Putting $$$ where our mouth is on mental health

Earlier this week, House Democrats released a proposed operating budget. There are a lot of highlights – our proposal is the high-water mark on education funding, saves the safety net, and goes all in on Obamacare.

What may have been missed in all the hoopla was the important investments our budget makes in mental health care. Our budget pays for improvements to ensure the mentally ill get the care they need and make Washington a safer place.

• House Bill 1114: Introduced by Rep. Jamie Pedersen, fills the gap between the criminal justice system and mental health care providers. It ensures that violent mental health offenders get the treatment they need, instead of ending up on the streets.
 
• House Bill 1336: A Rep. Tina Orwall measure that requires school counselors and nurses to receive training on suicide prevention – giving these professionals the tools to identify early warning signs of troubled youth and prevent tragedies. 
 
• House Bill 1777: Rep. Tami Green’s bill will accelerate the implementation of critical involuntary commitment of people with pressing mental health issues. The new approach will take input from family members and friends into consideration when making a decision to involuntarily commit. We pay for this change two years ahead of schedule. 
 
• House Bill 1522: Another Green bill, HB 1522 builds a bridge between hospitals and the community for the mentally ill. It creates a step down from state hospitals – which will provide an important service to folks beginning to transition back into day-to-day life. This isn’t just the right thing to do – it’s the cost-effective approach.
 
• House Bill 1627: A Rep. Dawn Morrell bill to give county jails the tools they need to meet the growing demand for competency evaluations. Our county jails aren’t mental health care providers and, without adequate care, the mentally ill deteriorate rapidly in jail.

We’ve seen the tragedies that can occur when the mentally ill don’t get treatment they need. House Democrats believe mental health care is a critical investment – it’s just one of many priorities we will be fighting for in coming weeks.

Photo: Members of the House Health Care Committee discuss budget priorities.

RIP RPA

Today nearly every insurance plan in Washington covers both maternity services and abortion services. However, the Affordable Care Act could inadvertently limit these reproductive choices by requiring additional administrative red-tape for abortion services. 

This change would interfere with a woman’s ability to make the best decisions for her family and her health.

Enter the Reproductive Parity Act (RPA) sponsored by House Health Care and Wellness Committee Chair Rep. Eileen Cody and 40 other co-sponsors. It would require insurance companies to continue their current policy of covering a full range of reproductive choice. The bill ensures fairness and protects freedom in a woman’s health care decisions. 

It passed the House back in February, and received a hearing in the Senate Health Care Committee on April 1st. At that hearing, Senator Steve Hobbs presented a letter signed by 25 senators who support the RPA – the majority needed to pass.

However, it appears the bill won’t be heading to Governor Inslee’s desk this year. The bill did not come up for a vote in committee ahead of Wednesday’s policy cutoff deadline.

Washington voters have a long history of supporting reproductive rights that stretches back over 40 years. Two years before Roe v. Wade, Washingtonians approved Referendum 20, which legalized abortion in the early stages of pregnancy.

Then again in 1991, when it looked like Roe could be overturned, voters approved Initiative 120, which protected a women’s right to make a private choice with her doctor regardless of what occurred at the federal level.

The Seattle Times, editorializing in favor of the RPA, summed it up perfectly:

A woman’s decision to become a mother shouldn’t be determined by a lack of resources or insurance. 

It’s a deeply personal choice between a patient and her doctor. Washington state has a history of respecting that right and should continue to protect it.

Refusing to let the RPA come up for a vote in the Senate is a defeat for women and privacy in Washington. This decision doesn’t reflect our state’s values.

You can find more information on the RPA here. You can also read some of the national attention the RPA and House Democrats have received over at the New York Times, Salon and Jezebel.

Read this story in Spanish.

The Affordable Care Act turns three

Tomorrow marks the third anniversary of President Obama signing the Patient Protection and Affordable Care Act (ACA) into law. At President Obama's side was Seattle-native Marcelas Owens - a tireless advocate for health reform. Like thousands of Americans year, the 11-year-old boy’s mother died of a treatable disease.

Last year, Governor Gregoire signed into law House Bill 2319 – legislation to ensure that our state was ready to fully implement health care reform. The measure was introduced and championed by HealthCare and Wellness Chair Eileen Cody.

