FAQ from Convening of Community-Based Organizations

(The following questions were gathered from feedback of those who attended the Convening of Community-Based Organizations on May 1.)

Confidentiality concerns in care coordination/partnership

How will CFR 42 Pt. 2 (Substance Abuse Confidentiality Regulations) be addressed if co-occurring behavioral health (including Substance Use Disorder) is chosen as a population of focus?

Anyone involved with Substance Use Disorder (SUD) treatment with an SUD provider must have a CFR 42 part 2 compliant Release of Information (ROI).  Outreach-only work does not require an ROI, but once someone enters into treatment it is necessary. Newly updated CFR 42 part 2 language includes a provision that “all involved” in treatment can be included in an ROI.  A SUD provider (for example a counselor in an outpatient clinic) can most easily develop ROIs and communicate with a specific individual (identified in the ROI) in various other areas (housing, school, job development, medical).


Becoming a Pathways CCA

How many agencies per county will be chosen and what scope is intended? Where is the training?

The North Sound ACH is not designating a specific number of Care Coordinating Agencies (CCAs). The number of agencies in the network will be contingent upon the responses we get from our call for CCAs because 1) We’re using that call as a final refinement tool to figure out which agencies are available and have the capacity to do the work around our populations and 2) what is their geographical scope of service.

What resources will be given to the new CCAs to support their management of the program in their community and staffing of new community health workers/community care coordinators? And when will they be distributed?

The CCA staff who the agency designates as their Pathways care coordinator, will be trained in the Pathways model and software at no cost to the CCA. Existing staff of CCA agencies are candidates for being designated and trained as care coordinators. The Pathways HUB model creates the potential for additional sources of reimbursement or funding for the work of existing care coordinators, as well as additional funds flow for adding care coordinator staff capacity as the HUB network of referrals is developed.  While the Hub is providing startup funding and training for care coordinators, it is important that a CCA is able to illustrate their ability to sustain care coordinators in the future, and that the Hub is not their only source of funding.


Pathways Planning Process for Conducting Key Informant Interviews

When were key informant interviews conducted, and with whom? 

During the Pathways Community Hub planning phase (January – April 2018), an environmental scan and key informant interviews were conducted to build understanding of care coordination activities and populations served across the North Sound region. Key informant interviews are still ongoing and community input will still be sought out. So far,  interviews have included:

County Resource Centers in Island and San Juan County

Home Health Lead Agencies

The North Sound Behavioral Health Organization

Community Based Organizations such as: The Opportunity Council, Compass Health, Mt. Baker Planned Parenthood

North Sound ACH Leadership: Program Council

Medicaid Managed Care Plans

High Utilizer Group initiatives serving Skagit, Snohomish, Whatcom counties.

Information that helped shape population of focus selection was also gathered during the North Sound ACH Community Based Organization convening on 5/1. Additional information was gathering during consultation, engagement and strategic development input of state and national partners in launching the Pathways Hub model (including Foundation for Healthy Generations, Health Home Lead agencies, and The Pathways Hub Certification Institute, ACHs around Washington State, and other certified Hubs (NEON in La Grande, OR)).

Please contact us if you have additional questions.  Email Hillary and your email will be forwarded to the appropriate member of our team.