Certified Community Behavioral Health Centers
|
|
- Rosalyn Dorsey
- 5 years ago
- Views:
Transcription
1 Certified Community Behavioral Health Centers Opportunity for Occupational Therapy December 9 th, 2015 Prepared for The American Occupational Therapy Association HealthManagement.com
2 CCBHC OVERVIEW 2
3 What is a CCBHC? A well-funded, coordinated, fully integrated comprehensive community-based provider of culturally and linguistically competent services that serves anyone, of any age, with a BH challenge while focusing on the needs of people with SED, SPMI and chronic SUD An always available single point of access and accountability for any member of the community who needs substance use or mental health treatment and support
4 Goals To improve behavioral health by enhancing and expanding community-based mental health and substance use disorder treatment To improve integration with medical/surgical health care To expand the use of evidence-based practices To improve access to high quality care To expand and improve data collections Although required to serve everyone, they are targeted primarily at people with Serious Mental Illness (SMI), Serious Emotional Disturbance (SED), and chronic Substance Use Disorders (SUD) 4
5 Authorizing Legislation 2014 Excellence in Mental Health Act $1.1 billion investment CCBHC Demonstration Program Two year demonstration for eight states expected to go live in early 2017 $25m planning grants Enhanced FMAP/CHIP rate CCBHCs are analogous to FQHCs, but state Medicaid systems serve as intermediaries 5
6 Critical Planning & Implementation Activities Planning Grant Application Jun Aug 2015 Review existing certification and other CCBHC requirements Identify subject matter experts Consider PPS Payment implications Develop the Planning Grant Application Planning Grant Funding Period Oct, 2015 Oct, 2016 Broad stakeholder involvement PPS development Provide necessary TA and system enhancements to certify at least two CCBHCs that represent diverse geographic areas, including rural and underserved areas Develop and submit a proposal by October 31, 2016 to participate in the Demonstration program CCBHC Demonstration Period Jan 2017 Dec 2018 Up to 8 States will be selected to implement CCBHC demo Track, measure and report on performance and participate in the National Evaluation of the Demonstration 6
7 The Planning Phase States have already begun to: Identify the target Medicaid population Solicit broad-based stakeholder input, including from providers and consumers Design the scope of the Medicaid-reimbursable CCBHC service package Certify the clinics that will participate in the pilot Establish and enact the Prospective Payment System Participate with the federal government 7
8 Minimum Standards The Act establishes standards in six areas that an organization must meet to achieve CCBHC designation Staffing Accessibility Care coordination Service scope Quality/reporting Organizational authority 8
9 Staffing Standards Diverse backgrounds Psychiatrist Medical Director Psychiatric Nurse Credentialed Substance Abuse Counselor MH professional who can perform psychological testing Case management and family support staff Peer specialist/recovery coach Optional: LCSW, LMHC, Psychologist, LMFT, OT Licensed and accredited Culturally and linguistically competent and appropriate Including for Veterans and members of the Armed Services 9
10 Availability/Accessibility Standards Initial evaluation within one business day Comprehensive evaluation within 15 days Crisis management services available 24x7x365 Within three hours maximum Average response is within one hour Although regulated through state Medicaid systems, must serve everyone regardless of ability to pay, insurance status or state of residence Protocols in place for ED access 10
11 Care Coordination Standards Partnerships (MOA, MOU) or formal contracts with FQHCs/rural health clinics, unless the CCBHC provides comprehensive healthcare services Inpatient psychiatry and detoxification Post-detoxification step-down services Residential programs Inpatient acute hospitals Department of Veterans Affairs facilities Other social services providers, including Schools Child welfare agencies Juvenile and criminal justice agencies and facilities Indian Health Service youth regional treatment centers Child placing agencies for therapeutic foster care service 11
12 The CCBHC Palace Services for Armed Forces and Veterans 24x7 Crisis Services Screening, Assessment, Dx MH and SA Tx Patient-Centered Planning Psych Rehab Med. Screening and Monitoring Targeted Case Management Peer and Family Support
13 Service Scope Standards Crisis services Crisis management services Crisis stabilization Emergency crisis intervention Screening, assessment and diagnosis, including risk assessment Direct provision for behavioral health conditions (updated monthly) Assessment includes comprehensive social services needs Formal arrangements are permitted for specialized screening Patient-centered treatment planning Includes consumer Family of child/adolescent consumer Adult consumer s family per consumer s preference 13
