1/29/10 Meeting Minutes

Joint Meeting

DMHAS Addiction Treatment & Mental Health Treatment Providers

In Attendance: Cinda Cash, CT Women’s Consortium (Co-Chair); Ron Fleming, ADRC ; Jack Malone, SCADD; Leanne Dillian, CPAS; Roberta Murtagh, CNV-Help; Sr. Pat McKeon, Mercy Housing & Shelter; Stacey Lawton, SCADD; Valerie Williams, Keystone House; Chris Jachino, Family & Children’s Agency; Joe Sullivan, MCCA; Fiona Jones, The Kennedy Center; Robyn Hawley, Catholic Charities; Mary Ellen Laskarzewski, Hands on Hartford; Asher Delerme, Chemical Abuse Services Agency; Paul McLaughlin, Hartford Dispensary; Joe Riker, CT Renaissance; Beth Pizzuto, Hartford Hospital/IOL; Jim Farrales, Continuum of Care; Peter Vangsness, Center for Human Development; Linda Mastrianni, Perception Programs; Ron Cretaro, CT Nonprofits; Liza Andrews, CT Nonprofits (recorder).

DMHAS Guests: Commissioner Pat Rehmer; Assistant Commissioner Paul DiLeo, Sabrina Trocchi, Chief of Staff

Significant discussion took place and highlights include:

§  Budget Issues: Ms. Cash thanked Commissioner Rehmer for including providers in discussions regarding how best DMHAS could implement the FY10 rescissions while causing the least harm to nonprofits and those we serve. Commissioner Rehmer does not have any information on further FY10 rescissions that may be made before the end of the fiscal year. The Governor will release her FY11 midterm budget adjustments next week. The FY10 rescissions are technically one-time cuts, but the Governor may choose to annualize some of the cuts in her FY11 recommendations. Assistant Commissioner DiLeo noted that “reductions” (e.g.: cuts made through the portion of the deficit mitigation plan that requires legislative approval) are annualized in the following budget year, while “rescissions” are one-time cuts, although the Governor has the option of proposing to annualize them.

Assistant Commissioner DiLeo noted that the check for the first two months of the 3rd quarter has been sent. The Department will release the final payment for the 3rd quarter during the second week of February. They split the payment due to the timing of the November rescissions, which will hit all in the 3rd quarter payment.

DMHAS will not meet with the Governor’s office until the day before the budget release, so they do not yet know which of their budget options have been accepted. The reduction to MRO will not affect providers, this was money that was put aside for the rate correction, but the rates have not yet been determined so the money is surplus. Commissioner Rehmer suspects that OPM would have seen the surplus and taken it either way. DMHAS has spoken with the methadone providers that are affected by the elimination of funding for co-occurring screening. The Department could no longer justify the expense in the current fiscal climate. Commissioner Rehmer has not heard back from OPM about the proposed elimination of GABHP reimbursement for partial hospitalization programs. Ms Trocchi noted that the proposal is meant to allow the Department to focus more money on outpatient intensive services.

Commissioner Rehmer noted that the Department has been meeting with providers to discuss how to make necessary cuts and rescissions. Moving forward into fiscal years 2012 and 2013, the Department will have to continue to look at new and different ways to provide services as state resources continue to dwindle. They will look at utilization rates, contracts for training, etc. The Department will be working in partnership with providers and invites providers to send input. Every dollar spent will need to be justified. Commissioner Rehmer continues to emphasize to the administration that any further cuts to DMHAS will result in a reduction of services.

§  Provider Report Card: Providers noted concern regarding the report cards as DMHAS is migrating to a new data system and it will take time for providers to acclimate to the new system. Providers are concerned about the amount of weight being placed on the information contained in the report card as they learn to use the new data system and deal with the potential of inaccurately reported data. Ms. Trocchi noted that the system goes live July 1st and that they recognize there will be a learning curve. Report cards won’t go live until September or October so it will give providers a few months to work with the new data system. She also noted that there are many safeguards with the new system and that providers are automatically notified if data is not input properly. Assistant Commissioner DiLeo stated that the Department would first talk to a provider if they saw something that was completely askew before publishing it in a report card. The report card will also serve as a discussion tool between the Department and the provider in terms of contract performance.

