Drafter
Clerk 01/17/2013
Title
AN ORDINANCE authorizing the execution of an interagency agreement between King County, the city of Seattle and the state of Washington for potential participation in a demonstration project of a financially integrated care model.
Body
STATEMENT OF FACTS:
1. On April 25, 2012, 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.
2. 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 both Medicaid and Medicare.
3. Approximately thirty-one thousand one hundred fifteen individuals in King County are eligible for both Medicare and Medicaid.
4. The mental health, chemical abuse and dependency services division of the department of community and human services provides mental health and chemical dependency services through a contract with the state to approximately five thousand persons in King County eligible for both Medicare and Medicaid.
5. The city of Seattle Aging and Disability Services, Area Agency on Aging provides case management services through a contract with the state to approximately five thousand six hundred persons eligible for both Medicare and Medicaid in King County.
6. The 2012 Washington state supplemental budget, Section 201(3)(b), Chapter 7, Laws of Washington 2012, provides that participation in the HealthPath demonstration project shall be limited to persons who are eligible for both Medicare and Medicaid who voluntarily elect to enroll in the demonstration project and to counties in which the county legislative authority has agreed to the terms and conditions under which the project will operate.
7. On September 4, 2012, the King County council passed Motion 13716, 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.
8. The executive's office has been negotiating 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.
9. The attached interagency agreement: defines the role of the county in the demonstration project; establishes a project implementation team to which the county will designate two members and the city will designate one member; and describes the agreed-upon financial terms that will impact the county budget beginning January 1, 2014. The agreement is an interim step to determine the county's potential participation in the demonstration project.
10. The county's participation in the demonstration project is contingent upon executive and council approval of the three-way contract between Washington state, the Centers for Medicare and Medicaid Services and successful health plans detailing the terms and conditions of the demonstration project. The three-way contract will be completed in August 2013.
BE IT ORDAINED BY THE COUNCIL OF KING COUNTY:
SECTION 1. The executive is hereby authorized to execute an interagency agreement with Washington state and the city of Seattle as an interim step to determine potential participation in a demonstration project of a financially integrated care model in substantially the form of the attached agreement.
SECTION 2. If the executive approves of a three-way contract between Washington state, the Centers for Medicare and Medicaid Services and apparently successful health plans detailing the terms and conditions of the demonstration project,
the executive shall transmit to the council, for its review and approval by September 30, 2013, a motion detailing the proposed terms and conditions