14 Service Scope Standards (cont.) Evidence based/informed outpatient mental health and substance use services Individual, group and family therapies CBT DBT First episode psychosis Multisystemic therapy Motivational interviewing Youth services (including youth in foster care) Medication evaluation and management Psychiatric medication Medication assisted treatment (i.e. Buprenorphine, methadone, naltrexone) Intensive services Prevention services 14
15 Other Required Outpatient MH and SA Services Hospitalization follow-up Suicide prevention and safety Smoking cessation therapy Co-occurring addictions disorders treatment Trauma-informed care Services for people with co-occurring developmental disabilities Older adults services Neurological consultation 15
16 Service Scope Standards (cont) Primary care screening and monitoring of key health indicators and health risk At a minimum, BMI and blood pressure at intake and annually (directly by the CCBHC) Either directly or through formal arrangement the CCBHC must assure that key screenings are done and follow up Targeted case management Up to and including ACT Psychiatric rehabilitation services Psychoeducation Personal care and ADL Supported housing Supported education Supported employment 16
17 Service Scope Standards (cont) Peer support and family support Family psychoeducation Parent training Family-to-family Services specifically targeted at veterans and members of the armed services Military cultural competence Coordination with TRICARE Coordination with VA 17
18 Uniform Reporting Standards Standardized data elements modeled on the FQHC Uniform Data System Encounter data Consumer demographics Staffing Service usage Service access Care coordination Clinical outcomes data Quality data Other data as requested 18
19 Organizational Authority Standards Nonprofit Local government behavioral health authority Indian Health Service, Indian tribe or Tribal organization Urban Indian organization Governing board members reasonably represent those served in terms of geographic areas, race, ethnicity, sex, gender identity, disability, age, and sexual orientation At least 51% consumer or family members 19
20 Federal Match for States Federal Match (FMAP) follows beneficiary eligibility: Regular Medicaid: Enhanced FMAP Expansion population: 100% now, down to 90% by 2020 Medicaid CHIP Expansion: Enhanced FMAP +23% Served by Indian Health Services Clinics: 100% State plan authority not necessary for payment for CCBHC services delivered by certified clinics States may claim administrative expenditures that support the development and implementation of the demonstration 20
21 Impact of CCBHC This is a game changer CMHCs have struggled for decades to offer comprehensive care. CCBHCs represent an opportunity to: Establish a behavioral health safety net Integrate and coordinate care for mental health, substance abuse, and primary care Promote access to improve care via standards for quality and accessibility Expand care coordination for all 21
22 State Awardees: 22
23 CCBHC PROSPECTIVE PAYMENT SYSTEM 23
24 CCBHC PROSPECTIVE PAYMENT SYSTEM 24
25 PPS Guidance Required by Statute for payment of participating clinics for CCBHC services delivered either directly by a CCBHC or through a formal relationship between a CCBHC and Designated Collaborating Organizations (DCOs) FMAP for CCBHC services Enhanced FMAP equivalent to the standard Children s Health Insurance Program (CHIP) rate For the newly eligible population, it is equal to the current FMAP for that population 25
26 CC PPS - 1 Daily fixed rate (like FQHCs) for all CCBHC services provided any given day Cost-based, per clinic rate that applies uniformly to all CCBHC services rendered by a certified clinic, including those delivered by qualified satellite facilities Pays CCBHCs a daily rate that is a fixed amount for all CCBHC services provided on any given day to a Medicaid beneficiary DY1: Cost and visit data from the demonstration planning phase updated by MEI DY2: update DYI 1 rates with MEI or rebaseline. Based on total annual allowable CCBHC costs divided by the total annual number of CCBHC daily visits and results in a uniform payment amount per day, regardless of the intensity of services or individual needs of clinic users on that day 26
27 CC PPS-2 (Alternative) Monthly rate to reimburse for CCBHC services Separate monthly PPS rates to reimburse CCBHCs for higher costs associated with providing all services needed to meet the needs of clinic users with certain conditions (SMI, SUD) Cost-based, per clinic rate applies uniformly to all CCBHC services rendered by a certified clinic, including all qualifying sites of the certified clinic Outlier payments made in addition to PPS for participant costs in excess of a threshold defined by the state (made monthly or annual basis) DY1: Cost and visit data from the demonstration planning phase updated by MEI DY2: update DYI 1 rates with MEI or rebaseline. 27