Speaking at the time of passage, Rep. Cody said “Health coverage for all has been a value of our state for years. So we have historically been in the lead – whether it’s covering all kids, establishing the Basic Health Plan or passing consumer protections for patients. This is the next step.”

Governor Gregoire signs HB 2319 into law. She is joined by House Democrats
Eileen Cody, Laurie Jinkins and Speaker Frank Chopp

The ACA has already made critical improvements to our health care system. However, the best is still yet to come.

Beginning next year, the ACA offers us the chance to cover 385,000 Washingtonians making less than $15,000/year through the expansion of the Medicaid program. Over the next two years, Medicaid Expansion is estimated to save our state about $275 million. The caveat being that the legislature has to accept the federal dollars to do this.

Speaking to Medicaid Expansion earlier this session, Rep. Dawn Morrell said "I think we have to get past the rhetoric and to the plain facts... It's the right thing to do."

Also coming in 2014, all Washingtonians will be able to utilize the health benefits exchange to shop for insurance. While shopping for coverage, you will have access to a web-based system and professional advisors trained to help you select the plan that is right for you.

A few additional ACA improvements already in effect or coming soon:

• Young adults who may be looking for work during these tough economic times can stay on their parents’ plan until they find a job or reach the age of 26 – whichever comes first.
• Our health care system finally incentivizes preventative care by doing away with out-of-pocket costs for preventative care. Treating folks before their condition worsens isn’t only the right thing to do, it saves us money.
• Starting in 2014, no one can be denied health care coverage if they’re sick. The ACA also removes any caps on lifetime benefits that may have been in place – common sense safeguards that will prevent a Washingtonian from losing everything when they get sick.
• Also coming in 2014, all health plans will be required to cover essential benefits. These essential benefits include maternity care, mental health treatment, prescriptions and pediatric care.

Making sure the mentally ill get the care they need

This afternoon, House Democrats made it clear that mental health care is a priority. The House of Representatives took action on several bills to ensure that the mentally ill get the attention they need.

Rep. Tami Green, a Lakewood lawmaker who doubles as a mental health nurse, introduced two of the measures.

Back in 2010, the Legislature OK’d new parameters for the involuntary commitment of people with pressing mental health issues. Often after a tragedy, we hear from family members or a close friend who admits that they could see the capacity for violence – just not when or where it would occur.

The new approach takes important input from family members and friends into consideration when making a decision to commit. It also allows decision makers to take a close look at a person’s history of mental health behavior.

However, budget constraints prevented the Legislature from funding the changes until 2015. House Bill 1777 speeds up the implementation of this involuntary treatment law – funding the reforms two years ahead of schedule.

HB 1522, another Green bill, builds a bridge between hospitals and the community for the mentally ill. It creates a step down from state hospitals – which will provide an important service to folks beginning to transition back into day-to-day life. This isn’t just the right thing to do – it’s the cost-effective approach as it is most expensive to treat these patients in a hospital setting. The bill will also free-up beds in our mental health hospitals, which are becoming more in demand every day.

The House also passed HB 1627 from Rep. Dawn Morrell – a critical care nurse at Good Samaritan Puyallup. The bill combats a mental health care crisis not only in Pierce County, but across the state.

The number of requests for competency evaluations for criminal defendants is sky-rocketing. In Pierce County, these requests have increased by 80 percent since 2001. Many of these defendants actually wait longer for an evaluation than the time they would’ve served if convicted.

Our county jails aren’t mental health care providers and, without the care they need, the mentally ill deteriorate rapidly in these settings. All too often, this mistreatment ends in tragedy. HB 1627 would give counties a critical tool to meet the growing demand for competency evaluations.

These improvements will go a long way towards keeping our communities safe and Washington families strong.

Read this story in Spanish.

Photo: Reps. Green and Morrell hard at work in the House Health Care and Wellness Committee

House OK for Hansen bills brightens job outlook

Rep. Drew Hansen

The state’s job market would gain strength for the future under four bills by Rep. Drew Hansen that cleared the state House this past week.

“There are signs we’re rebounding from the depths of the Great Recession, but we’ve got a long way to go,” Hansen said. “I want to protect the jobs we have and prepare our young people for opportunities in the 21^st –century economy. It’s very encouraging to me to get the strong, bipartisan support of my fellow legislators in that work.”

