2020 PERFORMANCE COMMISSION CHARTER The Finger Lakes Health Systems Agency (FLHSA) established the Community Health System 2020 Commission (2020 Commission) in early 2008 to examine from a community-wide perspective the healthcare infrastructure needs of the northern six counties of FLHSA’s nine county region. The 2020 Commission also was charged with recommending the best use and allocation of resources. The Commission formulated recommendations to the New York State Department of Health to guide the Department’s decisions on major health care investments proposed by Rochester General, Strong Memorial and Unity hospitals. It also expressed its ambition for the Rochester region to be recognized as one of the highest performing health systems in the country through a set of Community Investment recommendations. Specifically, the 2020 Commission called for a process to: Oversee the development of Community Investment recommendations into concrete, practical activities with specific performance targets and accountabilities. Assure a community-wide collaborative approach involving all stakeholders by creating accountable work groups to address specific issues. The 2020 Commission also was charged with establishing a framework by which to guide development of the region’s health care system. In so doing, the centerpiece of the Commission’s framework is the creation of a health care delivery system that focuses on improving broad spectrum performance (e.g. quality, patient and provider satisfaction and financial performance), and emphasizes collaboration in achieving this purpose. The Commission’s framework calls for maintaining a community-wide perspective to assure effective and non-duplicative investment for the benefit of the community as a whole and avoid expensive economic competition over market share, capital and expertise. Finally, the Commission urged the convening by the FLHSA of a task force to provide leadership, guidance, and oversight for developing inter-disciplinary community initiatives to address the Community Investment recommendations, including necessary funding mechanisms. New York State’s Department of Health is engaged in the review of health planning practices including Certificate of Need requirements. Neil Benjamin, Director of DOH’s Division of Health Facility Planning, describes their general approach as “mov[ing] away from institutional planning towards population based planning … [that] entails beginning with an assessment of community health and working with providers in forming the delivery system.” Mr. Benjamin commended FLHSA’s 2020 Commission for “[seizing] the opportunity to begin the process of change [in health planning] at the community level…[with] collaboration, community reinvestment and involvement of virtually every stakeholder impacted” by the CON projects proposed by the three Monroe County hospitals. It is in this context that the next phase of the 2020 Commission’s work begins. Purpose The Community Health 2020 Commission on System Performance will develop the processes and infrastructure to support the implementation of the Community Investment recommendations by integrating data, analytics and community engagement. These recommendations embody the 2020 Commission’s aspirations to: Create a patient-centered health care delivery system that focuses on improving collaboration and performance (e.g. quality, patient and provider satisfaction and financial performance); Reduce health disparities among populations; Develop coherent and integrated strategies to ensure the continued viability of the community hospitals in the region and to improve the adequacy of and access to health care services for the residents of those communities; Better manage the demand for acute hospital services through smart investments aimed at improving community-based system capabilities, thereby reducing the need for expensive investment in expanded hospital inpatient facilities; and, Establish improved metrics to quantify and improve health status and system effectiveness for the region, and apply these to cover all who use and/or provide health services in the region. Planning and Implementation Consistent with the 2020 Commission recommendations, the FLHSA will convene the 2020 Performance Commission with representation from key stakeholders in the community. The 2020 Performance Commission will: Oversee and guide the implementation of the 2020 Commission’s Community Investment recommendations; Facilitate the establishment of partnerships between hospitals and community-based providers and programs that will improve access to primary care and reduce dependency on EDs and acute care; these efforts should target initiatives that address disparities in access to care, and are expected to have a positive impact on both health status and the suboptimal use of emergency room and inpatient resources; Analyze and modify, as deemed appropriate, the preliminary goals suggested by the 2020 Commission to understand more precisely the potential magnitude and impact on ED utilization and inpatient capacity shortages. These preliminary goals, understood to be baseline starting points for improvement, are: A decrease of 15% in the number of low acuity visits to emergency rooms, A decrease of 25% in the number of admissions for Ambulatory Sensitive Conditions manageable in outpatient settings, and A decrease of 20% in the number of low acuity admissions to Monroe County hospitals of residents from outlying