BILL REQ. #:  H-1103.1 

Read first time 01/26/09.   Referred to Committee on Health Care & Wellness.

     AN ACT Relating to community health care collaborative grants; amending RCW 41.05.220; adding new sections to chapter 41.05 RCW; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 41.05.220 and 1998 c 245 s 38 are each amended to read as follows:
     (1) State general funds appropriated to the department of health for the purposes of funding community health centers to provide primary health and dental care services, migrant health services, and maternity health care services shall be transferred to the state health care authority. Any related administrative funds expended by the department of health for this purpose shall also be transferred to the health care authority. The health care authority shall ((exclusively)) expend these funds through contracts with community health centers to provide primary health and dental care services, migrant health services, and maternity health care services. The administrator of the health care authority shall establish requirements necessary to assure community health centers provide quality health care services that are appropriate and effective and are delivered in a cost-efficient manner. The administrator shall further assure that community health centers have appropriate referral arrangements for acute care and medical specialty services not provided by the community health centers.
     (2) The authority, in consultation with the department of health, shall work with community and migrant health clinics and other providers of care to underserved populations, to ensure that the number of people of color and underserved people receiving access to managed care is expanded in proportion to need, based upon demographic data.
     (3) Within funds appropriated for community health care collaborative grants, the authority may award grants for community-based health care collaborative programs that increase access to appropriate, affordable health care for Washington residents, consistent with requirements established by sections 2 through 4 of this act.

NEW SECTION.  Sec. 2   A new section is added to chapter 41.05 RCW to read as follows:
     (1) The community health care collaborative grant program is established to further the efforts of community-based coalitions to increase access to appropriate, affordable health care for Washington residents, particularly employed low-income persons and children in school who are uninsured and underinsured, through local programs addressing one or more of the following: (a) Access to medical treatment; (b) the efficient use of health care resources; and (c) quality of care.
     (2) Consistent with funds appropriated for community health care collaborative grants specifically for this purpose or for community grants established under RCW 41.05.220, two-year grants of up to five hundred thousand dollars per organization may be awarded pursuant to section 3 of this act by the administrator of the health care authority.
     (3) The health care authority shall provide administrative support for the program. Administrative support activities may include health care authority facilitation of statewide discussions regarding best practices and standardized performance measures among grantees, or subcontracting for such discussions.
     (4) Eligibility for community health care collaborative grants shall be limited to nonprofit organizations established to serve a defined geographic region. To be eligible, a nonprofit organization must have a formal collaborative governance structure and decision-making process that includes representation by hospitals, public health, behavioral health, community health centers, rural health clinics, and private practitioners that serve low-income persons in the region, unless there are no such providers within the region, or providers decline or refuse to participate or place unreasonable conditions on their participation. The nature and format of the application, and the application procedure, shall be determined by the administrator of the health care authority. At a minimum, each application shall: (a) Identify the geographic region served by the organization; (b) show how the structure and operation of the organization reflects the interests of, and is accountable to, this region and members providing care within this region; (c) indicate the size of the grant being requested, and how the money will be spent; and (d) include sufficient information for an evaluation of the application based on the criteria established in section 3 of this act.

NEW SECTION.  Sec. 3   A new section is added to chapter 41.05 RCW to read as follows:
     (1) The community health care collaborative grants shall be awarded on a competitive basis based on a determination of which applicant organization will best serve the purposes of the grant program established in section 2 of this act. In making this determination, priority for funding shall be given to the applicants that demonstrate:
     (a) The initiatives to be supported by the community health care collaborative grant are likely to address, in a measurable fashion, documented health care access and quality improvement goals aligned with state health policy priorities and needs within the region to be served;
     (b) An applicant organization documents formal, active collaboration among key community partners that includes local governments, school districts, large and small businesses, nonprofit organizations, carriers, private health care providers, and public health agencies;
     (c) The applicant organization will match the community health care collaborative grant with funds from other sources. The health care authority may award grants solely to organizations providing at least two dollars in matching funds for each community health care collaborative grant dollar awarded;
     (d) The community health care collaborative grant will enhance the long-term capacity of the applicant organization and its members to serve the region's documented health care access needs, including the sustainability of the programs to be supported by the community health care collaborative grant;
     (e) The initiatives to be supported by the community health care collaborative grant reflect creative, innovative approaches which complement and enhance existing efforts to address the needs of the uninsured and underinsured and, if successful, could be replicated in other areas of the state; and
     (f) The programs to be supported by the community health care collaborative grant make efficient and cost-effective use of available funds through administrative simplification and improvements in the structure and operation of the health care delivery system.
     (2) The administrator of the health care authority shall endeavor to disburse community health care collaborative grant funds throughout the state, supporting collaborative initiatives of differing sizes and scales, serving at-risk populations.
     (3) One-half the total amount of any award shall be disbursed to an organization upon its selection as a community health care collaborative grant recipient. The grantee shall submit quarterly performance reports on standard outcome measures among all grantees that show:
     (a) Improved access to care and a medical home;
     (b) Increased enrollment in coverage of the uninsured;
     (c) Decreased unnecessary emergency room use; and
     (d) Long-term sustainability.
     (4) The remaining portion of the community health care collaborative grant award must be disbursed one year later if the administrator of the health care authority (a) timely receives all quarterly progress reports from the organization and (b) determines that the organization is satisfactorily serving the purposes of the community health care collaborative grant program and meeting the objectives identified in its application regarding: Access to medical treatment; the efficient use of health care resources; and quality of care.

NEW SECTION.  Sec. 4   A new section is added to chapter 41.05 RCW to read as follows:
     By July 1st of each fiscal year the administrator of the health care authority shall provide the governor and the legislature with an evaluation of the community health care collaborative grant program, describing the organizations and collaborative initiatives funded and the results achieved. Particularly successful coalitions shall be highlighted with recommendations on whether, and how they could be replicated statewide. The evaluation shall also summarize any recommendations from the participating grantees regarding ways to improve the community health care collaborative grant program and for the state to otherwise support community-based coalitions working to improve access to health care and quality improvement for Washington residents, including any changes in state statutes or regulations.

NEW SECTION.  Sec. 5   The health care authority may adopt rules to implement this act.