Washington State Health Care Authority (HCA) staff discussed numerous efforts to transform and improve healthcare services in the state at the 2024 Washington State of Reform Health Policy Conference on Jan. 4th.
HCA operates several Washington health programs—and administers Medicaid and behavioral health activities—which is a unique opportunity, HCA Chief Policy Officer Mich’l Needham noted.
“I don’t see that across the nation very often,” Needham said. “It’s rare that we have all these major programs under one umbrella, and that allows us to build our clinical expertise and share that across programs.”
Taylor Linke is the director of information technology (IT) innovation and customer experience at HCA, which focuses on operational activities related to IT staff and customer service. She noted that, while the COVID-19 pandemic created a lot of uncertainty, it also presented opportunities for Washingtonians.
“For the first time, there was this equalizing moment where we all felt the same level of uncertainty as what many of those we serve feel day in and day out,” Linke said. “And I see that as an opportunity, if we can all remember what it felt like, and how we came together to move mountains, to get out of one another’s ways about bureaucracy and process. For years in state government, we’ve talked about things we can’t do because there’s this rule or regulation. And in that time, we came together and said, ‘We’re going to figure out how to make it happen.’ We need to carry that forward in the work we’re doing.”
The pandemic spurred an opportunity for Linke’s teams to collaborate and focus on human-centered design, and consider the journey an individual must go through when they seek out services. Collaborative efforts led to the state’s integrated eligibility and enrollment strategy, which provides a good example of several agencies working together to leverage technology in a way that helps transform the system, she said.
“We’re looking at figuring out how to recreate a single streamlined process so that when a Washingtonian finds themself in need, they don’t need to know which agency provides food benefits (or) which agency provides healthcare benefits. They don’t have to be an expert in our overly-complicated system. They can turn to one place, put in their information one time, and our agencies can proactively match them with programs that may be of benefit to them. It’s a long roadmap for us to get there. But we’re actively making progress on that initiative today.”
— Linke
Teesha Kirschbaum, deputy director of HCA’s Division of Behavioral Health and Recovery, said the division’s priorities are to ensure that the needs of individuals who need mental health or substance use disorder services are well-supported. And to ensure that people who are not actively engaged in treatment have the option to attain it.
HCA staff participate in legislative committees and workgroups—like the Behavioral Health Advisory Council, the Children and Youth Behavioral Health Work Group, and Crisis Response Improvement Strategy committees—to make those connections, Kirschbaum said.
The agency also administers the certified peer support counseling and training program, which trains and qualifies behavioral health consumers as certified peer counselors. HCA has trained almost 8,000 certified peer counselors since 2005, and it will train 105 individuals this year, Kirschbaum said.
The passage of Senate Bill 5555 in last year’s legislature created the certified peer specialist position, which will spur a lot of changes within the peer world over the next couple years, Kirschbaum said. It will affect how peers will be trained, certified, and licensed to provide peer support services.
“[It’s] enhancing our certified peer specialist curriculum from 40 to 80 hours, which is going to create gap training for previously certified peers (and) developing training for peer supervisors. And (it’s) continuing training for our operational peer supports training for agencies who want to start peer support services or continue to build their program.”
— Kirschbaum
Dave Iseminger is the director for HCA’s Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs, which serve about 725,000 people (19-20 percent of the commercial insurance market in the state). He also participates on the state’s Universal Health Care Commission, which garnered a lot of attention at the conference, he noted.
The commission’s goal is to create immediate and impactful changes in healthcare access and delivery in the state, and prepare it for the creation of a healthcare system that covers all Washingtonians. Iseminger believes the PEBB and SEBB programs could collaborate with the commission to fulfill those goals.
“The PEBB and SEBB programs are the perfect vehicle as the incremental gateway to whatever that nirvana is that many people want us to get to in a universal system,” he said. “If we can’t consolidate and keep all of our government employees, how are we going to convince the citizens in Washington that we can do it for everyone?
I manage two programs. Let’s get them into one program. I’m happy to welcome any governmental employees. We have the ability to broker you into our risk pool and grow that. Maybe I’ll be able to say 25 percent of the commercial market is in the PEBB and SEBB programs. Those are all incremental steps that could actually help make it easier to facilitate any sort of nirvana (or) universal system. It is definitely something that can be taken out for a spin to keep going in that direction.”