28 Quality Bonus Payment Optional for daily (PPS Option 1) Required for monthly (PPS Option 2) Required measures are shown in Table 3 of PPS Guidance option for state to include other measures, with CMS approval
29 ROLE OF OCCUPATIONAL THERAPY IN CCBHC 29
30 CCBHC Treatment Team The Treatment Team includes: The consumer & families/caregivers An interdisciplinary team composed of individuals who work together to coordinate medical, psychosocial, emotional, therapeutic, and recovery support needs of consumers Person and family centered treatment planning and care coordination activities are required 30
31 OT Option for CCBHC Team From the CCBHC Criteria: Providers must include individuals with expertise in addressing trauma and promoting the recovery of children and adolescents with serious emotional disturbance (SED) and adults with serious mental illness (SMI) and those with substance use disorders. Examples of staff the state might require include a combination of the following: psychiatrists (including child, adolescent, and geriatric psychiatrists) nurses trained to work with consumers across the lifespan licensed independent clinical social workers licensed mental health counselors licensed psychologists licensed marriage and family therapists, licensed occupational therapists staff trained to provide case management, peer specialist(s)/recovery coaches, licensed addiction counselors staff trained to provide family support medical assistants, and community health workers 31
32 Service Scope: Evidence-based practices States must establish a minimum set of required evidence based practices, such as: Motivational Interviewing Cognitive Behavioral individual, group, and on-line therapies (CBT) Dialectical Behavioral Therapy (DBT) Addiction technologies Recovery supports First episode early intervention for psychosis Multi-systemic therapy Assertive Community Treatment (ACT) Forensic Assertive Community Treatment (F-ACT) Evidence-based medication evaluation and management (including but not limited to medications for psychiatric conditions, medication assisted treatment for alcohol and opioid substance use disorders, prescription long-acting injectable medications for both mental and substance use disorders, and smoking cessation medications) Community wrap-around services for youth and children Specialty clinical interventions to treat mental and substance use disorders experienced by youth (including youth in therapeutic foster care) 32
33 OT Within CCBHC Model Services for Armed Forces and Veterans 24x7 Crisis Services Screening, Assessment, Dx MH and SA Tx Patient-Centered Planning Psych Rehab Med. Screening and Monitoring Targeted Case Management Peer and Family Support Potential area for occupational therapist contribution 33
34 OT can contribute to many CCBHC goals: Span the gap between CCBHC Services and Daily Living: Facilitate the development of day-to-day independent living skills for those with SMI Teach compensatory strategies that mitigate the impact of mental illness Help people with serious BH challenges translate coping skills into daily lives Reduce the symptoms of mental illness by engaging in healthy roles and routines Promote emotional wellness by enhancing people s skills and competencies Address the physical, cognitive, and sensory functioning of people with chronic behavioral health challenges Promote health and wellness through the use of everyday activities Help people improve critical reasoning skills Address the social determinants of health Span the boundary between behavioral and medical fields Help people identify and achieve outcomes that are important to them 34
35 OT Enhancement Promote Person- Centered Care Cognitive Functional Testing Individualized Interventions Performance based Testing Cognitive Functioning Testing: Determines degree of functional impairments Enables teams to better understand client thinking and processing skills related to diagnosis, care planning, medication adherence, appointment attendance, and interventions Facilitates appropriate engagement of individuals in the treatment and recovery support planning If functional cognition reduce capacity to understand diagnosis Improved Behavioral Health Performance Based Testing Assesses client s ability to perform real-world tasks Enables rapid client engagement Evaluates client awareness of and attention to environmental stimuli Helps to calibrate interventions (group or individual), develop health promotion plans, and support chronic disease management 35
36 OT in the Integrated Care Team Occupational Therapy supports critical behavioral health goals: Improve cognitive behavioral interventions understanding cognitive capacity is critical for these evidence-based approaches Promote self-management understanding functional capacity is critical to skill building Facilitate coordination between PC and BH improved person-centered care planning plus wellness programming and individualized wellness interventions OT promotes vocational goals vital and underaddressed aspect of whole person planning 36
