Michigan Association of COMMUNITY MENTAL HEALTH Boards Perspectives Integrating Care for Persons on Medicare and Medicaid (MME) AAA 25 th Annual Conference MACMHB ~ www.macmhb.org ~ 517-374-6848 1
What is MACMHB? The Michigan Association of Community Mental Health Boards (MACMHB) is a trade association of 46 Community Mental Health (CMH) boards and 70 affiliate members (mostly provider organizations under contract with one or more of the CMHs.) MACMHB ~ www.macmhb.org ~ 517-374-6848 2
What is a PIHP? PIHPs are Prepaid Inpatient Health Plans, an entity defined in federal regulations which is able to operate capitated, prepaid managed care programs for specialty populations This was the designation provided to 18 entities, 8 stand alone CMHs and 10 Affiliations 2 or more CMHs When established, minimum of 20,000 Medicaid beneficiaries CMHs in current affiliations were self selected MACMHB ~ www.macmhb.org ~ 517-374-6848 3
Keweenaw Michigan Association of Community Mental Health Boards Affiliation Map Copper Country Gogebic Ontonagon Gogebic Houghton Baraga Pathways Iron Marquette Northpointe Alger Schoolcraft Luce Hiawatha Mackinac Chippewa CMHSP AFFILIATIONS Dickinson Delta NORTHCARE Menominee Emmet NORTHERN AFFILIATION Cheboygan Charlevoix North Country Presque Isle Northeast Michigan Antrim Ostego Montmorency Alpena NORTHWEST CMH AFFILIATION ACCESS ALLIANCE OF MICHIGAN Leelanau Manistee- Benzie Benzie Grand Traverse Kalkaska Crawford Oscoda Alcona Northern Lakes CMH Au Sable Valley Manistee Wexford Missaukee Roscommon Ogemaw Iosco THUMB MENTAL HEALTH ALLIANCE AFFILIATION OF MID-MICHIGAN SOUTHWEST MICHIGAN AFFILIATION VENTURE BEHAVIORAL HEALTH CMH PARTNERSHIP OF SOUTHEAST MICHIGAN LAKESHORE BEHAVIORAL HEALTH ALLIANCE UNAFFILIATED OVER 20,000 Mason Lake Osceola Clare Gladwin Oceana West Michigan Muskegon Berrien Muskegon Ottawa Allegan Newaygo Ottawa Van Buren Newaygo Kent Allegan Mecosta Isabella Midland Barry Montcalm Ionia Eaton Gratiot Clinton Van Buren Kalamazoo Calhoun Jackson Cass Kent Kalamazoo St. Joseph Berrien Cass St. Joseph Branch CMH for Central Michigan Montcalm Barry Ionia Summit Pointe Branch Gratiot Hillsdale Ingham Ingham Saginaw Shiawassee Lenawee Arenac Bay Saginaw Shiawassee Clinton-Eaton- Bay- Arenac Livingston Washtenaw Lenawee Genesee Livingston Washtenaw Monroe Tuscola Genesee Oakland Wayne Huron Tuscola Lapeer Oakland Detroit/ Wayne Monroe Huron Macomb Macomb Sanilac Sanilac Lapeer St. Clair St. Clair MACMHB ~ www.macmhb.org ~ 517-374-6848 4 Updated November 4, 2010
Who are MMEs Served by the Public Mental Health System? Approximately 25% of persons served by the mental illness and developmental disabilities system 16,000 persons with developmental disabilities 24,000 persons with serious mental illnesses Some of the most complex and high need persons served Utilize approximately 50% of the Medicaid resources MACMHB ~ www.macmhb.org ~ 517-374-6848 5
Where and How are MMEs Served? Persons are served in community based settings: All regional centers for persons with developmental disabilities have been closed. Persons with serious mental illnesses are hospitalized for short term acute care in licensed psychiatric units in local general hospitals. Michigan s Medicaid waivers provide access to a broad, diverse set of community living services and supports, many not typically viewed as healthcare services MACMHB ~ www.macmhb.org ~ 517-374-6848 6
What are the Opportunities? Care Bridge Better communication and coordination between PIHPs and ICOs - Shared treatment planning; information technology used to share key treatment encounters and information. Lead responsibility for care coordination based on initial screening assessment, predominant healthcare need(s), and person s choice Shared incentives between ICOs and PIHPs MACMHB ~ www.macmhb.org ~ 517-374-6848 7
Opportunities Better transition planning for Medicare financed inpatient psychiatric hospitalizations, particularly for persons with serious mental illnesses Expanded substance use disorder screenings For psychiatric/substance use disorders, expanded use of evidenced based practices such as Motivational Interviewing, Co Occurring Disorders (Mental illness/substance Abuse), and Dialectical Behavioral Therapy (DBT) MACMHB ~ www.macmhb.org ~ 517-374-6848 8
Opportunities Health home for Persons with multiple chronic health conditions A health home is a service delivery concept, not a physical location. It is a care team designed to better coordinate and manage health and long-term services supports for individuals with complex care needs. Health home services include: Comprehensive care management Care coordination Health promotion Comprehensive transitional care from inpatient settings Referral to community and social support services Individual and family support services MACMHB ~ www.macmhb.org ~ 517-374-6848 9
What are the Challenges? 1)Restructuring of Current PIHP Regions fewer (6-7?) What are the functions of these restructured and larger PIHPs? Precursor to changes in all current Medicaid waivers? 2)Need for more physical healthcare-related personnel and training in CMH settings 3)Network development and coordination for mild to moderate psychiatric and substance use conditions MACMHB ~ www.macmhb.org ~ 517-374-6848 10
Contact Information Michael Vizena, Executive Director mvizena@macmhb.org Michigan Association of Community Mental Health Boards 426 S. Walnut St, Lansing, MI 48933 (517) 374-6848 MACMHB ~ www.macmhb.org ~ 517-374-6848 11