The bills are:

House Bill 1247, which makes it easier for small businesses to get money from a key state job-training program designed to help employees upgrade their skills. The bill also ensures that money from this program supports training that leads to degrees and credentials rather than dead-end jobs. The House voted unanimously for it Saturday, 98-0.

House Bill 1472, which helps students train for high-paying jobs in the computer industry by enhancing computer-science education in high schools and creating a statewide task force to address the computer programmer shortage. It was approved Friday 95-3.

House Bill 1245, which protects jobs in the shellfish and recreation industries by getting abandoned vessels out of our waters before they sink and cause pollution. It passed the House Thursday on a 96-1 vote.

House Bill 1660, which will lessen the paperwork burden on hospitals and colleges as they train new doctors and nurses. It won unanimous approval Tuesday, 96-0.

House approval of Hansen’s bills sends them to the Senate for action there.

To read a more extensive account of House action on these bills, click here.

Read this story in Spanish.

Adding capacity to the health care system

In coming years, Washington state’s health care providers will see an influx of new patients through both the expansion of the Medicaid program and the establishment of Washington Healthplanfinder – our state’s online health insurance exchange.

Today, the House of Representatives took action to make sure that our health care system is ready for this boom in business. From registered nurses to denturists, the bills approved will ensure that every Washingtonian has access to the provider they need.

A few of the capacity-improving measures include:

• HB 1155: will remove administrative barriers to patient care and support the transition to electronic care by allowing prescriptions to be issued electronically – promoting both safety and efficiency.
• HB 1271: will expand the types of services a licensed denturist may provide to include certain non-orthodontic removable oral devices – like sport mouth guards, bruxism devices and snoring devices.
• HB 1660: will streamline the administrative process for colleges and providers. By reducing unnecessary paperwork, we can train nurses and doctors in a more efficient and timely manner.
• HB 1538: willimprove access to critical prescription drugs at convenient locations around the state.

There is still a lot of heavy-lifting ahead in the health care arena this session, and the House will consider another package of health-related bills next week.

Read this stpry in Spanish.

House approves Reproductive Parity Act

​“We moved this legislation forward to continue Washington state’s proud history of staying out of people’s personal lives.” –Rep. Dean Takko on the passage of the Reproductive Parity Act

War on women? Not here in Washington.

While state legislatures across the country are turning back the clock on women’s health, House Democrats are moving Washington state forward as a leader in reproductive freedom.

Today, nearly every single insurance plan in Washington covers both maternity services and abortion services. However, the Affordable Care Act could inadvertently limit these reproductive choices by requiring additional administrative red-tape for abortion services.

This change would interfere with a woman’s ability to make the best decisions for her family and her health.

Enter the Reproductive Parity Act—which would require insurance companies to continue their current policy of covering a full range of reproductive choices. Introduced by House Health Care and Wellness Chair Eileen Cody, the bill ensures fairness and protects freedom in a woman’s health care decisions.

This morning a diverse group of lawmakers from across the state spoke in favor of the measure on the House floor.

Rep. Steve Tharinger spoke of growing up in a home with five sisters.

"These are independent, intelligent women," said Rep. Tharinger. "They do not want some bureaucrat in an insurance company, some politician, or even their brother telling them what to do with their health care."

Washington has long led the nation on this important issue. Two years before the U.S. Supreme Court made their landmark decision in Roe v. Wade, Washingtonians approved Referendum 20. R-20 legalized abortion in the early stages of pregnancy.

Then again in 1991, when it looked like Roe could be overturned, voters approved Initiative 120. I-120 protected a women’s right to make a private choice with her doctor in this state- no matter what occurred at the federal level.

When given the opportunity to weigh-in, the voters of this state have always came down on the side of reproductive choice and privacy. By advancing the Reproductive Parity Act, House Democrats are working to ensure that the law in our state reflects this fact.

Read this story in Spanish.

More COHEs: good for workers, good for employers, good for Washington

Among the huge workers' comp package we passed in 2011 was an expansion of the Centers of Occupational Health and Education (COHE) program so that all injured workers have access to a COHE by 2015, regardless of where they live.

COHEs are based in clinics and hospitals, and they provide education and financial incentives to more than 2,000 health care providers to encourage the use of best practices in occupational health. Funding from L&I supports health services coordinators who help with case management and getting appropriate services early in an injury claim.

A December 2011 study found that treatment by COHE providers reduced lost work days by nearly 20 percent and claim costs by $500 per claim.

