Update on the Governor’s new State-Federal Partnership

The announcement last week from the Governor.

OLYMPIA –Gov. Jay Inslee and the Washington State Health Care Authority (HCA) announced today a new state-federal partnership that will bolster state efforts to improve the physical and mental health of Washington families and transform the state’s Apple Health (Medicaid) program to control costs.

After months of detailed negotiations, the HCA—in partnership with the Department of Social and Health Services (DSHS)—and the federal Centers for Medicare & Medicaid Services (CMS) reached an agreement in-principle, on a five-year Medicaid demonstration waiver to continue implementing the governor’s Healthier Washington plan.

To get more input on this, I talked to Dr. Elya Moore, who is the Executive Director of the Olympic Community of Health, which is the Accountable Community of Health (ACH) that will help implement this new project on the Olympic Peninsula, and in Kitsap County.  There are eight similar ACH’s in various districts around the State.

Dr. Moore described the new program as a very positive step towards focusing on prevention and proactive management for conditions like diabetes and mental illness, along with addressing opiate dependency. To help illustrate the scope of this federal grant, the figure is 1/2 of the NFL budget, so it’s a large number. The breakdown of need  for our three counties are illustrative: In 2015 24% of people in our three counties were on Medicaid (27% is the statewide average); 30% of the health care recipients have been  prescribed opiates. Opiate use also often can lead to opiate abuse. The problem is very large in our counties. This grant will be used to address those and other issues.

The program, as described by the Governor, will also fund supported employment and housing services and long term care services along with supports for unpaid family caregivers so they are able to keep caring for their loved ones. The hoped for result will be less use of high-cost services  and better health outcomes.

The ACH in our district is comprised of a 22-member Governing Board including  15 sectors and seven tribes. There is also an Executive Committee and Regional Health Assessment and Planning Committee to review health assessments and advise board on regional priorities.

Dr. Moore said she hopes that  the money will be spent on programs to do the following:

  • Address chronic disease management and prevention.
  • Help with access of dental, behavioral  health,chronic disease, aging in place, integration of care and early childhood health.

The money from the Federal government will flow through two different paths. Approx $65 million will go towards the Healthier Washington program, and then into programs that the ACHs help coordinate that are the focus of that program. An additional new $1.25 Billion will flow through State programs  and also into State ACHs, for the programs that will help in healthcare transformation. Another $375M will be used on programs for in place housing programs for care maintenance and services that delay or divert the need for intensive interventions such as support for people who need long-term services. . (That money will not flow through the ACH’s but a different state program).

Once the funding has arrived, which is supposed to be very soon, the ACH for the Olympic Peninsula will then kick off projects to use that money effectively and on priorities. Opioid prevention and response is a major priority project to kick off. It is to be determined how much money will be used on this project, as the project has not yet been scoped. Other projects that address the other issues will follow soon.

We will continue to track this program in the future.

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