1 / 13

Peer Support for Substance use Disorders: The Future in Kentucky

Peer Support for Substance use Disorders: The Future in Kentucky. Carol McDaid Capitol Decisions, Inc. October 8, 2013. When are peer recovery support services delivered?. Across the full continuum of the recovery process: Prior to treatment During treatment Doctor’s Office Post treatment

berne
Télécharger la présentation

Peer Support for Substance use Disorders: The Future in Kentucky

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Peer Support for Substance use Disorders: The Future in Kentucky Carol McDaid Capitol Decisions, Inc. October 8, 2013

  2. When are peer recovery support services delivered? • Across the full continuum of the recovery process: • Prior to treatment • During treatment • Doctor’s Office • Post treatment • In lieu of treatment

  3. Where are they delivered today? • Recovery community centers • Faith and community-based organizations • Recovery homes and sober housing • Emergency departments • Addiction and mental health service agencies • Jails and prisons • Probation and parole programs • Drug courts • HIV/AIDs and other health and social service centers • Children, youth, and family service agencies

  4. Where else will they be delivered? • Trauma centers • Primary care practices • Patient-centered medical homes • Federally Qualified Health Centers • Accountable Care Organizations • Community mental health centers • Community-based alternatives to jails and prisons • Schools & colleges

  5. Who is paying for peer recovery services? • Medicaid • State, county & municipal service contracts • Private pay • Federal and state grants • As of May 2008: • 30 states developed criteria for peer specialists1 • 14 states have accessed Medicaid reimbursement for peer-delivered mental health and/or addiction services2 Sources: 1 http://gainscenter.samhsa.gov/peer_resources/pdfs/Davidson_Rowe_Peersupport.pdf 2http://www.dsgonline.com/RTP/2011.weekly/2011.06.09/WH.2011.06.09.html

  6. Why are peer recovery supports critical in the modern health care system? • Population changes • Increase in population diversity & younger cohorts of individuals from low-income families • Hispanic population increased 43% between 2000 and 2010 • Increase in elderly population (87 million by 2050) • Cultural understanding is essential • Managing population health requires community education • Provider shortages • Health system is increasingly complex; peers provide navigation & advocacy to underserved & vulnerable populations • Individuals with behavioral health conditions remain uninsured even with near universal access to insurance • In MA, average number of uninsured is 2%; average rate of uninsured with MH/SUDs is 16%

  7. How can addiction recovery coaches advance the goals of parity & ACA?

  8. ACA & Parity Background • The Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA) present opportunities for recovery coaches regardless of locale • Enroll individuals in exchanges & Medicaid expansion (ME) • Advocacy for coverage & reimbursement of peer recovery support services (PRSS) in state exchange & ME

  9. The Opportunity • Parity & ACA provide opportunities for delivering & receiving peer-provided recovery support services (PRSS) • Approximately 30 m Americans without coverage today expected to receive it under state exchanges or Medicaid Expansion • Medicaid expansion for childless young adults up to 133% of poverty • 11 m of the currently uninsured population below 400% of poverty have MH/SUDs • Specific strategies & tactics are needed to capitalize on this opportunity • How do recovery coaches take advantage? Will we let others capitalize on this opportunity?

  10. Medicaid Expansion & Exchange Enrollment Strategies • When available, use FAVOR’s ACA enrollment training curriculum for peers & volunteers • Arm outreach staff w/the right tools (Medicaid & exchange program manuals, outreach event materials, cell phone etc) • Develop an enrollment plan (who, how many, by when?)

  11. PRSS Advocacy Strategies & Tactics • Develop relationship w/state Medicaid director & meet with him/her to share info & data about recovery supports • Host webinar to educate local advocates on new rights and benefits • Meet with/write to insurance commissioner asking re parity guidance to health plans in state

  12. Use Parity to Include PRSS in Exchange & Medicaid Expansion • Contact CMS if state is not implementing parity • Send consumers to www.parityispersonal.org for information on how to appeal denied claim • Educate exchange & ME decision-makers that MHPAEA requires that PRSS must be included in exchange if other med/surg supports are covered • Seek inclusion of exchange/ME parity audit provision in state law or regs

  13. Questions? Carol McDaid cmcdaid@capitoldecisions.com

More Related