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September 2018
Mount Sinai PPS DSRIP Newsletter
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Issue #077 | September 27, 2018
Click on these links to jump to their sections (Best on desktop)
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The Mount Sinai Performing Provider System (MSPPS) is excited to share the results of our partner collaborations over the past year, including free training opportunities for partners as well as support for workforce change management. Our comprehensive training program is comprised of web-based and instructor-led trainings, which support all levels of health care professionals in the transition to population health. Learning opportunities include trainings around new models of teamwork, change, conflict resolution, emotional intelligence, as well as clinical topics such as chronic disease management, behavioral health, and social determinants of health. To view the 2018 Population Health Training Catalog, click here or email us at [email protected]
to receive a hardcopy.
Below are some resources we've developed for MSPPS partners:
Video: What is Population Health? To further enable population health workforce
transformation, MSPPS' workforce team created the 'What is Population Health?' video to help everyday members of our workforce to understand what population health is and why it matters to the health of patients, as well as support health care leaders around our network in their conversations with staff regarding continuous changes in the health care industry. Click here to view the video and download the supporting documents here.
New Learning Management System:
Through MSPPS' workforce team, MSPPS also redesigned the Clinical Integration Learning Center (CILC), our learning management system. CILC is available exclusively to MSPPS partners to take e-learnings, sign up for classroom trainings and access electronic resources - at the convenience of the user. And for our network, CILC provides a sustainable and cutting-edge learning platform designed to be flexible as the needs of our workforce change. MSPPS partners can access these
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Clinical Implementation & Innovation
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The Mount Sinai Performing Provider System (MSPPS) is committed to understanding the needs of our partners, providers, and patients to build programs that will create meaningful impact in our community well beyond DSRIP. The results from our 2016 Clinical Integration Readiness Survey along with recent conversations with PPS partners have highlighted and underscored the overwhelming need for social services to support our partners in providing better more well-rounded care to our patients. DSRIP has set the foundation for collaboration and MSPPS has been able to be a part of this ground breaking journey to create programs with our partners for our community. We are excited to introduce these programs and resources to our community. We will be sharing updates on our website about these initiatives, so please be sure to tune into our Community Partnership page.
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MSPPS Partner New York Common Pantry to Increase its Services throughout New York City
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Photo courtesy of Michael Priest Photography |
New York Common Pantry (NYCP), one of New York City's largest single-site community based food pantries, is expanding its mission to reduce hunger throughout New York City while promoting dignity and self-sufficiency. Through DSRIP funding, NYCP is expanding a few of its programs including:
- Choice Pantry Program, which focuses on helping participants choose culturally appropriate, nutritionally balanced food they would like to receive.
- Project Dignity Program, which supports homeless individuals with basic needs and care management referrals.
- Help 365 Program, which assists individuals with access to resources and other social services including the Supplemental Nutrition Assistance Program (SNAP), and Social Security Supplemental Income.
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DSRIP Funding to Expand LegalHealth's Legal Services to Address Social Determinants of Health in PPS Community
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Eric Hassell, Staff Attorney at LegalHealth, facilitates a training to employees at Ryan Health in early September.
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Assistance Group (NYLAG), is collaborating
with
MSPPS partners, Settlement Health in East Harlem and Ryan Health on the Upper West Side, to address socioeconomic and healthcare disparities through legal counseling.
"By working closely with PPS healthcare providers at Settlement Health and Ryan Health, we will work together to address the various legal issues that create health disparities in the PPS community," said Beth Breslin, Senior Staff Attorney of LegalHealth.
Through this effort, a patient referred to this service is connected to the LegalHealth multi-lingual attorney, who can help provide the patient with
appropriate counseling, advice, and/or legal representation. The attorney can also provide assistance with housing, benefits advocacy, and other civil legal matters including immigration and family law.
This service is available to patients from Ryan Health, Settlement Health, and within the East Harlem and Upper West Side neighborhoods. Partners can reach out to [email protected] for more information.
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Home-based Asthma Programs Available to Reduce Hospital Admissions by Addressing Environmental Factors Impacting Asthma Patients
Through DSRIP funds,
Little Sisters of the Assumption (LSA) and
AIRnyc, two community-
based organizations and MSPPS partners, have launched programs to provide
home-based asthma services to Medicaid patients with persistent and uncontrolled asthma. Through
home visits, patients receive assessments on environmental factors impacting their asthma condition and learn strategies to manage asthma triggers and symptoms.
