Ode to Joy

 

Pete Seeger 1919 - 2014

Meeting on Medicaid/Medicare Integrated Care canceled; to be rescheduled in the next 3 - 4 months

Snow Donuts

A Public Forum on Integrated Care for people eligible for both Medicaid and Medicare has been cancelled:

Dear Stakeholders,

Due to the current weather conditions and the forecast for the weather to decline tomorrow, MDCH has made the difficult decision to cancel the Integrated Care Implementation Forum scheduled tomorrow, January 28 at the Radisson Plaza Hotel in downtown Kalamazoo.  The safety of attendees is our most important priority.

This forum will be rescheduled within the next 3 to 4 months at the same location.  Watch your e-mail in March for the rescheduled meeting date.

Thank you

Integrated Care Team

Here's why it has been cancelled from wunderground.com: 

Monday

Times of sun and clouds. Highs in the mid single digits and lows -8 to -12F.

Tuesday Partly cloudy skies. High 2F. Winds WSW at 10 to 20 mph.

CMS publishes new rules for Medicaid-funded Home and Community Based Services

CMS, (The Centers for Medicare and Medicaid Services), the federal agency that regulates Medicaid, has published final rules on Home and Community Based Services (HCBS). The rules affecting people with developmental disabilities and the settings that may be eligible for continued HCBS funding remain controversial, but they are better than the rules proposed back in 2012.  Much of the responsibility for defining "community" settings that are eligible for funding Home and Community Based Services has been shifted back to the states, but they will require the approval by CMS of amendments to state plans.

We will all need to pay attention to Michigan's plans to implement the new CMS rules and make sure that everyone who wishes to have a say in how the State approaches new requirements is informed and ready to respond.

This is from the Michigan Department of Community Health:

CMS has placed links to several important items regarding the new rule defining HCBS settings at http://www.medicaid.gov/hcbs, including:

·         The text of the Final Rule
·         An Information Bulletin on the Final Rule
·         A press release announcing the Final Rule
·         Four factsheets:
o   An overview of the regulation
o   Changes to 1915 (c)
o   Changes to 1915 (i)
o   Summary of Key Provisions

The site also announces the dates and times of two Webinars open to the general public:
 

• January 23, 2014: 1:00pm - 3:00pm  Public Webinar on HCBS Final Rule
• January 30, 2014: 1:00pm - 3:00pm  (repeat) Public Webinar on HCBS Final Rule

Thank you,

Lori Mitchell
Community Practices and Innovations Section Secretary
Division of Quality Management & Planning
Bureau of Community Based Services
Department of Community Health
Lewis Cass Building, 5th Floor
Lansing, MI 48913
Telephone: (517) 335-3032
Fax: (517) 241-2969
Email: MitchellL10@michigan.gov

Public Forum on Integrated Care for people eligible for both Medicaid and Medicare

This is a notice from the Michigan Department of Community Health about a public forum on the integration of care for people eligible for both Medicaid and Medicare. The state is implementing a plan approved by the federal Centers for Medicare and Medicaid Services. As far as I know, the details of the plan have not changed much from the plan described here. The plan would cover mental health services as well as medical care. It has an opt-out provision for beneficiaries who do not wish to participate. The plan is being implemented in a limited number of regions in the state that does not include the four counties in southeast Michigan - Washtenaw, Lenawee, Livingston, and Munroe Counties.

****************************************

Dear Stakeholder:

The Michigan Department of Community Health (MDCH) will be hosting a public forum on the state’s plan to integrate care for individuals who are dually eligible for Medicare and Medicaid on January 28, 2014 at the Radisson Plaza Hotel and Suites, located at 100 W. Michigan Avenue in Kalamazoo.  The forum will be held in the Arcadia Ballroom located on the main level from 10:00 a.m. to 12:00 noon EST.

MDCH is providing a conference line for interested stakeholders to participate by phone.  The conference line information is also posted on the Integrated Care website.

Call-in number: 888-363-4734
Access number: 4162210

There are 250 lines available on a first come first served basis.  We encourage organizations to listen in groups in order to maximize lines available for others.  If you get a message stating “Please try your call again later”, all lines are full.
  
Prior to the forum, the presentation will be available on the Integrated Care website which can be found at the following web address: http://www.michigan.gov/mdch/0,4612,7-132-2939__2939__2939-259203--,00.html

A local map to the Radisson Plaza Hotel and Suites can be found here: http://www.radisson.com/kalamazoo-hotel-mi-49007/mikalama/area/map

The address for personal GPS and online mapping systems is:

100 W. Michigan Avenue, Kalamazoo, MI 49007

Parking is available in the hotel’s attached parking garage. Green parking passes will be available at the forum registration table to cover the cost of parking for participants.  When leaving the parking garage, enter your parking ticket into the machine followed by the green parking pass to avoid a parking fee.

Complimentary valet parking is available to those utilizing wheelchairs or with accessibility/mobility issues.

For interpreting services, or other accommodations at the forum, contact the Integrated Care Division at 517-241-4293.
 