There are currently 4 COHEs in Washington State:

• Renton COHE at Valley Medical Center, Renton, WA.
• Harborview Medical Center
• Eastern Washington COHE at St. Luke's Rehabilitation Institute, Spokane, WA.
• The Everett Clinic

When you have a work-related injury, the priority is to restore your health so you can go back to work. Research shows that returning to normal activity as soon as safely possible after injury reduces the likelihood of long-term disability. Developing goals for returning to work may improve your overall health and outcomes while protecting your income and benefits.

The COHEs offer training and resources to your doctor, but may also be able to help you plan your return to work. COHEs have Health Services Coordinators that work with doctors, employers, and with you to understand your restrictions and find work that you can do. Want to make sure your doctor is participating in the program? Contact the COHE. And you can also find out more about what L&I has to offer injured workers here.

But back to the expansion, according to a press release, right now L&I is seeking proposals from health care organizations interested in sponsoring new COHEs, they expect to select at least six COHE sponsors by April 19. 

Read this story in Spanish.

What the Affordable Care Act really means for small businesses in WA

Rep. Dawn Morrell

The coming years will bring many changes as Washington state takes the necessary steps to fully implement the Affordable Care Act. In fact, Washington is one of 21 states with approval from the federal government to move forward with our health care exchange on-time in October of this year.

This session we’ll continue this important work. Not only is it the fiscally responsible thing to do- it’s the right thing to do for families, businesses and public health. In the House, these efforts are being led by Appropriations Subcommittee on Health and Human Services Chair Dawn Morrell and Health Care and Wellness Chair Eileen Cody.

Rep. Eileen Cody

However, these changes have resulted in some misinformation and confusion surrounding the ACA reforms- especially with regards to small business (businesses with less than 50 employees).

Thankfully, we’ve got Insurance Commissioner Mike Kreidler to clear up the confusion. He outlines what reforms that have already gone into effect and what we can expect in coming years.

 ACA reforms already in place:

• Tax credits of 35 percent if you offer health insurance, have fewer than 25 full-time workers, and you pay an average annual wage of $50,000.
• In 2014, that tax credit goes up to 50 percent.

What’s coming in 2014:

• If you have fewer than 50 employees, you’re not required to offer them health insurance. However, if you choose to offer health insurance, you could qualify for a tax rebate.
• All health plans must cover essential benefits.
• You can shop online for coverage through Washington’s Health Benefit Exchange and enjoy greater purchasing power, similar to large employers.

For a complete list of what health care reform means for individuals, families, seniors and large businesses, please visit the Commissioner Kreidler’s webpage on health care reform.

Read this story in Spanish.

Rep. Cody receives AMA’s highest honor

Our very own Representative Eileen Cody received the American Medical Association’s Dr. Nathan Davis Award for Public Service by a State Legislator last night in Washington, D.C.

The Davis Award is the AMA's highest honor for government service in health care. It is named after the AMA's founder and recognizes the work of elected and career officials in federal, state and municipal service whose contributions have promoted medicine and the betterment of public health.

“Rep. Cody has led efforts toward improving health care access for low income individuals and transforming mental health services in Washington state,” said AMA Board Chair Steven J. Stack, M.D. “Her dedication to public health has also earned the state national recognition for its long term health care services and support system.”

Rep. Cody was nominated by former Governor Gregoire for the award. Rep. Cody has been twice previously recognized by the Washington State Medical Association as Legislator of the Year. The WSMA noted Rep. Cody’s previous efforts to advance public health in our state.

When she's not being honored by national organizations, Rep. Cody works as a nurse at Group Health Cooperative in Seattle and serves as chair of the Health Care and Wellness Committee.

In the legislature, Rep. Cody has worked for improved patient safety, mental health parity, public health services and to restore the universal purchase of vaccines.

More recently, she has led efforts to implement the federal Affordable Care Act at the state level. Largely because of her work, Washington is one of just six states ready to implement the health benefits exchange on-time in 2014.


Photo: Rep. Cody with (at left) Terry Moran of ABC News and AMA Board Chair Steven J. Stack, M.D. Photo courtesy of the American Medical Association.

Read this story in Spanish.