37 Special Populations Promoting Wellness and Supporting Healthy Lifestyles NEW-R intervention Individualized plans for Peer Specialists to implement Vocational Assessment and Planning Strategy Training Promoting community independence for those with Serious Mental Illness Promoting independence for older adults and others with physical and behavioral health limitations Sensory Profiling Veterans with PTSD Youth with Serious Emotional Disturbance Those experiencing First Episode Psychosis 37
38 Making the OT Case with State Planners: STRATEGY RECOMMENDATIONS FOR CCBHC PLANNING 38
39 Act Now: Connect with/join your state s Planning Grant Steering Committee Participate in your state s stakeholder engagement process Connect with community mental health centers in your state/region which are likely to be certified as CCBHCs Watch/participate in the CCBHC webinar provided by AOTA to learn more about the Demonstration Sign up to receive OT advocacy material developed for CCBHC planners 39
40 Get Involved with Central Players Executive Officer, Department of Human Services, Division of Mental Health and Disability Services Director of Policy Implementation & the Administrator of Research, Data Evaluation, and Compliance Both at the Dept. of Behavioral Healthcare, Developmental Disabilities, and Hospitals Deputy Director of Behavioral Health and Development Disabilities, Department of Health and Human Services Assistant Division Director of Planning, Research, Evaluation, & Prevention at the Division of Mental Health and Addiction Services within the Dept. of Human Services. 40
41 Tips for Behavioral Health Engagement Educate planners about OT Find out what they need populations, services, outcomes? Keep it simple use examples rather than terms to describe OT Be prepared to make state-specific financing policy recommendations Provide technical support to CCBHC Steering Committee and training for sites 41
42 Q and A Heidi Arthur Lee Repasch Josh Rubin 42
Certified Community Behavioral Health Centers and New York State s Healthcare Reform: Considerations for Providers
Certified Community Behavioral Health Centers and New York State s Healthcare Reform: Considerations for Providers November 30, 2015 Joshua Rubin HealthManagement.com Plan CCBHC basics NYS Health Reform
More informationCCBHCs 101: Opportunities and Strategic Decisions Ahead
CCBHCs 101: Opportunities and Strategic Decisions Ahead Rebecca C. Farley, MPH National Council for Behavioral Health Speaker Name Title Organization It Passed! The largest federal investment in mental
More informationCertified Community Behavioral Health Clinic (CCHBC) 101
Certified Community Behavioral Health Clinic (CCHBC) 101 On April 1, 2014, the President signed the Protecting Access to Medicare Act (PAMA) into law, which included a provision authorizing a two part
More informationCertified Community Behavioral Health Clinics (CCBHCs): Overview of the National Demonstration Program to Improve Community Behavioral Health Services
Certified Community Behavioral Health Clinics (CCBHCs): Overview of the National Demonstration Program to Improve Community Behavioral Health Services Cynthia Kemp (SAMHSA) Mary Cieslicki (Center for Medicaid
More informationThe CCBHC: An Innovative Model of Care for Behavioral Health
The CCBHC: An Innovative Model of Care for Behavioral Health B R E N D A G O G G I N S, J D V I C E P R E S I D E N T O A K S I N T E G R A T E D C A R E M I C H A E L D A M I C O, L C S W D I R E C T
More informationThe Current State of Behavioral Health Opportunities for Integration and Certified Community Behavioral Health Clinics (CCBHC)
Behavioral Health Transition to Managed Care Update The Current State of Behavioral Health Opportunities for Integration and Certified Community Behavioral Health Clinics (CCBHC) APRIL 2015 The Current
More informationLetter of Intent/Organizational Readiness Survey Certified Community Behavioral Health Clinics (CCBHCs)
Letter of Intent/Organizational Readiness Survey Certified Community Behavioral Health Clinics (CCBHCs) The North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services
More informationCCBHC CARE COORDINATION AGREEMENTS: OVERVIEW OF LEGAL REQUIREMENTS AND CHECKLIST OF RECOMMENDED TERMS
CCBHC CARE COORDINATION AGREEMENTS: OVERVIEW OF LEGAL REQUIREMENTS AND CHECKLIST OF RECOMMENDED TERMS Coordinating care across a spectrum of services, 29 including physical health, behavioral health, social
More informationDrug Medi-Cal Organized Delivery System
Drug Medi-Cal Organized Delivery System Presented by Elizabeth Stanley-Salazar, MPH CMS Approval of DMC-ODS Waiver under ACA August 13, 2015 Pathway to Parity 2010 President Obama Signs the Affordable
More informationSee Protecting Access to Medicare Act (PAMA) 223(a)(2)(C), Pub. L. No (Apr. 1, 2014).
