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Grant programs

Kern Family Health Care (KFHC) is dedicated to improving the health status of our members through an integrated managed health care delivery system.

We are committed to making quality health care accessible in our community. In recognition of the essential role that community organizations have in our health care delivery system, we have created diverse Grant Programs to financially aid and encourage innovative efforts to bring beneficial services to our community.

Health Homes Grant Program

Overview

The Health Homes Program (HHP) is an option afforded to the States under Section 2703 of the Affordable Care Act that focuses on intense medical and social care coordination to our most medically vulnerable members. This program allows States to create Medicaid health homes to coordinate the full range of physical health, behavioral health, homelessness, and community-based long term services and supports (LTSS) needed by beneficiaries with chronic conditions. With the primary goal of improving the health and enhancing the quality of life for its members, Kern Health Systems (KHS) is committed to assisting selected network providers in the funding, training, and implementation of Health Home Programs with the overall vision of infusing the HHP model into our network over the next few years.

Background

The intent of the HHP is to provide an intensive set of services to a select group of KHS membership who require care coordination at the highest levels. With health care costs and utilization concentrated in a small percentage of the membership, identifying and managing care for this group is an important step towards improving health outcomes and reducing total cost for the entire population. The Department of Health Care Services (DHCS) has identified chronic conditions that alone, or in combination, can be used to select high-risk members which present the best opportunity for improved health outcomes through participation in a HHP. In addition to select chronic conditions, a member's risk is further stratified using acuity and complexity measures based on medical, behavioral, and social factors. Through analytic analysis, members with a high risk score will be placed on a Target Engagement List representing those who are eligible for HHP participation.

KHS is executing a grant proposal process to identify network providers with the ability and capacity to implement a health home model with support from the plan. Providers selected to participate will receive a KHS grant to support the creation and operation of a HHP. These providers will function as Community Based–Care Management Entities (CB-CMEs) which are intended to serve as frontline providers for HHP services that are rooted in the community. The CB-CMEs, in conjunction with KHS, have the responsibility for ensuring the member receives access to the full range of HHP services at or near their usual point of care.

The HHP is a team-based health care delivery model with the intent of providing comprehensive, coordinated and continuous medical care to a select group of high-risk members with a goal of obtaining maximized health outcomes. The program focuses on effective care management that takes a holistic, person-centered, family-focused approach to health care while incorporating behavioral, social and physical aspects. A multi-disciplinary team is used in the HHP to meet the diverse and often complex issues faced by members with chronic conditions.

Guiding Principles

The overarching goal of the HHP is to achieve the health care Triple Aim of better care, better health, and lower cost. A number of policy goals and objectives were created to provide a framework for the development of HHP policies:

Policy Goals
  • Improved care coordination.
  • Integrate palliative care into primary care delivery.
  • Strengthen community linkages within health homes.
  • Strengthen team-based care, including use of community health workers.
  • Identify and serve members experiencing homelessness.
  • Increase integration of physical and behavioral health services.
  • Improve the health outcomes of people with chronic diseases.
  • Reportable net cost avoidance within two years.
Policy Objectives
  • Ensure sufficient provider infrastructure and capacity to implement HHP as an entitlement benefit.
  • Appropriately serve members experiencing homelessness.
  • Increase integration of physical and behavioral health services.
  • Maximize federal funding while also achieving fiscal sustainability after eight quarters of enhanced federal funding.
  • Focus on high-cost members with chronic conditions.
  • Wrap increased care coordination around existing care.

Provider Financial Opportunity

Please note: Grant funds shall be used exclusively for Kern Family Healthcare members only.

Participating providers in the Grant program will be compensated in three ways:

  1. Grant funding to operationalize the provider's proposed Health Home program (See KHS HHP Application, Scope of Work, and Budget), for a minimum of 2 years.
  2. Encounter payments for visits, procedures, tests or therapies members receive at the CB-CME site. These payments will be paid in accordance with Medi-Cal covered benefits and KHS's Medi-Cal fee schedule. Consideration for payment for these services will follow current claims adjudication policies, procedures and protocols currently used when processing provider claims.
  3. Provider Incentives/Capitation
    1. Payment related to multi-disciplinary team services in the form of a per member per month payment

The compensation structure formula is intended to combine the three revenue sources described above to cover the cost of care delivery. The grant application budget template will assist you in identifying expenses and projecting revenue based on member visits per month.

