Find a Summer Meals Site Near You!

OLYMPIA — June 14, 2023 — Good nutrition is essential for effective learning every day, all year long. Just as learning does not end when school lets out, neither does the need for good nutrition.

Every year, the federally funded Summer Food Service Program (SFSP) provides nutritious meals to children living in identified areas of high need. The program is available now through the end of August.

Summer meal programs help children aged 18 and under get the nutrition they need to learn, play, and grow during the summer. This program is sponsored by many organizations throughout Washington, including schools, nonprofit organizations, local governments, and tribes.

In the summer of 2022, approximately 850,000 meals were provided to children at 805 sites across Washington. Programs operate in areas where 50% or more of the children are in households that are at or below 185% of the federal poverty level. In a household of four people, an annual income of $55,500 represents 185% of the federal poverty level.

Resources in English to find a Summer Meals site near you:

Resources in Spanish to find a Summer Meals site near you:

For more information, please contact the Child Nutrition Services department within the Office of Superintendent of Public Instruction at 360–725–6200 or email summermeals@k12.wa.us.

As Fewer MDs Practice Rural Primary Care, a Different Type of Doctor Helps Take Up the Slack

WINTERSET, Iowa — For 35 years, this town’s residents have brought all manner of illnesses, aches, and worries to Kevin de Regnier’s storefront clinic on the courthouse square — and he loves them for it.

De Regnier is an osteopathic physician who chose to run a family practice in a small community. Many of his patients have been with him for years. Many have chronic health problems, such as diabetes, high blood pressure, or mental health struggles, which he helps manage before they become critical.

“I just decided I’d rather prevent fires than put them out,” he said between appointments on a recent afternoon.

Broad swaths of rural America don’t have enough primary care physicians, partly because many medical doctors prefer to work in highly paid specialty positions in cities. In many small towns, osteopathic doctors like de Regnier are helping fill the gap.

Osteopathic physicians, commonly known as DOs, go to separate medical schools from medical doctors, known as MDs. Their courses include lessons on how to physically manipulate the body to ease discomfort. But their training is otherwise comparable, leaders in both wings of the profession say.

Both types of doctors are licensed to practice the full range of medicine, and many patients would find little difference between them aside from the initials listed after their names.

DOs are still a minority among U.S. physicians, but their ranks are surging. From 1990 to 2022, their numbers more than quadrupled, from fewer than 25,000 to over 110,000, according to the Federation of State Medical Boards. In that same period, the number of MDs rose 91%, from about 490,000 to 934,000.

Over half of DOs work in primary care, which includes family medicine, internal medicine, and pediatrics. By contrast, more than two-thirds of MDs work in other medical specialties.

Read the full article from KFF.

Wildfire smoke forecasted to impact Washington again this season

As our climate changes, the threat of wildfires looms larger every year. The Washington State Department of Health (DOH) is urging the public to prepare now for smoke that can make air unhealthy to breathe. Smoke Ready Week, observed June 12-16, is an opportunity to take proactive steps to protect yourself and your family.

“We are expecting to have above normal fire activity in Washington by July,” said Kaitlyn Kelly, MPH, Air Quality Policy Specialist, DOH. “We have an outlook for below normal precipitation and that’s going to last into fall, so conditions are trending to a long fire season.”

When smoke arrives it’s important to reduce exposure by staying up to date on the forecast and air quality index, limiting time outside, and keeping indoor air as clean as possible. After several days smoke can enter homes and buildings through leaky gaps in windows and doors. Having a way to filter indoor air will benefit your health. It’s key to buy supplies in advance because they often sell out quickly when it’s smoky out.

Filter indoor air by using a:

“We no longer have smoke-free summers in Washington,” said Kelly. “It’s important to know what is in wildfire smoke and why it can be bad for your health.”

Smoke from wildfires contains fine particles and gases including carbon monoxide. Exposure to smoke can cause a number of health problems ranging from minor to severe. Those with pre-existing conditions, infants and children, pregnant individuals, adults 65 and older, and people with heart and lung disease can be most sensitive to wildfire smoke. Minor symptoms can include headaches, stinging eyes, runny nose, and trouble breathing.

You can stay updated on wildfires, air quality, the forecast, and health information on the WA Smoke Blog. For more information on how to protect yourself from wildfire smoke, visit the DOH’s Smoke from Fires webpage.

Burnout Threatens Primary Care Workforce and Doctors’ Mental Health

CHARLESTON, S.C. — Melanie Gray Miller, a 30-year-old physician, wiped away tears as she described the isolation she felt after losing a beloved patient.

“It was at the end of a night shift, when it seems like bad things always happen,” said Miller, who is training to become a pediatrician.

The infant had been sick for months in the Medical University of South Carolina’s pediatric intensive care unit and the possibility that he might not improve was obvious, Miller recalled during an April meeting with physicians and hospital administrators. But the suddenness of his death still caught her off guard.

“I have family and friends that I talk to about things,” she said. “But no one truly understands.”

Doctors don’t typically take time to grieve at work. But during that recent meeting, Miller and her colleagues opened up about the insomnia, emotional exhaustion, trauma, and burnout they experienced from their time in the pediatric ICU.

“This is not a normal place,” Grant Goodrich, the hospital system’s director of ethics, said to the group, acknowledging an occupational hazard the industry often downplays. “Most people don’t see kids die.”

The recurring conversation, scheduled for early-career doctors coming off monthlong pediatric ICU rotations, is one way the hospital helps staffers cope with stress, according to Alyssa Rheingold, a licensed clinical psychologist who leads its resiliency program.

“Often the focus is to teach somebody how to do yoga and take a bath,” she said. “That’s not at all what well-being is about.”

Burnout in the health care industry is a widespread problem that long predates the covid-19 pandemic, though the chaos introduced by the coronavirus’s spread made things worse, physicians and psychologists said. Health systems across the country are trying to boost morale and keep clinicians from quitting or retiring early, but the stakes are higher than workforce shortages.

Rates of physician suicide, partly fueled by burnout, have been a concern for decades. And while burnout occurs across medical specialties, some studies have shown that primary care doctors, such as pediatricians and family physicians, may run a higher risk.

Read the full article from KFF.

Developmental Disabilities Administration Annual Quality Assurance Report

It is now possible to view Putting Vision into Action: Annual Quality Assurance Report from the Department of Social and Health Services’ Developmental Disabilities Administration for Fiscal Year 2022: July 1, 2021 through June 30, 2022. The report shares data on services that they provide and those they support. The report is a good insight as to what the DDA does in the community and their outcomes.

Understanding the U.S. Behavioral Health Workforce Shortage

Nearly half of all Americans will have a behavioral health issue in their lifetime, from a mood disorder to a substance use problem. Behavioral health care encompasses a wide variety of interventions delivered by many different types of providers. In the U.S., nearly all these providers are in short supply.

The scarcity of behavioral health professionals is undermining people’s ability to get timely care. This is reinforced by historical underinvestment in behavioral health care by public insurance programs (like Medicaid and Medicare), private insurers, and employers — including lack of coverage and low reimbursement rates. In 2021, fewer than half of people with a mental illness were able to access timely care; those with substance use disorders were even less likely. Some groups are disproportionately impacted by workforce shortages:

  • Many rural areas and economically stressed cities have few, if any, behavioral health care providers. For example, in 2018, more than half of the counties in the U.S. did not have a practicing psychiatrist. One study found that counties outside of metropolitan areas had one-third the supply of psychiatrists and half the supply of psychologists as their more urban counterparts. As of March 2023, 160 million Americans live in areas with mental health professional shortages, with over 8,000 more professionals needed to ensure an adequate supply.
  • People covered by Medicaid and, to a lesser extent, Medicare struggle to find providers that accept their insurance, in large part because of low reimbursement rates, particularly in Medicaid. One study found that in Oregon, more than half of the mental health providers listed in network directories of Medicaid managed care plans did not actually see Medicaid enrollees. This has profound implications for equitable access, as Medicaid is the nation’s largest payer of behavioral health services.
  • Underserved groups like people of color, non-English speakers, and LGBTQ communities often struggle to find appropriate services. As is the case with many other health care specialties, the demographics of the behavioral health workforce often do not reflect those of the people they serve. For example, while nearly one-third of the U.S. population is Black or Hispanic, only about a tenth of practicing psychiatrists come from these communities. This mismatch limits the ability of people to get culturally and linguistically appropriate care.

To better understand these shortages, we need to know who makes up the behavioral health workforce and the challenges they face in providing care to underserved communities.

Read the full article from the Commonwealth Fund.

‘A System in Crisis’: Dysfunctional Federal Disability Programs Force the Poor to Pass Up Money

Brenda Powell had suffered a stroke and was in debilitating pain when she called the Social Security Administration last year to seek disability benefits.

