Equality vs. Equity

The North Sound ACH team will be traveling to Chicago in April to attend Equity Summit 2018.  More information can be found on the event here.

Equality vs. Equity

As we prepare for the 2018 Equity Summit, we continue to explore the concepts of equality and equity. Equality is the equal distribution of resources, while equity focuses on providing for those based on need, in order to gain equality. Achieving health equity requires collaboration and collective action.

In our work, equity and equal opportunity are inextricably linked.  We want all communities to be healthy and connected, but different communities have different structures which interact in different ways, to produce different outcomes. Structures can be cultural, physical or social. The placement of these structures in our lives can take us where we want to go, or they can prohibit us from getting where we’d like to be. Achieving equity requires creating targeted interventions to adjust or create structures that work for everyone. In our work, we pull from Targeted Universalism and Dr. John Powell’s theory that through these targeted interventions, we can affirmatively build structures to produce the better outcomes for everyone.

Would you like to know more about equity? The following resources can help give a better understanding of the root causes of health inequity.

Roots of Health Inequity: A web-based online learning collaborative

This course provides an online learning environment from which to explore the root causes of inequity in the distribution of disease, illness, and death.

Waiting For Health Equity

This graphic novel contextualizes health equity issues using both historical and personal perspectives.

Unnatural Causes

A seven-part documentary series exploring racial and socioeconomic inequalities in health.

Targeted Universalism

The UC Berkeley HAAS Institute and Dr. John Powell’s theory of Targeted Universalism.

Please feel free to connect with our team at the North Sound ACH if you are interested in screening any part of Unnatural Causes or having a community discussion on equity. We are able to help facilitate or support a community conversation. Email voices@northsoundach.org or send us a message on our Facebook page www.facebook.com/northsoundach.


A Reminder of Mindfulness

As 2018 begins, my brain is a buzz with ideas, plans, deadlines, and I’m sure I’m not the only one.

Our convoluted, intertwined, and sometimes abstract work in the Medicaid Transformation process can bring about anxiety and feelings of uncertainty (and can lead to sleepless nights). One highly effective and evidence-based tool that can help is the practice of mindfulness. Research reveals that by paying attention to what’s going on around us, we can reduce stress, unlock creativity, and boost performance. Mindfulness exercises promote intention through breathing and focus; the practice can turn the mundane into something with purpose. 

As innovators in Healthcare Transformation, the benefits of mindfulness are extensive and can assist of in our work—research shows a link between mindfulness and innovation! The practice is also relevant to the clinical workplace, as it can help improve patient engagement and satisfaction. The Institute for Health Improvement (IHI) offers a free course: Incorporating Mindfulness into Clinical Practice. During the 2017 Edge of Amazing conference in Snohomish County, neuroscientist Dr. John Medina discussed the biology behind stress, empathy, the “Theory of Mind and Mindfulness”, and suggested tools on how to implement these findings into the practical world.  One his suggested tools is the book Mindfulness: An 8 Week Plan for Finding Peace in a Frantic World.

We all experience work and life stress, and mindfulness can be used to help move past fears and root us in the present moment, allowing us to deal with challenges with a clear head and calm mind. 

Sample Exercises

Come Back

When you catch yourself caught up in worries about the future or guilt and regret about the past, simply and kindly say to yourself, “come back.” Then take a calming breath and focus on what you are doing right now.

Three Senses

Simply notice what you are experiencing right now through three senses – sound, sight, touch. Take a few slow breaths and ask yourself:

  • What are three things I can hear? (clock on the wall, car going by, music in the next room, my breath)
  • What are three things I can see? (this table, that sign, a person walking by)
  • What are three things I can feel? (the chair under me, the floor under my feet, my phone in my pocket)

Think of these answers to yourself slowly, one sense at a time. It’s impossible to do this exercise and not be present and mindful!


IHI Incorporation Mindfulness Course

Mindfulness book



Martin Luther King Jr Day in the North Sound

In observance of Martin Luther King Jr. Day the offices of North Sound ACH will be closed on Monday January 15th, 2017. During this day we encourage everyone to spread the message of freedom, equality, justice, tolerance and love.  There are several events happening around the North Sound and around the State.  In this time of turmoil let’s remember and act on Dr. Kings message of hope. 

