Tackling the Access Crisis in Vancouver

Sarah Rafton
WCAAP Executive Director

During the 2018 legislative session, I met with community health workers from Vancouver and Kachina Inman, vice president of equity, partnerships and policy for the Southwest Accountable Community of Health (SWACH). After talking with them, I realized WCAAP needed to deepen our understanding of access to care in the Vancouver region. Thanks to SWACH and the Child and Adolescent Clinic (CAC), we convened a meeting on July 19th with included a local family; Child & Adolescent Clinic’s Tsering Lhewa and Kimberley Robbins; Susan Lehr from early intervention provider Innovative Services NW, community health workers Brandi Williams and Dominique Horn; Sam Pike from Vancouver Public Schools, Barbe West from the Free Clinic; and Ana Bettancourt from Fort Vancouver High School.  We were also joined by Representatives Monica Stonier and Paul Harris.

Each participant shared how the lack of access to care in Vancouver was directly impacting school attendance and kids’ ability to learn. Reps. Stonier and Harris were incredibly supportive and the community who was assembled told powerful stories of kids’ inability to get timely care including:

  • Kids going to the free clinic for vaccines in order to attend school.
  • A 15-year old freshman boy who could not play basketball his freshman year because of a 3-week wait for a sports physical.
  • 68 thousand children in Clark County and almost 14 thousand in Cowlitz County are insured on Molina alone. CAC’s payor mix at their Vancouver site is now 89% Medicaid.
  • Lack of access to mental health care means that kids are failing out of school.
  • Several school personnel were convinced that the school district attendance and truancy rates are directly a result of lack of access to care for kids.
  • We also heard from school staff and pediatricians that trauma and mental health issues for undocumented immigrants are on the rise and there is no one prepared to serve their mental health needs.

Reps. Harris and Stonier provided helpful guidance on how to proceed in the 2019 legislative session as we pursue Medicaid/Medicare parity.  Both demonstrated a deep understanding of the wisdom of investing in quality, timely care for kids. Rep. Harris commented “Obviously! This is the right thing and the cost-effective thing to do.” Stonier said “This is fiscally conservative healthcare!” Their efforts to improve access to care will be strengthened if we can get other legislators around the state on board, a task we are happy to help with during the interim!

That evening, we held a listening session with several CAC providers and one Kaiser provider plus four Southwest Washington legislators (Representatives Stonier, Harris, Wylie and Senator Lynda Wilson) along with WCAAP’s legislative liaison Amber Ulvenes, communications manager Jennifer Donahue, and me.  We are grateful to Dr. Tsering Lhewa for facilitating the discussion and to all of the providers in attendance for their passion, innovation, and commitment to children. The four legislators came away from the listening session planning to seek the legislative delegation of nine  legislators from the 17th, 18th, and 49th districts working as united front for Medicaid access in 2019.

This was a terrific way to start our work for 2019. Amber and Jennifer agree this was one of the most effective days I’ve seen at WCAAP in my 3 years with the Chapter.

Hats off to the SWACH, CAC and to us!