Background on the Governor’s Indian Health Advisory Council
Tribal Leaders, Urban Indian Health Program Leaders and their staff have been working with the State to address issues from the implementation of managed care in the Medicaid system in Washington State. Issues were identified through the 2013 Tribal Centric Behavioral Health Report to the Legislature and Tribal consultation for the 1915 b and 1115 Medicaid waivers that change the way Medicaid services are provided in this State.
Through this process, a Tribal Issues Grid was jointly developed by the state and tribal representatives to track resolution of issues. From the fall of 2015 until July 1, 2017, issues identified as program or operational were addressed through workgroups, round tables and consultation. The remaining issues were identified as needing “a legislative fix.”
The Washington Indian Health Care Improvement Act (WIHCIA) was developed to resolve these legislative issues. This is also part of a three-year plan (insert link to 3-year plan) to improve the Medicaid Fee for Services system that has been adversely impacted by the changes made to the Washington State Medicaid Program through waivers and use of managed care entities and to enhance the 100% FMAP savings in the state
A proviso in the 2019 budget funds $200,000 to the Washington State Health Care Authority to further develop how these issues will be addressed. The proviso includes the convening of the Governor’s Indian Health Advisory Council. Council membership consists of:
- Representation from each tribe in Washington state, designated by the tribal legislative body, who is either the Tribe’s American Indian Health Commission (AIHC) delegate or the Tribes designee;
- Tribal Liaison from the Health Care Authority (HCA), Department of Children, Youth and Families (DCYF); Department of Commerce; Department of Corrections; Department of Health (DOH); Department of Social and Health Services (DSHS); Office of the Insurance Commissioner (OIC); Office of the Superintendent of Public Instruction (OSPI); and Washington Health Benefit Exchange (WAHBE);
- CEO of the Indian Health Service Portland area office and each service unit in Washington state or his or her designee;
- CEO of each Urban Indian Health Program (UIHP) in Washington state or his or her designee who may be the urban Indian health program’s American Indian health commission for Washington state delegate;
- Executive Director of AIHC or his or her designee;
- Executive Director of the Northwest Portland Area Indian Health Board (NPAIHB) or his or her designee;
- One member from each of the two largest caucuses of both the House of Representatives and Senate, appointed by the speaker of the House of Representatives or Senate, or his or her designee;
- Two individuals representing the governor’s office.
Between July 1 and December 21, 2018, this Council met four times to guide the development of the report to the legislature with recommendations for moving these solutions forward.
The Governor’s Indian Health Advisory Council Meeting schedule:
July 16, 2018- Hosted at Lummi Nation
November 7th and 8th, 2018, Hosted at the Suquamish Tribe
December 11, 2018- Hosted at Squaxin Island Tribe
December 21, 2018- via webinar
At the December 21st meeting the council voted to approve the report to be submitted to the Legislature. To review the final report, please click on the link below:
The report included legislation to establish to:
- Help expand 100% FMAP to payments made to specialty care providers, expanding the fee for service network and allowing for those providers to be paid more than Medicaid Fee for Services rates.
- Establish continuation of Governor’s Indian Health Advisory Council
- Establish the Tribal Health Reinvestment Account to keep the savings from going into the general funds and redirect back to improve the Fee for Services program so more savings can be achieved.
- Establish Reinvestment Committee of the Governor’s Indian Health Advisory Council to set a plan for how savings will be spent.
Since the report, the legislation has been updated by the Code Revisor so it could official be submitted as a bill. Follow the process for this bill on our Legislative page: