PCMS Meets with State Health Committee Members

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With the state legislative session underway and behavioral health expected to be a major topic of deliberation, PCMS Executive Director Bruce Ehrle headed to Olympia on Thursday, February 7.



While there he met with State Rep. Laurie Jinkins, a majority member of the House Health Care and Wellness Committee.  Rep. Jinkins represents the 27th District that includes most of Tacoma.  He was joined for that meeting by Nicholas Rajacich, MD, a member of the PCMS Board of Trustees.  During the meeting they shared examples of how the behavioral health resource crisis impacts Pierce County including low Medicaid reimbursement rates raising further access barriers as well as seriously impacting the finances of providers, how troops at the Joint Base who may wish to seek civilian behavioral health care off post have difficulties getting timely appointments due to lack of capacity, the roadblocks that primary care physicians have in referring patients for behavioral care due to lack of capacity even if they have integrated some of that patient care in to their own practice, how new facilities in the community such as the Mary Bridge Adolescent Behavioral Health Center immediately fill up slots when they open demonstrating the pressing need for even more capacity, and how patients not receiving care in the most appropriate setting continues to burden emergency departments and other provider care settings, also denying space to those who would be most appropriately cared for in those settings.  



Dr. Rajacich and Bruce asked Rep. Jinkins if there were any items that PCMS could add to its federal advocacy agenda to help her and others in Olympia meet their goals to help address the behavioral health crisis in locales like Pierce County.  She articulated specific examples of how CMS could administratively better handle Medicaid reimbursement classifications so that patients aren't denied access to new facilities as they become available because they are classified at the lower rate.  Bruce committed to raise the issue as a priority during his ongoing conversations with CMS officials in Baltimore and Members of Congress as one way they could quickly assist communities address the serious shortfall in behavioral health capacity.  



Dr. Rajacich thanked Rep. Jinkins for her work to increase the smoking age in Washington to 21.  



Bruce also met with State Sen. Steve Conway, a majority member of the Senate Health and Long Term Care Committee.  Sen. Conway represents the 29th District that includes South Tacoma as well as portions of Lakewood, Parkland, and Spanaway.  During their 45 minute meeting, they discussed the same examples of challenges in Pierce County that had been noted to Rep. Jinkins.  They also discussed at length more broadly the access challenges that so many patients continue to face with every payer, the administrative burdens facing providers, as well as connections between the state and federal health care landscape.  Sen. Conway requested that PCMS continue pressing for increased assistance from the nation's capital to help address the behavioral health crisis as part of its federal advocacy agenda. 



Bruce also raised serious consequences for the physician sector if the proposed increase in the B&O tax from 1.5% to 2.5% contained in the governor's draft budget is enacted.  He noted to Sen. Conway that at a time when physician practices are being tasked with behavioral health integration, when they are faced with greater administrative burden due to the complexities of coding and charting, and when they are faced with massive reforms to the payment system as payment for value, quality, and outcomes supersedes fee-for-service, placing a giant new tax burden on them would deeply harm physicians and patients.  Sen. Conway responded that such a frontline reality is a message to keep sharing and that one outcome could be that physicians be assigned a special rate, lower than the full rate--or exempted entirely from the increase if it is enacted.  He also thought that all or part of any B&O tax increase that the legislature might pass could be temporary as it was earlier in this decade.  Bruce stressed that even a temporary increase all the way to 2.5% would have a negative impact on the physician community and such a special lower rate or complete exemption as raised by Sen. Conway would still be needed to protect patients and caregivers. 



PCMS will continue to confer with members of the state legislature from Pierce County on these and other matters as the session continues.  



While in Olympia today, Bruce and Dr. Rajacich also attended the WSMA Legislative Summit.  Behavioral health capacity, the B&O tax, and the smoking age are also top priorities for WSMA.  Several active and retired physician members of PCMS also attended the Summit and visited with legislators from their own districts across Pierce County in meetings that WSMA scheduled on their behalf where they also focused on those three topics.