Budget Redux: What the Mid-Biennium Review Means for Advocates Featuring: Gayle Channing Tenenbaum, co-Chair of Advocates for Ohio’s Future and Director of Policy and Govt Affairs at PCSAO Larke Recchie, Executive Director of the Ohio Association of Area Agencies on Aging (o4a) Lisa Hamler-Fugitt, Executive Director of the Ohio Association of Second Harvest Foodbanks (OASHF) Cathy Levine, Executive Director of Universal Health Care Action Network of Ohio (UHCAN Ohio) and Co-Chair of Ohio Consumers for Health Coverage
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Budget Redux: What the Mid-Biennium Review Means for Advocates
Featuring:
Gayle Channing Tenenbaum, co-Chair of Advocates for Ohio’s Future and Director of Policy and Govt Affairs at PCSAO
Larke Recchie, Executive Director of the Ohio Association of Area Agencies on Aging (o4a)
Lisa Hamler-Fugitt, Executive Director of the Ohio Association of Second Harvest Foodbanks (OASHF)
Cathy Levine, Executive Director of Universal Health Care Action Network of Ohio (UHCAN Ohio) and Co-Chair of Ohio Consumers for
Health Coverage
Today’s Agenda• 3:00-3:08 Will Petrik - Intro, Purpose, Timeline • 3:08-3:16 Gayle Channing Tenenbaum – Focus of
the Mid-Biennial Review, Mental health, Child Welfare
• 3:16-3:24 Larke Recchie – Mid-biennial issues for aging and disability networks
• 3:24-3:32 Lisa Hamler-Fugitt – Mid-biennial issues for the safety net -- food assistance
• 3:32-3:40 Cathy Levine – Health care, Medicaid Cost Containment, Care coordination
• 3:40-3:48 Will – Call to Action and other ways to build support and get involved
• 3:48-4:00 Q and A
Gayle Channing Tenenbaum
Co-Chair of Advocates for Ohio’s Future (AOF)Director of Policy and Govt Affairs at PCSAO
www.pcsao.org
Mid-Biennial BudgetReview
• The Kasich Administration to introduce version of Interim Biennial Budget shortly after March 6,2012
• Budget will focus on programmatic change
• Reform, restrain, and reduce where possible
Mid-Biennial BudgetReview
• Administration and legislature will be looking at Medicaid, Mental Health and Developmental Disabilities
• There will be opportunity for stakeholder input before the budget is introduced
Child Welfare• Still seeing reduction of children
coming into care• Adding 10 more counties to
Differential Response• Working on Plan for an Incentive
Fund that would reward counties who pass levies
• Working closely on several behavioral health initiatives as they relate to children, youth and families in the child protection system
Mental Health• Intensive-Home Based Therapy
( IHBT)• LAUNCH ( A Substance Abuse and
Mental Health Grant funded by SAMHSA ) working on “Telehealth Networks” to address the shortage of mental health practioners in Ohio
• Medicaid Health Homes, SPA submitted for seriously chronically mentally ill adults and children
Mental Health• BEACON (Best Evidence for Advancing
Child Health in Ohio Now) Meeting Feb 3, 2012 to determine which children’s mental health issues will be addressed in the next two years. • One issue will likely be the over-use of psychotropic
drugs with children in foster care
• Trauma as a Public Health Issue• Intensive Home Based Visitation
Mid-biennial issues for Aging and Disability Networks
Larke RecchieExecutive Director
Ohio Association of Area Agencies on Aging
Medicaid LTSS Changes
•Single waiver
•Medicaid Medicare Eligible (MME) waiver
•Medicaid Health Home
•Funding issues
•Take down 5 current waivers PASSPORT, Ohio Home Care, Choices, Assisted Living, Transitions(50,000 consumers)
•Replace with single Medicaid Waiver for all adults (age 21 and over?) who meet NF level of care
•Draft letter to CMS expected within 2 weeks
• Some potential changes to screening, assessment and case management
•Implement after MME Waiver (January 2013)
•Opportunity to address service needs
Single Waiver
Medicare Medicaid Eligible (MME) Waiver
•190,000 MMEs in Ohio
•Straw Man released last week of concept paper http://healthtransformation.ohio.gov/CurrentInitiatives/IntegrateMedicareMedicaidbenefits.aspx
•Implementation in Fall 2012
•Likely to start in metropolitan areas with higher concentration of MMEs.
Medicaid Health HomesFocus on severe and persistently
mentally ill
State Plan Amendment sent to CMS
Implement July 2012
Not to be confused with …
Rebidding of Medicaid Managed Care –
• RFA released last week• Applications by March 2012• Awards in April 2012• 3 regions with up to 4 providers• Combines CFC & ABD populations
• Implement January 2013
How do these initiatives relate?
