2018-11-14T09:36:27-06:00 2018-06-30 010494526 Baker Newman & Noyes PO Box 507 Portland ME 04112 990 2017-07-01 204935972 Maine Quality Counts MAIN 2076223374 16 Association Drive PO Box 16 Manchester ME 04351 Lawrence Clifford Executive Director 2076223374 2018-11-12 Nicholas E Porto P01310283 2078792100 2018-11-12 208.105.168.164 2018-11-12 11:07:02 ES P 89E582745F398AB9123794375B037D04AD0E63E3 86AD5A998A217BD7885303F5109AB5202568ED7D 2017 2019-02-21 02:37:17Z Lawrence Clifford 16 Association Drive PO Box 16 Manchester ME 04351 6754223 0 X www.mainequalitycounts.org X 2006 ME Transforming health and healthcare in Maine by leading, collaborating, and aligning improvement efforts. 18 18 48 30 0 0 4281802 5590566 2432152 1158414 3256 5243 0 0 6717210 6754223 8250 2000 0 0 2886685 2822656 10170 96 96 3861354 4190842 6766459 7015594 -49249 -261371 2968471 2478296 928650 699846 2039821 1778450 X Maine Quality Counts is transforming health and healthcare in Maine by leading, collaborating, and aligning improvement efforts. 0 0 5874368 2000 1158414 NORTHERN NEW ENGLAND PRACTICE TRANSFORMATION NETWORK (NNE PTN)Maine Quality Counts successfully completed the third year of the NNE-PTN in Maine, New Hampshire, and Vermont, with the goal of improving quality of care delivered, improving patient health outcomes, decreasing the cost of care, and lower the burden of "paperwork" for providers (patients over paperwork). (Continued on Schedule O) See Schedule O 5874368 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 26 0 1 48 1 0 0 0 0 0 1 1 0 0 0 0 X 18 18 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Lawrence Clifford 2076223374 16 Association Drive PO Box 16 Manchester ME 04351 Mylan Cohen MD Director 1.00 X 0 0 0 Lynn F Duby Director 1.00 X 0 0 0 Thomas P Ellis Director 1.00 X 0 0 0 Richard Freeman MD Director 1.00 X 0 0 0 Karynlee Harrington Director 1.00 X 0 0 0 Elizabeth Johnson MD Director 1.00 X 0 0 0 Edward J Kane Director (part year) 1.00 X 0 0 0 Daniel L'Heureux Director 1.00 X 0 0 0 Andrew B MacLean Director 1.00 X 0 0 0 Jessica Maurer Director 1.00 X 0 0 0 Louise McCleery Director 1.00 X 0 0 0 Sandra Parker Director 1.00 X 0 0 0 Jennifer Rottman Director 1.00 X 0 0 0 Iyad Sabbagh MD Director 1.00 X 0 0 0 Emilie van Eeghen Director 1.00 X 0 0 0 Gregory Bowers Chair 1.00 X X 0 0 0 Claire Cote Vice Chair 1.00 X X 0 0 0 Robert McCue Treasurer 1.00 X X 0 0 0 Joanne Bean Secretary 1.00 X X 0 0 0 Erik Steele MD Interim Exec. Director (part yr) 40.00 X 66294 0 6634 Lawrence Clifford Executive Director 40.00 X 58479 0 11048 Allison Watson MBA MS-CTE CFO (part year) 40.00 X 125817 0 21383 Amy Belisle MD Medical Director, Child Services 42.00 X 135157 0 4494 Joan Orr Deputy Director 40.00 X 108336 0 17955 494083 0 61514 3 0 0 0 University of New Hampshire 510 College Road Room 109B Durham NH 03824 Consulting Services 1920005 Mingle Analytics Inc 24B Market Square PO Box 82 South Paris ME 04281 Consulting Services 350345 Sweetser 50 Moody Street Saco ME 04072 Consulting Services 112294 HealthInfoNet 125 Presumpscot Street Box 8 Portland ME 04103 Consulting Services 105249 4 51711 5206533 332322 5590566 Contracted Services 541700 1022910 1022910 Conference Income 611430 102626 102626 Membership Dues 611430 27177 27177 Miscellaneous 900099 5701 5701 1158414 5243 5243 6754223 1158414 0 5243 X 2000 2000 289655 201456 88199 2065613 1546808 518805 40821 30628 10193 240295 180118 60177 186272 156468 29804 59666 59666 31501 31501 96 96 3562420 3455547 106873 8994 5399 3595 191141 124436 66705 56487 19770 36717 113519 9082 104437 91413 81979 9434 60677 60677 8948 8948 6076 6076 7015594 5874368 1141130 96 1299027 1703352 1628841 712399 17532 48422 55988 41865 23071 14123 2968471 2478296 697787 572970 230863 126876 928650 699846 X 2039821 1778450 2039821 1778450 2968471 2478296 -261371 0 X X 0 1 X 1 1 1 X 1009377 1199324 1454385 4281802 5590566 13535454 1009377 1199324 1454385 4281802 5590566 13535454 965965 12569489 708 2418 3451 3256 5243 15076 13550530 13746028 0.92760 0.74870 X 330000 330000 400000 70000 330000 400000 400000 400000 400000 1.00000 0.00000 0.00000 0 0 39333 30227 9106 16655 11638 5017 14123 X 6754223 0 6754223 0 6754223 7015594 0 7015594 0 7015594 Part V, Line 4: The Organization's endowment funds are to be used to further its exempt mission. Part X, Line 2: The Organization is exempt from federal and state income taxes under Section 501(c)(3) of the Internal Revenue Code (the Code). It has been classified as an organization that is not a private foundation under Section 509(a)(2) of the Code and qualifies for the charitable contribution deduction under Section 170(b)(1)(A). Accordingly, there is no provision for income taxes within the financial statements. Tax exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Organization has evaluated the positions taken on its filed tax returns. The Organization has concluded no uncertain income tax positions exist at June 30, 2018. The Organization's tax years from 2015 through 2017 are open and subject to examination. Form 990, Part III, Line 4a: Part of the focus of NNE -PTN during FY17 opioid overdose response via the implementation of a Community Opioid Overdose Response (COOR) ECHO initiative, with the goal of