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North Country Health Care Commission Issues Report

The North Country Health Systems Redesign Commission (NCHSRC), a group formed late last year, has just issued a report to Health Commissioner Nirav Shah, MD, with several recommendations aimed at ensuring access to health care services in the Adirondack region. The underlying goal is to create an effective, integrated health care delivery system for preventative, medical, behavioral, and long term care services to all communities throughout New York's North Country.

The report, ”Building Capacity and Promoting Value in the North Country,” assesses the current system of services in the nine counties of the North Country (i.e., Warren, Washington, Essex, Clinton, Franklin, St. Lawrence, Jefferson, Lewis and Hamilton). It includes a series of recommendations based on the framework and priorities of the State Health Innovation Plan, New York’s roadmap for achieving the Triple Aim.  The recommendations fall into five major areas; (1) improving access and integrating care; (2) financial rewards for value; (3) transparency and consumer engagement; (4) measurement and evaluation; and (5) promote population health.   

Long term care services and supports are the subject of several NCHSRC recommendations. Among them is a new concept known as Skilled Care Campuses, which could be a group of virtual expanded services provided by a current nursing home that would support a reduction in nursing home bed capacity, and reuse the existing nursing home space and infrastructure to support adults needing other services such as outpatient therapy, assisted living, social day care and supportive housing with meals and activities. The report also makes a strong case for expanding the availability of assisted living in the region, particularly for low-income individuals, and for bolstering home health services by supporting workforce availability and access to telehealth.

The NCHSRC recommendations also call for creation of a new funding category to address sustainability called an Essential Community Health Network (ECHN) for providers that are essential and financially distressed due to their engagement in transformation. ECHNs may be hospitals, nursing homes or some other entity that is a safety net provider, given their isolation and/or population served. These entities could qualify for time-limited Medicaid rate adjustments to advance system transformation.

As previously reported, LeadingAge NY has received grant funding for a project entitled “A Roadmap to a Rational, Sustainable and Replicable System of LTC Services in the Eastern Adirondacks” from the NYS Health Foundation. The project involves identifying the needed configuration of services in the region, assembling an action plan to rebalance the long term care and supportive services system, and growing a sustainable, integrated rural health network of services in the region. LeadingAge NY briefed NCHSRC members on this project, and the final report recommends that DOH “carefully evaluate and consider for implementation the recommendations that are made on or about September 30, 2014” as a result of our grant.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866