National Working Group for ACTTION

May 27, 2011

The ActionToQuit State Grantees are working on their year-long projects to implement innovative strategies to increase access to tobacco cessation treatments.  Each month the newsletter features an interview with a different grantee to share information about their projects.  This interview is with the Michigan grantee.

ActionToQuit:
Can you give our readers some basic information about your project and staff?

Michigan:
Tobacco Free Partners is taking the lead on this project.  Tobacco Free Partners is a membership-based nonprofit community coalition working to address tobacco issues at the community, hospital, business, and legislative levels. We serve West Michigan with treatment, prevention, and advocacy solutions.  I am Laura Van Heest, the Cessation/Education Coordinator at Tobacco Free Partners.  Our staff and staff from the University of Michigan Health Systems are helping with this project.

ActionToQuit:
Can you give us a brief summary of the project?

Michigan:
The goal of this project is to provide equity to all of Michigan’s Medicaid recipients who smoke.  In our state, we have 14 Medicaid providers.  They do not meet all the provisions in Public Health Service (PHS) Guidelines for Tobacco Dependence Treatment.  The state has some basic rules for what the Medicaid providers have to cover, but this falls short of the full Guidelines.  Each of the providers deals with this differently.

We want to bring together health providers and insurers to make them aware of the PHS Guidelines.  We want them to discuss the practices they use, barriers to providing the full benefit, how to best use and obtain available resources, and how to move Medicaid to the full benefit.

ActionToQuit:
Who are your partners?

Michigan:
In addition to Tobacco Free Partners and University of Michigan Health Systems, we are working with Tobacco Free Michigan, tribal organizations, Asian groups, and religious-based groups.

ActionToQuit:
Can you give us a brief snapshot of cessation policy in your state?

Michigan:
Michigan has no mandate for private insurance to cover cessation services.  Medicaid coverage—medication, counseling, and barriers—varies by plan.  Coverage for state employees also varies by health plan.

ActionToQuit:
Can you tell us a little about your summit? 

Michigan:
The date for our summit has just been set.  It will be October 13 at the Lansing Community College.  Our target is to have 50 people at the summit from different sectors including health providers and health care insurers.  This is a good sized attendance to allow for roundtable discussions after the presentations.  We are considering providing a teleconference link to allow participation from people in the Upper Peninsula, which is a long way from Lansing.

We hope to have a speaker from the one insurance provider in the state show how they   have dealt with barriers to cessation coverage.  Although we are hoping to change coverage for Medicaid recipients by administrative means, we are inviting a speaker from Massachusetts, where they obtained comprehensive coverage for Medicaid through legislation.  We hope to educate insurance providers by showing them that the Medicaid population is motivated to quit smoking through evidence-based treatment.  With much of the local expertise, we also plan to provide multiple specialty focused break-out sessions (i.e. OB/GYN, Pediatrics, Behavior health, etc) as part of the conference to benefit a wider group of interested attendees.

We would like to develop recommendations at the summit on filling in the gaps in tobacco dependence treatment coverage under Medicaid.  If we are successful with Medicaid, we hope that the changes will spill over into state employee and private coverage.

ActionToQuit:
Who are you inviting? 

Michigan:
We hope to have providers and caregivers, including health coaches, doctors, physician assistants, respiratory therapists, and the like.  We also want to include representatives from groups that address chronic diseases affected by smoking like diabetes and asthma. 

ActionToQuit:
What obstacles do you face? 

Michigan:
Right now the lack of, or variability in, coverage frustrates many providers and discourages active involvement by our providers in all fields of care. We need to get the right information to the people who influence decisions.  This is key to making a difference. 

People don’t know what they don’t know.  People who work in health, but not directly with tobacco, are not aware of the PHS Guidelines and what needs to be done to meet them.

ActionToQuit:
What would you like to be different in your state one year from now?

Michigan:
When the summit is over, I would like us to have an influence on decision-makers, including the governor and our legislators.  They need to use money in the most prudent way and they need to see that providing comprehensive cessation benefits for Medicaid recipients does that.  It would also be nice to have an effect on coverage for state employees.