ADVANCE MEETING MATERIALS - JULY 13, 2021 VIRTUAL MEETING Northwest Senior Services Board - Northwest Regional Council
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[Northwest Senior Services Board]
ADVANCE MEETING MATERIALS
JULY 13, 2021
VIRTUAL MEETING
1:00 – 3:30PM
Northwest Regional Council
600 Lakeway Drive
Bellingham, WA 98225
360.676.6749
NWSSB VIRTUAL MEETING INFORMATION Northwest Senior Services Board Tue, July 13, 2021 1:00 PM - 3:30 PM (PDT) Please join my meeting from your computer, tablet or smartphone. https://global.gotomeeting.com/join/323350549 You can also dial in using your phone. United States: +1 (646) 749-3122 Access Code: 323-350-549 New to GoToMeeting? Get the app now and be ready when your first meeting starts: https://global.gotomeeting.com/install/323350549
DocuSign Envelope ID: 45B6BCC9-C7C0-4383-8F82-E2E7DC177805
July 6, 2021
Dear Northwest Senior Services Board Members:
Our next meeting of the NWSSB will be held virtually on Tuesday, July 13th from 1:00
to 3:30 pm. Please see the enclosed instructions to connect to the GoToMeeting
meeting via your computer or phone.
The agenda for the meeting includes:
a discussion on the Federal Emergency Funding;
updates on the 2021 NWRC Budget;
a review of the COVID-19 situation and reopening;
a review of the Strategic Plan; and
an agency update and advocacy discussion.
We cancelled our regular meeting in May, but we will convene our regular July meeting
virtually. Please review the enclosed materials as your perspectives and thoughts are
an important part of the process. If you are unable to attend the meeting, please notify
Elizabeth Anderson on our staff.
The information you will need to connect to the virtual meeting can be found on
the back of the cover page for your reference. If you have trouble connecting to
either meeting, please contact our administrative staff for technical assistance at 360-
676-6749.
Sincerely,
Dan Murphy
Executive Director
Enclosures
An Association of County Governments
Serving the People of Island, San Juan, Skagit and Whatcom Counties
600 Lakeway Drive, Suite 100 – Bellingham, WA 98225 – 360.676.6749- nwrcwa.orgPAGE LEFT INTENTIONALLY BLANK
NORTHWEST SENIOR SERVICES BOARD
Date: July 13, 2021
Time: 1:00pm – 3:30pm
Location: Virtual Meeting (via GoToMeeting)
Agenda
Time Topic Pages Action
Required
1:00-1:05 Regular Meeting Call to Order
Barbara Pesola, Chair
• Introduction of Guests
• Roll Call
• Review of April Minutes 3-6 Motion
• NWSSB Member Renewals
• Announcements
• Public Comments
1:05-1:30 Federal Emergency Funding Verbal Discussion
Dan Murphy, Ryan Blackwell
1:30-2:10 NWRC 2021 Budget Adjustments Presentation Discussion
Dan Murphy
2:10-2:20 Break
2:20-2:40 NWRC Agency Update Presentation Discussion
Dan Murphy, Elizabeth Anderson
• COVID-19 Update
• Strategic Plan Update 7-21 Information
• Q&A
2:40-3:00 Importance of Advocacy for Next Session Verbal Discussion
Dan Murphy
3:00-3:05 State Council on Aging Update (SCOA) Verbal Information
Georgiann Dustin
13:05-3:15 Updates from Our Communities Verbal Discussion
Members
3:30 Adjourn Verbal Motion
Upcoming Northwest Senior Services Board Meetings and Events:
September 14, 2021 Regular Meeting TBD*
November 9, 2021 Regular Meeting TBD*
*These meetings may be virtual due to COVID-19 precautions.
Upcoming Northwest Regional Council Meetings:
July 22, 2021 Governing Board Meeting Virtual
December 9, 2021 Governing Board Meeting TBD*
*This meeting may be virtual due to COVID-19 precautions.
Anyone needing special accommodations to participate in a meeting should
contact NWRC at least 48 hours in advance of the scheduled meeting.
For more information, please contact NWRC at 360-676-6749 or 1-800-585-6749, 600
Lakeway Drive, Bellingham WA 98225.
