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CSHCS Update
CSHCS Update Regional Meeting Spring 2012 Lonnie D. Barnett, MPH Children’s Special Health Care Services Division Michigan Department of Community Health 1 New CSHCS Director Started with CSHCS in August 2011 Have been with MDCH since July 1998 Managed MDCH Health Planning and Access to Care Section Community Health Planner at Kent County Health Department from 1993 to 1998 All around good guy…. 2 The First 8 Months Build Plane In The Air Established program Changing Environment – – – – Accreditation Managed Care Health Care Reform New Administration in Lansing 3 Focus on Outcomes Scorecards and Dashboards Costs and Quality Program Data – – – – Enrollment Family Phone Line Utilization Billable Services Program Expenditures and Diagnoses 4 CSHCS Fiscal Year 2011‐Enrollment Per Month 5 CSHCS Clients with Other Insurance February 2011 6 Family Phone Line Calls By Region January thru April 2012 Region # of calls % of calls Northeast 98 2.0% Northwest 146 2.9% Southeast 3254 65.3% Southwest 1351 27.1% Upper Peninsula 135 2.7% 7 MICHILD Enrollees with CSHCS January 2010 – April 2012 900 800 700 600 500 400 300 200 100 0 Jan‐10 Mar‐10 May‐10 Jul‐10 Sep‐10 Nov‐10 Jan‐11 Mar‐11 May‐11 Jul‐11 Sep‐11 Nov‐11 Jan‐12 Mar‐12 8 Local Health Department Total Billing Per Fiscal Year 2007 ‐ 2011 9 FY 11 CSHCS Top Ten Diagnosis by Expenditure – Title V/XIX Only Cancer of Lymphatic and Hematopoietic 3% Respiratory 3% Cancer 4% Gastro‐Intestinal 2% Blood 17% Diseases of the Blood and Blood Forming Organs (Including Hemophilia) Diseases of the Central Nervous System (Including Cerebral Palsy) Newborn 6% Congenital Anomalies Diseases of the Endocrine Glands (Including Diabetes) Metabolic 8% Metabolic Diseases Certain Diseases of the Newborn (Including Respiratory Distress Syndrome) Cancer (Excluding Neoplasms of Blood and Lymph Systems) Endocrine 7% Central Nervous 17% Diseases of the Respiratory System Cancer of the Lymphatic and Hemtopoietic Systems (Including Leukemia) Congenital Anomalies 22% Diseases of the Gastro‐Intestinal System 10 FY 11 CSHCS Top Ten Diagnosis by Expenditure – Title V Only Cancer of the Lymphatic and Hematopoietic Systems 3% Respiratory 2% Ear 1% Gastro‐Intestinal 2% Blood 40% Cancer 3% Diseases of the Blood and Blood Forming Organs (Including Hemophilia) Diseases of the Central Nervous System (Including Cerebral Palsy) Congenital Anomalies Metabolic 16% Diseases of the Endocrine Glands (Including Diabetes) Metabolic Diseases Cancer (Excluding Neoplasms of Blood and Lymph Systems) Diseases of the Respiratory System Cancer of the Lymphatic and Hemtopoietic Systems (Including Leukemia) Endocrine 11% Diseases of the Ear Diseases of the Gastro‐Intestinal System Congenital Anomalies 7% Central Nervous 9% 11 FY 11 CSHCS Expenditures by Provider Groups – Title V/XIX Only Medical Home 0% Inpatient Hospital 27% Outpatient Hospital 9% Ancillary Services Dental DME/Supplies Hearing/Speech Home Health 12% Home Health Inpatient Hospital Medical Home Outpatient Hospital Pharmacy Physician Vision Hearing/Speech 0% DME/Supplies 10% Dental 0% Ancillary Services 1% Pharmacy 34% Vision 0% Physician 7% 12 FY 11 CSHCS Expenditures by Provider Group – Title V Only Pharmacy 74% Ancillary Services Dental DME/Supplies Hearing/Speech Home Health Inpatient Hospital Medical Home Outpatient Hospital Pharmacy Physician Vision Physician 3% Outpatient Hospital 5% Home Health 0% Medical Home 0% Inpatient Hospital 9% Anncillary 0% Hearing/Speech 1% Dental 0% DME/Supplies 7% Vision 0% 13 Updates FY13 Budget Health Insurance Program of Michigan (HIP) Autism Legislation Health Care Reform Plans of Care 14 Transition to Medicaid Managed Care Regional Meeting: Waterford, Michigan June 19, 2012 Children’s Special Health Care Services Division Michigan Department of Community Health 15 Medicaid Managed Care Benefits Timeline Family/Parent Involvement – Theme: Network, Network, Network Roles for LHDs Communications LHD/MHP Collaboration Discussion/Questions 16 Benefits for Enrolling CSHCS into Managed Care Organized approach to primary care Addition of complex case management Ability for quality monitoring Access to outpatient mental health services Increased access to non‐emergency transportation services 17 Timeline Oct‐ 11 Core Competencies Carve Outs Rates Nov‐ 11 Dec‐ 11 Jan‐ 12 Feb‐ 12 Mar‐ 12 Apr‐ 12 May‐ 12 Aug‐ 12 Sep‐ 12 Oct‐ 12 Nov‐ 12 Dec‐ 12 Waiver Amendment Process Systems Revisions Enrollment Planning Jul‐ 12 Readiness Reviews PCMH/Care Planning/Care Coordination Jun ‐12 Enrollment MHP Contract Changes/Data Sharing Agreements Policy Promulgation Communications Monitoring/Compliance Review (CAHPS, EQR, HEDIS, etc.) 18 CSHCS led Training Sessions Family/Parent Involvement Family Center Participation on Workgroups CSHCS Advisory Committee Parent Focus Groups – 3 Focus Groups with CSHCS Parents – Feedback from Other Parents – Additional Communications planned Network, Network, Network Communication Strategy 19 How Can LHDs Assist with this Transition? Plans of Care It is still premature to begin communications with families However, families may ask questions and will seek answers Much more clarity expected this summer Hard to reach families LHD/MHP Subcommittee 20 Communications Sub‐Group First meeting in May Comprehensive Communications Strategy to convey information to families – Utilize Provider Network – Utilize LHD Network – Utilize existing communication structures • Family to Family, Family Center 21 LHD/MHP Collaboration Workgroup forming Review LHD Plans of Care and care coordination/case management and MHP complex case management requirements Identify opportunities to enhance service to families Regional MHP/LHD Meetings 22 Discussion/Questions FAQs Monthly RNC Calls Other Communications 23 State/Local Communications Regional Meeting: Waterford, Michigan June 19, 2012 Children’s Special Health Care Services Division Michigan Department of Community Health 24 State/Local Communications How to assure effective communications with all health departments – – – – Health Officers Nurse Administrators Finance Directors CSHCS Program Staff 25 State/Local Communications: Purposes Information Sharing Training/Education Reporting Feedback from locals 26 State/Local Communications: Mechanisms Information and Alert E‐mails RNC Calls Trainings (Formal and Informal) Guidance Manual CLAC MALPH Forums Regional Meetings Site Visits 27 State/Local Communications: Discussion What is working? Not working? Where can we improve? Value of current annual LHD report to State? Additional comments, questions, discussions? Connection with Accreditation efforts? 28