HCS Highlights WINTER 2024
CONTENTS 04
CATHY’S MESSAGE
06
REGIONAL UPDATES
12
ALTSA’S WELLBEING JOURNEY CONTINUES
14
ADVANCING EDAI IN HOME AND COMMUNITY SERVICES
15
CLIENT SUCCESS STORIES
16
ADULT FAMILY HOME CREATES MEMORABLE EXPERIENCES FOR RESIDENTS
18
STAFF KUDOS: DAVID MINOR AND ADELLE MOSS
CATHY’S MESSAGE Well, we made it to the end of 2023, and I hope you are all settling into the New Year and are excited at what 2024 could bring our way! Thank you for another year of providing important services to our clients, supporting each other, and accomplishing so much. I wanted to take a moment to acknowledge the great achievements and highlights of the work we did in 2023, and what our plans look like headed into 2024. Winding down 2023 Unwinding the Public Health Emergency
Cathy Kinnaman Director
Over this past year we worked hard to unwind the public health emergency. Our financial teams led the Medicaid redeterminations, our imaging staff have been instrumental in ensuring our clients received renewal forms at their correct addresses, and our case managers continued to reassess and provide excellent services to our clients. With our clients as our focus, I know we did everything we could to ensure our clients did not lose access to their services and other essential benefits, while also ensuring ongoing accurate eligibility determinations. I know it has been hard work and we are not at the end of it yet, but we were also able to dip our toe into the ground-breaking world of technology in the form of HCS Bots who helped with our Medicaid redeterminations. Our Home and Community programs team also worked hard to ensure that flexibilities we wanted to keep were added to our permanent 1915c and 1915k authorities, specifically authority for ongoing remote services when appropriate. 1115 Medicaid Transformation Project Over the past year, in coordination with the Health Care Authority, we negotiated with the Centers for Medicare and Medicaid to renew our 1115 demonstration waiver. As a result, we now have higher income and resource limits for our TSOA program, ensuring that these vital services are available for more unpaid family caregivers when they need our help. With many thanks to our work team and our regional leadership team we were able to successfully implement presumptive eligibility in December 2023. This allows clients discharging from acute care hospitals to receive services quickly while we put all the elements in place to ensure they are safely transitioned back to their homes and communities. I’ve said before we are first in the Nation to do this and every time I see the reports showing how many clients we are serving with this new benefit, I am reminded how proud I am to work for HCS with such wonderful, compassionate, and dedicated people. Our housing teams are also working closely with HCA to roll out addition federal funding support for short term rental subsidies. If you would like to learn more about our programs but also the programs that HCA is able to implement and expand as a result of our CMS approval, our Special Terms and Conditions are listed here. Workforce Successes In September 2022, we had 164 vacant positions across HQ and the regions, putting incredible strain on our staff. By the end of 2023, that number had dropped in half to around 80 positions. That is a huge amount of work, but your creative approach and continuous hiring practices are paying off! And we are bringing new talented people to join our HCS family. Kudos to all our hiring managers for their hard work this past year. Civil Transitions Program In just this past month we launched the new Civil Transitions program, created because of E2SSB 5440. This program provides an avenue to LTSS for individuals leaving our jails who are found not competent to stand trial, and not restorable, who are suffering from a form of dementia, traumatic brain injury, or intellectual disability. The program will serve individuals who are functionally and financially eligible for our programs and those who are not. The program launched December 1st and we are already seeing a steadily increasing stream of referrals of individuals who are likely going to be eligible for these services.
Many other successes in 2023 Here’s just a few of other successes from 2023: •
The MultiCare bed readiness program at Harborview is being used as a model for new efforts to serve difficult to discharge clients from our acute care hospitals which will launch in 2024.
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There were many creative ways our Regional Administrators were able to offer training, leadership development, succession planning, and team building for our critical field staff.
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We continued to partner with the Adult Family Home Council, the Training Partnership, and our Home Care Aides to provide the training and communication needed.
