Bidder’s Conference: MGH/NWH Determination of Need

1. Bidder’s Conference: MGH/NWH Determination of Need May 29, 2019

2. Agenda • Determination of Need (DoN) Background Information • Newton Wellesley Hospital and the Massachusetts General Hospital DoN • Waltham Public Schools Involvement • Health Priority Selection Process • Review of the RFP • Question and Answer

3. Determination of Need The Massachusetts Department of Public Health (DPH) states: “The purpose and objective of the DoN program is to encourage competition with a public health focus; to promote population health; to support the development of innovative health delivery methods and population health strategies within the health care delivery system; and to ensure that resources will be made reasonably and equitably available to every person within the Commonwealth at the lowest reasonable aggregate cost. In this way the Department hopes to advance the Commonwealth’s goals for cost containment, improved public health outcomes, and delivery system transformation.”

4. The MGH DoN A DoN is required for certain types of healthcare providers, including hospitals that are proposing specific types of projects. Located at MG West • Surgical services (ambulatory) that will be provided at Mass General Waltham at completion of project include: • Interventional Radiology • Surgical Oncology • General Surgery • OBGYN/Fertility • Urology • Orthopedics  • MRI equipment NWH administering DoN

5. DoN - Community Health Initiative • Most DoN Projects include some level of Community Health Initiative investment and community engagement. • The amount depends upon the total DoN funding. CHI funding is 5% of the total maximum capital expenditure of the DoN project. • Of the total CHI funding, 75% is used for local health priority initiatives and 25% is provided to the CHI Statewide Initiative for statewide projects. This funding split is mandated by DPH. For NWH it provides a significant opportunity to provide funding for community investments. • Because the capital investment is happening in Waltham, the DoN CHI funding is focused in Waltham.

6. DoN Health Priorities Guideline • The environments in which we live, work, learn, and play have an enormous impact on our health. While research shows that addressing people’s physical, social and economic environments can encourage healthy behaviors and improve health, the fewest resources are allocated to these Social Determinants of Health (SDHs). As providers take on increased financial risk for their patients, addressing SDHs of both the patient populations and the larger community will be critically important for managing risk, improving health outcomes and producing long-term health care cost savings. • The goal of the DoN process is to promote population health and increased public health value. By focusing on the SDHs, DoN Health Priorities allow the Commonwealth to address health inequities based on race, class, and other socioeconomic factors which are a result of historical policies and practices.

7. DoN Health Priorities, cont. • Because access to care alone is not sufficient, the Massachusetts DPH, with broad stakeholder input has identified six (6) SDHs, which make up the DoN Health Priorities. • These Health Priorities: • Support successful transition by providers to increased financial risk; • Advance the Executive Office of Health and Human Services and DPH issue priorities; • Allow for greater collaboration and synchronization of investments regionally/statewide; and, • Encompass critical, ongoing community-based activities.

8. DoN Health Priorities, cont. The DoN Health Priorities are six (6) common social determinants of health: 1) Social Environment 2) Built Environment 3) Housing 4) Violence and Trauma 5) Employment 6) Education AND Current EOHHS/ DPH Focus Issues: Statewide trends and overall burden of morbidity and mortality point to: 1) Substance use disorders (SUDs) 2) Housing Stability/Homelessness 3) Mental illness and mental health 4)Chronic disease with a focus on Cancer, Heart Disease and Diabetes

9. Health Priority Selection • Waltham-centric Advisory Committee and Allocation Committee • Membership • Priority selection process • Health Priority/Strategy: Pathways to Graduation • Goal: Reduce ethnic and cultural disparities in graduation and drop out rates in Waltham • Indirectly will address areas of social environment, employment, housing and mental health • Population of Focus: refugee/immigrant students (primarily Central and South America • Outcome Measure: Education • Track through graduation rates and drop out rates

10. Waltham Public Schools

11. Request for Proposal

12. Request for Proposal Specifics: • Total Funding = $1.5 M • Funds will support a Collaborative Model Approach • One Collaborative selected from submitted proposals • $300,000 annually for 4 years • Waltham Public Schools designated as an anchor organization • $78,000 annually for 4 years

13. RFP • https://www.nwh.org/classes-and-resources/community-education/grants

14. RFP • Timeline • Next Steps