After the Storm

Dear Friend,


While the storm that hit this weekend wasn’t as brutal as some forecasts had expected, in many parts of our region, this was a tough and tumultuous weekend. It was a relief not to have “The Storm of the Century,” though the storm that hit our area still brought high winds, heavy rains, and huge waves that threatened properties and required fast action (particularly by those on the coast). Those coastal communities saw firsthand the encroachment of the ocean with serious surges and rains. Lots of folks lost power at their homes.

Thanks to all those who took the time to help a neighbor or check in on a loved one this weekend.

For those who were impacted by the storm, please know that my office is here to lend a hand. Please don’t hesitate to reach out.

Helping Rural Communities Access Affordable Health Care

On the Olympic Peninsula and in other rural parts of our nation, we face some unique health care challenges. The mix of patients is often different (so reimbursements under the Medicare and Medicaid system matter even more). It is often a struggle to recruit enough providers – particularly primary care providers – to these areas. And it can also be a challenge for seniors to get access to care.

As I’ve met with providers on the Peninsula, I’ve heard about a unique (and sort of wonky) challenge. In recent years, we’ve seen more and more medical providers form Accountable Care Organizations (also known as ACOs). ACOs are groups of hospitals, doctors, and providers that join together to serve a special population, like Medicare patients. ACOs are part of an effort to move our health care system from a strict fee-for-service model to a system that is more focused on patient outcomes. The Medicare Shared Saving Program was set up so ACOs that more effectively manage the health of folks under their care can share in the savings. 

A way to improve patient care and ensure providers are adequately reimbursed.

Sounds great, right? 

Unfortunately, under the Medicare Shared Savings Program, there is a rather strict definition of what constitutes a “provider” that would be eligible for reimbursement. Folks like nurse practitioners, physicians’ assistants, clinical nurse specialists, certified registered nurse anesthetists, and others currently aren’t considered eligible providers from which Medicare patients can obtain reimbursable treatment within the ACO.

As you can imagine, that’s particularly problematic in rural areas where many folks will often see a nurse practitioner as part of their effort to get primary care.

So before Congress went into recess, I introduced a bipartisan bill that would change that – and provide more flexibility in the definition of who qualifies as a “provider." Our bill would ensure that all these specialists can be eligible providers within an ACO. The bill would give seniors more options for finding care and would reward health care providers who are focused on improving the quality of care for patients. 

Senator Cantwell has introduced this bill in the Senate, and I’m looking forward to working with her to get this across the finish line.

Honoring a local leader

Speaking of the Peninsula...On Friday night, I joined Greater Grays Harbor Incorporated for their annual awards dinner. I was honored to play a role in recognizing retiring State Senator Jim Hargrove who received their Distinguished Service Award. Jim has served in the legislature since I was a kid, and has had extraordinary impact.

He worked tirelessly to ensure a social safety net for the most vulnerable. He took on tough issues – ranging from natural resource policy to addressing truancy to working to balance the state budget. And he always approached the issues with intellectual rigor and a big heart.

Too often in politics, the focus is on who’s up and who’s down—on who’s winning or losing. I’m grateful to Jim Hargrove because he focused on a better question: What’s RIGHT? If someone had a good idea, Senator Hargrove would support it (whether it was proposed by a Democrat or a Republican). I’ve certainly tried to follow that ethic.

I’m grateful for his decades of service, his principled servant leadership, and his friendship. Please join me in wishing him the best in retirement and some well-deserved time with his family.

Gearing up for Another Farm Bill

It’s expected that Congress will take up a new Farm Bill in the new year. In preparation, I had a terrific meeting in Tacoma with a coalition of folks working to ensure that federal agricultural policies incorporate fresh, locally-grown foods into food security and nutrition efforts. This diverse group included folks from the Tacoma Farmers Market, Northwest harvest, MultiCare, the Anti-Hunger & Nutrition Coalition, and the State Department of Health. Among other things, we discussed efforts to strengthen the Food Insecurity Nutrition Incentives (FINI) grant program.

FINI grants were awarded by the US Department of Agriculture to support innovative approaches to helping participants in the Supplemental Nutrition Assistance Program (also known as SNAP – formerly known as food stamps) to afford fruits and vegetables.

