MARYLAND MEDICAID ADVISORY COMMITTEE

DATE: Thursday, September 24, 2015

TIME: 1:00 - 3:00 p.m.

LOCATION: Department of Health and Mental Hygiene

201 W. Preston Street, Lobby Conference Room L-1

Baltimore, Maryland 21201

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AGENDA

I.  Departmental Update

II.  Maryland Medicaid and You

III.  Cash and Counseling and Transition to Personal Care Agency Model

IV.  Update on Enrollment and System Issues

V.  Update on ICD-10

VI.  Behavioral Health System Report

VII.  Waiver, State Plan and Regulations Changes

VIII.  Public Comments

IX.  Adjournment

Date and Location of Next Meeting:

Thursday, October 22, 2015, 1:00 – 3:00 p.m.

Department of Health and Mental Hygiene

201 W. Preston Street, Lobby Conference Room L-3

Baltimore, Maryland

Staff Contact: Ms. Carrol Barnes - (410) 767-5213

Committee members are asked to call staff if unable to attend

MARYLAND MEDICAID ADVISORY COMMITTEE

MINUTES

July 23, 2015

MEMBERS PRESENT:

Mr. Kevin Lindamood

Ms. Salliann Alborn

Ms. Lesley Wallace

Mr. Vincent DeMarco

Ms. Sue Phelps

Charles Shubin, M.D.

Ms. Lori Doyle

Mr. Floyd Hartley

Mr. Ben Steffen

Ulder Tillman, M.D.

Mr. Norbert Robinson

The Hon. Delores Kelley

The Hon. Pat Young

Ms. Rosemary Malone

MEMBERS ABSENT:

The Hon. Joseline Peña-Melnyk

Ms. Ann Rasenberger

Winifred Booker, D.D.S

Mr. Joseph DeMattos

Mr. C. David Ward

Ms. Christine Bailey

Ms. Michele Douglas

Samuel Ross, M.D.

Ms. Grace Williams

The Hon. Shirley Nathan-Pulliam

Ms. Kerry Lessard

Virginia Keane, M.D.

Ms. Tyan Williams

Maryland Medicaid Advisory Committee
July 23, 2015
Call to Order and Approval of Minutes

Mr. Kevin Lindamood, Chair, called to order the meeting of the Maryland Medicaid Advisory Committee (MMAC) at 1:10 p.m. Committee members approved the minutes from the June 25, 2015 meeting as written. Ms. Donna Fortson attended the meeting for Samuel Ross, M.D. and Ms. Michelle García attended for Delegate Joseline Peña-Melnyk.

Departmental Report

Ms. Shannon McMahon, Deputy Secretary for Health Care Financing, informed the Committee that we are entering a busy time for Medicaid redeterminations. The Department received some great suggestions from Senator Kelley, including reaching providers and individuals in provider settings. The Boards have been very helpful is getting out a simplified one-pager that the Office of Health Services (OHS) and Eligibility developed on the redetermination process. Mr. DeMarco and his team have been very successful in getting the word out and doing community events. Redetermination efforts are also under way at Connector Entities and the local departments of social services. As suggested at the last meeting, some of the documents that were presented at the last meeting have been translated to Spanish and are on the website.

We will be distributing guidance, including a toolkit, to the MCOs that explains the parameters regarding marketing and outreach.

Certified Community Behavioral Health Center’s Grant Opportunity

Deputy Secretary Shannon McMahon and Gayle Jordan-Randolph, M.D. informed the Committee that during the legislative session there were a couple of bills that would have required the Department to apply for a planning grant to establish certified community behavioral health clinics (CCBHC) (see attached presentation).

The Department is in the process of completing this grant application. There is a $2 million one year planning phase grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). Implementation is expected one month immediately after the grant planning phase ends. If Maryland receives a grant award, the Department has several concerns on its ability to execute this given potential budget implications. If we are going to implement a CCBHC program, the Department will have to ask for an appropriation and that is subject to the Department of Budget and Management (DBM) through the Governors budget process. Such an appropriation would also be subject to the legislative budget process. There are a lot of hurdles the Department will have to go through to robustly move forward with this, however, the Department will go forward and submit a grant application.

Through conversations with consultants that are helping us shape the grant as well as other states, the Department is in the process of building a CCBHC model and thinking about what a provider network would look like. Some states are thinking about certifying 2 to 8 programs under the grant. Maryland has decided if it implements to approve approximatel 5 sites which will allow us to hit rural and urban providers in the central region as well as the Eastern Shore and Western Maryland.

Ms. Doyle informed the Committee that the health initiative requires care coordination and the integration of all services. The great thing about this grant is it touches people that wouldn’t necessarily be in PRPs or in a methadone clinic. With health care expansion you have to work with the somatic providers to make sure everything that should be happening for the individual is happening.

A motion was made for the Medicaid Advisory Committee to send a letter to the Secretary in support of the Department’s submission of a grant application for the development of certified community behavioral health clinics. The motion was second and unanimously approved.

Maryland Community Health Resource Commission

Mr. Mark Luckner, Executive Director, gave the Committee an overview of the work of the Commission and highlighted three programs they have that most impact the Medicaid program (see attached presentation).

Faith-Based Community Initiative

Mr. Vincent Demarco, chair of the Consumer Outreach Taskforce of the Health Services Cost Review Commission (HSCRC) that has been tasked with trying to find ways for hospitals and communities to work together to achieve the goals of population health. Their faith-based partners urged the taskforce to go to Memphis to look at their local faith community health networks. LifeBridge Health, which consists of three hospitals, is using this system as a model. Sinai (northwest Baltimore City), Northwest (northwest Baltimore County) and Carroll (Carroll County) hospitals are going to pilot a faith-community health network later this year. The good thing about this pilot is it includes an urban, suburban and rural hospital (see attached presentation).

Colorectal Cancer Screening and HPV Vaccination Measures

Mr. Michael Dark and Ms. Laura Goodman of the Department gave the Committee an overview of the new measures included for both the Colorectal Rectal Cancer (CRC) screening and the Human Papillomavirus Vaccine (HPV) immunization in the annual HealthChoice Evaluation of the MCO Program (see attached presentation).

Waiver, State Plan and Regulation Changes

Ms. Tricia Roddy, Director, Office Planning, gave the Committee an update on the amendment to the 1115 waiver. The Department is asking for a Institutions for Mental Disease (IMD) exclusion provision that would allow the Department to receive federal matching dollars on IMD services for persons 21-64 years old. The Department held two public hearings and received several letters of support. The Department is planning on submitting its application next week. The Committee will receive a copy of the application once it is finalized and be apprised of discussions it has with the Center for Medicare and Medicaid Services (CMS).

Public Comments

No public comment given.

Other Committee Business

Residents in nursing homes and assisted living facilities are complaining that doctors are not giving patients a chance to discuss their needs or concerns. Some complain that the doctor comes in and takes their blood pressure and that’s it or they don’t see a doctor at all. Committee members ask that the Department look at what these doctors are supposed to provide as opposed to what they are really providing. The Department suggested a meeting with the long-term care staff to discuss specifics of this issue.

Medicaid Redeterminations

As a follow up to last month’s presentation on Medicaid redeterminations for individuals on the Client Automated Resource and Eligibility System (CARES) who have to be moved to the Maryland Health Connection (MHC), as of today, 29% of the 311,000 redeterminations that were falling due between April and October have been moved to the MHC.

Adjournment

Mr. Lindamood adjourned the meeting at 2:30 p.m.

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Maryland Medicaid Advisory Committee – July 23, 2015