Presentation on theme: "Advocate with Managed Care Companies to Get Recovery Ed Knight, PhD, CPRP Co-Investigator UCLA Health Services Research Center."— Presentation transcript:
Advocate with Managed Care Companies to Get Recovery Ed Knight, PhD, CPRP Co-Investigator UCLA Health Services Research Center
ORGANIZE YOURSELVES THE MOST IMPORTANT ORGANIZING TOOL NOW IS FACEBOOK. START A CLOSED FACEBOOK GROUP TO COORDINATE YOUR ACTIVITIES. START AN OPEN FACEBOOK GROUP TO KEEP UP A CONSTANT COMMENT ON THE RFP PROCESS. Facebook is how Obama got elected. It was central to his strategy. It also is bringing down dictators all over the world.
Pre RPF Describe the program categories you want. Give a very concrete description of what you want. What the peer program will do? The size or number of peers to be served? In what ways? SPECIFY THE NUMBER OF PEER EMPLOYEES AND HOURS AND PAY. This vision can be used to advocate with the state and mcos PUT YOUR VISION ON THE FB GROUP PAGES. Begin with the state, but mcos looking to impress you may also ask these kinds of things be put in rfp.
Pre RFP Use Evidence. Link at www.RecoveryCircles.orgwww.RecoveryCircles.org See Lit Review, Consumer Operated Services, Peer Support, Programs Toolkit A whole lot of scientific studies are summarized there. Also see Professor Eds Research links at www.professored.com scroll down on right hand side of page. About 26 research papers and articles. www.professored.com
Pre RFP MAKE SURE YOU TELL THE STATE VERY CLEARLY THAT THE RPF MUST BE PUBLIC. ALL OF IT. Many times they are not any longer. They are now for bidders only rpfs. IF that is the case there is no way to see if what you advocated for is in the rfp. And YOU LOSE HERE. End of game for what you want.
Pre RFP Demand ALL bidders conferences be OPEN to the PUBLIC. Go to them. Hear what is said or asked by each company. And what the state answers. Closed bidders conferences is where limits begin to be set on recovery or peer services. Not everywhere but…. Make sure NOT in your state.
Pre RFP Managed Care Companies will come to sell in the pre-rfp period. Check EVERYTHING THEY SAY. NO MATTER HOW MUCH YOU THINK YOU KNOW THE PEOPLE THE MCO SENDS. MCOs SEND PEERS TO TALK TO PEERS. PROFESSIONALS TO TALK TO PROFESSIONALS. FAMILY MEMBERS TO TALK TO FAMILY MEMBERS. ASK THE MCO PEER EMPLOYEES TO TELL THEIR RECOVERY STORY. IF THEY HAVE BEEN HOSPITALIZED. IF THEY HAVE EVEN BEEN TREATED OR HAVE A DIAGNOSIS. ASK WHAT THE DIAGNOSIS IS. ASK ESPECIALLY IF YOU HAVE NOT KNOWN THE MCO PEERS FOR A LONG TIME PERSONALLY.
Pre RFP ASK THEM TO TELL YOU HOW THEY THINK RECOVERY HAPPENS. WHAT IS MOST IMPORTANT IN THEIR RECOVERY. IF THEY ARE VAGUE ASK THEM FOR EXAMPLES. WATCH FOR HESITATIONS. ASK THEM THEIR EXPERIENCES IN SETTING UP AND RUNNING PEER SUPPORT GROUPS OR ORGANIZATIONS. MAKE THEM BE VERY SPECIFIC. IF THEY SAY THEY SET UP A PEER ORGANIZATION, ASK FOR A DESCRIPTION. Some will say they have set up a peer organization that turns out to be two peer specialists working in a department of the mco. ASK WAS THE PEER ORGANIZATION INDEPENDENT AND IF NOT WHAT ORGANIZATION IT WAS PART OF. NUMBER OF EMPLOYEES, WHERE IT IS LOCATED. AND HOW YOU CAN CONTACT.
Pre RFP CHECK ANY PROGRAMS ON MCO WEB SITES OR IN LITERATURE. Ask for names, locations addresses, websites, email addresses and phone numbers of all programs mentioned. Ask for number of peer employees IN EACH ORGANIZATION. ASK WHAT THE EMPLOYEES DO. Ask how many are from the Public Medicaid System. HOW MANY HAVE EVER BEEN HOSPITALIZED. THERE ARE NOW MANY PSEUDO PEERS.
