The document outlines the integration of social determinants of health with healthcare costs in Snohomish County through various initiatives focused on equity, empathy, and community empowerment. It highlights the collaboration among multiple organizations, including the Snohomish County Health Leadership Coalition, to address nonmedical needs impacting community health. The current initiatives aim to test the health and cost impacts over five years with a significant grant, emphasizing the importance of community partnerships and addressing issues like housing, nutrition, and transportation.

2. AHC & the Age of Integration
A network of networks come together to link social determinants & health care costs
Dawn Erickson, CTR Administrator, Everett Transit
Scott Forslund, Executive Director, Providence Institute for a Healthier Community
Vicci Hilty, Executive Director, Domestic Violence Services of Snohomish County
Mary Jane Vujovic, Dept. Director, Snohomish County Human Services Division
Neil Watkins, Director, Sky Valley Food Bank and Snohomish County Food Bank Coalition
#ConnectEOA
Equity – How disparities in access to housing, transportation, nutrition and other social determinants
affects overall community health and costs
Empathy – Building understanding that residents lacking basic needs are “us” and worthy of support.
Resilience – – How demonstrating the impact of meeting nonmedical needs can galvanize
community support and strengthen community capacity to endure hardship.
Empowerment – Impact of support for basic services on autonomy, independence, contribution to
community vitality and prosperity.

3. 3
Source: Centers for Disease Control and Prevention (CDC), 2008

4. • Focus:
• Targeted population health initiatives / collective impact or collaboration models
• Innovative community partnerships
• Administrative backbone for Snohomish County Health Leadership Coalition
• 2016 Initiatives:
–Accountable Health Communities Grant – and ‘thin-slice’ strategy
–Snohomish County Health Leadership Coalition / Backbone admin support
–Housing and Health partnership

5. AHC Grant
TotalHealth!
• Population Health at scale
• Testing the health & cost impact of addressing nonmedical social needs
• 5 year, $4.5M grant
• 75,000 Medicaid/Medicare screens / year starting 2018
• Working with partners in healthcare, social services and utility service
providers (25 MOUs, 293 affiliated orgs gross count)
• Worked with ACO & many internal stakeholders to build the model
• Submitted to CMS in May. Award in Q1 2016.
• CTC Grant opportunity to maintain community momentum

6. Testing impact on
healthcare costs
& health of …
• Housing
• Nutrition
• Transportation
• Utilities
• Domestic Violence
• Education
• Employment

7. TotalHealth! 25 MOUs in place
Community Service Provider Networks & Partners
(293 affiliated organizations / gross count)
• Senior Services of Snohomish County
• Snohomish County Food Bank Coalition
• SnoTRAC
• Farmer Frog
• Snohomish County Human Services Dept
• Domestic Violence Services
• Snohomish Health District
• Workforce Snohomish
• Snohomish STEM Network
• SnoCo Health Leadership Coalition
• United Way of Snohomish County
• Volunteers of America
• North Sound Accountable Community of Health
• Washington State Health Care Authority
Clinical Delivery Sites
(53 unique care sites)
• Providence Medical Group
• The Everett Clinic
• Edmonds Family Medicine
• SeaMar Community Health Centers
• Community Health Center
• Swedish Medical Group
• Compass Health
• Sunrise Services
• Providence Regional Med Center
• Swedish-Edmonds
• Swedish Mill Creek

8. Panel Discussion:
Insight into Core Social Determinants
• Overview of housing, utilities, transportation, domestic violence,
nutrition sectors
• who you serve in this county;
• how you see the relationship to community health and healthcare costs
• Current challenges in sustaining your work and untapped
opportunities

9. How might we take a “thin-slice” step forward
as a community?
• What assumptions should we make?
• What should we hope to learn?
• What would success look like?
• What are roadblocks or unintended consequences should we be on
the lookout for?
• What partnerships or other efforts should we be looping in – and
what assets will they provide?

10. Thank You!
#ConnectEOA
Time to network!
Enjoy each other and the resource tables
Don’t forget to turn in your connection “links” to the Resource Tables
and volunteers in the foyer – we’ll see how many were made when we
meet back in the ballroom!
Be back to the ballroom no later than 2:45!