decreasing drug overdose deaths by promoting collaboration across sectors, sharing learning, and the development of key strategies designed to reduce opioid overdose deaths in target states and communities. We are collaborating with over 100 faculty and community leaders reaching 500,000 Maine people in 12 communities on this initiative. Key achievements include: -Worked with 2,035 primary and specialty providers reaching 390,154 patients, across Northern New England; -Facilitated cost savings to payers of $107,982,223 since the start of the initiative; -Launched the NNE-PTN Community Opioid Overdose Response (COOR) ECHO - which provides 12 Maine communities with the opportunity to focus on the goal of decreasing drug overdose deaths by promoting collaboration across sectors, sharing learning and implement key strategies that have been proved to reduce opioid overdose deaths in other states and communities. -2 high performing practices enrolled in NNE-PTN were recognized at TCPI's National Expert Panel Event in August 2018 for their work in their practices that have contributed to the 7 AIMS of the Transforming Clinical Practice Initiative. -Graduated 46 practices to Alternative Payment Models since the start of the initiative. CONSUMER ENGAGEMENT/CHOOSING WISELY During MQC's final year of a three-year grant, we continued to work with a variety of partners to build a culture of consumer engagement and informed health care decision making, specifically in two target communities. Collaborating with key stakeholders in both regions, the initiative guided implementation of a range of innovative, person-centered, and community-based interventions. People were engaged at their points of health care (32 practice sites participated), where they live and work, and at a variety of other key locations. The goal was to reduce unnecessary care in three areas that were identified as high priority, and to cultivate a greater overall awareness of the potential impact of "Choosing Wisely". -The initiative directly reached over 100,650 health care providers and consumers in the last year with messages focused on three key topics-appropriate use of: 1) antibiotics for acute bronchitis, 2) benzodiazepines in older adults, and 3) imaging for low back pain. -One of the Health systems received a mini-grant to hardwire Choosing Wisely prompts into their EHR to assist providers with evidence-based prescribing of antibiotics to further reduce unnecessary antibiotic prescribing. A separately funded project centered on the need for cost of care conversations during clinical visits. With the help of two health care systems (involving six primary care practices), MQC assessed the impact of "cost discussions" with patients, using the five key questions that serve as the cornerstone of Choosing Wisely. Those questions focus on: publicly reported information that can be integrated into clinical workflows; the effect of these provider-patient conversations on provider confidence; and provider/patient awareness around the use of comparative cost information when making diagnostic/treatment choices. The project identified barriers to integrating cost conversations in the practice workflow. Practice teams found it difficult to initiate cost conversations prior to the provider talking with the patient. It was determined that providers who engaged in cost discussions were more comfortable delaying interventions (when appropriate), discussing the use of lower cost alternatives, and suggesting assistance from financial counselors. PROJECT ECHO (MQC Replication Hub and NNE Network) Maine Quality Counts became a formal Project ECHO Replication Hub after entering into a partnership with the ECHO Institute in July 2017. This initiative, led by MQC and funded through HRSA's Rural Health Network Development Program, Project ECHO of Northern New England Network (NNE Network) was established to bring several, key organizational partners together under a regional ECHO Hub. The purposes of the network include: (1) offering ECHO sessions for a range of complex conditions to rural primary care practice teams across Maine, New Hampshire and Vermont, and (2) providing technical assistance and support to other organizations across the region that would like to offer their own ECHO sessions, with an eye on building capacity among rural providers. The primary goal of the NNE Network is to improve the quality of care of complex conditions for practices and patients in HRSA-designated rural areas within the tri-state region, by offering specialty support to primary care clinicians and practice teams via the ECHO model. Key achievements include: -HRSA Rural Health Network Development grant proposal awarded: $900,000 on 7/2017 -QC signed Partnership Agreement w/the ECHO Institute 7/2017 -Several staff attended ECHO Immersion Training throughout the year -Secured visit by Dr. Sanjeev Arora (ECHO founder); Dr Arora provide keynote presentation at QC2018 (annual conference) -Project ECHO: Capacity Building for Compassionate Tapering launched: 9 faculty, average 30 participants; 9 sessions (10/2017- 5/2018) -Formation of Project ECHO: NNE Network - charter signed 10/2017 -HRSA Strategic Plan submitted 12/2017 -Project ECHO: Continuity