CCBHC CARE COORDINATION AGREEMENTS: OVERVIEW OF LEGAL REQUIREMENTS AND CHECKLIST OF RECOMMENDED TERMS Coordinating care across a spectrum of services, 1 including physical health, behavioral health, social
More informationCCBHC Standards of Care
CCBHC Standards of Care Mark Disselkoen, MSW, LCSW, LADC CASAT March 7, 2017 Disclaimer The views, opinions, and content expressed in this presentation do not necessarily reflect the views, opinions, or
More informationDivision of Mental Health, Developmental Disabilities & Substance Abuse Services NC Mental Health and Substance Use Service Array Survey
Table 1 Service Name Include any subcategories of service on a separate line In Table 2, please add service description and key terms Outpatient Treatment Behavioral Health Urgent Care (a type of outpatient)
More informationBERKELEY COMMUNITY MENTAL HEALTH CENTER (BCMHC) OUTPATIENT PROGRAM PLAN 2017
BERKELEY COMMUNITY MENTAL HEALTH CENTER (BCMHC) OUTPATIENT PROGRAM PLAN 2017 REVIEWED AND UPDATED NOVEMBER 2017 OUR MISSION PHILOSOPHY The staff of the Berkeley Community Mental Health Center, in partnership
More informationOUTPATIENT SERVICES. Components of Service
OUTPATIENT SERVICES Providers contracted for this level of care or service are expected to comply with all requirements of these service-specific performance specifications. Additionally, providers contracted
More informationNEW MEXICO CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS. Behavioral Health Collaborative July 14, 2016
NEW MEXICO CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS Behavioral Health Collaborative July 14, 2016 CCBHCs: Not Just a Grant Actively identify community members with high cost, complex health needs
More informationSANTA BARBARA COUNTY DEPARTMENT OF Behavioral Wellness A System of Care and Recovery. o--,-.m-a----,laa~-d-c~~~~~~~~~~-
Page 11 of 8 SANTA BARBARA COUNTY DEPARTMENT OF Behavioral Wellness A System of Care and Recovery Departmental Policy and Procedure Section Sub-section Alcohol and Drug Program (ADP) Policy Drug Medi-Cal
More informationMental Health Certified Family Peer Specialist (CFPS)
Mental Health Certified Family Peer Specialist (CFPS) Policy Number: SC170065A1 Effective Date: May 1, 2018 Last Updated: PAYMENT POLICY HISTORY VERSION DATE ACTION / DESCRIPTION Version 1 5/1/2018 The
More informationMacomb County Community Mental Health Level of Care Training Manual
1 Macomb County Community Mental Health Level of Care Training Manual Introduction Services to Medicaid recipients are based on medical necessity for the service and not specific diagnoses. Services may
More informationSpecialty Behavioral Health and Integrated Services
Introduction Behavioral health services that are provided within primary care clinics are important to meeting our members needs. Health Share of Oregon supports the integration of behavioral health and
More informationState of New Jersey Department of Human Services Division of Medical Assistance & Health Services (DMAHS)
State of New Jersey Department of Human Services Division of Medical Assistance & Health Services (DMAHS) Outpatient Facility Behavioral Health Integration Billing Frequently Asked Questions (FAQs) 1.
More informationPeach State Health Plan Covered Services & Authorization Guidelines Programs for Behavioral Health
Peach State Health Plan Covered s & Guidelines Programs for Health n-participating providers (those that are not contracted and credentialed with Peach State Health Plan) require prior authorization for
More informationAssertive Community Treatment (ACT)
Assertive Community Treatment (ACT) Assertive Community Treatment (ACT) services are therapeutic interventions that address the functional problems of individuals who have the most complex and/or pervasive
More informationDrug Medi-Cal Organized Delivery System Demonstration Waiver
Drug Medi-Cal Organized Delivery System Demonstration Waiver All County Orientation to Standard Terms and Conditions & Fiscal Provisions Presentation by DHCS and Harbage September 28, 2015 Overview of
More informationLOUISIANA MEDICAID PROGRAM ISSUED: 08/24/17 REPLACED: 07/06/17 CHAPTER 2: BEHAVIORAL HEALTH SERVICES APPENDIX B GLOSSARY/ACRONYMS PAGE(S) 5 GLOSSARY
GLOSSARY The following is a list of abbreviations, acronyms and definitions used in the Behavioral Health Services manual chapter. Ambulatory Withdrawal Management with Extended On-Site Monitoring (ASAM
More informationFlorida Medicaid. Community Behavioral Health Services Coverage and Limitations Handbook. Agency for Health Care Administration
Florida Medicaid Community Behavioral Health Services Coverage and Limitations Handbook Agency for Health Care Administration UPDATE LOG COMMUNITY BEHAVIORAL HEALTH SERVICES COVERAGE AND LIMITATIONS HANDBOOK
More informationAcute Crisis Units. Shelly Rhodes, Provider Relations Manager
Acute Crisis Units Shelly Rhodes, Provider Relations Manager Shelly.Rhodes@beaconhealthoptions.com Training Agenda Agenda: Transition and Certification Coverage of Services Service Code Definition Documentation
More informationTRICARE: Mental Health and Substance Use Disorder Treatment for Child and Adolescent Beneficiaries
TRICARE: Mental Health and Substance Use Disorder Treatment for Child and Adolescent Beneficiaries Clinical Support Division Condition-Based Specialty Care Section June 24, 2015 Medically Ready Force Ready
More informationClinical Services. clean NYS Driver s License, fingerprinting, criminal record check, and approval from NYS Office of Mental Health.