Schoolgirl Signs Christmas Songs for Deaf Parents

Kansas poised to turn over DD services to for-profit health plans

This is from an article in Kaiser Health News posted on 12/5/13 called  "In Kansas, A Fight Over Developmentally Disabled Shifting To Medicaid Managed Care" by Jenni Bergal. According to the article, Kansas is poised to hand over all home and community-based services for 8,500 people with developmental disabilities to three for-profit Medicaid managed health plans on January 1, 2014:

"…What concerns families and advocates the most is that the three for-profit national insurance companies that run KanCare [the program through which the State of Kansas administers Medicaid] will be responsible for a statewide program that they’ve never managed in Kansas or elsewhere. They’re also worried that the need to make a profit ultimately will destroy a system families and advocates think works well.

"While Kansas will become the first state to make such a leap, it is being watched closely elsewhere, as at least two other states – Louisiana and New Hampshire – are considering moving in the same direction.

“'This is an unprecedented model. No state has ever taken a developmental disability population and placed it in an arrangement like this, with an out-of-state managed care system, all at once,' said Rocky Nichols, executive director of the Disability Rights Center of Kansas, a legal advocacy group. 'It’s almost like throwing everyone into the deep end of the pool.'"
 
Families believe the current system is working well and wonder why the state would take such risks with their DD family members:

"In Kansas, where a network of community-based nonprofit organizations and county agencies oversee these services, individuals can choose a case manager, who visits them at home and coordinates their care. In some cases, those relationships go back decades. While these organizations will continue to determine what services clients are eligible for and case managers will work with families to arrange that care, ultimately the health plans will be responsible.

“'There is a great deal of fear in the community that these big private health plans don’t know much about this population,' said Maureen Fitzgerald, disability rights director for The Arc, a national advocacy organization for the developmentally disabled. 'These are such vulnerable people. Mistakes that are just inconvenient to some can be devastating to them. If the home care person doesn’t show up, you could be lying in your bed all day. It’s kind of scary.'

"Only a handful of states, including Michigan and Vermont, have moved the developmentally disabled into managed care for long-term services. They’ve mostly relied on existing networks of community-based nonprofits or county agencies or have made themselves the managed care organization. None has turned exclusively to national managed care companies."

The health plans currently manage the medical care for people with developmental disabilities, but not the non-medical care and social services that so many rely on.

The article continues:

"[Governor] Brownback, a Republican, has said that KanCare will improve care coordination and reduce growth in Medicaid spending for the state and federal government by $1 billion over five years.

"Although the frail elderly, physically disabled and mentally ill are now getting long-term services through KanCare, inclusion of the developmentally disabled was delayed until 2014 by the legislature following bitter protests from parents, advocates and providers. Lawmakers wouldn’t yield again, even as more than 1,000 people rallied outside the Capitol in Topeka in May, many wearing red T-shirts that read: 'Not Worth the Gamble.'"

The state says that nervous providers have gotten families unnecessarily riled up about the plan, and has assured them that services won't be cut. 

"…But many are skeptical. They fear that the managed care companies will seek to boost profits by reducing services or driving some small providers out of business because of payment delays or denials. The companies say these concerns are unfounded and insist that services will be maintained and providers paid promptly."

This is certainly a situation that warrants watching. Kansas is going to turn over the management of home and community-based services for people with developmental disabilities to for-profit health plans that have no experience serving this population but are very good at making money. What could possibly go wrong?

Kaiser Health News (KHN) is a nonprofit news organization committed to in-depth coverage of health care policy and politics.

Poem for a Lucky cat

Lucky and Grandpa

My 15-year-old cat Lucky had to be put to sleep today. She was a fine old cat and a constant, if needy, friend. This is an ancient Irish poem written by a 9th century Irish monk about his cat. Lucky was just like Pangur Ban except Lucky was a "she" and not a "he", she was not Irish although she had the luck of the Irish, and she did not chase mice but had a preference for chipmunks. I am not a monk and I am too tired to sit all night hunting words. But I like the poem, especially the line "In our arts we find our bliss, I have mine, and he has his."

Pangur Ban

I and Pangur Ban, my cat,
'Tis a like task we are at;
Hunting mice is his delight,
Hunting words I sit all night.

Better far than praise of men
'Tis to sit with book and pen;
Pangur bears me no ill will;
He, too, plies his simple skill.

'Tis a merry thing to see
At our task how glad are we,
When at home we sit and find
Entertainment to our mind.

Oftentimes a mouse will stray
Into the hero Pangur's way;
Oftentimes my keen thought set
Takes a meaning in its net.

'Gainst the wall he sets his eye
Full and fierce and sharp and sly;
'Gainst the wall of knowledge I
All my little wisdom try.

When a mouse darts from its den.
O how glad is Pangur then!
O what gladness do I prove
When I solve the doubts I love!

So in peace our tasks we ply,
Pangur Ban, my cat and I;
In our arts we find our bliss,
I have mine, and he has his.

Practice every day has made
Pangur perfect in his trade ;
I get wisdom day and night,
Turning Darkness into light.'

Lucy the dog and Lucky the cat: BFFs