of Care for Substance Use and Exposure During the Perinatal Period launched 1/201811 faculty; average 15 participants; 9 sessions (1/2018 to 9/2018) -NNE Network Evaluation Plan Submitted 3/2017 -Non-competing Continuation Progress Report submitted 4/2/2017 -QC2018 Annual Conference and Barnstorming Events23 informational sessions held from 4/2/17 to 4/5/17, covering ME, NH, VT, reaching a total of 317 individuals -QC Annual Conference, held on April 4, 2018, also provided ECHO education to 320 individuals -2018 Harvard Pilgrim Health Care Quality Grant proposal awarded - $99,000 5/2018 -USDA Distance Learning and Telemedicine proposal submitted 6/2018 (awarded $87,000 in 10/2018) CARING FOR ME Caring for ME supports Maine clinicians to improve their management of chronic pain and safety of opioid prescribing, in addition to improving the identification of addiction, and referrals to substance abuse treatment services. To do this, stakeholders were convened throughout the year to create a shared vision, promote collective leadership, and provide a range of supports, educational tools, and quality improvement methods focused on Maine clinicians and practice teams. These efforts align with the US Surgeon General's "Turn the Tide Rx" campaign. The goals of Caring for ME are: support prevention efforts; maintain a compassionate and trauma-informed approach to chronic pain management; reduce stigma around substance use disorder and its treatment; improve the safety of opioid prescribing; appropriately diagnose addiction when it exists; and improve access to effective treatments for patients with substance use disorder. The Caring for ME work is supported by several different funding sources. What follows is a summary of the achievements realized during the past year, through those partnerships: -Working with the Board of Licensure in Medicine, MQC launched six online modules on safe opioid prescribing and the opioid crisis, along with two additional modules. We awarded over 1500 CME certificates for more than 2300 CME credits. MQC also hosted and facilitated four webinars on opioid prescribing. -In partnership with the Physicians Foundation: Caring for ME Clinician Leadership Program, we helped support clinical leaders in addressing the opioid crisis in Maine. Maine Quality Counts is offering a unique opportunity for Maine clinicians (Physicians, NPs, and PAs) to improve their ability to respond to public health crises, with a focus on leading change to address the opioid epidemic. With the support of this grant, we are working with the Maine Medical Association and more than thirty medical providers across the state to develop leadership skills to impact a range of public health issue (specifically to develop stronger skills around leading the practice and policy changes that are needed to address the opioid epidemic, using both in person sessions and Project ECHO. MQC coordinated the Project ECHO aspects of the project, hosting and facilitating three group sessions per month. We also planned and hosted two learning sessions, including a day-long track at the QC Annual Conference on April 4. -Working with the Maine Attorney General's Office, the Caring for ME Leadership Group facilitated a monthly leadership session with 30-50 participants, to help align opioid efforts in the state. -continued below- Form 990, Part III, Line 4a: -In partnership with Maine Health Access Foundation, MQC provided project management, quality improvement support, and technical assistance to ten grantee sites that are working to increase access to Medication Assisted Treatment. We planned for and hosted two learning sessions, along with monthly group technical assistance calls that involved both internal and external attendees. Those sessions included grantee update presentations, and didactical training on various technical assistance topics. -Finally, MQC hosted and facilitated three webinars on safe opioid prescribing with support from the Maine Independent Clinical Information Service (MICIS). CHRONIC DISEASE IMPROVEMENT COLLABORATIVE (CDIC) CDIC is a quality improvement-centered learning collaborative focused on supporting primary care practices through direct QI support and shared learning activities with other practices/content experts. The focus is on adopting changes and interventions that improve population health outcomes for patients living with hypertension (HTN) and diabetes mellitus (DM). MQC sought to provide practices with quality improvement support, along with access to best practices around primary care transformation (including tools, resources, and examples from around the region/country), and to promote collaborative learning across all practices. Between August 2017 and June 2018, Maine Quality Counts (QC) provided quality improvement (QI) support to thirteen primary care practices: -Central Maine Health Care -Spruce Mountain - Livermore Falls (Practice closed in April 2018) -Family Residency Program - Lewiston -Health Reach Community Health Centers -Belgrade Regional Health Center -Bethel Family Health Center -Bingham Area Health Center -Lovejoy (Albion) Health Center -Madison Area Health Center -Mt. Abram Regional Health Center -Rangeley Family Medicine -Richmond Area