communities Oversee the development of a coherent and integrated “West Side” strategy to assure the continued viability of the western Monroe County hospitals and improve the adequacy and access to health care services for the community; and Facilitate URMC/Strong Memorial Hospital’s collaboration with the other providers in the community as they: Take the lead, together with other workforce training programs in the region, to develop strategies to train and retain adequate numbers of primary care providers (MDs, NPs and PAs) and specialty physicians in the region; and Work with the other hospital providers in the region to develop clinical relationships to disseminate best practices and technology, and to create referral relationships so that patients will receive needed care in the most appropriate and cost effective settings. To accomplish these activities, the 2020 Performance Commission will: In its first six months, establish a timeline, with periodic milestones related to interim and final goals; Create a process and methodology for setting targets and measuring performance, and relate periodic milestones to these targets and measures; Create working groups (to consist of the stakeholders most affected by the 2020 Performance Commission’s priorities) to identify, recommend and develop initiatives in support of the goals; Create strategies to obtain resources commensurate with the scope of the initiatives and sufficient to ensure their long-term success; and Provide regular reports to the FLHSA Board of Directors and to the community at large. 2020 Performance Commission The 2020 Performance Commission will be comprised of 18-20 individuals who are committed to the best interests of the community, and who can be independent, objective and discuss the issues before the 2020 Performance Commission with integrity. These should include representatives from business, insurers, providers, consumers and other community constituencies who will set priorities with respect to goals, targets and innovative care models, and also to secure funding for services through third party payers, government programs and grant awarding foundations. Roles and Accountability FLHSA Board of Directors Approves Charter, 2020 Performance Commission composition; Establishes and monitors Performance Commission’s budget; receives from the 2020 Performance Commission projected interim and ultimate milestones, timeline for accomplishing them, and regular reports of progress, successes and challenges; where appropriate, works with Performance Commission leaders to revise charter purpose, goals and implementation; and accepts the Performance Commission’s interim and final reports. FLHSA Staff Provides project coordination and technical support. 2020 Performance Commission Within Charter, establishes ground rules for its work; within its first six months, establish a timeline, with periodic milestones related to interim and ultimate accomplishments, and reports these to the FLHSA Board of Directors; identifies topics for research, review and discussion; within its allotted budget, charges FLHSA staff, technical experts and consultants to acquire data and conduct specific research and analysis of project-related data and related materials; selects consultant(s) as needed; deliberates on study findings and issues; directs staff in development of draft reports; provides periodic reports of its progress, successes and challenges to the FLHSA Board and to the community at large; accepts and approves, as appropriate, any consultants’ reports commissioned in the course of the project; approves all interim and final reports with recommendations. Technical Experts Invited as needed by the 2020 Performance Commission to provide subject matter expertise to the Performance Commission, its work groups and staff in the course of the Performance Commission’s work; may also be invited to take part in the work groups. Consultants Selected, engaged and charged by the Performance Commission to provide analyses and research to support its work; consultants may also be selected and engaged by FLHSA staff to assist in their technical support activities for the Performance Commission. Benefits Provides a planned, proactive approach to develop the region’s health care system to achieve measures of high performance and improved health status. Establishes community-wide priorities to align health care services to provide preventive, primary care and outpatient services more efficiently and cost effectively and to reduce demand for inpatient services. Develops strategies and metrics to drive and measure progress toward community goals for health status and a high performing health care system. Critical Success Factors Regular, active participation by all Performance Commission members. Full participation in work groups by all health care stakeholders. Major Deliverables Strategies for converting the tenets developed by the 2020 Peformance Commission into reality; Performance measures and targets for health care delivery for specific service areas as well as for the region as a whole; Regular reports of performance of both the regional delivery system as a whole and of the specific project activities; and Strategies to obtain resources commensurate with the scope of the intitiatives and sufficient to ensure long-term success. Charter | Meeting Documentation | Roster | Calendar | Supplementary Materials 2020 PC Home | Last update: 7 May 2009 | FLHSA Home | Contact