3.0 FTE Paramedic Total Request: Resource to provide Paramedic outreach to geographic hot spotted ED HUs in Sub $156,000 Full Year of Implemented Strategy 3 Workforce Cost: Total: $640,510 Strategy 4: Regional Care Management Education Center Regional Partnership Need: 1.0 Care Management Education Specialist $117,000 1.0 Coordinator $104,000 1.0 Community Partner Liaison $84,500 1.0 BS HED w/MH $67,600 Full Year of Implemented Strategy 4 Workforce Cost: Total: $373,100 IT/Technologies Description Amount Strategy 3: Reduce Potentially Avoidable Emergency Department Utilization Regional Partnership Need: Tele-Monitoring Technology Support Tele-Monitoring of a subset of the ED HU’s (250 patients) Purchase of monitoring devices Total: $112,251 Strategy 4: Regional Care Management Education Center Laptops with Docking Station $1500 X100 needed $ 150,000 Cell Phone with Data x 50 needed (annual cost) $ 42,000 CM Training System 1 license per facility utilizing established best practice as per American Case Management Association (ACMA) $ 50,000 Tech. for CHW documentation and communication with Care Team Equipment, services, bandwidth, license $ 80,000 Centralized Internet Registration Program Development of regionally centralized system to facilitate enrollment and engagement of Regional Partnerships employed and Community Partners. $ 78,000 Teleconferencing / Web Conferencing Infrastructure Equipment, services, bandwidth $ 300,000 Disease Management Curriculum 1 license per facility; ensures consistency in regional educational material utilizing best practice $ 300,000
(Baseline screening not available for MMC and WMHS, but will be collected going forward.) 1.3. Reduce stigma and increase understanding of behavioral health needs through community health education # of Mental Health Aid (MHFA) trainings held in our service area per year Process 39 trainings held (FY2015) 1.3. Reduce stigma and increase understanding of BH needs through community health education # of individuals in our service area trained on MHFA per year Process 440 individuals trained (FY 2015) 1.3. Reduce stigma and increase understanding of BH needs through community health education Rate of ED visits related to mental health disorders (per 100,000 population per year) Outcome 4,800 ED visits per 100,000 population (2014) 2. Complex Care Management (CCM) # of patients in the high utilizer target population annually Outcome 1,153 (FY 2015) 2. Complex Care Management (CCM) Total inpatient/OBS charges for target primary diagnoses in the high utilizer target population annually Outcome $20,323,779 2. Complex Care Management (CCM) Total readmission charges for target primary diagnoses in the high utilizer target population annually Outcome $6,867,767 2. Complex Care Management (CCM) # of admissions per patient per year in the high utilizer target population (all causes) Outcome 4.4 admissions per patient per year (FY 2015) 2. Complex Care Management (CCM) # of readmissions per patient per year in the high utilizer target population (all causes) Outcome 1.3 readmissions per patient per year (FY 2015) 2. Complex Care Management (CCM) inpatient and observation charges for the high utilizer target population per year Outcome $52,500,880 (FY 2015) 3. Decrease PAU # of patients in the ED high utilizer target population group per year Outcome 3,171 patients (FY 2015) 3. Decrease PAU # of ED visits per patient per year in the target population Outcome 5.7 ED visits per patient per year (FY 2015)
