Welcome

• James Pogue, Comprehensive Life Resources
• If you have changes based on weather, please forward to the coalition listserv.
  • Let us know where to send people
  • What programs are available

Presentation

Coordinated Care  - https://www.coordinatedcarehealth.com/  - 1-844-354-9876 – fostercareMGMT@coordinatedcarehealth.com

• Jennifer Estroff, Liaison, Tribal Outreach and Apple Health, Coordinated Care - JESTROFF@coordinatedcarehealth.com
• Excited to be here – just moved back to Pierce County – was born in Gig Harbor
• Coordinate Care – one of 4 managed care plans in Pierce County. 
• Apple Health Core Connections  
  • Program for youth adopted out of foster care and alumni of the foster care program
  • Provide these services this statewide.
  • Every kid should have an annual exam – for kids out of the foster care system, call 1-844-354-9876
• Who do we serve
  • 25k members –
    • Children/ youth in out-of-home placement (meaning Child Protective Services is involved – the state is the legal guardian)
    • Children adopted out of foster care – can stay on state Medicaid
    • 18-21 youth can pick this when they age out of foster care extended foster care
    • Foster care alums – 18-26
    • Children and youth reunited with parents get coverage one year post-dependency.  Theresa – this is great. Jennifer – thanks. – from house bill 2530 (https://app.leg.wa.gov/billsummary?BillNumber=2530&Year=2017 –ed.) – families must be Medicaid eligible. 
    • Al – languages?  Jenn – we will make sure it works.
    • Exceptions - There are some exceptions – if foster care folks get coverage through other entities, like undocumented or Native American.  Youth in detention get healthcare through the detention facility.
• Program and benefits
• What is new in 2019
  • Behavioral Health
    • Kids – lots of words about restrictions in care that aren’t there anymore
    • Program is now state-wide.  Kids can move around and more easily get service wherever.  Questions – is this all areas of the state?  Jenn – not all regions in the state.  For foster care – state wide.  Other clients, perhaps issues.
    • Client can get in Behavioral Health – even if getting healthcare from Medicare or tribal health, can get just behavioral health from coordinate care – but only in counties that are integrated, and Pierce County is integrated.
    • Trauma informed care – all staff, especially in foster care, will have trauma informed training. 
      • Trauma informed means we are working on asking questions in a more normal way – understanding that there is always trauma involved in the lives of kids in the foster care system.
    • Establish a Primary Care Provider and a medical home.  One physician can oversee all treatment and bring it together.  Know medications, therapies.  If can identify two therapists doing similar treatments and work to coordinate care.  When we do this right, youth get right care at the right time.
  • Eligible members are automatically enrolled
    • Will receive a welcome packet.  May get a welcome call.  At enrollment, will work to use someone’s current providers.  We do a ton of care coordination to help families meet the needs of their kids.
• Local approach.  Based in Tacoma, but have Yakima, Wenatchee and Seattle locations. Looking at Spokane.
• Have liaisons – regionally based supports
• Have Community Educators – can do training on trauma informed care at no cost.  I you are serving a population that includes clients on Medicaid, contact us to coordinate training.
• Try to make things easier
  • Being in the foster care system is challenging. 
  • Ensure timely access, assist care workers and care givers.
  • Results
    • Improved functional outcomes
    • Fewer placements
    • Better prescription medicine oversight
    • Improved school performance
    • Higher member/caregiver satisfaction
• Clients don’t need to show card to receive service - although many provider like to see it (does showing the card actually work to prevent fraud or something?  I’ve always been puzzled by this –you’d think some ID would do the trick. –ed).
• We don’t cover dental, but that phone number is on the card.
• Interim vouchers allow instant access to healthcare providers while youth is in the process of getting enrolled.  If there are issues with voucher, 24 hour phone support will make it all happen.
• Will provide 90 days of continuity of care for kids with existing providers that aren’t in the system.  Will try to get those provider in network so they can continue to provide care.
• Find provider on the website, or call us.  
• Question – what about children homeless with their families?  Jenn – not the foster care plan, but they would most likely be eligible for regular state healthcare through Coordinated Care

Benefits –

• Medical services
• Doctors office visits
• Urgent care
• Vision exams
• Prescriptions
• Hearing exams
• Hearing aids
• Durable medical equipment
• Hospital care
• Home health
• Emergency room visits
• Physical Therapy
• Specialty therapies
• Lab tests/x-rays
• Transplants
• Family planning
• Disease management (asthma, diabetes, etc.)
• Transgender benefits
• Behavioral health outpatient and inpatient
• Drug and alcohol treatment
• Vision Health Benefits
  • 20 years and younger – exam with refraction once per calendar year.  Also, Hardware (glasses + lenses or contact lenses) with ProviderOne Card
  • 21 year and over, one eye exam with refraction every 2 calendar years
• Behavioral Health
  • Wraparound with intensive services
  • Program of assertive community treatment
  • Substance use disorder treatment - outpatient, intensive outpatient, residential, detox, mediation assisted treatment (MAT)
  • Crisis Service- call crisis lines
• Al – cover partial hospitalization?  Jenn – yes, if medically necessary. 

