Summary of Regional Health Hub Legislation – A5977/S4282
Primary Sponsors: Assembly Majority Leader Greenwald, Assemblywoman Downey, AssemblywomanVainieri Huttle; Senator Vitale, Senator SingletonAs of July 2020
Section 1: Legislative Findings
- The goal of the legislation is to improve Medicaid benefits and payment models and their interactionwith social services.
- This is accomplished through regional non-profits who take a data-driven approach to personcentered care, connecting social services and community resources to the healthcare system.
- Regional Health Hubs will enable the state to identify emerging threats, pilot innovative solutions andevaluate outcomes in support of the health of New Jersey residents.
Section 3: Establishment of a Regional Health Hub Program
- The Department of Human Services (DHS) shall establish a Regional Health Hub Program toreplace the Medicaid Accountable Care Organization Demonstration Project.
- Four organizations shall be the initial Hubs:
- Healthy Greater Newark ACO;
- Trenton Health Team;
- Health Coalition of Passaic County; and
- Camden Coalition of Healthcare Providers.
Section 4: Designation of a New Regional Health Hub
- In order to name a new Hub the Commissioner of DHS shall consider the needs of the prospective region, in consultation with the Commissioner of DOH, including:
- The availability of funds to support a new Hub making sure not to impact the sustainability of existing Hubs; and
- The number of Medicaid beneficiaries, healthcare and social service systems and avoidable hospitalizations in the area.
- The Commissioner shall designate an area of the state as a prospective region for a new Hub and solicit applications for organizations interested in becoming a Hub.
- Only organizations who are NJ non-profits and who submit a request to become a Hub that includes a proposed core region and data catchment area may be designated. The Commissioner has discretion to choose between competing applications.
- Once a new Hub organization is designated they shall establish a headquarters in the region,convene a diverse advisory committee representing the community, healthcare stakeholders and social service organizations, and establish a governing board.
- Existing Hubs may, at any time, submit applications to the Commissioner to expand their core region.
Section 5: Revocation of Hub Status
- The Commissioner may revoke the designation of an organization as a Regional Health Hub if theorganization fails to perform the mandatory activities of a Hub, provided the organization is givenwarning and time for corrective action.
- If a Hub’s status is revoked, the Commissioner shall review that region’s need and, if warranted,designate a new Hub organization
Section 6: Activities of a Regional Health Hub
- Mandatory Activities:
- Operate a Health Information Platform;
- Convene community stakeholders, at least quarterly; and
- Serve state departments as a strategic planning partner.
- Other Activities:
- Plan and execute population and patient-level health interventions;
- Operate a community resource inventory;
- Perform a health needs assessment for the region;
- Other quality improvement activities;
- Screening protocols on Social Determinants of Health;
- Care management and coordination; and
- Provide an annual report on the health goals and needs of the region.
Section 7: Proposals between each Hub and DHS
- Hubs shall submit a proposal to DHS annually for approval by DHS, in consultation with DOH, thatcontains the Hub’s annual goals and elective priorities for the next fiscal year. To inform theproposal, each Hub shall convene local stakeholders to identify regional priorities and DHS shallprovide departmental goals, projects and priorities for the coming year.
- DHS and each Hub shall agree on the appropriate funding to support the list of priorities and projects in the proposal for the fiscal year.
- Between 10% and 25% of the proposal funding shall be performance based.
Section 8: Funding
- DHS must approve a Hub’s annual proposal prior to the Hub receiving funding.
- Funding will be in accordance with the provisions of the annual appropriations act.
- The DHS Commissioner has discretion to fund Hub innovation projects that advance Medicaid priorities with other available dollars as appropriate
Section 9: The Health Information Platform
- The Health Information Platform of each Hub shall contain detailed health data, both macro-population level data and analytics as well as individual level data.
- Hubs shall maintain a data sharing use and reciprocal support agreement, and any applicable usecase agreement, with any statewide health information platform designated by the Commissioner inorder to promote interoperability.
- Other NJ State Departments are authorized to share data with Regional Health Hubs.
Section 10: Other NJ State Departments
- Other NJ State Departments that implement health related pilot programs are encouraged to consultwith the Regional Health Hubs.
Sections 11, 12 & 13: Administration of the Act
- The Commissioner shall apply for all amendments and dollars that can help implement this act,adopt all necessary rules and regulations, and the act shall take immediate effect.