Strategy 3 ROI: Decrease ED Potentially Avoidable Use (PAU) CY 2016, Year 1 CY 2016, Year 2 CY 2016, Year 3 CY 2016, Year 4 Years 1 - 4 Combined A. Number of Patients 3,171 3,171 3,171 3,171 3,171 B. Number of Medicare and Dual Eligible 1,291 1,291 1,291 1,291 1,291 C. Annual Intervention Cost $ 1,094,640 $ 1,193,955 $ 1,158,405 $ 1,158,405 $ 4,605,406 D. Annual Intervention Cost/Patient $ 345.20 $ 376.52 $ 365.31 $ 365.31 $ 1,452.35 E. Annual Intervention Cost (B x D) For Medicare and Dual Eligible Patients $ 445,657.81 $ 486,091 $ 471,618 $ 471,618 $ 1,874,985 F. Annual Charges (Baseline) $ 10,485,129 $ 10,485,129 $ 10,485,129 $ 10,485,129 $ 41,940,516 G. Annual Charge Savings % Target 5% 8% 15% 15% 11% H. Annual Gross Charge Savings (F x G) $ 524,256 $ 838,810 $ 1,572,769 $ 1,572,769 $ 4,508,605 I. ROI: Gross Charge Savings Per Intervention Cost Invested (H / C) $ 0.48 $ 0.70 $ 1.36 $ 1.36 $ 0.98 J. Variable Savings % 30% 40% 40% 40% 39% K. Variable Savings (H x J) $ 157,276 $ 335,524 $ 629,107 $ 629,107 $ 1,751,016 Attachment C – Governance Structure & Members
Attachment D – Community Advisory Council (CAC) Members Community Advisory Council Members Representation Needed: FRHS WMHS MMC (2) LHIC and Service Agency (CSA) Representatives Barbara A. Brookmyer, MD, MPH Frederick County Health Care Coalition Board of Directors Health Officer Lesa Diehl, Director Allegany Co. Health Dept., MHSO, CSA Rod MacRae, MA MHP, Director, Washington County Health Department Josh Pedersen Frederick County Health Care Coalition Board of Directors CEO, United Way of Frederick Cathy Chapman, CRNP Chapman and Associates Health Care Rick Rock, LCSW-C, Executive Director, Washington County Mental Health Authority, CSA Law Enforcement Designated Washington Co. Rep.to be the Regional Representative Todd Kerns, Washington County Sheriff Representative Area Agency For Aging Designated Washington Co. Rep.to be the Regional Representative Amy Olack Executive Director Commission on Consumer Advocacy Group or Consortium Dr. Joseph Berman; Advocates for the Aged in Frederick County; (Back-up rep.: Cindy Powell) Designated Frederick Co. Rep.to be the Regional Representative SNF Designated Alleghany Co. Rep.to be the Regional Representative Christopher P. MBA, LHNA, Devlin Manor Healthcare Center Designated Alleghany Co. Rep.to be the Regional Representative Hospice Helen Kimble; Hospice of Frederick County Candy Adams; Nurse Manager Eric Klimes, CEO Hospice of Washington County DSS Richard Paulman, Ed. D. Director, Allegany County Department of Social Services Designated Frederick Co. Rep.to be the Regional Representative Exec. Committee Representation Eileen Jaskuta, MMC and Manny Casiano, FRHS Membership from Alliance Work Team Allen Twigg, Nancy Forlifer, Jo Wilson, Andrea Horton, Heather Kirby Liaison between CAC, EC, and Work Teams Work Team Allen Twigg, Nancy Forlifer, Jo Wilson, Andrea Horton, Heather Kirby CAC Meeting Facilitator Kristie Carbaugh, Regional Partnership Project Management Director
Attachment G – Sponsor Hospital-specific cost detail for all Strategies FRHS Cost For All 4 Strategies Year 2, 3 and 4 Annual Cost Year 1 for Start-Up Work Team 1 Proposed Staffing FTE Salary 30% Benefits Total Masters Level BH 8.7 $57,950 $75,334 $655,406 Total Cost WT 1 $655,406 $491,554 Work Team 2 Proposed Staffing FTE Salary 30% Benefits Total RN - Manager/Clinician 1.0 $100,000 $130,000 $130,000 NP 1.5 $146,000 $189,800 $284,700 Registered Dietician 1.0 $63,000 $81,900 $81,900 Respiratory Therapist 1.0 $80,000 $104,000 $104,000 CHW 9.0 $30,000 $39,000 $351,000 RN CM 2.0 $75,000 $97,500 $195,000 Receptionist 1.0 $25,000 $32,500 $32,500 SW 1.0 $75,000 $97,500 $97,500 Total Cost WT 2 17.5 $1,276,600 $957,450 Work Team 3 Proposed Staffing FTE Salary 30% Benefits Total CM for Tuck in Service working 7am to 7 PM on Fridays at each hospital 0.34 $23,800 $30,940 $30,940 Relief 0.04 $2,800 $3,640 $3,640 Shift Differential 0.34 $2,618 $3,403 $3,403 $37,983 ED High Utilizers FTE Salary 30% Benefits Total CHW 3.2 $30,000 $39,000 $124,800 $124,800 Tele monitoring Technology $37,417 Paramedic Program FTE Salary 30% Benefits Total 1.0 $40,000 $52,000.00 $52,000 $52,000 Total Cost WT 3 4.92 $252,200 $189,150