Title
a. Approve and Authorize the Director of Health or Assistant Director of Health to sign a Memorandum of Understanding with Oregon Community Health Information Network, Inc. (OCHIN) to participate in the Back on Track study, which will evaluate the impact of Medicaid reimbursement policies for treatments for back and neck pain, including various restrictions on long-term opioid prescribing and variable coverage for non-drug treatments, effective October 1, 2018; and
b. Accept a $2,900 clinic impact fee from OCHIN once the study activities are completed.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and Authorize the Director of Health or Assistant Director of Health to sign a Memorandum of Understanding with Oregon Community Health Information Network, Inc. (OCHIN) to participate in the Back on Track study, which will evaluate the impact of Medicaid reimbursement policies for treatments for back and neck pain, including various restrictions on long-term opioid prescribing and variable coverage for non-drug treatments, effective October 1, 2018; and
b. Accept a $2,900 clinic impact fee from OCHIN once the study activities are completed.
SUMMARY/DISCUSSION:
The Health Department Clinic Services Bureau (Health Department) operates nine community clinic sites designated as Federally Qualified Health Center Look-Alikes (FQHC-LA), which provide preventative, primary, and specialty medical care services. The Health Department has been a member of the OCHIN collaborative since 2007, which allows for access and usage of Epic’s Practice Management (PM) and Electronic Medical Record (EMR) systems.
Through the years, OCHIN has provided valuable health information technology support and services to the Health Department during the course of the Epic PM and EMR System implementation and utilization, and continuously offers innovative tools and methods, such as progression towards a paperless system, supporting meaningful use incentives through the American Recovery and Reinvestment Act (ARRA), tracking of quality of care variables, and hosting studies focused to improve health care.
Back on Track is a Patient Centered Outcomes Research Institute (PCORI)- funded 3-year collaborative study that runs from November 1, 2017 to October 31, 2020. This study is led by the Kaiser Permanente Washington Health Research Institute (KPWHRI) in partnership with OCHIN, Inc. and Harvard Medical School. Study activities have been approved by KPWHRI’s human subjects’ protection committee (IRB). KPWHRI’s IRB research waiver for patient’s written consent, authorizes the Health Department’s use and disclosure of Protected Health Information.
The study will work with several OCHIN member clinics in Oregon and California in order to evaluate the impact of Medicaid reimbursement policies for treatments for back and neck pain, including various restrictions on long-term opioid prescribing and variable coverage for non-drug treatments such as acupuncture, physical therapy, and chiropractic care. The experiences of patients, clinicians, and administrators within OCHIN health systems in Oregon and California are critical to fully understanding the impact of state Medicaid guidelines around opioid prescribing and use of other treatments.
Patients who agree to participate will be asked to complete between 1 to 5 surveys over the course of one year, depending on how long a patient has had back or neck pain and their use of pain medication. Participants will be reimbursed $30 for the baseline survey, and an additional $10 per completed survey. If participants complete all surveys requested, they will receive a $20 bonus. Participants can opt out of the study at any time.
Approval of this action allows Health Department with the opportunity to contribute to scientific knowledge about the how policies can impact back pain, opioid prescribing, and improve access to care among underserved patients in California and Oregon.
While this work is not directly in support of a Health Department strategic initiative, it is in support of one or more of the ten essential public health services, specifically: 1) Monitor health status to identify and solve community health problem; and 3) Inform, educate, and empower people about health issues.
OTHER AGENCY INVOLVEMENT:
County Counsel, the Auditor-Controller, and Contracts/Purchasing have reviewed the Memorandum of Understanding and concur with the recommendation.
FINANCING:
OCHIN will be paying the Health Department a $2,900 impact fee for participation of this study. While sufficient appropriations are available in FY 2018-19 Adopted Budget for Clinic Services Bureau, Health Department (4000-HEA007); the funds from this payment will help offset a portion of Clinic Services Bureau’s expenditures. Reimbursements to participants will be coordinated and issued directly by OCHIN.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Sheena Morales, Management Analyst III, x1393
Approved by: Elsa M. Jimenez, Director of Health, x4526
Attachment:
Memorandum of Agreement is on file with the Clerk of the Board