Health chief nick lyon_ i was responsible for budget language to shift mental health funding – crain’s detroit business

Embattled Director Nick Lyon of the Michigan Department of Health and Human Services faced behavioral health leaders Tuesday and acknowledged he was the one who made the decision to insert controversial language that would have privatized mental health funding into Gov. Gas vs diesel cars Rick Snyder’s 2017 proposed budget earlier this year.

The budget language, known as Section 298, called for the privatization of the $2.4 billion public mental health system under the management of managed care organizations that would contract with the state, ignited a firestorm of opposition among mental health officials, advocates, providers and families of the affected 300,000 patients and clients.

While replaced this summer with more inclusive wording that requires the Department of Health and Human Services to issue a report with recommendations to the state Legislature in January on how to improve integration between the parallel physical and behavioral health systems, the Section 298 process created a rift and air of distrust and uncertainty between mental health officials and state government.

In a wide-ranging interview at the annual meeting of the Michigan Association of Mental Health Boards earlier this week with Director Robert Sheehan, Lyon also answered questions about the Flint water crisis, the 2014 merger of two departments that created 14,000-employee MDHHS and two federal demonstration projects that seek to integrate mental and physical health.

But it was Lyon’s explanation of Section 298 that left the room full of 800 directors, managers, nurses and staff in stunned silence at the Grand Traverse Resort for part of the talk, especially when he seemed to praise and defend Medicaid HMOs while not mentioning the state’s 10 prepaid inpatient health plans, which currently manage the bulk of the state’s Medicaid mental health dollars.

Lyon opened his remarks by saying he didn’t want to rehash the history of Section 298. M gasbuddy He said he felt the time was right to propose the idea that would allow Medicaid HMOs to become more involved in coordinating physical and behavioral health services.

“For years we have talked about removing the stigma of mental health,” he said. Electricity voltage in china “I felt now was a great opportunity to move health care forward.”

“(Former) Director Jim Haveman noted before (he retired in 2014) that integration was important and something we need to look at,” said Lyon, who was Haveman’s deputy director at the time. Q gas station cleveland ohio “I had talked with many (mental health executives) that we need to improve integration.”

“I made the recommendation. Wd gaster theme Integration and improving services is very important to the governor,” Lyon said. Electricity vocabulary words “Anything we can do to maximize services and better coordinate care is important to him and me.”

“The discussion forced me to step back,” he said, especially after Lt. Gas relief while pregnant Gov. Gasbuddy app Brian Calley intervened in February and “called a timeout on the process” and the creation of the multi-stakeholder Section 298 Workgroup.

In the Thursday interview, Lyon said he would have done two things differently after deciding to insert the boilerplate language in the budget.

First, he would have told more people in the mental health field what was coming in the governor’s budget so they wouldn’t have been as surprised. Electricity symbols worksheet Secondly, he would have worded the boilerplate to emphasize a planning process should begin to improve integration of behavioral and physical health.

“It would have been less prescriptive and more about here is the potential for a solution,” Lyon said. Kansas gas service bill pay “Then I would have asked for input into that process.”

But Lyon told Sheehan that his overarching intention for including Section 298 in the budget was to “start a discussion on how to move mental health on par with physical health” and “how we could best maximize dollars going to providers.”

At the heart of the controversy is $2.4 billion in Medicaid funding that currently is dispersed to behavioral, mental and substance abuse providers through the 10 regional and nonprofit prepaid inpatient health plans.

Medicaid health plans, seven of which are for-profit HMOs, want to take responsibility of the funding stream to integrate physical and mental health care. La gasolina daddy yankee mp3 Opponents, who include mental health executives, providers and families, believe the current system can be improved to integrate care, expand services and become more transparent to clients and their families.

A so-called Stakeholder Section 298 Workgroup, which included more than 120 participants, spent three months earlier this year developing policy recommendations for the Legislature. Electricity around the world The workgroup’s report was completed in July and turned over to MDHHS, which is developing the final report with ongoing stakeholder input.

One of the key recommendations approved overwhelmingly by the workgroup is that Medicaid behavioral health funding would continue to be managed by the public mental health system.

However, going forward, advocates for improving the existing public mental health are concerned that Medicaid HMO influence and a longstanding desire by Snyder and others within his administration to privatize government services will overshadow key recommendations by the workgroup.

Lyon acknowledged the undercurrent of distrust when he told the audience: “There is consternation and fear that a back-room deal” is in the works. Electricity history in india He suggested indirectly that a deal hasn’t been cut. Gasoline p But he did seem to imply major changes are ahead for the public mental health system.

“We have an opportunity,” he said, “to transform the system, but it will not be done overnight. Electricity merit badge worksheet … U gas hampton To be successful, we need to move forward together.”

While the draft legislative report was supposed to have been completed by mid-October to circulate among stakeholders, Lyon said the draft report will be ready by mid-November.

In the interview Thursday, Lyon said he doesn’t know yet if the report will contain specific policy recommendations that the Legislature can act on or if will simply contain a summary of the various discussions and policy positions of the stakeholders.

“We have to wait until the process is complete,” said Lyon, noting that the payer affinity group will meet for the first time in early November.

Lyon said the three main core values for reforming the mental health system that the original Section 298 Workgroup proposed “are important” and will be used to guide the final legislative report.

“We need to make sure we recognize services go to the (developmentally disabled) or mentally ill,” said Lyon, adding: “We (also) need to recognize the substance abuse side.”

But what seemed to some in the audience to be a defense of the state’s Medicaid managed care organizations and their possible expanded role, Lyon highlighted the growth and success of the industry.

“Let me say a few things that some might not like to hear,” he said. Electricity receiver definition “Our Medicaid HMOs cared for 1.8 million people before Healthy Michigan. Youtube gas laws Another 600,000 have been added” (since April 2014 under Healthy Michigan Medicaid expansion) with some additional behavioral health services provided.

When asked Thursday why he didn’t highlight the contributions the prepaid inpatient health plans have made to managing the $2.4 billion Medicaid behavioral health budget at the MAMHB meeting, Lyon said it wasn’t intentional.

“I do think the PIHPs are doing a good job, but there are issues that need to be addressed, and we are working on them now,” Lyon said. Electricity lab activities “Community mental health agencies are very integral and proven providers. Electricity and magnetism online games They have partnered very well with the health plans.”

Whatever mental health delivery system evolves — led by Medicaid HMOs, the PIHPs or a hybrid approach — Lyon said he favors a “fair system” that takes into consideration the needs of the people and focuses on prevention.

In Thursday’s interview, Lyon said he agreed that Medicaid HMOs should become more involved in managing behavioral health services because integration is important.

He also acknowledged several pilot projects underway in Michigan that is testing how to integrate behavioral and physical health. Gas out game commercial For example, the Medicare-Medicaid dual eligible demonstration program and the state SIM grant that begins next year in five regions.

Under the $70 million Obamacare SIM grant, hospitals, doctors, health plans, social service and mental health agencies will try to improve care coordination to reduce chronic care costs, obesity, depression, infant mortality, high-cost health care users and individuals will multiple chronic diseases.

“We have a lot of great health organizations in Michigan — health plans and PIHPs — and we need to use the affinity group process to come up with the best solution,” Lyon said.