>>> GOOD MORNING AND THANK YOU
ALL FOR JOINING THE HOUSING
HEALTH ENERGY AND RIGHTS
COMMITTEE.
TODAY IS THURSDAY, MARCH 7,
2019.
THE HOUSING HEALTH ENERGY AND
WORKERS RIGHTS WILL COME TO
ORDER.
I'M TERESA MOSQUEDA.
THE CHAIR . I WILL GO AHEAD AND
START WITH THE PUBLIC TESTIMONY
SINCE WE HAVE ONE PERSON SIGNED
UP TO TESTIFY.
THERE ARE TWO ITEMS ON THE
AGENDA TODAY.
MISTER ZIMMERMAN FOR YOUR
COMMENTS, WE HAVE A FIRST
BRIEFING ON THE MEDICAL
DEMONSTRATION TRANSFORMATION
WAIVER AND EVERYTHING FROM
SEATTLE HOUSING AUTHORITY.
GO AHEAD AND START YOUR TWO
MINUTES.
>>
IT'S WORKING?
GOOD.
MY NAME IS ALEXANDER AND I WANT
TO SPEAK ABOUT HOUSING.
I COME TO THIS PLACE TO SPEAK
MORE THAN 2000 TIMES AND
HOUSING IS THE GOAL NUMBER ONE.
WE NEED APPROXIMATELY 300,000
HOUSING FOR POOR PEOPLE AND FOR
MANY YEARS, I COME TO THIS
PLACE.
FIXING THIS PROBLEM IS VERY
EASY BUT THEY ARE BILLIONS OF
PEOPLE THAT MAKE LESS THAN
$40,000 PER YEAR AND MORE THAN
30%.
LET'S MAKE EVERYONE EQUAL.
HOW WE CAN FIX THIS.
NUMBER ONE, SEATTLE RIGHT NOW
RECOGNIZED FROM EAST COAST TO
WEST COAST LIKE NUMBER ONE CITY
IN THE AMERICA.
TO CHANGE HIS POLITICAL
PHILOSOPHY, NOTHING WILL BE
CHANGED.
NUMBER TWO, WHAT IS ABSOLUTELY
CRITICAL, ALL OF THE CONSULS
NEED TO COME OUT RIGHT NOW.
THIS IS EXACTLY WHAT IS THIS
SUPPOSED TO DO.
WE HAVE A CONSOLE BECAUSE WE
ARE LATE AND CONSTITUTION FIVE
TIMES LIKE GONZALES.
SHE SHOULD BE GOING TO JAIL FOR
LIFETIME BUT HERE DOESN'T
CHANGE.
>> MISTER ZIMMERMAN . ITEMS ON
THE AGENDA.
>> NO, NO, IT'S NUMBER TWO .
IT'S VERY SIMPLE BUSINESS
LOCATION.
SO, PLEASE, LISTEN TO THIS AND
STAND UP SEATTLE AND SEND UP
AND CHANGE THE RULES.
THANK YOU VERY MUCH.
CHANCE OF ANYONE US ANYONE ELSE
HERE TO SIGN UP FOR PUBLIC
TESTIMONY?
THAT WILL INCLUDE PUBLIC
TESTIMONY FOR TODAY.
THANK YOU VERY MUCH MISTER
ZIMMERMAN.
I WOULD FIRST LIKE TO TAKE A
QUICK MINUTE TO SAY HAPPY
INTERNATIONAL WOMEN'S DAY.
TOMORROW WE WILL BE CELEBRATING
AND WHETHER OR NOT WE ARE OUT
THERE PROTESTING AND
COMPOUNDING INEQUALITIES OR
CELEBRATING THE CONTRIBUTIONS
OF WOMEN ACROSS THIS WORLD, WE
NEED TO TAKE TIME TO REFLECT
AND DO SELF-CARE ABOUT HOW WE
ARE WORKING TO CHANGE THE
CURRENT CONTEXT OF INEQUALITIES
AND TO ENSURE THAT WOMEN TRULY
DO HAVE EQUAL RIGHTS.
SO, WE SEE YOU.
WHETHER YOU ARE OUT THERE
TRYING TO HAVE BUSINESS AS
USUAL ARE DOING YOUR DAILY JOB
THAT MAY BE DOES NOT GET
RECOGNIZED EVERY DAY, WE SEE
YOU.
IT'S INTERNATIONAL EVENTS A AND
WE RECOGNIZE YOU AND THANK YOU
FOR ALL YOU HAVE DONE
ESPECIALLY TO ALL THE WOMEN IN
MY LIFE IF MY MOM IS WATCHING
AND TO MY SISTER AND MY GRANDMA
AND ALL OF OUR FAMILY AND
FRIENDS AND ESPECIALLY TO OUR
ALL WOMEN'S OFFICE. IT'S AN
INCREDIBLE HONOR TO WORK WITH
YOU EVERY DAY AND THE WOMEN IN
CENTRAL STAFF AND THE MAJORITY
COUNCIL OF WOMEN. THANK YOU FOR
ALL THE WORK THAT YOU DO.
WE ALSO WANT TO RECOGNIZE THE
INCREDIBLE WORK THAT THE CITY
HAS DONE AND TO MAKE SURE THAT
THE WORKERS IN THE CITY WHETHER
OR NOT YOU ARE IN SEATTLE CITY
LIGHT, WE HAVE TALKED OFTEN AND
THE FOLKS WE WILL BE TALKING
ABOUT TODAY THE HAVE
DISPROPORTIONATE HEALTH
OUTCOMES AS WOMEN AND HAVING
OUR HEALTHCARE ACCESS
CONSTANTLY THREATENED.
WE ARE CONTINUING TO FIGHT IN
SEATTLE TO STAND UP AND FIGHT
FOR RIGHTS IN THE WORK BASED
AND EQUAL RIGHTS IN TERMS OF
ACCESS TO EQUAL PAY AND
HEALTHCARE ACCESS.
WE ALSO WANT TO MAKE SURE THAT
WE ARE RECOGNIZING ALL OF THE
LABORERS WHO ARE WOMEN ACROSS
VARIOUS SECTORS FOR YOUR
CONTRIBUTION TO MAKE SURE THAT
WE DO BETTER IN TERMS OF NOT
JUST ACCEPTING $.78 ON THE
DOLLAR BUT RECOGNIZING THAT
EVEN THOUGH WE HAVE INCREASED
PENNEY BY PENNY AND YEAR-BY-YEAR
SINCE 2012, WE HAVE ACTUALLY
DECREASED FROM $.80 ON THE
DOLLAR SO WE HAVE SOME ROOM TO
MAKE UP FOR.
WE WILL KEEP FIGHTING AND ONE
OF THE WAYS WE ARE DOING THAT
IS ON THE TOPIC WE ARE TALKING
ABOUT TODAY WHICH IS ENSURING
EQUAL ACCESS TO HEALTHCARE.
THAT IS AN ECONOMIC STIMULUS
AND ALSO ECONOMIC STABILIZER.
ONE OF THE BIGGEST ISSUES THAT
I WILL BE WORKING ON IS ACCESS
TO AFFORDABLE CHILDCARE BROUGHT
THE CITY.
WE KNOW WHEN WE COUPLE
CHILDCARE WITH ACCESS TO
HOUSING AND MAKE SURE THAT
FOLKS NOT ONLY DON'T HAVE TO
RUSH HOME AND WORRY ABOUT AN
HOUR AND A HALF COMMUTE AND
CATCHING MULTIPLE BUSES AND
WHETHER OR NOT THEY WILL BE
OVERCHARGED BY DAYCARE WHO ARE
PROMINENTLY WOMEN AS WELL, WHEN
WE CREATE GREATER ACCESS AND
SHOW THAT IT IS AFFORDABLE,
THAT IS AN EQUALIZER AS WELL.
ONE OF THE BIG ISSUES THAT WE
ARE TALKING ABOUT IS ACCESS TO
HOUSTON.
WE KNOW THAT WOMEN AND PEOPLE
OF COLOR AND MEMBERS OF THE
TRENTON COMMUNITY ARE MORE
LIKELY TO HAVE DISCRIMINATION.
WE WANT TO MAKE SURE THAT AS WE
CELEBRATE INTERNATIONAL WOMEN'S
DAY, WE ARE THINKING ABOUT
HEALTHCARE AND ECONOMIC
STABILITY AND ACCESS TO HOUSING
AN EARLY LEARNING AND EDUCATION.
THANK YOU ALSO TO THE WOMEN OF
COLOR SPECIFICALLY IN SEATTLE
WHO WORK FOR OUR DEPARTMENTS
EVERY DAY.
WE ALSO SEE AND HEAR THE
RESULTS FROM THE JEWELS JUSTICE
WORK.
I KNOW OUR OFFICE HAS BEEN
PARTICIPATING IN THE TASK FORCE
TO ADDRESS SEXUAL HARASSMENT
AND ASSAULT AND WE SAW THE MOST
RECENT STATISTICS THAT SAID NOT
ONLY WAS THERE DISCRIMINATION
BASED ON GENDER BUT COMPOUNDED
BY RACE AND ETHNICITY. THAT IS
UNACCEPTABLE TO US.
WE TAKE A MOMENT TO CELEBRATE
AND WE ALSO RECOGNIZE THAT WE
HAVE A LOT OF WORK TO DO TO
ENSURE THAT OUR INTERSECTIONAL
APPROACH TO CREATING GREATER
JUSTICE FOR ALL AND THE CITY
REALLY DOES START WITH US AND
WE ARE LOOKING FORWARD TO
CELEBRATING ALL THAT WOMEN HAVE
BROUGHT TO THE SUCCESS OF THIS
INCREDIBLE CITY AND RECOGNIZING
THAT WE HAVE SO MUCH MORE TO DO.
WITH THAT, LET'S TALK ABOUT
HEALTHCARE.
D MIND-READING INTO THE AGENDA
ITEM NUMBER ONE?
>> AGENDA NUMBER ONE, MEDICAID
DEMONSTRATION TRANSFORMATION
FOR BRIEFING AND DISCUSSION.
>> WELCOME.
THANK YOU SO MUCH FOR BEING
HERE.
SO, WE ARE LUCKY TODAY TO HAVE
JEFF SAKUMA AND SUSAN
McLAUGHLIN TO SHARE WITH US A
LITTLE BIT ABOUT THE MEDICAID
DEMONSTRATION TRANSFORMATION.
I KEEP SAYING WAIVER AND IF
THAT IS THE APPROPRIATE TERM,
YOU GUYS CAN HELP US OUT.
WE ARE VERY EXCITED ABOUT THIS
AND GIVEN OUR WORK ON THE BOARD
OF HEALTH AND OUR ONGOING
OFFICES WITH CONTINUED
COMMITMENT TO CREATING OUR
REGIONAL HELP WHEN, WE HAVE
BEEN WORKING CLOSELY WITH KING
COUNTY PARTNERS AND VERY
INTERESTED IN MARRYING WHAT WE
SEE IN SAN FRANCISCO AND LA
WHICH IS A TRUE SAFETY NET
HEALTH PLAN FOR THOSE WHO ARE
PRICED OUT OR EXCLUDED FROM
OPTIONS IF THEY DON'T GET IT
FROM THEIR EMPLOYER.
WE LOVE HEALTH IN THIS
COMMITTEE AND WE ALSO KNOW THAT
OUR OPTIONS FOR POLICY AT THE
CITY OF SEATTLE AREN'T AS GREAT
AS THEY ARE AT KING COUNTY SO
REALLY RELYING ON A PARTNERSHIP
WITH ALL OF YOU AND PERHAPS
THERE ARE WAYS IN WHICH WE CAN
STEP UP OUR EFFORTS THAT WE ARE
NOT AWARE OF.
CAME FORWARD TO HEARING THE
PRESENTATION TODAY AND MORE
ABOUT HOW WE CAN BE HELPFUL AND
CONTRIBUTE MORE TO THE
TRANSFORMATION EFFORTS.
>> PERFECT, THANK YOU FOR THE
INTRODUCTION.
HOPEFULLY WE WILL BE ABLE TO
SORT OF DEMONSTRATE THIS
ALIGNMENT THAT WE HAVE AT THE
CITY WITH WHAT IS GOING ON.
I LOVED YOUR OPENING.
WHAT CAME TO MIND VERY QUICKLY
WAS MY 93-YEAR-OLD MOTHER AND
THREE OLDER SISTERS WHO RAISED
A VERY WOMAN CENTERED MAN IN
THIS COMMUNITY TO UNDERSTAND
AND APPRECIATE.
>> I LOVE THAT.
YOU ARE GIVING ME GOOSEBUMPS
AND I ALREADY TEARED UP EARLIER
SO IT WILL BE A GOOD DAY.
>> OKAY, SO, THANK YOU FOR THIS
OPPORTUNITY AND SUSAN HERE
WILL TAKE A BOOK OF THIS.
I REALLY APPRECIATE THE FACT
THAT WE HAVE BEEN ABLE TO HIRE
SUCH AN AMAZING LEADER FOR THIS
VERY IMPORTANT PROJECT.
AGAIN, MY NAME IS JEFF SAKUMA.
I AM THE HEALTH INTEGRATION
STRATEGIST AND THE HUMAN
SERVICES DEPARTMENT HERE IN THE
CITY OF SEATTLE. I ALSO AND THE
CITY OF SEATTLE REPRESENTATIVE
ON THE GOVERNING BOARD.
SO, WE ARE GOING TO GO THROUGH
A SERIES OF SLIDES THAT WILL
TALK VERY SPECIFICALLY ABOUT
THE MEDICAID TRANSFORMATION
WAIVER AND SPECIFICALLY WHAT WE
ARE HERE TO FOCUS ON AND THAT
IS INITIATIVE ONE.
IS A THREE-PART WAIVER BUT WE
WILL TALK ABOUT THAT IN JUST A
SECOND.
OUR GOAL HERE AS YOU WILL FIND
OUT AND A LOT OF OUR WORK
OBVIOUSLY IS VERY FOCUSED RIGHT
NOW ON PEOPLE WHO ARE ON
MEDICAID IN OUR COMMUNITY BUT
OUR GOAL AS YOU WILL SEE IS
MUCH BROADER IN TERMS OF TRYING
TO IMPACT THE HEALTH OF ALL THE
FOLKS HERE IN THE CITY AND IN
THE COUNTY AND IN THE STATE OF
WASHINGTON.
SO, I WILL LET SUSAN TAKE IT
FROM HERE.
>> THANK YOU, JEFF AND THANK
YOU COUNCILMEMBER MOSQUEDA FOR
INVITING ME.
I'M EXCITED TO HAVE THE
OPPORTUNITY TO TALK TO YOU
TODAY AND SHARE WHAT WE ARE
DOING AND HEAR OUR STRATEGY
LEASE FOR 2019 AND GOING BEYOND.
I TOO ECHO THE THANKS FOR THE
INTRODUCTION.
THAT WAS WONDERFUL AND
EMPOWERING AND APPRECIATIVE OF
THE CITY OF SEATTLE'S FOCUS ON
WOMEN AND EQUALITY, GENDER
EQUALITY SO THANK YOU.
SO, I AM THE EXECUTIVE DIRECTOR
, SUSAN McLAUGHLIN.
I AM THE EXECUTIVE DIRECTOR OF
HEALTHIER HERE.
I THOUGHT I WOULD START BY
TELLING YOU A LITTLE BIT ABOUT
WHO WE ARE.
HEALTHIER HERE IS A NONPROFIT
ORGANIZATION AND WE ARE
DEDICATED TO IMPROVING THE
HEALTH AND WELL-BEING OF PEOPLE
IN KING COUNTY THROUGH
INNOVATIVE CROSS SECTOR
COLLABORATIONS.
SO, WE ARE WORKING IN
PARTNERSHIP WITH THE HEALTHCARE
PROVIDERS IN OUR COMMUNITY AS
WELL AS COMMUNITY-BASED
ORGANIZATIONS AND SOCIAL
SERVICE AGENCIES SO THAT WE CAN
CATALYZE AND TEST NEW AND
BETTER WAYS TO RESPOND TO THE
HEALTH AND SOCIAL PROBLEMS OF
OUR REGION.
ESPECIALLY FOR THOSE THAT ARE
MOST VULNERABLE.
YOU TALKED ABOUT THE
STRENGTHENING OF THE SAFETY NET
AND THAT IS VERY IMPORTANT TO US
AS WELL AND MAKING SURE THAT
PEOPLE HAVE ACCESS TO CARE AND
AS JEFF MENTIONED, THE MEDICAID
TRANSFORMATION PROJECT IS
REALLY FOCUSED ON THE MEDICAID
POPULATION AND THE GOALS OF
HEALTHIER HERE ARE FROM PEOPLE
FROM THE REGION AND THE ENTIRE
REGION IN PARTICULAR WITH
REDUCING HEALTH DISPARITIES AND
WE WANT THE SYSTEM TO WORK
BETTER REGARDLESS OF HOW THEY
ACCESS THEIR HEALTHCARE.
HEALTHIER HERE HAS A MULTI-STAKE
GOVERNING BOARD AND IT HELPS
MEDICAL AND BEHAVIORAL HEALTH
PROVIDERS.
OUR HOSPITAL HEALTH SYSTEMS AND
ALL THE LOCAL TRIBES ARE
COMMUNITY-BASED ORGANIZATIONS
OF THE MEDICAID MANAGED CARE
ORGANIZATIONS.
WE HAVE CITY AND COUNTY
GOVERNMENT SEATS ARE PRESENTED
AND FOUNDATIONS AS WELL AS
ADVOCATES AND CONSUMERS ON OUR
GOVERNING BOARD.
HEALTHIERHERE HAS A STAFF OF
ABOUT 15 PEOPLE RIGHT NOW THAT
PROVIDE THE BACKBONE FUNCTIONS
TO ENSURE THAT WE HAVE SUCCESS
IN THE TRANSFORMATION GOALS
THAT WE HAVE SET OUT FOR THE
REGION.
HEALTHIERHERE IS CONTRACTED TO
BE THE ACCOUNTABLE COMMUNITY OF
HEALTH OR ACH THROUGH SHORT.
WHAT THAT MEANS IS INTEREST IN
THE PROJECT BUT WE EXPECT TO
HAVE MORE OF A DIVERSE PORTFOLIO
THAT INCLUDE GRANTS AND
COMMUNITY AND PROVIDER AND
PARTNER SUPPORT AS WELL AS
PHILANTHROPIC INVESTMENTS TO
MAKE SURE THAT WE CAN CONTINUE
THE TRANSFORMATION WORK BEYOND
ANY WAIVER OF PERIOD WHICH IS
TIME-LIMITED.
SO, THERE ARE NINE ACH'S IN THE
STATE OF WASHINGTON.
THE MAP ON THE SLIDE SHOWS YOU
THE DIFFERENT REGIONS.
HEALTHIERHERE IS ONLY TWO OF
THE COUNTIE SO MOST OF THE
ACH'S REPRESENT MULTIPLE
COUNTIES.
WE ACT AS CHANGE AGENTS FOR THE
HEALTHIER WASHINGTON INITIATIVE
THAT IS THE STATE'S VISION THAT
THEY HAVE SET FORTH FOR
TRANSFORMING THE ENTIRE
HEALTHCARE DELIVERY SYSTEM.
THE MEDICAID TRANSFORMATION
PROJECT WHICH IS THE GOPHERS
OPPORTUNITY.
WE ARE RESPONSIBLE AT
HEALTHIERHERE FOR PLANNING AND
DESIGNING AND THE OVERSIGHT
WITH THE WORK FOR THIS REGION.
HEALTHIERHERE AIMS TO HAVE A
SYSTEM OF CARE THAT WORKS
BETTER FOR PEOPLE AND PROVIDERS
AND FOR ARE COMMUNITY-BASED
ORGANIZATIONS.
THIS MEANS THAT PEOPLE IN OUR
REGION GET BETTER AND MORE
EQUITABLE CARE THAT RESULTS IN
AN IMPROVED QUALITY OF LIFE AND
OUR PROVIDER ORGANIZATIONS GET
THE SUPPORTS THAT THEY NEED TO
ACHIEVE BETTER RESULTS AND ALSO
TO MAKE THE TRANSITION FROM THE
CURRENT FEE-FOR-SERVICE WAY OF
PAYING FOR CARE TO VALUE-BASED
PAYMENT ARRANGEMENTS THAT
REALLY FOCUS ON OUTCOMES. ALSO,
TO MAKE SURE THAT OUR COMMUNITY-
BASED ORGANIZATIONS HAVE THE
INFRASTRUCTURE AND CAPACITY
THEY NEED TO ENGAGE WITH THE
DELIVERY SYSTEM AND IN AN
APPROVED WAY SO THAT WE CAN
MORE INTENTIONALLY ADDRESS THE
NEEDS OF INDIVIDUALS.
SO, JEFF MENTIONED THAT THE
MEDICAID TRANSFORMATION PROJECT
IS MADE UP OF THREE
INITIATIVES.
STARTING ON THE FAR RIGHT IS
THE FOUNDATIONAL COMMUNITY
SUPPORT SERVICES. THIS INCLUDES
NEW MEDICAID BENEFITS FOR A
SMALL SUBSET OF MEDICAID
ELIGIBLE INDIVIDUALS TO
SPECIFICALLY PROVIDE SUPPORTIVE
HOUSING AND EMPLOYMENT SERVICES
AND INITIATIVE 2 IS INCLUDING
MEDICAID BENEFITS AGAIN TO A
SUBSET OF ELIGIBLE INDIVIDUALS
AND IT'S PRIMARILY TO SUPPORT
FAMILY CAREGIVERS THAT ARE
CARING FOR THEIR LOVED ONES TO
HELP PEOPLE AGE IN THEIR HOMES
LONGER AND THE CITY OF SEATTLE
IS ACTIVELY INVOLVED IN THIS
INITIATIVE THROUGH THE AGING
AND DISABILITY SERVICES.
THEN, INITIATIVE ONE IS THE
DELIVERY SYSTEM REFORM
INCENTIVE PROGRAM AND THAT IS
THE COMPONENT THAT SEEKS TO
TRANSFORM THE HEALTHCARE
DELIVERY SYSTEM THROUGH THE
ACCOUNTABLE COMMUNITIES AND IT
IS BY FAR THE LARGEST PART OF
THE MEDICAID TRANSFORMATION
WAIVER AS YOU CAN SEE.
IT'S UP TO $1.1 BILLION OVER
THE FIVE YEARS FOR THE STATE.
THAT IS WHERE WE WILL FOCUS
TODAY ON THE TRANSFORMATION
THROUGH ACCOUNTABLE COMMUNITIES
OF HEALTH.
HOWEVER, IF YOU'RE INTERESTED
IN THE OTHER TWO INITIATIVES,
JEFF AND I CAN ARRANGE FOR
OTHERS TO COME TALK AT ANOTHER
TIME IN MORE DETAIL ABOUT THOSE
TWO COMPONENTS.