2Northwest Senior Services Board Meeting Minutes
April 13, 2021
Members Present In-Person: None
Members Present via GoToMeeting or Telephonically: Alberta Horn, Barb Pesola,
Bob Monize, Carl Bender, Denise Irey, Doug Cornelsen, George Edward, Georgiann
Dustin, Jana Finkbonner, Kathleen O'Connor, Marshall Gartenlaub, Shirley Forslof,
Stephen Shubert, Tasker Robinette, Wendy Gilbert, Mary Kanter, Jennifer Lautenbach.
Members Absent: Anna Ankrum, Shirley Bennett, Jodi Sipes
Staff Present GoToMeeting or Telephonically: Dan Murphy, Elizabeth Anderson,
Kristine Glasgow, Ryan Blackwell, Katie Zimmermann, and Jeri Johansen.
Guests Present via GoToMeeting or Telephonically: None.
_________________________________________________________________
Call to Order (Barb Pesola) at 1:02 PM
GoToMeeting Reminders
Guests: None
Roll Call
Barbara Pesola: Welcomed new member Jennifer Lautenbach.
Review of January Minutes:
Motion put forward by the board president, Barb Pesola to accept the minutes from the
1/12/21 meeting.
Shirley Forslof: Amend minutes from January 12 meeting to indicate that Shirley
Bennett was helping with Coupeville vaccinations - for clarification.
Motion made by: Bob Monize
Seconded: Shirley Forslof
Result: Approved
Announcements: None
Public Comment: None
Federal Funding Allocation Recommendations:
Consolidated Appropriations Act, American Rescue Plan Act
Dan Murphy
Presentation of and recommendations made for distribution of additional Federal
Coronavirus Response Older Americans Act funding.
1
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3Discussion ensued with reference to:
Table 1: Total New Funding
Table 2: Reserve and Administrative Funding
Table 4: Proposed New Funding by County
(See NWSSB Advanced Meeting Materials, pages 7, 8 and 9)
Questions were raised by Stephen Shubert, Carl Bender, Marshall Gartenlaub, and Bob
Monize such as; how the funds break down for San Juan County, how the 15% reserve
funding was used, if the funding will allow for increases to individual family providers,
and what the administrative costs are.
Dan Murphy and Ryan Blackwell addressed each question to the satisfaction of each
member. San Juan County will negotiate the funds allocated to them, the 15% reserve
will be used much the same as previous-allocating all of the reserve, and funding to
family caregiver support, administrative costs are approximately 6-7%.
Proposed Motion: The NWRC Board authorizes the acceptance of $1,969,600 into the
disaster relief line of the NWRC budget, that 10% be used to cover administrative costs,
15% be held in reserve, and the balance distributed to major providers based on their
current share of Older American’s Act and volunteer services funding.
Motion made by: Stephen Shubert
Seconded: Jana Finkbonner
Result: Approved
Proposed Motion: The NWRC Board authorizes the Executive Director to review
provider plans for the use of the emergency funds, amend contracts to disburse these
funds immediately, and requires the Executive Director to report on progress and submit
any related budget amendments to the NWRC Board at its July meeting.
Motion made by: Stephen Shubert
Seconded: Jana Finkbonner
Result: Approved
NWRC Vaccination Efforts and Collaborations
Katie Zimmerman
Katie Zimmermann gave a presentation of the vaccination outreach efforts and
successes in collaboration with hospitals, other counties, and health departments.
Future plans for outreach via mail and the possibility of mobile vaccination stations for
those who cannot get to standard vaccination sites or who might be homebound.
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4Discussion ensued with questions from Jana Finkbonner, Barbara Pesola, Carl Bender,
Mary Kanter and comments from members. The consensus being that the tribes have
been very active in helping get extra vaccines to those who need them working through
our tribal liaisons. San Juan and Island County have been very successful in their
vaccination programs and that the percentages of vaccinations given overall are
encouraging.
Dan Murphy thanked Katie and her team for their efforts in helping those who wish to
get the vaccinations have the ability to do so.
Break for 10 minutes
2:00 p.m. NWSSB meeting resumed.
NWRC Agency Update
Dan Murphy
Dan shared the changes to our Governing Board, including four new members.