• Al – do you address other social determinates of health?  Jenn – yes
• System of Care – member is at the center, we surround the member with community based supports, providers, wrap around services, crisis services.  We work to serve the people serving our members.  We have lots of liaisons.  Have a tribal liaison.   We do a lot of care coordination
• We get lots of questions about CLIP – Children’s Long-Term InPatient – there are very specific beds in the state.  I don’t know much about this – we can bring a presentation in about this.  If outpatient doesn’t work and we’ve tried everything – this is the last resort.  (I often think people just make up new acronyms to keep me on my toes, but as always, it is a real thing - http://clipadministration.org/ -ed.)
• We do lots of care coordination and care management. 
  • Use data to inform risks, find care gaps, etc. (glad to hear it – that is what data is for. –ed)
• Larry – with court involvement – courts may disrupt plans.  Jenn – what the court has dictated may not be medically indicated for the child.  We provide medical care documentation back to the court to get better info into the court’s hands.
• Can help with placement transitions.  Can make sure that equipment and medications properly follow the children.  Have suicide prevention and safety planning protocol. 
• Provider One – still covers usual stuff – call us to find out who will cover what. 
• Question about Transportation? – Coordinated Care will cover medically necessary transportation – for all clients.
• Lots of value add
  • Nurse line
  • Pregnancy supports
  • Adoption success
  • Zero suicide
  • Adolescent to adult
  • We care – go out to youth shelters to see if kids are covered and accessing services
  • Psychotropic medication utilization review- make sure clients are on appropriate medications
  • Health library
  • Cell phone program
• Patricia – overarching question – what are the effects on kids in foster care if the foster family is about to be homeless?  The sooner Coordinated Care knows, the easier a time we have providing services (I’m no expert, but I can’t image you would continue to be a foster family if you lost your housing.  –ed.) 
• Al – you can call a provider and talk to them about your client, but they can’t acknowledge that they know the client.  but if you have information to pass on, you can share that.
• Al – do you follow up to make sure they make a connection when a referral to services is made?  We have to follow-up once every 30 days at least, we’ll always check in if they reached out or engaged services.
• Al – the ACH is looking at having physicians prescribe food, and someone lives in a food desert, would Coordinated care extend transportation to assist with getting to food?  Jenn – we cover Medicaid benefits – we cover what we have to, but during the EPSDT (Early and Periodic Screening, Diagnostic and Treatment – essentially well child exams), if a doctor prescribes something, we have to cover it.  In our regular health plan, I’m not sure what we’d do. 
• James – on one night at the youth shelter, some 40% of youth were ex-foster youth.  Coordinated care came out to review youth benefits, at a time convenient for our youth – which was super helpful. 

Reports

Inclement Weather – open to at least Monday. 

• Youth and Young Adult shelter at Beacon Shelter – at 4pm will open today on Faucet and 13 – for anyone who is youth and young adult.  18+ can stay.  Will be open all weekend during the day (all ages youth) and evening  253-677-0102 – Beacon center youth and young adult on-call phone.  Staff will brave the elements, but would rather you get clients to us.  Meals provided.  Can do more folks.  Take stuff folks can hold.  No pet policy, but do it on a by pet basis.
• TRM – Luis – running inclement – increase capacity by 78 beds – filling between 50 and 60 beds.  At the South Tacoma shelter.  Staying open all day at least through Monday.  3 meals a day and can use the facilities all day.  Haley - Outreach – going out to encampments – hand out food and try to bring folks back to shelter.  If you know folks that want to get back to shelter –search and rescue –  253-883-1513. 
• Salvation Army – open shelter for families.  Send folks to us.  1501 6^th avenue – from 4pm to 7pm.  If it is later, it needs to be folks coming from the police or search and rescue.  Open all day all weekend.  Families, couples,
• Nativity House- increase capacity by 80 (to 247) – had 5 spots open last night.  Open 7:30 on.  Sign in at 3:30 for inclement weather.  Breakfast, lunch and dinner provided.  Case management and mental health team on site M-F.  Molina connects folk.  Have parking lot for shopping carts – with tarps and such to keep them dry.
• Freezing Nights – in Puyallup at the New Hope Center.
• We work hard to take in everyone at every shelter, banned rules are sometimes flexed to keep as many people as safe as possible
• Adams street family shelter – some capacity - has to have id and pass UA. 

