Chair-Stephen Kutz Cowlitz Tribe

Vice-Chair- Cheryl Rasar Swinomish Indian American Indian Health Commission for Washington State Community Quarterly Meeting Tulalip KIF Health Clinic, Tulalip, WA Treasurer-Andrew Shogren February 21, 2018 Suquamish Tribe 9 am to 3:30 pm

Secretary- Charlene Minutes: Nelson Shoalwater Bay Tribe Welcome/Invocation- Tulalip Tribal Elder; Introduction to Health Services at the Tulalip Karen I. Fryberg Health Clinic, Jim Steinruck, Health Director Member-at-Large Tulalip Tribe Aren Sparck Seattle Indian Health Establish Quorum – Charlene Nelson, Secretary Board

Delegates in attendance: Chehalis, Cowlitz, Jamestown S’Klallam, Kalispel, Makah, Executive Director Samish, Shoalwater Bay, Squaxin Island, Suquamish, Swinomish, Tulalip. Quorum Vicki Lowe established. Joined later by Upper Skagit, Seattle Indian Health Board, NATIVE Project Member Tribes: and American Indian Community Center. Chehalis Colville Introductions – Attending in person: Maureen Kinley, Lummi Nation; Todd Dixon, Cowlitz OIC; Steve Valandra, OIC; Veronica Smith, Lummi Nation; Terra Horton, AIHC; Vicki Jamestown S’Klallam Lowe, AIHC, Lou Schmitz, AIHC; Cheryl Rasar, Swinomish Indian Community; Melissa Kalispel Naemi, HCA; Sue Steward, NPAIHB; Jan Olmstead, AIHC; Jen Estroff, Coordinated Lower Elwha Klallam Care; Jim Steinruck, Tulalip Tribes; Charlene Nelson, Shoalwater Bay Tribe; Sarah Lummi Desautel, DH/HCA; Tina Anderson, HCA; Debbie Jones, Samish Tribe; Leah Muasal, Makah Muckleshoot OIO/DSHS; Cindy Gamble, AIHC; Sarah Sullivan, NPAIHB; Charlene Abrahamson, AIHC; Nisqually Onora Lien, NWHRN; Deb Sosa, WAHBE; Charlie Mitchell, NOHLA; Janet Varon, Nooksack NOHLA; Heather Erb, AIHC; Jessie Dean, HCA: Francesca Murnan; SIHB; Marilyn Scott, Port Gamble S’Klallam Upper Skagit Tribe; Robert May, American Naturopathic Association Puyallup Quileute Attending via webinar: Kathryn Akeah, AIHC; Marietta Bobba, DSHS; Deryl Brown- Quinault Archie, Muckleshoot Tribe; Natalie Christopherson, CHPW; Tim Collins, OIP/DSHS; Samish Sauk-Suiattle Libby Cope, Makah Tribe; Kay Culbertson, Cowlitz Tribe; Alexandria Desautel, Kalispel Shoalwater Bay Tribe; Dylan Dressler, NATIVE Project; Tamara Fulwyler, DOH; Maria Gardipee, AIHC; Skokomish Christy Hoff, SBOH; Vickie LaFromboise, Amerigroup; Carolyn Leptich, Amerigroup; Snoqualmie Rhonda Martinez-McFarland, CMS Region X; Lucilla Mendoza, DBHR/HCA; Lena Spokane Nachand, HCA; Leah Niccolocci, Chehalis Tribe; Jennifer Olson, AIHC; Lisa Rey Squaxin Island Stillaguamish Thomas, AIHC; Andrew Shogren, Suquamish Tribe; Brent Simcosky, Jamestown Suquamish S’Klallam Tribe; Shad St. Paul, Spokane Tribe; John Stephens, Swinomish Tribe; Kim Swinomish Thompson, Shoalwater Bay Tribe; Denise Walker, Chehalis Tribe; Lisa Wells, Nisqually Tulalip Tribe; Matthew Whitacre, Lower Elwha Klallam Tribe; Connie Whitener, Squaxin Upper Skagit Island Tribe. Yakama Member Organizations: Seattle Indian Health 1 Board AIHC Delegates Quarterly Meeting Minutes 2-21-19 NATIVE Project of Spokane American Indian Community Center

Approval of Agenda -Samish moved, Cowlitz seconded approval of agenda. Motion carried

Prior Meeting Minutes- Samish moved, Swinomish seconded approval of December 12, 2018 meeting minutes. Motion carried.

State Agency Reports:

Health Care Authority- Jessie Dean, Administrator Tribal Affairs; Lena Nachand, Tribal Liaison- Medicaid Transformation

