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Effective Partnerships School-Based and School Linked Health Care Michigan Perspective School Community Health Alliance of Michigan.

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Presentation on theme: "Effective Partnerships School-Based and School Linked Health Care Michigan Perspective School Community Health Alliance of Michigan."— Presentation transcript:

1 Effective Partnerships School-Based and School Linked Health Care Michigan Perspective School Community Health Alliance of Michigan

2 Partnering with Health Care Systems Michigan Perspective Hospital Systems Medicaid Managed Care Plans Commercial Payers Medicaid Behavioral Health Plans Local Health Departments FQHCs/Community Health Centers

3 Hospital Systems Michigan Perspective Approximately 1/3 of Michigan’s SBSL Health Centers and Programs are operated by hospital system Provide and/or Contribute Staffing such as nurses, physicians, social workers Medical supplies, equipment, lab services Financial support through hospital foundations, community benefit/health, pediatrics Hospital Benefit: Mission driven care, reduction in costly ER visits, referrals to specialists, etc. Benefit to Center: Liability coverage, access to a range of referral sources, Medical oversight, billing

4 Medicaid and Commercial Carriers Michigan Perspective Michigan SBSL health centers must bill for all services provided There is a carve out for SBSL health centers that requires Medicaid health care plans reimburse for services Medicaid health care plans (8) use a school aged adjuster rate within their rates to work with SBSL health centers around outreach and referral for prevention services for Medicaid and Medicaid eligible children and youth All providers are credentialed and paneled with both Medicaid and Commercial Carriers

5 Behavioral Health Plans Michigan Perspective Majority SBSL health centers provide mental/behavioral health services by a licensed social worker Mental health plans under Medicaid have extensive paneling and oversight requirements - create a barrier to children receiving needed services Negotiated a pilot project that will allow SBSL health centers to enter in to a separate contract with different paneling requirements – Allows for billing to occur GOAL: Successful pilot will allow for active discussion with commercial carriers around licensing requirements and reimbursement for mental health services

6 Local Health Departments and Community Health Centers – Michigan Perspective Approximately 1/3 of SBSL health centers are operated by local health departments and community health centers Each entity can obtain a cost based reimbursement which provides additional reimbursement for services provided to Medicaid and Medicaid eligible patients Local health departments can federally match funds for outreach and referral services for Medicaid and Medicaid eligible youth

7 Engaging Health Care Systems Meet with them!! Understand their funding streams and related requirements if possible Look for ways to collaborate Understand they have both a social and fiscal responsibility Invite them to meetings with others Invite them to the center/program and engage parents, students, school personnel in discussion

8 Partnering with Government Agencies Michigan Perspective State Legislators Department of Community Health Department of Education State Medicaid Office Governor’s Office Congressional Delegation

9 Governing Authorities Michigan Perspective State Legislatures appropriate annually $5 million dollars for SBHC health centers and programs Governor recommended an increase in funding for SBSL health centers in her budget for 08-09 Michigan Congressional Members took lead in putting language in SCHIP and for securing sponsorship for Authorizing Bill

10 How to Engage Governing Authorities Michigan Perspective Invite both state and congressional members to visit a health center/program Meet with the Governor’s Staff and have visit Offer to do any leg work that needs to occur Maintain on-going communications with elected officials staff – no not under estimate Remember: Involve school personnel, students, parents in the meeting and discussion Create a visual image for them to remember the center

11 Partnering with State Agencies Michigan Perspective Department of Community Health Contract to provide TA services to field and centralized billing and reporting service Work jointly to establish guidelines and issues Department of Education Work with them on special projects – Mental Health in Schools Grant Serve as resource for information and support State Medicaid Office Manages federal match on general funds Works with us on reimbursement issues and access to care concerns Serve as worker bee and resource

12 Relationship Building with State Agencies Michigan Perspective Sit down and talk Look for ways to work together Identify solutions and offer to help Act as a worker bee Act as ambassador for their issue perspective Invite them to meet with programs and services that shine and include young people Understand the role they play and the role you play

13 Other Partnerships and Alliances Michigan Perspective School Nurses MI Association of Health Care Plans Mental Health in Schools Coalition Michigan Model Dropout Prevention Coalition Primary Care Association Maternal Child Health Coalition

14 Thanks from the Great Lake State Michigan Debbie Brinson, Executive Director School Community Health Alliance of Michigan 517-908-0847, ext. 229

15 School Health Initiatives Midwestern Regional Conference Effective Partnerships for School-based, School-Linked Health Care: What’s Working in the Midwest July 24, 2008

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