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We completed reports for the legislature and updated the State Plan on Aging.
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Our team launched the Human Centered Design community of practice and resources, a new Direct Care Workforce Collaborative, and conducted numerous focus groups and outreach events to ensure that our client’s, providers, and families voices are all incorporated into the work that we do.
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We initiated a case aide pilot in the regions to provide additional support to our case managers and assessors.
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We worked closely with the Consumer Direct Washington and the Area Agencies on Aging to make progress towards reducing our HCS caseloads – speeding up the timeline to get new individual providers through the hiring process and coming to an agreement with our AAA partners to pilot ways to transition clients while waiting for a caregiver to be available.
Among all of this, our teams continued to support our programs and core business. We have transitioned over 3700 number of clients from nursing homes, over 370 clients were discharged or diverted from our state hospitals, and over 8400 from our acute care hospitals. When you see these numbers, you can really see why we make such a difference in people’s lives. It has truly been another successful year for HCS! Looking Forward As we look toward the new year, we have a number of priorities. We look forward to increasing and streamlining access to services by expanding our Application Assistance Line, our Case Aide pilot, and rolling out additional phases of presumptive eligibility. We will continue our transition work, including our acute care hospitals, state hospital discharge and diversions and our new civil transitions in addition to our long-standing nursing home and RCL transitions. We will continue to focus on efforts to address provider workforce shortages by marketing our Caregiver Careers website, implementing additional High School Home Care Aide programs, and implementing a remote caregiving pilot. In addition, we look forward to increasing the use of technology to support staff workload and client safety by adding remote supports to our 1915c waivers and leveraging BOTS technology to fully automate Medicaid renewals. I’m also looking forward to the groundwork for a multisector plan for aging, planning for the Governor’s Summit on Aging in May and increasing awareness across the state around age-friendly communities. These are no small tasks, but they are critically important to our ability to support our clients. Thank you for another successful year in Home and Community Service and my sincere wishes for an outstanding year ahead in 2024. Our division has grown to over 1,300 employees and continues to grow because our work is vital, world class, effective, and transformative. We could not realize the successes we have had, and which we continue to build on year after year without each and every one of you. Happy New Year!!
REGION 1 UPDATE Three of our critical programs in Region 1 have experienced a lot of change and growth within the last quarter of 2023: our Training and Quality Assurance/In-Training program, our Residential Support Waiver (RSW) team, and the State Hospital Discharge & Diversion (SHDD) team.
Tami Rucker, Region 1 Administrator
The Training and QA team has hired 3 new SHPC’s and is now full and can focus on staff training needs and looks forward to developing new training PowerPoints in 2024 to bring to the field. Laura Smith is our Program Manager for this team and has been a visionary when it comes to the future of her team. Until mid-October of this year, our State Hospital Discharge & Diversion group and Residential Support Waiver group were all on one team. The RSW team grew quickly and significantly as the result of receiving much-needed RSW FTEs to provide the intensive case management our behaviorally challenged clientele needs. It wasn’t long before we realized the team needed to split off, with one team being State Hospital focused, and the other being all things RSW. Sharon Miranne, the SHDD Program Manager, did an amazing job holding both teams together until we were able to hire an additional program manager specific to RSW, Tonia Juarez, who began in her position on October 16, 2023. We are excited for the future and to be a part of this culture of change!
The SHDD and RSW Team having fun on Halloween.
REGION 2 UPDATE In each of our 7 offices in Region 2, our Customer Service and Regional Business Operations teams are the backbone of smooth operations and service to our clients and staff. Each member of this team handles a varied set of tasks that allow our region to function effectively.