ER best practices is music to state budget writers’ ears

Washington's Seven Best Practices initiative is improving care and reducing state Medicaid costs. The Washington State Health Care Authority reported that in its first six months, the initiative is saving the state more than 10 percent in Medicaid fee-for-service emergency care costs, which could result in as much as $31 million for the fiscal year. But these savings are just one of many achievements:

• A 23-percent reduction in emergency visits by Medicaid patients.
• Doubling the number of shared care plans to ensure patients receive coordinated care.
• A 250-percent increase in the number of providers registered in the state's Prescription Monitoring Program
• Increasing the number of hospitals exchanging emergency department information electronically from 17 to 85, and 10 more are in the process.
• Patients have fewer emergencies since a primary care physician is implementing a cohesive care plan for them.
• Prescription drug abuse has decreased.

The seven practices included in the 2012 Operating Budget are summarized below:

1. Tracking frequent ER users and exchanging patient information electronically with other hospitals.
2. Educating patients that the ER should only be used for true emergencies.
3. Designating staff to receive and circulate information on Medicaid clients.
4. Contacting primary care providers at the time of the emergency visit and relaying any issues regarding barriers to primary care.
5. Implementing narcotic guidelines that direct patients to primary care or pain management services.
6. Enrolling physicians in the state's Prescription Monitoring Program.
7. Designating emergency physician and hospital staff to review and provide feedback reports— and taking appropriate action.

For more information, you can read the report: "Emergency Department Utilization: Assumed Savings From Best Practices Implementation".

Read this story in Spanish.

Reproductive Parity Act gets public hearing tomorrow morning

Rep. Eileen Cody

While state legislatures across the country are turning back the clock on women’s health, Washington state and House Democrats are continuing to move forward as a leader in reproductive freedom.

Washington voters have a long history of supporting reproductive rights that stretches back over forty years. In fact, two years before the U.S. Supreme Court made their landmark decision in Roe v. Wade, Washingtonians approved Referendum 20, which legalized abortion in the early stages of pregnancy.

Then again in 1991, when it looked like Roe could be overturned, voters approved Initiative 120. I-120 protected a women’s right to make a private choice with her doctor in this state- no matter what occurred at the federal level.

Over twenty years later, nearly every single insurance plan in Washington covers both maternity services and abortion services. However, the Affordable Care Act could inadvertently limit these reproductive choices by denying coverage for terminating a pregnancy.

This change would interfere with a woman’s ability to make the best decisions for her family and her health.

Understanding that this could be an unintended consequence of the Affordable Care Act, Rep. Eileen Cody (D-West Seattle) has introduced the Reproductive Parity Act for the second year in a row. The House version of the bill has over 40 co-sponsors.

The Reproductive Parity Act would protect a woman’s right to make their own health care decisions by requiring insurance plans to offer full coverage for repoductive health, as they do under current law.

Curious about the legislation? Interested in the conversation? The House Health Care and Wellness Committee is holding a public hearing on the Reproductive Parity Act tomorrow at 8:00 AM.

As always, TVW will be covering all the action from the hearing. You can also follow us on Twitter for live updates.

Read this story in Spanish. 

Tissues, tea and TLC

This morning the State Capitol, engulfed in a dense freezing fog, looked like a scene from an old scary movie. It is really cold out there. 

While our winters are not as extreme as those in Minnesota or North Dakota, they are severe enough to give us our fair share of black ice on the roads, make our sidewalks very slick and let the flu virus run rampant. More often than not, the first two issues are successfully overcome by paying more attention behind the wheel and while walking, but dealing with the flu takes a lot more work. 

Nobody knows for certain why winters lay a welcome mat for the flu virus. One theory says it's because people are in closer proximity to each other due to the cold weather, according to another one it's because the virus is more stable when the air is cold and dry, and yet another theory suggests that the virus thrives in dry, warm (70 to 80 degrees) conditions, which is the usual room temperature when it's cold out. 

While scientists continue trying to figure that one out, we'll continue stuck with flu seasons during the fall and winter months. Fortunately, experience over time has taught us more effective ways of treating it.


It's not too late to get a flu shot

Wednesday's Yakima Herald editorial points out that the flu is not a common cold, so it should not be taken lightly. According to the Center for Disease Control and our Department of Health, the best protection against the flu is the flu vaccine. If you have not gotten it, go to the DOH's Flu Vaccine Finder to find out where it's available. It's not too late. 

Influenza is a serious ailment that has already claimed the lives of seven people in our state. Let's do our best to take care of ourselves and keep that figure from crossing the two-digit threshold. 

