Providing backbone support to the Washtenaw Health Initiative
The Patient and Protection Affordable Care Act (ACA) was signed into law on March 23rd, 2010. The most sweeping health care reform the U.S. had seen in decades, the ACA was meant to dramatically increase access to health insurance for those without employer-sponsored care, to expand access to Medicaid for low-income Americans, and to encourage states to develop and explore innovative medical care delivery methods designed to lower the cost and improve the quality of health care. With the passage of health reform, Washtenaw County leaders anticipated that a greater number of persons with limited resources would be insured, increasing their potential access to care. Without a well-conceived action plan that responds to the impending changes, many worried about overwhelming the county’s health care providers, about persons newly eligible for insurance failing to apply or becoming frustrated by the application process, and about safety net providers not qualifying for new types of funding for medical homes, federally qualified health centers, and accountable care organizations.
In early 2011, more than three-dozen individuals from 20 community organizations gathered to talk about how they could better serve Washtenaw County’s uninsured and low-income Medicaid population. Group members included representatives from the Saint Joseph Mercy Health System (now Trinity Health), Michigan Medicine, University of Michigan, United Way, the Washtenaw County Health Department, the University of Michigan School of Public Health, and the Washtenaw Health Plan. Together, they decided that the region needed to assess primary care capacity in Washtenaw County safety-net clinics to ensure local providers could serve all of the residents who would be newly insured under the ACA. They also discussed gaps in care, such as inadequate dental care, for the county’s low-income and uninsured populations.
At the time, the participating organizations anticipated that the project would be a six-month effort to prepare for the successful implementation of the ACA in 2014. Six months after their first meeting, the WHI published a report: A picture of health care in Washtenaw County. Based on findings from dozens of community conversations, as well as additional research, the report highlighted a series of significant health care challenges for low-income and uninsured populations across Washtenaw County. At a Steering Committee meeting, WHI leaders discussed recommendations for future projects including boosting primary care capacity, launching an acute dental care pilot, launching a reduced fee dental care referral program, conducting outreach to ensure more qualified families enrolled in Medicaid health insurance, and more. The WHI, which was originally intended to be a six-month effort, would make a lasting impact on Washtenaw County for years to come.
More than 10 years later, the Washtenaw Health Initiative is a voluntary collaboration between more than 200 individual and organizational stakeholders dedicated to improving health, health care, and health equity of low-income, uninsured, and under-insured populations across Washtenaw County. In these efforts, the WHI supports three active working groups, the WHI Opioid Project, the Washtenaw Healthy Aging Collaborative, and a robust Communications Committee that develops important and timely information to our partners and stakeholders. Supported by CHRT, the Washtenaw Health Initiative helps members and stakeholders work together, within established WHI principles, to:
• Improve coordination across providers and integrate health and human services locally;
• Support community-wide efforts to improve care and services for mental health, substance use, and other health issues impacting vulnerable populations;
• Strengthen community-wide efforts to improve health equity;
• Increase insurance coverage among uninsured individuals and help those with Medicaid and Marketplace health plans maintain their coverage, use it more effectively, and find access to care;
• Help local and regional health agencies reduce service redundancies and use resources more efficiently and effectively; and
• Connect community resources to health care organizations and to each other.
CHRT provides backbone support to the WHI and serves as the initiative’s fiduciary agent. In this role CHRT is responsible for:
• Serving as a neutral convener to facilitate the WHI Steering Committee’s activities (including the WHI’s overall strategic agenda);
• Housing the WHI’s Project Manager, who oversees the WHI’s numerous community-based projects;
• Coordinating regular meetings of various subgroups, and managing WHI communications;
• Hiring and maintaining appropriate administrative and project management staff;
• Conducting data collection, analysis, and reporting for WHI program evaluation;
• Providing additional support through data and policy analysis, work group project plan development, and evaluation; and
• Facilitating connections and discussions across multiple stakeholders.