Reports

Advocacy Update

• Maureen Howard, Housing Advocate, maureenhowardconsulting@gmail.com
• Remember Chris Gildon – candidate for 25^th legislative district (https://www.chrisgildon.com/ )– around Fife.  All bills that will affect people we care about will end up in his committee – where he is the ranking Republican.  If you live or work in the 25^th – if your organization covers the 25^th – make a friend with Chris Gildon - gildon@leg.wa.gov
• Al – we should all consider contacting him – whether we are in his district or not.
• Theresa – 1591 house bill (https://app.leg.wa.gov/billsummary?BillNumber=1591&Initiative=false&Year=2019 ) – rights of persons experiencing homelessness working to survive in public.  This is using people first phrasing, and theirs right to survive in public.  Will come up in the next week or so.  (after doing disability advocacy for years, people first language is pretty ingrained in my thinking – the thought is that people are people, not defined by a disability or a race or a religion or homelessness – and there is real power in making sure when we talk about people we identify that personhood before any other characteristic about them.  “A person who is blind” says it is a person with a characteristic, just like “a person with a  red hat”.  Much nicer than saying “that red hat person”. But it makes every sentence a little bit longer – a small price to pay for dignity. –ed) 
• Bill 1377 (https://app.leg.wa.gov/billsummary?BillNumber=1377&Initiative=false&Year=2019 )– out of committee – give religious organization to get density bonuses if they develop density.
• 1581 (https://app.leg.wa.gov/billsummary?BillNumber=1581&Initiative=false&Year=2019 )– Tacoma Housing Trust Fund
• Tenant bills are moving forward – we all testified. 
• Will pass on alerts from the Washington Low Income Housing Alliance. 
• HUD 2019 Continuum of Care awards are out (https://www.hudexchange.info/news/fy-2018-coc-program-competition-funding-announcement/ )
• City of Tacoma has sent out the 2019 amendments to the Comprehensive Plan – I know this sounds bizarre when we are trying to house someone tonight.  I can do talking points around these things. 
• Haili - Five Calls app (https://5calls.org/ )- shows lots of bills enacted now – shows you how to contact senators – has what to say and how to contact them.
• Theresa – sounds like Maureen is going to send us some stuff. 
• In City of Tacoma and County, I want you to consider encouraging testifying before the Councils.  Every 2^nd Tuesday of the month, City of Tacoma has citizens forum.  People rarely come down and talk about homelessness.  Next one is February 12^th.  Join me on March 12^th – I’ll  be there.  I’ll be pitching as New Connections.  County Council allows citizens to respond every Tuesday, at 5pm at the County City Building.  The forum is at the end of the meeting.  Sometimes the meetings are short, sometimes they are long.  Look on-line for the agenda or the status of the meeting. 
• Sheila – went to Sumner/Bonney Lake homeless coalition.  They talked about an apartment building being build – I asked how many were going to be low income units?  All were going to be for folks 60% and under.  We are are creating the awareness about what needs to be done.
• Al – I sent out the housing strategies – they are long reads.  I think they are very good starts, but the one thing that needs to be emphasized, we need housing for folks that are genuinely low income. 
• Maureen – only 5 jurisdictions can use the property tax exemption.  We need something to help someone with very low income. 
• Maureen – we have to build relationships with folks over time. 
• Rosemary – the County Council meetings are at 3pm at the County City building.  Very few people are there to testify – you get known very quickly.  Theresa and I often testify together.  The more the policy makers know us as people, the better our voice is heard.  It is at 3pm, and you can speak at every council meeting.

Good of the Order

• Martha – I’m a hypocrite(hardly –ed.), I talk about the listserv all the time.  I sent an e-mail out yesterday, and got such an amazing response from my request.  I’m so encouraged by this group.  Give yourselves a hand.
• Martha - at the end of February, we have a volunteer recognition banquet.  Our volunteer coordinator, who was new, was so impressed by this meeting, that they want to turn the banquet into something new.  We are doing the KEY awards.  We’ll have some people’s choice awards – you help by picking agencies or people who have been super effective or impactful.  Will have one night in February and we’ll throw a big shindig.  We’ll send out a survey and announcements. (we are running out of February somewhat quickly – just saying. –ed.)
• Al – We talked about keeping people educated about what is going on in  the legislature.  Don’t want to be a formal lobbying group – that means that each of our individual voices are important.  Thanks to Maureen for keeping us informed day by day.  Send an email or phone call to your representative.
• Patricia – one upside to the freeze – it might knock out some of the insects (but hopefully not The Tick, Ant-Man, or The Wasp – don’t want crime to run rampant in the metropolis).  There are a few things that will be better in the summer because of a deep freeze this week
• James - we are evolving this year – keeping our loose structure and adding some different structure. 
• March 1^st, reentry group coming in for a joint meeting
• Later this month – looking to do this with the youth coalition as well. 

