3-Star Healthy draft to be submitted soon

Rep. Cameron Sexton, chairman of the 3-Star Healthy task force, says the group expects to submit a draft TennCare expansion pilot proposal to the U.S. Centers for Medicare and Medicaid Services in a week and he’s optimistic about approval, reports The Tennessean.

In a meeting Monday at Tennessee Tower, presenters with expertise in telehealth and a specific workforce training program called “individual placement and support” told task force members and interested health care officials about how the initiatives could bolster the TennCare expansion proposal as well as existing programs.

Representatives from Mental Health America of Middle Tennessee, Park Center and the National Alliance on Mental Illness talked about success with placing people in jobs then providing training under the individual placement and support system pioneered at Dartmouth College.

However, both initiatives carry a set of challenges that might need legislative or other government action beyond a vote on a TennCare expansion waiver.

Using telehealth, or virtual visits, as a way to connect people to mental health providers would help work with the existing, and small pool of, providers, said Dr. Kenneth Gaines, a stroke expert. But if telehealth is used with patients at their home then internet connectivity could be an issue with areas that lack broadband access, noted Gaines and task force member Rep. Karen Camper, D-Memphis.

The work placement program, too, would need an expanded budget to meet the needs of pilot members around the state, particularly if it was expanded via a second phase to be a full Medicaid expansion.

Sexton said in addition to crafting a new Medicaid expansion waiver — taking the place of Gov. Bill Haslam’s Insure Tennessee — the task force will make a presentation to the governor with information on what other networks or programs are needed to enhance the expansion plan. Broadband could be one issue they raise along with additional funding for safety net hospitals and health care providers or ways to incentivize medical schools to train more psychiatrists, Sexton said.

“As we’re focused on this endeavor, we’ve always said there are other things that need to happen,” Sexton said.

Sexton is optimistic the task force will structure a proposal “vastly different from any other state” that garners federal and state legislative approval in addition to having a long-term impact on access to care across the state and TennCare. Camper said it’s important the proposal get approval from both political sides.