• Peer SUD Consultant SPA will be Feb. 25 form 3 pm- 5pm at the HCA/Apple conference room. At the last roundtable, the Medicaid rules that apply to payment for services provided by a peer support counselor were shared: Patient must have a specific treatment plan, with specific goals, PSC must be under the supervision of a state defined provider. However, if a PSC is SBERT certified, they be paid to provide up to 4 brief interventions and provide some crisis services. • Tribal FQHC SPA- SPA complete, Dear Tribal Leader Letter has gone out, 1st roundtable Feb. 15th, next one will be March 1 with Consultation at the MTM on March 6th from 11-12:30. HCA will use expedited process to submit SPA to CMS after March 6th which triggers 90- day response time frame for CMS. Discussion on need for CMS Consultation, since the SPA is based on Montana SPA language that has been approved by CMS, the hope is it will just go through. If not, then will look into the need for consultation. • Consultation Policy- Hoped to have it ready for the meeting today, due to inclement weather, this was not possible. Hope to have ready for review and we should still be on track to have it signed at the Centennial Accord in the fall. • Tribal Contracting, formerly consolidated contracting under DSHS, will be referred to Indian Nation Agreement, similar to Indian STCs. This will be one agreement per program with a Tribe. Marilyn asked that the agreement can be shared asap with the Tribes so the can go through their internal legal process. If there is not enough time for this process, Marilyn requested that the DSHS agreement be extended. Jessie added the STCs will be sent out with a synopsis of what it is for and a crosswalk from the DSHS contract. • PCCM-Currently Tribal and UIHP Clinics receive $3 per member per month to provide primary case care management. The program is currently not in compliance with the Medicaid Managed Care rules that came out in July of 2016. As part of updated the program and bringing it into compliance, there will be more reporting and 24-hour call requirements, as example. However, updating the program will also include updating payment that has been the same wince the 1990s, additional payments for enhancements such as using the Health Information Exchange, patient medical homes and diabetes education. • MCO ability to pay encounter rate should begin mid-July. Provider One needs to be updated.

Dept. of Behavioral Health and Rehabilitation- Lucilla Mendoza, Tribal Behavioral Health Administrator

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• Picked a new date for Opioid Response Workgroup, March 12 2 pm-4m. • Peace Health in Vancouver reached out about an inpatient hospital ward that is closed down. Steve and Charlene will be meeting with them tomorrow to discuss the possibility of use as a Tribal facility. Current I.H.S. hospital inpatient rate is $3400. Jessie shared that the Tribal FQHC SPA includes reference to Tribal Behavioral Health inpatient facility. • Opioid Media Campaign- (see attachment: https://drive.google.com/file/d/162Yv9- rmZ9hs2IuJLXNba_eoO9ndNkvy/view ) TOR and SOR funds can be used to work with DH for media campaign. UIHPs can access services as DH as well. Both Lummi and Suquamish have done work around the Good Samaritan law and will share. http://watribalopioidsolutions.com/

Office of the Insurance Commissioner- Steve Valandra, Tribal Liaison, Todd Dixon, SHIBA

For the Behavioral Health Parity survey, two questions as suggested by Tribes/UIHP will be added:1) List provider networks that include Tribal and UIHP and 2) do insurers reimburse Tribal/UIHP providers for traditional health services. Results by Sept.

Priority bill for commissioner: Legislation on balance/surprise billing, through Health Committee, in Appropriations, Senate bill through Health Committee, now in Ways and Means. More information on this bill can be found here: https://www.insurance.wa.gov/surprise-medical-billing

Dept. of Health - Tamara Fulwyler, Tribal Relations Director Connected DOH staff to HCA staff working on Peer support counselors and how they will be certified.

State Board of Health / Governor’s Interagency Council on Health Disparities- Christy Hoff, Manager, SBOH Public health rules the board have authority over are currently being updated. Counsel’s priorities - statewide to promote equity within state agencies. Gov. Inslee allocate $2 million in HB 1783/SB5776 to create Washington State office of Equity. The Governor’s Health Disparities Council would convene a task force to come up with a strategic plan for Office of Equity. Health Impact reviews are analysis that are done on bills- look to see what the potential impacts of legislation on health and equity are. Steve is the Tribal representative on SBOH.

Northwest Health Care Response Network- Onora Lein, Executive Director (see presentation) left government and became non-profit in 2014, does west side, Spokane Regional Network for Eastside.

NOON - Lunch - from Ryan’s REZ-ipes (Tulalip Tribal Member business)

Northwest Portland Indian Heatlh Board Updates:

Federal Legislation- Sarah Sullivan, Government Policy Analyst https://drive.google.com/file/d/1hTW_C1xAt9Qp4GcJEci4eECuTsmzKF1d/view

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CHAP/DHAT- Susan Steward https://drive.google.com/file/d/1yXXVRpqc40yWKqkQmVjsHP1LaRKuJd2J/view https://aihc-wa.com/wp- content/uploads/2019/02/Alternative_Training_Matrix_for_BHA_Certification_2017-06.pdf

Naturopathic Legislation- Robert May, ND, Executive Director, Washington Association of Naturopathic Physicians 2019 Legislation and Administrative Advocacy- Janet Varon, Executive Director, Northwest Law Advocates https://aihc-wa.com/wp-content/uploads/2019/02/Northwest-Law-Advocates-2018YearInReview.pdf

AIHC Grant Updates:

Public Health -Pulling Together for Wellness -Jan Olmstead, https://aihc-wa.com/wp-content/uploads/2019/03/PHEPR-Pulling-Together-for-Wellness-Update.pdf Public Health- Women, Infant Children, Maternal Infant Health -Cindy Gamble, Public Health- Cross Jurisdictional Collaboration -Medical Countermeasures Project Report- Lou Schmitz, Heather Erb Access to Healthcare- Tribal Coordinating Entity- Vicki Lowe Access to Healthcare- Tribal Evaluation and Treatment Facility- Charlene Abrahamson https://aihc-wa.com/wp-content/uploads/2019/02/Tribal-ET-Higher-Level-Overview-Presentation-2-20- 2019.pdf AIHC Business-Resolutions and matters requiring delegation vote

Resolution 2019-001 Regarding CDC Guidance Medical Counter Measures Resolution 2019-002 Regarding Maternal Infant Health Work and Funding

Chairperson’s Report- Steve Kutz, Chair

Public Health Services

Executive Director’s Report- Vicki Lowe, Executive Director

Update on Legislation AIHC Website

Executive Session (as needed)/Other Business:

Adjourn

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