Comments on Health Reform Goodies

Now that health reform has passed, what can we expect?

In the Near Term:

• In 90 days, a temporary high risk pool for people with pre-existing conditions. High risk pools only work for people with chronic conditions if the premiums are controlled. Otherwise, the premiums tend to drift up and make the pool not affordable.
• Parents can cover their kids up to age 26. I think, but am not sure, this adds a year and broadens already existing practice for some carriers.
• No more life time limits on dollars of coverage.
• Better coverage of preventive services
• Better monitoring of carrier use of funds, and better investigation of big rate increases
• Medicare Donut hole rebate for the near term, and elimination of the donut hole by 2020
• Expanded Medicare coverage for people exposed to an environmental emergencies
• Improved care coordination for people who receive both Medicare and Medicaid
• A 10% tax on tanning services(!)

A couple of other interesting things:

• Section 2402 and what follows seem to allow home and community based services in a waiver to easily use 300% of SSI as the income limit. This would broaden eligibility for waiver services in many waivers.
• An interesting project on shared medical decision making

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/

Recovery Council Six

Rich Casteels gave a report on the Michigan Recovery Center of Excellence. Many, many activities and information tools at http://www.mirecovery.org/

Rich reviewed web use data, as well. They have done a variety of online trainings. He also pointed out that their technology could be used by MRC and MDCH for any recovery related events.

Rich asked the Recovery Council to form a Steering Committee to guide the work of the Recovery Center.

Volunteers made their willingness known, and Marlene voluntold a couple of others.

Comments covered a wide variety of things. Northern Lakes channel on YouTube has a recent video work from NLCMH. Also, how do deal with cuts in services.

Meeting Adjourned.

Recovery Council Part Five

The 4th Work group has set up a wiki at http://www.copower.org/milawswg/ to allow comments on laws and rules over the next few months.

The fifth work group focused on stigma, trauma, and health/wellness. Sara went over the ladder of meaningful involvement from consumers are manipulated to Consumer directs the Recovery Meeting.

The WG wants to gain an understanding of existing efforts, generate positive messages of recovery, and increase frequency of training.

Ideas include awareness campaign, prevention and early intervention, and how education credits work.

They have reviewed what is being done now. They have established some goals and next steps for each area. They are linking with other groups that focus on these same issues.

They will be requesting training proposals for trainings and trainers.

Recovery Council Part Four

The work groups are updating the Council on their progress and next steps. The first group found many, many policies on Recovery and will borrow freely from them. Pat Baker reviewed some longitudinal research that has shown how much more important the person's view of recovery is in reaching good outcomes. Planning must be driven by the person, and the role of other people in the mental health system is supporting that person driven framework internalized.

How well do we do recovery management planning in this light? Pat believes that we need a state initiative to improve system approach to this planning area.

The second group explored the possibility of a survey to agency staff about their recovery experience and its impact on recovery policy in their organization.

The third group is focusing on the ARR and how it is being implemented. They reviewed the meaning of Renewal and Re-commitment. They also went through the 11 sections of the ARR, and reviewed the principles embedded in them.

LUNCH TIME!!

Recovery Council Part Three

Community Block Grant RFA process will be reviewed.All CMHs are eligible to apply, and Irene is hoping to get a proposal from every one. $70,000 per year for up to 2 years. Applications due in May.

Available to support recovery for people with severe mental illness and co-occurring disorders. They will require partnership with consumers in the application. Another focus will be barriers to Recovery. They expect concrete changes that include PCP and Recovery concepts, such as incorporating PSS in new places, expanding self determination opportunities, improving PCP processes, expanding opportunities for integrated employment, ARR goals attainment, and expanding community partnerships. bot GF and MA funds can be the target of self-determination control proposals. There are a lot of other suggestions and examples, as well as a format for the proposal narrative.

May 11 is the probable deadline. Will not require match or the usual sustainability (money) criteria for the proposals because of the problems with GF. However, they will look for policy change that is permanent and capability improvement that is permanent. Irene wants everyone to use this opportunity to improve their recovery agenda.

Irene asked for volunteers to review proposals. There is enough money that each CMH can have a grant.

Recovery Council Two

Several great recovery stories. Mike head talked about the passage of the Health Care Reform bills. Expansion of Medicaid availability is one. Bad news is that the Senate cut 20% of General Fund dollars from the proposed budget. There is a hearing today in Detroit on the cut. There seems to be energy for finishing the budget early, but there has been no real effort to solve revenue issues. Caretaker relatives and 18-19 year olds have been removed from the Medicaid options. Small Board administration will likely go as well as CMH's are integrated into PIHPs. The physician tax will likely not go through. Stimulus will be extended into 2011, so that will help. PIHPs will be held accountable for assuring that each Medicaid beneficiary has the same expectation for services regardless of location. Mike has become at least a temporary Spartan fan.

Recovery Council One

We are at LCC West for the March Recovery Council Meeting. It appears there will be a large turnout. The work groups on Council Strategy will report on their progress, and we will review policy issues.

More later.