MHMRA of Harris County - Annual Report FY 2012 2012 - Page 14

Investing in Healthy Minds and a Healthy Community Investing in the Future Every year brings its own opportunities and challenges. Here’s a look at what we’re expecting for FY 2013: Medicaid 1115 Waiver The 1115 Waiver of the Social Security Act gives states funding and flexibility to develop new, more costeffective approaches for meeting Medicaid and CHIP goals. In Texas, the new Quality Based Payment Reform plan will phase out the Upper Payment Limit program, which helped cover hospitals’ financial losses from providing under-compensated care. The payment reform plan brings Delivery System Reform Incentive Payment (DSRIP) with almost $3 billion new local, state and federal funds to transform the health care delivery system, reduce high-cost intensive services utilization to address chronic conditions, and improve patient satisfaction and clinical outcomes. MHMRA has submitted 19 project proposals to our region’s anchor for inclusion in Texas’ funding request to the Centers for Medicare and Medicaid Services. Our top priority among these projects is to expand outpatient behavior health services for adults who have severe mental illness, often life-long psychiatric conditions that require ongoing treatment. In Harris County, there are estimated to be approximately 86,000 adults with a chronic mental health condition without health insurance. Current funding from the Texas Department of State Health Services allows us to serve approximately only 8,800 adults, with the most severe forms of mental illness. Once authorized and in operation, MHMRA’s DSRIP projects could help eliminate our waiting lists for services. Other projects include developing a day hospital to step people down from psychiatric hospital care and creating more opportunities for integrated mental health and primary care. If we receive funding, we expect to begin implementing approved projects in late FY 2013. Affordable Care Act One aspect of the Patient Protection and Affordable Care Act gives each state the option to participate in Medicaid expansion. If Texas were to participate, it has been estimated that the state would receive up to $100 billion in federal money over 10 years to help provide Medicaid coverage to up to 4.1 million people who are currently uninsured. The 10 year cost to the state has been estimated to be between $10 and $15 billion. This represents a significant opportunity for our state, as 25 percent of Te