How is the rest of the country faring? 

Not all the states in the nation track flu deaths, of the ones that do, the highest number of fatalities as of January 15 is 27 in both Minnesota and Illinois, followed by 23 in Pennsylvania, 22 in South Carolina, 18 in Massachusetts, 17 in North Carolina, 15 in Indiana and 14 in New Hampshire.

Take a look at this snapshot of influenza activity in all 50 states for more information.

Read this story in Spanish here.

Hurt on the job? There's a new provider network for you.

If you get injured on the job, there's a new medical provider network available to you as of this week.

Back in 2011, Governor Gregoire signed legislation that passed both the House and Senate nearly unanimously. This legislation required the state Department of Labor and Industries (L&I) to create a provider network, and for participating providers to adhere to certain standards to ensure injured workers get the highest quality care.

An injured worker's initial medical visit can be to any provider or emergency room, but subsequent visits must be with a network provider in order to be covered by workers compensation.

This change will improve quality of care because providers within the L&I network will be required to have certain credentials and to follow evidence-based guidelines for treating patients. The goal is to help people get back to work as safely and quickly as possible.

It shouldn't be too hard to find a provider within the network - there are currently over 9,300 of them, with more being added each day. This online directory lists all of them, and L&I can also help you find a provider in your area if you aren't sure which one to see.

The Tri-City Herald published an article about this new network today, which you can read here.

Apple Health outreach gets national notice

Just 5% of Washington's children do not currently have health care insurance -- about half the national average.  A good deal of credit for that low number goes to the extensive outreach efforts of the Apple Health for Kids program and the Washington Health Care Authority (HCA).

The federal Centers for Medicare and Medicaid Services(CMS) recently recognized those efforts with a bonus of more than $12 million.  This is the fourth year in a row that the state has received extra federal money for the good work they do, according to the HCA. In all, we've gotten $59 million additional dollars to make sure our kids are healthy and have access to affordable health care insurance.

This year, 23 states received a combined $306 million for meeting enrollment and renewal targets for children who are Medicaid- and CHIP-eligible. The awards ranged from about $1.5 million for Idaho to $43 million for Colorado.

Read this story in Spanish here.

Moving forward on health care reform

It's full steam ahead for Washington state's health exchange after the federal government gave the Washington Healthplanfinder an O.K. earlier this week.

In order for the exchange to be up and running by 2014, the Affordable Care Act (ACA) requires that the U.S. Department of Health and Human Services give conditional approval before January 1, 2013.

Our state is one of only six states to meet this deadline.

House Democrats didn't wait around for the Supreme Court to make their ruling on Obamacare. Last session, we passed legislation to ensure that we'd be ready to make health care more accessible, portable, and affordable once the ACA coverage provisions are implemented.

Our early action has paid off to the tune of more than $150 million in federal funding.

The Washington Healthplanfinder and other reforms are aimed at the largest remaining groups of people without health coverage: young adults, college students, workers at small businesses, the self-employed, and people who can't afford to buy health coverage on the individual market.

The program is designed to make it easier to compare health plans and get a better price for the coverage you want. This effort has been led by House Healthcare and Wellness Committee Chair, Rep. Eileen Cody.

A registered nurse, Rep. Cody said that, "Health coverage is one of the basics. Your family needs a home, food on the table, clothes, health care – it's just fundamental, and our goal with this legislation was to make it easier for every family, rich or poor, to get affordable health care for their loved ones."

Washingtonians with incomes up to 400% of the federal poverty level may qualify for premium financial assistance. Current estimates say that more than 200,000 uninsured residents will now be able to receive benefits.

For more information, visit the Washington Health Benefit Exchange website.

Read this story in Spanish here.

Our schools just keep getting healthier

You may remember this HDC Advance post from a year ago reporting that 21 Washington schools had won the HealthierUS School Challenge. If you thought that was good, wait until you hear what happened this year.

The number of award-winning schools doubled.

No, not nearly doubled, not almost doubled. Exactly twice as many schools won awards this year. We must be doing something right!

Photo credit:  HUSSC

The HealthierUS School Challenge (HUSSC) is a voluntary certification initiative for schools participating in the National School Lunch Program. It supports First Lady Michelle Obama's Let's Move campaign by recognizing schools that are creating healthier school environments through their promotion of good nutrition and exercise. Sponsored by the USDA Food and Nutrition Service, the initiative encourages all schools take a leadership role in helping students to make healthier eating and physical activity choices that will last a lifetime.

