Fw: Update regarding Network180 budget and the Lakeshore Regional Entity Budget

[Tom Bird]

Sent from Yahoo Mail for iPad

Begin forwarded message:

On Sunday, September 30, 2018, 9:36 PM, Marianne Huff <marian...@sbcglobal.net> wrote:

 Sunday, September 30, 2018

Greetings and Good Evening:

This communication is intended to update all of you with regard to the Network180 budget for the next fiscal year, which begins tomorrow, October 1, 2018. It is also intended to provide an update regarding the current financial challenges that the Lakeshore Regional Entity may be experiencing as it navigates an unexpected Medicaid deficit.  This email will begin with brief points about the Network180 budget and will then provide a few points about the Lakeshore Regional Entity budget. 

Network180 held its budget approval board meeting on Monday, September 24, 2018.  The board ultimately voted to adopt the budget for fiscal year 18-19 that includes an almost 10% reduction in provider network costs.  This will, in turn, mean that Network180 will either reduce the rates that are paid to network providers OR it will, through the "utilization management process", systematically review the person-centered plans of persons served and it will reduce services to impact the line item.    If you would like to hear about this from Bill Riley, Network180's acting CEO, here is an article that appeared on MLIVE on September 25, 2018:

https://www.mlive.com/news/grand-rapids/index.ssf/2018/09/network_180_spending_10_millio.html    

I encourage you to read the article because it makes it sound "like" Network180 has been providing services that have not been deemed to be "medically necessary" which is problematic for many reasons.  

Network180 amended its current budget (fy17-18) at the meeting on September 24 and requested that the Network180 board approve the addition of $13, 296, 045 into the current budget so that it would be balanced.  $12, 796, 045 was added into the provider network service costs line item.  When asked by the public, "where did the extra money come from", the response was that the extra dollars will actually be felt "upstream" at the Lakeshore Regional Entity. The "LRE" is the health plan that is responsible for making the community mental health services providers "whole" at the end of the year.   I have attached the budget documents that were provided at the Network180 board meeting.  

To make it easier to "read", here are the definitions:  Traditional Medicaid or Medicaid refers to the dollars that pay for what are called the "B/B3/Hab Support Waiver" services.  You will know these services by names such as community living supports; supports coordination; respite; skill building and/or out of home non-vocational; supported employment; psychiatric care; and other services.  The term 1915 B/B3 or C refers to a section of the Social Security Act that was amended when the Medicaid program was created in 1965.  Healthy Michigan was added in 2014 when Michigan adopted Medicaid Expansion and the Autism Benefit came about because of a Federal Lawsuit.  What you will note, however, is that Network180 amended its budget for this year that just ended and it increased by over $13 million dollars. However, the budget that was adopted for the new fiscal year, 18-19, is $148, 223, 007, which means that there will have to be reductions in expenditures but, when asked "how" Network180 is going to accomplish those reductions, a clear answer was not provided.  

However, the LRE was not anticipating the extra expenditures/costs and, at the September 20 meeting of the LRE, the board expressed "concern" and some degree of "alarm" about the projected deficit for the end of the current fiscal year which, ironically, ends today.  The Board Chair of the LRE is also a member of the Network180 board and he made it clear that the problems with the Network180 budget and with other CMHSP budgets (he did not name the CMHSPS individually, although CMH of Ottawa County has a projected Medicaid deficit of about 1 million dollars across the Medicaid "buckets") are going to negatively impact the LRE.  There was a comment that the 'LRE was not ready for an additional 2.4 million dollar deficit.'  The LRE "Bucket Report" is also attached to this email. 

For those of you who have loved ones or children in the public mental health system in the Lakeshore region or who receive services, it is going to be important that you remain vigilant and that you understand your rights to "due process". It is also critical for you to understand the importance of person-centered planning.  The CMHSPS cannot arbitrarily decide to reduce or terminate services, although I am aware that it happens frequently although it is not technically not supposed to.  

Being aware, being vocal and attending board meetings of the CMHSPS and/or of the LRE is critical.  

Finally, it has been reported that at least 2-3 other regional entities or PIHPS, like the LRE, are struggling financially.  There are many ways that this can be interpreted including a concern that the system may be underfunded and is not able to "do" what it is intended to "do".  

If you have questions, please let me know.

Marianne Huff

Marianne Huff, CEO/Founder

Person-Centered Advocacy Services, LLC

Person-Centered Counseling Services, LLC

Business phone:  616-848-7630

Cell phone:  313-641-1109

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