• Current state of NWRC services
Much of our staff is still working remotely. Recovery is encouraging and staff are
able to get the vaccination. We may be able to conduct face-to-face home visits
on a limited basis with full protective equipment if needed. We are still a ways
away from normal. What we have learned that works well in working remotely
may stay in place moving forward. We expect to have a plan for a gradual
opening of NWRC in front of the Governing Board for the July meeting.
• Future Considerations
The communications consultant we have conferred with will be providing
information on a plan to make NWRC more visible. How can we provide better
social and case management services to help clients have better access to
programs. Elizabeth Anderson will be looking at the possibility of addressing
substance use treatment for older adults and adults with disabilities.
Discussions included the possibility to see case studies to share on substance use in
client(s), models that work well for help with substance use, and the possibility of
inviting county commissioners to our meetings in the future. Dan Murphy stated for the
record, “That’s a good idea!”
Legislative Update
Ryan Blackwell and Dan Murphy
Overview of legislative and budget timelines.
• Budget Updates and Developments
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5Two bills passing through are of particular note HB1323, concerning the long-
term services and supports trust program and HB1120, concerning state of
emergency operations impacting long-term services and supports.
Explanation and discussion of impacts ensued.
State Council on Aging Update (SCOA):
Georgiann Dustin
Listen to legislative representatives, such as weekly updates with Debra Leckanoff.
Extend invite to attend NWSSB meetings to the various county representatives.
Governor’s mandate to addressing senior’s isolation and socialization, Georgiann was
one of those appointed to represent SCOA. Some of the suggestions provided by this
group will be printed in a pamphlet, regarding isolation and socialization solutions for
seniors.
Discussion inviting county representatives to visit NWSSB meetings continued.
Updates from Our Communities
Members shared updates from their communities.
Shirley Forslof: Invitations to join the Whatcom County Senior Center were mailed out
recently.
Marshall Gartenlaub: John Oliver is a comedian with a focus on home care and
specifically Washington – quite good.
Adjourn:
Motion put forward that there being no further business this meeting is adjourned.
Motion made by: Bob Monize
Seconded: Shirley Forslof
Result: Approved.
The meeting adjourned at 2:49 p.m.
_________________________________
Jerilyn (Jeri) Johansen, Receptionist/Administrative Aide
Reviewed and approved by the Northwest Senior Services Board at the July 13,
2021 meeting.
_________________________________
Barbara Pesola, NWSSB Chair
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6NORTHWEST
REGIONAL COUNCIL
— 2020 - 2023 —
Strategic Plan
Summary of Goals
2022 – 2023 Update
Page 1
7Building a Long-Term Services and Supports (LTSS)
System to Meet Complex Needs
PROFILE
Washington state is a national leader in offering home and community-based Long-
Term Services and Supports (LTSS) for people with significant disabilities.
Washington’s publicly funded home and community-based services support people with
moderate to severe physical limitations, as well as those who have medically complex
conditions, often also accompanied by significant behavioral and cognitive challenges.
Those who need and qualify for publicly funded supports, who do not want to move to a
nursing home, can choose to receive care in an adult family home, in assisted living, or
at home.
Most people, about 75%, choose to receive care in their homes.
As health care options for those with disabilities and complex conditions improve, people
achieve increased wellness and independence and more people are able to remain
successfully living at home longer. Unfortunately, the health care system often is
confusing and provides fragmented care. That can create daunting challenges for those
with complex conditions who must interact frequently with that fragmented system, often
for the remainder of their lives.
Some specific concerns in Island, San Juan, Skagit, and Whatcom Counties are:
• Those who need LTSS use community-based in-home and residential options at a
lower rate than the rest of the state.
• The percentage of LTSS recipients in the region with a mental health diagnosis who
obtained treatment is below the statewide average.
• The rate of emergency room use among LTSS recipients in the region is higher than
the comparable state average.
• Funding for case management of in-home LTSS services is 26% short of what is
necessary to provide those critical services at the necessary level.
• The recently passed Long- Term Care Trust Act will provide private funding for LTSS
in 2025 and will shift the approach to delivering LTSS from its long-standing Medicaid-
centric orientation.