Erin Klones, Interim Region 2 Administrator
On November 16, 2023, we hosted our 1st Customer Service All Staff meeting inperson in our Lynnwood office. This meeting was an opportunity to bring together our Customer Service and Regional Business Operations staff from throughout the region for a day of connecting and information. The group had a chance to enjoy some fun activities, learn about future planning to increase efficiency and regional alignment and receive training on locating information in Barcode, ACES and CARE Web to best assist our clients. Our Customer Service and Regional Business Operations teams are central to the work we do in each of our offices and it was wonderful to have them all in the same room! Thanks to Joanna Blanford-Pirak (Acting DRA) and Julie Long (Regional Operations Manager) for planning a great day. And thanks to all our staff who were able to attend and were engaged and enthusiastic throughout the day! We look forward to making this an annual event! Over the past few years, the work of these two diverse sides of our operations has becomes increasingly complicated and increasingly intertwined. In 2024, we will be working to bring the Customer Service staff and Regional Business Operations staff under one centralized organizational structure. These changes will allow our staff across the region to support the essential work of these teams and to share best practices to increase efficiency. We are also working towards opening two new office locations in 2024, which will broaden the reach of this team. We are extremely lucky to have dedicated, flexible and enthusiastic staff throughout our Customer Service and Regional Business Operations teams. While changes are on the horizon, I know these staff will be able to rise to the challenge and continue their vital support staff and clients throughout Region 2.
Swinomish Channel near Skagit Bay in La Conner, Washington State
REGION 3 UPDATE 2023 was a year of great teamwork! We had so many challenges and I continue to be inspired by the teamwork that goes on in the Region as they work through those challenges. One way we recognize the work going on is through Team of the Month awards. While this by no means encompasses ALL the great teamwork out there, it gives a glimpse at what a difference we can make when we come together! Thank you, Region 3, for valuing teamwork and prioritizing our clients and each other! January: Danna Pfeifer and Susan Aigner were recognized for transitioning a very challenging client that has been in a hospital setting since 2019. February: Region 3 South Residential Teams collectively assisted co-workers and our clients with 451 in-home cases in Vancouver and Kelso that would have otherwise waited even longer for services.
Debbie Willis, Region 3 Administrator
March: Justin Munn and Roberto Gutierrez were recognized by the daughter of a client for assistance with the Medicaid application process for her 86-year-old mother. April: Dionne Smith and Heidi Hughes went above and beyond to help a client who was need of RSW support following an APS referral. May: Nolan Henderson and Steve Getman-Gerbec helped get intake out of a persistent backlog, have delivered training to new staff and partner agencies, and truly care about the Intake team’s success. June: Jen Pierce and Nancy Price have received upwards of 75 intakes EACH with an average of 68 Intakes each per month. They go above and beyond to serve our clients and do the best they can in a difficult situation. July: Jenna Villalobos, Christine Follett, Kate Kowalski and RCS PM Jody Just worked with family members and clients to find placement after a fire broke out at a Vancouver AFH. August: Dustin Rudoll and Snezana Ivanoska have shouldered the burden of staff turnover, hiring, onboarding, and carrying cases for 7 months as brand-new supervisors. September: Roxy LaRoy, Emily Comstock, Nicole Varland, Patrick Dettling, and Ahmed Eldegwy, supported team members out on extended leave, mentored new employees, and assisted covering new employees’ caseloads during training. October: •
Jennifer Bureau, Kimberly Schmidt, Isaiah Lozano, and Michael Wiggins have supported each other through transitions to new teams, coworker absences and vacant caseloads to ensure clients are still served timely.
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Sundy Ballester and Paulette Handley have created and delivered a comprehensive presentation on Administrative Hearing to the entire Region 3 PBS, sharing their expertise and best practices.
November: •
Maria Clinton, Benjamin Thomas, Heidi Hughes, Corey McClanahan, Tony Huynh, Jinene McCormick, Trinity Le, Heather Ross, Nicole Cox, and Marco Villa are always willing to help all clients that come into the office whether they are their client or not. They are professional and caring.
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Social Services SHPC’s (Tara Benson, Samantha Cammon, Tari Lennox, Brian Stewart, Rae Sherk, Jourdan Weitzel, Oksana Wilson) have revamped their trainings and have trained/onboarded 83 staff (76 SSS3 and 7 Supervisors) so far this year; this is the highest number of staff ever to be onboarded!