Clinical Services Clinical Social Worker- Fee for Service Location: Wyandanch- Clinic Job Function: Provide direct clinical care to clients as needed as a member of a multi-disciplinary treatment. Qualifications:
More informationMajor Dimensions of Managed Behavioral Health Care Arrangements Level 3: MCO/BHO and Provider Contract
Introduction To understand how managed care operates in a state or locality it may be necessary to collect organizational, financial and clinical management information at multiple levels. For instance,
More informationOptum/OptumHealth Behavioral Solutions of California Facility Network Request Form / Credentialing Application
Optum/OptumHealth Behavioral Solutions of California Is the facility currently in the Optum network? Yes No Acceptance into the Optum/OptumHealth Behavioral Solutions of California (Optum) provider network
More informationCHILDREN'S MENTAL HEALTH ACT
40 MINNESOTA STATUTES 2013 245.487 CHILDREN'S MENTAL HEALTH ACT 245.487 CITATION; DECLARATION OF POLICY; MISSION. Subdivision 1. Citation. Sections 245.487 to 245.4889 may be cited as the "Minnesota Comprehensive
More informationClinical Services. clean NYS Driver s License, fingerprinting, criminal record check, and approval from NYS Office of Mental Health.
Clinical Services Clinical Social Worker- Fee for Service Location: Wyandanch- Clinic Job Function: Provide direct clinical care to clients as needed as a member of a multi-disciplinary treatment. Qualifications:
More informationCovered Service Codes and Definitions
Covered Service Codes and Definitions [01] Assessment Assessment services include the systematic collection and integrated review of individualspecific data, such as examinations and evaluations. This
More informationBulletin. DHS Provides Policy for Certified Community Behavioral Health Clinics TOPIC PURPOSE CONTACT SIGNED TERMINOLOGY NOTICE NUMBER DATE
Bulletin NUMBER 17-51-01 DATE February 27, 2017 OF INTEREST TO County Directors Social Services Supervisors and Staff Case Managers and Care Coordinators Managed Care Organizations Mental Health Providers
More informationDRUG MEDI-CALWAIVER STAKEHOLDER FORUM
October 27, 2015 DRUG MEDI-CALWAIVER STAKEHOLDER FORUM Patrick Zarate Division Manager, Alcohol & Drug Programs Objectives for Today Learn About the Drug Medi-Cal Organized Delivery System waiver Gain
More informationSTAR+PLUS through UnitedHealthcare Community Plan
STAR+PLUS through UnitedHealthcare Community Plan Optum 06012014 Who We Are United Behavioral Health (UBH) was created February 2, 1997, through a merger of U.S. Behavioral Health, Inc. (USBH) and United
More informationMAGELLAN UNIVERSAL SERVICES LIST - Includes Preferred HIPAA Compliant Codes. UB-04 Revenue Codes
Service Name & Detailed Magellan Description (see column heading explanations at end of this document) MAGELLAN UNIVERSAL SERVICES LIST - Includes Preferred HIPAA Compliant Codes Codes Used to Determine
More informationLOUISIANA MEDICAID PROGRAM ISSUED: 06/09/17 REPLACED: CHAPTER 2: BEHAVIORAL HEALTH SERVICES SECTION 2.2: OUTPATIENT SERVICES PAGE(S) 8
Licensed Practitioner Outpatient Therapy includes: Individual; Family; Group; Outpatient psychotherapy; Mental health assessment; Evaluation; Testing; Medication management; Psychiatric evaluation; Medication
More informationManaged Medi-Cal Behavioral Health Benefits. Alliance Board Meeting October 23, 2013
Managed Medi-Cal Behavioral Health Benefits Alliance Board Meeting October 23, 2013 Purpose Discuss role of ACA in expanding benefits Review philosophy of integrated health care Review State policy process
More informationClinical Utilization Management Guideline
Clinical Utilization Management Guideline Subject: Therapeutic Behavioral On-Site Services for Recipients Under the Age of 21 Years Status: New Current Effective Date: January 2018 Description Last Review
More informationInternship Opportunities
Internship Opportunities Mission Statement The Harrisonburg-Rockingham Community Services Board provides services that promote dignity, recovery, and the highest possible level of participation in work,
More informationPROPOSED AMENDMENTS TO HOUSE BILL 4018
HB 01-1 (LC ) //1 (LHF/ps) Requested by Representative BUEHLER PROPOSED AMENDMENTS TO HOUSE BILL 01 1 1 1 1 On page 1 of the printed bill, line, after ORS insert.0 and. In line, delete Section and insert
More informationWelcome to the Webinar!
