Participation Expectations

Because of the significant amount of funding that is obligated to each selected organization, Board of Directors (BOD) must be ready, willing, and able to support Executive Leadership to:

  1. Fully participate in all facets of the Program to meet expectations.
  2. Fulfill Program purpose of developing a local coordinated system of care to prepare for population health.
  3. Complete the three-year participation cycle to successfully graduate from the Program.
  4. Fulfill Program goal areas to:
    1. Develop and sustain a community care coordination plan.
    2. Adopt telehealth recommendations and/or expand telemedicine services to fill gaps and sustain long-term access to local care.
    3. Implement telehealth action plans to fill gaps in local services and secure access to health care
    4. Consider options to enhance financial systems for performance improvements.
    5. Implement consultant recommended best practices and action plans to increase operational efficiencies, and improve financial performance and quality of care.
    6. Adopt evidence-based models to improve quality of care and care coordination.
    7. Implement value-based care (VBC) recommendations to participate in, and further benefit from, VBC activities.
    8. Adopt population health strategies to prepare for population health management
    9. Utilize BOD and leadership development resources to build internal capacity that sustains post-project gains, and address workforce needs.

Chief Executive Officer must be ready, willing, and able to:

  1. Sign a Memorandum of Understanding (MOU) for the selected organization to participate in the Program.
  2. Be fully engaged and actively involved in all facets of the Program.
  3. Ensure executive and management teams, and Community Champion are actively involved in, engaged, and prepared for all Program activities. Program activities include, but not limited to, virtual and onsite:
    1. Community Care Coordination (CCC) community events
    2. Community Champion selection and progress calls
    3. Consultations
    4. Pre-planning activities, calls and zoom meetings
    5. Action planning sessions
    6. Post-project follow-up activities
    7. Implementation technical assistance projects
    8. Annual Summit
    9. Educational events and learning activities, which include, but not limited to, learning collaboratives, Champion Q & A Worktime, technical assistance webinars, zoom meetings, peer-to-peer education, in-person trainings, bootcamps and workshops.
  4. Complete multiple consultation projects over the three-year participation cycle to include, but not limited to, process improvement projects for telehealth, financial system enhancements, financial, operational, quality, revenue cycle and physician practice management.
    1. Reserve dates, submit data requests and meet project timelines
    2. Implement action plans and consultant recommended best practices at department level
    3. Complete reassessments and post-project evaluation activities
    4. Demonstrate measurable outcomes from projects
  5. Implement and sustain a community care coordination (CCC) plan
  1. Direct the CCC development to ensure that the plan aligns with organization's mission and community health needs
  2. Guide the Community Champion and Champion’s Supervisor in the CCC planning and implementation process
  3. Collaborate with community joint partners to develop a CCC plan
  4. Direct partnerships in CCC planning for sustainability
  5. Develop a sustainability plan to retain the Community Champion position and to secure access to local services
  6. Actively participate in CCC community events
  1. Provide oversight of the Community Champion and the Champion Supervisor roles
    1. Sign agreement to support the Champion position for the organization
    2. Select and hire a Community Champion, and appoint a Supervisor
    3. Supply workstation and materials for Champion to perform job duties
    4. Ensure the Champion’s Program supported time and resources are devoted to fulfilling Program:
      1. Goal of developing a community care coordination plan, and;
      2. Purpose of strengthening the local system of care and sustaining access to local health services.
        1. Ensure Community Champion job duties target CCC planning and development initiatives listed below, and other Center and organizational assigned tasks that implement and sustain the CCC plan:
          1. Assist leaders with CCC planning
      1. Engage community in planning
      2. Foster community relations
      3. Generate community buy-in
      4. Build collaborative partnerships
      5. Perform outreach activities
      6. Build awareness of available local services
      7. Promote hospital/clinic services 
      8. Help build patient and family loyalty
      9. Participate in learning activities (virtually and in-person) that build and support skills that augment sustainability.
    1. Ensure Supervisor effectively manages the Champion:
      1. Confirm the Champion’s Program supported time is obligated to performing and completing job duties that result in the development and implementation of a CCC plan
      1. Participate in Champion onboarding, trainings, progress calls, virtual and onsite community events, and other meetings
      2. Meet regularly with Champion on weekly or bi-weekly basis to:
        • Communicate Executive Leadership’s expectations for CCC planning
        • Discuss progress and next steps for CCC planning
        • Provide coaching and mentoring to Champion
        • Identify performance goals to support the Program’s expectations for managing the Champion’s activities to fulfil Program goal of developing a CCC plan.
      3. Verify quarterly progress documentation to justify invoicing of Champion’s salary reimbursement
      4. Report regularly to Executive Leadership on monthly basis to drive CCC planning. Communicate organization’s CCC successes, barriers and lessons learned and develop potential resolutions to challenges.
  2. Apply educational trainings to build staff knowledge to support implementation of action plans and augment sustainability
  3. Participate in the Annual Summit to share successes and lessons learned

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $10,000,000 with 100% funded by HRSA/HHS and $0 amount and 0% funded by non-government sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by HRSA/HHS, or the U.S. Government.