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Presentation Minutes

Accountable Communities of Health (ACH) – Community Voice Council (CVC)

  • Pamm Silver - pammsilver@gmail.com  - Accountable Communities of Health - http://www.piercecountyach.org/
  • History of Accountable Communities of Health
    • In 2014 two bills passed to integrate a new payment system for Medicaid billing
    • Washington state was broken into 9 regions to implement the ACHs.
    • The existing Medicaid system was broken system.  The New one puts a different pay approach in place.  Instead of paying for the issue of an illness, we are going to be addressing the entire person- physical health, mental health, environmental, family environment, transportation, food crisis, where they work – putting it all together.
  • Want community members to tell us issues folks are encountering that affect their health so they can be worked on.
  • Pathways model is being adopted – launching in 2019 (info on the Pathways model at http://www.piercecountyach.org/pathways-101/ -ed.). 
    • Avoid expensive care  like the emergency room – get them before they go the ER
    • Improving population health through prevention
    • Work to a value based payment program – not fee for service – paid because of the outcomes of the people they serve. 
  • Community Voice Council brings recommendations to the Board of Trustees – which takes them to the State – to get resources for needed care. 
  • 17 members on the Community Voice Council looking at all the social determinates of health (the World Health Organization website on Social Determinates of Health is an informative one: http://www.who.int/social_determinants/sdh_definition/en/ - ed.).
    • The Council needs to advocate for neighbors, friends and family.
    • Work to make sure the system is accountable for the health outcomes of the community
    • Survey out in the community –
      • Asks what does healthy look like to you
      • Are there barriers to your health
      • Talk to folks one on one.
      • Gather that data and send it to board of trustees, who can make a difference with it.
    • Any comments or questions,  contact me.  Want to do a survey – contact me (pammsilver@gmail.com)
    • Martha – I’m pragmatic.  Give me an example of what kind of change the ACH can make? Pamm – with the new model, care coordination is followed by one person coordinating the care.  That will make it easier for folks to get better coordinated care. 
    • Carrie – this is Medicaid only, correct?  Pamm – yes, only for Medicaid recipients.. 
    • Carrie – can people join the Community Voice Council?  What is the Mission?  After review by Regional Health Improvement Plan (RHIP) Council, it goes to provider council, then to the board of trustees, then to health department, and finally to the governing body (“Though I am not a chief of state, I must work twice as hard as one because I have to both administer a bureaucracy and run a revolution.”  I’m not sure if you think of Yasser Arafat as a terrorist or a hero, or why this came to mind now, but this quote of his has stuck with me. –ed). 
    • Carrie – the Accountable Communities of Health are focusing on lots of areas – we should bring someone from the ACH to learn about the ACH as a whole.
    • Pamm – there are open, public forums at the Council meetings.  (info about upcoming ACH and Council meetings at http://www.piercecountyach.org/meetings/ -ed.)
    • Carolyn – Is there are racial equality lens this work is viewed through?  Pamm – there is a Data and Learning Team within the ACH. They look at cultural, financial, racial – and put all that data put together so we can fix the problems.  (info about that team at http://www.piercecountyach.org/who-we-are/ )
    • Do you have Medicaid recipients on the Community Voice Council?  Pamm – Yes – we have different ages, ethnicities, peer supports, Medicaid patients and more - 17 hard-working people. 
    • There is currently one slot open on the CVC (an old announcement seeking members with a link to the application - http://www.piercecountyach.org/seeking-applicants-for-pierce-county-accountable-community-voice-council/ -ed)
    • Time is set aside each meeting for public comment.  Everything is open, lots of collaboration and openness.
    • Website is a little weak – the mobile version doesn’t work – so use your laptop (and the site has some ADA accessibility issues too – someone spent real money on a fancy website, and it doesn’t get the job done… ed.)
    • The next Community Voice Council meeting is Tuesday, June 5th, from 1pm-3pm at the ACH building 2201 S 19th, suite 101, Tacoma, WA 
    • Please provide us some comments. 
    • Gerrit Nyland    
      • Some Health Maintenance Organizations, like Kaiser Permanente (putting in a plug for my wife’s agency –ed) already tie patient outcomes into physician compensation.
      • We have lots of room to make health improvements for folks experiencing homelessness.  The average age of all deaths in Pierce County last year was 72.  The average age for someone with a  connection to the Pierce County homeless system was just 50 years.     
    • James
      • We need to incentivize lower cost options to meet needs.

Also need an ACH overview
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