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The Patient and Protection Affordable Care Act (ACA) was signed into law on March 23rd. The most sweeping health care reform the U.S. had seen in decades, the ACA was meant to dramatically increase access to health insurance for those without employer-sponsored care, to expand access to Medicaid for low-income Americans, and to encourage states to develop and explore innovative medical care delivery methods designed to lower the cost, and improve the quality, of health care.
WHI Focus: Engaging Stakeholders
In 2011, in response to the passing of the Affordable Care Act, a group of dedicated community members—later called the Washtenaw Health Initiative—came together to prepare local safety-net clinics to respond to an influx of newly eligible Medicaid patients. After six months of community conversations, as well as historical research, the volunteers published their first report, titled A Picture of Healthcare in Washtenaw County. The report highlighted a series of significant health care challenges for low-income and uninsured populations across Washtenaw County.
WHI Focus: Identifying community health needs
In 2012, the WHI clearly defined their organizational structure and started long-lasting projects. The WHI developed workgroups composed of volunteers to further the group's work. Workgroups initiated Acute Dental Care, which referred patients from the Emergency Room to local dental clinics, and BlueCaid, which referred new Medicaid patients to social services and a primary care physician. The WHI also completed the Substance Use Detox Protocol, a guide for responding to substance use disorders.
WHI Focus: developing a common agenda
In 2013, members of the Washtenaw Health Initiative traveled to Lansing to discuss Michigan’s Medicaid expansion, which would allow more Michiganders to be eligible for health care insurance. Partly thanks to the WHI, and other advocates across the state, Governor Synder signed the bill into law. 2013 was also the first year of the marketplace exchange. The WHI’s Medicaid and Marketplace Outreach and Enrollment workgroup helped dozens of residents enroll in 2013 and every year following.
WHI Focus: education and advocacy
In 2014, leaders of the WHI’s Mental Health and Substance Use Disorder (MHSUD) workgroup investigated successful collaborative care models across the country to identify best practices. They then designed a pilot to test those strategies closer to home by treating individuals with mild to moderate mental health diagnoses at safety-net clinics across Washtenaw County. The WHI’s role: Securing funding for the pilot and providing strategic and administrative support to get it off the ground.
WHI Focus: Securing funding for pilots
Beginning in 2012, the Washtenaw Health Initiative's Advance Care Planning group investigated hospice and end-of-life care. In 2015, the group hosted a movie showing and a facilitated discussion at the Michigan Theater and began developing their end-of-life conversation guide, titled: Making Your Healthcare Wishes Known. The group's work was highlighted in a Michigan Radio interview.
WHI Focus: Communicating with the public
In 2016, WHI and CHRT were chosen by the State of Michigan to be the coordinating organizations for the Washtenaw and Livingston County Community Health Innovation Region (CHIR) State Innovation Model (SIM) intervention. Together, the WHI and CHRT facilitated conversations between more than a dozen local organizations as they developed a novel three-year care coordination pilot to reduce emergency department visits and connect vulnerable patients to care.
WHI Focus: Testing new approaches
Washtenaw County residents voted two to one to approve the county's Public Safety and Mental Health Preservation Millage in November 2017. Prior to the vote, WHI staff reps volunteers conducted a Mental Health and Substance Use Service Gaps Assessment that helped build the case for the millage. The assessment, which was developed from information gathered during key stakeholder interviews, addressed capacity shortages, funding gaps, and proposed solutions.
WHI Focus: Setting agendas for reform
In 2018, the WHI’s Opioid Project hosted the first Opioid Summit and the State Innovation Model committee hosted the first systems change convenings to discuss substance use care and prevention. Together, these events reached over 400 people, serving to reduce stigma and strategically plan for the county’s coordinated response to substance use disorders.
WHI Focus: Fostering systems change
In 2019, the Vital Seniors Initiative launched. The Ann Arbor Community Foundation funded 6 innovation ideas. WHI and CHRT would serve in a backbone role for grantee organizations. Each project uniquely addressed challenges commonly faced by Washtenaw County seniors to allow seniors to stay in their homes as long as they are able. The WHI would help organizations map out barriers to care for seniors, strategically plan and implement their programs, evaluate the success of their program, and provide guidance on sustaining the initiatives.
WHI Focus: Mutually reinforcing activities
In July, the WHI renamed the Medical Care Coordination pilot previously under their State Innovation Model the MI Community Care (MiCC). With new funding, the WHI and several hublets would continue the intervention aimed at reducing emergency department visits and connecting vulnerable patients to care
WHI Focus: Sustainability planning
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