Here in Washington, that’s involved some innovative efforts. Grocery stores are providing rebates for customers who spend their SNAP benefits on fruits and vegetables. Farmers’ markets are providing matching funds. It’s even involved community health providers distributing “fruit and vegetable prescriptions” to patients who participate in SNAP, with participants “filling” their prescriptions at participating farmers’ markets or Safeway stores.

This important out-of-the-box thinking can strengthen access to healthy food. Stay tuned in the months to come as Congress begins debating these efforts.

An Exciting Announcement

Rural communities often face challenges in securing investments to help them grow and prosper. The United States Department of Agriculture has taken note of this challenge and is trying to do something about it. That’s why I was happy to announce that Craft3, a nonprofit Community Development Financial Institution, was awarded major new resources to help communities access capital.

It comes in the form of $20 million from the USDA Rural Development Program that Craft3 can lend out as low-interest, long-term financing to help communities build, acquire, or improve community facilities. The investments can help local communities enhance their health care or child care facilities and strengthen economic development, among other benefits.

As Adam Zimmerman, President and CEO of Craft3, noted, “Lack of capital in tribal communities means a lack of opportunity – and that lack of opportunity has helped create generational, persistent poverty. We’re proud to be partnering with USDA Rural Development and the Northwest Area Foundation on Uplift America to make critical investments that improve quality of life, reduce poverty, improve access to capital and create jobs.”

Exploring a Local Treasure

Recently I had the time to explore some of the best parts of the Olympic Peninsula. That included a trip to one of our region’s gems: Olympic National Park. I marked the National Parks Centennial on a daylong hike with the National Parks Conservation Association (NPCA). We visited the Hoh Rain Forest – one of the most remarkable parts of our region.

The day was a powerful reminder of the value of our parks – and of the need to protect them. The NPCA is key to these efforts, and I’m proud to call them partners in keeping the area beautiful for future generations.

Reducing the role of money in politics

Longtime readers know that I’ve continued to raise the alarm about the damaging influence of big money in our elections.  In my view, our country is at its best when we are fueled by people-power. Too many folks these days feel like they don’t have a voice in our government. They feel left out and see toxic political ads funded by the deepest pockets.

A smaller and smaller number of people are having an oversize influence on our politics. Just how small? So far this year, wealthy individuals have contributed $1.1 billion to super PACs with a quarter of it coming from just 10 super wealthy donors.

The era of a handful of people using big money to influence our elections needs to end. It’s why I’m leading the fight to reform our campaign finance system and to bring your voice back to Congress. It’s why I’ve sponsored a constitutional amendment to undo the Supreme Court’s Citizens United decisions. It’s why I’ve sponsored the DISCLOSE Act to get some transparency, so we can at least see where dark money is coming from. It’s why I’ve sponsored a bill to enable citizen-financed elections that would incent candidates to rely on small contributions. And it’s why I’ve sponsored a bill to put the teeth back into our election watchdog, the Federal Elections Commission.

This election should be determined by voters – not by big money. Read more here about how mega-donors have poured record money into our elections.

Meeting with You

I had a great visit with the Lower Elwha Klallam Tribe. There are some really exciting things happening for the tribe – including about 80 new acres of beach along the mouth of the Elwha River stemming from the dam removal. Thanks to Chairwoman Frances Charles, the terrific staff, and Councilman Steve Robideau (an old friend from high school) for taking the time to visit.

Apprenticeship programs are a valuable resource for training the next generation of workers. I’m grateful to the sprinkler fitters, plumbers, and pipe fitters for taking the time to show me their digs.

I had an awesome visit to the Washington State History Museum in Tacoma where they had their 125th Birthday Bash. They had some terrific exhibits, some delicious cake, and even Teddy Roosevelt showed up!

It was great to sit down and meet with the new Navy Region Northwest Commander, Rear Admiral Mayes. I also met with the new Commander of Naval Base Kitsap, Captain Schrader. It was an honor to welcome both these leaders to the Pacific Northwest, and I look forward to working with both of them to ensure our sailors have the resources they need to carry out their import missions.

As always, I’m grateful for the honor of representing you. Please don’t hesitate to holler if I can help you or someone you know!

Derek Kilmer