>> JUST REAL QUICK, LOOKING AT
THE LAST SLIDE , THESE THREE
BUCKETS, TO THOSE CORRESPOND TO
THE PREVIOUS SLIDE WHICH IS THE
TRIANGLE THAT TOUCHES ON
DELIVERY OF HEALTHCARE AND
SUPPORTING PROVIDERS AND SOCIAL
DETERMINANTS OF HEALTH?
DO THEY CORRESPOND OR OVERLAP?
>> YES.
SORT OF.
THE SLIDE WITH THE TRIANGLE IS
REALLY FOCUSED ON THE
INITIATIVE ONE AND THE DELIVERY
SYSTEM REFORM.
HOWEVER, THE GOAL OF THE WHOLE
WAIVER IS TO ADDRESS THESE
THREE THINGS AND WHEN YOU LOOK
AT SUPPORTIVE HOUSING AND
EMPLOYMENT SERVICES, THAT IS
REALLY GETTING AT THE SOCIAL
DETERMINATE NEEDS OF
INDIVIDUALS AND PROVIDING NEW
MEDICAID BENEFITS AND SIMILARLY
WITH THE LONG-TERM SERVICES AND
SUPPORT.
SO, THEY ARE FOCUSING ON
DIFFERENT POPULATION SOMEWHAT
IN DIFFERENT AREAS AND ARE
CURRENTLY SIDELOAD AND HOW THEY
ARE MOVING FORWARD.
WE ARE WORKING TO FIGURE OUT
WHERE WE CAN LEVERAGE THEM
TOGETHER. FOR EXAMPLE, AS WE
ARE DOING THE REFORMS THAT YOU
HEAR ABOUT, WE ARE THINKING
ABOUT HOW CAN WE CONNECT TO THE
SUPPORTIVE HOUSING SERVICES
THAT ARE AVAILABLE AND IT'S
JUST A SMALL SUBSET OF THOSE
THAT WILL BE ELIGIBLE FOR THAT
BUT IF THEY ARE, WE WANT TO
MAKE SURE WE CAN CONNECT THEM
INTO THAT SO THERE IS SOME
CONNECTION THAT WAY.
>> OUR FRIENDS FROM SEATTLE
HOUSING AUTHORITY ARE HERE AND
THEY ARE DOING THE PRISON
VISION AFTER YOU WHICH IS
REALLY TIMELY.
WE WANTED TO TIE IN THE HEALTH
OF INDIVIDUALS ON THE HEALTH OF
THE HOUSING BECAUSE YOU CAN'T
BE HEALTHY IF YOU DON'T HAVE
STABLE HOUSING.
COULD YOU TELL US A LITTLE BIT
MORE ABOUT THIS TYPE OF
SUPPORTS THAT THE INDIVIDUALS
OR THE COMMUNITIES PROVIDE OR
MAYBE THE CITY IS PROVIDING OR
THE MEANS TO STEP UP IN THAT
THIRD AREA ON THE TRIANGLE
RELATED TO SOCIAL DETERMINANTS?
TO ME, I'M TRYING TO FIGURE OUT
HOW WE CAN BE MOR HELPFUL AND
MAYBE THIS IS THE AREA WE CAN
LEAN IN ON.
>> ABSOLUTELY.
INITIATIVE THREE, THE
FOUNDATIONAL COMMUNITY SUPPORT
IS MANAGED BY A THIRD PARTY
ADMINISTRATOR THROUGH A REQUEST
FOR PROPOSAL PROCESS AND THEY
ARE WORKING WITH A MIRROR GROUP
WHICH IS A MEDICAID CARE PLAN
TO ADMINISTER THAT.
AND THE SUPPORTIVE HOUSING ARENA
, IT DOES NOT PROVIDE ANY
DOLLARS FOR HOUSING. IT'S THE
SERVICES THAT SUPPORT PEOPLE TO
FIND AND MAINTAIN HOUSING.
SO, IT CAN LOOK LIKE CASE
MANAGEMENT SUPPORT TO HELP
IDENTIFY AFFORDABLE HOUSING OR
HOUSING WHERE THEY MIGHT BE
ABLE TO USE A SUBSIDY OR HOUSING
VOUCHER LANDLORD NEGOTIATIONS
AND THEN IN-HOME SUPPORTS AND
SERVICES TO KEEP PEOPLE HEALTHY
SO THAT THEY DON'T GET KICKED
OUT OF THEIR HOUSING.
A LOT OF CASE MANAGEMENT
CHECKING IN AND LINKING TO
OTHER TYPES OF SERVICES THAT
MIGHT BE NECESSARY SO THAT THEY
CAN MAINTAIN THEIR HOUSING.
FOR THE EMPLOYMENT IT IS
SIMILAR KINDS OF THINGS AND IT
DOESN'T PROVIDE WAGES OR
ANYTHING LIKE THAT BUT IT
PROVIDES THE SERVICES AND
SUPPORTS THAT HELP PEOPLE FIND
AND MAINTAIN EMPLOYMENT.
>> AMIR GROUP MANAGES THAT?
>> A MIRROR GROUP MANAGES THE
BENEFITS.
>> TO THE RECEIVED FUNDING FROM
THE CITY OF SEATTLE OR CONTRACT
WITH THEM IN ANY WAY?
>> THIS IS ENTIRELY FUNDED BY
THE MEDICAID TRANSFORMATION
PROJECT AT THIS TIME.
WHAT AMIR GROUP DOES IS
CONTRACTS WITH LOCAL AGENCIES
AND ALL THE REGIONS ACROSS THE
WHOLE STATE AND THEN THERE IS
THE STATE THAT HAS SET
ELIGIBILITY CRITERIA TO ACCESS
THOSE BENEFITS SO WHEN THEY
MEET THE ELIGIBILITY CRITERIA,
THEY CAN REQUEST A BENEFIT FROM
A MIRROR GROUP AND THEY WOULD
RECEIVE AND MOST OF THEM ARE
HOUSING PROVIDERS.
THEY CAN RECEIVE THE MEDICAID
BENEFIT FOR THE INDIVIDUAL TO
PROVIDE SUPPORTIVE SERVICES FOR
THAT PERSON.
>> THANK YOU.
THIS SEEMS LIKE AN AREA THAT I
WILL NEED TO FOLLOW UP ON
BECAUSE I WANT TO MAKE SURE
THAT WE ARE ACTING AS GOOD
PARTNERS EVEN IF THEY ARE NOT
RECEIVING ANY FUNDS FROM THE
CITY OF SEATTLE AND IT TOTALLY
AND MAYBE WE CAN TALK ABOUT
THIS AT THE NEXT MEETING.
WHEN I HAVE BEEN TO SHELTERS
FOR EXAMPLE, THE WOMEN SHELTER
IN BELLTOWN AND I TALKED TO ONE
OF THE CASE MANAGERS THAT HAS
BEEN THERE FOR 10 YEARS, SHE
SAID LAST YEAR WAS THE HARDEST
YEAR THAT SHE HAD EVER HAD
BECAUSE SHE HAD WOMEN WHO WERE
GETTING TO THE END OF THEIR 12
MONTH STAY AT THE SHELTER AND
THEY HAD SECTION 8 VOUCHERS BUT
THERE WAS LITERALLY NO PLACE
THAT SHE CAN FIND TO PUT THEM
IN THE CITY ALONG TRANSIT LINES
THAT WOULD BE ACCESSIBLE TO
THEIR WORK.
I WANT TO MAKE SURE THAT WE ARE
ACTING ALSO IN GOOD FAITH TO
MAKE SURE THAT THEY CAN MEET
THE GOALS OF THE TRANSFORMATION
WAIVER.
IT SEEMS LIKE A BIG AREA THAT
MAYBE WE CAN STEP UP AND
BECAUSE EVEN IF THEY ARE
CONTRACTED WITH THE LOCAL
COMMUNITY PARTNERS, THERE ARE
SO FEW RESOURCES AND MAYBE YOU
CAN SHED SOME LIGHT ON THAT
LATER BUT THAT SEEMS LIKE A BIG
COMPONENT OF YOUR WORK TO
CREATE STABLE AND HEALTHY
COMMUNITIES AND I JUST WANT TO
MAKE SURE WE ARE DOING OUR PART
.
>> IT ABSOLUTELY IS AND THANK
YOU FOR THAT.
ONE OF THE GOALS OF HEALTHIER
HERE AND OUR ROLE AS SORT OF
THIS NEUTRAL OBJECTIVE ENTITY
THAT IS NOT ATTACHED TO ANYBODY
BUT SUPPORTED BY OUR WHOLE
COMMUNITY IS TO FIGURE OUT HOW
WE CAN LEVERAGE AND ALIGN
RESOURCES TO REDUCE
FRAGMENTATION AND HAVE GREATER
IMPACT.
SO, WHAT YOU HAD JUST DESCRIBED
IS A GREAT WAY TO DO THAT AND
TO TAKE THE LITTLE BIT THAT IS
AVAILABLE THROUGH THE MEDICAID
TRANSFORMATION AND MAKE IT MORE
IMPACTFUL BY ALIGNING RESOURCES
SO, THANK YOU.
WE CAN HELP GET YOU CONNECTED
TO THE RIGHT PEOPLE TO GET MORE
INFORMATION ON THAT.
MOVING ALONG, ONE OF THE MOST
IMPORTANT THINGS TO KNOW AND
UNDERSTAND ABOUT THE MEDICAID
PROJECT IS THAT IT IS NOT GRANT
FUNDING.
IT'S A PAY-FOR-PERFORMANCE
CONTRACT BETWEEN THE FEDERAL
GOVERNMENT AND THE STATE OF
WASHINGTON AND AND ALSO BETWEEN
THE STATE HEALTHCARE AUTHORITY
AND THAT ACH'S.
IN THIS CASE, AND
HEALTHIERHERE.
WHAT THAT MEANS IS WE ONLY EARN
MONEY FOR THE REGION IF WE
COLLECTIVELY AS A REGION ARE
SUCCESSFUL IN IMPROVING THE
HEALTH OUTCOMES FOR INDIVIDUALS
IN THE MEDICAID PROGRAM.
THE HEALTHCARE AUTHORITY IN ITS
NEGOTIATIONS WITH THE FEDERAL
GOVERNMENT SET AND DETERMINED
THE OUTCOME METRICS.
I WILL SHOW THEM TO YOU IN A
MINUTE SO YOU HAVE A SENSE OF
WHAT THEY ARE.
THEY ALSO SET TARGETS FOR EACH
REGION AND EACH ACH.
WE GET MEASURED SEMIANNUALLY
ON THESE METRICS.
TO SEE IF WE HAVE MET THE
MILESTONES AND IF WE DO, WE
HAVE A CERTAIN AMOUNT OF
INCENTIVE DOLLARS THAT WE CAN
INVEST TOWARDS INNOVATIONS IN
OUR REGION.
>> TO THAT POINT, WE WANT TO
úMAKE SURE THAT WE ARE HELPING
ON THE HOUSING AND ECONOMIC
STABILITY FRONT IF THIS IS HOW
YOU GENERATE REVENUE FOR FUTURE
EFFORT.
WELCOME COUNCILMEMBER BAGSHAW.
>> I APOLOGIZE, MEETINGS WERE
LONG.
>> NO PROBLEM.
WE HAD A GOOD CONVERSATION AND
WE ARE ON SLIDE 10 RIGHT NOW.
WE TALKED A LITTLE BIT ABOUT
HOW THE TRANSFORMATION WAIVER
INCLUDES ACCESS TO BETTER CARE
AND MORE EQUITABLE CARE FOR
FOLKS IN KING COUNTY AND
SUPPORTING PROVIDERS TO MAKE
SURE THAT THEY ARE INTEGRATED
AND INTEGRATIG THEIR CARE
BETTER AND THAT IT IS A VALUE
PAY AND THIS IS WHERE WE MAY
WANT TO FOLLOW UP TO ENSURE
GREATER ACCESS AND ECONOMIC
STABILITY. IT SOUNDS LIKE THE
THIRD PARTY CONTRACTOR IS WITH
AMIR GROUP SO WE WILL FOLLOW UP
WITH THEM LATER.
>> DO I UNDERSTAND THAT SOME OF
THIS MONEY CAN BE USED TO PAY
FOR SUPPORTIVE HOUSING?
>> YES.
IN THE MEDICAID WAIVER, THERE
ARE THREE INITIATIVES AND ONE
OF THE INITIATIVES IS NEW
MEDICAID BENEFITS SPECIFICALLY
FOR SUPPORTIVE HOUSING AND
EMPLOYMENT. IT'S INITIATIVE
THREE.
IT'S A SUBSET OF ELIGIBLE
INDIVIDUALS THAT ARE ELIGIBLE
úTO RECEIVE THOSE BENEFITS BUT
THEN IT PROVIDES RESOURCES TO
HOUSING PROVIDERS TO PROVIDE
SUPPORTIVE SERVICES TO
INDIVIDUALS TO HELP THEM GET
AND MAINTAIN HOUSING STABILITY.
OKAY, THIS NEXT SLIDE JUST
SHOWS A LITTLE BIT DEEPER ABOUT
THE PAY FOR PERFORMANCE
CONTRACT AND A RELEASE AND IF
IN PART FOR US AND OUR REGION
IN TERMS OF HOW WE EARN
INCENTIVES.
AS WE MOVE DOWN THE PATH OF THE
MEDICAID TRANSFORMATION
PROJECT, THE AMOUNT OF MONEY
THAT WE ARE ELIGIBLE TO EARN
BCOMES MORE AT RISK FOR
MEETING OUTCOMES. IN THE FIRST
TWO YEARS AS YOU SEE ON THE
SLIDE, 2017 AND 2018, 100% OF
OUR FUNDING WAS EARNED BY
MEETING REPORT REQUIREMENTS.
WE HAD TO HAVE AN APPLICATION
AND A NOTATION PLAN AND
SEMIANNUAL REPORTS AND WE EARN
INCENTIVE DOLLARS THAT WAY.
BEGINNING THIS YEAR, ONE
QUARTER OF OUR FUNDING WILL BE
AT RISK BASED ON HOW WE PERFORM
ON THE METRICS AND THEN IT GETS
GREATER AND GREATER AMOUNT.
WHAT THAT MEANS IS EXACTLY WHAT
YOU ARE SUGGESTING WHICH IS
THAT WE HAVE TO BE REALLY
FOCUSED ON HOW CAN WE AS A
REGION MEET OUR TARGETS ON THE
MEASURES SO THAT WE CAN MAKE
SURE WE KEEP THE MONEY FLOWING
INTO OUR REGION AND EARN THE
MAXIMUM AMOUNT.
THEN, THIS NEXT SLIDE HERE
SHOWS YOU WHAT THE ACTUAL
METRICS ARE. AGAIN, THESE ARE
METRICS THAT WERE SET BY THE
HEALTHCARE AUTHORITY AND
NEGOTIATED IN THE CONTRACT WITH
THE FEDERAL GOVERNMENT.
SO, WE AS A REGION AND ALL THE
REGIONS ACROSS THE STATE DID
NOT HAVE ANY INPUT INTO WHAT
THE METRICS WERE AND THE OTHER
THING IS THAT THEY ARE TIED TO
THE PROJECTS THAT WE SELECTED
AS A REGION.
JEFF WILL TALK ABOUT THAT JUST
A MINUTE BUT YOU CAN SEE THAT
THE METRICS ARE VERY HEALTHCARE
ORIENTED AND CLINICAL MEASURES
AND YOU CAN ALSO SEE ACROSS THE
TOP, OUR FOUR PROJECT AREAS
THAT WE WILL TALK ABOUT HOW
THERE IS A LOT OF OVERLAP AND
THAT WAS DONE INTENTIONALLY SO
THAT WE CAN COME AT IMPROVEMENT
FROM A VARIETY OF DIFFERENT
ANGLES TO INCREASE OUR
LIKELIHOOD OF SUCCESS.
I WILL TELL YOU AND JEFF CAN
SAY MORE ABOUT THIS AS A BOARD
MEMBER.
THE BOARD IS VERY INTERESTED IN
LOOKING AT MEASURES THAT GO
BEYOND JUST THE HEALTHCARE
CLINICAL MEASURES BECAUSE IF WE
WOULD HAVE HAD A SAY, I THINK
WE WOULD HAVE SELECTED
DIFFERENT MEASURES FOR OUR
REGION TO CORP.
RATE THINGS LIKE EQUITY AND
HEALTH DISPARITIES AND ALSO TO
BE LOOKING AT HOW SUCCESSFUL WE
ARE IN ADDRESSING THE SOCIAL
DETERMINATE NEEDS OF
INDIVIDUALS AND WHERE THERE ARE
SIGNIFICANT CARE GAPS.
WE WILL BE BUILDING THOSE INTO
OUR WORK GOING FORWARD AS WELL.
>> THAT WAS MY QUESTION.
THANK YOU, CHAIR.
THERE IS NOTHING THAT STOPS US
FROM ADDING THOSE METRICS SO
THAT WE ARE NOT JUST TO THIS
LIST.
>> THAT IS CORRECT.
WE ONLY GET PAID FOR THIS LIST
BUT WE CAN ADD AS MANY MEASURES
AS WE SEE FIT TO HELP US BE
SUCCESSFUL.
>> ONE OF THE THINGS THAT WE
HAVE BEEN WORKING ON AND NOT
JUST IN COUNCILMEMBER
MOSQUEDA'S WORK BUT WHERE WE
SEE THERE IS REAL EQUITY AND
REAL VALUE IN ADDRESSING THE
SOCIAL CONCERNS WE HAVE THAT
THE OTHER ELEMENTS FALL INTO
LINE.
JUST AS AN EXAMPLE, WE RECEIVED
A COPY OF A STUDY LATE LAST WEEK
THAT WAS CALLED SYSTEM FAILURE
AND THE FOCUS THEY HAD WAS
REALLY ON MORE OF THE MENTAL
HEALTH AND 100 PEOPLE THAT WERE
MOST OFTEN SEEN IN JAIL OR UP
BUT IF WE CAN FOCUS ON THE
HEALTH MEASUREMENTS ON THE
OUTCOME AND THE EQUITY ISSUES
THAT THESE OTHER THINGS BEGIN
TO FALL IN LINE AND THINGS AND
WAYS THAT WE HAVEN'T
ANTICIPATED.
WHEN OTHER QUESTION, SORRY
ABOUT MY SOAP BOX.
>> THAT'S OKAY BECAUSE I
COULDN'T AGREE WITH YOU MORE .
>> ACROSS THE TOP AND ON SLIDE
11, IT SAYS OPIOID USE 7%.
I'M ASSUMING THAT THAT IS WHAT
YOU ARE LOOKING FOR IS A
REDUCTION IN OPIOID USE. WHAT
DOES THE 7% MEAN?
>> THANK YOU FOR THAT . IT'S
ACTUALLY THE STATE WHEN THEY
SET UP THE MEDICAID
TRANSFORMATION PROJECT, WE
PICKED FROM A DIFFERENT PROJECT
AREAS AND WE HAD TO PICK A
MINIMUM OF FOUR AND COULD PICK
UP TO EIGHT PROJECTS TO FOCUS
ON.
AT HEALTHIERHERE WE SELECTED
FOUR.
THOSE ARE THE FOUR PROJECTS AT
THE TOP.
THE STATE ALSO ASSIGNED WEIGHT
TO THOSE PROJECTS SO THOSE
PERCENTAGES ARE ACTUALLY HOW
MUCH WEIGHT IS ASSIGNED TO THE
MEASURES AND INCENTIVE DOLLARS
SO IN TRANSLATION BIDIRECTIONAL
INTEGRATION, THAT IS 56% AND
THAT MEANS 86% OF THE DOLLARS
WE COULD EARN ARE GOING TO BE
TIED TO THE METRICS THAT ARE IN
THAT COLUMN WHEREAS FOR THE
OPIOID USE, ONLY 7% OF THE
DOLLARS THAT WE CAN EARN ARE
TIED TO THOSE MEASURES SO WHAT
IT DOES FOR US AS AN
ORGANIZATION IS IT HELPS US
PRIORITIZE SOME OF OUR WORK
TOWARDS HIGH-VALUE MEASURES SO
THAT WE CAN BRING IN MORE MONEY
AND ONCE WE HAVE THE INCENTIVE
DOLLARS AND HAVE EARNED THEM,
WE CAN USE THEM HOWEVER WE WANT.
THAT IS THE NICE THING ABOUT
THE PERFORMANCE BASED
CONTRACTING.
>> ON THE LEFT SIDE ANY
PERFORMANCE BASED CONTRACTING,
WE SEE THE MAKEUP OF THE FULL
FUNDING.
WHAT HAS BEEN YOUR YEARLY BUDGET
AND HAVE YOU BEEN ABLE TO
MAINTAIN THE FUNDING THIS YEAR
GIVEN THE INCENTIVE PAYMENTS?
>> ONLY GET TO THAT AND WE JUMP
AHEAD, I WILL SHOW YOU THE
YEARLY BUDGETS BUT WHAT I CAN
TELL YOU IS THAT IN 2017 AND
2018 WE DID EARN 100% OF THE
DOLLARS WE WERE ELIGIBLE TO
EARN.
>> WHAT WE HAVE TO DO AND HOW
HE WILL EARN THEM.
>> SO, I WILL TURN OVER TO
JEFF WHO WILL GO DEEPER INTO
OUR PROJECT PORTFOLIO AND HOW
WE ARE MOVING THE WORK FORWARD.
>> YEAH, AS SUSAN SAID , WE HAD
A SET OF MEASURES OR AREAS THAT
WE COULD FOCUS ON AND WE
DECIDED AS A GOVERNING BOARD TO
NARROW IT DOWN TO FOUR.
FOUR WAS THE MINIMUM THAT THE
STATE REQUIRED.
TWO OF THEM WERE TARGETS THAT
WERE DICTATED TO US AND THAT IS
NOT REALLY GOOD TERM.
THAT WERE REQUIRED AND THE
OTHER TWO WERE OPTIONAL.
THE TWO THAT WERE REQUIRED IS
STARTING WAS THE INNER CIRCLE
AND INTEGRATED CARE AND THAT IS
PHYSICAL AND BEHAVIORAL HEALTH
OR AS I TELL PEOPLE, BRINGING
PEOPLE'S BODY AND THEIR HEADS
TOGETHER IF YOU WILL.
WE ARE SERVING THE WHOLE PERSON
AS OPPOSED TO OUR SYSTEM IN THE
PAST WHICH HAD FUNDING THAT
CAME DOWN FOR PHYSICAL CARE AT
SEPARATE FUNDING THAT CAME DOWN
FOR BEHAVIORAL HEALTH.
