Tag: Cohorts

2022-23 Behavioral Health Initiatives

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As 2021 was coming to a close, BHT still had approximately $1.5 million of IMC incentive funds to allocate. At the September BH Forum, partners discussed how they would like to see us use the IMC funds over the next two years. At the November Board meeting, the Board approved allocation for the remaining IMC funds toward behavioral health initiatives in 2022-23. Five categories of potential initiatives have been identified based on the September Behavioral Health forum (BH Forum) and prior discussions about behavioral health needs for our region. The specifics of initiatives and use of funds will be designed collaboratively with providers and impacted individuals.

Background

In 2018, the BHT region elected to become a “mid-adopter” of Integrated Managed Care (IMC), which brought payments for behavioral health care under Medicaid managed care contracts. Because we chose to adopt early, the HCA gave the region $8.2 million in incentive dollars.

In 2018, BHT convened our behavioral health providers to support the IMC transition and invested $3.1 million in IMC capacity building.  

We continue to gather partners as the BH Forum after IMC. The forum includes our behavioral health and integrated primary care partners, the Spokane BH-ASO, managed care organizations (MCOs), the state Health Care Authority (HCA), and other local organizations.

In 2020, the BH Forum focused on addressing challenges emerging from COVID, especially the transition to telehealth. Later in 2020 and into 2021, we supported investments in workforce issues identified by the forum partners. We invested $3.6 million in behavioral health pilot programs, including criminal justice, workforce support, telehealth, and broadband.

2022-2023 initiatives

At the September BH Forum, partners discussed how they would like to see us use the IMC funds over the next two years. Based on their initial recommendations, the BHT Board approved allocating the remaining $1.5 million in IMC funds toward behavioral health initiatives in 2022-23. The Board allocated $300,000 for BHT staff support during 2022-23 (category #4 below). The rest of the funds will be allocated by collective decision-making by the BH Forum members.

The September forum and prior discussions about behavioral health needs for our region informed the following 5 categories. The specifics of initiatives will be co-designed in 2022-23 with providers and impacted individuals guiding the interests and needs and collaborating in participatory budgeting.

Initiative Categories

  1. Workforce Retention & Expansion

  2. Training & Ed – Peers & CHWs

  3. Training & Ed – EBPs

  4. Staffing – Network Administrator & Program Manager

  5. Emerging Opportunities Funds

1. Workforce Retention & Expansion

The Need: The region faces a severe and increasing workforce shortage—this category supports behavioral health agencies in workforce retention and expansion.

Based on initial conversations, may include:

  • Loan forgiveness pilot
  • Scholarships to complete BH education, such as BIPOC/LGBTQ workforce scholarship
  • Continued BH Supervision support, especially for newly licensed BH agencies
  • Other projects or initiatives as designed by BH Forum partners

2. Training & Education – Peers & CHWs

The Need: Increased training opportunities to expand workforce through Certified Peer Counselor (CPC) training specific to our region and cross-training CPCs & Community Health Workers (CHWs).

CPC/CHW cross-training – to be designed, may include:

  • Networking sessions
  • Joint training sessions in supplemental skills (MI, ACES, WRAP, etc.)
  • Stipends for participants
  • Additional offerings of CPC and CHW training sessions in our region

3. Training & Education – EBPs

The Need: Support for ongoing clinician training and clinical integration following training to increase consistency in evidence-based practice (EBP) understanding and use across the region.

Organizations are currently paying individually for training & implementation, which is expensive – this would support regional-level training on evidence-based practices (EBPs) based on WAC requirements and EBPs prioritized by partners.

4. Staffing – Network Administrator/Program Manager

The Need: Increase administrative capacity for providers and help them build capacity internally to navigate state-level hurdles to workforce and funding, as well as supporting BH Forum administration.

  • Bureaucracy navigation support (agency licensure, DOH credentialing, NPI, MCO rostering, Identifying & supporting application for outside funding (loan forgiveness, education, training scholarship, etc.)
  • VBP contracting readiness & support (identifying training and/or providing support)
  • Retention and recruitment support (e.g., building agreements for the length of service)
  • Staffing and administrative support for the Behavioral Health Forum, including facilitation, communication, and administering release of funds, contracts, reporting, and evaluation

5. Emerging Opportunities Funds

The Need: Allows us to adapt to emerging opportunities & requests from partners, community, and state.

