HCA outlines priorities for 2022 supplemental budget request


Soraya Marashi


At the 2021 Inland Northwest State of Reform Health Policy Conference, senior representatives from the Washington State Health Care Authority (HCA) gave updates on several initiatives currently being pursued at the agency. Charissa Fotinos, MD, interim medicaid director at HCA, highlighted some of the legislative priorities that will be included in the agency’s budget request for the supplemental budget year. 


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One of the initiatives is supporting the community information exchange (CIE). The HCA defines CIE as “complementary modules” that support access to and communication between “organizations and services, care coordination, referrals, and appropriate sharing of patient information/records.” This system would include things like a resource directory, closed-loop referral, community health records, event notification, and user-based access. Fotinos says the tool will improve the overall provider and patient experience and support access to resources for patients. 

“We recognize that all of our hopes and dreams for integration are not going to happen unless people can communicate with each other … So can we develop a consent management system that we can better share information in, and that patients have the ability to pick and choose who gets what information and when?”

Fotinos stated that supporting the CIE is critical in working toward meeting the social determinant needs of people by allowing them and their providers to have access to resources and social services that the greater community offers.

Another key aspect of the budget request and a legislative priority for the agency, Fotinos noted, is to expand behavioral health resources, particularly with crisis response for youth and adults. She mentioned HB 1477 and the 9-8-8 crisis system, as well as creating a real-time bed tracker that shows where there are open spaces for people. She says these initiatives are meant to better connect information around the needs that people have, and who can facilitate the care they need in a timely manner. 

“COVID has again made us more than aware that our youth are struggling. We have seen increases in hospital visits for suicidal ideation, we have seen increases in visits for anxiety and depression, and now that kids are going back to school, how can we best support youth? Whether they are just stressed because life is stressful now, or they may have underlying behavioral health needs, we don’t necessarily have the capacity we need to, in an efficient time, respond to their needs.”

Fotinos said they will also focus on improving conditions for the primary care workforce. 

“They are underpaid. Especially with complex folks who may have multiple medical needs, but also multiple social needs. [Their needs] really can’t be met in a 10 or 15 minute visit. So how do we not only provide them with the ability to spend the appropriate amount of time with their patients, but also really build a health care team? And by health care team, I mean does that clinic need a care coordinator, does that clinic need a community health worker? How do we better support people, and really think about health in a health-focused way?”

The HCA is also requesting funding for a community-based mental health center program, similar to that of the Federally Qualified Health Centers (FQHCs).