the local health department’s role in healthcare reform in washington state lauren ho, mph, ches...

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The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local and Territorial Support Centers for Disease Control and Prevention 2015 PHAP Summer Seminar June 2 nd , 2015 Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support

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Page 1: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

The Local Health Department’s Role in Healthcare Reform in Washington State

Lauren Ho, MPH, CHESPublic Health Associate

Office for State, Tribal, Local and Territorial SupportCenters for Disease Control and Prevention

2015 PHAP Summer SeminarJune 2nd , 2015

Centers for Disease Control and Prevention

Office for State, Tribal, Local and Territorial Support

Page 2: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

The Affordable Care Act

Enacted into law in 2010 Two key goals

Expand health care coverage to uninsured Slow Down the rising cost of health care

Expands Coverage Individual Mandate Expands Medicaid (Washington Apple Health) Advanced premium tax credits

Page 3: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Figure 1.0 taken from http://kff.org/health-reform/state-indicator/state-health-insurance-marketplace-types/#map

Page 4: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Lead Organization Service Areas

Figure 2.0 taken from www.wabexchange.org.

Page 5: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Affordable Care Act ImplementationLead Organization Model in WA

Build local network of community-based organizations Focus on target population Comprehensive work plan

Train Assisters within service area County-wide mapped outreach plan Financial agent for network partners Performance monitoring Reporting

Figure 3.0 taken from www.wahealthplanfinder.org. Figure 4.0 taken from www.hca.wa.gov. Figure 5.0 taken from www.tpchd.org.

Page 6: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Pierce County, Washington

One million uninsured in Washington State

100,000 in Pierce county

30,000 eligible for Medicaid Expansion

A quarter of the population needed enrollment assistance

90 percent of newly insured received financial assistance

Figure 6.0 taken from www.tpchd.org.

Page 7: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Target Populations in Pierce County

Page 8: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Barriers to Enrollment

Limited health literacy

Minimal English-language proficiency

Inadequate access points for insurance enrollments

Page 9: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Uninsured Map

Figure 7.0 taken from www.tpchd.org.

Page 10: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Pierce County IPA Network Partnerships with 15 community-based organizations (CBOs) Coordinate outreach, education and enrollment assistance Trained, certified assisters will provide one-on-one support In-Person Assister Role

Tailored support with cultural, linguistic, disability or other special needs

Assist, explain, confirm, and facilitate

Figure 8.0 and 9.0 taken from www.wabexchange.org.

Page 11: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Outreach and Events

Health Fairs

Mall enrollment events

Libraries

Food banks

Utilizing GIS Maps to identify vulnerable populations geographically

Figure 10.0 taken from www.tpchd.org.

Page 12: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Successes

74,469 newly insured residents in Pierce County

300 in-person assisters trained and certified

Tacoma-Pierce County in RAND Corp report

Page 13: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Lessons Learned Building relationships

Tailoring outreach methods

Approaching the next open enrollment with experience and flexibility

Figure 11.0 taken from www.wabexchange.org.

Page 14: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Future Implications

Local health department to mobilize the boots on the ground for major public health efforts

Life after enrollment

Local health department’s future role in the Affordable Care Act

Page 15: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

Special Thanks To:

Abstract co-authors Kayla Scrivner and Antoinette Craig

In-Person Assister Program Team

Tacoma-Pierce County Health Department

Page 16: The Local Health Department’s Role in Healthcare Reform in Washington State Lauren Ho, MPH, CHES Public Health Associate Office for State, Tribal, Local

For more information, please contact CDC’s Office for State, Tribal, Local and Territorial Support

4770 Buford Highway NE, Mailstop E-70, Atlanta, GA 30341Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: http://www.cdc.gov/stltpublichealth

The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Lauren [email protected] ([email protected])

253-798-4762

Centers for Disease Control and Prevention

Office for State, Tribal, Local and Territorial Support