Provider Requirements

  1. Complete KHS HHP Grant Application and return by November 19, 2016. Applicants can reach out to the KHS HHP Oversight Team for assistance, questions or input.
  2. Work with the HHP oversight team and current Health Information Technology (HIT) vendor to upgrade Electronic Health Record (EHR) in order to meet program data exchange requirements.
  3. Participate in the KHS enrollment program by:
    1. Allowing limited access to scheduling software, or other means of promoting remote real-time appointment scheduling.
    2. Working with KHS enrollment team to achieve the quarterly and maximum capacity membership goals outlined in the Health Home Financial Expectations document. Quarterly and maximum enrollment numbers may vary by CB-CME depending on model, location and available HHP population.
  4. Complete all member data reporting requirements utilizing HIT where able, but use alternative methods (e.g., paper, excel or provider portal) when necessary.
  5. Comply with CB-CME program audits and administration by the KHS oversight team to ensure compliance with all DHCS HHP requirements. Requirements include care programming standardization as defined by DHCS and KHS, as well as training for staff.

Submit monthly budget finance report indicating HHP personnel and operating expenses for KHS HHP grant distributions.

You are strongly encouraged to review the full HHP description for further information by visiting: http://www.dhcs.ca.gov/services/Documents/HealthHomesForPatients_Final.pdf

Reporting

Reporting types and frequency will be structured to provide timely measures of the HHP program efficacy, while meeting DHCS reporting requirements. KHS will receive member data from the CB-CMEs using HIT to populate many of the required reports. Some reports related to utilization and quality may use other sources, such as claims or inpatient log. The primary responsibility of providers related to reporting will be the timely and accurate documentation of information related to HHP members, and in establishing an efficient means of exchanging this information electronically with KHS. Below are some of the reports that KHS will run based on the provider's HHP member data. Note that this list will change based on DHCS and KHS requirements.

Membership Reports
  • Number of members meeting program criteria
  • Number of members engaged for HHP participation
  • Number of members actively participating in HHP
  • Member Engagement Status (contacted, engaged, declined, dis-enrolled, re-enrolled)
  • Member Engagement Rate
  • Current Care Manager to Member ratios
Member Tracking
  • Member Consent Date
  • Health Action Plans (HAP) completion date
  • Documented discussion of HAP care goals
  • Health Action Plans completed within 90 days of HHP enrollment
  • Annual Reassessment
  • Number of HHP service/visit/units provided
  • Number of members experiencing homelessness and current intervention status
Financial Reporting
  • Cost Avoidance
  • Cost of HHP services/visits/units during reported period
Bed Day Reports for Acute/SNF/Behavioral Health
  • Number of ER visits
  • Bed Days per 1000
  • Admissions per 1000
  • Readmission per 1000
  • Average Length of Stay
  • Avoidable readmissions following inpatient stays
Utilization
  • ER Visits
  • HHP Team Contacts
Health Home Core Measures
  • Adult Body Mass Index (BMI) Assessment
  • Screening for Clinical Depression and Follow-up Plan
  • Plan All-Cause Readmission Rate
  • Follow-up for Hospitalization for Mental Illness
  • Controlling High Blood Pressure
  • Care Transition – Timely Transition of Records
  • Initiation and Engagement of Alcohol and Other Drug Dependence and Treatment
  • Prevention Quality Indicator (PQI) 92: Chronic Conditions Composite Quality Managements
Authorizations
  • Number of authorizations
  • Denial rate
  • Turn-around times
Quality Management
  • Number of Appeals
  • Over-turn rate
  • Grievance and Complaint reporting
Satisfaction Survey
  • Comprehensive survey measuring satisfaction, self-assessment of health status, and suggestions for improvement.

