5 Things Washington: Acute depression looms, Black leaders in health care, Yakima County

We have a lot for you this week, content that I don’t think you’ll find anywhere else in our state. In fact, we are featuring six things this week because we think there is a lot going on worth knowing about. I hope you take something useful from our work.

I also want to feature a virtual conversation we’re hosting on race and health care, which you’ll see in item 3 below. Now is a time to be reflective about our biases, the benefits or detriments of our skin color, and how we can foster conversations that will have a measurable and positive impact moving forward. So, I hope you’ll consider finding time to join that conversation next week.





With help from Emily Boerger

1. DOH on behavioral health impacts

A document from the Department of Health forecasts a worrisome outlook for the potential behavioral health impacts of COVID-19. DOH updated the document on May 15, at which point they categorized the state as leaving the “honeymoon” phase – meaning, this is the peak period of emotional highs resulting from the pandemic. After the honeymoon, the chart shows a rapid increase in emotional lows.

“Based on population data for Washington, and known cycles of common psychological responses to disasters, we can reasonably expect that between TWO to THREE MILLION Washingtonians will experience behavioral health symptoms over the next three to six months,” reads the document. DOH also warns of a potential 30-60% rate of depression in Washington’s general population (2.25 million – 4.5 million people) due to the ongoing social and economic disruption of COVID.


2. Five plans file for public option

In our reading of OIC filings by health plans for plan year 2021, it appears five plans have filed to be in the public option market known as Cascade Care. Those plans include Community Health Network of Washington, UnitedHealthcare of Oregon, Lifewise Health Plans, Bridgespan and Coordinated Care. Lifewise is a Premera product, and Bridgespan is a Cambia product, a sister to Regence.

I’m told that at least one of those plans may be using the First Choice provider network, though I can’t verify that myself. That network, which is built on reimbursement equal to 90% of billed charges, would make hitting the provider reimbursement caps in Cascade Care very difficult. But, putting a network together under those caps is very difficult, too. The HCA tells us they’ll have an announcement about plan filings and participation next week.

3. Virtual event: Black leadership in US health care and health policy

Next week, we host a virtual conversation with three leaders I hold in the highest esteem across our entire nine state footprint. They also happen to be Black. So, on June 19th – also known as Juneteenth – we will hold a discussion of how health care organizations can grapple with the structural racism built into American institutions. We’ll hear their thoughts, their lessons, and their counsel on how best to address the topic of race in US health care.

The panel includes Eric Hunter of CareOregon, Demetria Malloy, MD of Anthem Medicaid in California, and Rep. Garnet Coleman, a 30-year legislator out of Houston Texas. It’s a tremendous honor that these three folks are coming together to join in a mutli-state conversation. I hope you’ll find time to listen and to be part of the conversation with us next week. We’ll announce a panel specific to Washington State, but not specific to health care, at our sister site, the Washington State Wire.

4.  Yakima County COVID update and context

Yakima County has emerged one of the nation’s top hot spots of COVID infections. The latest data from the Yakima Health District shows an infection rate of over 537 cases per 100,000 during the last two weeks, and approximately 30% of COVID tests in the district are positive. On Monday, Washington State reported 384 new cases of COVID-19; 215 of those cases (55%) came from Yakima County despite the area making up just 3% of the state’s population.

A recent report from the Institute for Disease Modeling explores potential reasons for the different virus trajectories in King and Yakima Counties including demographic variations. But one thing is certain: Yakima County is understaffed and under resourced when it comes to public health support. According to 2018 data, there is one public health worker for every 8,800 Yakima County residents, the poorest ratio in the state. The county also spent just $23 per resident on public health in 2018, the third lowest in the state.


5. What 15% cuts at HCA, DOH, DSHS look like

Next week, OFM will release an updated revenue forecast that will guide a supplemental budget to address the shortfall. In preparation, Governor Inslee directed state agencies to prepare a list of budget cuts equal to 15% of revenue. The HCA’s list of cuts to Medicaid include elimination of adult dental benefits, hospice services, OT/ST/PT services, and Medicaid-covered abortion services.

At DSHS, cuts include 100% furloughs of staff two days a month, rollbacks of staff salary increases, and the closing of 6 wards at Western State Hospital. At DOH, reductions include hits to neurodevelopmental centers for kids, family planning and reproductive health, and the rural health program.


6. Committee on Economic Recovery to meet next week

The first work session convened by the bipartisan Senate Special Committee on Economy Recovery will take place virtually on June 16th at 10:00 AM. This will be the initial meeting of the committee, which is led by Chair Sen. David Frockt and Vice Chair Sen. Randi Becker. The committee is expected to offer possible legislative options to support the post-COVID economic recovery.

According to the work session’s agenda, three core topics will be covered: national perspectives on the COVID-19 economic crisis, unemployment challenges, and regional perspectives on the economic crisis. Speaking to the committee’s purpose after it was announced, Frockt said, “The purpose of this select committee is to look deeply at the ways in which the pandemic has structurally changed our state and regional economies, and to make recommendations on how we can come out stronger on the other side for workers and the businesses that employ them.”