The former Louisiana state office worker struggled at times to write her name or carry a glass of water. Powell, then 62, believed she could no longer work, and she was worried about how to pay for medical care with only a $433 monthly pension.

Although the Social Security Administration agreed that Powell’s condition limited the work she could do, the agency rejected her initial application for Supplemental Security Income. She had the choice to appeal that decision, which could take months or years to resolve, or take early retirement. The latter option would give her $302 a month now but might permanently reduce the full Social Security retirement payment she would be eligible for at age 66 and 10 months.

“I didn’t know what to do. These decisions are not easy,” said Powell, who lives in Alexandria, Louisiana, about 200 miles northwest of New Orleans. She decided to appeal the decision but take early retirement in the meantime.

“I had to have more money to pay my bills,” she said. “I had nothing left over for gas.”

Every year, tens of thousands of people who are disabled and unable to work consider taking early retirement benefits from Social Security. The underfunded federal disability system acknowledges that it is stymied by delays and dysfunction, even as over 1 million people await a decision on their benefits application.

The United States, which has one of the least generous disability programs among developed Western nations, denies most initial claims, leaving applicants to endure a lengthy appeals process.

At the same time, Social Security agents may neglect to explain the financial downside of taking retirement benefits too early, said attorneys who help patients file disability claims. The result is a growing population of vulnerable people who feel stuck between a proverbial rock and a hard place — to live with little money while they wait it out or agree to a significantly lower payment for the rest of their lives.

“They don’t have the luxury of waiting,” said Charles T. Hall, a disability attorney based in Raleigh, North Carolina. “The vast majority of people need the money now, and you can get early retirement benefits in two months or less.”

In a nation where more than a quarter of residents have a disability, Social Security Disability Insurance and Supplemental Security Income programs are intended to provide financial help to people who cannot work.

Read the full article from KFF.

Apple Health (Medicaid) Renewal Letters Have Begun Mailing

Some clients will automatically renew; and others will need to update their information

OLYMPIA – The Washington State Health Care Authority (HCA), Washington Health Benefit Exchange (Exchange), and the Department of Social and Health Services (DSHS) have begun mailing letters to Washington Apple Health (Medicaid) clients reminding them to update their contact information and renew coverage to see if they still qualify.

For the first time in over three years, people on Apple Health could lose coverage if their family income has gone up. Federal requirements during the COVID-19 public health emergency (PHE) led to income checks being suspended to keep clients enrolled in Apple Health during the pandemic. However, last December’s federal omnibus spending bill directed states to resume evaluating eligibility of Medicaid enrollees on April 1 to wind down COVID-19 pandemic emergency measures.

Washington has until April 2024 to process eligibility redeterminations for all 2.3 million Apple Health clients. It’s the largest benefit renewal process the state has ever attempted. Here is what you need to know during this effort.

How the renewal process works

Washingtonians on Apple Health will get their renewal notifications at different times. To manage the workload, the renewals are being spread out over the next 12 months.

Some clients will be automatically renewed based on the most recent information already on file with the state. If the state does not have enough information on file, clients will need to take action to complete the renewal process to stay insured.  

  • If clients are auto renewed, they will get a notification saying their health coverage was renewed. For most, health coverage will be renewed for 12 months. The requirement will continue for clients to report any changes within 30 days.
  • If clients are not auto renewed, they will get a renewal notice in the mail. They must respond to complete their renewal by the 60-day deadline. If at the end of 60 days the client hasn’t responded, the state will send a notice informing them their Apple Health benefits are ending.

How to know when it’s time to renew

Your renewal month typically matches the month your Apple Health coverage started. Clients can check their most recent Apple Health notice to confirm their renewal date. The month before their renewal date, clients will receive a notice about their Apple Health renewal. For example, if a client’s coverage is up for renewal on May 31, 2023, they should act now to avoid a loss in coverage.

Starting April 2023 through March 2024, HCA and DSHS will evaluate current Apple Health client eligibility for continued coverage and renew or terminate coverage as appropriate.

What steps do clients need to take?

We encourage Apple Health clients to take the following steps:

  • Update their contact information as soon as possible.
  • Check their mail or email. Starting in April and through March 2024, clients will receive information about their Apple Health coverage via mail or email. This notification may require them to take action in order to maintain coverage.
  • Complete their renewal by the deadline on their notice.