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LSA and AIRnyc conduct home visits to learn more about the different factors impacting their patients' asthma condition. |
According to Enrico Cullen, Chief Strategy Officer at AIRnyc, Harlem has some of the highest
rates of asthma and other chronic diseases in the country. He says, "With our home-based interventions, AIRnyc can meet Sinai patients where they live, develop customized action plans
at the household level, and support the whole family to achieve better health outcomes."
LSA is available to patients who reside in East Harlem and AIRnyc is available to patients in
other parts of Manhattan, Queens, and Brooklyn.
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God's Love We Deliver Partners with PPS on Nutritional Meal Delivery Pilot Program
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Photo courtesy of God's Love We Deliver
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God's Love We Deliver (God's Love) is collaborating with Mount Sinai St. Luke's and Mount Sinai Doctors Jackson Heights on a three month meal delivery pilot to provide nutritional meals to high-risk Medicaid patients with diabetes. In line with God's Love belief that "food is medicine, food is love," the goal of the pilot is to provide nutritional stability, increase comfort, and
reduce hospital utilization for participants.
God's Love will develop a nutritional assessment for each enrolled patient and tailor menus to each patient's needs. These meals include breakfast, lunch and dinner and they will be delivered to each patient for three months.
"We are excited to be in this new partnership with Mount Sinai as well as the opportunity to work with the staff at both Mount Sinai St. Luke's and Jackson Heights to see what the impact of medically tailored
meals can have on those individuals dealing with severe diabetes. Our hope is to support individuals who have been challenged by both their illness, and in management of their diet," said Dorella Walters, Senior Director of External Program Affairs at God's Love.
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Engaging with Churches and the Community Around Early Cancer Screening and Health Education
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Photo courtesy of Mount Sinai's Center for Spirituality and Health |
The Center for Spirituality and Health at Mount Sinai Health System is led by Director Dr. Deborah Marin and through efforts by Rev. Dr. Zorina Costello, Director of Community Engagement at the Center, she is engaging with
nine churches primarily in East and West Harlem on M.I.C.A.H™ Project HEAL. M.I.C.A.H stands for
the Multi-faith Initiative on Community and Health - Project HEAL-Health through Early Awareness and Learning.
The project provides church leaders known as Community Heal Advisors (CHA) with basic health education curriculum training and health provider resources. The curriculum highlights the importance of early screenings related to prostate cancer, cardiovascular health, diabetes, smoking cessation, and mental health.
Once trained, the CHAs schedule workshops and activities to offer health education to community members.
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Encouraging Parents to Complete and Submit Asthma Medication Administration Form to Reduce Unnecessary ED Admissions
As a part of the effort to reduce avoidable hospitalizations, MSPPS is working with partners to educate parents about completing an Asthma Medication Administration Form (MAF) for children with asthma. If the Asthma MAF is not completed and submitted to the child's school, the school will be unable to administer the medication and the child may be brought to the emergency department (ED) for treatment.
Forms are accepted on a rolling basis to the school. They can be
found here
or obtained at a child's primary care provider. For more information on Asthma MAFs, please visit here.
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Community Paramedicine Program Achieves Milestone with 300th call!
We're excited to announce that we've received 300 calls since April 2017 through the Mount Sinai Community Paramedicine Program! Through DSRIP funding, the program has also recently expanded its service to Queens. Now serving four borough across New York, the program continues to provide care to patients in real time at the comfort of their homes through telemedicine. 74% of our patients successfully remained at home and avoided an unnecessary visit to the emergency department.
"With nearly 3 out of every 4 patients being managed at home, this program has had a substantial impact in avoiding ED visits and even admissions," said Dr. Kevin Munjal, Associate Medical Director of Prehospital Care for Mount Sinai Health System and Clinical Champion at MSPPS.
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If you have questions about any of our programs, please contact us at
[email protected]. We're excited to provide this update and look forward to sharing more in the near future. Be sure to check out other events (non-DSRIP related) within our community
here.
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