Development and Implementation Grant
                            Phase Two National Press Release

Spokane, WA

This grant is now inactive.  The community requested withdrawal from the program.




Through assessment and planning activities during 2000-2002 Inland Northwest in Charge (INIC), identified a series of priorities for regional healthcare system reform, which include goals to:

  • Triage healthcare access solutions for the region's uninsured and underserved

  • Offer new solutions for employers and employees not currently involved with health coverage

  • Expand primary, preventive, and chronic disease services available to the uninsured and underserved

  • Identify and develop local resources for improving healthcare access for targeted populations

  • Develop information technologies and infrastructure that support efficient tracking and channeling for the uninsured/underserved into sustained preventive healthcare

  • Promote the shared interests of healthcare purchaser as they collaborate to identify regional solutions that strengthen healthcare access

  • Promote the development of a unified regional healthcare access planning capacity

→Back to Top

        Program Design

Inland Northwest in Charge is a collaborative project to implement comprehensive and sustainable healthcare access solutions for the uninsured and underserved in Eastern Washington.  Facilitated by the Health Improvement Partnership (HIP), over 200 organizations and community members in Spokane and surrounding counties participate in planning and implementation activities.

Collaborators represent urban and rural populations and are from public and private sectors.  This includes; hospitals, physicians, safety net providers, health plans, human service providers, Chamber of Commerce and employer representatives, government agencies and analysts.

INIC is organized into a large Assembly, and Advisory Committee and smaller targeted groups.  These groups focus on project areas such as long-term sustainability, establishing referral protocols between hospital emergency departments and primary care clinics, and developing alternative benefit packages from small employers.  Based on participant's experience in healthcare and information from the assessment process, work groups develop and prioritize strategies that are presented to the Advisory Committee for input at key decision points.  INIC staff also work with individual partners and other plan elements such as policy information systems, and linking the uninsured with new access options via HealthforAll.

INIC Goals and Strategies for 2002/03

"Triaging" Healthcare Access - HIP's HealthforAll phone center talks to approximately 600 uninsured people every month, looking for custom-designed coverage and access solutions.  By far the most important strategy so far has been educating and enrolling people on Medicaid, Basic Health and SCHIP.  As of May 2002, HealthforAll channeled more than 16,000 previously uninsured people into those subsidized health plans.

New Solutions for the Employed Uninsured - Seventy-five percent of the uninsured in the Spokane region are employed.  With its Expanded Choice Initiative, HIP and its partners have developed a new vision and a new plan for engaging small employers in offering healthcare coverage for the first time.  The plan involves a creative combination of public and private dollars with technical assistance for these employers as they transition to the commercial marketplace.

Cooperative Regional Funding - There is an economic benefit to achieving full access to healthcare.  HIP is working to quantify this benefit and to define an array of investments that various regional organizations can make that will produce a positive return for these organizations as well as for the community as a whole.  Conceivably these investments may form a local subsidy pool that the community can apply to particular underserved uninsured populations.

Regional Information Systems Development - One of the keys to serving the underserved is to know how and where they are, what health problems they are experiencing, what services and what obstacles are occurring.  Another key is to extend the reach of healthcare technologies to people who can not access services by other means.  The Spokane region has achieved a degree of healthcare information system integration that is unprecedented nationally.  HIP is working with various partners to see that the uninsured and underserved become part of the emerging regional computer-based healthcare tracking and delivery system.

→Back to Top

        Financing & Outreach Strategies

Current Project Funding - Inland Northwest in Charge (INIC) funding comes from a Robert Wood Johnson Foundation Communities in Charge grants of $700,000 over three years (2001-2003).  Year one was supplemented with $916,000 community access program grant from the Health Resources and Services Administration (HRSA).  In September 2002, HIP received $641,000 in 2002 HRSA renewal funds.  INIC also receives funding from a variety of smaller groups.

→Back to Top

        Accomplishments to Date

Enrollment and Healthcare Access

  • Helped approximately 6,000 individuals enroll in health coverage (total of approximately 13,000 since HealthforAll program inception).

  • Launched 100% Healthy Kids Campaign, generating three itmes the number of calls from the previous year.

  • Referred approximately 2,800 individuals to a primary care medical home offering low-or-no-cost care.

  • Began linking ineligible uninsured individuals with donated primary care via Columbia Care.

  • Implemented the MEDs program which streamlines the application process for prescription drugs through pharmaceutical company Patient Assistance Programs.

  • Designed and launched new "Expeditor" role to coordinate access solutions for uninsured individuals with multiple, complex health issues.

New Solutions for the Employed Uninsured

  • Employers, brokers, health plans, hospitals, and providers formed the Expanded Choice Team, designing a new health coverage option for the employed uninsured and creating recommendations for public-private partnerships.

  • The team coordinated market research to evaluate how well the package meets employer and employee needs and engaged state policy makers in discussions regarding financing.

  • The State Health Care Authority (Basic Health Plan) has assigned a design team to work with HIP and its partners to explore implementation of Expanded Choice and has expressed commitment to becoming the Expanded Choice Partners.

  • Dialogues underway with all relevant state agencies regarding developing supportive relationships/removal of possible barriers to Expanded Choice implementation (Governor's Office, Healthcare Authority, Office of the Insurance Commissioner, Department of Social and Health Services, and the Department of Health).

New Service for the Chronically Ill


→Back to Top


Double-digit cost increases in Washington State's healthcare budget resulted in "Managed Enrollment" whereby the state prolonged the Basic Health application process to decrease the number of enrollees through attrition.  This affected the numbers of uninsured that HealthforAll was able to successfully enroll and impacted INIC planning in light of reduced state budgets.  At the same time, budget shortfalls have resulted in an increased willingness among state policy makers to look at creative solutions for healthcare access to work across traditional state agency boundaries.

INIC continues to benefit from broad and diverse partnerships locally and statewide.  At times, it has been difficult to secure follow-through with some partners, but other new partnerships have developed that and provide the opportunities for fruitful collaboration.  The challenge of maintaining the collaborative model from planning to implementation are offset by the diversity of expertise and long-term-buy-in results from broad based partnerships.

        →Back to Top

        Contact Us

Daniel Baumgarten
Executive Director
Health Improvement Partnership
421 West Riverside, Suite 400
Spokane, WA 99201
Phone: (509) 444-3088
Fax: (509) 444-3077
Web Address:

                  →Back to Top

Communities In Charge 2002 is a program of The Robert Wood Johnson Foundation.
E-mail Webmaster with comments: Last Modified:7/2003