Examples of potential emerging work:

  • Adapting to changing the HCA approaches with Waiver extension and renewal, including BH/PC Integration Pilot in 2022
  • Facilitation & support for community initiatives, such as University of Washington youth integration EBPs
  • Emerging workforce initiatives, such as supporting Spokane Falls Community College (SFCC) BA program stand-up

Funds Flow for 2019, 2020, & 2021

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Related Posts:
Contract Payment Policy – updated March 2020
How Do I Get Paid?
Project Funds FAQ

Update 09/2021 – Pay-for-Performance Funds Flow model updated to reflect Sept 2021 Board decisions.

BHT took into consideration many factors when designing the funds flow model for Medicaid Transformation Project achievement. The BHT Board intends for the funding to support the region’s ability to hit Pay-for-Performance measures and support real transformation to the delivery of care. To do that, we wanted to maximize investments in primary care and behavioral health Partnering Providers, so the model acknowledges that volume matters if we want to ensure that population level impact occurs. We also wanted to demonstrate our commitment to equity, so there is emphasis on provider level activities to support equity. And as always, our goals were to get dollars into the hands of our providers and—while we are trying to develop a regional system—to honor provider choice/independence.

Below are the funds flow models approved by the BHT Board at their November 28, 2018 meeting.

Pay-for-Reporting Funds Flow Model

Based on a unanimous recommendation from the Waiver Finance Workgroup, the Board has approved the following Pay-for-Reporting funds flow model for behavioral health and primary care Partnering Providers for 2019, 2020, and 2021. The Board approved this Partnering Provider Volume Calculation POLICY which outlines how the numbers were calculated, the tiers, and the dispute resolution process. .

  1. Partnering Providers will be divided into 3 groups based on volume and allocated earning potential based on that volume.

    • 20,001+ Beneficiaries

    • 1,201-20,000 Beneficiaries

    • 1,200 or less Beneficiaries

  2. An optional Tribal Carve Out will be offered to Tribal Partners who wish to opt out of Pay-for-Reporting. The Tribal Carve Out requires identification of other Transformation efforts undertaken and continued participation in Tribal Partner Leaders Council and county-based Collaborative.

  3. Unearned funds will be placed in a pool, to be distributed at the recommendation of Waiver Finance Workgroup and approved by BHT Board. 

The funds will be earned by a combination of hitting milestones developed by the Partnering Provider in their Final Transformation Plan and meeting Pay-for-Achievement measures selected from a BHT-provided list.

40% – Transformation Plan milestones
40% – Pay-for-Achievement measures
20% – Equity Activities & Measures

How many dollars are there?
The following table shows the potential Pay-for-Reporting earnings, per partner.

Contract Payment Schedule

Partners will receive three payments during the contract period, with the third payment based on achievement:

  • Payment 1: Contract signing

  • Payment 2: Completion of mid-contract reporting on Milestones and P4A measures

  • Payment 3: Achievement of Milestones and P4A measures based on results of end-of-contract reporting.

The following payments proportions for Year 2 and Year 3 contracts was approved by the Board in March 2020. This mirrors how the funding levels from HCA are divided between reporting and achievement for these years. The Board previously approved the Year 1 division.

This payment schedule applies to the contract dollars for Transformation Plan milestones (40%) and Pay-for-Achievement measures (40%). The contract dollars for Equity Activities & Measures (20%) is reporting-based only.

This payment schedule applies to the contract dollars for Transformation Plan milestones (40%) and Pay-for-Achievement measures (40%). The contract dollars for Equity Activities & Measures (20%) is reporting-based only.

Pay-for-Performance Funds Flow Model

Pay-for-Performance funds are earned by the region meeting the measures created by the Health Care Authority (HCA). These dollars will be earned based on 25% of Pay-for-Performance Project funds in 2019, 50% of Pay-for-Performance Project funds in 2020, and 75% of Pay-for-Performance Project funds in 2021. Please note that 2019 Pay-for-Performance funds will be distributed by HCA in 2021; 2020 Pay-for-Performance funds in 2022; and 2021 Pay-for-Performance funds in 2023.

