Arc Update on COGFA Vote and Aetna Managed Care Advisory Committee Meeting
Commission on Government Forecasting & Accountability Meeting on Closures
I wanted to provide you with some updated information on a couple important meetings on managed care and the COGFA meeting.
Arc Board Member and our Public Policy Chairperson Susy Woods covered the COGFA meeting on Thursday morning. Here is Susy’s point by point report.
All of the COGFA Members were there except for Kevin McCarthy.
Singer: 3 to close (Nekritz, Schoenberg, Trotter); 8 to remain open (Bellock, Frerichs, Murphy, Poe, Riley, Schmidt, Syverson, Tryon)
Comments: Syverson: This is a cost effective facility which fills a very important need in this part of the state. It serves as a triage center serving 1000 individuals a year. Cost to transport these people to either Chicago or Alton would be horrendous. We need to look at the continuum of care in the state. No plan is in place. Easy for people in the suburbs to make this decision. Bellock: We are trying to do something in 3 weeks which we should have started 8 years ago when the Blueprint was passed. Community providers’ budgets were cut by 50 million dollars so they are strained. We have to look at how this impacts the whole system. Nekritz: We can’t keep doing the same thing and expect changes. This is about harm versus less harm, risk versus less risk. We simply don’t have the resources to keep Singer open. Riley: Winnebago county sheriff was there because some of these people will end up in criminal justice system. We can’t be hasty. Economic impact statements were telling us we are moving too fast. Schmidt: We have to consider the spin off effect on community and county. Have to look at the impact on the jails. Schoenberg: Time shouldn’t be the pretense for not doing this. We can make this conditional on other things. Former director of Singer said there existed in the community the capacity to put together a not for profit group to run this. Funding needs to follow clients and the state should appraise the facility and see what part of this land they could sell.
Murphysboro: 4 to close (Murphy, Nekritz, Schoenberg, Trotter); 7 to remain open (Bellock, Frerichs, Poe, Riley, Schmidt, Syverson, Tryon)
Comments: Tryon: Youth detention is changing but there is a need for the secure facilities. Not convinced this is the correct facility to close. Not opposed to seeing some change. Trotter: This is a farce. Republicans should have voted for proper funding in the spring. Either close these places or come up with funding. Murphy:Administration is dealing with shortfalls in the wrong way. A better concept has to happen. Bellock: She is a strong supporter of Department of Juvenile Justice. Murphysboro seems to be working well so why mess with that?
Chester: unanimous vote to not close.
Comments: Trotter: Chester is unique and needs to remain open. Hard to get physicians down to this remote part of the state but those people need to be in that remote area to get the services they need. Tryon: What he is hearing all over is the two places we can’t close are Chester and Lincoln. Bellock: Transition takes more time and we can’t hurry.
Mabley: 3 to close (Frerichs, Nekritz, Trotter) and 8 to remain open (Bellock, Murphy, Poe, Riley, Schmidt, Schoenberg, Syverson, Tryon)
Comments: Tryon: This is not an institutional based model. It is a series of group homes where the largest houses 12 people. There is sound therapeutic treatment there. Cost of labor there is what is driving the cost. Bring in contract providers. He disagrees with The Arc on this. Many of the families spoke out on how their family member had been in and out of Mabley and the community 6 or 7 times and the community could not give them what they needed. There is no plan in place. Community providers are saying this can’t be done by March. Willing to look at a plan but there is no plan. Frerichs: Shares a lot of these concerns but we continue to vote not to close us are keeping the status quo as it is. Murphy: There are two main things going on: concern about how quick this is and a weariness to wait to change things. If I had to choose one place to close it would be Jacksonville. Bellock: 50% could probably live in group homes but the other 50% could not. Why don’t we have a task force that makes this happen? Syverson: Mabley is a model facility. The issue is can there be cost savings? Mabley has transitioned from the old Dixon. Riley: This is really tough whether you are for or against closing. Schoenberg: Administration is wrong. They would have been better served to close one DD facility at a time and made sure that would work.
Then Secretary Michelle Saddler spoke about DD facilities and said the main reason Choate was not chosen was that Jacksonville had received a notice of possible decertification because of safety reasons and that CMS was preparing the letter to decertify when this hearing started. This would mean a huge loss to Illinois because of the federal match for Medicaid.
Aetna Managed Care Advisory Committee
Faye Manaster, Director of our Family to Family Health Education Center, attended the first Aetna Advisory Committee meeting in Forest Park yesterday.
The Aetna staff members participating were Bob Currie, Jacqleen Musarra and Katie Hall.
Eighteen people participated in all (roster is forthcoming).
The majority seemed to be mental health and substance abuse providers and some consumers.
Gina Richter and her daughter Kim attended. Gina is a nurse.
Gina was elected chairperson yesterday.
Carl LaMell from Clearbrook was the sole DD provider present.
Illinois Home Care Association (which focuses primarily on seniors) was represented.
Bob Currie was asked about Phase 2 and Phase #3.
Phase 2 is still slated for the next fiscal year; they are waiting for more information from HFS. Probably will be delayed by 6 months to July, 2012.
He mentioned that it’s quite likely that the start date for Phase 3 will be delayed at least a year beyond the projected date of January, 2013.
Questions I raised included:
Ineligible persons becoming auto-enrolled (these are SSI recipients who also have Medicare and/or private insurance).
What provisions are being made re network adequacy- specifically related to participants ages 21-50 who still go to Children’s Memorial since there are no “adult providers” available to meet their highly specialized medical needs.
Number of calls to F2F regarding name brand seizure medications vs. generic ones required by the health plan.
Need for consumers to have emergency back-up supplies of their meds on hand, which is not covered by Medicaid.
A listserv will be established for the advisory group members.
The next meeting is scheduled for January 25, 2012 at 1pm, location to be determined.
New members for the advisory group are still being sought.
Aetna will provide round-trip transportation for advisory members who are enrolled in Aetna Better Health.