* Sun-Times…

Gov. Bruce Rauner on Monday announced the federal government has approved a state Medicaid waiver that will allow community-based service providers to provide more care for patients with substance abuse and other mental health problems.

The waiver, which was more than two years in the making and includes 10 pilot programs, will provide services that are not currently covered by Medicaid, Felicia Norwood, director of the state Department of Healthcare and Family Services, said Monday at a West Side press conference. And it’s aimed at getting patients continual care instead of having them go to pricey emergency rooms or institutions.

“I personally believe this is maybe one of the most important days in the history of public health for the state of Illinois, anywhere in our state’s history,” Rauner said.

The initial focus of the program will be behavioral health, both mental health and substance abuse, and that was chosen “due to the urgency of the issue as well as the potential financial and human impact,” the state’s department of Healthcare and Family Services said in a fact sheet. The goals are to help stem the opioid epidemic, reduce violent crime and violent encounters with police and improve maternal and child health.

This waiver has been sought for years, starting with Gov. Quinn. It’s a very big thing.

* Illinois News Network…

Gov. Bruce Rauner announced Monday that the federal government has approved $2 billion in Illinois-directed Medicaid funding for the use of programs focusing on behavioral health conditions and addiction treatment via a 5-year pilot program named Better Care Illinois. Without the waiver, the money couldn’t be used in this manner.

Rauner says the waiver will allow the state to care for the whole person while finding savings in the Medicaid system.

“We believe that this will save huge amounts of taxpayer funding while improving the quality of mental health and total health for the people of Illinois,” he said.

* Those savings won’t be realized right away, of course. It will take time to implement the programs and lots more time for the programs to work as intended…

Rauner said one in four Medicaid recipients have behavior health conditions. They account for 52 percent of Medicaid spending.

“We are going to change the way our services are provided up front,” Gov. Bruce Rauner said. “That will save money over the five-year waiver program, and we’re going to then reinvest those savings back in the program and then drive major savings in the future subsequent to the five-year waiver.”

So some savings within five years and then “major savings” after five years.

* With that in mind, check this out from yesterday’s IDHS bullet points…

What is budget neutrality?

The federal government requires the demonstrations to be “budget neutral,” meaning that during the course of the waiver Medicaid expenditures cannot exceed what they would be without the waiver. The 1115 waiver is not a grant but rather an opportunity to use Medicaid dollars differently to increase the efficiency and quality of care for Medicaid populations.

That link and language was provided by a commenter, who asked…

Question for the Governor: since the overall state spending of federal dollars cannot increased, what will he be cutting out of current Waiver spending in order re-direct money to the pilot programs, or is he planning to use money out of GRF that receives no federal match for the pilots and what will he then cut out of GRF to pay for that?

* More…

The state has five years of flexibility for how it spends $2 billion. It’s a fraction of Illinois Medicaid spending, which is about $21 billion a year.

In other words, they’ll be repurposing about ten percent of current Medicaid spending. It’s actually 2 percent per year for five years…

$1,997,670,906 in repurposed spending over 5-years… So we’re talking about 2%, not 10%.