From:Kenneth S Fink/Medicaid To:Patricia Johnson/Medicaid@Medicaid,Patricia Bazin/Medicaid@Medicaid,
Lydia Hemmings/Medicaid@Medicaid,Ann Kinningham/Medicaid@Medicaid,
Noreen Moon-Ng/Medicaid@Medicaid Date: Wednesday, April 01, 2009 08:26PMSubject:Fw: HELP!
fyi. We've already had some high level meetings on DOH decisions that cost-shift toMQD. This may come to a head again while I'm away, resulting in another high levelmeeting. Not sure who Lillian would want at such a meeting, but wanted to make sure youwere all aware.Kenny-----Forwarded by Kenneth S Fink/Medicaid on 04/01/2009 08:24PM -----To: email@example.com, Barry.Fukunaga@hawaii.gov,Georgina.K.Kawamura@hawaii.gov, Chiyome.L.Fukino@hawaii.gov,Susan.J.Jackson@hawaii.govFrom: Lillian.B.Koller@hawaii.govDate: 04/01/2009 03:38PMcc: firstname.lastname@example.org, ATsark@dhs.state.hi.usSubject: HELP!
Aloha Linda, Barry, Georgina, Doc and Susan:I need your help! I am getting overwhelmed with alerts from my staff that DOH is taking actions or proposing totake actions ASAP that will cause a huge cost-shift from DOH to DHS without DHS getting any extra resources tohandle the influx.You all already know from our meeting on March 12th that AMHD's March 9th letter to all AMHD providers(stating that AMHD had run out of money for SFY 2009 and had to shut down services and stop payments to providers) greatly aggravated an already growing wave of AMHD refugees streaming into my Medicaid programs.The latest from AMHD is a proposal by Dr. Bill Sheehan dated 02/25/09 that Michelle Hill forwarded last week toDr. Kenny Fink asking for his expedited approval. Dr. Sheehan explains that "The number of individuals who weredeemed eligible for [AMHD] services rose from approximately 4,200 in 2001 to approximately 15,000 in 2009" sohe proposes to "tighten the Eligibility Criteria for state funded mental health services so as to enroll only theindividuals who are most in need, most impaired, and have no other access to services." That's fine, but I have noidea how many more AMHD clients this change will cause to seek Medicaid services on top of the thousands whoare already streaming into Medicaid due to AMHD's March 9th letter. Further, neither the design nor the funding of my QUEST and QExA Medicaid programs can accommodate this transition at this time. We have a plan to makethis transition in October when I will be entering new contracts with my QUEST and QExA health plans, but that'scontingent on my obtaining both CMS and SPO approval to expand my Medicaid programs and contracts in thisway. And, I can't see how I can so substantially expand my QUEST and QExA contracts without increasing mycapitated payments to the health plans which means I'll need more money which nobody has to give me.Additionally, last week I got an email from Patti Bazin saying: "I am hearing in the community that the nurses whowork in both the public health nursing and children with special health needs programs would like to transition allof the work they do with disabled or aged Medicaid clients to the QExA health plans." Again, this transfer was not