THIS IS ABOUT TIME OUT
ALTOGETHER AND DOING SO AT OUR
ACH LEVEL BUT ALSO AS WE BRING
THAT DOWN TO THE EXPERIENCE
FOR THE PATIENT AS WELL.
THE OTHER MANDATE WAS AROUND
OPIOID USE DISORDER AND WE WILL
GET INTO, SUSAN WILL TALK ABOUT
THIS IN A GREATER EXTENT AND
OBVIOUSLY THAT WAS THE MANDATED
AREA AND SOMETHING THAT HAS
BEEN VERY IMPORTANT FOR US HERE
IN THE COUNTY.
THE TWO THAT WERE OPTIONAL THAT
WE PICKED WERE WHAT IS CALLED
TRANSITIONS AND INCREASED
SAVINGS SUCCESSFUL TRANSITIONS
SPECIFICALLY FOR THOSE LEAVING
JAIL AND THE HOSPITAL AND THEN
THE OTHER IS THE EXPANSION
SUPPORTS FOR THOSE WITH CHRONIC
CONDITIONS.
AS YOU CAN SEE, THOSE ARE ALL
THINGS THAT FIT VERY WELL IN A
LARGER GOAL THAT WE HAVE BOTH
IN THE COUNTY AND IN THE CITY.
>> ARE YOU GOING TO TALK MORE
ABOUT THE TRANSITIONS?
>> YES.
SUSAN WILL GO INTO MORE DEPTH
ABOUT EACH OF THOSE.
THE SECOND SIDE HERE, THE NEXT
SLIDE IS SUPER IMPORTANT AND
THAT IS THAT SUSAN HAS BEEN
TALKING ABOUT THE EQUITY
FRAMEWORK THAT OUR BOARD HAS
SET AROUND ALL OF THIS.
IT'S JUST ENOUGH THAT WE MEET
THESE TARGETS IF YOU WILL AND
THAT WE REALLY NEED TO BE VERY
VIGILANT ABOUT MAKING SURE THAT
THE EQUITY IS PUT THROUGHOUT
EVERYTHING THAT WE DO SO THAT
WE ARE NOT JUST IMPROVING THE
HEALTH OUTCOMES OF CERTAIN
SEGMENTS OF OUR POPULATION BUT
THAT WE ARE DOING THIS FOR
EVERYBODY AND PARTICULARLY
LIFTING THOSE WHO HAVE THE MOST
DISPARITIES.
SO, ALSO THE OTHER FRAMEWORK IS
THAT THIS BECOMES A VERY
CONSUMER FOCUSED PROCESS AS
WELL SO THAT WE HAVE THESE
THREE FRAMEWORKS THAT WE WORK
FROM AND THAT IS COMMUNITY-
BASED CARE COORDINATION SO THAT
THINGS HAPPEN ON THE GROUND
WHERE PEOPLE ARE ACCESSING CARE
AND THAT WE ARE ADDRESSING THE
SOCIAL DETERMINANTS OF HEALTH
AND EVERYTHING THAT WE DO AND
THAT WE ARE IMPROVING EQUITY
AND REDUCING DISPARITIES.
I WILL HAVE SUSAN TALK SOME
SPECIFICALLY.
>> I WILL BREAK THAT DOWN A
LITTLE BIT FOR YOU.
STARTING WITH THE PHYSICAL AND
BEHAVIORAL HEALTH INTEGRATION
WORK, YOU HAVE PROBABLY HEARD A
LOT ABOUT THIS.
AND HAS BEEN GOING ON STATEWIDE
FOR A NUMBER OF YEARS NOW AND
THE WAIVER WORK IS DESIGNED TO
COMPLEMENT WHAT THE STATE HAS
BEEN DOING WHICH IS TO MOVE AND
INTEGRATE THE FINANCES FOR
BEHAVIORAL HEALTH THAT INCLUDES
MENTAL HEALTH AND SENTENCE USE
DISORDER TREATMENT WITH THE
PHYSICAL HEALTHCARE SYSTEM INTO
SINGLE INTEGRATED VINTAGE CARE
CONTRACTS AND THAT STARTED IN
KING COUNTY ON JANUARY 1 OF
THIS YEAR.
THAT FINANCIAL INTEGRATION.
WHAT THE WAIVER IS DOING AND
WHAT WE HAVE THE OPPORTUNITY TO
DO THROUGH HEALTHIERHERE IS TO
MAKE SURE THAT THE INTEGRATON
GOES BEYOND JUST INTEGRATING
THE FINANCES AT THE CLINICAL
POINT OF CARE AND THAT CARE IS
DELIVERED IN A WAY THAT
PROVIDERS ARE ACTUALLY
ADDRESSING WHOLE PERSON NEEDS
WITH THE HEAD AND THE BODY AND
ALL THE NEEDS OF THE INDIVIDUAL
INSTEAD OF JUST ONE PIECE AS
JEFF MENTIONED.
>> IS EVERY HOSPITAL AND
MEDICAL CENTER IN OUR REGION
SIGNED INTO THIS?
>> YES.
>> IF SOMEBODY COMES UP FOR
EMERGENCY TREATMENT THAT THEY
WILL BE ADMITTED AND MEDICAID
WILL HELP COVER THAT?
>> SO, YES.
ALL OF THE HOSPITALS IN THE
REGION ARE PARTNERING WITH
HEALTHIERHERE BECAUSE OF THE
SIZE AND SCOPE AND NUMBER OF
PROVIDERS WE HAVE, WE HAVE THE
STAGE A LITTLE BIT.
NOT EVERYBODY WILL RECEIVE
RESOURCES AND SHIFT TO THE NEW
MODEL BUT IT WILL BE A ROLLING
AND WE HAVE COHORTS OF
PROVIDERS THAT BY THE END OF
THE WAIVER, THAT IS ONE OF THE
MAIN GOALS WHICH IS WHEREVER
ANYBODY RECEIVES THEIR CARE IN
KING COUNTY, THE WHOLE HEALTH
NEEDS ARE GETTING MET AND THEY
HAVE A MULTIDISCIPLINARY TEAM-
BASED CARE THAT ADDRESSES ALL
OF THE NEEDS.
>> A QUESTION ABOUT THE
INTEGRATION AND PHYSICAL
HEALTH, THIS IS ALSO
INCORPORATING ORAL HEALTH. WE
KNOW PEOPLE SELF MEDICATE IF
THEY ARE IN CHRONIC PAIN AND WE
ALSO KNOW THAT ESPECIALLY FOR
KIDDOS, SOMETIMES THEY ARE
PERCEIVED AS ACTING OUT WHEN
REALLY THEY HAVE ORAL HEALTH
CRISIS.
HIS OR HER HEALTH INTEGRATED
INTO THIS MODEL AS WELL?
>> THANK YOU FOR ASKING THAT
QUESTION.
ORAL HEALTH IS A VERY
SIGNIFICANT COMPONENT TO ALL OF
THIS AND ACTUALLY CROSSES ALL
THE PROJECTS.
IN THE INITIAL VERSION AND THE
WAY THAT THE WAIVER WAS
WRITTEN, IT WAS NOT BUT I CAN
TELL YOU THAT THE LONG-TERM
VISION FOR THE STATE IS TO
START WITH PHYSICAL BEHAVIORAL
HEALTH AND TO ROLL IN ORAL
HEALTH AND ALSO SOME OF THE
LONG-TERM SERVICES AND SUPPORTS.
YOU WANT TO GET THE FINANCING
AND INCENTIVES AND IT'S ALL IN
THE SAME PLACE.
WITH THAT SAID, WE HAVE HAD A
PARTNERSHIP WITH THE DECORAH
FOUNDATION AND WE CALLED THE
WASHINGTON DENTAL ASSOCIATION.
>> THAT MAKES MORE SENSE TO ME.
>> INTUITIVELY ANYWAY.
WE HAVE BEEN HAVING
CONVERSATIONS WITH OUR
PROVIDERS AS WELL SO THAT
ESPECIALLY WHEN WE TALK ABOUT
MAKING MODIFICATIONS TO
ELECTRONIC HEALTH RECORDS AND
WAYS THAT PEOPLE ARE SCREENED
WHICH IS VERY COSTLY AND TIME-
CONSUMING, MAYBE WE WILL FOCUS
ON PHYSICAL AND BEHAVIORAL
HEALTH RIGHT NOW BUT LET'S PUT
THE ORAL HEALTH QUESTION IN SO
WE ONLY HAVE TO DO THE
MODIFICATION WANTS AND PUT THE
RESOURCE BEHIND IT AT A LATER
DATE.
I AM HOPEFUL AND ANTICIPATE
THAT WE WILL GET THERE.
>> AS YOU THINK ABOUT
ADDITIONAL METRICS THAT YOU
ARE HOLDING YOURSELF
ACCOUNTABLE TO THAT MIGHT BE
OUTSIDE OF WHAT WE ARE GETTING
REIMBURSED FOR, I THINK ORAL
HEALTH IS CRITICALLY IMPORTANT
IN OUR LENS OF TODAY AND
TOMORROW IN TERMS OF WOMEN'S
HEALTH AND MATERNAL HEALTH AND
CHILD HEALTH.
WE KNOW ACCESS TO APPROPRIATE
PREVENTIVE ORAL HEALTH IS GOOD
FOR THOSE WHO ARE PREGNANT AND
MAY BECOME ARROGANT AND THE
HEALTH OF THEIR BABIES IN THE
FUTURE AND HELP DISPARITIES DO
REALLY STEM FROM POOR ORAL
HEALTH ACCESS AND FOR MANY
CASES OF THOSE THAT ARE TRYING
TO CONCEIVE OR ARE HAVING
BABIES SOON.
I THINK IT'S A HEALTH EQUITY
ISSUE AS WELL AND I APPRECIATE
YOUR BRINGING THAT FORWARD.
>> YEAH, THANK YOU.
SO, SOME OF THE LEVERS FOR
HEALTHIERHERE FOR THE
INTEGRATION IS THE DEVELOPMENT
OF MECHANISMS FOR SHARED CARE
PLANNING ACROSS PROVIDERS AND
PROVIDER TYPES.
WE WILL ALSO BE LOOKING TO
ENHANCE THE SCREENING AND
IDENTIFICATION OF INDIVIDUALS
WITH CHRONIC MEDICAL OR
BEHAVIORAL HEALTH CONDITIONS
REGARDLESS OF WHERE THEY ENTER
THE SYSTEM SO WHAT THIS MEANS
IS THAT IF A PERSON GOES INTO A
COMMUNITY BEHAVIORAL HEALTH
AGENCY BECAUSE THEY ARE
DEPRESSED, THE COMMUNITY IS
ALSO SCREENING THEM TO SEE IF
THEY HAVE SEEN A PRIMARY CARE
DOCTOR AND IF THEY HAVE ANY
CHRONIC CONDITIONS THAT MIGHT
BE IMPACTING THEIR DEPRESSION
AND VICE VERSA SO THEN PRIMARY
CARE, PEOPLE ARE BEING SCREENED
FOR MENTAL ILLNESS AND
SUBSTANCE USE.
WE ALSO HOPE TO CONTINUE EXPAND
EVIDENCE-BASED AND BEST
PRACTICE APPROACH TO CARE
ACROSS PROVIDERS.
WE WILL BE DEVELOPING
INTEROPERABILITY'S SO THAT DATA
SYSTEMS AND ELECTRONIC HEALTH
RECORDS CAN TALK TO EACH OTHER.
WE KNOW THAT ONE OF THE BIGGEST
BARRIERS TO DOING WHOLE PERSON
CARE IS THAT PEOPLE DON'T HAVE
THE INFORMATION THEY NEED AND
INFORMATION IS NOT EASILY
FLOWING OR BEING SHARED ACROSS
PROVIDERS SO WE ARE WORKING ON
SOLUTIONS TO THAT.
ENHANCE CARE COORDINATION AGAIN
TO HELP IF PEOPLE ARE RECEIVING
SERVICES FOR MULTIPLE PROVIDERS
WHICH IS THE HIGHEST LIKELY
SCENARIO IN KING COUNTY.
THERE ARE MECHANISMS TO
COORDINATE CARE AMONG THOSE
PROVIDERS.
>> THE LAST BUDGET CYCLE, WE
PUT MONEY IN FOR A COORDINATED
APPROACH AND THERE IS A GROUP
IN NORTHGATE THAT ANSWERS AND
ALLIE FRANKLIN IS THE CONTACT.
I DON'T KNOW IF YOU ARE WORKING
WITH HER BUT I WOULD LOVE TO
KNOW AND PARTLY THIS ROSE OUT
OF SOMETHING AND I WILL BE ON
MY SOAPBOX FOR JUST 30 SECONDS.
WE ALSO PUT MONEY IN FOR
SOMETHING WE CALL THE LOW
ACUITY APPROACH FOR THE FIRST
RESPONDERS SO THAT THIS IS A
LITTLE DIFFERENT BUT NOT NEW.
SEATTLE HAS NOT ADOPTED IT YET
BUT WE ARE WORKING ON THAT.
I WANTED DONE AND I WAS HOPING
BY MARCH BUT WE ARE HOPING BY
LISA SECOND QUARTER AND SO
RATHER THAN SENDING OUT OUR
FIREFIGHTERS AND FIRST
RESPONDERS WITH AMBULANCES FOR
SOMEONE THAT MAY SIMPLY NEED A
DIFFERENT KIND OF RESPONSE, IT
IS NOT A HIGH RESPONSE BUT LOW
MEANING MAYBE AN OVERDOSE OR
SOMEONE THAT HAS PASSED OUT
FROM ALCOHOL OR WHATEVER.
THE IDEA IS THAT WE SEND PEOPLE
OUT IN A WORD FIND MOM THEN AND
NOT WITH AN AMBULANCE BUT
PEOPLE THAT MAY HAVE A NURSE
PETITIONER ON BOARD OR SOMEONE
WITH METAL MENTAL HEALTH OR
MAYBE A FIRST RESPONDER THAT
HAS THAT MEDICAL RESPONSE AT
THEIR FINGERTIPS.
OVERALL, WE ARE LOOKING AT THIS
MODEL FROM COLORADO SPRINGS AND
IT MAKES SO MUCH SENSE IN A
SYSTEMWIDE APPROACH BECAUSE
PEOPLE GET THE CARE THEY NEED
AT THE LEVEL THEY NEED BUT WE
HAVE TO HAVE A BED FOR THEM.
WE HAVE TO HAVE A PLACE WHERE
THEY CAN GO 24/7.
IT NEEDS TO BE A PLACE WHERE
THEY CAN GET WHATEVER CARE THEY
NEED FOR THAT PERIOD OF TIME.
I AM WORKING WITH EVERY
PROVIDER AND ANYONE THAT WILL
SIT STILL LONG ENOUGH TO TALK
TO ME.
WE NEED MORE BEDS AND OF COURSE
MEANS WE NEED MORE HOUSING AND
THAT OF COURSE IS SOMETHING THAT
COUNCILMEMBER MOSQUEDA AND I
ARE REALLY DEEPLY FOCUSED ON.
I WOULD LOVE TO TALK TO YOU
MORE ABOUT HOW WE INTEGRATE
OUR LOW ACUITY MODEL WITH THE
WORK YOU ARE DOING.
>> I WOULD LOVE TO FOLLOW UP
AND TALK WITH YOU MORE ABOUT
THAT.
THAT IS VERY CONSISTENT WITH
SOME OF THE CONVERSATIONS THAT
WE ARE HAVING.
I WAS SAYING TO JEFF EARLIER,
OUR CONVERSATION IS STARTING
WITH THE EMERGENCY DEPARTMENT
AND HOW WE PREVENT PREVENTABLE
EMERGENCY DEPARTMENT BUSINESS
WHICH IS THE LOW ACUITY PEOPLE
THAT YOU ARE TALKING ABOUT SO I
THINK THERE IS REAL OPPORTUNITY
THERE TO LEVERAGE THE RESOURCES
AND INTEREST TO BUILD OUT
SOMETHING CREATIVE AND
INNOVATIVE FOR OUR REGION.
>> BEFORE YOU LEAVE TODAY,
LET'S MAKE SURE WE EXCHANGE
PHONE NUMBERS BECAUSE YOU ARE
A PART OF THE LINCHPIN OF WHAT
WE ARE TRYING TO ACCOMPLISH.
>> YES, WE WOULD LOVE TO DO
THAT.
JUST A SIDE NOTE, WE ARE
WORKING WITH CRISIS CONNECTIONS
AND WE ARE VERY EXCITED WITH
THE PARTNERSHIP OF THE CITY AND
WHAT THE CITY IS BRINGING TO
THAT.
I WILL TALK A MINUTE ABOUT THE
CONCEPT OF THE COMMUNITY
INFORMATION EXCHANGE.
>> YOU GOT THAT FROM SAN
DIEGO, RIGHT?
>> YES.
THAT IS A HIGH PRIORITY FOR OUR
REGION AND HAS COME UP IN EVERY
TABLE AND DESIGN PLANNING
MEETING THAT WE HAVE HAD.
WE WILL, ACTUALLY
HEALTHIERHERE WILL CONVENE
PARTIES AROUND THE AND IT WILL
TAKE ALL OF US TO BUILD IT AND
GET IT TO SCALE OVER THE NEXT
COUPLE OF YEARS.
>> YOU ARE THE BEST.
IF I CAN ASK, WE WILL FOLLOW UP
ON THIS BUT WE WOULD LIKE TO BE
INVOLVED.
I HAVE ONE INDIVIDUAL WHO IS MY
LEGISLATIVE AIDE THAT ALLISON
MacLEAN HAS BEEN DEEPLY ENGAGED
IN THIS FOR MENTAL HEALTH AND
BEHAVIORAL HEALTH AND HAS GOOD
CLOSE CONNECTIONS WITH THE
COUNTY AND IF I CAN'T BE THERE,
WE WOULD REALLY LIKE TO HAVE
HER THERE JUST SO THAT WE ARE
SHARING THE SAME INFORMATION.
>> THANK YOU, YES, WE WOULD
LIKE TO HAVE YOU THERE AS WELL.
>> I WOULD JUST ADD THAT THE
BEAUTY OF THE HEALTHIERHERE
BOARD IS THAT IT IS 26 MEMBERS
AND A CROSS-SECTIONAL GROUP OF
FOLKS.
AS ISSUES ARISE IN THE CITY,
IT'S A VERY QUICK DISCUSSION
WITH ELISE SHYAT WHO WAS ON OUR
GOVERNING BOARD AND WE CAN
QUICKLY PREVENT THE SILOS FROM
BECOMING EVEN MORE AND WE CAN
QUICKLY BEGIN CROSS
DISCUSSIONS.
>> WONDERFUL.
BETWEEN YOU AND SUSAN AND
ELYSE, I HAVE GREAT FAITH.
>> THANK YOU.
MY MANTRA IS IF WE CAN GET IT
TO ONE CONVERSATION INSTEAD OF
SEVEN . WE CAN DO MORE
TOGETHER.
SO, REALLY QUICKLY BECAUSE I
WANT TO BE MINDFUL OF TIME.
UNDER SAFE AND SUCCESSFUL
TRANSITIONS, THIS INCLUDES AS
JEFF MENTIONED TRANSITIONS FROM
HOSPITALS AND TRANSITIONS FROM
PSYCHIATRIC SETTINGS AND
TRANSITIONS FROM JAILS.
IN 2019, HEALTHIERHERE IS GOING
TO FOCUS PRIMARILY ON
HOSPITALS AND PSYCHIATRIC
SETTINGS AND WE WILL EXPAND OUT
TO INCLUDE TRANSITIONS FROM
JAILS ALTHOUGH KNOWING THAT WE
ARE TALKING OFTENTIMES ABOUT
THE SAME INDIVIDUALS AND IT'S
KIND OF A ROLL OF THE DICE
WHETHER OR NOT THEY LAND IN
JAIL OR HOSPITAL.
WE ARE VERY MINDFUL OF THAT.
>> SO, BETTY PINE IS SO WHEN I
HAVE WORKED WITH FOR DECADES
AND SHE IS IN THE KING COUNTY
JAIL HEALTH.
ONE OF THE ISSUES THAT SHE AND
I HAVE TALKED ABOUT BEFORE IS
THAT IF SOMEBODY ENDS UP IN
JAIL, WE KNOW THAT IT IS
DRAMATIC AND MORE DRAMATIC THAN
ALMOST ANYTHING ELSE BUT IF
úSOMEONE IS SUFFERING FROM AN
ADDICTION, WE NEED TO GET THEM
ON A PLAN BEFORE THEY LEAVE THE
JAIL FOR ONGOING WHETHER WE CAN
GET THEM ON METHADONE OR
WHATEVER AND I KEEP RUNNING
INTO WALLS WHERE PEOPLE SAY WE
CAN'T DO THAT BECAUSE THE FEDS
DON'T ALLOW US AND IT MAKES NO
SENSE TO ME.
IF WE CAN GET PEOPLE STABILIZE
ND PROVIDE THEM WITH A PLAN SO
THAT THEY CAN MOVE ON RATHER
THAN THIS THIN CYCLE OF GETTING
BACK ON THE STREETS AND BUYING
MORE DRUGS.
I WOULD LOVE FOR US AS PART OF
THE CONVERSATION IF YOU CAN GET
ME UPDATED ON THAT.
>> ABSOLUTELY.
>> CAN YOU TALK ABOUT THE
METRICS YOU HAVE SEEN SO FAR?
HAVE YOU SEEN AN UPDATE IN
SOCIAL SERVICES AND WHAT YOU
THINK HAS BEEN THE MOST NEEDFUL
LEVER THERE?
>> WE ARE JUST MOVING INTO
IMPLEMENTATION SO WE HAVE NOT
IMPLEMENTED MUCH OF ANYTHING
YET.
THAT IS THE ENTIRE 2019 AND
TODAY WE HAVE A GOVERNING BOARD
MEETING.
THEY ARE GOING TO HOPEFULLY
APPROVE OUR 2019 INVESTMENT
STRATEGY OF ABOUT $8.7 MILLION
THAT WILL GO INTO THESE FOUR
AREAS THAT WE ARE TALKING ABOUT.
I WILL HAVE MORE INFORMATION ON
THAT AS WE MOVE FURTHER IN THE
YEAR AND I WOULD LOVE TO COME
BACK AND SHARE SOME OF THE
THINGS THAT ARE WORKING AND
LESSONS THAT WE ARE LEARNING.
>> WONDERFUL.
