As the California Legislature and Gov. Gavin Newsom continue negotiations for the 2023-24 budget, which will be adopted on July 1st, Timi Leslie, leader of BluePath Health and Connecting for Better Health, seeks to overcome challenges of the lack of funding for health information exchanges (HIEs).
Leslie told State of Reform that Connecting for Better Health was formed years ago, when Newsom signaled an interest in the exchange of health information data. The organization provided the legislature and the administration with a diverse group of stakeholders on the importance of HIEs and data sharing between provider networks.
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She mentioned how health information exchange between provider types eases the burden of providers having to go on data hunts to find more out about their patients, and it eases the burden of having to make medical suggestions for a patient when they do not have full access to the patient’s records. A huge portion of getting everyone behind HIEs and data sharing begins with trust, she said.
“The public trust in wanting and desiring data sharing, I think, they assume that it’s happening—more so than we give them credit,” Leslie said. “I’m not as concerned about the public trust when I say trust, I think it’s trust in data sharing partners, so it’s building trust among health plans and hospitals and primary care and Federally Qualified Health Centers and specialists, telehealth providers.
It’s really saying that even though you may not be affiliated under this same umbrella, that patient is really requiring care among different providers, and those providers need to communicate with each other, and they need to share that patient data.”
Last year, Newsom allocated $50 million towards the state’s Data Exchange Framework, aiming to streamline connectivity to promote more whole-person care. While the funds will go out this year to facilities that have submitted requests for proposals, Leslie expects that it will cost over $50 million to build data exchange infrastructure across the state.
“That amount is not in the budget for next year,” Leslie said. “I think we’re missing the boat here, and we need to think incredibly creatively on how we bring those additional dollars that can be matched by the federal government through Medi-Cal, primarily, to be able to bring that necessary investment into the system.”
Leslie said state leadership needs to realize the importance of funding HIE development and allocate funds to the area for in the 2023-24 fiscal year budget, that the state’s leadership needs to step up. The data exchange framework grants, known as DSA Signatory Grants, come in three rounds, with the third round of award announcements set to take place on December 1st.
“I think you have to be really focused on making sure that those [rural] organizations are prioritized, and that your evaluation rubric accounts for making sure you have equitable allocation of those funds,” Leslie said.
Leslie added that the third round of these grants are for non-mandatory signatories, such as community-based organizations and social service organizations, who are in the most need of these funds.
“For them to be in the third bucket, we really had hoped that they would be prioritized,” Leslie said. “I think the thought process [is] more time to be able to apply [for the grants].”
While other states, such as Texas and New York, have HIEs, Leslie said that California is the first to implement this infrastructure with a wider array of provider types, to include social workers. She said that having health and social services baked in from the getgo makes it clear that social service workers have an equitable seat at the bargaining table, and that the data they receive is just as important as health information from a physician.
“I think it’s a tremendous opportunity if we get this right, to be able to serve the whole patient,” Leslie said.
With no foreseen plans of increasing the funding for HIE infrastructure in California within the budget framework, Leslie refuses to pause. She said the Department of Health Care Services (DHCS) is making additional funds available, and that her focus for the time being is working with DHCS for the investments, while finding ways in which they can work with CMS, who they hope will provide federal matching dollars. Another avenue she’s interested in is collaborating with the Department of Public Health to pull funds in order to build the digital infrastructure.
Leslie said Connecting for Better Health coalition will most likely have several exchanges with the legislature around November, which is the time when they host get-togethers where they discuss what priorities for the next year are, and what investments need to be made. Although the Connecting for Better Health coalition has been focused on the lack of additional funding for the next fiscal budget, she acknowledges how goals align between the administration and leading health agencies on this topic. Going forward, Leslie believes that this HIE build-up process will require effort, compromise, and trust.
“Shame on us if we don’t take advantage of this opportunity, and shame on us as a collective and not do this for our patients and our families and our caregivers,” Leslie said.