December: Still to be announced.
Makah Tribe’s Cape Flattery Trail, Cape Flattery, Neah Bay, Washington
ALTSA’S WELLBEING JOURNEY CONTINUES
By Amy Besel, ALTSA Senior Organizational Development Administrator, Office of the Assistant Secretary
Teammates- Here’s what I believe I know about you: You show-up, you do hard work, and you make a difference! Our success as individuals, as an organization and as an entire service delivery system depends on each one of us doing this, every day. Thank you for all you bring of yourself to your work and for choosing to be public servants in Amy Besel ALTSA. Public service is an honorable calling and if you are here, it means you share our values and mission, which fills my heart with joy and gratitude. We are in this together! And part of being in this together means we take care of ourselves and each other. We are doing many things to help take care of each other in ALTSA. •
We have fully embraced hybrid work, maximizing telework and flexibility wherever we can while ensuring our service needs are consistently met with the highest degree of quality because the people whom we serve deserve nothing less than the best (that’s you!)
and you deserve good work/life harmony in the process. •
We have increased our focus on wellbeing throughout the pandemic and beyond, offering many free Focal Point sessions on topics such as Resiliency, Preventing and Overcoming Burnout, and Thriving Through Change and have created the monthly Wellness Note to offer support every month on each of the 12 dimensions of wellbeing. We have added Wellbeing to our strategic plan. We have added the ALTSA Organizational Engagement and Wellbeing Manager position to our team and are excited to have Derrick Ross serve in this new role, further supporting you.
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We have ensured wellbeing is a part of our leadership conversations, establishing and teaching others how to create psychological safety, navigate change, manage time, and promote a true sense of belonging. All are essential to our inclusion efforts and will help us be an Employer of Choice for years to come.
Even as we work on these wellbeing efforts as an organization, to reach real success requires each of us taking care of ourselves. As we move into 2023, here are some things you can do:
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Carve out time on your calendar for daily planning and prioritization and try some of these templates to help you manage your workday and wellbeing goals
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Come to the ALTSA Thrives Connection Café (or any other Café that excites you)
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Read the monthly wellness note and commit to trying new things
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Join a Focal Point session on a variety of great subjects
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Reach out and connect with others in person, on a Teams call, or send a RAVE review
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Check out SmartHealth, sponsored by the Governor’s office
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Remember you are not alone, and you are always encouraged to utilize the Employee Assistance Program if additional support is needed
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Please visit our ALTSA Organizational Development intranet site for more information and resources.
Here is a video that inspires me and reminds me of my own power to make daily choices that support my wellbeing. I hope it does the same for you. (Note, not an endorsement of any business) Thank you for taking good care of yourself and each other as part of our wellbeing journey in ALTSA!
Disabled And Here Project: Photo by Chona Kasinger.
ADVANCING EDAI
IN HOME AND COMMUNITY SERVICES By Michelle Joseph, ALTSA EDAI Administrator In the evolving landscape of social services, Washington State’s commitment to fostering equitable, diverse, accessible, and inclusive culture, Home and Community Services (HCS) stands as a beacon for this positive change. Transforming HCS through the lens of Equity, Diversity, Access, and Inclusion (EDAI) is woven into the fabric of what we do to promote choice for persons who are aged, blind, and disabled. By incorporating EDAI principles into promoting choice, we are setting an example for our nation of the value our agency sees in promoting a culture that serves Washingtonians with intricate and creative care possibilities! Regardless of one’s background, everyone is provided an opportunity to receive the care they deserve.
communities we serve. Celebrating diversity not only enriches the sector but enhances its ability to adapt and cater to a broad spectrum of individuals.
Equity in HCS
Inclusion for All
Understanding the essence of equity is foundational to reshaping HCS. Equity in HCS involves ensuring that everyone, irrespective of their race, gender, age, disability, or socio-economic status, has equal access to services. Delving into this aspect involves a strategic examination of systemic disparities, aiming to eliminate barriers that hinder certain communities from receiving optimal care. By embracing the principle of equity, we as professionals and advocates for change, can work towards a more just and fair distribution of resources and services.