Coming Attractions

• February 15^th – Amerigroup
• February 22^nd – Racism and Homelessness
• March 1^st – Joint meeting with Community Partnerships for Transition Solutions
• March 8^th – Census Presentation
• March 15^th – A focus on Youth Homelessness
• March 22^nd – Does your fireplace really suck heat out of your home, or provide vital warmth during a cold snap? Your Aunt, some sort of Cousin, someone’s Grandfather, and “Dallas”, an old army buddy of your Dad’s (rest in peace), will form our panel and present opposing viewpoints, no actual research, and impassioned pleas with data points they’ve simply made up.  You hear the argument, and decide your own reality.  The dangers of unattended candles in bathrooms will be discussed, time allowing.

Restaurant Review

Valentine’s Day is not a moment when Nyland men shine strong.  Our traditional Dutch practicality has some upsides, but efficacy in the romance department is a long-standing shortcoming.  Over time, Nyland men just sort of hope a potential mate recognizes the value of someone that can hold down a job, address the occasional plumbing crisis, and fold some laundry.  It has worked out so far, but there are bumps in the road.  Valentine’s day is one of those bumps.  Growing up, many a Valentine’s Eve were spent with some last ditch efforts on my father’s part to create some sort of show-of-appreciation for my mom.  For that last minute gift, Brown’s Flowers (4734 South Tacoma Way - https://www.brownsflowersandgifts.com/ ), LeRoy jewelers (940 Broadway, Tacoma, WA - http://www.ljewelers.com/ ) and, most importantly, Johnson’s Candy Company (924 MLK Jr. Way, Tacoma WA) formed the holy trinity of mom-gifts.  If you’ve never been to Johnson’s Candy Company, you are missing out.  You may not know this, but Tacoma has a long history of making candy. Places like Johnson’s Candy and Almond Roca are all that is left of the major chocolate powerhouse we once were.  My Good Grandmother said everyone called Tacoma “Broken Bars Washington”, because of all the shops along Highway 99 (the main North South arterial before I-5) that sold factory rejects – everyone loves a deal.  Johnson’s Candy Company, starting as an ice cream counter about 100 years ago, shifted to making and selling chocolates in the 20’s, and haven’t really looked back.  Still owned by the original family (last time I checked, at least), entering the shop is a sure step towards happiness.  There is something about being in a proper candy shop that is somehow electric, and Johnson’s delivers in spades.  I’m no sweets man, but I do enjoy the occasional bit of chocolate, and Johnsons provides.  Walking around the shop, the possibilities for instant gratification seem endless.  The staff is sweet (see what I did there), and always happy you came in.  So, when you need that box of chocolates that says I love you – Johnson’s is a great place to make that happen.  You’ll be supporting a storied local business, you may score a free sample, and hopefully you’ll get a “meets expectations” on the next report card from your better half.  If a box of chocolates doesn’t light the fire of romance, it will at least keep the pilot light lit for a bit longer…

Attendees

• James Pogue, Comprehensive Life Resources
• Larry Seaquist, League of Women Voters
• Elijah Moon, Department of Social and Health Services, Community Services Division
• Emily Less, Tacoma Pierce County Health Department
• Martha Sheppard, The Salvation Army
• Joseph Sanders, Tacoma Rescue Mission
• Justin Tillis, Tacoma Rescue Mission
• Andrea Sanz, Tacoma Rescue Mission
• Haili Crow, Tacoma Rescue Mission
• Brendan Baker, Veterans Administration
• Ryan Gutierrez, Veterans Administration, Social Work Intern
• Bryan Green, Olive Crest – Safe Families for Children
• CC Mendoza, Metropolitan Development Council
• Al Ratcliffe, whatever
• Theresa Power-Drutis, New Connections
• Matthew Jorgensen, City of Tacoma
• Kiedrick O’Bannon, City of Tacoma
• William Stinson, Catholic Community Services
• Byron Corzo, Comprehensive Life Resources
• Carrie Ching, Molina Healthcare
• Maureen Howard, Housing Advocate
• Carolyn Read, St. Leo’s
• Charleen Fitzgerald, Coordinated Care
• Jen Estroff, Coordinated Care
• MaryBeth McCarthy, Tacoma Community College
• Rosemary Powers, New Connections
• Stephanie Wright, Adonai Counseling & Employment
• Richard Berghammer, Fellowship Bible Church
• Melissa Moss, Catholic Community Services
• Greg Walker, Valeo Vocation
• Luis Rivera, Tacoma Rescue Mission
• Stacey Olson, Comprehensive Life Resources
• Patricia Menzies, Tent City Tacoma
• Eric Hasstedt, Safe Streets
• Hannah Dike, Catholic Community Services
• Brendon Ault, Catholic Community Services
• Sheila Miraflor, Molina Healthcare
• Gerrit Nyland, Catholic Community Services