to ensure services like breastfeeding, mental health, well woman/prenatal care, well child checks, and other support services are accessible to families.

• Advise on how to integrate this work in to Sac Family Connect.

Plan and Convene:

• Utilize experience, expertise, and information gathered to develop a plan of potential strategies the Commission and its partners may want to pursue to improve access to and utilization of care, particularly those services available through local health plans, health systems, and family service organizations.

• Convene partners to review the draft plan, gather feedback, and discuss avenues for implementation.

Implement:

• Work with Commission staff, health systems, health plans, and family service providers to begin implementation of the plan, build improved communication and closed loop referral pathways.

Parameters:

Amount of Funding Available: A maximum of $250,000 is available cumulatively over the three-year period. Proposers should build realistic budgets based on the activities proposed each year. Consultants should not front load all of their costs in year 1, and should plan to provide services all three years.

Contract Term: 07/01/24 – 06/30/27

Eligibility to Apply:

1. Lead agencies or fiscal agents applying on behalf of groups such as, but not limited to:

o Grassroots or community-based groups o Voluntary organizations

2. Non-profit organizations, including those applying on behalf of a community collaborative.

3. Public and private businesses (corporations, LLC’s, sole proprietors, partnerships, etc.) with a current business license, complying with all local, State and Federal requirements.

4. Evaluation, research, or health and social service consulting firms

5. Faith-based or religious organizations or groups, although active participation cannot be a prerequisite for individual involvement or participation in funded programs.

Please note that while partnerships and subcontracts are allowed, organizations/consultants cannot apply for the funds and then re-grant the funds to other entities/consultants to provide the services.