5 Things Washington: Special session, Inslee’s vetoes, Tim Lieb

It’s ok to feel sad right now. It’s ok to feel less productive than what you’d like. We’re all going through a trauma, as individuals and as a community. This is not a time for us to be at our best. It’s a time for us to hold on as best we can, and accept that our “best” today may be 50% of our best two months ago.

The best way to manage your stress right now is to talk about it. You may not want to, but if you don’t talk about it, it can eat you up on the inside. If you don’t have someone that you feel comfortable talking to, you can always write me a note. I may not have anything smart to say in response, but I will read it and I will see you.

 

 

 

 

With help from Emily Boerger

1. An “extinction-level event” in our economy

I think we are in an “extinction-level event” in our economy. Imagine the dinosaurs. That’s us. The meteor hit on the other side of the planet. We felt the earthquake. But, we still gotta eat, right? While we’re eating, we see the dust clouds on the horizon. They’re coming, slowly, darkening the sky, while we keep going like normal. Soon, we notice it’s getting colder – and darker. Then, 90% of Earth’s biology is in stress. Many won’t make it.

The metaphor is not about life on Earth. It’s about our economy, particulary jobs and small businesses. If you’re a hospital with 40% revenue drops, you know what I’m talking about. If you’re a physician now on furlough or closing your practice, you know what I’m talking about. If you’re one of the 22m Americans who have filed initial jobless claims in the last four weeks – a number greater than all of the jobs created since the Great Recession – you know what I’m talking about.

If it doesn’t feel that way to you, hopefully you’re right and I’m wrong. But, just wait. We’re only in the beginning.

2. Vetoes to health care budgets

Gov. Inslee got in front of a looming fiscal downturn by vetoing $235 million from the supplemental operating budget approved last month. There were several health related vetoes on the list, though the bulk of these cuts are to new programs.

SB 6088, which had $108k appropriated in FY 2020 to establish a prescription drug affordability board, is the only program to get cut in the current fiscal year. The in FY2021, the HCA saw cuts to post-partum extention of Medicaid; a big cut to primary care rates and behavioral health reimbursements; and a cut to the Patient Safety Coalition. Also noteworthy is the $2.1 million in projected spending cuts for a evidence-based intensive case management model to serve youth exiting foster care, juvenile justice and mental health systems.

 

3. We’re going to need a special session

There is very little interest among legislators I’ve spoken with about going into a special session. They just got done. They want to be with their families during COVID. And, it’s not clear what they would do if they returned to Olympia. What is clear, I think, is that there won’t be a special session until after June 2nd. That’s when the new revenue forecast will be out. However, we may get some revenue guidance next week during a ERFC call. Given Washington State’s tax structure, we are uniquely exposed among states to a revenue collapse during COVID.

Over the next two weeks, we’ll be working on a series of policy ideas that we think the legisalture should consider. These are not pre-COVID ideas. These are things to consider in the new normal. I think they all meet a standard of criticality given the looming hit to Washington State. If you have ideas for health policy for the next special session, I’d welcome hearing about them.

4.  Video: Tim Lieb, Regence BlueShield

Tim Lieb is the President of Regence BlueShield in Washington, where he is charged with directing Regence’s overall performance including government affairs, sales, provider contracting, and community relations. Lieb also serves on the board of the Washington Health Alliance. He joins us in this edition of “What They’re Watching” to talk through the ways data, policy and care intersect to support a more complete view of a patient’s needs.

“One of the key areas [we’re watching] and one of the things that’s very exciting is interoperability. So, as Medicare put in the requirements surrounding interoperability, we were one of the entities providing the rules and helping to develop those rules. And we have multiple pilots right now with how we’re going to do the data sharing and then what’s going to be the advantages for members.”

 

5.  Inmates, COVID and Dept of Corrections

Gov. Inslee announced on Monday the state’s intent to release up to 950 incarcerated individuals to help reduce the spread of COVID-19 within the Department of Corrections system. The news comes after a group of over 100 inmates at Monroe Correctional Complex (where 10 inmates and 5 employees have tested positive for COVID) staged a demonstration, and after a group of inmates filed a lawsuit calling for the release of individuals particularly vulnerable to complications from the disease.

On Friday, the State Supreme Court ordered Inslee and the DOC to “take all necessary steps” to protect the health of inmates and issued a Monday deadline for the release of the state’s plan. Inslee signed both a new proclamation and an accompanying commutation order on Wednesday, detailing the criteria for individuals who will be released early. The order authorizes their release within seven days or “as soon as can reasonably be achieved thereafter.”