“It’s imperative that Washingtonians enrolled in Apple Health take time to update their contact information to ensure they receive upcoming notices related to their health care coverage,” said Sue Birch, HCA director. “If people learn they are no longer eligible for Apple Health, there are other options for low-cost health coverage.”

“We know how important it is to have access to health care when we need it most, and we are committed to making sure people stay connected to this vital benefit,” said Jilma Meneses, DSHS secretary. “We are ready to answer any questions or concerns people might have, and to provide as seamless a process as possible.”

“We want to ensure all Washingtonians stay covered, whether it is Apple Health, employer sponsored, or a new qualified health plan,” said Ingrid Ulrey, CEO at Washington Health Benefit Exchange powering Washington Healthplanfinder. “If you receive a letter from HCA, Washington Healthplanfinder, or DSHS, make sure you open it, and visit Healthplanfinder right away so we can help you with your insurance needs. For those who are now above income eligibility, they will have the opportunity to enroll in high-value, low-cost Cascade Care Plans, now available for as low as $10 or less per month.”

To help Washingtonians transition to other health insurance, HCA has partnered with DSHS and Washington Healthplanfinder to connect people to other coverage. To ensure clients receive important notices about their health care coverage, including other coverage options, Apple Health clients can update their contact information using one of the following options:

  • For individuals who are aged, have blindness or a disability, or are eligible for Medicare:

Proposed Work Requirements Could End Federal Medicaid Coverage for 1.7 Million People

A new KFF analysis finds that an estimated 1.7 million Medicaid enrollees could become ineligible for federal Medicaid under proposed work requirements and presents state-by-state projections, based on estimates of coverage loss from the Congressional Budget Office (CBO). 

States could continue to provide Medicaid to those enrollees but would not receive federal matching funds for doing so. It is unclear if any states would choose to do that, though CBO estimated over half of enrollees would continue to be covered at the states’ expense. If states did choose to continue coverage for those individuals, states collectively could face $10.3 billion in new costs in 2024. 

The work requirements were included in the Republican-backed debt ceiling legislation that passed the House of Representatives on April 26.

Five states would pay nearly half of the estimated $10.3 billion in new costs: California (326,000 enrollees at a cost of $1.6 billion), New York (186,000, $1.1 billion), Illinois (116,000, $692 million), Pennsylvania (83,000, $537 million) and Washington (72,000, $578 million).

Read the full article from KFF.

Your Apple Health: What you need to know about the Public Health Emergency

During the Covid-19 Public Health Emergency, Washington State changed some rules about Apple Health (Medicaid). If you or a family member had Medicaid for health insurance, you did not have to renew every year. If you paid a premium for Medicaid health insurance, premium payments stopped during the Public Health Emergency. Some people received temporary health insurance coverage if they qualified for other benefits.

The PHE ended March 31, 2023, and now:

  • Beginning April 2023, you must renew your Apple Health/Medicaid insurance
  • If you usually paid a premium, premiums are starting up again
  • You may need a new eligibility review

If you do not renew, do not complete a required eligibility review or if you do not pay a premium when it is due, you may lose your health insurance coverage for you or your family member.

What to do:

  • Update your contact information with your insurance provider so your provider can send you important information about renewal, eligibility reviews and premiums
  • Renew your insurance when your provider tells you
  • Premiums for certain Apple Health/Medicaid insurance plans are starting again (Apple Health for Kids with premiums/Children’s Health Insurance Program, Apple Health for Workers with Disabilities (HWD). Watch your mail or email for notices or premium bills from your provider

If you are on one of these Apple Health/Medicaid plans, call:

  • Amerigroup: 1-800-600-4441
  • Community Health Plan of Washington: 1-800-440-1561
  • Coordinated Care: 1-877-644-4613
  • Molina:1-800-869-7165
  • UnitedHealthcare: 1-877-542-8997

If you usually get notices from WA State Health Care Authority email askmedicaid@hca.wa.gov with your name, date of birth, and updated contact information.

If you usually get notices from Washington Healthplanfinder:

  • Log in to your Washington Healthplanfinder account at wahealthplanfinder.org
  • Call Washington Healthplanfinder at 1-855-923-4633

If you are age 65 and older, have blindness or a disability, get Medicare, and get healthcare coverage through Department of Social and Health Services (DSHS):

  • Update contact information at waconnection.org or call 1-877-501-2233 or
  • Visit your local Community Service Office