9700 Stockdale Hwy.
Bakersfield, CA 93311

For questions regarding this program, please contact:

Emily Duran
Director of Provider Relations
661.664.5000
Emily.Duran@khs-net.com

Amisha Pannu
Provider Relations Program Manager
661.664.5157
Amisha.Pannu@khs-net.com

2019-2020 Provider Quality Care Grant Program

Program Overview

Kern Health Systems (KHS) is committed to maintaining a strong, adequate, and diverse network of Primary Care Physicians (PCP), Specialty Care Physicians (SCP), and ancillary providers in order to ensure quality access to more than 255,000 KHS Members. KHS is always looking for opportunities to assist network providers in exploring ways to implement Quality Care Programs and services to meet the needs of our members throughout Kern County. In an effort to accomplish this, we are pleased to announce the availability of grant funds for KHS network providers.

Provider Quality Care Program Description

The goal of Kern Health Systems is to provide grant proposals for innovative ideas and creation of Provider Quality Care Programs.

The grant funds can be used for a variety of activities such as:

  • Access to Care
  • Service Area Expansion
  • Quality Care Initiatives
  • Special needs populations
  • Expansion in provider hours of operation
  • New PCP or Specialty care clinics
  • Provider Recruitment and retention efforts
  • HEDIS focused Quality Care Initiatives
  • Minor capital projects/medical equipment
  • Home health program for High risk members

Provider Financial Opportunity

KHS has allocated $4,000,000 in grant funding for this program distributed in the following provider categories:

  • Safety Net Providers—$3,200,000
  • Non-Safety Net/Community Providers—$800,000

Upon award and approval of the Scope of Projects and Budget, KHS will develop a grant agreement. The contracting agency can then invoice monthly (see financial reporting template attached).

Provider Requirements

Quality Care Program Grant Funds are available to providers who meet the following criteria:

  1. Provider must be Contracted with KHS
  2. Contracted provider must be in good standing
  3. Provider must meet ALL KHS Credentialing Requirements

Reporting

The provider will report to KHS on their proposed workplan on a monthly basis or when submitting for reimbursement of expenses.

On a monthly basis, grantee will submit the following:

  • Progress report: Narrative of measured progress of proposed project
  • Financial report: Detailed Expenses being requested for reimbursement
  • Evaluation reporting based on goals and objectives outlined in grant scope of work

For questions regarding this program, please contact:

Amisha Pannu
Provider Relations Managers, Special Programs
661.664.5157
Amisha.Pannu@khs-net.com

Emily Duran
Director of Provider Relations
661.664.5000
Emily.Duran@khs-net.com

2019 School Wellness Intern Program

Background

Kern Family Health Care (KFHC) offers funding to help schools and community partners implement school wellness policy and related strategies that promote school and community health. School health programs that align with an evidence based school wellness policy can help children stay healthy, prevent future chronic diseases, and improve academic performance. KFHC is offering a paid internship to support school wellness interns who can provide assistance to school wellness policy implementation. Some schools may need assistance organizing school wellness policy meetings, implementing their school wellness policy strategies, and organizing activities with local residents and community partners that would benefit school and community health. The school wellness interns will function as liaisons between the school, community partners, and KFHC. The length of assignment is August 2019 – June 2020.