Welcome to the Webinar! We will begin the presentation shortly. Thank you for your patience. Attendees can access the presentation slides now at: http://www.mctac.org/page/events A recording of the event
More informationMental Health Liaison Group
Mental Health Liaison Group The Honorable Nancy Pelosi The Honorable Harry Reid Speaker Majority Leader United States House of Representatives United States Senate Washington, DC 20515 Washington, DC 20510
More informationSection V: To be completed by the PIHP contract manager as applicable. Section VI: To be completed by the PIHP Credentialing Committee as applicable.
Sections I-IV: To be completed by the organizational provider at the time of initial network application for enrollment and credentialing; or at the time of the biennial re-credentialing. Section I. Agency
More informationDrug Medi-Cal Organized Delivery System (DMC-ODS) Waiver
Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver Medi-Cal Managed Care Advisory Committee Uma K. Zykofsky, LCSW Director, Behavioral Health Services Alcohol & Drug Administrator Waiver Authority
More informationBehavioral Health Providers: Frequently Asked Questions (FAQs)
Behavioral Health Providers: Frequently Asked Questions (FAQs) Q. What has changed as far as behavioral health services? A1. Effective April 1, 2012, the professional and outpatient facility charges for
More informationPaula Stone Deputy Director, DMS, DHS
Paula Stone Deputy Director, DMS, DHS 1 Outpatient mental health services available to AR Medicaid beneficiaries include: Individual, family and group counseling services provided in an outpatient agency
More informationAPPENDIX A-8 Credentialing Criteria
APPENDIX A-8 Credentialing Criteria Introduction Credentialing criteria The general eligibility criteria for individual practitioners, individual practitioners in a group, and organizational providers
More informationInteractive Voice Registration (IVR) System Manual WASHINGTON STREET, SUITE 310 BOSTON, MA (800)
Interactive Voice Registration (IVR) System Manual 1000 WASHINGTON STREET, SUITE 310 BOSTON, MA 02118-5002 (800) 495-0086 www.masspartnership.com TABLE OF CONTENTS INTRODUCTION... 3 IVR INSTRUCTIONS...
More informationILLINOIS 1115 WAIVER BRIEF
ILLINOIS 1115 WAIVER BRIEF STATE TESTING FOR THE FOLLOWING ACHIEVED RESULTS: 1. Increased rates of identification, initiation, and engagement in treatment 2. Increased adherence to and retention in treatment
More informationTreatment Planning. General Considerations
Treatment Planning CBH Compliance has been tasked with ensuring that our providers adhere to documentation standards presented in state regulations, bulletins, CBH contractual documents, etc. Complying
More informationTHE ADDICTION AND RECOVERY TREATMENT SERVICES PROGRAM (ARTS) PROVIDER MANUAL
THE ADDICTION AND RECOVERY TREATMENT SERVICES PROGRAM (ARTS) PROVIDER MANUAL SUPPLEMENTAL INFORMATION This Supplement to the Optima Health Provider Manual is available for Providers who provide services
More informationMHANYS Behavioral Health Managed Care Update
MHANYS Behavioral Health Managed Care Update Mental Health Association in New York State, Inc. October 28, 2016 September 22, 2016 2 Presentation Overview What are the Goals for the Medicaid Changes? Changes
More informationADULT MENTAL HEALTH TRACK
ADULT MENTAL HEALTH TRACK COORDINATOR: Dr. David LeMarquand NMS Code Number: 181514 4 Resident Positions are available Number of applications in 2011: 68 The Adult Mental Health Track is designed to prepare
More information(b)(3) Transitional Living Adolescents MH/SA Adults MH/SA Medicaid Billable Service Effective Revised
(b)(3) Transitional Living Adolescents MH/SA Adults MH/SA Medicaid Billable Service Effective 10-01-13 Revised 11-20-15 CODE: H2022 U4 The Transitional Living program is designed to aid young adults from
More informationPartial Hospitalization. Shelly Rhodes, LPC
Partial Hospitalization Shelly Rhodes, LPC Shelly.Rhodes@beaconhealthoptions.com Transition and Certification 2 Transition and Certification Current Rehabilitative Services for Persons with Mental Illness
More informationInteractive Voice Registration (IVR) System Manual WASHINGTON STREET, SUITE 310 BOSTON, MA
Interactive Voice Registration (IVR) System Manual 1000 WASHINGTON STREET, SUITE 310 BOSTON, MA 02118-5002 1-800-495-0086 www.masspartnership.com TABLE OF CONTENTS INTRODUCTION... 3 IVR INSTRUCTIONS...