• 1.6 million Ohioans enrolled in Managed Care
•190,000 Ohioans eligible for Medicaid and Medicare (MME)
•50,000 Medicaid Nursing facility level of care waiver consumers
The MME waiver will pull some people from Medicaid Managed Care and some people from waiver (85% of PASSPORT consumers are MMEs)
Consumer Input Sessions on the Single Waiver and MME
Waiver Dates and locations: January 24, 2012 Toledo
January 31, 2012 Dayton or Columbus
February 3, 2012 Columbus or Dayton
February 7, 2012 Cleveland February 14, 2012 Athens
Olmstead Task Force funding Lewin Group to help facilitate.Watch OHT website for details http://healthtransformation.ohio.gov/
• Likely 1:00 – 4:30pm• More like focus groups, less like hearings
Our Concerns:
• Don’t tear down or destroy what is working – Build on Ohio’s strengths
•Make sure new services are responsive to wide range of consumers.
•Make sure funding is available to provide real choice for home and community options
Lisa Hamler-FugittExecutive Director
Ohio Association of Second Harvest
Foodbanks
(614) 221-4336www.oashf.org
Three-Year Framework from Governor’s Office of Health Transformation2011: Modernize Medicaid2012: Streamline Health and Human Services2013: Improve Health System Performance
Payment and delivery reform (see AOF doc)AOF Cost Containment Agenda aligned
What does this mean for advocates?
2011: Modernize MedicaidAdministration priorities (using ACA)
Improve care coordination – new modelsIntegrate behavioral and physical health careRebalance long term care
AOF Consumer Friendly Cost Containment Agenda aligned – Devil is in Details
2012: Opportunities for AdvocatesInput into new models of care
Medicaid Health Homes – starting with SPMINew Models for People who are Dually Eligible
Regional Consumer Input Meetingscoming your way!
Mid Biennial Review (MBR) – watchful waiting
2011: FY 2012-13 BUDGET – AdvancesAlmost no cuts to Medicaid eligibility/benefits Spending shifted from institutional to home
and community based long term carePolicies enacted and investment made in care
coordination for most vulnerable patientsLaunched Patient Centered Primary Care
Collaborative
FY 2012-13 Budget: Weaknesses: Policies not always supported by $Continued inadequate funding for behavioral
healthLimits put on certain BH treatment
Home and community based services for people with disabilities < 60 inadequate
Gutting of public health programsCounty funding cuts: inadequate JFS staff
2012: Streamline Health and Human Services
Streamline governance, efficient operations and funding
Single waiverModernizing eligibility determination systems
Easier to enroll and reenroll in all programsGetting ready for “Health Exchange” in 2014
Coalitions Working on Implementing ACAOhio Consumers for Health Coverage
www.ohioconsumersforhealth.org
Ohio Campaign for Better Care: building a voice for older adults in achieving better care and better coordination for older adults and family caregivers.www.uhcanohio.org/ohiocampaignforbettercare
Take Action: Will you meet with one of your local lawmakers
before Mar 6th?• Prioritize meeting with members on the House and Senate
Finance Committee
If you don’t know who your lawmakers are, you are not alone! Find out here:• http://go.advocatesforohio.org/getLocal.jsp
If you’ve never met with a lawmaker before (or it’s been a while since your last visit), use this guide to set up and execute your meeting with lawmakers:• http://
advocatesforohio.org/perch/resources/Invite.Legislators.to.Tour.Your.Program.or.Facility.pdf
Share this map with your lawmakers
• highlight the growing need in your county and in Ohio
• Download and print the map here:
http://www.advocatesforohio.org/perch/resources/PovertyMap.pdf
The Ask
Can we count on you to stand up for health,
human services, safety net services and early
care & education in your Caucus?
Follow Up: Report backand send a Thank You
Let us know: • how your meetings went • who you visited with• Report Back Document: https
://docs.google.com/spreadsheet/viewform?formkey=dHFYQTNNMVJ5Vm9mVi04M081N1lkVWc6MQ
• Don’t forget to send a Thank You note!
How OrganizationsCan Help
• Endorse Advocates for Ohio’s Future
• Educate your board, staff, volunteers, and clients
• Recruit other agencies and organizations to endorse
Contact Us Advocates for Ohio’s Future
www.advocatesforohio.org510 East Mound Street, Suite 200
Columbus, OH 43215Fax: (614) 228-5150
Will PetrikOutreach Director
614-602-2464
Scott BrittonCoordinator
614-602-2463
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