§  Cedar Ridge: Commissioner Rehmer expects to hear by March 15th if OHCA will grant closure. She understands advocates’ concerns that budget cuts will negatively impact the ability of the Department to fund the services in the community. There are rolling decisions being made on the proposals from nonprofits to provide services in the community.

§  Federally Qualified Health Centers: It is somewhat unclear at this point how the federal proposal regarding FQHCs will affect services provided by nonprofits. The whole proposal may be put aside while problems with federal healthcare reform are worked out. Commissioner Rehmer stressed the importance for all nonprofits to make connections with their local FQHC.

§  General Assistance Audits/Regulations: Assistant Commissioner DiLeo briefly explained the basis for the audit program, noting that it was patterned after the CMS audit system. Any reduction made is based on a random sample of GA claims. If a provider feels that the reduction they receive is not representative of the documentation for their own agency, they have the option to appeal and may receive less of a reduction.

Ms. Trocchi noted that the Department is putting together a brief summary of the new GA regulations and that it will be available on the DMHAS website.

§  Medicare: Providers requested the Department’s support in seeking coverage for detox services under Medicare. Medicare Part A requires treatment for substance abuse to be given in a hospital in order to be eligible for coverage. However, nonprofits work to keep people out of hospitals and Medicare should cover detox services in the community. Commissioner Rehmer understands the position of providers and is willing to speak with staff at DSS about the possibility of approaching CMS, although she noted historical difficulty with getting CMS to do things differently.

§  SAGA Waiver: Assistant Commissioner DiLeo noted that no decisions will be made regarding the SAGA waiver until federal healthcare reform has been addressed. The waiver will take approximately 12-18 months to complete and DMHAS would have a role in case management and financing.

2010 Legislative Agenda

·  Midterm Budget Adjustments: Ms. Andrews explained that the Governor would release her FY11 midterm budget adjustments the following week on Wednesday, February 3rd. The Appropriations Committee will hold budget hearings during the second and third weeks of February. The hearing on the DMHAS budget is tentatively scheduled for Thursday, February 18th. If providers are interested in testifying, they can email Ms. Andrews who is happy to sign them up.

·  2010 Behavioral Health Legislative Agenda: Ms. Andrews discussed the draft agenda and requested input from providers. Providers noted that low interest loans to help with tightening lines of credit would be helpful. Providers also suggested possible legislation to request that state agencies review their contracts and identify unfunded mandates/duplicative requirements placed on nonprofits. Members approved the legislative agenda. Ms. Andrews will distribute the agenda to all members.

CT Nonprofits Updates

·  CT Nonprofits Week at the Capitol: Ms. Andrews reminded members that CT Nonprofits will hold two weeks at the Capitol this year and that Julia Wilcox is currently accepting requests for participation for the first week, which is the week of February 22nd. Members who are interested in participating should contact Julia at asap as spots are filling up.

·  Annual Legislative Reception: Ms. Andrews noted that CT Nonprofits will be holding its legislative reception a little later this year. The reception will be held on Wednesday, April 14th from 5:00-7:00pm at the State Capitol. More details will follow.

·  Center for Professional Development: Ms. Andrews distributed the Winter CPD catalog to members and encouraged them to take advantage of the great line-up of offerings. Members are also encouraged to suggest training topics specific to behavioral health services.

·  Legislative Meetings: Mr. Cretaro discussed recent meetings with Senators Doyle, DeFronzo, Harp and Looney and Representatives Geragosian, O’Brien, Walker, Dillon, Merrill, Johnson, Hurlburt, and Flexer.

Other/New Items

Next Meetings: 2/25/10 for CASAA/Addiction Treatment Providers; 3/25/10 for CASAA/Addiction Treatment Providers; 4/22/10 for Addiction Treatment & Mental Health Treatment Providers (DMHAS Guests)

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