Page 2
8NWRC HAS THREE MAIN GOALS IN THIS FOCUS AREA:
• Provide person-centered, in-home LTSS, integrated with health care, for older adults
& adults with disabilities to allow them to remain as independent, healthy, & safe as
possible.
• Provide person-centered coordination of health and community supports for people
with significant health challenges, including mental health and substance use, to
improve their health and reduce avoidable health care costs.
• Represent the interests of families, consumers, and providers in shaping the access to,
the scope, quality, and availability of services, and the consumer protections that will
be essential to delivery of services under the Long-Term Care Trust Act.
HOW WILL NWRC ACHIEVE THESE GOALS?
1. We will continue to develop and expand an integrated, robust, and
multidisciplinary in-home care management system.
Maintain the average number of individuals served each month for:
Average served per month: 2020 2020 2021 2022 2023
Goal Achieved Goal Goal Goal
Care Transitions* 25 18.6 25 20 25 20 25
Recovery Based Care Coordination 45 33.3 45 45 45
Supportive Housing 25 20.2 25 - -
2022-2023 Update: Care Transitions work at PeaceHealth St. Joseph Hospital in
Whatcom County has shifted slightly and we are in the middle of revamping how we
count “transitions” work and have adjusted the 2022 & 2023 goals to reflect this
change.
Increase the average number of individuals served each month for:
Average served per month: 2020 2020 2021 2022 2023
Goal Achieved Goal Goal Goal
In-Home LTSS 1,850 1864.9 1,925 2,000 2,075
In-Home Behavioral Mental Health 75 83.8 135 100 175 175
Counseling Program* 125 150
Health Home Care Coordination** 1,175 1122.3 1,210 1,200 1,200
1,235 1,250
2022-2023 Update: *Behavioral Health name changed to reflect integration of mental
health and substance use. The goals shown are for the counseling program and
changed due to program growth and an increase in counseling staff from 3 clinicians
to 7 in 2021. **Health Home Care Coordination goals were reduced to reflect the shift
in program focus and the effect of Medicare Part C impacting client eligibility for care
coordination services.
Page 3
9HOW WILL NWRC ACHIEVE THESE GOALS? (Continued)
Participate in planning for sustainment of supportive housing services after the
Medicaid Transformation Demonstration funding ends in 2021.
2022-2023 Update: This funding ends in 2021.
Develop recommendations for substance abuse models that are effective for older
adults and individuals with disabilities. Goals for 2022 & 2023 TBD.
2022-2023 Update: Substance Use Program is in development at this time. The
license with Department of Health is in pending status.
Develop and implement jail transitions models as our member counties have
interest and resources.
2022-2023 Update: Discontinued due to lack of funding for this service.
Develop hospital transitions care coordination models for our member counties
as health care providers have interest and resources
2022-2023 Update: *This remains a goal and has been implemented in Whatcom
and Skagit Counties.
2. We will maintain a comprehensive network of quality in-home service providers
to address the complex needs of the individuals we serve and to prepare for
services in the Long-Term Care Trust Act.
Complete a utilization inventory of in-home contracted services.
2022-2023 Update: In process.
Compare utilization with client need based on assessments and location.
2022-2023 Update: Remains a goal.
Identify gaps in service supply or referral patterns, and develop strategies to
close them.
2022-2023 Update: Remains a goal.
Page 4
10HOW WILL NWRC ACHIEVE THESE GOALS? (Continued)
3. We will represent the interests of families, consumers, and providers in shaping
the access, scope, quality, and availability of services, along with the consumer
protections, that will be essential to delivery of services under the Long- Term
Care Trust Act.
Represent the Washington Association of Area Agencies on Aging on the LTC
Trust Commission.
2022-2023 Update: In process and remains a goal.
Identify and advocate at a statewide level for:
• Approaches to access and eligibility that make LTC Trust Act services locally
available and provides the information beneficiaries need to make the most
efficient use of their benefit.
• Infrastructure and service design changes that will efficiently make services
provided by NWRC and its’ contactors available to LTC Trust Act
beneficiaries.
• Consumer protections that are necessary to protect against price- gouging,
fraud, conflict of interest, and service quality problems.
• Methods to assure continuity of care for individuals, who exhaust their LTC
Trust Act benefits, but continue to need services.