Based on a unanimous recommendation from the Waiver Finance Workgroup, the Board has approved the following model to allocate the 85% of the region’s Pay-for-Performance funds earned for distribution to behavioral health and primary care Partnering Providers. The dollars will be allocated by volume to large- and medium-sized providers as follows:

75% of earnings to Large: serves 20,001+ Medicaid patients
25% of earning to Medium: serves 1,201-20,000 Medicaid patients

How do partners earn dollars? – updated September 2021
Large and medium volume Partnering Providers will receive their portion of the 2019 and 2020 P4P measurement year dollars for completed respective Year 1 and Year 2 Transformation contracts .

Large and medium volume Partnering Providers will earn 2021 P4P dollars based on expectations in Year 3 contracts.

How many dollars are there?
The following table shows the potential Pay-for-Performance earnings for the BHT region.

Assume 85% of Pay-for-Performance (both Collaborative & Regional Infrastructure) Assumes 80% achievement of HCA Pay-for-Performance metrics

Notes on Volume

The Board approved this Partnering Provider Volume Calculation POLICY which outlines how the numbers were calculated, the tiers, and the dispute resolution process. 

How many Partners are in each volume group?

  • 4 providers in Large, comprising approx. 75% of the Medicaid volume in our region.

  • 17 partners in Medium, comprising approx. 20% of Medicaid volume in our region.

  • 18 partners Small, comprising approx. 5% of Medicaid volume in our region.

How is BHT calculating volume numbers?

  • BHT is utilizing third-party data from the Health Care Authority (HCA) to establish an unduplicated count of Medicaid beneficiaries for each Partnering Provider.

  • Only fully eligible Medicaid and SCHIP clients are included. Duals with Medicare and individuals with Third Party Liability (TPL) are excluded from the count.

  • Only Medicaid clients that reside in BHT’s six counties are counted. No continuous enrollment criteria were imposed.

  • Counts are based on paid fee-for-service (FFS) claims and accepted MCO encounters, including BHO (RSN) encounters.

We Gon’ Be Alright; A Space for Black Healing (September 2021)

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We Gon’ Be Alright; A Space for Black Healing

Wednesday, September 29th
5:30-7pm

This is a space for the Black community and all Black experiences to be seen, belong, and to be a source of inspiration, connection, and healing.

Alethea Dumas and Kiantha Duncan will facilitate a conversation addressing current priorities, and needs in the Black community of Spokane. We invite all Black educators, health care workers, and all Black experiences in Spokane.



Register Here

*To contact Alethea alethea@betterhealthtogether.org
*This is not a space for allies

we gon' be alright.jpg

Alethea Dumas is the program manager of Equity and Engagement for BHT. She grew up in Spokane, attended Lewis & Clark Highschool, and furthered her education at WSU where she received a degree in Women’s Studies, Critical Culture, Gender & Race Studies, along with minor degrees in Human Development, and Popular Culture.

Alethea is passionate about equity, and believes that equity is about always being open to learning how to love people better. On her spare time she enjoys singing, reading, thrifting and watching movies.

Kiantha Duncan is a highly sought-after speaker, facilitator and moderator supporting non-profit organizations, corporations and higher education institutions in the areas of leadership, program and project development, community affairs and personal/professional development. 

A seasoned leader with over 25 years of leadership experience, Kiantha has had dedicated her career to supporting marginalized and disproportionately impacted communities and is recognized nationally as a community builder and mobilizer.

As an influencer, newspaper columnist, author and radio personality Kiantha’s reputation as a master communicator precedes her. In 2019 Kiantha was a TEDx speaker in which she shared her experience of being “A Perfect 10.” Having experienced 10 out of 10 on the Adverse Childhood Experiences Assessment. Kiantha inspires and challenges audiences to repurpose negative experiences for good. Kiantha’s passion is to help others actualize their potential, purpose and connectedness through the art of conversations.

As a commitment to civic engagement, Kiantha currently serves as the President for the Spokane NAACP as well as serving on numerous Washington State Boards and committees including the Spokane Public School Board Diversity and Advisory Committee, Treehouse Program Advisory Committee, City of Spokane 5th Avenue Revitalization Planning Committee and many more.

Kiantha is well connected in both the Eastern and Western regions of Washington State through a history of leadership, advocacy, networking and community building. 

We Gon’ Be Alright; A Space for Black Healing (August 2021)

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We Gon’ Be Alright; A Space for Black Healing

Tuesday, August 24th.
5:30-7pm

This is a space for the Black community and all Black experiences to be seen, belong, and to be a source of inspiration, connection, and healing.

