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News & Press: Legislation/Policy

NASW-MI Submits Comments About Harmful DHHS Policy

Monday, November 13, 2017  
Posted by: Allan Wachendorfer
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Public Comments RE: 1635-PE Provider Enrollment Fitness Criteria

 

November 13, 2017

 

Margo Sharp

Bureau of Medicaid Policy and Health System Innovation

Medical Services Administration

P.O. Box 30479

Lansing, Michigan 48909-7979

 

Dear Ms. Sharp,

 

I am writing out of serious concern about some of the language included in proposed policy 1635-E Provider Enrollment Fitness Criteria. While I certainly applaud the effort to protect vulnerable citizens – which I believe is the intent of this proposed policy and is extremely important – I am certain that there will be detrimental unintended consequences should this policy be enacted as written.

 

Specifically, sections II.5 and II.6 outline a number of felony and misdemeanor level convictions and a 10 year time frame that would exclude someone from working for Medicaid providers. Unfortunately, these parameters are so broad – much broader than the federal policies already in place – I fear it will unintentionally disqualify hundreds if not thousands of peer specialists, social workers, personal assistants, and other providers with lived experiences that have brought them to their respective professions.

 

For instance, many peer recovery coaches – who work to help people with addiction find recovery – have conviction records. These are people who have done the hard work in their recovery programs, satisfied the terms of the courts, and are now using those lived experience to make a significant impact on others with a similar story.  This shared experience plays a key role in their ability to help that new person find a path to recovery that works for them. This also can be true for social workers, as it’s common that peoples’ lived experiences bring them to helping professions – especially social workers who work in the treatment of addiction.

 

In the treatment field, we know that there is a strong likelihood of a person in recovery having this legal history, so most agencies have developed a strong vetting process to evaluate a person’s fitness for providing services. There are several areas of misdemeanors and felonies that are usually excluded and I feel should NOT be removed from the list that you have established. However, areas such as financial crimes, theft, prostitution, and drug related offenses are seen often in criminal background checks that are run. Furthermore, state licensing boards already screen out potentially dangerous individuals and this policy attempts to duplicate that process.  

 

Additionally, going back 10 years is a long time, and a lot can happen to a person within that time frame (II.1 even includes crimes with no time frame).  In fact, according to a January 2015 report from the Congressional Research Service, the longer a person went without being rearrested, the less likely they were of reoffending. Of those offenders that had gone 4 years without reoffending, only 13% of those folks were re-arrested in the 5th year.  (https://fas.org/sgp/crs/misc/RL34287.pdf)

 

A secondary concern is how the reinstatement section is written.  While it appears to establish some means to allow someone to work as a Medicaid provider, it has the potential to create bottlenecks when trying to get a future candidate approved. No information was provided on who at MDHHS would be making these determinations, what the turnaround time in delivering these decisions might be, or who establishes the standards and accepts the liability for determining someone’s fitness for enrollment/reinstatement in some of these more subjective, non-violent criminal areas.

 

In the face of the Opiate Crisis we find ourselves in Michigan, this would move us in the wrong direction. Considering part of Governor Snyder’s plan to address the opioid crisis includes the “expanded use of peer recovery coaches” this proposal also goes against the Governor’s agenda. The scale of these restrictions would have a devastating blow on our workforce, and more importantly, would create a substantial hardship to the beneficiaries that we are trying to serve. 

 

I want to reiterate that I applaud your efforts to protect our most vulnerable citizens. Yet, this policy may harm the very people it is intended to protect. I am asking that you please reconsider the proposed policy, as written. I’d be happy to speak with you in person about this. You can reach me at 517-487-1548 ex 11 or policy@nasw-michigan.org.

 

Sincerely,

 

 

 

Allan Wachendorfer, LMSW-Macro

Director of Public Policy

National Association of Social Workers - Michigan Chapter

 

741 N. Cedar St.

Lansing, MI 48910

517-487-1548 ex11

 


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