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| Behavioral health, dental initiatives begin
Much attention is given to the medical needs of the uninsured and underinsured, but there is relatively little said -- or done --about the need for dental care and behavioral health care to create a true comprehensive approach to patient care. With Michigan's Medicaid dental care program offering only a limited level of service, many medically underserved individuals have no access to dental care. Similarly, the need for behavioral health care in this population is great, but the personel and reimbursement resources to pay for it are scarce. Federally Qualified Health Centers offer both in their portfolio of services. The challenge is to cultivate capacity to cover the growing population of underinsured in Detroit and Wayne County.
The Health Authority has announced that it will begin initiatives to address these issues. They will be community based and reflect the professional and community diversity throughout the county. Initial meetings will be scheduled for the first quarter of 2009. For more information on Michigan Medicaid Dental Services go to http://mdch.state.mi.us/dch-medicaid/manuals/MedicaidProviderManual.pdf.
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Covenant Care, Southwest Solutions collaborate on behavioral health
Federally qualified health centers have long offered behavioral health services to complement their holistic approach to health care. In Southwest Detroit, Covenant Community Care and Southwest Solutions have a unique arrangement that expands the ability of both organizations to provide comprehensive care for their community.
Southwest Solutions, a human service organization providing mental health, housing, commercial redevelopment and other social services, was determined to address the results of a national study that showed that persons with severe mental illness have a life expectancy 25 years shorter than the average American. Some of them had established physician relationships, but many went without health care for much of their lives.
Nearby, Covenant Community Care was established, sharing a similar philosophy of holistic care. In 2006, Southwest proposed that Covenant provide medical care on site at the agency's Waterman site. The proposal required some investment on the part of both. Southwest renovated about 500 square feet of space for medical services and stocked its on-site pharmacy accessible for medical prescriptions.
The risk for Covenant
The arrangement added an element of risk for the Covenant caregivers who would be treating a more challenging patient population outside of their familiar health center surroundings. "There is a lot of stress in that environment," explains Paul Propson, Executive Director of Covenant Care. "It's harder to provide primary care. The patients have complicated health conditions. It's not dangerous, just harder."
From a financial standpoint, Covenant assumed considerable risk, given that 40 percent of the patients are uninsured. Patient encounters tend to be longer. And, the health center assigns a physician, medical assistant and clinical manager to that site exclusively. However, financial risk was never an issue, Propson says. A federal 330 grant helped. But fundamentally, the collaboration was based on values first, finances second. "It isn't motivated by the funding mechanism but the shared commitment for the well-being of those we serve," he says.
"There are revenue sources that will support the mission eventually." He says that other health centers could adopt this model, but a critical question that needs to be answered at the outset is, "Are they willing to make the commitment without getting anything (financial) out of it initially? If so, then it will work."
A behavioral health model that can be replicated
"This collaboration represents an excellent model for other health centers," explains Chris Allen, CEO of the Detroit Wayne County Health Authority. "Collaborations are an essential method of strengthening the health care safety net, especially when they represent cross-disciplinary arrangements like medical and mental health care." The Health Authority will soon announce a behavioral health initiative to promote more integrated care.
With a year's experience, Covenant and Southwest Solutions have found their collaboration fruitful and are exploring options for growth. Propson would like to extend the collaboration to include a Southwest psychiatrist onsite at Covenant's Grand Boulevard site in early 2009 to complement the existing therapist. Covenant will provide behavioral health care for moderately ill patients, and refer others to Southwest for more complex care.
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| Health Authority, WSU School of Medicine plan safety net conference for '09
With the economy in Michigan in decline, increasing numbers of people are finding themselves uninsured or underinsured, adding financial pressures on already vulnerable households, especially people who live in Detroit and Wayne County. Safety net providers and health authorities are increasingly challenged to organzie and deliver necessary care to the uninsured and underinsured.
The challenges among health authorities are similar, while each have best practices to share. With the support of its educational partner, the Health Authority is designing a national conference for health authorities that will offer a professional forum for safety net providers, sharing best practices and collaborating in areas of mutual gain.
"We believe that we are creating solutions that will benefit other health authorities -- such as our East Side intiative, creating a partnership between Medicaid health plans and FQHCs, our Safety Net Resource Center, and our strong Medicaid outreach initiative," explained Chris Allen, CEO of the Detroit Wayne County Health Authority. "However, the challenges facing our safety net, and those throughout the country, are enormous and growing. We need colleagial support and one way we can do this is through an educational forum. Having the expertise of the School of Medicine at Wayne State will add tremendous value to our educational offerings."
The conference is planned for spring, 2009 and will include the follow topical areas:
- Application of the Medical Home Concept nationwide
- A perspective on the new president's health policy
- The Michigan and local Detroit-area experience of safety net providers
- Clinical issues in chronic disease management, the role of clinical protocols.
- The use of technological innovation such as electronic medical records, e-prescribing, and telemedicine to enhance the delivery of care
For more information on this conference, call 871-3751, ext. 110. |
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Health authority website poll shows strong preference for Obama's health policy
Respondents to the Health Authority website poll, which compares Sen. John McCain with Sen. Barak Obama in terms of their health policy, prefer Obama by 71.4 percent to 28.6 percent. The poll compared Obama's plan that subsidizes and regulates the current public-proviate health insurance market with McCain's plan to expand the individual insurance market through tax credits and health savings accounts.
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The Detroit Wayne County Health Authority's mission is to coordinate efforts to meet the health needs of the uninsured and underinsured residents in Detroit and Wayne County by assuring access and improving the health status of all people.
"It's about access...for all."
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