Partner Spotlight: Community Voices Council

The Community Voices Council is off and running!  

This council's charge is to tap directly into the needs of the very citizens the Transformation is meant to serve. With that in mind, it was decided that the top priority for recruitment is to ensure that we have representation from each of the populations identified within the four project areas selected for our region. This will include folks experienced with co-occurring disorders (both a behavioral health issue and a chronic disease), pregnant Medicaid moms, people transitioning from jail, those with diabetes or prediabetes, children with asthma, youth exiting foster care, and those impacted by the opioid crisis. 

Once established, this group will be responsible for developing health equity metrics for the Collaboratives as they prepare their Transformation plans and also for ensuring that the plans meet the needs of the patients which they aim to serve. The entire council will be comprised of at least 50% Medicaid Beneficiaries, with the other half made up of Community advocates with first-hand experience helping complex patients access and navigate community services. We are still in recruitment mode, and BHT is currently drafting a job description and application for those interested in joining the council. We are also reviewing member submissions received through our online survey. We are very excited about the potential for this growing space to amplify community voices!

During our last meeting we welcomed guest speaker, Gretchen Hansen, from the Foundation for Healthy Generations. Gretchen has experience leading a similar council in the Pierce County ACH, and led an informative and lively discussion about the best methods for creating an authentic community voice. We appreciated hearing her advice on how to make sure that our council represents the diverse range of experiences of the people in our region. View the meeting notes here.

BHT's Navigator, Israel Vidales, Goes to D.C. for 2018 Families USA Conference

The Navigator Network team gave their newest team member, Israel Vidales, the opportunity to attend the 2018 Families USA conference in Washington D.C. last month. Israel learned about the various ideas that states are planning with their Medicaid waivers. These ideas included Medicaid buy-in options and payment reform. He also attended a panel discussion on lowering prescription costs and how states were strategizing to implement bills pertaining to price gouging and drug pricing transparency. Israel had the pleasure of hearing inspiring speeches from Senators Cory Brooker, which can be found here, and Elizabeth Warren, which can be found here. Besides the exciting topics and speakers from the conference, Israel managed to visit all the national monuments around the D.C area. Out of all the monuments, he enjoyed the Lincoln and Jefferson Memorials. Our Navigator team are making east coast connections and enjoying the sites in their spare time.

BHT ACH Project Plan Approved with a Score of 100%

In November, BHT submitted our Regional Project Portfolio. We are excited to announce that the HCA has made a final determination for the approval of BHT's project plan! Not only was it approved, but BHT also scored 100% on it - a perfect score! Having earned the maximum amount of dollars available to us this year, BHT is now poised to launch transformation efforts and begin pushing dollars out to partners to begin planning for transformation in their settings. Read the project plan here.

Managed Care Contracting Training with Adam Falcone

As part of our FIMC investment in Behavioral Health providers in the region, BHT hosted a presentation and training session on Managed Care Contracting, presented by Adam Falcone. With a turnout with 23 agencies and 60 individuals participating, it was clear this was a topic of importance for our region! His presentation included preparing for Managed Care contracting, evaluating contracts, negotiation, and key terms and legal protections. Check out the agenda of the presentation here to take a look at the full span of everything that was covered. 

ACH Communications Council Recap

Last Wednesday, BHT sat in on a call with the eight other ACHs and the HCA for our monthly Communications Council call, an opportunity for all parties to align on communication projects and language for Healthier Washington.

One discussion point during the call was around the use of the word “Demonstration” in our project work. This word was determined to be insensitive because of its association with experimental medical and surgical practices in the antebellum South. Going forward, it has been decided that ACH work will be referred to as the Medicaid Transformation. For more information, see the full guidance here.

A second point of discussion was the HCA’s VBP webinar series, which launched in January and will continue through March. This series is a great opportunity to get familiar with all things VBP, so we encourage everyone to participate if they are able to or listen to the recordings of the webinars when they find time. Find out more about the series here

Community Voices Council Meets for the First Time

The Community Voices Council met officially for the first time this week in its very early stages. Co-chairs Phil Tyler and Marion Lee led a lively discussion on factors to consider as we work together building the rest of the council in a way that best represents the diverse needs and interests of the Medicaid community in the BHT region.

The nomination survey is still open—we would love to hear who you consider to be a strong community advocate with either lived experience as a Medicaid beneficiary or experience navigating the Medicaid system on behalf of others and who is willing to make their voice heard.