PRE RFP Ask for the number of hours each is employed. How much each makes. Are they hourly or salaried. ASK EXACTLY WHAT PEER EMPLOYEES DO. This is just the initial fact finding to see what the mco SALES PEOPLE ARE SAYING. PEERS ARE JUST AS MUCH SALES PEOPLE AS ANYONE ELSE. DO NOT ACCEPT WHAT IS SAID JUST BECAUSE THEY ARE A WELL KNOW PEER.
PRE RFP Now start CALLING each program. DO NOT just talk to the Executive Director. Ask to talk to peer employees. Ask to talk even to peers attending the program. DO NOT JUST TALK TO MCO employees EVEN MCO PEERS EMPLOYEES. YOU MUST CHECK UP ON EVERYTHING THE MCO SALES PERSON SAYS, PEER OR NOT. JOB TITLES ARE IRRELEVANT. ALL MCO EMPLOYEES ARE SALES PEOPLE AND ARE TOLD A COMPANY LINE TO USE. A WHOLE LOT OF TRAINING GOES INTO COMPANY LINE. SELLING POINTS ARE WORKED OUT BEFORE HAND.
Pre RFP If you hear a mission statement or value ask for examples of where it is implemented. I have traveled to states I check for mco peer programs. Sometimes there are none where an mco says there is one.
Pre RFP Operate as a team. Divide up and offer to help write the rpf for different companies. IF YOU ARE NOT HIRED submit ideas anyway. Pick the one you think will WIN not the one you like. Send them original ideas to put in their proposals. Make sure you submit something substantial to ALL bidders.
Pre RFP TELL the state you will read rfp carefully to see if what you want is in it. Ask how to get the rfp. If it is not public you did not do a good advocacy job. If it is not public raise holy hell. Use the internet to make public what your issues are. REMEMBER Start an open Facebook group AT THE BEGINNING and a closed one to communicate.
RFP When the RFP is out. Get the document. Read the program sections. There will be tons of stuff about IT and other things. Check out quality assurance program demands, complaints and grievances. Check to see if what you wanted got in. If not raise holy hell. Use the World Wide Web to do it.
WEB and SEO Skills are NOW BASIC ADVOCACY SKILLS I have developed skills to put up web sites. You can also!!!!!! Do a blog it is the simplest. Like WordPress.com or Blogger or Blog Spot. Do one specifically for the bid process in your state. Choose a name that Google will like NOT one you like. I will post how to do this on my website. The process is free.
SEO SKILLS: A Further Step than Facebook You need to learn SEO. What is SEO? Search Engine Optimization. SEO is the set of skills to end up on the first page of Google and other search engines. Learn how to target a key word to end up on the FIRST PAGE. GOOD SEO SKILLS GET YOU ON PAGE ONE OF A SEARCH ENGINE FREE.
Web and SEO Advocacy Skills SEO is not that difficult. I can consult on it if you like. Go to the book store and look up seo books. I will recommend some seo books soon on my website. www.professored.com.www.professored.com I will post the basic principles of SEO for free on my website. If the RFP is not what you want then set up a site to tell your side. When people search for the mco or rfp or state Medicaid authority your site comes up.
RFP When the rfp is out the MCOs who are going to bid will descend like locusts. Some will spread money around. This does NOT mean the money will be there after the proposal is accepted and contract implemented. If you have done your home work you will have information to check out what they now say. May not be the same as pre rfp.
RPF Bidders Conferences Go to as many bidders conferences as are held. Listen. It will be hard to get in. YOU MUST ADVOCATED FOR THIS before the rfp comes out. Ask the state to notify you when and where they are. GET NOSEY> This public money. IT IS YOURS> Not the states or the mco.
SCORING After the proposals are finished, they will be scored. DEMAND PEERS be one the scoring team. DO NOT MAKE ANY OF YOUR OWN COMMENTS ON THE PROPOSAL OR SCORE CARD. JUST GIVE IT NUMBER RANKING. IF ASKED TO MAKE COMMENTS ABOVE ALL DO NOT MAKE ANY REFERENCES TO A COMPETING COMPANY. YOUR WHOLE SCORING WILL BE THROWN OUT. I HAVE WITNESSED THIS AND LOST CONTRACTS BECAUSE OF THIS.
SEO AND WEB AGAIN Remember if you have SEO skills you can answer back VERY POWERFULLY. OR USE FACEBOOK, THOUGH NOT AS POWERFUL. Use the internet to connect around the state. Bob Whitaker and Will Hall were cancelled and re- instated at last years Alternatives by FaceBook advocacy. Set up an invitation only Facebook group to organize and hash out around the state. Or a google group and list serve. OR yahoo. This is bringing down dictators all over the world.
