Drafter
Clerk 08/30/2012
Title
A MOTION supporting the executive's negotiation of potential participation in a demonstration project of a financially integrated care model for individuals eligible for both Medicare and Medicaid in which medical, mental health, substance abuse and long term care services would be purchased through a managed care organization.
Body
WHEREAS, the Washington state Department of Social and Health Services, Aging and Disability Services Administration, and the Washington state Health Care Authority jointly submitted a proposal, titled HealthPath Washington, to the Centers for Medicare and Medicaid Services to create a model that improves the quality, coordination and cost-effectiveness of the Medicare and Medicaid system for individuals eligible for both Medicare and Medicaid, and
WHEREAS, the HealthPath Washington proposal includes a strategy that provides a financially integrated model in which medical, mental health, substance abuse and long term care services would be purchased through a managed care organization for individuals dually eligible for Medicaid and Medicare, and
WHEREAS, approximately thirty-one thousand one hundred fifteen individuals in King County are eligible for both Medicare and Medicaid, and
WHEREAS, the mental health, chemical abuse and dependency services division of the department of community and human services is responsible for providing mental health and substance abuse services to approximately five thousand beneficiaries in King County eligible for both Medicare and Medicaid, and
WHEREAS, the city of Seattle Aging and Disability Services, Area Agency on Aging is responsible for providing case management services to approximately five thousand six hundred beneficiaries eligible for both Medicare and Medicaid in King County, and
WHEREAS, the 2012 Washington state budget, Section 201(3) (b), Chapter 7, Laws of Washington 2012, states that participation in the HealthPath demonstration project may be limited to persons who are eligible for both Medicare and Medicaid and shall be limited to counties in which the county legislative authority has agreed to the terms and conditions under which the project will operate, and
WHEREAS, King County is currently negotiating with the state and other counties to develop terms and conditions for participation in a financially integrated model; and
WHEREAS, King County is committed to increasing access to healthcare, improving health outcomes for its residents and reducing overall per capita costs;
NOW, THEREFORE, BE IT MOVED by the Council of King County:
A. The King County council supports the executive's negotiation of potential participation in a demonstration project of a financially integrated care model where medical, mental health, substance abuse and long term care services would be purchased through a managed care organization.
B. As required by 2012 Washington state budget, Section 201( 3)(b), Chapter 7, Laws of Washington 2012, the executive is authorized to negotiate with the state Department of Social and Health Services and Health Care Authority on the terms and conditions of King County's potential participation in the financially integrated model.
C. If the executive, Washington state and the Centers for Medicare and Medicaid Services mutually agree on the terms and conditions for King County's participation in the financially integrated model, the executive shall transmit to council for its review and approval a motion detailing the proposed terms and conditions by November 29, 2012.
Final council action on the proposed terms and conditions is needed no later than January 28, 2013.