County Health Rankings show great improvements in Lincoln County

In the newly released 7th edition of the county by county ranking report by the Robert Wood Johnson Foundation, Lincoln county ranked among the top 10 counties in Washington State and achieved the highest rank in the BHT region for health outcomes. Rankings were determined by evaluating two specific measures: length of life and quality of life. Lincoln county has shown significant improvement over the last three years in the following areas:

·      Reduction of premature deaths from 8,000 in 2014 to 6,000 in 2016

·      Overall poor physical health days from 3.8 to 3.3 days

·      Improved ranking from 29th in 2014 to 8th in 2016

 The average length of life within the county is determined by the rate of premature death, considered death before the age of 75. Evaluation of mental health, physical health and birth outcomes determined quality of life rankings. This is great news for Lincoln County but there is always more work to do! BHT is committed to spearheading efforts that support continued growth and improvement throughout the region through our Accountable Community of Health, Prevention First work, scaling Community Based Care Coordination, and our Navigator Network. For more information on your county’s ranking and ideas on improving the health of your community follow the link to the County Health Rankings & Roadmaps website, and check out the wide range of suggestions and ideas.

A Community of Change

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I love Spokane. My family and I feel blessed to live in a place that is filled with beautiful landscape, amazing people and an independent spirit that makes things possible. There is a secret sauce in Eastern Washington that makes our Accountable Community of Health work. We are not waiting to be told what to do; we are making it happen.

You see this in the building of much needed Housing First housing by VOA, Catholic Charities, the City and County (plus some super generous donors and finance folks). You see it in the collaborative ways that our community partner organizations come together for our weekly client management meetings.

You see it in our rural communities as they figure out how to solve their most pressing issues, often without the resources of the big city. And you see it in community investment strategies that are not perpetuating the status quo (way to go, United Way, City of Spokane and Empire Health Foundation for pushing us to be more strategic, innovative and impactful).

Why is this happening here? Our success can be partly attributed to our frontier spirit that permeates our approach. It is also because we have not always had choices—we have needed to take action to achieve the change we want in our communities.

I am grateful to be here in Eastern Washington, leading this important work. Better Health Together is not limited to implementing specific parts of health care reform plan. Instead, I believe, it is a social movement—dare I say revolution?—to make our communities healthier, more equitable and better places to live, learn, work and play.

This movement is not just about saving money for our health care system; it is a movement that
balances and respects individual rights to health and wellbeing with our collective responsibility to each other. This is a movement that implores us to change how we work as a community health system, to be more impactful and to behave in different ways. I am grateful for the chance to be on the front lines of this revolution with you all.

 


 

Guest Blog: Better care through integrated Behavioral Health Organizations

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By Jeff Thomas, CEO of Frontier Behavioral Health

Published in Frontier Behavioral Health Magazine

Behavioral health conditions, including mental illness and substance use disorders, are widespread among Medicaid’s high-need, high-cost recipients, many of whom also have chronic physical conditions.  As a result, many states across the country are working on new strategies to improve the coordination of physical and behavioral health services for Medicaid populations and other populations within state priorities and available resources.

In 2013 the state of Washington received a $1 million State Innovations Model (SIM) planning grant from the Center for Medicare and Medicaid Innovation (CMMI).  This grant enabled the state over the next year, with significant stakeholder participation, to develop the State Health Care Innovation Plan (SHCIP) that outlined a bold vision for health system change in our state.

The SHCIP was used by the state as the basis for a Round 2 model test grant proposal submitted to CMMI titled “Healthier Washington,” which resulted in the state being awarded in 2014 a five year grant in the amount of $65 million.  This grant is helping to finance key initiatives that invest in Washington’s infrastructure to support system transformation over the next four years.

To help accomplish this, the legislation called for the joint creation of Regional Service Areas (RSA’s) by the Health Care Authority and Department of Social and Health Services for purposes of healthcare purchasing.  The RSA’s, the boundaries of which have shifted some since initially identified in 2014, are required to include contiguous counties, contain at least 60,000 Medicaid beneficiaries, possess and adequate number or healthcare providers, and reflect “natural healthcare service referral patterns.”