Awarding of Contract Get the winning proposal immediately. Before it comes out find out how to get it. Exactly what web site. Some states have multiple websites and they are often very hard to navigate. Often without adequate indexes. Demand to know exactly where and how to get the proposal when it is FIRST released. READ IT. GET READY TO RAISE HOLY HELL. USE A SNIPER SITE TO OBJECT IF YOU CAN. Blogs like WordPress.com are FREE.
THE BLACK BOX OF CONTRACTING THE TOTALLY SECRET CONTRACT NEGOTIATIONS COMES NEXT THIS IS WHERE MOST OF THE TIME THE BATTLE IS LOST. THE STATE AND MCO WINNER MEET SECRETLY AND DECIDE WHAT GOES IN THE CONTRACT. HERE IS WHERE MOST RECOVERY, PEER AND FAMILY PROGRAMS DISAPPEAR. AND SO DO WHAT MANY PROVIDERS WANT.
MCOS SAY THAT CONTRACTING MUST BE CLOSED I SAY BULLSHIT. THEY SAY THEIR TRADE SECRETS WILL BE REVEALED. I SAY THE PUBLIC RIGHT TO KNOW OUTWEIGHS ALL ELSE. NO SECRET GOVERNMENT. IT IS UNCONSTITUTIONAL. START ADVOCATING NOW TO OPEN THEM UP. START NOW. LOBBY THE STATE EXECUTIVE AND THE LEGISLATURE AND THE FEDERAL GOVERNMENT TO OPEN UP THESE SECRET NEGOTIATIONS. THIS IS WHERE THE BATTLE IS LOST. AND YOU NEVER KNOW IT.
POST CONTRACTING MAKE THE STATE AND MCO AWARE YOU WILL READ THE COMPLETE CONTRACT AFTER NEGOTIATIONS. AND QUICKLY FIND OUT IF WHAT YOU WANT IS IN THE CONTRACT. THE CONTRACT IS NOT THE SAME AS THE PROPOSAL. NO MATTER WHAT ANYONE SAYS. AGAIN BE PREPARED TO RAISE HOLY HELL AND SET UP SNIPER SITES FOR THE NAME OF THE MCO AND THE TRUTH ABOUT THEIR CONTRACT.
CONTRACTING ALL COMPANIES PUT STUFF IN THEY NEVER INTEND TO DO TO GET YOU TO LIKE THEM STATES OFTEN PUT THINGS IN RFPS THEY NEVER INTEND TO PUT IN CONTRACTS TO GET YOUR BUY IN TO MANAGED CARE IN THE FIRST PLACE. BE PREPARED TO GO TO BATTLE IF RECOVERY IS TOKENIZED OR MEDICALIZED.
NOT DONE YET: IMPLEMENTATION UP FRONT ASK AT THE PRE RFP TIME TO BE PART OF ANY IMPLEMENTATION MANY COMPANIES WILL LIKE THIS. THIS MAY BE A TRICK. YOU MAY NOT SEE THE ACTUAL PROGRAMS PUT UP OR PEOPLE HIRED. YOU NEED FACEBOOK OR ON LINE GROUPS AND LIST SERVES TO CHECK OUT WHAT IS GOING ON. YOU NEED TO COORDINATE ALL OVER THE STATE TO MAKE SURE WHAT YOU ASKED FOR IS ACTUALLY THERE. DO NOT ACCEPT THE MCO WORD FOR IT. PHYSICALLY GO THERE OR HAVE A COLLEGUE GO THERE..
UNFORTUNATELY WE LIVE BY IMAGE IS EVERYTHING. SEE WAS A PEER RESPITE MEDICALIZED. IS THERE ONE 10 HOUR A WEEK PEER IN A PROGRAM CALLED A PEER PROGRAM. CHECK IT OUT. THE MCO MAY SAY A PROGRAM EXISTS AND NEVER PUT IT UP CHECK CHECK CHECK. AGAIN RAISE HOLY HELL. I AM WILLING TO CONSULT ON ANY ISSUE IN HERE AND SHOW YOUR ORGANIZATION HOW TO DO THIS. BY PHONE, EMAIL OR IN PERSON.
ED KNIGHT, PhD CPRP www.professored.com mailto:firstname.lastname@example.org Address Ed Knight POB 921 Colorado Springs, CO, 80911 Lets get image out of recovery. Enough paint. Let substance be the rule. Everything is substance. YOU CANT EAT A PAINTED CAKE.