Creating an inclusive environment is the ultimate goal. This involves not only acknowledging differences but actively working towards integrating them into the fabric of HCS. We play a pivotal role here, as it fosters understanding and compassion, making individuals from all walks of life feel seen, heard, and valued within the system.
Diversity as a Strength Diversity, one of our strengths, is an asset in HCS. Recognizing diversity as a strength is an inherent part of the journey towards a more inclusive HCS. As professionals we actively seek to understand and appreciate the unique perspectives, cultures, and needs of the
Access to Services Ensuring accessibility is not only a legal obligation but a moral imperative in the realm of home and community services. At HCS, we must continue to advocate for policies that break down barriers to services. This involves a concerted effort to make services available to all, regardless of socio-economic status, geographical location, or cultural background.
In conclusion, as a social services professional, you hold a key role in the transformative journey toward advancing equity, diversity, access, and inclusion in HCS. By leveraging your strengths and championing these principles, you contribute to a more equitable and inclusive future for all clients, caregivers, and communities we serve.
CLIENT SUCCESS STORIES ROBOTIC PET COMPANIONSHIP
ELBOW GREASE AND TEAMWORK
A few months ago, we (HCS) purchased a robotic companion cat for a client who has dementia, a TBI, and an intellectual disability. This client was noncommunicative, combative, and verbally abusive. If he spoke, he just repeated the same question over and over. He exhibited extreme behaviors that were very difficult to manage. He’s been in the same Adult Family Home (AFH) for over two years.
This success story concerns ‘elbow grease’ and teamwork between the HCS acute hospital case manager, the hospital social worker, the Managed Care Organization (MCO), and our Region 1 Adult Family Home (AFH) provider. The client has a history of schizophrenia and substance abuse and is very clinically and behaviorally complex.
The Residential Support Waiver case manager conducted his monthly SBS (Specialized Behavior Support) meeting. This client is now asking questions, trying to orient himself, and speaking during visits with his Ascend Network behavior support provider clinician. His aggression has also been reduced. The AFH provider and Ascend clinician reported that the client is more aware and has made more sense. The robotic companion pet is his best friend, and he focuses all his attention on it. There has been a slight improvement in the client’s condition for the first time in a few years!
Last summer, he had several acute hospitals stays due to multiple organ failure. While at his most recent AFH, he took methamphetamine that was laced with Fentanyl and had cardiac arrest there. At Sacred Heart Hospital, he was struggling with ostomy management and had severe behaviors on the floor. The hospital social worker and HCS acute hospital case manager brainstormed and met with him. They worked closely with the MCO, Molina, to get funding. The AFH provider is a psychiatric nurse practitioner who was very patient when the discharge was delayed. The client was discharged to the AFH owned and run by an RN and is doing well!
Elizabeth Jewett (L) Lauren Callender (R)
PICNICS, DANCES AND A UNICORN: ADULT FAMILY HOME CREATES MEMORABLE EXPERIENCES FOR RESIDENTS
by Jessica Nelson, DSHS ALTSA Media Relations Manager
When a family member is placed in an adult family home, it’s expected they will receive quality care. But one Washington father says his daughter gets so much more — a sense of family and friendship. Lauren Callender has lived at Abenezer House in Everett since 2018, when she and her father relocated to Washington from Maryland after her mother passed away. Russel Callender says that while the initial transition was challenging, Lauren is now thriving. “Lauren has blossomed in this environment,” he says. “Although she has significant developmental delays, she is progressing in her development and learning how to interact more appropriately with others, build relationships and deconflict difficult situations.” Callender says a huge reason for his daughter’s success is Abenezer House Administrator Elizabeth Jewett. “Ms. Jewett has built a loving and caring atmosphere for all the residents with birthday parties, dancing, holiday celebrations, cultural experiences and regular opportunities for other life experiences,” he says. “Together they go bowling and swimming, go to church, picnics and participate in Special Olympics.”
