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Washington State Medical Home Plan

Purpose

News
Launch of the Medical Home Strategic Plan

State Medical Home Strategic Plan

National Medical Home Endorsements

Medical Homes in Washington State

State Plan History

Purpose

Washington and many other states have developed a "road map" or plan to help the state reach the national Healthy People 2010 goal of every child and youth with special health care needs having access to a medical home by 2010. 

News

NEW! Washington State Care Coordination within a Medical Home Fact Sheet

One of the core elements of a medical home is care coordination. In order to provide consistent language about the definition of care coordination and its key elements, a fact sheet was developed based on the work of the 2006-2007 Financing Care Coordination Workgroup, facilitated by the Department of Health. The Workgroup was made up of stakeholders from across the state representing health care providers, families, and state and private agencies and organizations. The fact sheet us intended to use as a reference when describing care coordination within a medical home.

Download: Care Coordination within a Medical Home

NEW! 2007 WA Legislative Session Summary - Children's Health Issues

WA Chapter American Academy of Pediatrics- AFAAP's Fables, June 2007 issue

• Summary of several key pieces of legislation passed in 2007 that support children's health, including expansion in numbers of children covered by Medicaid, increased reimbursement to children's health providers, medical home performance measures, mental health and more.

  www.wcaap.org/openSection/Fables_June_2007.pdf

NEW! 2007 Fact Sheet: SB 5093: A Roadmap to Health Care

Fact sheet from WA State Dept of Social & Health Services outlining highlights of the Child Health Care Act of 2007 and plans for implementation

http://fortress.wa.gov/dshs/maa/News/Fact/FS007013ChildHealthCareAct.pdf

Child Health Care Bill Signed into Law

Senate Bill 5093 was signed into law March 13 by Governor Gregoire.  The bill will provide affordable, comprehensive health coverage options to all children in Washington State.  The bill seeks to ensure that children will be able to see a doctor, encourages high quality care through a medical home, invests in outreach to find and enroll eligible families and declares goals for nutrition and exercise in schools.

The importance of a child having a "medical home" is highlighted throughout the legislation.  Section 4 of the bill specifies that quality improvement measures and targeted provider rate increases aim to provide coordinated regular care for children through medical homes and that children with medical homes have improved health outcomes:

Section 4. A new section is added to chapter 74.09 RCW to read as follows:

(1) The department, in collaboration with the department of health, health carriers, local public health jurisdictions, children's health care providers including pediatricians, family practitioners, and pediatric subspecialists, parents and other purchasers, shall identify explicit performance measures that indicate that a child has an established and effective medical home, such as:

(a) Childhood immunization rates;

(b) Well child care utilization rates, including the use of validated, structured developmental assessment tools that include behavioral and oral health screening;

(c) Care management for children with chronic illnesses;

(d) Emergency room utilization; and

(e) Preventive oral health service utilization.

Performance measures and targets for each performance measure must be reported to the appropriate committees of the senate and house of representatives by December 1, 2007.

(2) Beginning in calendar year 2009, targeted provider rate increases shall be linked to quality improvement measures established under this section.  The department, in conjunction with those groups identified in subsection (1) of this section, shall develop parameters for determining criteria for increased payment or other incentives for those practices and health plans that incorporate evidence-based practice and improve and achieve sustained improvement with respect of the measures in both fee for service and managed care.

(3) The department shall provide an annual report to the governor and the legislature related to provider performance on these measures, beginning in September 2010 and annually thereafter.

For copy of legislation see:

www.leg.wa.gov/pub/billinfo/2007-08/Pdf/Bills/Session%20Law%202007/5093-S2.SL.pdf     (11 pages)

Detailed summary of the bill from the Children's Alliance: http://childrensalliance.org/4Download/health/SSB_5093_summary.pdf

Washington State Medical Home Fact Sheet

A brief fact sheet was developed at the request of participants in the Washington State Partnership for Medical Homes group to have a document that would help people describe the Medical Home concept consistently.