ONE OF THE THINGS WE WERE ABLE
TO DO WITH COUNCILMEMBER
BAGSHAW WAS TO PUT SOME
ANALYSIS INTO THE BUDGET OF HOW
OUR HEALTH SERVICES OR HOW THE
JAIL ENVIRONMENT IS AFFECTING
INDIVIDUAL HEALTH AND WANTED
FEEDBACK WHILE KING COUNTY
MANAGES THE JAILS, IT IS WITHIN
OUR BORDER SO I THINK WE FEEL
THAT THERE IS A RESPONSIBILITY
AND A ROLE FOR US TO PLAY TO
MAKE SURE THAT THOSE WHO ARE
GOING INTO JAIL THAT WE ARE
TRYING TO DO EVERYTHING WE CAN
TO PREVENT THAT AND THEY
ACTUALLY HAVE A HEALTHIER
EXPERIENCE AND THAT THEY ARE
NOT BEING EXPOSED TO MOLD HER
TRAUMA OR HARASSMENT AND IF
YOUR BODY IS ABLE TO GIVE US
ANY FEEDBACK. IF THERE ARE
THEMES THAT YOU ARE HEARING IN
TERMS OF ASTHMA OR CONDITIONS
THAT PEOPLE ARE EXPERIENCING
WITH HIGHER RATES WHEN THEY GO
INTO JAIL, WE WOULD LOVE TO
HAVE THAT HELP DATA SO THAT WE
CAN DO OUR PART TO HELP
RESPOND.
>> GREAT.
I WILL CHECK INTO THAT AND SEE
WHAT WE HAVE ACCESS TO.
WE ARE CONTINUING TO BUILD OUT
OUR ACCESS TO DATA.
OBVIOUSLY, DATA IS A GREAT AND
BIG PART OF THIS.
WE NEED TO UNDERSTAND WHERE THE
NEEDS ARE.
OKAY, I WILL MOVE US TO THE
PREVENTION AND MANAGEMENT OF
CHRONIC CONDITIONS.
HEALTHIERHERE IS IN ADDITION
TO PRIMARY FOCUS ON PEOPLE
EXPERIENCING MENTAL ILLNESS, WE
ARE FOCUSING ON CARDIOVASCULAR
DISEASE, DIABETES, ASTHMA AND
CHRONIC OBSTRUCTIVE PULMONARY
DISEASE OR LUNG DISEASE FOR OUR
REGION.
WE WILL SUPPORT ACTIVITIES THAT
HELP MANAGE AND PREVENT THE
WORSENING OF THESE CONDITIONS
SO YOUR QUESTION IS REALLY
RELEVANT IN TERMS OF WHO IS IN
EXPOSURE.
AND INCLUDE THINGS AND MAKING
SURE THAT PROVIDERS HAVE THE
NECESSARY KNOWLEDGE AND TOOLS
TO MANAGE THE POPULATION SO IF
I AM UP PRIMARY CARE CLINIC,
WHO ARE ALL THE PEOPLE IN MY
CLINIC THAT HAVE DIABETES AND
WHAT PERCENTAGE OF THEM HAVE
UNCONTROLLED DIABETES? I WILL
REALLY FOCUS IN ON FOLLOWING UP
WITH THEM AND GETTING THEM INTO
THEIR APPOINTMENTS AND TRY TO
GET THEIR DIABETES UNDER
CONTROL.
HAT IS AN EXAMPLE OF HO
WOULD WORK.
ALSO, COMMUNITY BASED
MANAGEMENT SUPPORT.
WHETHER PERSON IS NEWLY
DIAGNOSED OR TRANSITIONING OUT
OF A HOSPITAL OR JAIL AND HAVE
A CHRONIC CONDITION, WHO IS
WORKING WITH THEM TO MAKE SURE
THEY CAN FILL THEIR MEDICATIONS
AND HOW TO TAKE THEIR
MEDICATIONS APPROPRIATELY AND
CAN DO ALL THE FOLLOW-UP WITH
EXERCISE ACCESS TO NUTRITIOUS
FOOD AS EXAMPLES.
COMMUNITY HEALTH WORKERS ARE A
CORE PART OF THAT.
THAT IS ONE OF THE THINGS THAT
WE HAD HEALTHIERHERE ARE
INTERESTED IN BUILDING CAPACITY
FOR . THE NONTRADITIONAL
COMMUNITY-BASED WORKFORCE THAT
CAN REALLY SUPPORT PEOPLE IN
THEIR COMMUNITY AND SPEAK THE
SAME LANGUAGE AND HAVE COMMON
EXPERIENCES AND SO FORTH.
>> HAS HEALTHIERHERE BECOME
SOMETHING THAT PEOPLE THINK OF
? LET'S SAY I AM A NURSE IN A
SMALL CLINIC.
DO I THINK ABOUT WHAT
HEALTHIERHERE IS DOING?
DO I THINK THERE MIGHT BE SOME
RESOURCES ONLINE THAT I COULD
GO TO? IT STRIKES ME THAT
EVERYTHING THAT YOU ARE TALKING
ABOUT WITH INTEGRATING THE
SYSTEM IS PRECISELY WHAT WE
HAVE BEEN TRYING TO ACCOMPLISH
FOR DECADES AND YOU ARE NOW
DOING IT.
DO PEOPLE KNOW ABOUT YOU?
>> SO, YES AND NO.
SOME PEOPLE DO AND SOME PEOPLE
DON'T AND OUR GOAL IS TO MAKE
SURE EVERYONE KNOWS ABOUT US.
WE ARE DOING A LOT TO MAKE THAT
HAPPEN AS WE GO THROUGH THE
WAIVER PROCESS WITH MORE A
MARKED MEDICATION.
ALL OF THE MEDICAID HOSPITAL
HEALTH SYSTEMS AND COMMUNITY
HEALTH CENTERS AND BEHAVIORAL
HEALTH AGENCIES KNOW ABOUT US
AS AN ORGANIZATION.
THAT DOES NOT MEAN EVERYBODY IN
THE ORGANIZATION KNOWS ABOUT US
YET.
WE HAVE BEEN GOING THROUGH AND
WE WILL TALK ABOUT THE PROCESS
AROUND THE COMMUNITY-BASED
ORGANIZATIONS AND ALSO
CONSUMERS AND COMMUNITY
MEMBERS.
WE HAVE BEEN DOING A LOT TO TRY
TO ENGAGE THOSE FOLKS.
TODAY, I WOULD SAY PEOPLE WHO
ARE CONNECTED AND KNOW ABOUT
THE WAIVER ARE INTERESTED IN
BEING A PARTNER AND THEY KNOW
ABOUT US BUT NOT EVERYBODY AND
WE ARE WORKING ON THAT.
>> JUST TO ADD, I THINK AS WE
BEGIN THE FUNDS FLOW PROCESS
WHERE WE BEGIN TO REIMBURSE
FOLKS FOR PROVIDING THE CARE,
THAT IN ALLOWING THESE AGENCIES
TO HIRE COMMUNITY HEALTH
WORKERS, ALL THOSE THINGS WILL
OBVIOUSLY SORT OF BRING ALL OF
THIS FORWARD VERY QUICKLY LATER
THIS YEAR WHEN WE ARE AT THAT
STAGE.
>> AND THE END RESULTS THAT WE
CAN REALLY DEMONSTRATE THAT.
I THINK ONE OF THE UNIQUE
THINGS AND JEFF ALLUDED TO
ABOUT HEALTHIERHERE.
WE ARE A STANDALONE
ORGANIZATION AND WE ARE
REPRESENTED BY EVERY SECTOR IN
OUR COMMUNITY AS BEING A PART
OF OUR GOVERNING BOARD.
REALLY TRYING TO BE COMMUNITY
DRIVEN BUT REALLY CAN FOCUS ON
WHAT IS BEST FOR THE PEOPLE AND
NOT ANY SINGLE SECTOR OR
ORGANIZATION.
ONE OF OUR VALUES IS THAT ALL
THE TRANSFORMATION IS DRIVEN BY
THOSE INDIVIDUALS THAT ARE
LIVING THE SYSTEM AND HAVING
THE EXPERIENCES. THEY ARE
REALLY THE ONES I CAN IDENTIFY
THE SOLUTIONS.
WE ARE WORKING ON MECHANISMS TO
CREATE THAT IN A MORE
SUSTAINABLE WAY.
THE OPEN PROJECT IT REALLY
FOCUSES ON THREE AREAS.
WE WANT DOCTORS AND INDIVIDUALS
THAT ARE PRESCRIBING OPIOIDS TO
DO THEM IN LINE WITH THE STATE
AND NATIONAL GUIDELINES AND
MAKE SURE WE ARE BEING
CONSERVATIVE ABOUT THAT AND
PREVENTING DISORDERS.
AND THEN, INCREASING ACCESS TO
MEDICAID ASSISTANT TREATMENT
AND OVERDOSE PREVENTION.
AS YOU KNOW, THERE IS A LOT OF
WORK AROUND THE OPIATE
ADDICTION GOING ON IN THE CITY
HAS BEEN INVOLVED FOR A COUPLE
OF YEARS NOW.
THERE ARE A LOT OF FEDERAL
MONIES COMING INTO THE REGION
TO ADDRESS THE OPIATE CRISIS.
SO, WE ARE REALLY WORKING WITH
ALL THE PARTNERS WHO ARE
RECEIVING THAT MONEY AND TRYING
TO IMPLEMENT THINGS TO
STREAMLINE AND ALIGN SO THAT WE
ARE WORKING TOWARDS THOSE
COMMON GOALS.
>> THE OPIATE ADDICTION IS
SOMETHING THAT WE ALL AT THIS
TABLE HAVE BEEN FOCUSED ON
SINCE THE SEATTLE KING COUNTY
REPORT CAME OUT SEVERAL YEARS
AGO.
I KNOW, JEFF YOU HAVE BEEN
INVOLVED IN THAT FROM THE
BEGINNING.
AGAIN, THESE ROADBLOCKS THAT WE
HEAR ABOUT WAS THAT MORPHINE
MIGHT BE GOOD FOR SOME AND
METHADONE MAY BE BETTER FOR SOME
BUT HAVING IT AVAILABLE WHERE
THE PEOPE ARE IS CRITICAL.
I THINK IT WAS DOCTOR KAYLA
AGREEMENT SAID TO ME I WILL NOT
DRIVE TO GET MY MORNING CUP OF
COFFEE AND I THINK THAT IS
SIMILAR HERE.
WE ARE LEARNING THAT IT IS
AVAILABLE IN MANY MORE
LOCATIONS THAN WE KNEW.
DOZENS ACROSS THE CITY AND
HAVING THE GENERAL PRACTITIONER
SIGN UP AND BE A PROVIDER, WHAT
I HEAR IS THAT WHAT I REALLY
DON'T WANT TO FOCUS THE
PRACTICE JUST ON PEOPLE WHO
HAVE ADDICTIONS SO THAT THERE
IS MAYBE A LITTLE RELUCTANCE
AND HAVING MORE AND MORE PEOPLE
GETTING TO THE LEVEL WHERE THEY
ARE ABLE TO PRESCRIBE.
WITH THAT SAID, WE ARE LOOKING
AND WE KNOW THERE IS NO CIVIL
BULLET BUT I THINK YOU ARE
DOING GREAT WORK FOR US.
IF THERE IS FEDERAL MONEY
FLOWING INTO OUR REGION AND IT
CAN BE USED FOR MORE CLINICS OR
MORE DOCTORS OR HELPING PEOPLE
GET THE TRAINING THAT THEY NEED
TO BE ABLE TO DO THE
PRESCRIBING, I WOULD JUST LIKE
TO BROADEN AN OPEN THOSE GATES
A LITTLE BIT TO SEE WHAT WE CAN
DO BECAUSE WE KNOW TREATMENT ON
DEMAND AND THE MEDICALLY
ASSISTANT TREATMENT CAN REALLY
WORK.
>> YES, ABSOLUTELY.
>> I'M TRYING TO BE CONSCIOUS
OF THE FACT THAT YOU WERE NOT A
BRAND BUT A PAPER PERFORMANCE
CONTRACT BETWEEN THE GOVERNMENT
AND THE STATE AND THE STATE AND
HEALTHIERHERE.
HEALTHIERHERE IS ONE ELEMENT OF
HEALTHIER WASHINGTON.
OKAY, YOUR ROLE IS TO MAKE SURE
THAT WE ARE RECEIVING FUNDING
IN OUR REGION FROM THESE
FEDERAL DOLLARS BY IMPROVING
HEALTH OUTCOMES AND MORE
INTEGRATIVE, YOU'RE DOING THAT
BY DOING MORE INTEGRATIVE CARE
AND THE SOCIAL DETERMINANTS OF
HEALTH IN TERMS OF THE GREATER
HEALTH STABILITY.
SO, THERE IS A NUMBER OF
PARTNERS THAT YOU HAVE MENTIONED
AND WHAT WOULD BE HELPFUL FOR
ME IS TO HAVE A BETTER SENSE OF
WHO THOSE PARTNERS ARE
SPECIFICALLY AS WE THINK ABOUT
THE OPIATE CRISIS IN OUR REGION
AND WHO ARE SOME OF THESE
PARTNERS AND WHAT ARE SOME OF
THE TYPES OF SERVICES THAT HAVE
CHANGED AND HAVE YOU SEEN A
NOTABLE OR MEASURABLE IMPACT
SINCE YOU ALL HAVE THEM WORKING
TOGETHER TO TRY TO HAVE GREATER
INTEGRATION AND COORDINATION
ACROSS PROVIDERS? ESPECIALLY IN
THIS AREA I FEEL LIKE WE ARE ON
A HAMSTER WHEEL AND JEFF, I
UPGRADED YOU TO A DOCTOR.
YOU KNOW BETTER THAN ANYONE
THAT WE ARE LOSING GROUND
ESPECIALLY ON OPIOID ADDICTION
ISSUES AND DESPITE OUR BEST
EFFORTS TO TRY TO CREATE A SAFE
PLACE FOR OVERDOSE PREVENTION
SITES, WE CONTINUE TO HIT
ROADBLOCKS, ESPECIALLY WITH THE
FEDERAL GOVERNMENT BUT OTHER
CITIES ARE FACING THE SAME
THING.
SPECIFIC ON THIS ISSUE, CAN YOU
TELL US ANY KEY PARTNERS THAT
YOU HAVE THEM WORKING WITH AND
ANYTHING THAT YOU THINK THE
CITY OF SEATTLE NEEDS TO DO TO
STEP UP?
>> THE SHORT ANSWER IS I CAN
TELL YOU BUT NOT OFF THE TOP OF
MY HEAD . I WILL GET YOU A LIST
OF ALL OF OUR MEDICAID FUNDING
PROVIDERS THAT ARE WORKING WITH
US DIRECTLY AND ON WHICH
PROJECTS BECAUSE NOT EVERYONE
IS SIGN UP FOR EVERY PROJECT
AND THEN JEFF WILL TALK A
LITTLE BIT ABOUT OUR COMMUNITY-
BASED ORGANIZATIONS.
WE ARE STILL IN THE WINNOWING
DOWN OF AGENCIES THAT WILL
PARTNER WITH US.
I WON'T HAVE THAT FINALIZED
LIST UNTIL PROBABLY MAY BUT
THEN I CAN GET THAT TO YOU AND
WE WILL BE BRINGING THOSE
CLINICAL COMMUNITY PARTNERS
TOGETHER TO BUILD OUT THE
INNOVATION STRATEGIES.
SOME OF THAT WORK IS BEGINNING
SO I CAN GET YOU THE NAMES OF
THOSE.
>> YOU JUST THAT WINNOWING
DOWN.
I THOUGHT WE WERE TRYING TO
EXPAND.
>> WE ARE BUT WE HAVE A
LIMITED AMOUNT OF TIME AND A
LIMITED AMOUNT OF MONEY AND
CAPACITY SO WHEN YOU TALK ABOUT
COMMUNITY-BASED SOCIAL SERVICES
ORGANIZATIONS WHERE THERE ARE
OVER 500 AND KING COUNTY, WE
CANNOT WORK WITH EVERYBODY ALL
THE SAME TIME.
WHEN YOU ARE TALKING ABOUT ALSO
CONNECTING THAT COMMUNITY
SOCIAL DETERMINATE TO THE
HEALTHCARE DELIVERY SYSTEM IN A
NEW WAY, THAT IS NOT HAPPENING
AT ALL.
RIGHT NOW THERE ARE POCKETS OF
PARTNERSHIPS BUT FOR THE MOST
PART, IF I AM A PRIMARY CARE
DOCTOR IN THE CLINIC, I DON'T
KNOW WHERE TO SEND PEOPLE FOR
HOUSING SUPPORTS OR TO GET
ACCESS TO HEALTHY FOOD AND SO
FORTH.
WE ARE BUILDING THAT OUT AND WE
CANNOT DO IT WITH 500 PROVIDERS
SO IT IS DEFINED WITH THE SOME
AMOUNT OF PROVIDERS THAT WE CAN
START WITH AND THAT WE CAN
DESIGN THE CARE MODELS AND WORK
OUT ALL OF THE KINKS IN IT AND
WE WOULD DO THAT IN 2019 SO
THAT IN 2020, OUR INVESTMENTS
CAN FOCUS ON BRINGING IT TO
OTHER PROVIDERS.
>> THAT TAKES US DIRECTLY INTO
THE NEXT SLIDE HERE . AGAIN, A
LOT OF WORK THAT WE HAVE BEEN
DOING, THE ENGAGEMENT OF THE
HEALTHCARE PROVIDERS ABOUT
BEHAVIORAL AND PHYSICAL HEALTH
PROVIDERS HAS BEEN PRETTY
STRAIGHTFORWARD BECAUSE THESE
ARE AGENCIES OR ENTITIES THAT
HAVE WORKED WITH MEDICAID FOR
MANY, MANY YEARS.
THEY KIND OF HAVE A HEAD START
IF YOU WILL.
I THINK THE REAL CHANGE HERE IS
REALLY BEING ABLE TO HELP
COMMUNITY-BASED ORGANIZATIONS
TO BE A PART OF THIS PROCESS
AND IN THAT WHAT WE DO IS WE
HAVE RELEASED TO BEGIN TO DO
INTERVENTIONS AS OPPOSED TO THE
WORK OF THE HEALTHCARE PROVIDERS
AFTER PERSON ALREADY HAS A
HEALTH CONDITION.
THIS IS THE REALLY EXCITING
PART AT LEAST FOR ME OF THIS
TRANSFORMATION PROCESS. AS
SUSAN SAID, JUST TO THROW THE
NET AND SEE WHO WANTS TO BE A
PART OF THIS.
THERE IS SOME WORK THAT THEY
HAVE TO ENGAGE IN BUT THE
BEAUTY OF THE WAIVER PROJECT
AND WHAT YOU SAW IN THE FIRST
YEAR IS THAT WE HAVE BEEN ABLE
TO PROVIDE A LOT OF THESE
AGENCIES SOME UPFRONT FUNDING
TO REALLY ASSESS THEIR ABILITY
TO PARTICIPATE AND TO UNDERSTAND
WHAT IT MEANS TO BE A PART OF
THIS PROCESS.
SO, THAT IS WHAT HAS GONE ON.
WE WILL BE SELECTING A COHORT
OF ORGANIZATIONS TO BEGIN
WORKING INITIALLY AND OBVIOUSLY
THAT CAN EXPAND OVER TIME AS
WELL.
IT IS TO REALLY HAVE THAT
LINKAGE THAT SUSAN TALKED ABOUT.
THIS IS REALLY ABOUT WHERE WE
BEGIN TO MAKE SURE THAT THE
INDIVIDUALS THAT ARE BEING SEEN
IN OUR COMMUNITY-BASED AGENCIES
ARE ALSO CONNECTED TO HEALTHCARE
BUT NOT JUST THAT CONNECTIONS
ARE MADE BUT THAT THE ACTUAL
CARE PLANNING AND LOOKING AT
THE PERSON INTO HOW WE CAN BEST
IMPROVE THEIR HEALTH AND
PREVENT DISEASE.
>> I HAVE TO TELL YOU, I LOVE
THIS SLIDE.
WITH A LONG-TERM SUCCESS LOOKS
LIKE.
>> THANK YOU.
I SKIPPED OVER THAT FOR THE
INTEREST OF TIME BUT THIS IS
WHAT THE GOVERNING BOARD DID
IN 2017.
WE SAID WE HAVE A LIMITED
AMOUNT OF TIME, FIVE YEARS AND
LIMITED AMOUNT OF MONEY.
WE CAN'T DO EVERYTHING AND AT
THE END OF FIVE YEARS IF WE
WERE TO SAY HOW IS THE REGION
DIFFERENT, THIS IS WHAT THE
BOARD CAME UP WITH.
THESE FOUR THINGS ON THIS
SLIDE.
THANK YOU.
>> THE OTHER THING THAT I
WANTED TO TALK TO YOU BRIEFLY
ABOUT IS SORT OF THE ACTUAL
GOVERNING STRUCTURE THAT WE ARE
WORKING UNDER AND THAT ONE
THIRD OF THE BOARD IS COMMUNITY
CONSUMER-BASED ORGANIZATIONS
THAT WE HAVE A VERY SPECIFIC
COMMITTEE THAT IS A FORMAL PART
OF EVERYTHING THAT WE DO AND
ANY DECISION THAT WE MOVE
FORWARD ON IS PASSED THROUGH
THIS COMMITTEE AND THEY PROVIDE
BOTH THE INPUT IN THIS
DEVELOPMENT AS WELL AS
RECOMMENDATIONS ABOUT HOW THE
GOVERNING BOARD SHOULD MOVE
FORWARD.
ALSO AS WE TALKED ABOUT
PREVIOUSLY IS GETTING MONEY OUT
TO A LOT OF ENTITIES INITIALLY
JUST TO BE ABLE TO HAVE FOLKS
PARTICIPATE TO THIS LEVEL.
>> WHAT DO YOU USE SMALL
GRANTS FOR?
$3700 DOES NOT STRIKE ME TO
MAKE MUCH OF A DIFFERENCE.
>> THE SPECIFIC SMALL GRANTS
PROGRAM THAT WE RAN IN 2018 WAS
SPECIFICALLY TO WORK WITH
COMMUNITY-BASED ORGANIZATIONS
THAT ARE EMBEDDED IN VARIOUS
COMMUNITIES TO RUN FOCUS GROUPS
AND SURVEY THEIR MEDICAID
INDIVIDUALS ABOUT THE
HEALTHCARE SYSTEM AND WHAT IS
WORKING AND NOT WORKING AND
WHAT CAN WE IMPROVE UPON?
IT REALLY DEPENDED ON THE SIZE
OF THE ORGANIZATION AND IF THEY
WERE DOING ORGANIZATIONS WITH
TWO FOCUS GROUPS AND OTHERS
SAID WE COULD GET 250 SURVEYS
DONE BY PEOPLE SO THAT IS THE
RANGE.
YOU CAN SEE THAT WE ENDED UP
WITH 900 INDIVIDUALS WHO
RECEIVED MEDICAID TO COMPLETE
SURVEYS ABOUT THEIR EXPERIENCE
WITH THE HEALTHCARE DELIVERY
SERVICE SO WE ARE REALLY TRYING
TO REACH A BROAD BASE OF FOLKS.
