DENT Story: A Pregnant Woman Receives Vital Dental Care

BHT-icons-DENTstories_Dent Stories.png

The initial visit to the ER doesn’t always mean the dental patient will accept the resources offered the first time. In the case of a 31-year-old woman with right and left lower teeth pain who was referred from the ER to the DENT Program, she received antibiotics and her abscess appeared to have cleared. However, pain and abscesses almost always return with a vengeance.

Unfortunately, the woman did not return DENT calls with offers of dental appointments the next day.  DENT staff continued to call and text and even mailed a letter, reminding her that she was Apple Health eligible and that the insurance would pay for her dental care. Still no response.

A little over a month later, she called in pain with a very swollen face. She was newly pregnant and very ill and needed emergency dental care. She was very concerned about the pain and swelling but even more worried about the possible effect on her unborn child. In crisis, she became motivated to call. Luckily, she kept the DENT phone number. 

Both the Unify and CHAS Clinics (FQHCs) offer immediate dental appointments to pregnant women because they are committed to assisting in any way to ensure healthy births. DENT staff was able to schedule the woman the following day with the Unify Clinic for emergency dental care.

The woman stated, “I am so thankful you did not give up on me after not calling back last month. I was in a bad situation and just couldn’t think about my teeth. I started to feel better and I thought the tooth problem was over. I was so wrong.”

Guest Blog: Bring Santa and they will come…for vaccines?

Contributed by: Jenny Smith, Marketing & Foundation Director, Newport Hospital & Health Services

 

Rural Pend Oreille County’s exceptional geography shares a border with our Idaho neighbors and community partners (think northeast Washington, jagged mountains and north-flowing river). Our demographics include high poverty and a relatively unhealthy population with increased cases of chronic disease and dismal immunization rates. With that said, in 2014 an incredible collaborative spirit birthed a passionate coalition of individuals pressed with the charge of making our broad community a healthier piece of Washington. Enter Pend Oreille Health Coalition. 

The Pend Oreille Health Coalition kicks off its first collaborative venture in a partnership with the Newport Hospital and Health Services Foundation’s annual Festival of Trees event on December 5. The free event draws families from all over with visions of Santa Claus photos, cookie decorating and the possibility of winning one of a dozen dramatically decorated prize trees (some worth well over $1,000) with a simple $1 raffle donation.

Creativity unleashed as we started thinking about a way to reach local children in need of immunizations and the light bulb beamed—a free immunization clinic during the Festival of Trees! Children who bare a sleeve for their MMR, HepB, Polio, Diphtheria, Pertussis or Varicella vaccines will receive 5 raffle tickets for their troubles and pokes.

We hit the proverbial partnership jackpot when Bethany Osgood of Amerigroup offered her expertise in setting up the clinic with Jan Steinbach (Registered Nurse with Northeast Washington Tri County Health District). Bethany committed Amerigroup for the day, handing out kid-friendly freebees as part of their sponsorship for the Festival of Trees and their participation in the Pend Oreille Health Coalition.

Fast forward … planning is moving at Mach speed: supplies have been ordered, standing orders are being signed, and Northeast Tri County Health District, Family Medicine Newport’s medical assistants, and Newport School District administration are on board. All children, ages 5 to 18 years, will receive requested vaccinations … not to mention, extra kudos and empathy from Santa when they show off their bandages. Check out the Festival of Trees event page

The Pend Oreille Health Coalition is comprised of individuals and elected officials representing: Newport Hospital and Health Services, Northeast Tri County Health District, Pend Oreille County, the Kalispel Tribe of Indians, Better Health Together, Amerigroup, Aging and Long Term Care of Eastern Washington (Conexus Health Resources), Pend Oreille County Counseling Services, Rural Resources Community Action, Newport School District, the Newport Miner, Washington State University Pend Oreille County Extension, and the office of U.S. Congresswoman Cathy McMorris Rodgers. 

 

A Community of Change

Hotspot-02.jpg

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

Jeff Thomas cropped.jpeg

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.