The 2 page document addresses Medical Homes for all children and youth, including those with special health care needs. Topics covered are: What is a Medical home, who can provide one, what are the core components, benefits, how many children and adolescents have a Medical Home in WA, challenges, opportunities to build a foundation for the Medical Home model, and information about the development of the key message document.
Washington State “Medical Home Key Messages” Fact Sheet

NEW! Medical Home-related grants in Washington State

“Epilepsia en Washington:  Improving Access to Care for Children and Youth”

Grantee: Washington State Dept. of Health, CSHCN Program

Funder: US Maternal and Child Health Bureau

“Improving Access to Oral Health Care for Children with Special Health Care needs (CSHCN) with Minor and Moderate Chronic Conditions in Washington State”

Grantee:  Washington State Dept. of Health, Oral Health Program

Funder: US HRSA

Launch of the Medical Home Strategic Plan

On November 2, 2006, a wide range of stakeholders committed to promoting Medical Homes met to (1) Officially launch the Washington State Medical Home Strategic Plan for children and youth with special health care needs and (2) begin planning our efforts to promote Medical Homes beyond children and youth with special health care needs. Participants included the WA Chapter of the AAP, Family Voices, Department of Health, Department of Social and Health Services, parents, Kids Get Care, the Medical Home Leadership Network, Spokane Regional Health District, Washington Association of Community and Migrant Health Centers, Public Health Seattle-King County, Clark and Cowlitz County, State Board of Health, Children's Alliance, Molina Health Plan, Center for Children with Special Needs at Children's Hospital & Regional Medical Center, Docs for Tots, Washington State Parent to Parent, Whatcom Health Information Network. For more information, contact the Washington State Children with Special Health Care Needs Program at 360-236-3571.

Click on the links below to view the following:

• Agenda (see below to view individual presentations)
• List of Attendees
• Meeting Notes

Download PowerPoint Viewer to view below presentations if you don't have it already installed on your computer.

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Washington State Medical Home Strategic Plan for Children and Youth with Special Health Care Needs

Washington State has developed a strategic medical home plan for children and youth with special health care needs.  The Washington State Department of Health's Children with Special Health Care Needs Program hosted meetings in February and April 2006 with partners from family organizations, health care provider groups, state agencies, health care plans and other groups to identify how we could achieve a medical home for every child with special health care needs.

• Partners developed this 2010 Strategic Plan to build upon the 2000 “Promise to the State”, Washington’s original “road map” for achieving medical homes for children and youth with special health care needs.

• Action Steps in this plan are designed to increase the percent of children and youth with special health care needs (CSHCN) who have a medical home. 

Percentage of Children and Youth (0-18) with Special Health Care Needs with a Medical Home:

WA State: 44.8% (38.5, 51.4)

US: 44.2% (42.9, 45.4)

(source: National Survey of Children’s Health, 2003)

Percentage of all Children and Youth with a Medical Home:

WA State: 48.5% (45.9, 51.1)

US: 46.1% (45.6, 46.7)

(source: National Survey of Children’s Health, 2003)

• Partners involved in implementing the plan acknowledge that strategic planning is a process—that the goals, objectives, and activities of this plan might change over time based upon evolving vision and environment.

Vision: All children and youth with special health care needs will receive coordinated, ongoing, comprehensive care within a medical home.

Organization of Plan: Partners identified three key strategic areas and broke them out by the individuals or organizations involved in carrying out specific objectives.

Download copy of Washington State Strategic Medical Home Plan for Children with Special Health Care Needs – Making it Happen in Washington State 2006-2010

For more information please contact the Washington State Department of Health, Children with Special Health Care Needs Program at (360) 236- 3571.