Alethea Dumas and Kiantha Duncan will facilitate a conversation addressing current priorities, and needs in the Black community of Spokane. We invite all Black educators, health care workers, and all Black experiences in Spokane.



Register Here

*To contact Alethea alethea@betterhealthtogether.org
*This is not a space for allies

August BHS.jpg

Alethea Dumas is the program manager of Equity and Engagement for BHT. She grew up in Spokane, attended Lewis & Clark Highschool, and furthered her education at WSU where she received a degree in Women’s Studies, Critical Culture, Gender & Race Studies, along with minor degrees in Human Development, and Popular Culture.

Alethea is passionate about equity, and believes that equity is about always being open to learning how to love people better. On her spare time she enjoys singing, reading, thrifting and watching movies.

Kiantha Duncan is a highly sought-after speaker, facilitator and moderator supporting non-profit organizations, corporations and higher education institutions in the areas of leadership, program and project development, community affairs and personal/professional development. 

A seasoned leader with over 25 years of leadership experience, Kiantha has had dedicated her career to supporting marginalized and disproportionately impacted communities and is recognized nationally as a community builder and mobilizer.

As an influencer, newspaper columnist, author and radio personality Kiantha’s reputation as a master communicator precedes her. In 2019 Kiantha was a TEDx speaker in which she shared her experience of being “A Perfect 10.” Having experienced 10 out of 10 on the Adverse Childhood Experiences Assessment. Kiantha inspires and challenges audiences to repurpose negative experiences for good. Kiantha’s passion is to help others actualize their potential, purpose and connectedness through the art of conversations.

As a commitment to civic engagement, Kiantha currently serves as the President for the Spokane NAACP as well as serving on numerous Washington State Boards and committees including the Spokane Public School Board Diversity and Advisory Committee, Treehouse Program Advisory Committee, City of Spokane 5th Avenue Revitalization Planning Committee and many more.

Kiantha is well connected in both the Eastern and Western regions of Washington State through a history of leadership, advocacy, networking and community building. 

Virtual Spaces on Racial Justice

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My Black Life Matters;
A Space for Black Healing

Friday, February 26th
5:30-7pm

This is a space for the Black community and all Black experiences to be seen, belong, and to be a source of inspiration, connection, and healing.

Alethea Dumas and Kiantha Duncan will facilitate a conversation addressing current priorities, and needs in the Black community of Spokane. We invite all Black educators, health care workers, and all Black experiences in Spokane.



Register Here

*To contact Alethea alethea@betterhealthtogether.org
*This is not a space for allies

black-lives-matter-illustrations-roundup-hero-1.jpg

Alethea Dumas is the program manager of Equity and Engagement for BHT. She grew up in Spokane, attended Lewis & Clark Highschool, and furthered her education at WSU where she received a degree in Women’s Studies, Critical Culture, Gender & Race Studies, along with minor degrees in Human Development, and Popular Culture.

Alethea is passionate about equity, and believes that equity is about always being open to learning how to love people better. On her spare time she enjoys singing, reading, thrifting and watching movies.

Kiantha Duncan is a highly sought-after speaker, facilitator and moderator supporting non-profit organizations, corporations and higher education institutions in the areas of leadership, program and project development, community affairs and personal/professional development. 

A seasoned leader with over 25 years of leadership experience, Kiantha has had dedicated her career to supporting marginalized and disproportionately impacted communities and is recognized nationally as a community builder and mobilizer.

As an influencer, newspaper columnist, author and radio personality Kiantha’s reputation as a master communicator precedes her. In 2019 Kiantha was a TEDx speaker in which she shared her experience of being “A Perfect 10.” Having experienced 10 out of 10 on the Adverse Childhood Experiences Assessment. Kiantha inspires and challenges audiences to repurpose negative experiences for good. Kiantha’s passion is to help others actualize their potential, purpose and connectedness through the art of conversations.

As a commitment to civic engagement, Kiantha currently serves as the President for the Spokane NAACP as well as serving on numerous Washington State Boards and committees including the Spokane Public School Board Diversity and Advisory Committee, Treehouse Program Advisory Committee, City of Spokane 5th Avenue Revitalization Planning Committee and many more.

Kiantha is well connected in both the Eastern and Western regions of Washington State through a history of leadership, advocacy, networking and community building.