2.9 Lisa Stand


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2.9 Lisa Stand

  1. 1. Services in PSH: Medicaid Makes a Difference Lisa Stand July 13, 2011
  2. 2. Medicaid Essentials - Today <ul><li>Medicaid populations – Children and parents, pregnant women, elderly, people with disabilities , other adults as states permit </li></ul><ul><li>Federal matching funds – specific state formula </li></ul><ul><li>State flexibility – coverage, reimbursement, eligibility </li></ul><ul><li>70% of Medicaid enrollees, around 36 million nationally are in managed care </li></ul>
  3. 3. Medicaid Essentials - Today <ul><li>Health care services and long-term supports </li></ul><ul><li>Primary care, acute care, Rx, prevention & screening, rehab, mental/behavioral health </li></ul><ul><li>In-home attendant care, case management, care coordination, mobility aids </li></ul><ul><li>Chronic illness management </li></ul>
  4. 4. Medicaid Essentials – High-Risk Adults <ul><li>Essential Health Care (previous slide) </li></ul><ul><li>Case Management/Care Coordination – examples </li></ul><ul><ul><li>Targeted case management </li></ul></ul><ul><ul><li>Psychosocial counseling/support </li></ul></ul><ul><ul><li>Access to benefits & community programming </li></ul></ul><ul><ul><li>Housing referral & move-in assistance </li></ul></ul><ul><ul><li>Habilitation </li></ul></ul>
  5. 5. Medicaid Essentials – High-Risk Adults <ul><li>Behavioral Health – examples </li></ul><ul><li>ACT </li></ul><ul><li>Psychiatric services </li></ul><ul><li>Medication management </li></ul><ul><li>Day treatment </li></ul><ul><li>Rehabilitation services, life skills </li></ul>
  6. 6. Medicaid Value Proposition MACPAC. “Report to the Congress on Medicaid and CHIP.” March 2011. http://www.macpac.gov/reports For more information about Chronic Homelessness policy solutions, find our policy brief at http://www.endhomelessness.org/content/general/detail/2685
  7. 7. The Next Medicaid <ul><li>Essential Health Benefits – Coming in 2014 </li></ul><ul><li>Medicaid for new group: adult citizens up to 133% of federal poverty level </li></ul><ul><li>Basic coverage subject to federal and state definitions, under development </li></ul><ul><li>Mental health coverage is required </li></ul>
  8. 8. The Next Medicaid <ul><li>Delivery System Changes </li></ul><ul><li>More options for states to provide home and community-based services </li></ul><ul><li>Quality improvements in primary care delivery – health homes, care coordination </li></ul>
  9. 9. Implications for Housing Solutions <ul><li>Medicaid Changes – </li></ul><ul><li>New Tools to End Homelessness </li></ul><ul><li>Potential to boost supportive housing as strategy to end homelessness, especially for individuals with multiple co-occurring conditions </li></ul><ul><li>Drivers Wanted: Homelessness advocates are in position to press for changes and shape effective systems to end homelessness </li></ul>
  10. 10. A Homelessness Advocate’s Agenda <ul><li>Step One – Educate – </li></ul><ul><li>Medicaid Makes a Difference (for PSH) </li></ul><ul><li>Possible audiences: </li></ul><ul><ul><li>Housing leaders and community developers </li></ul></ul><ul><ul><li>Healthcare partners (local reform coalitions, nonprofit hospitals, clinics, plans) </li></ul></ul><ul><ul><li>Public agencies (health, housing, social services) </li></ul></ul><ul><ul><li>Safety net advocates and providers </li></ul></ul><ul><ul><li>State legislators </li></ul></ul>
  11. 11. <ul><li>Your Audiences </li></ul><ul><li>Know them </li></ul><ul><li>Add an advocacy voice </li></ul><ul><li>Offer ways to connect </li></ul>Advocate’s Agenda
  12. 12. Advocate’s Agenda <ul><li>Topline Talking Points </li></ul><ul><li>Medicaid helps end homelessness by providing access to primary care and coordinating key services </li></ul><ul><li>PSH + Medicaid can be cost-effective for communities </li></ul><ul><li>Housing and health pieces can fit together to improve lives and make a stronger safety net </li></ul>
  13. 13. Advocate’s Agenda <ul><li>Step Two: How Do the Pieces Fit? </li></ul><ul><li>Start with where you are </li></ul><ul><li>Focus on outcomes for individuals – housing stability, physical health status, long-term supports </li></ul><ul><li>Build more client-centered service processes </li></ul><ul><li>Be realistic about the cost case </li></ul>
  14. 14. Advocate’s Agenda <ul><li>Other Issues for Top-of-Mind </li></ul><ul><li>Enrolling chronically homeless people in Medicaid and other public benefits </li></ul><ul><li>Organizing and delivering services in scattered-site PSH </li></ul><ul><li>Maintaining and increasing state support for PSH services </li></ul>
  15. 15. References & Resources <ul><li>Aligning Homelessness Assistance With Health Care Strategies </li></ul><ul><li>The Alliance, www.endhomelessness.org/section/issues </li></ul><ul><ul><li>Questions? Contact us – [email_address] </li></ul></ul><ul><li>“ Permanent Supportive Housing Voucher Demonstration Evaluation Design Options,” HHS/ASPE, 2011 </li></ul><ul><li>Leveraging Medicaid: A Guide to Using Medicaid Financing in Supportive Housing,” CSH, Inc. and TAC, Inc., 2008 </li></ul>
  16. 16. References & Resources <ul><li>About Medicaid, the ACA & Health Care Reform </li></ul><ul><li>The Kaiser Family Foundation, www.kff.org/medicaid </li></ul><ul><li>National Academy for State Health Policy, www.nashp.org </li></ul><ul><li>Families USA, www.familiesusa.org </li></ul>