Health Center -Sheepscot Valley (Coopers Mills) Health Center -Strong Area Health Center -Western Maine- Livermore Falls Family Health Center To guide the CDIC Learning Collaborative, QC utilized the Breakthrough Series - a model developed by the Institute for Healthcare Improvement to achieve breakthrough improvements in quality. The series served as a foundation for helping practices learn from one another and from experts in topic areas, specifically in areas where they want to make improvements. Practices were empowered to develop and implement interventions that are focused on improving blood pressure and diabetes control, implementing a tiered team-based approach to chronic disease management while enhancing patient care and the patient experience. CDIC 4 learning activities included: motivational interviewing training, four webinars, one learning session (w/report-outs), and four practice-based self-studies. COLLABORATIVE ADHD LEARNING IN MAINE (CALM) MQC ran a year-long learning collaborative with seven sites to improve ADHD care in Maine (as part of a national project) with five sites being managed by the American Academy of Pediatrics. The project included data collecting, quality improvement coaching, and the execution of two learning sessions and six virtual sessions. FROM THE FIRST TOOTH (FTFT) MQC provided quality improvement coaching for participating practices, along with two webinars focused on improving oral health for children, under a contract with the FTFT Association. PERINATAL QUALITY COLLABORATIVE (PQC4ME) Maine is one of only five states without a perinatal quality collaborative. MQC was asked to host a Perinatal Quality Collaborative as part of our previous and current child health work, which helped identify us as a statewide leader in this space. We established planning and steering committees that are comprised of approximately 25 individuals, then developed a timeline and structure for the planning year. MQC received funding for this effort from the Maine Health Access Foundation and the Bingham Foundation, both in the form of grants. Form 990, Part VI, Section A, line 6 Voting membership is open to any individual or organization within the State of Maine that supports the mission and purpose of Maine Quality Counts. Membership is granted after receipt of a completed membership application, payment in full of annual dues, and upon a majority vote of the Board. Form 990, Part VI, Section A, line 7a At the annual meeting, the Members shall elect new directors to the board, receive reports on the activities of the corporation, and provide input on the direction of the corporation for the coming year. Form 990, Part VI, Section A, line 7b Members vote on the following actions in addition to electing the Board of Directors: a. amendment of articles of incorporation; b. transfer of a material part of the assets of the corporation other than in the normal course of business; c. borrowing by the corporation in excess of $100,000; d. merger or consolidation of the entity with or into another entity, or conversion of the corporation into another form of entity; or e. dissolution of the corporation Form 990, Part VI, Section B, line 11b The Finance Committee of Maine Quality Counts reviews the Form 990 in detail and makes a recommendation to the Board of Directors for approval. The Board then reviews the Form 990 for accuracy. The Form 990 is filed with the IRS after Board review and approval. Form 990, Part VI, Section B, line 12c All officers and directors are required to disclose any actual or possible conflicts of interest. Each director, principal officer, and member of a committee with governing board delegated power annually signs a statement affirming s/he has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands Maine Quality Counts is a charitable organization that must engage primarily in activities which accomplish one or more of its tax-exempt purposes in order to maintain its federal tax exemption. To ensure Maine Quality Counts operates in a manner consistent with charitable purposes and does not engage in activities that could jeopardize its tax-exempt status, periodic reviews of compensation arrangements, partnerships, joint ventures, and arrangements of management organizations are conducted to ensure all transactions are reasonable and there is no impermissible private benefit. Form 990, Part VI, Section B, line 15 The Executive Director's compensation is derived by reviewing compensation of other individuals with similar positions within associations and nonprofit organizations of a similar size, scope, and purpose. In addition, compensation is compared against state averages of individuals with similar educational background and length of experience. The compensation of other organization officers is based on the market value for individuals with similar roles within like organizations. Form 990, Part VI, Section C, line 19 Maine Quality Counts makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part IX, line 11g Consultants and Contractors: Program service expenses 3,455,547. Management and general expenses 106,873. Fundraising expenses 0. Total expenses 3,562,420. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year.