North Sound Mental Health Administration

Improving the mental health and well being of individuals and families in our communities
A Regional Support Network for Island, San Juan, Skagit, Snohomish & Whatcom Counties.
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Joe's Corner

Joe Valentine, Executive Director

I would like to introduce myself. I am the new Executive Director of the North Sound Mental Health Administration. Unfortunately, that is all the time I have in this newsletter to talk about myself. Change is swirling about us, and we're working hard with all of our partners in the NSMHA system of care to make sure that those we serve are not left behind. The Affordable Care Act ["Health Care Reform"] has unleashed a torrent of different initiatives at the state and local level to better integrate all systems of care and move from a provider centric to a "person centric"method of service delivery. I'll briefly mention four areas of Health Care Reform in which we're active.

  1. Healthy Options
    Effective July 1, the state will be contracting with 5 Managed Care Organizations [MCOs] to provide "managed care" health services to persons receiving services from the state's "Healthy Options" Medicaid and "Basic Health Plan"programs. Effective August 1, these services will be expanded to other groups such as foster children and blind and disabled SSI recipients. In addition to primary health care, these managed care organizations will also have to arrange for and fund a defined level of mental health and chemical dependency services to their members. Since their members will still be eligible for RSN funded services if they meet Access to Care criteria, close coordination will be required between RSNs and these Managed Care Organizations to ensure that there is continuity of care between the services provided under the two systems. At NSMHA, we are in active discussions with the MCOs serving our area on how this coordination will take place. Effective care coordination strategies and data exchange will be critical components of maintaining a coordinated system of care.

  2. Health Path Washington
    The next step in integration of care will be launched under the state's "Health Path Washington". Under this proposed program, the state will again look to use managed care models to integrate health care, behavioral health, and long term care services to persons who are receiving both Medicare and Medicaid. Local county legislative authorities will play a key role in determining the degree to which such models are implemented in their counties. Under one of the proposed models, a "fully capitated care" model, some of the funds now included in NSMHA's pre- paid health plan will need to be transferred to the plans managing these capitated care systems. This will again require effective care coordination and data exchange, as well as adjustments in NSHMA's current organizational and system structure.

  3. Regional Health Alliance
    In order to ensure continued account- ability to local government and their citizenry as larger parts of the health care/behavioral health care system are managed by outside Managed Care Organizations, the NSMHA Board asked staff to work with county human services staff to develop a proposal for a "Regional Health Alliance". Regional Health Alliances are springing up in various parts of the country, including Southwest Washington and Oregon, to create a structure for joint planning, accountability, and opportunities for reinvestment of savings in local systems of care. We have worked with the county human service staff from our 5 counties to develop a proposal for a "Regional Health Alliance Task Force" that would help us take the first steps towards developing a structure for regional planning. One of the key tasks for this "regional health alliance" planning structure is to attempt to combine data from multiple sources. This data could be used to help us get a better picture of who is being served across the different systems, how well they are being served under the new managed care models, and where there are particular opportunities to contain costs and improve coordination of care to individuals who use a higher number of services. In order to be effective, this North Sound Regional Health Alliance will also have to include representatives from a number of other systems including: primary health care clinics and hospitals, behavioral health providers, Tribal providers, Public Health, Long Term Care Services, law enforcement, fire departments, etc.

  4. Tribal Centric Behavioral Health System
    As we experiment with strategies for integrated systems of care, it's important for us to remember that we have a unique partnership and commitment to working with the Tribes in our region. Care integration strategies need to be adapted to recognize the unique challenges that Tribal health and behavioral health care providers face, as well as recognize the sovereignty of tribal systems and the rich legacy of cultural healing strategies that can be incorporated into care integration strategies. The recently concluded 12th Annual North Sound Tribal Mental Health Conference [see article in this newsletter] highlighted some of these issues. Finally, on a more personal note, I would like to acknowledge the passion, commitment, and skill of my predecessor, Chuck Benjamin, in providing leadership to a mental health system that has established such high standards for quality of care. I hope to continue this legacy, as well as continue the close relationships with all of our system partners that Chuck so effectively nurtured.



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North Sound Mental Health Administration