Island  County

Trinity Lutheran Church Minister of Music, Karl Olsen, is planning to perform gospel music and movements in the program. A speech from New Orleans Mayor Mitch Landrieu will also be read; Landrieu gave the speech against white supremacy as his city removed Confederate statues.

Whidbey Island Center for the Arts in Langley is hosting a performance at 7:30 p.m. Friday that combines theater with archival film, called “The Right to Dream.”

The performance is from award-winning Seattle “historical theater troupe,” Living Voices, that tells an African-American student’s coming of age story in Mississippi during the 1950s and 1960s.

On Jan. 15, Whidbey Island Friends Meeting is showing a video of King’s speech delivered from Riverside Church, “Beyond Vietnam.”

King denounced the Vietnam War in the speech. The viewing is 7 p.m. Monday at the Unitarian Universalist meeting house in Freeland.

Read the entire article

Whatcom County

Noon-1 p.m. 210 Lottie St. Free. The city of Bellingham hosts a celebration at City Hall and a day of service at Maritime Heritage Park. The celebration includes music by the Kulshan Chorus, with City Council member Roxanne Murphy as emcee. Speakers include Mayor Kelli Linville; Kristen French, director of WWU’s Center for Education, Equity, and Diversity; musician Edwin “Skip” Williams; and poet and activist Ellen Murphy. This year’s theme: “Infinite Hope: The Courage of the Movement.”

10 a.m. to 1 p.m. Nooksack Salmon Enhancement Association, Bellingham Parks and Recreation Department, and the Volunteer Center of Whatcom County, work to improve salmon habitat at Maritime Heritage Park. Volunteers should come dressed for the weather and prepared to work on steep slopes. Gloves, tools, directions, and refreshments will be provided. nd Recreation and NSEA. Park in the C Street parking lot.

Celebration details: Marie Marchand, 360-778-8202 or mmmarchand@cob.org. Park work details: Rae Edwards, 360-778-7105 or redwards@cob.org.

17th Annual MLK Jr. Poetry Reading and Open Mic

6 to 8 p.m., Community Food Co-Op, 1220 N. Forest St. People of all ages can share a poem or song focusing on diversity, human rights, or related issues (limit presentation to five minutes). Kevin Murphy emcees. Details: 360-734-8158.


Snohomish County

 The annual Whidbey Island Martin Luther King Jr. “Blessed Are The Peacemakers” event at St. Augustine’s-in-the-Woods from 1 to 2:30 p.m. Jan. 16 will feature interactive readings on the martyrs of Selma and voting rights, recordings of King’s speeches, musical performances and a keynote speaker.

Free lunch provided from noon to 12:45 p.m. 

St. Augustine’s is at 5217 Honeymoon Bay Road, Freeland. Call 360-678-5071 for more.

Also in Freeland, Unitarian Universalist Congregation of Whidbey Island will screen the PBS Tavis Smiley special, “A Call to Conscience,” at 6:30 p.m. Jan. 16. The church is at 20103 Highway 525. 

On April 4, 1967, King delivered the controversial speech, “Beyond Vietnam,” about his opposition to the war in Vietnam. The one-hour special includes his speech and commentary. Call 360-342-1457 for more. 

Global Peace Foundation USA, Service for Peace, Corporation for National &Community Services, and Lynnwood Parks &Recreation are hosting an MLK Day of Service for youth ages 14-18 on Jan. 18. Meet at Prestige Care Inc., 21008 76th Ave. W, Edmonds, to volunteer from 9 a.m. to 3 p.m.

Service projects will include poster making for Meadowdale Elementary School, writing letters for the Lynnwood Food Bank and trail rehabilitation at the Lynnwood Golf Course. 

Lunch will be provided.

Call 406-794-2847 or email usyouth@globalpeace.org for more information.

Treat your fellow Americans with dignity and respect, regardless of their background.

— Sara Bruestle, Herald writer (Read the article)

Seattle/King County Celebrations




Thoughts on Community Engagement

Evidence-Based Practice (EBP) is the integration of clinical knowledge, patient values and preferences, and the best research evidence. Yet, all too often, we focus too heavily on the clinical expertise and best research evidence and fail to incorporate the patient values and preferences. In fact, step one requires the provider to start with the patient– ask questions and solicit information.

