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News & Press: Legislation/Policy

NASW Writes Letter to Conferees Re: DHHS Budget

Wednesday, June 21, 2017   (0 Comments)
Posted by: Manny Karakitsos
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June 1, 2017

 

Re: DHHS Budget, Section 298

 

Dear Conferees,

 

On behalf of the NASW-Michigan Chapter and the 24,000+ social workers in Michigan, I am writing to express grave concerns about the proposed amendments to boilerplate section 298 and the addition of section 234 in the Senate version of the FY 18 budget. Social workers provide more than 60 percent of behavioral health services; we understand the needs of our clients and have a tremendous stake in ensuring that services are provided in a way which best serves their needs.

 

We concur with the measured approach of using PIHP or CMH run pilots to help guide future decisions on the improvement of behavioral health care delivery. Through the 298 Workgroup and its subsequent public input process, the 298 report to the legislature accurately reflected the voices of vulnerable people in the state of Michigan and its recommendations should be followed.

 

Social workers are often the conduits for successful care among multiple systems. As such, we can effectively integrate services in the current behavioral health system. When there is a shift in these systems, consumers frequently receive substandard care including provider inconsistency, long wait lists, and less freedom in their healthcare choices, thus putting recipient rights at stake. Within the current pilot programs, 60 percent of consumers have opted out, leading to concerns about the success of full MHP integration or their ability to run a successful pilot. We recommend further evaluation and believe that communication with those affected by this bill is critical.

 

As licensed professionals, we recognize the needs of our clients and strive to provide cost-effective and quality care. We cannot argue that the current system has too many administrative layers with the current PIHP design. However, handing the system over to MHPs does not guarantee less administrative burden; the profit motive alone will eat up much-needed service dollars. Additionally, depending on how it is constructed, reducing the number of PIHPs to a single entity could also set the stage for an MHP takeover, so further caution is warranted.

 

We firmly believe that the care of vulnerable people should be as closely controlled by the public as possible - both at an administrative and service level. This belief is echoed by the 298 workgroup report. Publicly controlled systems have a better track record for protecting recipient rights. If MHPs take over, who will a parent call if their developmentally disabled child is not getting the care they are entitled to?

 

MHPs have a poor track record serving people with mild to moderate mental health needs. This population under-utilizes the 20 outpatient visit benefit (on average only 4 visits are used), is physically sicker than the general population, and when they do seek treatment they are often met with long waiting periods or no providers at all (reimbursement rates are too low). Additionally, according to DHHS, only 10% of the billed services for outpatient mental health visits were with an actual mental health professional. This is extremely alarming.

 

The National Association of Social Workers is certainly in agreement with the effort to find ways to improve the system. Many improvements to health outcomes can be achieved by better coordinating care and addressing the social determinants of health. This is the work we do as social workers. It is not clear at this time what the path forward should be. It is not clear how we incentivize both systems to coordinate care without cost shifting. It is not clear that the proposed shift to MHPs will benefit the patients. That is why we need to take it slow and pilot test first - on a voluntary enrollment basis - so that we can help guide this important decision.

 

I appreciate you taking the time to read the concerns of our members, which very much reflect the concerns of our clients. If you should have any questions or would like to seek our input, please contact me at 517-487-1548 ex. 11 or by email at policy@nasw-michigan.org.

 

Sincerely,

 

 

Allan Wachendorfer, LMSW

Director of Public Policy

National Association of Social Workers – Michigan 


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