Building Healthier Communities Together In Snohomish, Skagit, Island, San Juan & Whatcom Counties

Building Healthier Communities Together In Snohomish, Skagit, Island, San Juan & Whatcom Counties

Health Transformation and the North Sound Accountable Community of Health Stephen Gockley, JD North Sound ACH Governing Body Member Northwest Health Law Advocates CLE November 18, 2016

Washington s ACHs North Sound ACH

Our Vision A coalition with the triple aim of transforming the health system: to improve the health of our communities and our people to improve the experience of care and access to care and to lower per capita health care costs in Snohomish, Skagit, San Juan, Island and Whatcom counties

Process All five counties in the region 17 sectors participate All 8 federally recognized Tribes in our region have been invited to participate MCOs caucus around 1 vote

Governing Body, 1 of 2 Name Title Sector Geographic area Brian Burch Provider Services Manager, Group Health Cooperative Commercial Health Plans Regional Kevin Collins, CDP, CCDCII Health Service Director, Stillaguamish Tribe Stillaguamish Tribe Snohomish Federico Cruz-Uribe, MD VP of Clinical Affairs, SeaMar Primary Care Regional Specialty Care, also Connie Davis, MD Chief Medical Officer, Skagit Valley Hospital Hospitals Skagit Regina Delahunt, MS Director, Whatcom County Health Dept. Public Health Whatcom Robin Fenn, PhD, LSW Research Dir., Snohomish Human Serv. SS&S, also Behavioral Health Snohomish Scott Forslund, MBA Snohomish Health Lead Coal. Dir, Providence Hospitals Snohomish Linda Gipson, PhD, RN Chief Nursing Officer, Whidbey General Hospitals Island Stephen Gockley, JD Retired, Northwest Justice Project Consumers Whatcom Gary Goldbaum, MD, MPH Vice Chair Health Officer, Snohomish Health Dist. Public Health Snohomish Erin Hafer Community Health Plan of WA MCO Health Plans* Regional Jennifer Johnson Health Director, Skagit County Public Health Skagit Tim Key Everett Division Chief, EMS First Responders Snohomish Advisory Board Vice-Chair, North Sound Consumers, also David Kincheloe, PhD Behavioral Health Organization Behavioral Health Regional

Governing Body, 2 of 2 Name Title Sector Geographic area Human Services Manager, San Juan County Barbara LaBrash Government SS&S San Juan Linda McCarthy Dan Murphy Chris Phillips Glenn Puckett, MPA Executive Director, Mt. Baker Planned Parenthood Executive Director, Northwest Regional Council Director for Community Affairs & Strategic Communications, Peace Health Senior Program Officer, Washington Dental Service Foundation Specialty Care Long Term Care Hospitals Specialty Care, also Philanthropy Whatcom, Skagit & San Juan Whatcom, Skagit, SJ & Island Whatcom, Skagit, San Juan Regional Cheryl Sanders Vice Chair, Lummi Nation Lummi Nation Whatcom Marilyn Scott Vice Chair, Upper Skagit Tribe Upper Skagit Tribe Skagit Dean of Health Sciences & Public Safety, Jason Smith, MA Everett Community College Education Snohomish John Stephens Programs Administrator, Swinomish Tribe Swinomish Tribe Skagit Joe Valentine, MSW Chair Executive Director, North Sound Behavioral Health Organization Behavioral Health Regional Kim Williams, RN Chief Operating Officer, Providence Hospitals Snohomish Greg Winter Executive Dir. Opportunity Council SS&S, also Housing Whatcom

Structural Evolution Hired Liz Baxter as Executive Director Planning around board composition underway Operational oversight discussion in progress Consumer Engagement Workgroup created

Consumer Engagement Co-chaired by Governing Body members representing Consumer sector Consumer Engagement plan in development

Regional Priorities Based on analysis of CHA and CHNAs, other health assessments, Inventory of Health Initiatives, Qualitative Interviews and Community Forums: Behavioral Health Care Coordination for High Utilizers Health Disparities (primary consideration for the other 5) Housing Oral Health Prevention

Early Win Selection July 2015 RHNI priorities and GB project brainstorm Sept 2015 Criteria approved Oct 2015 Interim Ops Work Group: scored applications, selected 2 candidates Nov 2015 Proposal finalist presentations Dec 2015 Presentations round 2 and report to HCA* July 2016 Progress reports and Early win finalization: Prevention via LARC

Early Win: Prevention

Why LARC? Women and families are healthier when women choose if and when to parent. Pregnancies resulting in births from women 24 and under are more likely to be unintended : 78% for under 20, 70% for 20-24 Only a quarter of pediatricians and internal medicine physicians offer LARC insertion. LARC methods have a failure rate of 0.27% as compared to a 4.55% failure rate among pill, patch and ring users. 72% of women selected a LARC method when cost, access, and knowledge barriers were removed

Prevention via LARC 1) Provider training on how to: utilize client centered contraceptive counseling best practices incorporate reproductive life planning clarify pregnancy intentions, and inserting/implanting LARC when patients choose. 2) Outreach to women to: increase awareness of their contraceptive options o including risk/benefit information regarding LARCs

LARC Project Goals Decreased unintended pregnancy rates (State Common Measure #2) Increased provider and consumer awareness of LARC as most effective contraceptive options Increased provider capacity to provide LARC to female patients at patient discretion Increased use of LARC Decreased Medicaid spending per enrollee (#51)

LARC Project To Date the best family planning training [we] have attended ~nurse from SeaMar Inaugural training on September 15 for 34 providers from Snohomish, Skagit, Whatcom & Island Thanks to UCSF for partnering in training, MBPP for support, NSBHO for donation of space, LHJs for outreach, work group participation from all 5 MCOs, Skagit Regional Health & SeaMar CCHE & AIM on progress toward data, and donations from GHC and individuals!

Looking Ahead 10/3: CMS announces Medicaid Transformation Waiver of up to $1.5billion Anticipate 60-120 day negotiation of terms ACH initiative to focus on value based payment via: Health system capacity building Care delivery redesign Prevention Additional initiatives: LONG TERM CARE SUPPORTIVE HOUSING & EMPLOYMENT

Thank You! Questions about the North Sound ACH? Contact: Lee Che P. Leong NorthSoundACH.org LPLeong@hinet.org 360.788.6570