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Health Impacts of Extreme Heat and Wildfire Smoke

Read our Report and Guidelines

(adopted January 2025)

Climate change is widespread, rapid, and intensifying with a direct regional health impact. Washington has seen an increase in climate related illnesses including such as hyperthermia and respiratory disease from short-term temperature increases and increased smoke exposure from wildfires. During the heat dome of 2021, over 400 Washingtonians lost their lives due to heat related illnesses. Extreme heat disproportionately impacts children, pregnant individuals, the elderly, outdoor and some indoor workers, people with disabilities, low-income communities and communities of color. Agricultural workers, construction workers, and electricity and pipeline utility workers are at increased risk for heat-related illness and deaths. Short and long-term heat exposure increases severe maternal morbidity (SMM). Wildfire smoke in 2020 was associated with approximately 92 more all-cause mortality cases, and those in Eastern and Central Washington were estimated to experience the highest per-capita mortality during the episode. Coordinated efforts across sectors are needed to prevent and respond to the health effects of extreme heat and wildfire smoke, including early detection and warning systems, preventative education and communication with communities at highest risk, home environment measures, and standardized clinical protocols for reducing risk related to heat and wildfire smoke.

Implementation Tools

Supporting Materials

 

Workgroup Members

Name Title Organization
Chris Chen, MD (Chair) Medical Director for Medicaid Washington HealthCare Authority
Brad Kramer, PhD Program Manager Public Health Seattle King County
Kristina Petsas, MD Chief Medical Officer for Employer and Individual Plans United Healthcare
Bre Holt Senior Director Population Health Comagine Health
Jessi Kelley Research Coordinator UW Collaborative for Extreme Event Resilience
Stefan Wheat, MD Emergency Medicine Physician UW
Raj Sundar, MD Family Medicine Physician Kaiser Permanente
Jessica Symank/Amy Anderson Senior Director, Safety Quality and Rural Programs Washington State Hospital Association
Kelly Naismith, MPH Climate Change and Health Epidemiologist Supervisor Washington Department of Health
LuAnn Chen, MD, MHS Medical Director Community Health Plan of Washington
June Spector, MD, MPH Internal Medicine Physician/Scientist Washington Labor & Industries
Mary Beth Bennett, MD Pediatric Resident Seattle Children’s
Seth Doyle, MA Director of Strategic Initiatives/President of WAPH Northwest Regional Primary Care Association/Washington Association for Public Health
Raymond Moeller, MD   Thurston County Medical Reserve Corps
Brian Henning, MD Director Gonzaga Institute for Climate, Water, and the Environment
Onora Lien Executive Director Northwest Healthcare Response Network

LGBTQ Health Care

 

Award Winners for Best Practices in LGBTQ care:

Read our Reports and Recommendations

(Adopted September 2018)

Lesbian, gay, bisexual, transgender, and questioning or queer (LGBTQ) persons often have distinct health care needs, including higher rates of behavioral health concerns. Men who have sex with men and transgender people who have sex with men have a higher risk for sexually transmitted infections including HIV. However, stigma and lack of training serve as barriers to consistent high-quality medical care and increase health disparities. The workgroup met from December 2017 to September 2018 to develop recommendations to align care delivery with existing evidence-based, culturally sensitive standard of care for LGBTQ people.

Implementation Tools

Supporting Materials

Department of Health Letter Accepting LGBTQ Health Care Recommendations
Health Care Authority Letter Accepting LGBTQ Health Care Recommendations
LGBTQ Health Care Workgroup Charter and Roster

Watch the Washington State Medical Association in Partnership with Washington Patient Safety Coalition Health Equity Mini Series on our LGBTQ recommendations and LGBTQ care at Virginia Mason

 

Workgroup Members

Name Title Organization
Dan Lessler, MD, MHA (Chair) Chief Medical Officer Washington State Health Care Authority
Olivia Arakawa, MSN, CNM, ARNP, RN Parent Advocate  
Scott Bertani Director of Policy Lifelong AIDS Alliance
Kathy Brown, MD Provider Kaiser Permanente
LuAnn Chen, MD, MHA, FAAFP Medical Director Community Health Plan of Washington
Michael Garrett, MS, CCM, CVE, NCP Principal Mercer
Chris Gaynor, MD, MA, FAAFP Family Practice Clinician Capitol Hill Medical
Matt Golden, MD Professor, Director, PHSKC STD Control Program University of Washington
Kevin Hatfield, MD Family Practice Clinician The Polyclinic
Corinne Heinen, MD Physician Lead, UW Transgender Clinical Pathway Department of Internal Medicine, Allergy & Infectious Disease, University of Washington
Tamara Jones End AIDS Washington Policy and Systems Coordinator Department of Health

Primary Care

Award Winners for Best Practices in Primary Care:

Read our Reports and Recommendations

Primary care, widely seen as the cornerstone of the health care system, is the usual source of care for many and is associated with better population health outcomes. However, access to primary care remains an issue across Washington state and reimbursement is low. Our workgroup met through 2020 to define primary care in order to support broader payment reform.