Washington State Partners in 2006 Medical Home Strategic Planning Process

Washington State Department of Health

                  Children with Special Health Care Needs Program

                  Child and Adolescent Health Section

Washington State Department of Social and Health Services

                  Infant Toddler Early Intervention Program

                  Health and Recovery Services Administration

Washington State Medical Home Leadership Network

Washington State Chapter of the American Academy of Pediatrics

Docs for Tots

Washington State Parent to Parent

Washington State Fathers Network

Center for Children with Special Needs, Children’s Hospital & Regional Medical

       Center

Health Services, Office of Superintendent of Public Instruction

Washington Health Foundation

Group Health Cooperative

Molina Healthcare of Washington

Family Voices of Washington

Spokane County Children with Special Health Care Needs Program

Public Health Seattle-King County Children with Special Health Care Needs   

       Program

Clark County Children with Special Health Care Needs Program

Washington State Medical Home Leadership Network Teams

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National Medical Home Endorsements

The Medical Home Concept has been endorsed as the standard of care by a growing number of health care provider organizations and other groups. The terminology used by organizations can vary slightly and includes "medical home,"  "personal medical home," "pediatric health care home" and "advanced medical home". " National organizations endorsing medical home include:

New!   

• The American Academy of Family Physicians, American College of Physicians (internists), American Osteopathic Association and American Academy of Pediatrics

  Joint Principles of the Patient-Centered Medical Home (March 2007, PDF file: 3 pages). This is an important step forward in promoting medical home throughout the healthcare system.

• The American Academy of Pediatrics

  Medical Home Policy Statement

• The American Academy of Family Physicians

  The Future of Family Medicine: A Collaborative Project of the Family Medicine Community

• National Association of Pediatric Nurse Practitioners

  The Pediatric Health Care Home

• American College of Physicians (Internal Medicine)

  The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of Health Care, (PDF file: 21 pages / 121 KB)

• The US Maternal and Child Health Bureau

  Achieving and Measuring Success: A National Agenda for Children with Special Health Care Needs

• American Academy of Pediatric Dentistry

  Policy on the Dental Home (PDF file: 2 pages)

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Medical Homes in Washington State

Awareness of the need for medical homes continues to grow in Washington State.  The medical home model of care is promoted in a number of key state documents including:

• The Washington State Board of Health's Public Discussion Draft of the 2006 State Health Report. In this report, Mary Selecky, Secretary of the Washington Department of Health writes about how Governor Gregoire has directed the Department of Health to convene a workgroup of key agencies to craft a prevention agenda for the state of Washington.   The group's prevention agenda focuses on five goals, including "increase the proportion of children and youth who have a medical home" (see page 9 of report).

• Kids Matter is a collaborative and comprehensive framework for building the early childhood system in Washington State in order to improve outcomes for children.  The plan offers a framework that supports the efforts of local and state stakeholders to coordinate, collaborate and integrate efforts that will lead to children being healthy and ready for school.  This plan identifies specific achieveable outcomes within four goal areas:
  • Access to health insurance and medical homes
  • Mental health and social-emotional development
  • Early care and education/child care and
  • Parenting information and support
  For more information see the Kids Matter Executive Summary (12 pages) or Full Report (66 pages) at  www.earlylearning.org/kids-matter

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State Plan History

As one of the first 12 states in the national Medical Home Mentorship Network, a team from Washington State developed an initial plan in January, 2001 to create a system of health care in which all children with special health care needs will receive their care through a medical home by the year 2010.   Team members came from the leadership of the Washington Chapter of the American Academy of Pediatrics, the Washington State Department of Health-Children with Special Health Care Needs Program, the Medical Home Leadership Network at the University of Washington Center on Human Development and Disability, the Center for Children with Special Needs and a parent leader active in several family organizations.

This plan became the basis of a successful US Maternal and Child Health Bureau grant application that led to the expansion of community teams involved in the Medical Home Leadership Network, the development of the Washington State Medical Website and other activities.

Links to the initial state medical home plan and various Washington State activities are available through the state medical home page at The National Center of Medical Home Initiatives for Children with Special Needs.

www.medicalhomeinfo.org/states/state/washington.html

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