2011 – 2012 Annual Report

The Washtenaw Health Initiative

In late 2010, community leaders agreed on the importance of developing local solutions to the problems of today while focusing on planning for the future. The Washtenaw Health Initiative (WHI) had its formal start with a planning group meeting in January of 2011, as community leaders came together to discuss how best to help Washtenaw County plan and prepare for implementation of the Patient Protection and Affordable Care Act of 2010. With the sponsorship of both the University of Michigan Health System and Saint Joseph Mercy Health System, a 12-member steering committee was formed. From January to March 2011, the planning group expanded to include more than 40 people from multiple community sectors working together to assess the state of health care for Medicaid recipients, low-income residents, and the uninsured in the county. By July 2011, this group made recommendations to improve access and coordination of care for these populations. The WHI has grown from 40 participants representing 20 organizations to more than 70 participants from more than 40 organizations.

A Community Effort

We are particularly pleased and proud to acknowledge the generous and tireless support of our funders and community members. To date, WHI members provided more than 8,200 volunteer hours in support of WHI projects. The WHI received more than $25,000 and another $86,000 has been committed by our generous community partners:



We are especially grateful for the University of Michigan Health System and Saint Joseph Mercy Health System, without whose sponsorships we would not succeed.

Our Goals

With a focus on Washtenaw County’s Medicaid recipients, low-income residents and the uninsured, the WHI is working toward two major goals for these priority populations:

  • Increasing and maintaining insurance coverage.
  • Improving access to coordinated, integrated care.


Additionally, the WHI seeks to be a model and a resource for other communities considering how best to serve the needs of its most vulnerable citizens.

Our Accomplishments

Since inception, the WHI has made considerable progress toward our goals.

Increasing and Maintaining Coverage

The WHI found that approximately 2,700 residents were eligible but not enrolled in Medicaid. To address this, Department of Human Services caseworkers were co-located within the Washtenaw Health Plan offices to streamline eligibility determination and enrollment. As a result of this new process, more than 1,700 people in our community enrolled in the state’s Medicaid program for the first time or were able to maintain their coverage with the help of these caseworkers. In addition, this program employs two full-time AmeriCorps members who determined eligibility, enrolled residents for Medicaid and other benefits, as well as educated organizations about eligibility for benefits at more than 40 locations.

Improving Access to Coordinated, Integrated Care

The WHI is improving  access to care through better coordination and integration of care.

Specific accomplishments include:

  • Worked with a major dental plan to clarify policies that prevented dentists in Washtenaw County from using sliding-fee scales for their uninsured patients. This enabled the creation of a new reduced-fee dental program. Since June 2012, six dentists agreed to see low-income patients using an income-based fee scale. In the first four months of operation, 19 patients were enrolled in the program.
  • Conducted a detailed analysis of safety net clinics’ capacity to accommodate new primary care patients. The project team developed a detailed business case that is now being considered by the sponsors. The goal is to augment staff in four safety net clinics in the county. Once fully integrated, the intent is for these clinicians to handle an estimated 15,000 additional primary care visits per year.
  • Developed a countywide protocol to streamline the referral process for substance use detoxification and treatment process for patients in the safety net setting.
  • Developed a pilot program to improve access to primary care providers among those newly enrolled in Medicaid. This will be tested in one safety net clinic in 2013 and includes assessment and referral for social service needs as well as processes to improve the likelihood of the newly enrolled receiving their first visits with their primary care providers within 90 days of enrollment.

Building a Model for Community Collaboration and Planning

Additionally, the work of the WHI generated many collaborative activities with WHI partners, demonstrating the synergy that is occurring in Washtenaw County thanks to this initiative:

  • Co-wrote and submitted a $10 million Centers for Medicare & Medicaid Services Innovation grant in collaboration with the University of Michigan Health System and the University of Michigan Depression Center.
  • Facilitated connections between Washtenaw County and the Michigan Department of Community Health that enabled successful submission of a Screening, Brief Intervention, Referral and Treatment grant. This grant will place care managers in local safety net settings to assist residents struggling with substance use.
  • Received several inquiries from other communities to learn more about the WHI and how they might replicate the effort in their own communities.
  • WHI activities have been highlighted in 15 publications.

Looking Ahead

In just a year and a half, the WHI accomplished a great deal; however, there remains much to be accomplished. Projects on the horizon include:

  • Supporting primary care clinicians in diagnosis, treatment, and management of depression symptoms.
  • Enhancing the capacity of the dental care safety net to provide acute and on-going care for uninsured and Medicaid patients.
  • Improving care coordination across the county by supporting care and case managers from many systems to interact and work together on a regular basis.
  • Developing a tool kit for other communities that wish to implement their own voluntary, community-based efforts.


Throughout the next year, the WHI will continue to reassess the needs of the community and develop additional projects to address emerging needs. We look forward to continuing our work improving health care coverage and access to care on behalf of Washtenaw County, and especially its most vulnerable citizens.


For more information, contact:

Carrie A. Rheingans, MPH, MSW

Washtenaw Health Initiative Project Manager



Phone (734) 998-7567

Fax (734) 998-7557


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Download the 2011-2012 Annual Report