The State of Health in the Commonwealth

1. The State of Health inthe Commonwealth 2008 Review & Future Goals

2. Council on Virginia’s Future HHR Measures Key measures drive HHR’s focus

3. HHR Strategy & Vision • Focus on 6 main areas • Access to Care • Healthcare Workforce • Long-Term Care • Quality and Transparency • Prevention • Mental Health Transformation • Ultimately want the Commonwealth to be in the top ten healthiest states in the nation

4. 2008 Results & Current Activities

5. 2008 Results & Current Activities( continued )

6. 2008 Results & Current Activities( continued )

7. Future Goals:Access to Care Medicaid: • Continue acute and LTC integration • Expand managed care statewide and in mental health • Brain injury waiver • Rebid Medicaid Management Information System (MMIS) • Web-based claims submissions

8. Future Goals:ContinueWorkforce Efforts • Nurse Practitioner scope of practice • Convening workgroup of stakeholders • Develop legislation prior to 2009 session • Expanding the scope of dental hygienists in underserved areas of the state • Clinical and practicing social workers • Evaluating loan repayment programs to improve LDSS and CSB workforce • Improve training for child welfare workers (Casey Family Programs)

9. Future Goals:Long-Term Care • Older Dominion Project • Aging Strategic Plan • Long term care • “Aging Well” communities • Individual Planning • Community Planning • State agency impacts

10. Smoking: Decide on policy Allow smoking after a particular time (i.e. after 9:00 p.m.) Carve out bars from restaurants and allow only in bars by changing ABC licensing structure Convene a workgroup of stakeholders and legislators, including those opposed Obesity: Bills from this 2008 that did not pass Competitive foods nutrition standards Transfats Requirements/hours/types of physical activity Health Impact Assessments Score the health assessment of a project VDH staff would implement Share with local governments and allow them to decide what is best for their community Could make statewide policy with disincentives and incentives Tax breaks Prevent a project from moving forward Future Goals:Prevention

11. Future Goals:Mental Health • Support Implementation of Mental Health Reforms • Training across courts, CSBs, law enforcement, and private providers • Monitor work of Commission on Mental Health Law Reform • Higher Education Conference on Disclosure of Student Information • November • Discussion of FERPA, MH law changes, services • Include student life, faculty, CSBs • Small and large universities • Commonwealth Consortium for Criminal Justice/Mental Health Transformation • Training kick-off in May • Goal: establishing local plans for jail diversion/improving mental health services for individuals encountering the criminal justice system • Involves local, regional law enforcement, CSBs, General District Courts, and state agencies • Substance Abuse in SW Virginia • Prisoner Reentry Workgroup • Improve upon existing MOU between DMHMRSAS, VACSB, and DOC

12. Future Goals:Modernizing Infrastructure • Statement of Work • VDSS, VDH, DMHMRSAS • Operational and programmatic review of the current operations • Compare senior/middle management skills sets to current management skill sets • Examine IT systems • Improve Eligibility Processes • For consumers and local workers

13. Future Goals:Health Benefits Taskforce • Taskforce convened in April 2008 • Improve state pharmaceutical spend: • State employees • Medicaid enrollees • Prisoners • Explore levering all three populations during contract negotiations • Wellness and prevention initiatives

14. Future Goals:Health Insurance Expansion • State code 32.1-335 allows for the appointment of a technical advisory panel (DMAS) with the authority to establish pilot health care projects for the uninsured • Riverside Foundation says yes to the use of their voluntary contribution for a pilot authorized in Code by the GA • Use results from that pilot to advance program in 2009 General Assembly session