5 Things Washington: Hawaii Lt. Gov. Josh Green, BH workforce, Jiquanda Nelson

We are about ten weeks away from our 2020 Washington State of Reform Health Policy Conference. This next year’s event will be our 10th, a big anniversary for an event we weren’t sure would have a second iteration, much less a 10th.

Ten years ago, I asked folks like Aaron Katz, Jack McRae, and Jenn Muhm whether there should be a “safe table” around which we should all gather. I talked to folks like Rebecca Kavoussi, Richard Onizuka, and Tom Fritz about whether there was a need to get together in the days following the ACA’s passage.

They said yes, and to this day, all of us at State of Reform believe we get to play this unique role in Washington State because you all say yes, there’s still a reason to get together. So, thank you for giving us this space. We appreciate it.

Happy Thanksgiving!



With help from Emily Boerger
and Michael Goldberg


1. Keynote:  Hawaii Lt. Gov. Josh Green, MD

One of the joys of hosting State of Reform now in nine states is that I get to meet a lot of really good actors in health care. Sometimes, I get to bring one to you to sort of cross-pollinate ideas from one state to another.

In a few weeks, we’ll release the Detailed Agenda for the 2020 Washington State of Reform Health Policy Conference, providing a list of over 100 speakers we’ll have lined up for you on January 9th. But, I am particularly excited to announce that Hawaii Lt. Gov. Josh Green, MD, will be one of our featured keynote speakers!

Green is a former ER physician and a national leader on the intersection of housing, homelessness, and health care. He argues that if homelessness is often a symptom of medical issues, particularly mental health, and if housing is generally a pre-requisite to addressing health concerns, then stable housing should be a covered prescription under Medicaid. Prior to being elected lieutenant governor, Josh Green served in the Hawaii House of Representatives and the State Senate where he chaired the Health Committee and Human Services Committee.

2.  The hidden uncertainty in Inslee’s re-elect race

The conventional wisdom is that Jay Inslee should sail to re-election. I think that’s accurate for a lot of reasons. But there is this nuanced problem with math when it comes to the 2020 gubernatorial re-election. I detail it here, but the logic goes like this: with 5 or 6 right of center candidates dividing up 45-48% of the primary vote, any other Democrat that files could make it through the primary to the general. That is particularly true if it’s a woman or person of color against a field of white men.

In Washington State’s “top two” primary system, two Democrats in the general election could fundamentally re-shape the election. A similar thing already happened in the 2016 race for state treasurer.

In 2020, depending on the candidate, there are probably a lot of voters out there looking to support someone with a vision for what he or she would like to do with four years, something Inslee has yet to deliver.


3. BH workforce draft recommendations

During the 2019 session, the legislature funded a workgroup to create recommendations for five “barrier areas” that limit the growth of the behavioral health workforce in Washington State. Last week the House Health Committee held a work session where they discussed draft recommendations for two of those barriers.

The workgroup presented its recommendations for addressing licensing reciprocity and the feasibility of an interstate licensing compact, as well as the barriers related to background checks on the workforce. Emily Boerger covered the meeting in detail here.

4. Video: Jiquanda Nelson, Kaiser Permanente

Jiquanda Nelson is the Sr. Manager of Equity, Inclusion, Diversity & Workforce at Kaiser Permanente. She joins us in this edition of “What They’re Watching” to discuss access to total health, workforce development, and Kaiser’s medical assistant apprenticeship program. Kaiser may have put more thought into how to train folks in a team-based approach than any other large health system, going so far as to launch their own medical school to do so.

“Our medical assistant apprenticeship program was a partnership with other employers – we have Swedish, MultiCare, UW Medicine, and then other union partners — we have OPEIU, UFCW, and SEIU 1199NW. We are the first multi-employer, multi-labor, health care apprenticeship consortium in the nation. And so, this model is around bringing all of these partners together, including education partners, to allow people to earn and learn at the same time.”


5.  An update on SEBB

The House Appropriations Committee convened a meeting during last week’s “Committee Days” with members of the Office of Program Research for updates on the school employees benefits board (SEBB). The SEBB is a new board which was created to oversee the direction of health benefits purchased by the HCA for school district and charter school employees.

SEBB funding sources support employer contributions and payments to providers. For the formula used to determine state school funding, the legislature sets a Health Benefits Rate in budget that applies to each SEBB-eligible school employee ($994 per employee).

Starting January 1, 2020, all school districts and charter schools must provide eligible employees with health care and other insurance benefits through the SEBB. Going forward, the intended milestones for the SEBB include completing dependent verification reviews, providing eligibility files to insurance carriers, processing open enrollment related appeals, and more.