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Health care reform is here: What's next?

Creating a fairer, more just playing field for King County residents, health care reform is anticipated to be a game changer for the public's health. With the launch of Washington's health insurance market place on October 1 and eligibility of nearly 800,000 King County residents for low cost or subsidized health insurance, health advocates have been very busy preparing for and implementing the Affordable Care Act.

Public Health - Seattle & King County's Assessment, Policy Development & Evaluation Unit (APDE) is working to ensure that throughout implementation of health care reform, real-time evaluation strategies will promote effective outreach and enrollment, particularly among low-income groups. An additional key role of a local health department is to assure that local populations get access to the care that they need.

APDE is partnering with the University of Washington's Department of Health Services and other key stakeholders to develop a comprehensive monitoring framework (see below) that will assess whether implementation of the ACA will have an equitable impact on access to and utilization of health care, quality and patient experience of health care, and cost of health insurance and care across sub-county regions and population groups. Additionally, there is insufficient evidence as to whether the current and proposed health plan networks and health workforce are sufficient to equitably meet the needs of an influx of new enrollees into the primary health care system. Monitoring implementation is key to understanding impact of the law. For more information, contact Nadine Chan, nadine.chan@kingcounty.gov.

Impact of health care from the Affordable Care Act

Community health needs identified by new hospital/Public Health collaborative

Community action informed by data can be a powerful tool to improve community health. The Affordable Care Act requires nonprofit hospitals to collect data on the health of their local communities and plan implementation strategies to address local challenges. Through Hospitals for a Healthier Community, a new collaborative with Public Health - Seattle & King County's Assessment, Policy Development & Evaluation Unit, King County hospitals are working together to complete a single health needs assessment for the entire county that will be used by each hospital. Collaborative members include:

  • EvergreenHealth
  • Franciscan Health Systems
  • Highline Medical Center
  • Group Health Cooperative
  • MultiCare Health System
  • Auburn Medical Center
  • Overlake Medical Center
  • Public Health-Seattle & King County
  • Seattle Cancer Care Alliance
  • Seattle Children's Hospital
  • Snoqualmie Valley Hospital District
  • Swedish Medical Center
  • UW Medicine
  • Valley Medical Center
  • Virginia Mason

Communities Count introduces new indicators

Communities Count, a public-private data partnership for which Public Health - Seattle & King County's Assessment, Policy Development & Evaluation Unit provides analysis and interpretation, has completed the launch of all indicators on its new website. While data on some topics have been staples of Communities Count for over a decade (Food, Housing, Discrimination, Reading to Children, Social Support, etc.), others made their public debut on the redesigned website. A sample of new offerings:

  • Childhood health risks, which includes King County data on the strong association between Adverse Childhood Experiences (ACEs) and adult health outcomes (for example, adults with high ACE scores are twice as likely as those with low ACE scores to be current smokers)

Impact of health care from the Affordable Care Act

  • Disability, which affects 23% of King County adults, and will probably touch all of us at some time in our lives;

  • Education of English Language Learners, a particular challenge for King County school districts, which serve the most diverse language communities in the state. In the 2011-2012 academic year:
    • 35% of students in the Tukwila School District had limited English facility.
    • the 5,791 English Language Learners in the Seattle School District spoke a total of 99 languages.
    • only 53% of students with limited English proficiency graduated with their class (4 years after starting high school.)

Marijuana policy: King County comments on Liquor Control Board's rules

The Assessment, Policy Development & Evaluation Unit leads county efforts to develop comprehensive policy solutions, including King County's response to voter legalization of marijuana by adults, and state efforts to regulate marijuana-related businesses. Through a multi-department response process, King County provided technical comments to the state Liquor Control Board on public health and other significant issues, as the Board develops a regulatory framework for recreational marijuana. King County will monitor changes in youth and adult marijuana use as the product becomes more widely available in our community.

With particular concerns regarding youth initiation and risk, King County Executive Dow Constantine, Public Health - Seattle & King County Director Dr. David Fleming joined colleagues from Snohomish and Pierce Counties in comments to the Liquor Control Board regarding youth access and strengthening the proposed rules.Read the letter to the board here. For more information regarding marijuana and health, see Public Health - Seattle & King County's key messages.

Innovative data collection shows 8% of drivers texting or otherwise distracted while driving

A new study is creating a measurement and enforcement evaluation framework to understand the extent of cell phone use and texting as part of distracted driving in 6 jurisdictions in Washington (3 intervention and 3 control group counties) and how the law is being enforced. Through observation of driver behavior, researchers were able to pinpoint the extent of distraction through cell use at 8% of all drivers, and over half of those who were found to be driving inattentively. Washington's state law (RCW 46.61.68) prohibits sending, reading or writing a text message while driving, and 'phone-to-ear' use (RCW 46.61.667). Those holding instruction permits (RCW 46.20.055) or an intermediate license (RCW 46.20.075) cannot use any wireless communication device (regardless of hand-held or hands-free). Upcoming interventions during the study include county-specific distracted driving report cards for the public, policy makers and the media, and educational interventions with law enforcement, judges and prosecutors.

The Robert Wood Johnson Foundation-funded study is a public health law research grant joint collaboration of the University of Washington/Harborview Injury Prevention Research Center (PI Dr. Beth Ebel), the Assessment, Policy Development & Evaluation Unit, Public Health's Prevention Division, and the King County Prosecutor's Office.

Incidence of distracted driving at controlled intersections

Pathway to accreditation: Improving what we deliver and how we improve Public Health

While most health care institutions undergo some type of accreditation process, a program for accreditation of health departments was not available until 2011. National standards developed by the Public Health Accreditation Board now allow accreditation of local, state, tribal and territorial health departments. A key step towards accreditation is development of a community health assessment, intended to paint a picture of health needs and assets in our community. Next steps towards accreditation include development of a departmental strategic plan, workforce development plan, and community health improvement plan to respond to the needs outlined in the community health assessment.

QuickStats

  • 180,000 county residents newly eligible for health insurance
    For more information about uninsured rates and King County's eligible population, see our data on uninsured individuals in King County.

  • Marijuana use among King County youth exceeds tobacco use
    Did you know that 14% of students in grades 6, 8, 10 and 12 reported using marijuana in the past 30 days? Marijuana use in youth in King County now exceeds tobacco use. For more information on youth marijuana use, see APDE's Community Health Indicators related to marijuana.