>> WHEN YOU DO PROVIDE THE
INFORMATION WITH THE PARTNERS
YOU ARE WORKING WITH, IT WOULD
BE HELPFUL TO HAVE A BREAKDOWN
OF THE ORGANIZATIONS BASED ON
WHO THEY ARE SERVING WITH
COMMUNITIES OF COLOR OR LOW
INCOME FOLKS.
WHEN YOU TALKED ABOUT COMMUNITY
, COMMUNITY HEALTH WORKERS. IF
YOU COULD GIVE US THOSE
DEMOGRAPHICS, I THINK THAT
WOULD BE SUPER HELPFUL.
>> ABSOLUTELY.
>> SO, THE NEXT SLIDE THAT I
WAS GOING TO TOUCH ON BRIEFLY
AND I WAS IS SOMETHING THAT
ALIGNS VERY MUCH WITH THE WORK
THAT WE ARE DOING IN THE CITY
HERE AND THAT IS REALLY ABOUT
WORK FIRST DEVELOPMENT.
A PIECE OF THE FUNDING THAT WE
WILL BE WORKING WITH IS REALLY
GOING TO BE FOCUSED ON TRYING
TO ANSWER SOME VERY COMPLEX
QUESTIONS AROUND BUILDING THE
CAPACITY FOR US TO SERVE ALL OF
THE INDIVIDUALS THAT WE WOULD
LIKE TO SERVE.
SO, ENSURING THAT WE HAVE A
TRAINED WORKFORCE ON SOME THE
AREAS PARTICULARLY AROUND
HEALTH AND BEHAVIORAL HEALTH
AND IT BUILDS CAPACITY AND
AREAS OF CARE COORDINATION AND
THE COMMUNITY HEALTH WORKERS IN
PEER SUPPORT SPECIALIST.
THERE ARE MODELS IN VARIOUS
PLACES OF HOW THOSE PROGRAMS
CAN WORK EFFECTIVELY SO WE
WOULD OBVIOUSLY USE THOSE
MODELS AND FIGURE OUT A WAY TO
BUILD A CAPACITY HERE IN OUR
COUNTY AND THEN ALIGN WITH
OTHER INITIATIVES AND THIS IS
WHERE THE CITY COMES IN BECAUSE
WE TOO WITHIN THE CITY HAVE A
VARIETY OF DIFFERENT
INITIATIVES THAT WE WOULD LIKE
TO SORT OF ALIGN WITH IN OUR
PROCESS.
>> CAN YOU TALK A LITTLE BIT
MORE ABOUT THAT?
DOES THAT MEAN ACCESS TO HIGH-
QUALITY UNION JOBS IN THE
HEALTHCARE INDUSTRY?
>> IT'S ABOUT THE DEVELOPMENT
OF HEALTHCARE WORKFORCE AND WE
HAVE RECENTLY CONNECTED WITH THE
HEALTH LEADERSHIP INDUSTRY
TABLE THROUGH THE CITY. I THINK
IT IS THROUGH THE ECONOMIC
DEVELOPMENT IN THE SEATTLE JOBS
INITIATIVE WHICH IS A BIG PART
OF THAT.
THAT IS REALLY LOOKING INTO
SOME OF THE LABOR UNIONS THAT
ARE INVOLVED IN THE HEALTH
INDUSTRY AS WELL WHICH IS HOW
WE GO ALL THE WAY INTO OUR
MIDDLE SCHOOLS AND HIGH SCHOOLS
TO GET PEOPLE EXCITED ABOUT
HEALTHCARE JOBS BUT ALSO WHEN
WE PULL AND ITS PEOPLE COME
INTO ENTRY-LEVEL JOBS AND
HEALTH SYSTEMS AND THEY MAY BE
A JANITOR OR SOMEONE THAT WORKS
IN THE HOSPITAL CAFETERIA THAT
THEY ARE ACTUALLY PUTTING
MECHANISMS IN PLACE TO EXPOSE
THOSE INDIVIDUALS TO A WIDE
VARIETY OF JOBS WITHIN THE
HEALTHCARE DELIVERY SYSTEM AND
CREATING WHAT THEY CALL UPSCALE
PROGRAMS SO THAT I MAY COME IN
AS A JANITOR AND I HAVE ACCESS
TO ENGLISH AS A SECOND LANGUAGE
AND OTHER KINDS OF OPPORTUNITIES
AND MAYBE I DIDN'T EVEN KNOW I
COULD BE A MEDICAL ASSISTANT OR
SOMETHING ELSE SO THEY ARE
CREATING PATHWAYS TO MOVE INTO
JOBS THAT WILL PAY MORE LIVABLE
WAGES.
>> MAYBE YOU SAID THIS AND I
MISSED IT BUT ARE WE WORKING
WITH OUR PROMISE, THE TWO YEARS
OF GOING INTO LOCAL COLLEGES?
ONE OF THE THINGS THAT I HAVE
LEARNED FROM MY FAVORITE FRIENDS
IN THE CONSTRUCTION UNION IS
OFTEN TIMES IF THEY CAN REACH
KIDS AT THE HIGH SCHOOL LEVEL
TO HELP THEM WITH MATH SKILLS
AND BASIC MATH SKILLS WHETHER
YOU JUST INFRACTIONS ON TAKING
A MEASUREMENT OR WHATEVER IT
MIGHT BE, IF WE COULD START
EARLY, AND HELPS PEOPLE BE
READY FOR THESE KINDS OF JOBS
AND I HAVE TO BELIEVE THAT THE
SAME THING IS TRUE ABOUT THE
MEDICAL WORLD.
>> WE HAD NOT SO THANK YOU FOR
THAT SUGGESTION.
I WILL ABSOLUTELY LOOK INTO
THAT AS WELL.
>> I KNOW THAT RICK BURKE IS
ON THE SEATTLE PUBLIC SCHOOL
BOARD.
THESE APPRENTICESHIP
OPPORTUNITIES AND INTERNSHP
OPPORTUNITIES ARE HIGH ON HIS
LIST SO IF YOU ARE LOOKING AT
REACHING OUT TO THE COMMUNITY,
I WOULD JUST SUGGEST THAT YOU
CONTACT HIM AND FEEL FREE TO
LET HIM KNOW THAT YOU HAVE BEEN
AT THIS COMMITTEE.
>> THANK YOU VERY MUCH.
I WILL DO THAT.
>> WITH THE HEALTH INDUSTRY
LEADER TABLE, YOU SAID THAT USW
21 ARE THE HELP NURSE UNIONS
AND 365 OR 367.
>> YOUR KNOWLEDGE IS BEYOND
MINE . WITH ALL THE NUMBERS BUT
THE LAST MEETING I WAS AT,
ANOTHER ONE OF MY STAFF PEOPLE
HAS BEEN ATTENDING MUCH MORE
REGULARLY BUT BOTH THE SEI YOU
AND THE OTHER THAT YOU
MENTIONED WERE REPRESENTED.
I THINK 1099 WAS THE SEIU.
>> IS ALSO FOLDS INTO THE
CONVERSATION BECAUSE WE KNOW
GETTING INTO THE HEALTHCARE
INDUSTRY WERE FILLED PROFESSION
IS THAT THEY STRUGGLE TO MAKE A
LIVING WAGE JOBS SO AS WE THINK
ABOUT CREATING MORE AFFORDABLE
HOUSING, ONE OF THE THINGS THAT
IS HAPPENING, YOU REMEMBER THE
OLD SPECIFIC HOSPITAL TOWER, WE
HAVE NOW FILLED THAT WITH
COMMUNITY ORGANIZATIONS WITH AN
ORIENTATION TOWARDS HEALTH AND
THERE IS A DENTAL TRAINING
PROGRAM AND THE NURSE TRAINING
PROGRAM AND IT IS RUN BY
PARTNERS FROM THE SEATTLE
COLLEGE SYSTEM THAT ARE HOUSED
THERE AND IN THE FUTURE VISIT
IS TO CREATE AFFORDABLE HOUSING
FOR FOLKS ON THE NORTH LOT.
IT ALL CONNECTS HERE AND I'M
GLAD TO HEAR THAT YOU ARE
WORKING WITH THOSE UNION
PARTNERS.
>> DID WE HAVE OUR MEETING
THERE?
>> YES.
OUR BOARD DOES MEET OVER AT
PACK TOWER OCCASIONALLY.
SO, I WILL TALK A LITTLE BIT
ABOUT OUR INVESTMENT STRATEGY.
U. S. QUESTIONS ABOUT THE MONEY
AND I WILL TELL YOU ALL ABOUT
IT.
WHAT I WILL SAY IS THAT IT
SOUNDS LIKE A LOT OF MONEY AND
WHEN YOU START TO SORT OF DIVVY
IT UP BY WHEN YOU GET IT AND
HOW YOU EARN IT OR WHETHER OR
NOT YOU ARE IN IT OR THE PEOPLE
THAT WANT SOME OF THAT, IT GOES
REALLY QUICKLY.
WE HAVE A RESPONSIBILITY AT
HEALTHIERHERE AND ULTIMATELY
THE GOVERNING BOARD TO FIGURE
OUT AS WE THINK ABOUT MAKING
THE INVESTMENTS IN THIS HUGE
OPPORTUNITY THAT IS IN FRONT OF
US, HOW CAN WE BE THE MOST
IMPACTFUL AND CHANGE KNOWING
THAT WE WILL NOT GET ALL DONE
IN FIVE YEARS WITH THE WAIVER.
CREATING A BALANCE BETWEEN HOW
MUCH GOES TO INDIVIDUAL
PROVIDER ORGANIZATIONS VERSUS
SYSTEM-LEVEL BENEFITS THAT HELP
EVERYBODY.
IT'S NOT MONEY THAT WILL GO TO
A SINGLE PROVIDER BUT RATHER AS
A SYSTEM-LEVEL THAT CONNECTS
PROVIDERS TOGETHER.
WE NEED TO DO BOTH IN ORDER TO
MAKE THIS WORK.
WE ALSO HAVE TO MAKE SURE WE
BALANCE INVESTMENTS BETWEEN A
TRADITIONAL HEALTHCARE DELIVERY
SYSTEM AND THE COMMUNITY-BASED
AREAS OF SIGNIFICANT
UNDERFUNDED IF WE WANT TO BRING
THEM TOGETHER IN A LEVELED WAY.
BIG HOSPITALS AND HEALTH SYSTEMS
DON'T NEED AS MUCH RESOURCES
FROM US AS A SMALL COMMUNITY-
BASED ORGANIZATION WHO IS
TRYING TO PROVIDE COORDINATION
FOR THE SOMALI COMMUNITY OR
SOMETHING LIKE THAT.
THAT IS PART OF THE STRATEGY
GOING FORWARD.
I WILL ALSO POINT OUT THAT
WHILE WE DO HAVE MONEY AND
INVESTING TRANSFORMATION IS A
BIG SIGNIFICANT IMPORTANT ROLE
FOR US, WE DO HAVE OTHER ROLES
THAT WE ARE PLAYING IN THIS
REGION.
WE HAVE TALKED A LOT ABOUT
CONVENING PARTNERS BECAUSE
HEALTHIERHERE IS MULTI-
STAKEHOLDER APPROACH.
WE DON'T REPRESENT ANY SINGLE
ORGANIZATION OR SECTOR.
WE ARE WELL-VERSED TO BRING
PARTIES TOGETHER TO TALK ABOUT
CRITICAL ISSUES THAT AFFECT THE
WHOLE SYSTEM. SHARED CARE
PLANNING AND HOW WE STANDARDIZE
THE COLLECTION OF SOCIALLY
DETERMINATE INFORMATION AND SO
FORTH.
WE ALSO HAVE A POLICY ROLE.
WE ARE PARTICIPATING BOTH IN
LOCAL AND STATEWIDE POLICYMAKING
RELATED TO THE TRANSFORMATION
GOALS.
THERE ARE A NUMBER OF POLICY
BARRIERS THAT WHILE YOU HAVE
PROVIDERS THAT WANT TO DELIVER
INTEGRATIVE CARE, THERE ARE
RULES AND REGULATIONS THAT
PREVENT THEM FROM DOING IT.
SOMETIMES IT'S AROUND LICENSING
ISSUES AND SOMETIMES AROUND
WHAT KINDS OF CODES CAN BE USED
ON THE SAME DAY.
WE NEED TO REMOVE THOSE
BARRIERS IF WE WANT PEOPLE TO
DELIVER CARE.
THE LAST PIECE OF SUSTAINABILITY
, WE ARE MAKING THESE
SIGNIFICANT INVESTMENTS IN
TRANSFORMATION AND BECAUSE THIS
IS NOT A GRANT FUND AND WE
DON'T WANT IT TO WORK LIKE A
GRANT FUND, WE DON'T WANT TO
WORK TO GO AWAY WHEN THE MONEY
GOES AWAY.
WE ARE WORKING WITH THE
HEALTHCARE AUTHORITY AND WE
WILL BE WORKING WITH OUR
MANAGED-CARE ORGANIZATIONS.
WHEN WE IDENTIFY CARE MODELS
THAT WORK, WE WANT TO FIND WAYS
THROUGH BASE PAYMENT
ARRANGEMENTS FOR THOSE CARE
MODELS TO BE FULLY COVERED AND
RESOURCE UNDER THE MEDICAID
PROGRAM WHERE IT IS APPROPRIATE
AND WHERE IT IS NOT.
WE HAVE TO IDENTIFY OTHER
RESOURCES TO SUSTAIN IT SO WE
WILL BE WORKING ON THAT AS WELL.
>> WHAT HAPPENS AT THE END OF
FIVE YEARS?
>> IT DEPENDS.
THE 11th 15 WAIVERS ARE
RENEWABLE. IT IS GIVEN WITH THE
CURRENT FEDERAL ADMINISTRATION
AND HIGHLY UNLIKELY AND IN FACT
NEW YORK WHO IS AHEAD OF OURS
WAS TRYING TO RENEW THEIR
WAIVER AND THEY WERE NOT ABLE
TO GET THERE. IF THERE IS AN
MINISTRATION CHANGE, OUR WAIVER
WILL NOT END UNTIL 2021 SO IF
THERE'S NEW THOUGHTS ON THE
VALUE OF THIS, THERE IS THE
POTENTIAL FOR RENEWAL.
IF WE DON'T DRAW DOWN ALL OF
THE FUNDING, WE CAN DO A NO-
COST EXTENSION TO CONTINUE TO
BE ABLE TO DRAW DOWN THE
FUNDING.
THOSE ARE KIND OF THE MAIN
OPTIONS WITH THE WAIVER AND
THEN THERE ARE OTHER OPTIONS AS
MENTIONED WITH REGARD TO SOME
OF THE INDIVIDUAL INVESTMENT
AND PROJECTS THAT WE DO IF WE
CAN CREATE MECHANISMS TO HAVE
THEM SUSTAINED UNDER A CONTRACT
OR THROUGH ANOTHER MECHANISM.
>> A DIFFERENT MEDICAID
CONTRACT IS DIFFERENT FROM THE
WAIVER.
>> YES.
>> THERE IS MONEY OUT THERE IN
DIFFERENT BUCKETS .
>> YES.
THAT IS A REALLY GOOD AND
IMPORTANT QUESTION.
THE STATE HAS A MEDICAID STATE
PLAN TO PROVIDE HEALTH AND
BEHAVIORAL HEALTH SERVICES AND
LONG-TERM CARE SERVICES AND
DEVELOP MENTAL DISABILITIES.
THOSE CONTRACTS ARE NOT
CHANGING TODAY.
THEY ARE THE SAME AND THAT
MONEY STILL FLOWS.
THIS IS NEW MONEY COMING INTO
THE SYSTEM AND WHAT MAKES IT A
WAIVER AND SO UNIQUE IS THAT IT
BASICALLY WAIVES THE RULES OF
MEDICAID AND ALLOWS THE STATE
TO USE IT IN NEW AND INNOVATIVE
WAYS TO PAY FOR THINGS MEDICAID
DOESN'T TODAY PAY FOR UNDER THE
MEDICAID CONTRACT TO TEST NEW
WAYS OF INNOVATION.
NOW, THE TRADE-OFF IN ALL OF
THAT IS THAT AT THE END OF THE
DAY, THE WAIVER HAS TO BE
BUDGET NEUTRAL SO THE WAY I
DESCRIBED IT IS THAT THE
FEDERAL GOVERNMENT IS FRONTING
THE STATE MONEY THAT THEY WOULD
HAVE SPENT ANYWAY FOR THE
MEDICAID PROGRAM AND THE STATE
IS AGREEING TO REDUCE THE TOTAL
TRAJECTORY BY A CERTAIN AMOUNT
SO THAT IT IS BUT YOU BUDGET
NEUTRAL.
>> THIS IS AN AREA THAT I LOVE
SO LET'S ANTICIPATE THAT THINGS
GO WELL . WILL REVENUE NEUTRAL
MEAN THAT THEY WILL LOOK AT
SYSTEMWIDE INVESTMENTS?
IF WE CAN DEMONSTRATE THAT OUR
FIRE DEPARTMENT SAVES MONEY
BECAUSE IT'S NOT SENDING OUT A
GUYS OR FIRST RESPONDERS IN
LADDER TRUCKS AND THEY ARE NOT
TAKING AN INDIVIDUAL TO HARVARD
MEDICAL CENTER. IF YOU ASSUME
ALL THAT, IT IS A $2000
RESPONSE AND $2000 OVERNIGHT.
IF YOU CAN SAY WE SAVE THE
SYSTEM FOR THOUSAND DOLLARS,
WHILE THAT BENEFIT OR WILL
PEOPLE SAY IT'S KIND OF LIKE
NOT BUDGET NEUTRAL BECAUSE THE
FIRE DEPARTMENT GETS THAT OR
DESC HAS A NURSE THAT THEY WILL
HAVE TO PAY FOR.
HOW WILL WE DEMONSTRATE THAT IT
IS REVENUE NEUTRAL?
>> SO, IN THAT SENSE IT IS
LESS ABOUT THEM TREATING THE
REVENUE NEUTRAL TO THE FEDS.
THAT IS JUST A FORMULA THAT THE
STATE HAVE TO MEET BUT WHAT
YOU'RE TALKING ABOUT IS HOW WE
ENSURE IF WE ARE SAVING MONEY
TO THE SYSTEM THAT IT IS
GETTING REINVESTED IN THESE
LESS-EXPENSIVE THINGS THAT
REALLY WORK.
THAT IS THE GOAL AND THE HOPE
AND YOU PROBABLY KNOW FROM THE
POSITIONS THAT YOU SIT IN AND
THE WORK THAT YOU DO THAT IT IS
SOMETIMES EASIER SAID THAN
DONE.
WE ARE IDENTIFYING WHERE THE
SAVINGS ACCRUE AND TO WHOM.
THAT IS A BIG FACTOR IN THAT.
CERTAINLY, WHEN YOU ARE REDUCING
HOSPITAL STAYS, IT'S ACCRUING
AND HEALTH PLANS SO YOU WANT
THEM TO REINVEST AND THERE ARE
OTHER WAYS WERE SAVINGS MIGHT
BE ACCRUING TO THE CRIMINAL
JUSTICE SYSTEM SO WE HAVE TO
FIGURE THAT OUT.
THE IDEA IS TO FIGURE IT OUT
AND THERE IS AN EVALUATION AND
WE DIDN'T REALLY TALK ABOUT
THAT BUT THERE WILL BE AN
EVALUATION HAPPENS LOCALLY AND
STATEWIDE.
THE HOPE IS TO SAY THIS IS
WORKING BETTER AND MORE
EFFECTIVELY IN SAVING MONEY.
LET'S MOVE OUR RESOURCES AND
REALLOCATE THEM HERE BECAUSE IT
WILL GENERATE SAVINGS.
TO THE EXTENT POSSIBLE, WE
REALLY DO WANT PEOPLE THAT ARE
EXPERIENCING THOSE SAVINGS TO
REINVEST THOSE RESOURCES IN THE
COMMUNITY AND WE WILL BE DOING
NEGOTIATION AROUND THAT AS WELL.
>> PLEASE KEEP US INFORMED ON
THAT , SUSAN.
THAT IS SUCH A TRICKY AREA BUT
WE KNOW EXPERIENTIALLY AND
COMMON SENSE SAYS IF YOU CAN
SAVE $4000 FROM ONE RUN-UP,
THAT IS A REALLY GOOD THING.
LET'S REINVEST THAT MONEY IN
OUR FIRE DEPARTMENT OR REINVEST
SO THAT DESC CAN AFFORD TO HAVE
A 24/7 NURSE ON SITE.
>> RIGHT.
TO DIVERT LIKE YOU ARE TALKING
ABOUT THE NEED FOR BEDS.
SO, I WILL SKIP AHEAD.
>> LET'S WRAP IT UP .
>> SORRY ABOUT THAT.
I JUST WANT TO SHOW THE WHOLE
PICTURE REALLY QUICKLY.
OUR HEALTHIERHERE TOTAL
AVAILABLE ANTICIPATED BUDGET
FOR THE FIVE YEAR WAIVER IS
$97 MILLION.
THIS SHOWS YOU THE AMOUNTS
ACROSS THE YEARS AND ON THE
LEFT-HAND SIDE ARE USED
CATEGORIES WHICH YOU CAN TAKE A
LOOK AT.
THE MOST IMPORTANT THING IS 97
MILLION ACROSS THE FIVE YEARS.
IT IS BASED ON CERTAIN
ASSUMPTIONS SO THERE IS A
CHANCE WE COULD EARN MORE THAN
THAT BUT WE NEED TO BE
CONSERVATIVE BECAUSE WE DON'T
WANT TO GO OFF A CLIFF.
75 MILLION OF THAT IS THE
PROJECT INCENTIVE DOLLARS THAT
WE HAVE BEEN TALKING ABOUT.
IF YOU FLIP TO THE NEXT SLIDE,
AT 75 MILLION THAT GETS DIVIDED
AMONGST MEDICAID PROVIDERS AND
COMMUNITY-BASED ORGANIZATIONS
AND TRIBES AND A LITTLE BIT TO
HEALTHIERHERE TO SUPPORT THE
IMPLEMENTATION . AGAIN, THIS IS
FOR THE FIVE YEARS.
YOU CAN SEE HOW IT IS DIVIDED
UP AND THAT IS THE MONEY THAT
WILL GO INTO THE SYSTEM OVER
THE NEXT SEVERAL YEARS FOR THIS
TRANSFORMATION WORK.
AS WE MOVE INTO IMPLEMENTATION
THIS YEAR AS I SAID, WE ARE
HAPPY TO COME BACK AND GIVE
REGULAR UPDATES ABOUT WHERE WE
ARE INVESTING AND WHAT IS
WORKING AND NOT WORKING AND
LESSONS LEARNED.