Delay of Collaborative Launch

Throughout the ACH development process the BHT team has committed to keeping our partners informed on the many moving parts of this work. This often means we release information ONLY to find it to be “clarified” by new information or additional guidance provided via the Health Care Authority. As we noted on Friday, there are ongoing uncertainties surrounding ACH Funds Flow, specifically related to negotiations with the BHO and HCA, on behalf of our region, for our Integrated Managed Care efforts and the timing of earned Project funds for Year 1.
Both of these outstanding issues caused us pause. We know we have a lot of work to do to be ready for transformational efforts. We are also very clear that this is a heavy lift for our Providers and Partners, and we want to maximize the amount of time we give you to plan and make sure we aren’t getting ahead of ourselves. To this end, we are delaying both the release and request for signed Commitment Forms/MOUs from Providers and Partners until the week of February 19th. We are encouraged by several conversations that have occurred in the last couple of days that the outstanding issues will be resolved and we will have more clarity on the release of earned funds to our region.
Throughout our 101 sessions, we noted that Collaborative membership was due on February 22nd. It’s our intent to extend this deadline until late March providing ample time for Collaboratives to develop and partners to be clear on commitments.
As always, please continue to reach out to BHT staff if you have any questions. We look forward to sharing updates as soon as we can.

-Alison Carl White, BHT Executive Director

Funds Flow Allocation for Year 1 Update

At our January 24th BHT Board meeting, the Board approved the first round of Funds Flow allocation for Year 1 Project Funds. Our intent is to push out as many dollars as we can now to support our partners in planning and preparation for transformation in their settings, while holding back a portion of funds to target investments based on our partner gap assessments.

The first set of Funds Allocations includes two streams of ACH Funding: Year 1 Project Funds: Collaborative, and the first payout of the FIMC Incentive dollars.

Year 1 Project Funding will be distributed to partners within our Community Health Transformation Collaboratives in three ways: 

  1. Base Funding will consist of payouts for meeting specific milestones on ACH work, such as submitting a letter of commitment, completing an assessment, and completing implementation plans.
  2. High Volume Funding acknowledges the needs of larger Primary Care and Behavioral Health providers to coordinate across multiple locations and more staff involved in delivery system efforts. This will be a payment to partnering providers based on the number of Medicaid patients they serve.
  3. Equity Accelerator Funding will provide extra dollars for partnering providers whose Medicaid patient pool is over 10% racially or ethnically diverse.

Please note that partners not in Primary Care or Behavioral Health settings (aka partners who do not bill Medicaid directly) will only have access to base funding pool.

FIMC Incentive Funding became available to the region when we voted to become a mid-adopter of Integrated Managed Care. The year one payment total will be $3,120,000. BHT is prioritizing our first round of funding to Contracted BHO Providers delivering mental health and substance use disorder services and Tribal Behavioral Health providers, to support a core set of transitional efforts required for financial managed care integration.

  • Contracted BHO providers will receive a base pay of $50,000 and a technical assistance payment of $20,000
  • Tribal Behavioral Health Providers will receive a base payment of $25,000 and a technical assistance payment of $20,000
  • Each rural county Collaborative will also receive a $50,000 rural accelerator payout, recognizing the unique challenges of providing care in rural settings.

This is our first run of funds flow allocation. Once we have completed assessments with our partners and are more informed around Domain 1 areas where investment may be needed, the Waiver Finance workgroup will begin building recommendations for the next round of funds flow. See the materials below for more information. 

FIMC Executive Summary

Year 1 Project Fund Executive Summary


1/22 Provider Champions Council Recap

The Provider Champions Council met last Monday evening. Robbi Kay Norman from Uncommon Solutions began the meeting with a brief presentation on the role of the ACH moving forward. Where BHT has previously had a heavy hand in helping to build partnerships and build a framework for regional health improvement, it will now serve as a high-level governance structure to provide support, facilitation, data collection and analysis. Alison Carl White, BHT Executive Director, walked the council through some of the reasoning behind the funding allocations that have been decided up to this point in the funds flow model.

Brian Sandoval of Yakima Valley Farm Workers Clinic then gave an overview of the differences and similarities between the Bree Collaborative and Collaborative Care models for bi-directional integration of Primary Care and Behavioral Health, and led a discussion on which concepts of each model might promote best practices for providers in our region. While both models are evidence-based approaches for integrating behavioral health into the primary care setting, each model brings different strengths into the care system. The Collaborative Care Model is a team-based model that adds a behavioral health care manager and psychiatric consultant to support the primary care provider and can be practice-based or telehealth-based, an important concept for our region. The Bree Collaborative’s Behavioral Health Integration Report and Recommendations focuses on routine, same day access to a shared care plan at the point of care and places a heavy emphasis on psychiatric services, including for those patients who are not improving or require a higher level of care. Both models rely on screening and tracking to monitor patient progress.

The discussion around best practices for integration of behavioral health and primary care will be ongoing in this council, and Monday’s discussion was an important introduction of what will be a significant topic for future work of the Collaboratives.