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Risk Pool and Fund Balance are protection against County Funds being held accountable if something goes wrong.
Clinical and Operational Side: WHN is ready and very comfortable with this side of the operations. Smoky is also committed to a waiver but admits that they will not be ready for another year. WHN feels that they are ready and have confidence in the stable trained staff here at WHN. WHN has the flexibility to use funds under different billing codes and understands where the money can be used in a cost effective way to get the most use of the money.
WHN understands the concern the community has regarding the smaller provider within the outer counties. With this waiver, WHN will have more ability to design services around the different areas.
Public also seems concerned about the affect on the counties.
Out of network contracts – these will be available. If certain services are needed and not offered but offered in the next county, contracts can be done for the consumer to use the services in that county.
Nancy Baker: If WHN takes over this waiver – WHN will be the over viewer of clients PCP instead of Value Options. So WHN will be able to go in and pick each service/services. At the current time: Value Options just decides Medical necessity – Yes or No. They do not decide quality of Care. The Waiver would help WHN dig into the services and find the quality.
Is an REC (Recovery Education Center) still a plan for the future? WHN is still working towards that goal. An REC will be the expectation from money saved from having the Medicaid Waiver.
Is this waiver moving too fast? WHN feels like it is moving too slow – WHN has been preparing for this for over four years.
Peer Support is a part of this waiver. WHN getting the waiver will give more flexibility with Peer Support Specialist Employment.
Only 5 LME’s are eligible to apply for this waiver unless the smaller LME’s merge with larger LME’s.
Rosemary has concerns the community not being informed about the way the money is being spent and then the money not being spent effectively. The comment was said that “this is the job of CFAC”. One of the jobs of CFAC is to inform the communities and consumers of happenings at WHN and help keep them connected to WHN.
Cons: Risk Factor – If WHN does not pull this off – then they loose the money. This give WHN the power to limit providers – this is a negative along with a positive.
Rosemary motions that CFAC send the WHN Board a letter of support in whatever decision the WHN Board makes. Tracey seconds the motion. Bob suggests that CFAC put their concerns regarding the support. Tracey withdraws her motion. Motion is withdrawn.
Tracey motions that CFAC support the LME in going forward with the Medicaid Waiver. Bob again suggests that CFAC add concerns about the waiver. Howard seconds the motion. All in favor.
Bob motions now that CFAC add an attachment of CFAC concerns to the letter of support. Howard seconds the motion. All in favor.
Donald asks that CFAC get WHN a copy of these concerns so that they can respond to these concerns.
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