THANK YOU SO MUCH FOR THE TIME
AND I'M SORRY WE RAN OVER BUT
THIS HAS BEEN SUCH A GREAT
CONVERSATION.
WE ARE SUPER EXCITED AND THERE
A LOT OF OPPORTUNITY FOR
PARTNERSHIP ALIGNMENT.
I LOOK FORWARD TO FOLLOW-UP.
>> YOU CAN REALLY SEE WHY AS A
MEMBER OF THE GOVERNING BOARD,
WHAT THIS DIVERSE GROUP OF
FOLKS THAT WE ARE SO LUCKY TO
HAVE, SUSAN SORT OF LEADING
THIS PROCESS HERE AND THE
STAFF.
SHE HAS AN AMAZING STAFF THAT
SHE HAS PUT TOGETHER AS WELL.
>> 1002nd AVENUE SO NOT FAR
FROM HERE BETWEEN SPRING AND
MEDICINE ON SECOND.
>> SO, I WAS EXCITED TO LEARN
ABOUT ALL THAT YOU ARE DOING
AND I HEAR A LOT ABOUT
ACCOUNTABLE COMMUNITIES OF
HEALTH AND IT DOESN'T REALLY
ACTUALLY GIVE YOU A VISION OF
WHAT IS HAPPENING. SO, WHAT YOU
JUST ARTICULATED TODAY REALLY
PAINTS A PICTURE OF HOW OUR
COMMUNITY PARTNERS ARE INVOLVED
IN WITH A BETTER UNDERSTANDING
OF WHO YOU ARE WORKING WITH
ONCE YOU MARRIED THAT DOWN TO
YOUR CORE GROUP, THAT WILL BE
HELPFUL FOR US TO KNOW.
I AM EXCITED AND ALSO NERVOUS
ABOUT THIS NEED TO HAVE
MEDICAID DOLLARS BE NEUTRAL TO
THE FEDERAL GOVERNMENT AND THIS
MEANS THAT WE HAVE TO GET THE
ECONOMIC STABILITY AREA OF THE
SOCIAL DETERMINANTS OF HEALTH
RIGHT IN THE COUNTY AND THE
CITY WILL PLAY A HUGE ROLE IN
THAT.
IF IN THE FUTURE, I KNOW
MEDICAID DOLLARS ARE STABLE FOR
NOW BUT IF THEY ARE SOMEHOW
AFFECTED BY DOLLARS NEEDING TO
BE OFFSET BY THE FRONTLOADING
OF INVESTMENT INTO THE
TRANSFORMATION WAIVER, MAYBE
THAT DON'T MATERIALIZE LATER IN
THE FUTURE MINISTRATION DECIDES
TO REDUCE THE DOLLAR AMOUNT FOR
OVERALL MEDICAID, THAT CAN BE
TRAUMATIZING.
I THINK THERE IS A LOT OF
OPPORTUNITY HERE BUT IT DOES
FEEL LIKE THERE IS ALSO FACTORS
THAT COULD BE OUT OF YOUR
CONTROL.
IT'S SPECIFIC TO YOUR NETWORK
OR PARTNERS AND THAT IS A HUGE
ROLE FOR US TO PLAY.
SO, I WOULD LOVE TO STAY
ENGAGED IN COME TO ONE OF YOUR
COMMUNITY MEETINGS.
>> PLEASE DO.
ALL THEM ARE OPEN PUBLIC AND
ALSO WITH THE FOLLOWING
MATERIALS.
WE CAN SEND A LINK TO THE
WEBSITE WITH THE VARIOUS
MEETINGS.
>> THE LAST IS I AM VERY
INTERESTED IN THE SUCCESSION OF
THIS AFTER THE FIVE YEAR PERIOD.
MAYBE THE BILL WILL BE
SUCCESSFUL AND HAVE A DIFFERENT
WAY OF IMPLEMENTING HEALTHCARE
IN THE FUTURE BUT AT THIS POINT
, WE WOULD LOVE TO WORK WITH
YOU TO MAKE SURE THE FIVE YEAR
MARK DOES NOT EQUAL A CLIFF.
THANK YOU.
THANK YOU FOR ALL YOU ARE
DOING.
>> THANK YOU VERY MUCH AND
THANKS FOR ALLOWING YOURSELF TO
BE REPRESENTED ON OUR BOARD.
IT'S VERY HELPFUL.
>> THANK YOU SO MUCH.
WE WILL MOVE INTO ITEM NUMBER
TWO ON OUR AGENDA.
COULD YOU READ THE SECOND ITEM
OF BUSINESS INTO THE RECORD?
>> ITEM NUMBER TWO SEATTLE
HOUSING AUTHORITY UPDATE FOR
BRIEFING AND DISCUSSION.
>> THANK YOU.
WE WILL BE JOINED AT THE TABLE
BY ANDREW LOFTON AND JARED
CUMMER.
IS THERE ANYONE ELSE WHO IS
JOINING YOU TODAY?
OKAY.
HI GUYS.
WELCOME.
THANK YOU FOR REACHING OUT TO
OUR OFFICE WITH THIS GOOD NEWS
ABOUT THE PROJECT YOU ARE
WORKING ON.
WE I THINK HAVE TEED UP WELL
WHY WE HAVE INTEGRATED HEALTH
AND HOUSING INTO ONE COMMITTEE.
NOT TO MENTION WORKERS RIGHTS.
SO, WE ARE LOOKING FORWARD TO
HEAR MORE FROM YOU ABOUT THE
WORK FOR AFFORDABLE HOUSING AND
HOW IT CAN BE HELPFUL.
>> THANK YOU.
IT'S A PLEASURE TO BE HERE AND
I APPRECIATE THE OPPORTUNITY
TO SHARE WITH YOU THE NEW
PROGRAM THAT WE ARE EMBARKING
UPON.
THERE ARE ALSO A FEW OTHER
QUESTIONS THAT WERE RAISED AND
I THOUGHT WE WOULD DO A COUPLE
OF THINGS.
WE WOULD TOUCH ON FOUR THINGS.
THREE VERY BRIEFLY AND HIGH-
LEVEL AND THE FOURTH IS THE
ACQUISITION PROGRAM AND GOING
TO SOME DEPTH WITH THAT.
I THOUGHT I WOULD TALK A LITTLE
BIT AND GIVE YOU A SNAPSHOT ON
WHERE WE ARE. A SNAPSHOT OF
WHERE WE ARE WITH THE HOME FROM
SCHOOL PROGRAM WHICH IS
CONNECTED AND GIVE YOU LITTLE
BACKGROUND OVER WE ARE WITH
THAT.
TALK ALSO SOME ABOUT OUR WORK
ON THE HOUSING STABILITY
EFFORTS THAT ARE UNDERWAY AND
THEN SPEND THE REST THE TIME ON
THE ACQUISITION AND
PRESERVATION PROGRAM.
I WILL TRY TO DO VERY HIGH
LEVEL ON THE OTHER THREE AND WE
WILL BE BACK TO YOU BECAUSE WE
USUALLY DO AN ANNUAL REPORT TO
YOU ON WHAT WE ARE DOING WITH
THAT SO I WILL SPEND A LOT OF
TIME ON THAT.
AT A HIGH LEVEL, THE SNAPSHOT
TO THINK THAT WE ARE VERY
PLEASED WITH THE PROGRESS
THERE, JUST BY THE NUMBERS, WE
HAVE COMPLETED OR WILL HAVE
COMPLETED BY THE END OF THIS
MONTH 298 REPLACEMENT UNITS.
WE ARE VERY EXCITED ABOUT THAT.
THE OPENING OF THE RED CEDAR
WHICH IS THE FIFTH BUILDING
WHICH WILL BE COMPLETED
SOMETIME IN THE NEXT 30 DAYS.
IT WILL BRING THOSE REPLACEMENT
HOUSING UNITS UP TO 298.
IN ADDITION TO THAT, WE HAVE
TWO MORE PROJECTS IN THE
PIPELINE AND ONE THAT WILL GET
STARTED THIS SPRING OR LATE
THIS SUMMER.
ANOTHER WHICH IS IN PARTNERSHIP
WITH THE CHINATOWN DISTRICT AND
CAPITAL HOUSING ON THE COUNTY
RECORDS SITE.
THEY WILL BE DOING 186 UNITS OF
AFFORDABLE HOUSING AND 92 WHICH
WILL BE REPLACING HOUSING AND
THE PROJECT THAT WE ARE DOING
THAT WILL BE STARTED LATER THIS
YEAR WILL ADD ANOTHER 139 UNITS
AND 88 OF WHICH WILL BE
REPLACEMENT HOUSING WITH THE
COMPLETION OF THOSE TWO PROJECTS
, WE WILL HAVE 85% OF THE
REPLACEMENT HOUSING DONE.
SO, IT STARTS SOMETIME THIS
SUMMER AND THE RECORDS SITE
PROJECT IS STILL IN DISCUSSIONS
AND DESIGNS SO THEY WON'T
PROBABLY GET STARTED FOR
ANOTHER YEAR OR SO BUT WE ARE
VERY EXCITED ABOUT THE PACE
THAT HAS BEEN HAPPENING AND WE
ARE VERY CLOSE TO THE
COMPLETION OF THOSE TWO
BUILDINGS AND ALL THE
REPLACEMENT HOUSING.
WE ARE ABOUT A THIRD OF THE WAY
ALREADY WITH A 60% TAX CREDIT
HOUSING.
WE HAVE A THIRD OF THAT
COMPLETED AND WE ARE SCHEDULED
TO DO 300 UNITS THERE.
WE HAVE A LITTLE OVER 100 DONE
WITH THE TWO BUILDINGS THAT WE
ARE TALKING ABOUT AND WE WILL
BE TWO THIRDS OF THE WAY WITH
ALL THE TAX CREDIT HOUSING.
THE MARKET RATE AND 80% HOUSING
IS ALSO MOVING ALONG VERY WELL.
WE WILL HAVE A THIRD MERCURY
BUILDING COMPLETE IN ABOUT A
MONTH AS WELL AND THEN WE HAVE
TWO ADDITIONAL MARKET RATE
PROJECTS THAT ARE CURRENTLY
UNDER CONSTRUCTION.
SO, THINGS ARE MOVING ALONG
VERY WELL THERE.
ARE BUILDINGS THAT HAVE BEEN
OPENED ARE FULL.
THE MARKET RATE BUILDINGS HAVE
BEEN, THE LEASING PACE HAS BEEN
VERY STRONG.
SO, WE ARE PLEASED WITH THE
RESPONSE TO THE MARKET.
>> I THINK THAT IS A VERY
IMPORTANT CLARIFICATION.
YESTERDAY THERE WERE SOME
FOLKS THAT WERE MISINFORMED
ABOUT WHAT WAS HAPPENING AND I
THINK PEOPLE SEE THESE
BEAUTIFUL BUILDINGS AND THEY
ASSUME THAT ALL OF THEM ARE
MARKET RATE.
WHAT YOU HAVE DONE AND JUST
DESCRIBED IS YOU HAVE IMPROVED
THE CONDITIONS.
IT'S ABSOLUTELY WAS IN THE
CITIES ROLES AND
RESPONSIBILITIES TO RECOGNIZE
WHEN WE HAVE HOUSING THAT MAY
BE UNHEALTHY OR AN ACCESSIBLE
TO OUR GROWING POPULATION BY
ITS LOW HEIGHT TO REBUILD AND
CREATE ADDITIONAL HEIGHT AND
INCLUSIVE COMMUNITIES WITH
MIXED INCOME AND FOLKS LOOKING
TO TESTIFY YESTERDAY
UNFORTUNATELY IN THE PLANNING
COMMITTEE ASSUMED THAT THERE
WEREN'T FOLKS WHO WERE
PREVIOUSLY LIVING THERE AND
GETTING IN AND WHAT YOU JUST
SAID IS THAT THERE WILL BE 85%
OF THE REPLACEMENT HOUSING
BEING BUILT ON SITE AND THAT
YOU HAVE 92 HER PLACEMENT
HOUSING USING COMING IN AND 88
COMING IN AND CURRENTLY 298
UNIT REPLACEMENT HOUSING
OPTIONS AVAILABLE NOW.
>> THAT'S CORRECT.
THE OTHER FIGURES YOU USED, 92
AND 88, THOSE ARE IN THE
PLANNING STAGE AND THE TWO
BUILDINGS THAT WILL BE
COMPLETED.
THOSE WILL BE DONE.
THOSE COLLECTIONS OF BUILDINGS
EQUAL 85% OF OUR REPLACEMENT
HOUSING.
ALL 100% OF THE REPLACEMENT
HOUSING WILL BE BILLED ON SITE.
THIS JUST REPRESENTS THE
PROGRESS AND SO WE ARE MEETING
OUR COMMITMENTS THAT WE HAVE
MADE TO THE COMMUNITY WITH
INDIVIDUAL RESIDENTS ALSO WHO
HAVE MOVED OFF-SITE ARE ABLE TO
COME BACK ON SITE AND THEY HAVE
FIRST CALL ON THOSE UNITS AND
THEY ARE TAKING ADVANTAGE OF
THAT SO WE WILL HAVE A FULL
REPORT ON THAT FOR YOU BUT HERE
I JUST WANTED TO GIVE YOU A
SNAPSHOT TO SHARE WITH YOU THE
GOOD NEWS AND THE PROGRESSTHAT
HAS BEEN MADE.
IF THERE IS ADDITIONAL
QUESTIONS BEFORE WE COME BACK,
WE ARE MORE THAN WILLING TO
COME BACK.
>> THANK YOU.
I WANT TO ACKNOWLEDGE HOW MUCH
WORK YOU HAVE DONE AND LOOKING
BACK TO WHEN I FIRST STARTED ON
THIS COUNSEL, THE DESIGNS WERE
JUST COMING TO FRUITION AND TO
SEE HOW THE PEOPLE NOW ARE
COMING BACK IS EXCITING.
CAN YOU REMIND ME WHAT THE
TOTAL NUMBERS AND ANTICIPATED
NUMBERS ARE? WE HAVE THE VERY
LOW INCOME AND WE ARE BRINGING
PEOPLE BACK WITH 500 I BELIEVE.
>> THERE 561 UNITS AND 498
FAMILIES AT THE TIME.
SO, ALL 561 UNITS WILL BE
REPLACED ON SITE AND ALL 498
HOUSEHOLDS HAVE THE GUARANTEED
RIGHT TO RETURN TO THOSE UNITS.
MANY OF THEM ARE TAKING
ADVANTAGE OF THAT AND MANY OF
THEM DID NOT RELOCATE OFF-SITE.
THEY RELOCATED TO PROPERTIES
THAT WERE EXISTING AND SO THEY
MOVED A COUPLE OF TIMES BECAUSE
THEY DID NOT WANT TO LEAVE THE
FACILITY AND AS UNITS COME
AVAILABLE, THEY ARE MOVING
DIRECTLY INTO THE UNIT SO THEY
DON'T HAVE TO MOVE OFF-SITE
INCOME BACK.
THOSE THAT DID MOVE OFF-SITE
WHEN PROJECTS ARE COMPLETED,
THEY GET NOTIFIED THAT THERE
ARE UNITS AVAILABLE AND ARE YOU
INTERESTED IN COMING BACK AND
THEN WE WILL WORK WITH THEM TO
MEET THEIR NEEDS AND THAT
REQUIREMENT.
>> WHAT ARE THE PERCENTAGES OF
PEOPLE THAT ARE CHOOSING TO
COME BACK?
>> ROUGH NUMBERS, --
>> MORE THAN HALF QUESTION
SEVEN MORE THAN HALF, YES.
WHEN YOU SAY COME BACK, MANY OF
THEM DID NOT LEAVE AND I WAS
TRYING TO FACTOR THAT IN BUT
THE MAJORITY OF FOLKS WHO LIVED
THERE WILL BE ABLE TO RETURN.
>> NICE.
WHAT IS THE OVERALL TOTAL
INCREASE?
WE HAVE THE REPLACEMENT UNITS
AND THEN WHEN YOU ARE THINKING
ABOUT MARKET RATE OR AFFORDABLE
RATE, HOW MANY MORE UNITS ARE
WE BUILDING UP?
>> JUST AROUND NUMBERS, WE ARE
REPLACING ALL 561 HOUSING UNITS
AND CREATING AN ADDITIONAL 300
TAX CREDIT UNIONS AT 60% OF THE
INCOME.
WE ARE ALSO CREATING AN
ADDITIONAL 850 UNITS THAT ARE
TARGETED AT 80%.
>> 800?
>> YES.
ALMOST 850.
THE BALANCE OF THE UNIT SO WE
MARKET RATE SO SOMEWHERE
BETWEEN 2500 AND 3000 MARKET
UNITS WILL THEN BE BILLED IN
ADDITION TO THAT.
SO WE ARE CREATING A ROUGHLY
4500 TO 5000 TOTAL UNITS IN THAT
STRATA.
>> SO, BASICALLY TENFOLD.
YOU HAVE TO HAVE 561 UNITS AND
NOW YOU HAVE TREATED MORE THAN
5000 UNITS ON THE SAME
PROPERTY.
>> IS CORRECT .
>> THANK YOU FOR THAT.
I'M HOPEFUL THAT THE PEOPLE
THAT CAME TO TESTIFY YESTERDAY
HEAR THIS MESSAGE AND THAT YOU
HAVE CLARIFIED FOR THE RECORD.
WE WILL CONTINUE TO CLARIFY AS
WELL.
IT IS ERRONEOUS TO BELIEVE THAT
ANYONE DOES WAS DISPLACED AND
IT HAS BEEN ABSOLUTELY
INCLUSIVE.
I HAD THE CHANCE TO TOUR AND WE
WOULD ENCOURAGE ALL THE COUNCIL
MEMBERS TO GO ON THE GRAY TOUR
AS WELL.
>> I HAVE WORKED AROUND AND
SEEN THE NEW SOCCER FIELD AND
JUST SEEN THE KIDS UP THERE AND
I SAW SOME OF THE PLAYERS
WORKING WITH THE KIDS AND WE
HAVE THE STREETCAR.
IT'S AN AMAZING EFFORT SO I
THANK YOU FOR THAT.
>> YES, THANK YOU.
YOU WILL BE RECEIVING AN
INVITATION TO THE OPENING OF
RED CEDAR WHICH WILL BE
COMPLETED LATER THIS MONTH AND
WILL BE SCHEDULING OPEN HOUSE
AND WE INVITE ALL OF YOU TO
COME AND TAKE A LOOK AND ONLY
RED CEDAR BUT ALSO THE ENTIRE
PROJECT.
>> THANK YOU.
>> SECONDLY, ONE OF THE
EMPHASIS IS HAS BEEN FOCUSING ON
CREATING OPPORTUNITY TO IMPROVE
THE QUALITY OF THE SCHOOL.
ONE ISSUE IS THE SIGNIFICANCE
OF HOMELESS FAMILIES AND
STUDENTS THAT ARE ATTENDING.
WE CREATED A PROGRAM TO HOUSE
THE STUDENTS FAMILIES WHO ARE
HOMELESS THREE YEARS AGO.
WE HAD ABOUT 50 OVER THE THREE
YEARS INCLUDING THIS YEAR AND
ABOUT 51 FAMILIES REFERRED TO
US.
WE HAVE ISSUED THEM 36 VOUCHERS
AND 28 OF THOSE WERE HOUSED AND
25 OF THEM REMAIN HOUSED.
WE ARE WORKING CONTINUALLY WITH
THE SCHOOL AND THE SCHOOL'S
HOMELESS COUNSELORS TO IDENTIFY
STUDENTS WHO ARE EXPERIENCING
HOMELESSNESS THAT ARE TRYING TO
FIND HOUSING SOLUTIONS AND
PROVIDE THEM SOME SERVICES TO
HELP THEM THROUGH THE
TRANSITION FROM HOMELESSNESS TO
BEING HOUSED.
THAT PROGRAM, WE ARE PLEASED
WITH IT.
IT'S HELPING TO STABILIZE THE
SCHOOL ITSELF WHICH IS WHAT THE
DESIGN WAS SO THAT THE
EDUCATION EXPERIENCE FOR THE
STUDENTS THAT ARE GOING THERE
MOSTLY WHICH ARE LIVING AT
TERRACE IS IMPROVED.
WE HAVE SOME DATA THAT SHOWS
THAT IT IS OCCURRING AND WE
WILL BE ABLE TO SHARE THAT WITH
YOU WHEN WE COME BACK LATER ON.
>> FINALLY, THERE HAS BEEN A
LOT OF EFFORT ON OUR PART AS WE
FOCUS ON HOUSING STABILITY AND
BY THAT WE MEAN KEEPING OUR
RESIDENTS HOUSED. AS WE HOUSE
THEM, THERE ARE CHALLENGES THAT
SOME RUN INTO AROUND THEIR
ABILITY TO MEET ALL THE
OBLIGATIONS AND WE ARE TRYING
TO FIGURE OUT WAYS IN WHICH WE
CAN BE MORE SUPPORTIVE OF OUR
RESIDENTS SO THAT WE HAVE FEWER
THAT WILL ULTIMATELY END UP
HAVING TO LEAVE HOUSING.
WE HAVE WORKED WITH SOME
COMMUNITY MEMBERS TO IDENTIFY
AREAS THAT WE ARE CONCERNED AND
WE HAVE WORKED WITH THE OWN
STAFF TO TRY TO STREAMLINE THE
PROCESSES TO MAKE SURE THAT WE
ARE CONSIDERING ALL THE FACTORS
THAT GO INTO THE SITUATION THAT
THE INDIVIDUAL IS IN.
WE ARE REACHING OUT TO A LOT OF
OUR COMMUNITY PARTNERS AND
PROVIDE SERVICES TO OUR
RESIDENTS SO THAT THEY HAVE
SHIFTED THE FOCUS TO REALLY
HOUSING STABILITY AND WORKING
WITH A FAMILY VERY DIRECTLY ON
THE OBLIGATIONS AND WHAT HAS TO
HAPPEN AND WHAT ARE THE OPTIONS
THAT WE HAVE TO WORK WITH THEM
SO THAT THEY CAN PREVENT A THIS
IS A TERRY UNNECESSARY HOUSING
AND I THINK THAT HAS BEEN
SUCCESSFUL.
WE HAVE LESS THAN 1% OF OUR
RESIDENTS THAT HAVE TO GO
THROUGH AN EVICTION PROCESS IN
ANY EVENT WITH SOME OF THE
CHANGES WE HAVE MADE.
IT HAS GONE DOWN TO LESS THAN
ONE HALF OF A % AND WE ARE
LOOKING TO SEE IF THERE ARE
WAYS IN WHICH WE CAN BE WATCH
AND MUCH MORE SUPPORTIVE SO IT
DOESN'T BECOME A CRISIS
SITUATION.
