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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

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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

Thank you.

Larke [email protected]

Ohio Association of Area Agencies on Aging

Lisa Hamler-FugittExecutive Director

Ohio Association of Second Harvest

Foodbanks

(614) 221-4336www.oashf.org

Medicaid and Health Care in Ohio 2011-2013

Cathy Levine, UHCAN [email protected]

www.uhcanohio.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

[email protected]

614-602-2464

Scott BrittonCoordinator

[email protected]

614-602-2463