• Design of infrastructure, marketing, and other functions that are appropriate
for the delivery of an insurance benefit, and that distinguish delivery of LTC
Trust Act insurance benefits from the delivery of Medicaid entitlement
benefits.
• Any necessary legislative changes.
2022-2023 Update: In process and remains a goal.
Page 5
11Supporting Family Caregivers and People
Impacted by Dementia
PROFILE
It is clear that families want to support their loved ones, but may not realize or be
prepared for the challenges. Caregivers often have difficulty maintaining work/life
balance and many report that caregiving significantly affects their work. Among working
caregivers, 69% report having to rearrange their work schedule, decrease their hours, or
take unpaid leave in order to provide care. Few have the resources or insurance options
to pay privately when they need help. For many, the path can quickly lead to the Medicaid
program, which next to family care- givers, is the major source of long-term services and
supports.
Providing care can also impact the caregiver’s physical and mental health. From a
National Alliance for Caregiving and AARP study of caregivers:
• 11% report that caregiving has caused their physical health to deteriorate.
• 21% of older caregivers caring for those age 65+ report a higher degree of
physical strain, compared to 13% who are younger.
• Caregivers of those with emotional or mental health issues are more likely to
report a decline in their own health (28% vs. 12%).
• Caring for people with dementia is reported to impact a person's immune sys-
tem for up to 3 years after the caregiving experience ends, which increases the
caregiver’s chance of developing a chronic illness.
• 40% to 70% have symptoms of depression with about a quarter to half of them
meeting the diagnostic criteria for major depression.
There are about 900,000 family caregivers in Washington. Eighty percent of the care
for older adults and others who face difficulty accomplishing routine daily activities on
their own is provided without pay. Almost a third provide care for someone with
memory loss, including Alzheimer’s or another form of dementia.
• Washington has an estimated 110,000 individuals with Alzheimer’s disease or a
related dementia. By 2025 that will increase by 36% to 150,000.
• In a statewide survey of families affected by dementia, almost half said it was
difficult to get a clinical diagnosis.
• From that same survey, just 14% received information about community re-
sources. Only one in ten were referred to an Alzheimer’s organization.
• Although early stage detection of dementia is important, a statewide survey of
clinicians reports that most cognitive screening is performed when the clinician
has a concern. Only 20% of clinicians perform an annual screening.
Page 6
12The NWRC Family Caregiver Support Program (FCSP) provides access to a range of
supports tailored to the individual caregiver’s strengths and needs. About half of FCSP
clients are caregivers of people who have dementia, another third care for individuals with
other memory or cognitive problems. FCSP provides a spectrum of support for all stages
of caregiving and services are distributed throughout the four county region. However, it
is estimated that NWRC’s FCSP reaches only about 1% of the potential number of
family caregivers in our region.
NWRC HAS TWO MAIN GOALS IN THIS FOCUS AREA:
To aid family caregivers who need help accomplishing daily activities provide as
much care as possible, for as long as possible.
To provide support for people and families affected by Alzheimer’s disease or other
forms of dementia.
HOW WILL NWRC ACHIEVE THESE GOALS?
1. We will continue to develop and expand family caregiver supports throughout
the region using federal resources through the end of Medicaid Transformation
Demonstration in 2021.
Year Average Number of Caregivers
Per Month
2020 Goal 360 (20% waiver funded)
2020 Achieved 341.8 (Average per month
achieved)
2021 Goal 380 (20% waiver funded)
Work with DSHS and the state legislature to develop post waiver funding vehicles
and resources to sustain at least 2021 levels of support for family caregivers
2022-2023 Update: In process and remains a goal.
2. We will assess best program fit for people without caregivers who are served
with waiver resources and adjust program scope accordingly.
Year Average Number Without
Caregivers Per Month
2020 Goal 115
2020 Achieved 134.7 (Average per
month achieved)
2021 Goal 120
Page 7
13HOW WILL NWRC ACHIEVE THESE GOALS? (Continued)
3. We will maintain a comprehensive network of quality caregiver support providers to
address the needs of the caregivers we serve, and to prepare for services in the
Long-Term Care Trust Act.
Complete an inventory of current utilization of contracted services.