WE ARE NOT ALWAYS ABLE TO DO
THAT BUT THAT IS OUR GOAL.
WE WILL CONTINUE TO KEEP YOU
APPRISED OF HOW WE ARE DOING IN
THE AREA.
>> WHAT IS THE NUMBER, ONE
HALF OF ONE PERCENT?
>> I BELIEVE IT WAS 51
INDIVIDUALS AND IN 2018 IT WAS
ABOUT 28.
HOUSEHOLDS, NOT INDIVIDUALS.
>> WHEN YOU COME BACK TO DO A
PRESENTATION, COULD WE DO A
LITTLE OVERVIEW OF THE POLICIES
THAT YOU PUT IN PLACE?
>> ABSOLUTELY.
>> I THINK IT IS IMPORTANT TO
HAVE THOSE POLICIES RECOGNIZED
AND ONE OF THE THINGS I WANT TO
MAKE SURE IS THAT WE CORRECT
THE NARRATIVE AND IF FOLKS
BELIEVE THERE IS A HIGHER RATES
OF EVICTION AT SEATTLE HOUSING
AUTHORITY HOMES AND YOU HAVE
GONE THROUGH THIS PROCESS TO
CHANGE THAT INTERNAL PROCESS,
THE NUMBER IS RELATIVELY BLOW
AT THE BEGINNING BUT ALSO YOU
ARE ON YOUR WAY TO ZERO. WE
WANT TO RECOGNIZE THAT AND SEE
WHAT ELSE WE CAN DO.
IF WE COULD COME BACK TO THAT.
>> I APPRECIATE THAT.
WE WOULD BE DELIGHTED TO DO
THAT.
THANK YOU VERY MUCH.
NOW, I WANT TO TURN TO THE
ACQUISITION.
>> ALL RIGHT.
>> NOW WE ARE GETTING TO THE
REAL DEAL.
THIS IS AN EFFORT THAT OUR
BOARD WAS VERY EXCITED ABOUT
AND IT IS AN EFFORT THAT MEETS
THE GOALS OF OUR STRATEGIC PLAN
WHICH IS FUNDAMENTALLY
PREDICATED ON SERVING MORE
PEOPLE AND MORE LOW INCOME
PEOPLE WITH AFFORDABLE HOUSING.
THIS IS A PROGRAM THAT WE THINK
WILL HELP US DO THAT AT A LOWER
COST AND MORE EXPEDITIOUSLY.
I WILL TURN IT OVER TOWHO IS
OUR DIRECTOR OF HOUSING FINANCE
WHO WAS KIND OF THE ARCHITECT
OF THIS AND I WILL LET HIM WALK
YOU THROUGH THE GOALS OF THE
PROGRAM AND HOW WE THINK IT
WILL WORK.
>> THANK YOU.
AS INJURY WAS SAYING, THE
PRIMARY GOALS OF THIS PROGRAM
IS ALIGNING WITH THE STRATEGIC
PLAN TO EXPAND HOUSING
OPPORTUNITIES TO SERVE MORE
PEOPLE AND ALSO TO PROMOTE
QUALITY COMMUNITIES AND BY THAT
MEANING MORE IN THE
PRESERVATION REALM BUT ALSO
ADDING AFFORDABLE UNITS INTO
AREAS OF THE CITY WHERE LOW
INCOME PEOPLE HAVE BARRIERS TO
ACCESS DUE TO THE COST AND ALSO
WE ARE LOSING AFFORDABLE
HOUSING AS THE YEARS GO ON SO
PRESERVING WHAT WE CAN TO MAKE
SURE THAT THE STOCK IS STILL
THERE.
FINALLY, WE KNOW THAT THE COSTS
ARE VERY HIGH SO NOT ONLY
PROMOTING THE FINANCIAL
STABILITY OF OUR ABILITY TO
CONTINUE TO PROVIDE LOW INCOME
HOUSING TO SEATTLE RESIDENTS
BUT ALSO THE STABILITY OF
RESIDENTS THEMSELVES SO THAT WE
HAVE VARIOUS LEVELS OF HOUSING
FOR INCOME RANGES SO THAT WE
CAN SERVE FROM EXTREMELY LOW
INCOME HOMELESS AND 30% ALL THE
WAY UP TO 80% SO YOU HAVE THE
WHOLE SPECTRUM.
>> SO, THE PROGRAM ITSELF AND
THE INITIAL PHASE OF THE PROGRAM
THAT WE TOOK TO THE BOARD WAS
THE ACQUISITION OF 500 UNITS.
THIS STRATEGY WAS DESIGNED TO
PURCHASE AND EITHER CREATE OR
PRESERVE 500 UNITS.
OBVIOUSLY, WE WANT TO CREATE A
NUMBER OF UNITS AND WHERE WE
ENDED UP RIGHT NOW, WE ARE
GOING TO BE DOING THAT BUT WHAT
WE ARE TRYING TO, OUR INITIAL
GOALS ARE 50% OF THOSE UNITS AT
250 UNITS WILL SERVE 30% OF
MEDIAN INCOME BELOW SO THEY
WOULD ALIGN WITH THE PREFERENCE
FOR THE HOUSING PROGRAM THAT
SERVES HOMELESS AND BELOW 30%.
THE OTHER 50 UNITS WOULD SERVE
60 TO 80% OF MEDIAN INCOME.
THERE CAN BE ARRANGE IN THEIR.
WE ARE STILL WORKING ON WHAT
THAT PART OF THE PROGRAM LOOKS
LIKE AND HOW MANY AT 60 OR 70
OR 80 BUT THAT IS THE RANGE.
>> CAN I JUST CLARIFY?
YOU SAID 50% OF UNITS AT 30% AMI
260?
>> NO, 30 OR BELOW.
>> THE OTHER WAS 6080 AND WHAT
ABOUT BETWEEN 30 AND 60?
>> BETWEEN 30 AND 60 IS A
DIFFICULT AREA TO SERVE BASED
ON WHAT THE FUNDING THAT IS
AVAILABLE FOR US.
THE NEEDS THAT WE ARE SEEING
BASED ON THE WAITLIST AND WHO
WE SERVE AT THE HOUSING
AUTHORITY AS A HIGH DEMAND.
OBVIOUSLY BELOW 30% UNDER THE
MEDIAN INCOME BUT ALSO BECAUSE
THE TAX CREDIT RULES ALLOW YOU
TO GO UP TO 60% AMI BUT NO
HIGHER.
THERE IS A GAP FOR HOUSEHOLDS
THAT MAY BE WORKING AND EARNED
JUST OVER BECAUSE IT'S A BRIGHT
LINE.
IF YOU AREN'T 62% OF MEDIAN
INCOME YOU DO NOT QUALIFY FOR A
TAX CREDIT UNIT.
THIS IS AN IDEA.
I AM NOT A MASSIVE ANACONDA
WORKFORCE HOUSING BUT A LOT OF
PEOPLE WOULD CALL IT WORKFORCE
HOUSING AND IT WOULD BE PEOPLE
THAT ARE WORKING BUT DON'T
QUALIFY FOR THE OTHER SUBSIDY
PROGRAMS.
>> THAT IS SUPER HELPFUL.
I THINK THAT IS SOMETHING WE
WILL WANT TO CONTINUE TO WORK ON
. BETWEEN 30 AND 60, THERE IS
THIS GAP OF FUNDING AND PART OF
WHAT I APPLAUDED OUR FRIENDS AT
MICROSOFT FOR WITH WHAT THEY
HAVE DONE WITH HALF OF THE
AMOUNT OF MONEY THAT THEY HAVE
ALLOCATED OUT IS IMPACT
INVESTMENT LOANS.
MY UNDERSTANDING THAT IS IT
WOULD GO TO AREAS THAT WERE
MISSING THIS FUNDING.
IS THAT 30 TO 60% FUNDING WHERE
IMPACT INVESTMENT LOANS FOR
COMPANIES AND ORGANIZATIONS
THAT HAVE ADDITIONAL CASH
RESERVE IS REALLY NEEDED?
THAT IS A GAP AREA THAT OTHERS
COULD POTENTIALLY FILL?
>> I WOULD SAY THAT COULD
DEFINITELY BE A USE . ONE OF
THE REASONS 30 TO 60 IS SO
DIFFICULT IS THAT THE WAY THE
FUNDING PROGRAMS ARE SET UP IS
YOU HAVE TO MAKE BETWEEN 50 AND
60% OF INCOME TO AFFORD THE RENT
WITHOUT AN ADDITIONAL SUBSIDY
AND IF YOU ARE ON THE CUSP OF
THAT OR BELOW IT, IT IS
DIFFICULT.
THERE IS NOT A LOT OF SHALLOW
SUBSIDY PROGRAMS THAT ARE OUT
THERE.
>> DID YOU SAY SHALLOW?
>> SHALLOW SUBSIDY.
THAT WOULD BE SOMETHING WHERE
YOU ARE PROVIDING A LITTLE BIT
OF SUBSIDY NOT TO THE EXTENT OF
A VOUCHER OR SIMILAR TO PUBLIC
HOUSING UNIT BUT THERE IS A
LITTLE BIT TO OFFSET SOME OF
THE OPERATING COSTS THAT CANNOT
BE COVERED BY THE RENTS THAT
ARE PAID WERE OTHER WAYS WITH
MORE INVESTMENTS LIKE YOU ARE
TALKING ABOUT TO BUY DOWN THE
COST SO THAT YOU DON'T HAVE
DEBT TO PAY OR OTHER COSTS LIKE
THAT.
>> THAT IS HELPFUL FOR US TO
KNOW.
THANK YOU.
>> NO PROBLEM.
BACK TO THAT SLIDE, SORRY.
WHERE WE ARE AT RIGHT NOW AND
WHAT WE HAVE CURRENTLY ACQUIRED
AND WHAT WE ARE IN NEGOTIATIONS
ON IS WE ARE LOOKING AT IT 260
UNIT OF PRESERVATION AND THEY
WILL SERVE HOUSEHOLDS AT 30%
WITH A VERY MEDIAN INCOME OR
BELOW.
WE ARE A LITTLE BIT NORTH OF
WHAT THE TARGET WAS BUT THAT IS
GOOD AND WE ARE ABLE TO SERVE
MORE EXTREMELY LOW INCOME
HOUSEHOLDS AND I WILL TALK
ABOUT IT IN A FEW SLIDES.
WE HAVE ACQUIRED ONE BUILDING
ALREADY THAT SERVES 60 TO 80%
AND WE ARE CURRENTLY OUT
LOOKING FOR MORE BUILDINGS TO
FULFILL.
>> TALK ABOUT PRESERVATION,
YOU PROBABLY KNOW LEGISLATION
WITH THE LEGISLATOR THAT
REPRESENTED DEALIO AND ERIC
PETTIGREW WITH THE PACER
FINANCING.
THIS MAY NOT WORK FOR YOU BUT
IT IS FOCUSED ON PRIVATE
INVESTMENTS THAT AN INDIVIDUAL
CAN BORROW MONEY AND THEN
ATTACHES TO A LIEN ON THE
PROPERTY AND THEY DON'T HAVE TO
PAY OFF OR PAY THE PROPERTY
TAXES AS I UNDERSTAND UNTIL
THEY SELL.
IN ENCOURAGES INVESTMENTS
ESPECIALLY IN THE RATE.
I AM ONLY JUST SCRATCHING THE
SURFACE.
I DON'T THINK IT'S AS
COMPLICATED AS I JUST MADE IT
SOUND BUT I AM DELIGHTED THAT
THERE ARE THESE MECHANISMS AND
ENCOURAGING THE PRIVATE
INVESTORS TO GET INVOLVED AND
IF THEY DON'T HAVE TO PAY THE
INTEREST BACK OR THEY CAN
ACTUALLY ATTACH IT TO THE
PROPERTY WHEN THE PROPERTY SELLS
, IT JUST GOES ALONG WITH THE
COST OF THE PROPERTY.
ANYTHING AND EVERYTHING THAT WE
CAN DO TO TRY TO FIND MORE
SPACES FOR PEOPLE TO BE AND
FRANKLY TO PRESERVE SOME OF THE
OLDER DUTIFUL YOU RM'S IS
WORTHY.
WITH THAT SAID AND YOU'RE
TALKING ABOUT PRESERVATION
SPECIFICALLY, YOU HAVE CERTAIN
BUILDINGS IN MIND?
>> WE DO.
WE ARE NEGOTIATING ON THREE
DIFFERENT BUILDINGS RIGHT NOW
AND I HAVE A SLIDE ON THAT.
WE ARE STILL IN NEGOTIATION
PHASE SO WE ARE NOT ABLE TO
SHARE THE EXACT LOCATIONS AND
THE DETAILS LIKE THAT BUT WE
WILL DEFINITELY GIVE YOU A HIGH-
LEVEL OF WHERE THEY ARE IN THE
CITY AND WHO THEY ARE SERVING
AND BEDROOM SIZES AND THINGS
LIKE THAT.
>> ONE OF THE OTHER THINGS,
THIS IS JUST A PREVIEW OF
SOMETHING I WOULD LIKE TO BRING
TO THIS COMMITTEE LEADER WITH
INPUT FROM OUR COLLEAGUES WITH
THE COMMUNITY AND YOU ALL AT
HSA.
WE HAVE TALKED TO SOME OF THE
20 PARTNERS IN THE HOUSING
WORLD ABOUT A PIECE OF
LEGISLATION THAT WAS PASSED BY
MY PREDECESSOR. IT REQUIRES
BUILDINGS THAT HAS AT LEAST 80%
AMI OR BELOW AND THEY NOTIFY
THE CITY IF THE UNIT IS GOING
UP FOR SALE SO THAT MAYBE THE
PARTNERS AND NONPROFIT
DEVELOPERS COULD GET
NOTIFICATION OF A POTENTIAL
BILLING THAT WOULD GO UP AND
POTENTIALLY HAVE AFFORDABLE
UNITS WITHIN IT.
MY UNDERSTANDING IS SINCE
LEGISLATION WAS PASSED, ONLY
NINE SELLERS HAVE NOTIFIED
BECAUSE IT IS VOLUNTARY AND IT
IS FOR UNITS AND APARTMENT
COMPLEX TO HAVE FIVE UNITS OR
MORE.
ONE OF THE THINGS THAT I'M
TRYING TO EXPLORE BEING A
RENTER LIVING IN A BUILDING
THAT HAS EIGHT UNITS, WE DID
NOT GET NOTIFICATION WHEN OUR
BUILDING WAS SOLD AND I THINK
THERE IS A LOT OF US WHO WOULD
HAVE WISHED WE COULD'VE HAD
NOTIFICATION SO WE COULD HAVE
COUPLED TOGETHER FUNDING AND
PURCHASED IT OUR SELVES IN A
COULD'VE OPERATED AS CONDOS
POTENTIALLY OR AS A CO-OP IF
YOU WILL WITH THE COMMUNITY
PARTNERS OR POTENTIALLY IF HSA
HAD BEEN NOTIFIED, PERHAPS
THERE WAS OPPORTUNITIES FOR HSA
TO STEP IN AND HELP CREATE MORE
AFFORDABLE UNITS ESPECIALLY IN
AN AREA LIKE QUEEN.
WITH ACCESS TO NEIGHBORHOOD
PARKS AND LIBRARIES AND GREAT
BUS LINES.
MY POINT IS, ONE OF THE THINGS
THAT I WOULD LIKE TO DO IS TO
REDUCE THE NUMBER OF UNITS THAT
ARE REQUIRED SO IF THERE'S ANY
BUILDING THAT HAS TWO UNITS OR
MORE, WORK WITH YOU ALL TO SEE
WHAT WE CAN DO IN TERMS OF
NOTIFICATION AND MAYBE HSA GETS
A BETTER NOTIFICATION WITH SOME
OF THE NONPROFIT FRIENDS AS
WELL AND THAT THE TENANTS GET
NOTIFICATIONS THEMSELVES.
OBVIOUSLY, I AM NOT ASSUMING
THAT EVERY TENET WOULD BE ABLE
TO COBBLE TOGETHER FUNDING
BECAUSE THAT IS VERY CUMBERSOME
AS YOU KNOW ON AN INDIVIDUAL
BASIS BUT WHAT I'M THINKING IS
AS WE HEAR MORE ABOUT THE
ACQUISITION STRATEGY, WHAT CAN
THE CITY DO TO CHANGE POLICIES
LIKE THAT SO MAYBE YOU GET
NOTIFICATION OF MORE UNITS THAT
POTENTIALLY WOULD BE COMING
ONLINE BECAUSE WHAT I AM
HEARING IS THAT YOU ARE NOT
ACTUALLY, YOU ARE BROADENING OUT
THE NUMBER OF COMPLEXES OR
APARTMENTS THAT HSA COULD
POTENTIALLY HAVE OWNERSHIP OF.
WOULD SOMETHING LIKE THAT, TENET
OR CITY NOTICE OF UNITS WITH
MORE THAN TWO OR MORE APARTMENT
UNITS WITH AND IT BE OF INTEREST
TO HSA?
>> YES.
I BELIEVE THAT WOULD HELP
NICELY WITH THIS PROGRAM TO
KEEP US INFORMED OF THE STOCK
THAT IS OUT THERE THAT COULD
CONSIDERABLY BE CHARACTERIZED
AS PART OF THE PROGRAM AND IF
WE KNEW, THAT IS THE FIRST STEP.
HAVING KNOWLEDGE ABOUT WHAT IS
AVAILABLE UNDER THE MARKET AND
WE WELCOME THE INFORMATION
ABOUT THAT.
>> I TALKED TO STEVE NORMAN
RECENTLY FROM THE KING COUNTY
HOUSING AUTHORITY AND I KNOW
FOR 20 YEARS HE HAS BEEN
WORKING OVER THERE, THEY HAVE
BEEN GOING AFTER BUILDINGS AND
HOLDING THEM AND THAT IS ONE OF
THE WAYS THEY ARE ABLE TO OFFER
UNITS THAT AREN'T AS EXPENSIVE
AS THE PRIVATE MARKET.
HAVE WE DONE SOMETHING SIMILAR
TO THAT?
>> THIS IS SIMILAR.
IT'S A LITTLE BIT DIFFERENT
BANKING COUNTIES BECAUSE WE ARE
GENERALLY NOT BRINGING ANY NEW
SUBSIDY INTO THE BUILDING.
WE ARE TRYING TO HAVE THE
BUILDING PERFORM ON ITS OWN BUT
IT'S THE SAME CONCEPT OF
IDENTIFYING OPPORTUNITY
BUILDINGS AND AREAS THAT WE CAN
SUSTAIN IN OUR OWNERSHIP IN
PERPETUITY AND KEEP IT
AFFORDABLE.
>> SO, THE TOTAL PROGRAM COST
ITSELF WE ESTIMATE , WE ARE
HOPING TO DO THIS OVER THE NEXT
TWO YEARS AND ACQUIRE THESE 500
UNITS.
IT WILL COST US RIGHT AROUND
THE HUNDRED MILLION DOLLARS.
WE ARE LOOKING TO FINANCE THAT.
ALSO, THROUGH TAX EXEMPTS
ISSUANCE WITH BONDING CAPACITY
AS WELL AS MAKING USE OF THE
LOW INCOME HOUSING WHERE IT
MAKES SENSE TO DO SO.
ONE OF THE KEY THINGS THAT WE
WORKED FOR QUITE SOME TIME WITH
ON THE BOARD AND INTERNALLY AND
WITH THE BOARD WAS WHAT IS THE
CRITERIA FOR SELECTING BUILDINGS
AND WHAT WOULD BE OF MOST
BENEFIT TO RESIDENTS THAT ARE
ON THE WAITLIST BUT ALSO
RESIDENCE IN THE CITY AS WELL AS
TO ENSURE THAT THE HOUSING
AUTHORITY REMAINS FINANCIALLY
STABLE AND WE ARE ABLE TO
CONTINUE TO PROVIDE THE LEVEL
OF SERVICE THAT WE DO RIGHT NOW
TO THE RESIDENTS OF THE CITY.
SO, WE CAME UP WITH THIS SIX SET
OF CRITERIA THAT WE ARE
EVALUATING WITH EACH OF THE
ACQUISITIONS.
FIRST AND FOREMOST, ARE WE ABLE
TO SERVE MORE LOW INCOME
HOUSEHOLDS IN THE CITY?
SECONDLY, DOES IT MAINTAIN
FINANCIAL STRENGTH?
WE DON'T WANT TO BE IN A
POSITION AS ANDREW WAS
MENTIONING OF HAVING TO TAKE
FROM SOME OF THE OTHER PROGRAMS
THAT ARE ALREADY SERVING PEOPLE
THROUGH EITHER THE VOUCHER
PROGRAM OR PUBLIC HOUSING
PROGRAM TO GO OUT AND PURCHASE
MORE UNITS BECAUSE WE ARE NOT
REALLY GETTING A NET GAIN.
THIRDLY, AS TAX CREDIT PROJECTS
AND OTHER PROJECTS THAT WERE
FUNDED BY THE FEDERAL
GOVERNMENT IN THE 70s AND 80s
ARE AGING AND THE REVELATORY
REQUIREMENTS OF THOSE ARE
TIMING OFF, WE WILL BE SEEING
PROJECTS THAT NEED TO BE
PRESERVED.
SO, ARE THERE OPPORTUNITIES FOR
US TO STEP IN AND SAY THIS IS A
BUILDING IN AN AREA WHERE IT IS
PROVIDING A BENEFIT TO
RESIDENTS AND THE CITY AND
PROVIDING SUBSIDY POTENTIALLY.
CAN WE PURCHASE THIS BUILDING
AND MAINTAIN IT IN PERPETUITY?
THAT IS THE KEY AROUND THAT.
THE OTHER THING IS DOES THE
ACQUISITION INCREASE OUR
INVENTORY AND OPPORTUNITY? WE
HAVE BEEN FOCUSED A LOT ON
PROVIDING ACCESS FOR HOUSEHOLDS
AND AREAS THAT THERE IS A LOT
OF BARRIERS TO ENTRY WHERE I
LIVE IN MAGNOLIA AND IT IS VERY
DIFFICULT TO GET INTO IF YOU
ARE A LOW INCOME HOUSEHOLD AND
NEXT TO IMPOSSIBLE IF YOU ARE
EXTREMELY LOW INCOME HOUSEHOLD.
SO, THAT IS THE AREA TO FOCUS
AND THAT WE ARE USING THEIR.
THE OTHER THING IS LARGE FAMILY
UNITS.
THE HOUSING AUTHORITY OWNS
ALMOST A QUARTER OF THE ENTIRE
SUBSIDIZED LARGE FAMILY UNIT
STOCK AT THE CITY OF SEATTLE
THREE FOURS AND FIVE BEDROOMS.