Implementation Tools

Workgroup Members

Name Title Organization
Judy Zerzan, MD, MPH (Chair) Chief Medical Officer Washington State Health Care Authority
Patricia Auerbach, MD, MBA Senior Medical Director UnitedHealthcare
Cynthia Burdick, MD Medical Director, Medicare and Medicaid Kaiser Permanente Washington
Tony Butruille, MD Chair, Primary Care Investment Task Force Washington Academy of Family Physicians
Jason Fodeman, MD Associate Medical Director Washington State Department of Labor and Industries
Bianca Frogner, PhD Associate Professor, Family Medicine; Director of Center for Health Workforce Studies University of Washington School of Medicine
Ingrid Gerbino, MD, FACP Chief, Department of Primary Care Virginia Mason
Karen Johnson, PhD, MHSA Director of Performance Improvement and Innovation Washington Health Alliance
Louise Kaplan, PhD, ARNP, FNP-BC, FAANP, FAAN Associate Professor, Associate Academic Director Washington State University Vancouver College of Nursing
Catherine Mazzawy
 Senior Director, Safety and Quality
Washington State Hospital Association
Carl Olden, MD Family Physician Virginia Mason Memorial
Mary Kay O’Neill, MS, MBA Partner Mercer
Ashok Reddy, MD, MS Assistant Professor, Medicine University of Washington School of Medicine, Veterans Administration
Keri Waterland, PhD, MAOB Division Director, Division of Behavioral Health and Recovery Health Care Authority
Laura Kate Zaichkin, MPH Director, Health Plan Performance and Strategy SEIU 775 Benefits Group

Shared Decision Making

Award Winners for Best Practices in Shared Decision-making:

Read our Report and Recommendations

(Adopted November 2019)

Shared decision making is “process that allows patients and their providers to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values and preferences.” This workgroup will focus on increasing use of shared decision making and patient decision aids. The workgroup met from January to November 2019.

Shared Decision Making 101

 

 

Shared Decision Making 102: Adopting Shared Decision Making

 

Shared Decision Making 103: Elevating Shared Decision Making to Uphold Equity

Workgroup Members

Member Title Organization
 Emily Transue, MD, MHA (Chair)  Associate Medical Director  Washington State Health Care Authority
Sharon Gilmore, RN Risk Consultant Coverys
Leah Hole-Marshall, JD General Counsel and Chief Strategist Washington Health Benefit Exchange
Steve Jacobson MD, MHA, CPC Associate Medical Director Care Coordination The Everett Clinic, a DaVita Medical Group
Dan Kent, MD Medical Director United Health Care
Andrew Kartunen Program Director, Growth & Strategy Virginia Mason Medical System
Dan Lessler, MD, MHA Physician Executive for Community Engagement and Leadership  Comagine Health
Jessica Martinson, MS Director of Clinical Education and Professional Development Washington State Medical Association
Karen Merrikin, JD Consultant Washington State Health Care Authority
Randy Moseley, MD Medical Director of Quality Confluence Health
Michael Myint, MD Medical Director, Population Health Swedish Hospital
Martine Pierre Louis, MPH Director of Interpreter Services Harborview
Karen Posner, PhD Research Professor, Laura Cheney Professor in Anesthesia Patient Safety Department of Anesthesiology & Pain Medicine, University of Washington
Angie Sparks, MD Family Physician and Medical Director Clinical Knowledge Development Kaiser Permanente
Anita Sulaiman Patient Advisor & Consultant IBEX

SDOH and Health Equity

Read our Reports and Recommendations

The spaces in which we are “born, grow, live, work and age” have a large impact on our overall health and length of life. These social determinants of health such as education, employment, the experience of racism, safety; contribute to a greater amount to our health than clinical interventions and also contribute to disparities seen within and between populations. This workgroup met from September 2020 to May 2021.

Implementation Tools

Previous Meeting Materials

Date Materials
September 17 Agenda September 17
Screening for SDoH – Andermann
October 15 Agenda October 15
September Minutes
November 19 Agenda November 19
October Minutes
Charter Draft
CMS Z-Code Utilization
December 17 Agenda December 17
November Minutes
Charter Draft
January 21 Agenda January 21
December Minutes
CMS Medicaid and SDOH Z-Codes
February 18 Agenda February 18
January Minutes
March 18 Agenda March 18
February Minutes
Draft Framework
April 15 Agenda April 15
March Minutes
Draft Framework
Draft Checklist
May 13 Agenda May 13
April Minutes
Draft Recommendations
for Public Comment
Public Comment Survey

Telehealth

Award Winners for Best Practices in Telehealth:

Read our Recommendations

Using phone or video to access clinical care has increased significantly since the onset of the COVID-19 pandemic.  This rapid acceleration shows a knowledge gap among physical and behavioral health providers in when and how to use telehealth and highlights issues related to confidentiality and access.

Implementation Tools

 

Workgroup Members

Name Title Organization
Shawn West, MD, FAAFP (Chair) Chief Medical Officer Embright
Christopher Cable, MD Executive Director of Operations, Telehealth and Access Management Kaiser
Sarah Levy, MD Medical Director, Solution Center and Telehealth Kaiser
Mandy A. Weeks-Green Senior Health Policy Analyst Washington State Office of the Insurance Commissioner
Tracey Hugel, MSN, RN Senior Clinical Program Consultant Regence
Lydia Bartholomew, MD, MHA, FAAPL, FAAFP, CHIE Chief Medical Officer, Clinical Health Services, West and Southcentral Aetna
Stephanie Shushan, MHA Senior Analyst, Integrated Programs & Strategic Initiatives Community Health Plan of Washington
Jennifer Polello, MHPA, MCHES, PCMH-CCE Senior Director of Quality and Population Health Community Health Plan of Washington
Laura Groshong, LICSW Director, Policy and Practice Clinical Social Work Association
Omar Daoud, PharmD Director of Pharmacy Community Health Plan of Washington
David Tauben, MD Chief of Pain Medicine University of Washington Medical Center
Lindsay Mas Senior Program Manager, Behavioral Health SEIU 775 Benefits Group
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