Critical Health Areas Project (CHAP) Newsletter

Integrating Services for Mental Health and Chronic Disease

In January 2005, the state of Washington started a pilot project in Snohomish county for supplemental security income (SSI) or SSI related Medicaid clients who are 21 years of age or older.  It is a voluntary project that can provide care for up to 6,000 participants.  The Washington Medicaid Integration Partnership (WMIP) combines medical, mental health and chemical dependency treatment services.   The goals of the pilot project are to improve health care access and care coordination, improve client satisfaction, improve outcomes and quality of life by focusing on prevention and improving the management of Medicaid expenditures. 

Participants will work with a care coordination team made up of nurse case managers, social workers and care coordination specialists.  The team does an initial health screening and health assessment, develops an issues list and shares the assessment with the primary care provider (PCP).  The PCP and team then develop an initial care plan.  The team coordinates referrals and provides disease management services.

The pilot project was created in the 2003-2005 biennium appropriation to the Department of Social and Health Services (DSHS).  The DSHS plans an evaluation of the project.

Resources:

• WMIP website:  http://fortress.wa.gov/dshs/maa/MIP/
• Evaluation plan for WMIP:  http://fortress.wa.gov/dshs/maa/MIP/files/WMIPEvaluationDesign.pdfhttp:/fortress.wa.gov/dshs/maa/MIP/files/WMIPEvaluationDesign.pdf
• Report on Medicaid cost offsets associated with Mental Health Care:  http://www1.dshs.wa.gov/rda/research/3/28.shtm

Other states with similar integration programs:

State Approaches to Universal Coverage

State health reforms are rarely achieved the first time they are introduced.   The passage of Massachusetts’s landmark reform and legislative successes in Illinois, Maine and Vermont have encouraged other states to step up efforts to expand coverage.  Here are some interesting initiatives under way around the country.  They range from studies conducted at the behest of local health foundations to legislation that has already been considered once and is likely to return with some changes in the next session.  These potential proposals involve a range of strategies, from market reforms to public insurance expansions.

• Wisconsin – Wisconsin has considered three different approaches to health care reform.  Assembly Bill 1140 (to be introduced in January 2007) would provide all Wisconsin resident under 65 with health coverage, unless they have resided in the state for less than 6 months, are institutionalized or are federal employees.  Eligible residents will be able to purchase health insurance using a “Premium Credit,” and will be given a Health Savings Account.  Senate Bill 698 establishes an employer mandate.  This bill would establish the Wisconsin Health Care Partnership Plan and would require employers to contribute a flat rate of $340 per employee per month.  The self-employed would also be able to buy into this plan.  Finally, Senate Bill 388 would establish universal coverage through a public health insurance program. 
• Further details with pros and cons of the three approaches are available online at http://www.greatermadisonchamber.com/documents/Government/Notes_july262006.pdf
• Louisiana – The Louisiana Health Care Redesign Collaborative is seeking to improve access to health care in New Orleans and the surrounding area.  The plan would establish a Health Insurance Connector to determine Medicaid eligibility or to match individuals with an affordable health insurance plan.  All money available to fund coverage, such employer contributions, employee contributions and public funds, would be pooled together in the Connector.  Further details of this plan are available at http://www.dhh.louisiana.gov/offices/news.asp?ID=288&Detail=979
• New Mexico – The Health Coverage for New Mexicans Committee has been charged with providing recommendations to the Governor and the legislature to reduce the number of uninsured in New Mexico. The Committee has selected three models of providing universal health care: the Health Security Act (close to a single payer system), the New Mexico Health Choices (based on government subsidized vouchers), and the Build on the Existing System (a compilation of various universal coverage ideas). Further details of the Committee’s work is available online at http://insurenewmexico.state.nm.us/HCNMC.html or at http://www.hsd.state.nm.us/pdf/HCNMC_Models_Picked_NR.pdf
• North Carolina – In collaboration with the state’s Department of Health and Human Services, the Department of Insurance, the North Carolina Institute of Medicine as well as a number of other organizations, the North Carolina Task Force on Covering the Uninsured developed five policy recommendations for the state’s legislature in April 2006.  The recommendations included expansion of the state’s health care safety net; the promotion of healthy lifestyle strategies, expansion of Medicaid for low-income parents; the development of a subsidized health insurance plan for small employers; and the development of a high risk pool in the state.  While these recommendations were ultimately not adopted by the state legislature, collaborative efforts to develop policy options continue.  Further details on the Task Force’s efforts are available online at http://www.nciom.org/projects/uninsured/uninsuredreport.html

Texas Department of State Health Services Receives National Health Care Technology Award
Texas Department of State Health Services
NEWS RELEASE
October 16, 2006

DSHS Receives National Health Care Technology Award

The Texas Department of State Health Services has received the 2006 Nicholas E. Davies Award of Excellence for its Web-based electronic health record system for substance abuse clients.

The national award, presented annually by the Healthcare Information and Management Systems Society (HIMSS), recognizes health care groups for their use of information technology in the categories of organizational, ambulatory care and public health.

DSHS was recognized in the public health category for its Behavioral Health Integrated Provider System (BHIPS), a comprehensive tool used by counselors for conducting screenings and assessments, building treatment plans, tracking services and client progress, and collecting discharge and follow-up information for those receiving substance abuse treatment.

Since BHIPS was implemented in 2001, DSHS has improved the technology and functionality of the system, adding electronic guidelines to more accurately place clients in the right level of care. These improvements have produced better outcomes, DSHS officials say.  The system uses a security encryption tool to protect patient information.

The data collected by the system is used to identify substance abuse trends and training needs to improve specific programs.  The system also automatically ties treatment and cost information together to allow for demographic cost analysis.  DSHS officials say the system’s Web-based approach allows for better quality control and management online.

Since 2001, the system has documented 300,000 patients. Approximately 2,000 counselors and staff members across the state use the system.

The award program is named after Dr. Nicholas E. Davies, a physician who believed that computer-based patient records were needed to improve patient care.

Kentucky Program Looks to Aid Substance-Abusing Parents