Jewett moved to the United States from Ethiopia in 2006 and has been with Abenezer House since 2016. She makes sure the residents stay busy and have the experiences of other people their age. Jewett is a licensed cosmetologist, so she enjoys helping the residents get ready for trips out to dinner or the movies. “My goal is to give them a home,” Jewett says. “Anyone can provide a house. I want them to have a home where they are loved and respected. I want them to be part of a loving and nurturing family.” She also shares her culture, including Ethiopian history, food, music and dance, even some of the language. When Lauren’s father remarried last year, Jewett taught all the residents a traditional Ethiopian wedding dance to perform after the ceremony. She also bought them matching peach dresses to be bridesmaids at the ceremony, and they all arrived in a limousine. The wedding guests loved the performance. “That’s what I want them to experience,” Jewett says. “For them to be complimented and told they are beautiful and talented.” Russell Callender says he’s also been able to partner with Jewett to provide positive experiences, like when the residents at Abenezer House got a visit from Amora the Unicorn during
the pandemic. Callender arranged for a neighbor to bring their horse for a visit, complete with a horn. Callender says the residents gathered in the driveway. Lauren was so excited she went back into the house and put on a unicorn T-shirt. “It felt so good to give them some joy,” he says. “It was so cool.” Jewett agrees. She says when Amora arrived, they couldn’t believe their eyes. One resident asked her: “Am I dreaming?” Callender described his experiences in a letter to DSHS Secretary Jilma Meneses, saying he wanted to share his appreciation for all the people at the Department of Social and Health Services who work hard to make families and people across Washington feel supported. “We love to hear stories like this, especially because we know many of our clients are thriving in community settings and living their best lives with needed support from their families, roommates and others,” says DSHS Secretary Jilma Meneses. “Our case resource managers and other staff are working with community partners all over the state to create these types of positive experiences for people with intellectual and developmental disabilities. Together, we can work together to create more situations like this for people in our lives who just need some extra support and the resources to make it happen.” Jessica Mora, the DSHS Aging and Long-Term Support Administration social service specialist who works with Lauren Callender, agrees. “It was emotional,” she says about receiving the letter. “It was nice to see that something so positive was coming towards us, that our client’s family member was taking the time to really reflect on everything that their loved one is receiving. Because that is their home, so we just want them to be happy and comfortable where they’re at.”
Lauren Callender stands with Amora the Unicorn
STAFF KUDOS DAVID MINOR AND ADELLE MOSS I just want to send kudos to my teammates, David Minor & Adelle Moss, who support the Traumatic Brain Injury (TBI) Strategic Partnership Advisory Council. Their work is often forgotten in all the goodness of ALTSA because we are a little different in that our team does not manage programs, but instead coordinates Council operations, communications, & manages all projects & activities driven by the Council. David Minor is the TBI Council & Funds Coordinator. He works tirelessly to listen & elevate voices of TBI lived experiences, caregivers, & providers across the state. He is a champion of the Council & of our partnerships, supporting partners internally & externally with a trauma-informed & person-centered approach that undoubtedly trickles down through all the work we do. He furthers the mission of transformative work with accountability, transparency, honesty, & persistence. I am proud to work with him!
Adelle Moss is the TBI Council Administrative Assistant, & we could do nothing without Adelle! The Council & its other two staff would be lost with her diligence, innovation, creativity, data smarts, & collaborative spirit. Adelle is always ready to jump in & learn something new or lend a listening ear to see how she can help. Most of the Council work done to dramatically increase outreach, awareness, & access in the last year has been because of Adelle’s leadership in finding a way to make the technical pieces work. I am proud to work with her! - Lauren Miles
Do you have a story tip? Want to submit a photo of Washington’s scenery? SEND THEM TO CYNTHIA.SHIPLEY@DSHS.WA.GOV!