Compare utilization with client need based on assessments and location.
Identify any gaps in service supply or referral patterns, and develop strategies to close
them.
2022-2023 Update: The inventory process is in development and remains a goal.
4. We will advocate for state funding of comprehensive elements of the state dementia
action plan.
2022-2023 Update: This is in process and remains a goal.
5. We will maintain the availability of caregiver and dementia support groups
throughout the region, and as resources are available, expand when possible.
Year Number of Support Group Sessions
2020 Goal 156
2020 Achieved 273 (Achieved for the year)
2021 Goal 156
2022 Goal 156
2022 Goal 156
2022-2023 Update: This is in process and goals for the upcoming years remain active.
6. We will maintain the availability Evidence-Based workshops (Chronic Disease Self-
Management, Powerful Tools for Caregivers) throughout the region, and as
resources are available, expand when possible.
Year Number of Workshops
2020 Goal 21
2020 Achieved 7 (for the year)
2021 Goal 21
2022 Goal 21
2023 Goal 21
2022-2023 Update: This is in process and goals for the upcoming years remain active. The
numbers for 2020 were impacted by the COVID-19 pandemic and the impact on future
years is still to be determined.
Page 8
14Providing Information and Access
PROFILE
According to a national survey, trends and developments in the requests for services
continue to change and grow. Results from this survey indicate that services associated with
benefits outreach, access, and enrollment are in demand. In addition, the most frequently
requested topics include financial assistance, health insurance counseling, Medicaid benefits,
utility assistance, food assistance, Medicare, and prescription drug assistance.
Accessing services and programs that assist older adults and people with disabilities
can be confusing. An Internet search for the phrases “long-term care” or “disabilities” yields
thousands of hits, many of them selling products or services that may or may not be relevant
to the person’s needs. Telephone calls made to many of the private or governmental
organizations can result in equally bewildering descriptions of programs, services, insurance
coverages and limitations, along with opportunities to spend resources. Individuals and
families are often overwhelmed by trying to sort out the best option. By the time many people
reach out for help, they may have unnecessarily wasted time and resources, and are often in
crisis.
To help address the need for accurate, impartial information, to help with accessing needed
services, and to sort through confusing options, NWRC has designated focal points in each
county to help provide information and support for people who face challenges related
to aging and disabilities.
Island County: Senior Information & Assistance Program
Oak Harbor Office South Whidbey Office Camano Island Office
51 SE Jerome 14594 SR 525 606 Arrowhead Road
Oak Harbor WA 98277 Langley WA 98260 Camano Island WA 98282
(360) 675-0311 (360) 321-1600 (360) 387-6201
San Juan County: Senior Information & Assistance Program
Lopez Island Orcas Island San Juan Island
Woodmen Hall Senior Center Mullis Community Center
4102 Fisherman Bay Road 62 Henry Road 589 Nash Street
PO Box 154 PO Box 1146 PO Box 951
Lopez WA 98261 Eastsound WA 98245 Friday Harbor WA 98250
(360) 370-7521 360) 376-2677 V/TDD 360) 378-2677
Skagit County: Aging & Disability Resources Program (Northwest Regional Council)
301 Valley Mall Way, Suite 100, Mount Vernon WA 98273 (360) 428-1301
Whatcom County: Aging & Disability Resources Program (Northwest Regional Council)
600 Lakeway Drive, Bellingham, WA 98225 (360) 738-2500
Page 9
15Unfortunately, Washington does not have a new or sustainable revenue source to
fund expansion of outreach, information, assistance, and options counseling to meet the
demand driven by the increasing numbers of people who face aging and disability
challenges.
NWRC HAS ONE MAIN GOAL IN THIS FOCUS AREA:
To provide outreach, information, assistance, and options and benefits counseling for
people with aging or disability related challenges, who are trying to plan for their
needs, or who are lost as they try to understand the confusing and complex array of
programs, supports, and options that may assist them.
HOW WILL NWRC ACHIEVE THIS GOAL?
We will continue to maintain capacity (and expand as resources allow) to provide
information and assistance services that are in high-demand in each of our counties.
