Agenda - 12-15-2009 - 3b - Laserfiche WebLink

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19 MENTAL HEALTH TASK FORCE REPORT an array of services that meet that young person's set of needs. When XDS has attempted to obtain authorization for ACCT services for young people 18-21 years of age, the amount of time spent on seeking appeals has prohibited XDS' ongoing ability to serve this age range. ^ There are few housing and programming options for young people with mental health challenges. The existing mental health programs are often not a good developmental fit for this age group. ^ Unless the parents have obtained guardianship, the young person becomes their own guardian at age 18 years. Challenges -Providers ^ For provider to serve this age group, must make a huge expenditure of non-billable time. This is a challenging age group -very few providers. ^ Provider agenaes never know exactly what their budgets are/can be -cuts can come anytime and can be retroactive. ZZ-64 AGE GROUP Challenges ^ The system is fragmented - no one knows where to go. ^ Lack of preventive care. ^ Developmental Disabilities agency can't provide both services and case management; must be separate functions. ^ Current case management is ineffective. Agencies set up shop and then find there is no money and leave. Agencies cherry-pick clients who have billable hours. Case management disappeared -there needs to be an access team that knows about local providers and resources and processes ^ Sharing of information is a huge challenge -differing interpretations of confidentiality laws. Challenges to continuity of care. Under old system, state hospitals, area programs, and UNC hospitals could share information on shared clients to ensure continuity of care. With privatized, fragmented system, much more difficult. ^ Difficult to find providers for particular groups,. such as people who set fires and sex offenders; .borderline personality disorders; DBT Dialectical treatment areas. These individuals use up resources if not treated properly. Funding Sources/Issues ^ Providers can bill Medicaid but many clients are not eligible for Medicaid AND there are several different types of Medicaid, for which there are various eligibility restrictions. Reapply based on other diagnosis after initial entry. Takes time to follow the client. ^ Difficult for mentally ill who do not have Medicaid to access services. Many disabled adults have disability income that is too high for them to qualify for Medicaid. They may have significant service needs that Medicare does not pay for. Co-pays are high. Limited number of providers in the community are certified as Medicare providers. Similar difficulties apply to dual-eligible's -those with Medicare and Medicaid. Medicare is considered the primary insurance, so providers who are not certified Medicare providers cannot receive Medicaid payments either. ^ Private insurance does not pay for services needed by the more severely ill (ACTT, Community Support). 17