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Health Care Reform In New York State:

Taking Our Seat at the Table. Health Care Reform In New York State:. Amy Colesante, Executive Director Mental Health Empowerment Project, Inc.

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Health Care Reform In New York State:

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  1. Taking Our Seat at the Table Health Care ReformIn New York State: Amy Colesante, Executive Director Mental Health Empowerment Project, Inc.

  2. The Mental Health Empowerment Project, Inc. (MHEP) is a “peer run,” not-for-profit corporation organized in 1988 to develop and strengthen self-help and mutual support & recovery activities throughout the United States. • Training & Skill Building • Community Organizing • “Creating a Trauma Informed Community Project” • Direct Peer Support Services

  3. January 2011 – Uncertain Future • “Cuomo… to consider major cut to NY Healthcare…” • “Tough realities ahead..” • “Act now, before it’s to late..” • “Medicaid Reform…have your voice heard!” • “Medicaid & Peer Services, the wave of the future.”

  4. Developed Materials that outlined official positions on issues like: • Medicaid and Peer Services • Behavioral Health Organizations & Peer Services • Health Homes and Peer Services • Accreditation of Peer Run Organizations • Forced Treatment Developing the Coalition as a Political Force

  5. Statewide & Local Relationship Building • New York State Government Offices • Department of Health • Office of Mental Health • Office of Alcohol and Substance Abuse Services • New York State Legislators • Senate & Assembly Mental Health Subcommittees • Key Stakeholders • Coalitions with Similar Agendas • Members & Leads of the Medicaid Redesign Team

  6. The Medicaid Redesign Team Creates an Increased Demand for Peer Services New York State’s Medicaid Redesign Team (MRT) highlighted efforts to “promote acknowledgement and respect for the unique contributions and value of Peers in delivering services that help people, promote wellness and decrease costs.” The MRT also urged new systems to “incorporate peer services into health homes as a required element in health home applications, given the recognition that peer services are evidence-based practices which can improve outcomes while being cost effective.”

  7. New York State Department of Health Convenes a Peer Run Services • Work Group • Recommendation # 1 • Promote acknowledgement and respect for the unique contributions and value of Peers in delivering services that help people, promote wellness and decrease costs.

  8. New York State Department of Health Convenes a Peer Run Services Work Group • Recommendation # 2 • Facilitate ways to accommodate Medicaid funding for peer services, such as waivers, grants and funding for programs rather than for the position itself.

  9. New York State Department of Health Convenes a Peer Run Services Work Group • Recommendation #3 • Establish an accreditation process for peer-run agencies which would professionalize their activities and require that supervision be provided by a trained peer to preserve the unique, whole health/wellness approach that peers provide.

  10. New York State Department of Health Convenes a Peer Run Services Work Group • Recommendation # 4 • Incorporate peer services into health homes as a required element in health home applications, given the recognition that peer services are evidence-based practices which can improve outcomes while being cost effective.

  11. New York State Department of Health Convenes a Peer Run Services Work Group • Recommendation # 5 • Address children and their care separately.

  12. MRT Final Recommendations • Peer services are incorporated into the new behavioral health specialty managed care system. • To the extent possible, Medicaid funding will be sought for peer services through waivers, grants, and program funding. • Advance and improve the peer workforce through funding for training and education, certification, and leadership development, as well as through the establishment of an accreditation process for peer-run agencies. • Peer services will be incorporated into Health Homes

  13. The Next Hurdle--- Peer Run Services and Managed Care Why the anxiety? • Can we remain advocates despite being a part of a MC network? • Is there research we can point to that supports the benefit of services we have to offer? • Do we have enough administrative staff and experience to handle the paperwork and billing? • Is the opportunity to influence them worth the risk of cooptation?

  14. Table of Contents • Principles of Peer Support • Qualities of Authentic Peer Run Services • Peer Run Service Models • Outcomes & Cost Savings • “Critical Components of Peer Run Services” Chart • Available at WWW.MHEPINC.ORG • Phone 518/434-1393

  15. Next Steps • Focus on building an evidence base for our services, collectively and individually. • Build alliances that will allow us to shape the future of peer run services. • Influence managed care companies through education & MC contracts. • Become central to discussions around accreditation of peer run organizations. • Shape the future of the “peer specialist certification” question.

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