Application deadline

June 1, 2019

Internship selection announcement date

June 15, 2019

Program period

August 1, 2019 – June 30, 2020

I. School wellness intern hours, wages and travel
  • The pay rate is $16.00/hour
  • The expected number of hours of commitment is 16-24 hours per week.
  • If using own vehicle, mileage will be reimbursed at the current IRS rates.
II. School wellness intern responsibilities
  • Read and become familiar with the assigned school's or school district's school wellness policy.
  • Work with the assigned school to conduct an assessment of the school's wellness program and school wellness policy.
  • Assist with organizing and facilitating school site school wellness committee meetings with the school staff, school district, parents, and community partners. Work with the school wellness committee to update the school's or school district's school wellness policy.
  • Assist the school with organizing and facilitating regular school wellness committee meetings to develop a school wellness program.
  • Assist with organizing separate meetings with the school staff, residents, and community partners to plan and implement the school wellness program.
  • Provide monthly written reports on work completed and internship experience.
  • Attend monthly internship meetings with KFHC to discuss school's progress and challenges, Meetings will be up to 2 hours in length and may include trainings and presentations.
  • Report weekly hours worked.
III. Applicant selection criteria
  • Must be 18 years or older.
  • Must not be a dependent of a Kern Health Systems (KHS) employee.
  • Must have a high school diploma or GED.
  • Must be a college student or have graduated from college within the past 12 months. Must be able to provide proof of current college enrollment or college degree.
  • Students or graduates of a college degree program related to health, childhood development, or social services are preferred.
  • Must have a reliable form of transportation. If driving own vehicle, must possess a valid California driver's license and state required auto liability insurance.
  • Must have good communication and written skills.
  • Must be very organized and have strong time-management skills.
  • Candidates who are fluent in English and Spanish are highly desired.
  • Candidates with experience working with schools or community health programs are highly desired.
  • Must be willing to complete a background check, DMV check and a health clearance.
  • Candidates with strong computer skills are highly desired.
IV. Application process
  • A public notice announcing the application period along with the stipend application will be made available at kernfamilyhealthcare.com and mailed by request when made in writing. Click here to download a copy of the stipend application.
  • Completed applications must be submitted during the application period, and received no later than the application deadline, June 1, 2019.
  • Applications should be emailed to: healthedprograms@khs-net.com
V. Award process and evaluation

KHS will review eligible applications, conduct follow-up interviews and make recommendations to the CEO for stipend awards.

Questions

Contact healthedprograms@khs-net.com.

2019 School Wellness Grant Program

Background

Kern Health Systems dba Kern Family Health Care (KFHC) is committed to improving the health status of our members and our community through an integrated managed health care delivery system. Since 2015, KFHC has been funding schools wellness grant programs throughout the county and these programs have demonstrated success with decreasing obesity, improvement of physical fitness, and increasing student knowledge around nutrition, physical activity and safety. To continue assisting KFHC in fulfilling its commitment towards a healthier Kern County, KFHC will award up to 6 public schools in Kern County grant funding to implement a school wellness program that will engage students and stakeholders in activities that promote and support the physical, social, emotional and behavioral health and wellbeing among students and their families.

Award amount

Up to $35,000

Application deadline

April 9, 2019

Award announcement date

June 15, 2019

Program period

July 1, 2019 – June 30, 2020

Program expectations

  • Program Lead must participate in monthly meetings to discuss the progress of the grant funded program and at least four of these meetings will be in-person at the school. It is highly recommended that key staff identified in the school's work plan and grant application attend these meetings.
  • Monthly Progress Reports on the status of the work plan activities are due by the 5th of each month.
  • Quarterly Financial Reports on all actual and encumbered expenses are due by the 5th of the month.
  • End of Program Financial Report is due no later than 45 calendar days following the completion of the program.
  • End of Program Evaluation Report is due no later than 45 calendar days following the completion of the program.
  • The KFHC should be visible on all rewards, incentives, marketing and promotional items when possible.
  • Any changes to the approved program or budget must be received in writing and approved by KFHC.
  • Program activities must commence within 45 calendar days from the 1st day of school.
  • End of Year Reward must be tied to the school's work plan and cannot exceed 40% of total grant funds.

Eligibility requirements

  • Applicants must serve Medi-Cal beneficiaries and low income students.
  • Applicants must be a public school or district dependent charter school that serves students from Kindergarten up to 12th Grade in Kern County, California.
  • Applicants that have previously participated in the KFHC School Wellness Grant Program are not eligible to reapply.
  • Program expenses must be tied to the approved student wellness program objectives. Professional development, staffing, utilities, and furniture are not eligible expenses.
  • Applicants must prepare and submit a completed School Wellness Grant Program Application, Work Plan and Proposed Budget.
  • Preference will be given to applicants that demonstrate readiness and motivation to successfully implement the program, commitment to the program at all levels (from administrative staff to teachers), ability to engage in regular communication with the program liaison, and plans for sustaining the program after the conclusion of the program.

Application process

Award process

The KFHC Wellness Committee will review eligible applications, conduct follow-up interviews and make recommendations to the CEO for grant awards.

Questions

Contact healthedprograms@khs-net.com.