5 Things Washington: Monkeypox stigma, Peer support specialists, COVID emergency orders


Eli Kirshbaum


My name is Eli Kirshbaum and I’m a Senior Reporter/Editor here at State of Reform. Emily is out on vacation for the next two weeks, so I’m stepping in to write her newsletters while she’s gone. Please feel free to reach out to me if you have any questions or comments during her time off—I’d be happy to connect!

We will be releasing the Detailed Agenda for the 2022 Inland Northwest State of Reform Health Policy Conference this week! This breakdown of panels and speakers that we’ve curated should be hitting your mailbox on Thursday, so keep your eyes out. If you haven’t registered to join us already, you can do so here.

Thanks for reading!

Eli Kirshbaum
State of Reform


1. Washingtonians experience monkeypox stigma

The Washington Department of Health is warning the public of harmful stigma and “awful, ugly comments” being directed at some members of the LGBTQ+ community in wake of the spreading monkeypox virus. The virus has been predominantly found in men who have sex with men, making many of these individuals susceptible to discrimination reminiscent of the HIV/AIDS epidemic in the 1980s.

“This is a human disease and it’s not limited to any community,” said DOH Secretary of Health Umair Shah. He warned that this stigmatic rhetoric can disincentivize affected individuals from seeking care. DOH is engaging in regular conversations with impacted community members and intends to work with local and federal health organizations to combat the unhealthy stigma.

2. State works to expand peer support specialists in BH care

State health care leaders are exploring ways to expand access to peer support specialists in an effort to improve behavioral health care. “Peers know what it’s like to be in the person’s shoes,” said HCA Deputy Director Lou McDermott. “They hold and promote hope for recovery. They have a unique and comforting presence and an ability to build rapport based on shared lived experience.”

In a meeting with Gov. Jay Inslee late last month, McDermott said HCA—which is responsible for credentialing peer support specialists—has certified over 6,000 support specialists since 2005 and is regularly working with other state agencies to implement initiatives similar to HCA’s own Peer Bridger program. For example, the Department of Children, Youth, & Families is working to establish a peer support advisory group and peer bridger pilot program at Jaspr Health.


3. Washington congressional candidates voice support for universal health coverage

During Whole Washington’s “Seattle March for Healthcare Justice” last month, several of the state’s congressional and legislative candidates voiced their support for a universal health care system. The march aimed to gather support for I-1471, an initiative Whole Washington hopes to get on the ballot this fall that would guarantee health insurance for all Washingtonians regardless of citizenship.

Rebecca Parson, a candidate for Washington’s 6th Congressional District, said the initiative is necessary because universal health coverage is unlikely to move forward at the federal level. Stephanie Gallardo, a candidate for the 9th Congressional District, also expressed her support: “Medicare for All and fighting for health care justice in our communities is something that will make every single industry easier because people will be healthy and people will be taken care of.”

4. Inslee to rescind COVID emergency orders

Gov. Inslee announced late last month that he will rescind 12 COVID-related emergency proclamations for the health sector, effective Oct. 27th. These proclamations include restrictions on nursing home visitation, limiting the provision of non-urgent medical procedures, and waiving certain licensing requirements for health care workers.

The Department of Health and the Department of Social and Health Services plan to provide technical assistance to facilities to help providers transition out of the regulations. The state is also allocating $22 million to maintain contracted staff and support patients who transition to community-based services. Once these rescissions take effect, around 87% of Washington’s COVID-related emergency decrees will have been rescinded.


5. Updating Medicare’s physician fees is a challenge again

In the wake of rapidly rising inflation following a complicated history of federal policy, physicians across the US are expressing disapproval over Medicare reimbursement rates. In his most recent piece, State of Reform columnist Jim Capretta overviews the history of Medicare reimbursement policy and evaluates Congress’s likely path for addressing the inadequate reimbursements provided to physicians as the cost of providing care increases.

With “notably low” reimbursement levels outlined by Congress in 2015, mandatory cuts to Medicare spending through the PAYGO and the BCA programs, and a record 8% inflation rate, Capretta says physicians face increasingly significant cuts to Medicare reimbursement. “Given the many challenges involved, the most likely path forward is the one that Congress has been on for some time: annual ad hoc adjustments to address immediate pressures without any clear plan for finding, much less implementing, a more enduring solution,” he writes.