In the North Sound ACH and throughout the state, evidence-based practices play a central role in transformation; they offer data backed evidence that supports increased efficiency and improved outcomes. The Health Care Authority has provided (in the Medicaid Transformation Toolkit) the suggested models to implement in each project area. Yet, if the Toolkit prescribes the What (evidence based models such as Transitions Care Model (TCM), Bright Futures, Pathways), then the question for the ACHs is How?  How will we use these models for successful healthcare transformation?

We have a plan. As the 2018 planning year approaches, the North Sound ACH staff and project planning teams will look to community input, values and preferences, assuring it is a part of the data that drives creation of implementation plans. Data-driven evidence based practices hold great promise, and together with engagement data, will move our region toward meaningful transformation. We will have to embrace the complexity that this approach brings. If we do, we will have transformation activities that truly bring about improved health outcomes for all communities in the North Sound ACH region.

Happy New Year!

As we close out the final days of 2017, and march into the new year, we are grateful for the breadth and depth of knowledge, innovation and passion that exists within the North Sound partners and communities. Together, you all have laid the groundwork for change, and our team sees so much opportunity in front of us. To address an issue as challenging – and devastating – as opioids will take us all, with the usual and unexpected partners working together. 

In 2018, we will be working with you to – 

  • Support the counties and the BHO (Behavioral Health Organization) as they forge ahead in integrating managed care and behavioral health services;
  • Detail out the initiatives that will be carried out in our region, with the goal of having those initiatives starting on the ground in the second half of the year;
  • Negotiate contracts with partners who will be carrying out the initiatives; 
  • Pushing out data that describes needs and assets across the region;
  • Analyze workforce (current and future needs), value based payment and population health management strategies;
  • Explore opportunities with partners to support regional work beyond the Medicaid Transformation Project (recognizing that the current Transformation funds will only carry us so far).

That is the promise of the ACH – to be a regional table that coordinates work across partner organizations, optimizes funding to partners who do the work of transforming Medicaid; solicit and incorporate insights and perspectives from community members to guide the work, and find the ‘next’ opportunity to work together for positive change. Thank you for being on this journey with us, and we wish you all a healthy and happy new year!


North Sound Staffing Updates

We  have two new additions to our team at the North Sound ACH, and one departure:

  • Deborah Barnes-Josiah, PhD has joined our team in a part-time capacity. Debbi is an epidemiologist who recently moved to the Bellingham area after working 18 years in Nebraska at the state health department and the College of Public Health.  Her work has focused primarily on maternal and child health, including infant and maternal mortality, but has also included diverse projects such as teen violence prevention and community needs assessments.  She is enjoying learning about new geographical and content areas working with the North Sound ACH.
  • Kelly Veit, MHA will be joining our team as the Pathways HUB Director. Kelly has spent the past three years as Director of the Washington Patient Safety Coalition, a Foundation for Healthcare Quality program dedicated to convening patient safety, quality and risk executives around patient safety initiatives. Prior to that position, Kelly spent three years managing the REACH Program, a long-term case management program for people experiencing homelessness and drug addiction in King County. Kelly brings a familiarity of the broad spectrum of health care delivery, from social services to acute care and the various points of interplay between them. She will be joining our team in mid-January. 

In addition, we are sending best wishes to Kyle Davidson, as he left our team to join the Pierce County ACH in a new leadership role. 

CMS Announcement Does Not Affect WA Transformation Funding

The Center for Medicare and Medicaid Services (CMS) recently issued a letter to all state Medicaid Directors stating that it would no longer accept state requests to receive funding where Designated State Health Programs (DSHP) are identified to draw down federal matching dollars. This impacts new requests and requests for renewals of waivers. This ruling does not impact Washington’s current five-year Medicaid project, which the ACHs are an integral partner in. You can find the HCA Authority announcement here and the CMS letter here

Interested in a Board or Committee Seat?

Members of the North Sound ACH Board of Directors have staggered terms, so each year they go through a process of filling open seats. Some Board members have their terms renewed, while some seats are filled by new members. People who express interest are considered for the Board, Program Council and other committees. If you are passionate about this region’s work to transform health and are looking for a way to formally get involved, please email us and we will send you some introductory materials!