Safety Net in the public sector involves services and programs across multiple departments - health, behavioral health, social services, housing, justice – coming together to help individuals with complex needs.

Abstract

Interdepartmental collaboration is the key to improved client outcomes. Another key to improved outcomes is the Departments’ enablement of a network of Contracted Service Providers (CSPs), and Community Based Organizations (CBOs). In addition to providing services directly, departments must also provide the central trove of resources that their partners can use to render services.

This new operational model is supported by an emergent information technology architecture, where the Department provides the core systems and surrounding Application Programming Interfaces (APIs). Various departments line of business application is able to interact by calling and orchestrating these APIs. The economics of this model are sound and its elasticity unbeatable. Each party does what it does best – the Department manages data, stipulates business rules, ensures compliance, and evaluates performance; the CSPs and CBOs can build point of service applications informed by their close proximity to the client. In this model, new programs for public assistance and healthcare can be launched rapidly through the effective use of the Departments’ existing resources. The ecosystem shares the burden of the launch, such that the services reach the client at the time of need, and not weeks or months later.


Sonoma County is one of the first Counties to have undertaken this paradigm shift. Through a recent information technology initiative, Sonoma County has provisioned a Care Coordination hub and an API backplane, to which various Care Management and process automation systems attach. The hub brings together data from various back-end systems – medical, behavioral health, social services, housing, and justice – to compose the holistic picture of the client. Access to various aspects of this holistic picture are controlled by client consent and Department policies to maintain compliance with regulations such as HIPAA and CFR 42 Part 2. The hub provides the Master Data Management, business rules engine, authorization and consent, and alerts and notifications. Watson Care Management and process automation systems access the hub through a set of HL7 FHIR APIs. (The HL7 FHIR standard for RESTful APIs has been endorsed by the Center for Medicaid Services (CMS), and is now widely used across the Healthcare industry.)

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