As a first step toward the integration of healthcare purchasing, SB 6312 stipulated that administration and purchase of public-funded mental health and substance use disorder (SUD) treatment services be combined under a single, financial risk-bearing Behavioral Health Organization (BHO) for each RSA.  The BHO’s, which will come into effect April 1, 2016, will replace the current system wherein mental health services are overseen by Regional Support Networks (RSN’s), and SUD services are overseen by individual countries.

Spokane County Regional Behavioral Health (SCRBH) will assume responsibility April 2016 for providing substance use disorder treatment, and the mental health services previously overseen by these Regional Support Networks (RSNs).  These services include inpatient and outpatient treatment, involuntary treatment and crisis services, jail proviso services, and services funded by the federal block grants for the Medicaid population.

SB 6312 stipulates that the only entities that can apply to become BHO’s are the current RSN’s.  In other words, it is not a competitive procurement process.  However, the RSN’s are required to submit – and have approved – a comprehensive Detailed Plan that demonstrates their ability to meet all of the state’s contractual requirements to operate as a BHO – which are significantly expanded from current requirements and include various outcome measures such as treatment retention, penetration of Medicaid eligible, timely access to care, hospital readmission, and quality improvement projects.  The SCRBH is currently creating a detailed plan for state approval in January.

The geographic boundaries of the Eastern Washington RSA have significant overlap with those of Spokane County Regional Support Network (SCRSN), with a couple of notable differences.  In addition to Spokane, counties that are currently a part of the SCRSN include Adams, Lincoln, Stevens, Pend Oreille, Ferry, Okanogan and Grant.  All but Grant County will be included within the initial boundaries of the Eastern Washington RSA, with Okanogan also potentially moving to a different RSA at some future point.

Inception of the BHO model will, for the first time on our state, beak down the silos that have separated funding and oversight of mental health and SUD treatment services.  Ultimately, the BHO model is targeted at a set of principles known as the Triple Aim which will direct states to strive to simultaneously improve the health of the population, enhance the experience and outcomes of the patient, and reduce per capita cost of care for the benefit of communities. 

The Triple Aim framework serves as the foundation for organizations and communities to successfully navigate the transition from a focus on healthcare to optimizing health for individuals and populations.  Among the benefits of this model will be a blending of this funding, which will afford BHO’s greater latitude than RSN’s or counties have historically had with regard to how funding is allocated and services funded.

Frontier Behavioral Health is looking forward to working closely with the SCRBH and others in our community to support successful implementation of the BHO model and help achieve the goals established through the Healthier Washington initiative.

Our Regional Map

A key to the success of Better Health Together is the vast web of partners across our region. The interactive map below, provides a visual snapshot of these partnerships throughout Ferry, Stevens, Pend Orielle, Lincoln, Spokane, Adams and Whitman counties. Can’t See the map?

  


 

Navigator Network

The In-person Assistance Network provides on the ground support to individuals enrolling in health insurance through Washington

Accountable Community of Health (ACH) Partners
Our action-oriented partners are working to achieve the Triple Aim of better health and better care at a lower cost. Learn more about our work.

Hot Spotters
Hot Spotters targets high need patients who present to emergency rooms and emergency responders with a complex blend of social, medical, mental health and/or substance abuse issues.

DENT
The DENT program connects patients to dental care and expands the network of dental providers accepting Apple Health. It was designed to reduce unnecessary Emergency Room utilization for dental emergencies and to coordinate a network of oral health care providers to improve access, health, and reduce costs for this population.

FAR
, a program of Children’s Administration, seeks to keep families united by providing alternative interventions for allegations of child neglect.

Medicaid Managed Plans Available by County
Medicaid Health plan choice varies from county to county. This map provides a high-level visual of the available Medicaid Health plans and how this compares to other counties in our region. Note that the Medicaid data on this map does not provide location information.