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

On the morning of June 28, I along with millions of others, sat glued to the TV awaiting the outcome of a decision. No - this was not to find out the winner of the latest American Idol or Dancing with the Stars contest - but to find out how the Supreme Court ruled on the constitutionality of the Affordable Care Act. As a lifelong social worker, the Supreme Court decision provided a rare moment of professional euphoria - followed by the sobering realization of just how much work is yet to be done to make the vision of a better health care system a reality.

In our own corner of the world, we've been working with the counties, Managed Care Organizations [MCOs], and our providers to work through the details of how we will implement two of the state's major initiatives related to the Affordable Care Act: mandatory enrollment of "Healthy Options" and "Basic Health Plan" recipients into managed care health plans and the Health Path Washington initiative to better integrate services to persons who are receiving both Medicare and Medicaid. Implementation of managed care for Healthy Options recipients began July 1 and thousands of recipients have received notices providing them with information about their benefits and the choices they face regarding which managed care plan they want to be enrolled in. Staff at NSMHA have been involved in numerous meetings and discussions with the MCOs on how we will work together to coordinate care to persons who qualify for both behavioral health service benefits with a managed care plan but also require NSMHA services. We have already agreed to a set of general operating principles and are confident that over the next several months we will be able to establish detailed procedures and mechanisms for coordinating care between our two systems. One of the key areas of discussion has been how we work together to facilitate a successful discharge from psychiatric hospitalization to outpatient services.

However, in the midst of discussions about care coordination and data exchange protocols we cannot lose site of the persons we are serving. Any new strategies for improving care while reducing costs must be based on the recognition that "health outcomes" are achieved one person at a time and depend on a "person centric" approach. As a reminder to us that systems of care must be person centric, it's worth pointing out that July is "National Minority Mental Health Month". This provides us the opportunity to reflect on the fact that all of our treatment strategies need to continue to be culturally relevant and provided by culturally competent staff. Two examples of areas where we can improve are increasing the number of bilingual mental health specialists and working with the tribes on the evolution of a "Tribal Centric Mental Health System". NSMHA remains committed to working on both of these issues as well as encouraging and supporting ongoing cultural competency training for everyone in the NSMHA system.

Over the next two years, NSMHA will be initiating new procurement processes to re-select the providers for most of the major mental health programs and services that we fund. This will begin in the fall with the issuance of a "Request for Qualifications" [RFQ] for medication and outpatient services and to operate an Evaluation and Treatment facility. The RFQ will give us the opportunity to re-state the requirement that treatment providers demonstrate the capacity to provide services that are linguistically appropriate and culturally competent. However, NSMHA will also continue to work in partnership with its contractors to help achieve these goals.




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North Sound Mental Health Administration