Effective Partnerships School-Based and School Linked Health Care

1. Effective PartnershipsSchool-Based and School Linked Health Care Michigan Perspective School Community Health Alliance of Michigan

2. Partnering with Health Care SystemsMichigan Perspective • Hospital Systems • Medicaid Managed Care Plans • Commercial Payers • Medicaid Behavioral Health Plans • Local Health Departments • FQHCs/Community Health Centers

3. Hospital SystemsMichigan Perspective • Approximately 1/3 of Michigan’s SBSL Health Centers and Programs are operated by hospital system • Provide and/or Contribute • Staffing such as nurses, physicians, social workers • Medical supplies, equipment, lab services • Financial support through hospital foundations, community benefit/health, pediatrics • Hospital Benefit: Mission driven care, reduction in costly ER visits, referrals to specialists, etc. • Benefit to Center: Liability coverage, access to a range of referral sources, Medical oversight, billing

4. Medicaid and Commercial CarriersMichigan Perspective • Michigan SBSL health centers must bill for all services provided • There is a carve out for SBSL health centers that requires Medicaid health care plans reimburse for services • Medicaid health care plans (8) use a school aged adjuster rate within their rates to work with SBSL health centers around outreach and referral for prevention services for Medicaid and Medicaid eligible children and youth • All providers are credentialed and paneled with both Medicaid and Commercial Carriers

5. Behavioral Health PlansMichigan Perspective • Majority SBSL health centers provide mental/behavioral health services by a licensed social worker • Mental health plans under Medicaid have extensive paneling and oversight requirements - create a barrier to children receiving needed services • Negotiated a pilot project that will allow SBSL health centers to enter in to a separate contract with different paneling requirements – Allows for billing to occur • GOAL: Successful pilot will allow for active discussion with commercial carriers around licensing requirements and reimbursement for mental health services

6. Local Health Departments and Community Health Centers – Michigan Perspective • Approximately 1/3 of SBSL health centers are operated by local health departments and community health centers • Each entity can obtain a cost based reimbursement which provides additional reimbursement for services provided to Medicaid and Medicaid eligible patients • Local health departments can federally match funds for outreach and referral services for Medicaid and Medicaid eligible youth

7. Engaging Health Care Systems • Meet with them!! • Understand their funding streams and related requirements if possible • Look for ways to collaborate • Understand they have both a social and fiscal responsibility • Invite them to meetings with others • Invite them to the center/program and engage parents, students, school personnel in discussion

8. Partnering with Government AgenciesMichigan Perspective • State Legislators • Department of Community Health • Department of Education • State Medicaid Office • Governor’s Office • Congressional Delegation

9. Governing AuthoritiesMichigan Perspective • State Legislatures appropriate annually $5 million dollars for SBHC health centers and programs • Governor recommended an increase in funding for SBSL health centers in her budget for 08-09 • Michigan Congressional Members took lead in putting language in SCHIP and for securing sponsorship for Authorizing Bill

10. How to Engage Governing AuthoritiesMichigan Perspective • Invite both state and congressional members to visit a health center/program • Meet with the Governor’s Staff and have visit • Offer to do any leg work that needs to occur • Maintain on-going communications with elected officials staff – no not under estimate • Remember: • Involve school personnel, students, parents in the meeting and discussion • Create a visual image for them to remember the center

11. Partnering with State AgenciesMichigan Perspective • Department of Community Health • Contract to provide TA services to field and centralized billing and reporting service • Work jointly to establish guidelines and issues • Department of Education • Work with them on special projects – Mental Health in Schools Grant • Serve as resource for information and support • State Medicaid Office • Manages federal match on general funds • Works with us on reimbursement issues and access to care concerns • Serve as worker bee and resource

12. Relationship Building with State AgenciesMichigan Perspective • Sit down and talk • Look for ways to work together • Identify solutions and offer to help • Act as a worker bee • Act as ambassador for their issue perspective • Invite them to meet with programs and services that shine and include young people • Understand the role they play and the role you play

13. Other Partnerships and AlliancesMichigan Perspective • School Nurses • MI Association of Health Care Plans • Mental Health in Schools Coalition • Michigan Model • Dropout Prevention Coalition • Primary Care Association • Maternal Child Health Coalition

14. Thanks from the Great Lake StateMichigan Debbie Brinson, Executive Director School Community Health Alliance of Michigan 517-908-0847, ext. 229 dbrinson@scha-mi.org

15. School Health Initiatives Midwestern Regional Conference Effective Partnerships for School-based, School-Linked Health Care: What’s Working in the Midwest July 24, 2008