Appendix IV — Co m m e n t s f r o mStatewide Or g a n iz a t io n smust defines its specific goals for supporting the fourinitiatives. It should not build a PCMH model and see whathappens, but rather identify specific desired outcomes andbuild a system to achieve those outcomes.The issues of supporting an adequate medical workforceand meeting the challenges of ethnic and racial disparitiesin both the workforce and patient populations are importantissues that must be included as we move forward throughthe decision time frames.Service Employees International UnionSEIU fully supports the Core Transformational Strategiesof achieving Payment Reform, establishing primary careand the Patient Centered Medical Home as the anchor forimproved outcomes, increased efficiencies and affordableaccess, Creating Informed and Activated Individuals andPatients, and transforming <strong>Health</strong> Information Technologyas outlined in the <strong>Ohio</strong> <strong>Health</strong> <strong>Quality</strong> <strong>Improvement</strong> <strong>Plan</strong>.Integration of other initiatives, especially the UnifiedLong Term Care Budget Workgroup recommendationsinto the <strong>Health</strong> Care Coverage and <strong>Quality</strong> Council isessential to achievement of the Vision for a <strong>Health</strong>y <strong>Ohio</strong>.Payment reform initiatives must exist across the continuum,including primary care, acute, and long term care systems.Likewise, without a long term care system in place thatwill be responsive to the needs and desires of the activatedand informed patient, the benefits outlined in that strategicfocus area are minimized, if not reversed. Additionally, thegoals outlined in the Activated/Informed consumers focusarea can only be effective if there is an equally focused anddeliberate effort to change the culture of providers and howthey relate to consumers.When looking at a Patient Centered Medical Home thattakes care of all health care needs of an individual, Homeand Community Based services and supports can not be leftout of the equation. This is especially true when lookingat <strong>Ohio</strong>ans with chronic care needs. Homecare workersare often the only providers who have daily interactionwith the individual with chronic care needs as they are inthe home on a daily basis over the long term. Homecareworkers could be trained to provide the kind of chroniccare management/monitoring that we envision in a PatientCentered Medical Home.As SEIU represents health care workers across care42settings in <strong>Ohio</strong>, the issue of workforce capacity is apriority for our organization. This is especially true in thearea of the <strong>Ohio</strong>’s homecare direct support workforce.The stabilization, professionalization and growth of thisgroup of workers will be essential into the future as ourpopulation ages, and an ever larger share of the state budgetis directed toward providing long term care for <strong>Ohio</strong>ans.We look forward to working with the Council to addressthe issues of this workforce.Through our membership of 35,000 individuals we havethe ability to reach many consumers to encourage andmarket the methods laid out towards creating activated andinformed consumers.As the HCCQC begins to move forward on therecommendations outlined in the plan, a coordinatedadvocacy and lobbying strategy should be developed toaddress barriers that exist to implementation at a federallevel. As a national organization SEIU is heavily involvedin national health reform discussions and has the capacityadvocate strongly and effectively for reforms that musthappen in order to move these initiatives forward on astate level. As an organization with an additional presenceon local and regional levels, we have the desire andability to share best practices developed in other regions,and to advocate for states’ abilities to continue to act aslaboratories to health reform strategies.UHCAN <strong>Ohio</strong> and <strong>Ohio</strong> Consumers for<strong>Health</strong> CoverageI write on behalf of UHCAN <strong>Ohio</strong> (a statewide consumerhealth advocacy organization) and <strong>Ohio</strong> Consumers for<strong>Health</strong> Coverage, a coalition uniting diverse consumerinterests in health care reform. On behalf of <strong>Ohio</strong>’s healthcare consumers, we are extremely supportive of the visionand strategies embodied in the plan, as we seek highquality, affordable health care for all <strong>Ohio</strong>ans.We are committed to collaborating with all stakeholders onpursuing strategies and tactics beneficial to consumers.We will help to build support, through public education andadvocacy, for public policies that:• expand patient-centered medical homes, especially to<strong>Ohio</strong>ans with or at risk for developing chronic healthconditions• adopt payment methods that make significantinvestment in patient-centered medical homes and
Appendix IV — Co m m e n t s f r o mStatewide Or g a n iz a t io n shealth outcomes and that reward providers for meeting performance benchmarks• increase public reporting on quality, utilization, spending, and other transparency data to measure, analyze, andimprove quality and cost-effectiveness, and• enable consumers and providers to choose the most effective, safe, and appropriate treatments and medications.We believe that improving both quality and cost-effectiveness of health care is critical to achieving a healthy <strong>Ohio</strong>,but that expanding coverage to all <strong>Ohio</strong>ans should not wait until delivery system reform is achieved. Rather, coverageexpansion and quality improvement must happen at the same time.Consumers – the customers and beneficiaries of health care – are too often excluded, confused, or ill-served by today’scomplex, fragmented health care system. Unless organized consumers are actively involved both in their own healthcare and in improving the health care system, efforts to improve health care may fail. We are committed to ensuring thata coordinated consumer voice informs the development, implementation and evaluation of all strategies described inthe plan, and we will work with others to organize effective consumer participation in key aspects of the work. We willalso work to make sure that consumers have adequate resources to become partners both in their own health care and inimproving the health care system for all.We also want to make sure that quality health care in <strong>Ohio</strong> is affordable to all consumers and will lend our expertise indeveloping affordability standards that prevent consumers from going without needed care or suffering financial hardship.We are committed to ensuring that health care delivery reform reduces racial and ethnic disparities in health care and thathealth care is culturally appropriate to all residents of <strong>Ohio</strong>. We also seek to prevent implementation of strategies andtactics that are punitive to, or impose hardships on consumers.43