The Minnesota Example Insuring More People Increasing Coverage Sue Abderholden, MPH

1. The Minnesota Example Insuring More People Increasing Coverage Sue Abderholden, MPH Executive Director NAMI Minnesota

2. Results • Extremely low percentage of uninsured: 5.4 percent in 2001 and 6.7 percent in 2004 and 7.2% in 2007 • Very comprehensive set of mental health services covered

3. Collaboration • Mental Health Legislative Network Coalition of 21 organizations • Minnesota Mental Health Action Group Chaired by Commissioner and Pubic Interest Group, all stakeholders (public & private, children & adults, advocates & providers). Subcommittees on model benefits, access, outcomes, school based, early intervention, etc.

4. New View • Mental health care is health care not social services • Access through any health insurance plan • Private sector must be at the table • No shift policy

5. Actions Leading Up to Changes • Sued by Attorney General • All denials reviewed by committee • Managed care for Medicaid non-disabled • Commitment to reducing uninsured • Commitment to increasing access to mental health care

6. Strong Commitment to Reduce Number of Uninsured • MinnesotaCare • General Assistance Medical Care • MN Comprehensive Health Plan • Medicaid options (TEFRA, MA-EPD)

7. Strong Commitment to Reduce Number of Uninsured • Continuing or Suspending Coverage in Jail • Discharge Planning out of Prison • Coverage under Parent’s Plan until age 25 even if not in school • Children off of Medicaid to MinnesotaCare

8. Strong Commitment to Mental Health Care • Strong Mental Health and Substance Abuse Parity Act • Medical Necessity Standard same as other health care, appropriate to diagnosis

9. Strong Commitment to Mental Health Care • Insurance pays for court ordered treatment • Medication access • CBHH 15 bed state operated

10. Model Benefit Set • All Medicaid covered services for all publicly funded plans • ACT, ARMHS, CTSS, IRTS, TCM, Crisis Services, Intensive Outpatient, Day Treatment • Children’s Residential Treatment and others under PMAP

11. Strong Commitment to Mental Health System Infrastructure • Crisis teams • Supportive Housing • Rate increases of 23% to providers • Extended Employment • School screening and mental health • Specialized Treatment

12. Strong Commitment to Mental Health System Infrastructure • Respite Care • Replace loss of LCTS funding • Certified Peer Specialist • Use of CADI waiver

13. Strong Commitment to Mental Health System Infrastructure • School-based mental health care • Culturally specific providers • EBP children (trauma, etc) & Adults (ACT and dual diagnosis) • Bed tracking • Suicide prevention • Telemedicine

14. Other Changes and Issues • Preferred Integrated Networks • Medication Access • Co-payments - $7 cap on medication and none on antipsychotics, none on MH visits

15. Lessons Learned • Engage private and public • View as a seamless system • Private plans begin to move into additional benefits • Managed Care can Manage to be Good

16. Lessons Learned • Big Tent, no villains and no angels • Engage NAMI members • Mega bill and Governor’s bill • Press conference, action alerts, personal stories, op ed pieces • Timing is everything

17. Next Steps • Stakeholders to develop recommendations to reduce the number of unnecessary patient days in acute care facilities. Analysis of current services and workforce issues, recommendations on what we need and how to get there. • Health Care Reform

18. If everyone is moving forward together, then success takes care of itself. Henry Ford