Fw: REMINDER: LAKESHORE REGIONAL ENTITY BOARD MEETING ON THURSDAY, SEPTEMBER 20, 2018 AT 1 PM AT 3310 EAGLE PARK IN GRAND RAPIDS

[Tom Bird]

Note that a Medicaid recipient is entitled to services "appropriate to their needs", not subject to available (or reduced) budgeting. It is the CMH's responsibility to provide all of those appropriate services. It is the state's responsibility to provide adequate funding. The Regional Entity is the intermediary in this process, possessing the contract for providing eligible Medicaid services through it's provider network and CMH agencies. If the Region does not have adequate funding, then it must press the state to allocate more funds for these needed (required) services. Oversight of individual CMH agency funding and the region's budget is a critical component of its mandate. You have an opportunity to speak to this process at the meeting. Encourage the prohibition of "rationing" in any shape or form. "Utilization management" can just be a buzzword for rationing, and is what the medical insurance business uses to limit their financial exposure.  The more they restrict or make difficult to access, the better their bottom line. If a service is appropriate and needed, is Medicaid allowable and requested via the PCP, then insist on its delivery, or challenge any such failure to provide it via the Medicaid Fair Hearing process. Demand what is your entitlement. It's their job to figure out how the provide it.

Tom Bird

cell-616.2041683

----- Forwarded Message -----

From: Marianne Huff <marian...@sbcglobal.net>

To: Marianne Huff <marian...@sbcglobal.net>

Sent: Wednesday, September 19, 2018, 8:08:34 PM EDT

Subject: REMINDER: LAKESHORE REGIONAL ENTITY BOARD MEETING ON THURSDAY, SEPTEMBER 20, 2018 AT 1 PM AT 3310 EAGLE PARK IN GRAND RAPIDS

Greetings and Good Evening:

Hoping that this email communication finds you doing well!  

This email is a reminder that the Lakeshore Regional Entity Board meeting is being held tomorrow, Thursday, September 20, 2018 at the Network180 Administrative offices located at 3310 Eagle Park in Grand Rapids.  It begins at 1:00 PM and I encourage those who can attend, to come!  Since the Lakeshore Regional Entity is a PUBLIC BODY, it is subject to a "sunshine law" known as the "Open Meetings Act".  This means that you can "LET YOUR VOICE BE HEARD" with regard to issues/concerns that you might have about publicly-funded community mental health services in the Lakeshore Region.  

I encourage those of you who have loved ones who receive services in the Lakeshore region, especially those who live in Kent County, to attend.   The Network180 Budget Hearing was quite interesting on Monday, September 17 and there were about eight members of the community who provided public comment.  However, the Network180 Board chose to spend more time discussing whether or not to support the legalization of Marijuana than it did providing feedback to community members who gave public comment about the mental health budget.  This was unfortunate and although one of those who provided public comment raised the concern that the Network180 board did not follow its agenda, there was only feedback from one of the board members, Commissioner Jim Talen.  Commissioner Talen seemed to be genuinely interested in some of the concerns that were raised about the emphasis that Network180 is placing on "utilization management".  "Utilization Management" was an issue that was raised as an issue by at least three of the individuals who provided public comment at the meeting.   

The talking points for the LRE Board tomorrow are the same talking points that were raised at the Network180 budget hearing.  Recall that the LRE is responsible for giving Network180 its Medicaid dollars and is also responsible for monitoring the way in which those Medicaid dollars are being spent by Network180.  

The Network180 budget recommendations were part of a letter that was sent by a group of parents, advocates and providers who live and work in the Lakeshore Region.  Each of the budget points below was addressed by the letter.  The Network180 CEO stated that he will be providing a written response to each of the individuals who made public comment on Monday. 

Here are key items that you may wish to review regarding the budget recommendations:

1.   Network180 is seeking to reduce its expenditures for fiscal year '18 and is planning to reduce reimbursement to providers. If you review page 2 of the budget documents, you will note that the requested budget for fiscal year 18/19 for provider network service costs is $114,045,746.  For this current fiscal year of 2017, the provider network services costs are $128,107,867, which is the annual "projection".  If this is accurate, then Network180 plans on reducing provider network service costs by approximately $14 million dollars.  If that is accurate, then it means that either services to consumers are going to be reduced in the individual plans of services (PCPS) OR network providers are going to be sustaining a reduction in rates of reimbursement, which could be devastating.    

From Page 1 of the budget detail, it states:  

Provider network services - 10.9% decrease from projected 2018 to 2019 budget request Network180 has reviewed service trends and determined there are several areas that should be reviewed for medical appropriateness. This process is known as utilization management. These services include, but are not limited to: home-based services, community living supports and personal care in specialized residential homes, skill building, supported employment, inpatient, and community living supports in independent settings.

Projections for FY 2019 local revenue include using the 2019 liquor tax allocation of $1.8M. Network180 has not historically used the entire year's allocation in the year it is received, but because projected Medicaid and Healthy Michigan revenue decreases, in addition to limited risk reserves available for 2018 at the LRE, the entire amount was projected to be recognized and expended in FY 2019.
General fund dollars were increased in fiscal year 2019 by approximately $500,000 due to the roll out of the State's new General Fund allocation methodology. Budgeted revenue has been published by the State of Michigan and is final.

2.  Network180 is giving its employees a 2% increase in wages and on page 4 states:  "Direct run services-- 31.6% increase from projected 2018 to 2019 budget request".  This seems to mean that Network180 will be providing certain services itself as opposed to contracting out those services.   Direct run services also indicates on page 5 that the number of full time employees will increase by 9.20 staff for the next fiscal year.  Direct run services have increased by about $2 million dollars for FY 18/19. See page 2 for the detail.

3.  Network180 currently spends $242,000 for its new administration building located at Eagle Park.

4.  Network180 spends 10% of its revenue on administrative costs.

5. The Network180 CEO report for the September, 2018 board meeting reads as follows:

Utilization Management Initiatives
Management continues to take an aggressive track on Utilization Management initiatives. We
should be realizing an entire year’s impact on Home Based Services, Specialized Residential,
and Skill Building Programs. We will update the Board periodically throughout the year. A
brief update on UM initiatives will be presented at the September Board Meeting.

The LRE Board Agenda is attached to this email.  It is noted that there is no discussion of the LRE/Beacon Health Options contract on the agenda.  The LRE Board Agenda is attached to this email.  You may wish to read the September 12, 2018 Executive Committee meeting minutes from the LRE Board.  Those are also attached to this email.  For more information, visit the LRE web site:  http://www.lsre.org/board-packet

NOTE:  For those of you who are new, the Lakeshore Region includes:  Allegan County Community Mental Health Services; Network180 (Kent County CMH); HealthWest (Muskegon CMH); CMH of Ottawa County and West Michigan Community Mental Health Services (Lake, Mason and Oceana Counties).  

If you have questions, please let me know. I hope to see as many as possible at the meeting tomorrow!

Be well.

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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If you want to change the world, pick up your pen and write.

  

- Martin Luther

   
   

 "For we know that all things work together for good for those who love God,  who are called according to His purpose."  Romans 8:28

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