SO, THAT IS LARGELY IN THE
PUBLIC HOUSING PROGRAM AS WELL
SO THE VOUCHER PROGRAM BUT A
LARGE NUMBER IS IN THE PUBLIC
HOUSING PROGRAM SO WE HAVE HIGH
DEMAND AND WE FEEL THAT DEMAND
AND PRESSURE FOR THESE UNITS AS
WE HAVE LARGE FAMILIES AND
LARGE LOW INCOME FAMILIES THAT
NEED PLACES TO LIVE AND IT IS
DIFFICULT FOR A FAMILY OF FIVE
OR SIX OR SEVEN OR MORE TO LIVE
IN A TWO BEDROOM UNIT.
I DON'T KNOW EXACTLY HOW MANY
ARE MORE THAN TWO BEDROOMS.
I CAN TELL YOU THAT WE HAVE THE
SCATTERED SITE INVENTORY WHICH
IS SINGLE FAMILY HOMES AND
TOWNHOUSES AND SMALL BREAD
RISES LIKE LESS THAN 20 UNITS.
WE HAVE 711 UNITS IN 236
BUILDINGS ACROSS THE CITY AND
THAT RANGES FROM SEATTLE ALL
THE WAY TO LITERALLY ON THE
SHORELINE SEATTLE BORDER.
WE ARE ALL ACROSS THEY ARE AND
WITHIN THAT GROUPING, IT IS
BETWEEN 35 AND 40% LETTER THREE
AND FOUR AND FIVE BEDROOM UNIT.
>> A LITTLE OVER 200?
>> I WOULD SAY IN THAT
PORTFOLIO AND WE HAVE BEEN
ADDING SOME.
>> WE CAN GET TO THE NUMBER .
SURE.
>> SO OFTEN, FAMILIES COME
TOGETHER AND EXTENDED FAMILIES
WHICH IS REALLY WHAT IS
HAPPENING AND WHAT WE WANT TO
ENCOURAGE, FRANKLY I WOULD
RATHER HAVE PEOPLE GROUPING
TOGETHER WITH A SOLID ROOF OVER
THEIR HEADS TO HAVE SPACE FOR
THEMSELVES AND EACH OTHER BUT
IF WE ARE LOOKING AT 200 UNITS
WHEN WE KNOW THE DEMAND IS IN
THE THOUSANDS, IT'S TOUGH FOR
US.
>> LET US GET YOU A BETTER
OVERALL FIGURE.
THAT IS JUST A REAL SUBSET OF
THE ENTIRE PORTFOLIO.
IT IS AROUND 8000 UNITS TOTAL
THAT WE OWN OR MANAGE SO WE
WILL GET YOU THE BREAKDOWN OF
THAT.
>> GREAT, THANK YOU.
>> BECAUSE WE HAVE STRUGGLED IN
THE CITY DUE TO LAWSUITS BUT
ALSO THE PACE AT WHICH WE ARE
TRYING TO REZONE, IF WE THINK
OF THE UNITS, SORRY, IF WE
THINK OF COMPLEXES THAT ARE TWO
OR MORE UNITS COMING ONLINE FOR
YOUR POTENTIAL PURCHASE FOR THE
SCATTERED PROGRAM OPTION, I CAN
IMAGINE DUPLEXES AND TRIPLEX IS
BEING A REALLY GOOD ALTERNATIVE
SO THAT FAMILIES CAN STAY
TOGETHER.
IF THERE IS A SEPARATE ENTRANCE
FOR MOM AND DAD AND THE KIDS
WHO HAVE THEIR OWN INFANTS HAVE
ANOTHER ENTRANCE, YOU CAN
IMAGINE PHIL UNIT STAYING
TOGETHER SO I THINK A LOT OF
FOLKS THINK ABOUT LARGE
APARTMENT COMPLEXES AND EVEN 20
OR LESS MAY FEEL LARGE TO SOME
OF THE COMMUNITY PARTNERS AND
THEY WOULD LOVE TO WORK WITH
YOU AS WE THINK ABOUT POTENTIAL
OPTIONS FOR THE CITY TO
PURCHASE FOR SEATTLE HOUSING
AUTHORITY TO PURCHASE SMALLER
UNITS OF THAT MEANS TWO OR
THREE OR MORE IN A COMPLEX.
THAT IS ANOTHER WAY FOR
FAMILIES TO STAY TOGETHER AND
MORE FOLKS TO HAVE ACCESS TO
HIGH OPPORTUNITY NEIGHBORHOODS.
I HAVE NOT THOUGHT ABOUT THAT
UNTIL NOW BUT IT'S A REAL GOOD
INTERGENERATIONAL COMMITMENT AS
WELL WHICH IS HEALTHY FOR OUR
COMMUNITY.
>> THEN, OUR LAST AREA IS JUST
WITH THE SHEER COST INCREASES
THAT THE CITY HAS BEEN
EXPERIENCING IN REGARDS TO
DEVELOPMENT AND IT IS COMING
MORE AND MORE EXPENSIVE TO
BUILD NEW UNITS.
ONE WAY TO SERVE MORE PEOPLE IS
TO LOOK TO BUY UNITS THAT COST
LESS THAN VELTMAN COST.
THAT IS ANOTHER KEY CRITERIA
AND LOOKING AT A WAY TO
LEVERAGE FUNDS.
SO, ONE OF THE ACQUISITIONS
THAT WE ALREADY COMPLETED IS IN
THE LAKE CITY NEIGHBORHOOD.
IT'S CALLED THE SPRINGLIKE
APARTMENTS AND THERE IS 69
UNITS THEY ARE.
ONE STUDIO 55 BEDROOM AND IT IS
IN THREE BUILDINGS.
IT WAS BUILT IN 1986 AND IT IS
IN FAIRLY GOOD SHAPE.
WE PURCHASED THIS BUILDING AND
CLOSE IN THE END OF NOVEMBER
FOR ABOUT 15 1/2 MILLION
DOLLARS.
WE WERE ABLE TO PURCHASE THIS
BUILDING FOR $225,000 A UNIT
WHICH IS A GOOD VALUE AND NOW
THIS BUILDING, AS LONG AS THE
HOUSING AUTHORITY OWNS IT AND
THE RECORD OF SELLING, WE DON'T
REALLY HAVE ONE REALLY. AS LONG
AS IT WILL BE GUARANTEED, AS
LONG AS THE HOUSING AUTHORITY
IS AROUND.
THIS PROPERTY ITSELF HAD SOME
THE VOUCHERS AND IT ALREADY SO
THERE WERE SOME EXTREMELY LOW
INCOME HOUSEHOLDS MAKING USE OF
THAT AND THE RENTS THEMSELVES
WERE BETWEEN 60 AND 70% OF THE
MEDIAN INCOME RENTS RIGHT NOW SO
WE ACQUIRED A NATURALLY
AFFORDABLE BUILDING AND HAVE
BEEN ABLE TO ENSURE ITS
AFFORDABILITY IN THE LONG-TERM.
>> HAVE YOU EVER BLOWN THE
WALLS OUT ON SOMETHING LIKE
THIS SO THAT YOU ACTUALLY TAKE
TWO STUDIOS FOR EXAMPLE AND
ENLARGE THEM SO THAT PEOPLE CAN
DEAL WITH THE SPACE?
IS THAT EVER AN OPTION?
>> YES.
IN FACT, NOT THIS BUILDING BUT
WE ARE DOING IN THE SCATTERED
PORTFOLIO THAT I WAS JUST
INTERNING, WE HAVE UNDERTAKEN A
CONVERSION PROGRAM WHERE WE ARE
TAKING UNUSED SPACES WHETHER WE
HAVE UNFINISHED BASEMENTS OR
GARAGES AND BONUS ROOMS THAT
AREN'T REALLY GOOD USE OF SPACE
AND INCREASING THE BEDROOM
SIZES.
WE ARE ABLE TO TAKE THREE AND
FOUR BEDROOM UNITS TO FIVE
BEDROOM UNITS.
WE FOUND A HOME IN A FOLIO THAT
HAD THREE BEDROOMS BUT THE
PREVIOUS OWNER WHOEVER WE
BOUGHT IT FROM HAD BOARDED UP
THE ATTIC AND THE ATTIC WAS
ACTUALLY A 1 1/2 STORY SO THAT
IT COULD BE CONVERTED TO
ANOTHER TWO BEDROOMS WITH A
BATHROOM.
WE WERE ABLE TO INCREASE THE
NUMBER OF BEDROOMS.
SO, WE ARE ACTIVELY LOOKING AT
THESE NEW PROPERTIES AS WE
BRING THEM IN IF THERE ARE
OPPORTUNITIES TO DO THAT.
>> SO, I JUST WANTED TO TOUCH
ON SOME OF THE THREE PROPERTIES
I WAS TALKING ABOUT THAT WE
WERE IN NEGOTIATIONS ON THAT WE
HOPE TO HAVE UNDER CONTRACT AND
CLOSE TO THE NEXT 2 TO 3 MONTHS.
IT'S A TOTAL OF 262 UNITS AND A
LARGE NUMBER OF ONE-BEDROOMS.
SOME TWOS AND THREES.
THEY ARE LOCATED IN THREE
DIFFERENT AREAS OF THE CITY.
SO, THE LAKE CITY ON THE FAR
RIGHT CORNER IS THE SPRINGLIKE
APARTMENTS I SPOKE ABOUT.
THE ONE RIGHT BY THE LOCKS IN
BLLARD IS WHERE THE OTHER
BUILDING IS LOCATED.
THE OTHER ONE IS MORE IN THE
CENTRAL DISTRICT.
IT'S CLOSE TO THE YESTER
DEVELOPMENT AND THEN THE OTHER
ONE IS JUST SOUTH IF YOU
REMEMBER THE NEW HOLLY HOPE SIX
DEVELOPMENT WHERE WE HAVE JUST
OVER 600 UNITS, THE OTHER
PROPERTY IS DOWN IN THE RAYNOR
VALLEY DOWN IN THE AREA.
>> THREE PROPERTY LOCATIONS
BUT YOU HAVE FOUR DOTS.
>> THE FOURTH ONE IS THE ONE
WE ALREADY PURCHASE WHICH IS
THE UPPER LAKE CITY.
>> YEAH, UPPER LAKE CITY.
>> SO, THAT IS WHAT WE ARE UP
TO . AND STEERED HAS INDICATED,
WE CLOSE A PROPERTY LAST
NOVEMBER AND WE ARE IN
NEGOTIATIONS WITH THREE MORE
AND WILL BE CONTINUING TO SEARCH
FOR GOOD BARGAIN OPPORTUNITIES
THAT WE CAN PRESERVE WITH
AFFORDABILITY AND GREAT
OPPORTUNITIES FOR NEW HOUSING.
>> DO WE HAVE ANY OPPORTUNITIES
FOR SOME OF THE AGING MOTELS
AROUND HERE?
>> WE HAVE NOT FOCUSED ON
THAT.
WE HAVE BEEN FOCUSING ON LARGER
BUILDINGS AND RESIDENTIAL
STRUCTURES THAT WE HAVE NOT
REALLY FOCUSED ON THE AGING
HOTELS.
>> THEY DON'T HAVE KITCHENS SO
IT WOULD PROBABLY BE VERY
EXPENSIVE.
>> THAT IS A REALLY INTERESTING
IDEA ESPECIALLY AS WE THINK
ABOUT TO GO ROOM OCCUPANCY THE
BUILDINGS WERE USED IN THE PAST
AND ONE FOLKS AS WE HEARD CAME
INTO SEATTLE IN THE THOUSANDS
TO GET GOOD LIVING WAGE JOBS IN
THE SHIPYARDS AS WE SEE MORE
AND MORE PEOPLE COME IN TO GET
GOOD JOBS HERE IN THE TECH
INDUSTRY THINKING ABOUT HOW THE
PRESSURE HAS CREATED MORE
PEOPLE GETTING PUSHED OUT OF
THE CITY OR INTO THE STREET AND
PERHAPS LOOKING AT SINGLE HOME
OCCUPANCY BUILDINGS OR UNITS IS
A NEW LAYER THAT WE SHOULD
CONSIDER. OBVIOUSLY IT'S NOT A
GOOD LONG-TERM SOLUTION BUT BUT
COULD POTENTIALLY HELP YOUR
>> IS THAT SOMETHING THAT YOU
COULD YOU OR ARE YOU PROHIBITED
IN YOUR RULES TO INVEST?
>> I DON'T THINK WE ARE
PROHIBITED.
IT'S NOT SOMETHING WE HAVE
FOCUSED ON. A LOT OF OUR
INTERESTS CURRENTLY FOR SURE
HAS BEEN AROUND FAMILIES AND
CREATING OPPORTUNITIES FOR
FAMILIES BUT I DON'T THINK
THERE IS ANYTHING THAT
PROHIBITS US FROM INVESTING.
>> WE WOULD LIKE TO KNOW MORE
AND CLEARLY THIS IS NOT THE
DIRECTION YOU ARE GOING BUT IF
THEY ARE INVESTORS THAT ARE
INTERESTED IN THIS. I HAD
TALKED WITH SOMEONE 20 YEARS AGO
IN EUGENE, OREGON, I BELIEVE
THEY BUILT IT FROM SCRATCH AND
I DON'T THINK IT WAS A
CONVERSION BUT WHAT THEY DID
WAS HAVE SINGLE ROOMS BUT
COMMUNITY SPACE AND STUDY SPACE
AND THEY HAD ESSENTIALLY A
DORMITORY KITCHEN AND IT
CONTINUES TO THIS DAY. I TALKED
TO SOMEBODY RECENTLY WHO MOVED
FRM SEATTLE DOWN THERE AND SHE
IS SOMEBODY WHO IS IN HER MID-
50s BUT IT WAS LESS EXPENSIVE
DOWN THERE.
SHE LOVED THE IDEA AND SAYS SHE
HATES TO COOK AND DIDN'T WANT
TO AND THIS OFFERED HER THREE
MEALS A DAY AND GAVE HER SPACE
TO CONTINUE HER CAREER AND IT
STRIKES ME AS ONE OF THOSE
THINGS WHERE NOBODY WILL JUMP
UP AND RAISE YOUR HAND SAY THAT
IS WHAT I WANT TO DO BUT WE ARE
TRYING TO THINK OF EVERY OPTION
POSSIBLE TO GET PEOPLE WITH
ROOFS OVER THEIR HEADS AT AN
AFFORDABLE RATE.
>> ANOTHER TAKE ON THAT IS THE
NEW MODERN SHARED LIVING SPACE
CONCEPTS.
WHEN I HAVE THE CHANCE TO VISIT
GERMANY, I MET WITH THE
CONTRACTOR CAME FROM OUR
FRIENDS HERE AND I MET THIS
INDIVIDUAL WHO IS A RENOWNED
HOUSING EXPERT IN GERMANY AND
HE LIVES IN A SHARED HOUSING
FACILITY.
HIS FAMILY HAS ONE UNIT BUT
THEN THERE IS A SHARED LIVING
AND DINING ROOM AREA AND THEY
ALL TAKE TURNS MAKING DINNER
AND ALL GARDEN TOGETHER AND
EIGHT CREATES A MORE AFFORDABLE
OPTION.
IT'S ALSO GOOD FOR THE
FOOTPRINT OF OUR CITY BECAUSE
IT IS A SMALL UNIT OVERALL.
WE ARE REALLY EXCITED ABOUT
THIS AND JUST ONE MORE QUESTION
FOR YOU.
I THOUGHT I SAW IN A PRESS
RELEASE OR ANNOUNCEMENT THAT
YOU SENT US, A 2000 NUMBER.
WAS THAT INCORPORATED IN PART
OF THIS OR SHOULD I FOLLOW UP
WITH YOU AFTERWARDS ABOUT THE
NUMBER AND TOTAL NUMBER WAS
BIGGER THAN 500.
IS NOT THE LONG-TERM GOAL?
I CAN SEE IT BUT I CANNOT READ
WHAT IT SAID.
>> THEY REFERENCE THE NUMBER
OF AFFORDABLE UNITS THAT WE
WERE INVOLVED IN.
THIS WOULD AND TO THE INVENTORY
OF AFFORDABLE UNITS.
>> OKAY.
>> 8000 WOULD INCLUDE PUBLIC
HOUSING UNITS AND THEIR 6000
PUBLIC UNITS OF ANOTHER 2000
UNITS INCLUDING THIS THAT ARE
CLASSIFIED. SO, NOT SERVING THE
30 % AND BELOW.
>> SO, PUBLIC HOUSING IF I CAN
CATEGORIZE IT IS BELOW 30% AMI
AND IN THEORY SOMEONE GETS A
VOUCHER TO LIVE THERE?
>> THE PUBLIC HOUSING WOULD BE
ADMITTED SPECIFICALLY TO THE
LOW INCOME HOUSING PROGRAM AND
THAT IS WHERE WE ONLY UNIT AND
MANAGE THE UNIT, ETC.
THAT IS A HARD UNIT IN WHICH
THE HOUSING AUTHORITY ACTUALLY
OWNS AND MANAGES.
AND, GETS A SUBSIDY FOR THE
TENANT THAT LIVES THERE.
THEY WOULD QUALIFY FOR LIVING
THERE BASED UPON THEIR INCOME
WHICH IN OUR PERFECT SYSTEM
WOULD BE 30%. THEY HAVE TO EARN
30% OR BELOW THE INCOME AND
THEY WOULD QUALIFY TO LIVE IN
THAT UNIT.
THE AFFORDABLE UNIT, THE INCOME
CAN BE GREATER AND THEY CAN
AFFORD TO PAY A LITTLE BIT MORE
AND WE WOULDN'T HAVE AS DEEP A
SUBSIDY INTO THE UNIT ITSELF.
>> PUBLIC HOUSING BY DEFINITION
IS YOUR 30% AND BELOW?
>> YES.
THAT IS CORRECT.
>> SO, THIS HAS BEEN
FASCINATING.
I JUST LOVE WORKING WITH
COUNCILMEMBER BAGSHAW BECAUSE I
TINK WE ARE PASSIONATE ABOUT
THE SAME ISSUES.
THANK YOU FOR STAYING LATE.
I'M LOOKING FORWARD TO HAVING
YOU GUYS COME BACK AND TALK
ABOUT THE EVICTION PREVENTION
PROGRAM THAT YOU HAVE WORKED ON
IMPROVING WITH GREAT STATISTICS
THERE.
THANK YOU FOR SHARING SOME OF
THAT.
I AM ALSO INTERESTED IN HOW WE
TAKE INFORMATION ABOUT THE 30
TO 6 % OF HER STRENGTHS THAT
FOLKS HAVE FOR 30 TO 60% AMI.
IT SOUNDS LIKE THAT IS IN LINE
WITH THAT WE HEARD AT THE
SELECT COMMITTEE OR PERHAPS SO
WE NEED TO DO TO HELP FOLKS
FROM FALLING DEEPER INTO
POVERTY OR LOSING THEIR HOUSE
IN SOME CASES.
JUST CASH ASSISTANCE SOMETIMES
TO HELP FOLKS GET THROUGH A
TOUGH PERIOD.
I THINK WE HEARD FROM MARK JONES
THAT PROVIDED THE COMPREHENSIVE
RULES AND REPORT AND SOMETIMES
YOU SEEM TO STOP ASKING
QUESTIONS AND DON'T MAKE THEM
FILL OUT THE INTENT SURVEY OR
SPEND DOWN IN ORDER TO RECEIVE
IT.
THAT CAN BE A HOMELESSNESS
PREVENTION STRATEGY AND I THINK
WHAT I HAVE HEARD FROM YOU ALL
ESPECIALLY IN THE 30 TO 60% AREA
INCOME RANGE, WE COULD BE
LOOKING AT MORE TOOLS IN THAT
TO HELP PEOPLE SUFFER FROM
FALLING INTO FURTHER POVERTY.
SO, THIS IS VERY EXCITING.
WE WILL FOLLOW-UP WITH YOU AS
WELL ON THE POTENTIAL
OPPORTUNITY TO PURCHASE ACT.
THE TENANT NOTIFICATION ACT SO
THAT WE CAN ALSO MAKE SURE THAT
IT IS A HELPFUL TOOL FOR HSA.
I AM REALLY EXCITED ABOUT THIS
AS WELL.
WE ARE ABOUT WE CAN HAVE A WAY
FROM PASSING THE LEGISLATION
THAT THE COUNCIL HAS BEEN
WORKING ON FOR YEARS.
AS WE DO, WE ARE ALSO REMINDED
THAT THIS IS JUST ONE PIECE OF
THE PUZZLE AND JUST ONE
INGREDIENT IN THE MIX TO TRY TO
HELP CREATE MORE AFFORDABLE
HOUSING ACROSS THE BOARD.
I WANT TO TAKE THIS CHANCE TO
NOTIFY THE PUBLIC AND OUR
COLLEAGUES THAT WE WILL BE
HAVING A WORK SESSION OR A
LUNCH AND LEARN ON THE 21st OF
MARCH WHICH WILL GIVE US A
CHANCE TO SAY EMMA JADE PAST
AND NOW WHAT?
HOW DO WE WORK TO HELP WITH
DISPLACEMENT STRATEGIES AND
WHAT ARE THE OPPORTUNITIES AND
THE ZONING CHANGES IN THE
FUTURE THAT WE MAY NOT TO
CONSIDER AND IT WILL GIVE US A
CHANCE TO TALK ABOUT THE
HOUSING 2019 AGENDA AS WELL AND
BE BRINGING COMMUNITY PARTNERS.
SEE IT AS A CELEBRATION AND
RECOGNITION THAT WE HAVE SO
MUCH MORE TO DO FOR ALL.
THIS INFORMATION, WE WOULD LOVE
TO HAVE AS PART OF THAT WITH A
ROUNDTABLE DISCUSSION.
THANK YOU.
ALSO, WE WILL WRAP UP TODAY'S
MEETING.
THE NEXT MEETING FOR THE
HOUSING HEALTH ENERGY AND
WORKERS RIGHTS COMMITTEE WILL
BE ON MARCH 21 AT 9:30 A.M..
WE WILL HAVE THE DOMESTIC
WORKER CENTERBOARD APPOINTMENT.
LISTED IN THAT REVIEW PANEL
APPOINTMENTS AND BRIEFING ON
THE HEALTHCARE FOR LOW INCOME
WORKERS AND A SEATTLE CITY LIGHT
GADGET ENVIRONMENTAL COMMISSION
BUDGET. THAT SOUNDS FASCINATING.
PART OF THE TREATY WITH CANADA.
WE WILL MAKE SURE THAT OUR
FRIENDS KNOW ABOUT ALL THAT AND
LOOK FORWARD TO SEEING YOU ALL
ON THE 21st.
PACKED AGENDA THAT DAY.
THANK YOU GUYS.
THANK YOU FOR SEPARATING US
THROUGH TODAY'S AGENDA AND THAT
IS IT.
OUR MEETING IS ADJOURNED.