Information and Assistance Contacts
Year Unduplicated Clients Total Number of Contacts
2020 Goal 8,000 18,000
2020 Achieved 8,514 (for the year)* 28,371 (for the year)*
2021 Goal 8,000 18,000
2022 Goal 8,000 18,000
2023 Goal 8,000 18,000
2022-2023 Update: *The Number of contacts as a goal has been discontinued due to
difficulty in tracking this accurately. Adjustments will be made to the 2021, 2022, and
2023 goals if needed.
Build access funding into all major program initiatives.
2022-2023 Update: Remains in process and a goal.
Improve the Internet presence of our community information focal points,
including social media.
2022-2023 Update: This goal is in process and we are working with an agency that has
been contracted to redesign our brand identity and website.
Work in collaboration with the local tribes as detailed in the 7.01 Implementation
Plan.
2022-2023 Update: Remains in process and a goal.
Page 10
16Increasing Capacity to Meet Transportation Needs
PROFILE
NWRC currently manages a transportation network that provides non-emergent
transportation to all people eligible for Medicaid who are without transportation to
medical services. Transportation is provided in Island, San Juan, Skagit, and Whatcom
Counties, along with transportation out of the region for specialty services. Each month,
NWRC transportation provides an average of 15,124 trips.
Dispatch services are available during regular business hours during the workweek and after
hours for urgent care, hospital discharges, and emergency department visits. To facilitate
these rides, NWRC has a network of transportation providers, including:
• Eleven taxi and accessible van companies
• A charter boat
• An airline
• A shuttle van service
• Fuel services at nine gas stations
• Agreements with Tribal providers and volunteer organizations
• Booking arrangements with twenty hotels
These providers have capacity to provide additional transportation services if non-
Medicaid resources are made available. This capacity could respond to transportation
needs frequently identified in community needs surveys.
NWRC HAS TWO MAIN GOALS IN THIS FOCUS AREA:
• To help individuals with transportation needs access needed services.
• To leverage NWRC transportation brokerage and network capabilities to meet
additional transportation demand.
HOW WILL NWRC ACHIEVE THESE GOALS?
1. We will continue to provide essential transportation to Medicaid services with
exceptional customer service.
Increase the number of trips provided by 5% each year, based on Medicaid
expansion trends.
Page 11
17HOW WILL NWRC ACHIEVE THESE GOALS? (Continued)
Year Number of Trips
2020 Goal 192,000
2020 Achieved 103,004 (for the year)
2021 Goal 201,600
2022 Goal 211,680
2023 Goal 222,264
2022-2023 Update: Due to the COVID-19 pandemic the number of trips were
significantly reduced. The goal for the remaining years will remain as we continue to
assess the impact of the crisis on the numbers.
2. We will measure current brokerage and network capacity for additional rides in
each county and identify gaps.
Create analysis of brokerage and network capacity in a report.
2022-2023 Update: Remains in process and a goal.
3. We will seek additional funding sources for transportation services, including
Medicare Advantage plans, Medication Assisted Therapies, outpatient therapies,
Work First, and McKinney-Vento.
Explore contracting possibilities with three of the potential funders identified above.
2022-2023 Update: Remains in process and a goal.
Page 12
18Providing Quality Health Care in the Whatcom County Jail
PROFILE
Whatcom County operates two jail facilities and one juvenile detention facility. The Whatcom
County jail is a maximum-security facility responsible for the incarceration of approximately
245 inmates daily. The second adult facility is a minimum-security Interim Work Center that
averages 130 minimum or low- medium custody and alternative corrections inmates. The
total combined number of adults currently under supervision ranges from 275-320 per day.
There are approximately 7000 new bookings per year. Whatcom County also operates a
Juvenile Detention Facility with an average daily population of seven.
The average length of stay for the combined adult facilities is currently 8 days. This has
been steadily dropping due to the local criminal justice system emphasis on alternatives to
incarceration. There is rapid turnover of incarcerated adults, with approximately 60%
released from custody within 72 hours.
The majority of the incarcerated adult population has pre-existing health conditions when
they are booked into jail that often include a combination chronic medical concerns that
are the result of lifestyle choices and a lack of regular health care in the community. The
majority of this population also has some involvement and use of a variety of illegal and
legal substances, and a significant proportion have a co-occurring diagnosis of serious
mental illness (SMI).