To receive any of the bronze, silver, gold and gold of distinction awards, the schools had to meet the 2012 HUSSC criteria to show that they have taken the necessary steps to improve the nutritional quality of the foods they serve, provide students with nutrition education and physical education, and opportunities for physical activity.

National recognition is great, of course, but each award also comes with a monetary prize: $500 for bronze; $1,000 for silver; $1,500 for gold; and $2,000 for gold of distinction.

Want to find out if your children's school made the mark? Here's the list of the 42 winning Washington schools.

To read this story in Spanish, click here.

Cleaner air in Tacoma

Spokane and Tacoma – two of our state's biggest cities – have both struggled at times with air quality, partly because of geography and inversion zones.

The greater Tacoma area is one of 31 places in the nation that's not in compliance with federal limits on air pollution.

Only 30 percent of that problem is caused by auto exhaust. Half of it comes from wood burning.

There's a fancy name for soot -- fine-particulate pollution – but what isn't fancy is what soot does to a human body.

When wood burns and soot goes into the air, the problems start because soot particles are especially tiny. So small that they can skip past the body's defenses and really cause trouble in our lungs and bodies.

Places with too much soot in the air, like Tacoma, have more cases of asthma. It's rough on older people, and patients suffering from any kind of serious heart or lung problem.

Fixing this is important not just for the health of people living in the greater Tacoma area, but for our quality of life and businesses.

So how can we fix this problem?

The News Tribune recently ran a story on how people are working toward a solution.

The new effort got started through a law (House Bill 2326) by Rep. Laurie Jinkins, which passed in 2012.

The tough part about fixing this problem, especially in Tacoma, is the number of older homes where the main source of heat, or the only source, is an old wood stove or fireplace.

There are modern wood stoves that burn cleaner, and there are alternative ways to heat a home that are more efficient. But even then, it's hard to make the switch.

As the story in the News Tribune shows, a solution isn't as simple as passing a law saying people can't use wood stoves anymore. For a lot of people, wood stoves are the only source of heat in their home. Those people are exempt from the law.

Instead of passing a law that simply outlawed wood stoves, Jinkins worked with citizens, community leaders and businesses on finding a way to bring cleaner air to the Tacoma area.

If people have alternative ways to heat their house, they should use them, and this law helps make that transition in the smoothest way possible.

To read this story in Spanish, click here.

What does health care reform mean to people in Washington state?

Today’s U.S. Supreme Court ruling upholding national health-care reform (the Affordable Care Act) means that Washington state – already a national leader on health care – can continue moving forward on reforms.

Those reforms include innovations that Washington state has led the nation in implementing,including:

• the health care Exchange, a marketplace to make it easier to shop for health coverage;
• the Basic Health Plan, to offer affordable health care for people who can’t afford to buy health insurance on the individual market;
• Apple Health for Kids, part of Washington state’s effort to make sure every child has health coverage;
• evidence-based medicine; and
• moving away from simply paying for medical services like doctor visits and surgeries and toward paying for results – better health.

The court ruling means national health-care reform will work hand-in-glove with Washington state’s ongoing efforts. For example, budget cuts had threatened the existence of the Basic Health Plan, but national health reform means the federal government will soon cover the state’s costs for the BHP.

Washington was also one of the first states in the nation to set up a health care Exchange, a marketplace where people can buy private health insurance in a much simpler way than they can today.

Right now, truly comparing health insurance would take a health care expert with a law degree, reading stacks of health care policies. The Exchange also allows individuals and businesses to buy more affordable health coverage with the advantage of federal premium tax credits.

The Exchange board and staff are working through the steps needed to begin open enrollment on October 1, 2013, for coverage beginning January 1, 2014.

Other steps that our state has already taken to implement the Affordable Care Act include:

• extending health insurance to family members up to age 26, to cover college students and young adults, who typically do not have health insurance; 
• no co-payments for preventative health care, such as immunization shots; and 
• the elimination of lifetime caps on health benefits.

Related links:

Supreme Court upholds Obama health law

The history of the US health care reform effort

Where states stand on implementing health care law

Insurance Commissioner Kreidler: Affordable Care Act upheld –Washington now ahead of most states

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