D5 - Reframing the Narrative: How One State Changed Focus from Services and Programs to Systems and Families to Address Future Needs During a Crisis

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Full Description: Community Health Access and Navigation in Tennessee (CHANT) was launched statewide in 2019. CHANT combined three existing programs into one comprehensive care coordination initiative. The desired outcomes from this amalgamation of programs were to decrease infant mortality rates, eliminate redundancy in service delivery, create mutual goals across programs, have more measurable outcomes using an evidence-based approach, and create a more family-focused method to service delivery. Six-months into the statewide launch, the COVID-19 pandemic caused a major shift in service delivery and many of the care coordination and navigational aspects implemented for this new initiative.

During a tumultuous year, when staff and families had to shift and pivot to learn a new normal, many decisions were required to improve efficiency, and effectiveness in family engagement, navigation and coordination. A comprehensive assessment was conducted with all families with CYSHCN receiving services. The care coordinator workforce capacity was also assessed, and statewide contingency and triage measures were enacted. All processes in place prior to the 2020 COVID-19 pandemic were reviewed and new processes were established to minimize interruption, discontinuation of medically necessary services and critical functions of CHANT. Due to a year of “Work from Home” orders, in-person contact suspension, staff pulled from regular duties to man testing and vaccine clinics, families afraid to attend routine doctor visits, and experiencing delays in receiving medication or other medical treatment, a new narrative was required. Staff quickly assessed the situation and reframed the narrative from a programs and services focus to families’ needs and how to provide the best systems of care with limited operational capacity.

The team reviewed past processes and used that information and the desired outcomes to develop a new system of care. This new system includes established processes for continuity of services during emergency responses and disasters, identifying methods to reduce inequities in social determinants of health, moving from paper-based to electronic and virtual platforms, and creating strategies to combat issues that may occur when CYSHCN and families are unable to receive treatment and other necessary services. The impact of COVID-19 on families is still unknown at this time; however it is believed to be significant and long-term, this new narrative will continue to shape CHANT engagement navigation and care coordination as we move into the future.

This session will describe 1) how critical situations may lead to solutions for future best practices, 2) how including social determinants of health in care coordination provide additional supports to families, and 3) how responding to a crisis can lead to a panacea.

Abbreviated Description: Community Health Access and Navigation in Tennessee (CHANT) changed the focus of care coordination from services and programs to family-focused systems of care during the COVID-19 pandemic crisis and emergency response. This statewide program created a new narrative that included changes to many of the established processes. Although the impact of the COVID-19 pandemic on families and especially CYSHCN is still unknown, the processes instituted during this crisis will continue to shape CHANT and CYSHCN functions and processes, family engagement, navigation and care coordination as we move into the future.