Some of the most frequent health conditions are addiction and infections secondary to
intravenous drug use, SMI complicated by personality disorders, non-compliance with
treatment plans for illnesses such as systemic infections, diabetes, hypertension, cardiac
and gastrointestinal disorders and traumatic injury due to fighting, self-harm, or injuries
occurring prior to incarceration, such as from motor vehicle accidents.
Washington state health data has determined that Whatcom County has one of the highest
rates of opioid use in the state. This, coupled with the lack of availability of community
providers of Medication Assisted Treatment (MAT) services, led to the development of a
MAT program in the Whatcom County jail. As of the last quarter of 2018, the Whatcom
County Health Program began a three-phase response program for incarcerated individuals
addicted to Opioids. There is a great deal of support for the program from the local treatment
community.
Since 2013, NWRC has contracted with Whatcom County (WC) to deliver the health care
services to the population incarcerated at the WC Jail. These services are provided in
compliance with the National Commission on Correctional Health Care (NCCHC) 2018
Standards for Health Services in Jails.
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19NWRC Jail Health services include:
• Triaging patients at booking and when requested by Corrections;
• Reviewing receiving screens developed at booking;
• Gathering of information from each patient’s outside providers to assure that
treatments, medications, and conditions are appropriately identified and treated with
continuity;
• Treating urgent needs;
• Assessing and treating chronic and acute conditions;
• Assessing eligible patients with Opioid Use Disorder and enrolling them in the most
appropriate of three Medication Assisted Response programs (Medication Assisted
Withdrawal, Medication Assisted Treatment, or Medication Assisted Induction);
• Assessing and treating patients for withdrawal of other substances of abuse
(alcohol, benzodiazepine, etc.);
• Procuring and delivering prescribed medications;
• Referring for specialized treatment when necessary;
• Responding to patient request for treatment or care;
• Operating daily clinics (7 days per week at the Main Jail; 4 days per week at the
Work Center and at Juvenile Detention) to provide requested or required care for
patients including diagnosis, treatment, and referral when necessary;
• Providing health education;
• Supporting and referring to allied professional staff for psychosocial
interventions and services;
• Maintaining an accurate and organized medical records system;
NWRC HAS TWO MAIN GOALS IN THIS FOCUS AREA:
1. To maintain quality daily health care treatment and support for the people in
custody in the Whatcom County Jail.
2. To expand supports for incarcerated individuals experiencing opioid addiction and
transitioning back to the community with complex medical conditions.
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20HOW WILL NWRC ACHIEVE THOSE GOALS?
We will maintain NCCHC certification.
We will continue to provide:
Year Nurse Exams in Facilitate/support patients to be
the jail clinic seen in clinic by other
providers - (MD, Dentist, ARNP)
2020 Goal 4,590 950
2020 Achieved 3,406 (for the year) 996 (for the year)
2020 Goal 4,749 4,680 969
2020 Goal 4,845 4,775 988
2020 Goal 4,943 4,872 1,010
2022-2023 Update: Jail clinic numbers updated to reflect a likely increase in exams.
Expand elements of Medication Assisted Response to Opioid Use program to
include: Medication assisted withdrawal; Medication assisted treatment; Medication
assisted induction.
2022-2023 Update: Continue to expand elements of the Medication Assisted Response to
Opioid Use program, with the goal of providing a low barrier program.
Develop and implement a Navigation/Care Coordinator program to help offenders
with complex health conditions transition from the jail to the community.
2022-2023 Update: Discontinued due to lack of funding for this service.
Participate in the implementation of an Electronic Medical Record (EMR) system for
the jail health program.
2022-2023 Update: In process and remains a goal.
Coordinate with Whatcom County Health Department in developing and implementing
a plan for increasing accessibility to vaccinations for the jail population.
2022-2023 Update: Whatcom County Jail Health has been approved to administer
vaccinations. Jail Health will offer COVID vaccines to all patients and will begin offering
immunizations during the initial health assessment.
2022-2023 Update: New goals added to reflect current program needs.
Continue coordination with Corrections leadership and the Whatcom County Health Department
to update COVID protocols, as needed.
Assist in exploring options for a dental suite in the clinic to expand the dental services provided
on site.
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