More informationThe Oregon Administrative Rules contain OARs filed through December 14, 2012
The Oregon Administrative Rules contain OARs filed through December 14, 2012 OREGON HEALTH AUTHORITY, ADDICTIONS AND MENTAL HEALTH DIVISION: MENTAL HEALTH SERVICES 309-016-0605 Definitions DIVISION 16
More informationPerson Centered Agenda
1 Person Centered Agenda Initial Confusion Overwhelmed by Statistics and Acronyms Dramatic Engagement of Issue Extreme Interest and Curiosity Deep Sense of Relief SAMHSA S STRATEGIC INITIATIVES Leading
More informationMedicare Behavioral Health Authorization List Effective 5/26/18
100 All inclusive room and board 101 All inclusive room and board 104 Anesthesia, ECT 114 Room and Board- private psychiatric 116 Room and Board- private room detoxification 118 Room and Board- private
More informationBehavioral Wellness A System of Care and Recovery
., SANTA BARBARA COUNTY DEPARTMENT OF Behavioral Wellness A System of Care and Recovery P a g e \ 1 of 6 Departmental Policy and Procedure Section Sub-section Policy Alcohol and Drug Program (ADP) Drug
More informationState-Funded Enhanced Mental Health and Substance Abuse Services
and and Contents 1.0 Description of the Service... 3 2.0 Individuals Eligible for State-Funded Services... 3 3.0 When State-Funded Services Are Covered... 3 3.1 General Criteria... 3 3.2 Specific Criteria...
More informationIV. Clinical Policies and Procedures
A. Introduction The role of ValueOptions NorthSTAR is to coordinate the delivery of clinical services. There are three parties to this care coordination process: the Enrollee, the Provider(s), and the
More informationApproved Curriculum and Equivalency Standards. Parent Support and Training/Youth Support and Training
Approved Curriculum and Parent Support and Training/Youth Support and Training Introduction to Wraparound This initial training introduces new parent support and training and youth support and training
More informationSTATE OF NEW JERSEY DEPARTMENT OF HUMAN SERVICES DIVISION OF MENTAL HEALTH AND ADDICTION SERVICES REQUEST FOR INFORMATION
STATE OF NEW JERSEY DEPARTMENT OF HUMAN SERVICES DIVISION OF MENTAL HEALTH AND ADDICTION SERVICES REQUEST FOR INFORMATION PURPOSE The Division of Mental Health and Addiction Services (DHMAS) is seeking
More informationCHAPTER 24 ACCREDITATION OF PROVIDERS OF SERVICES TO PERSONS WITH MENTAL ILLNESS, MENTAL RETARDATION, AND DEVELOPMENTAL DISABILITIES PREAMBLE
Human Services[441] Ch 24, p.1 CHAPTER 24 ACCREDITATION OF PROVIDERS OF SERVICES TO PERSONS WITH MENTAL ILLNESS, MENTAL RETARDATION, AND DEVELOPMENTAL DISABILITIES PREAMBLE The mental health, mental retardation,
More informationMEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS OPPORTUNITIES FOR INNOVATIVE PROGRAM DESIGN
Louisiana Behavioral Health Partnership MEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS OPPORTUNITIES FOR INNOVATIVE PROGRAM DESIGN Rosanne Mahaney - Delaware Lou Ann Owen - Louisiana Brenda Jackson,
More informationPLACEMENT OPENINGS: Two Post-Doctoral Residency positions are available for our Integrated Behavioral Health track
San Mateo Medical Center Medical Psychiatry Services 222 W. 39 th Ave. San Mateo, CA 94403 (650)573-2760 PLACEMENT OPENINGS: Two Post-Doctoral Residency positions are available for our Integrated Behavioral
More informationDraft Children s Managed Care Transition MCO Requirements
Draft Children s Managed Care Transition MCO Requirements OVERVIEW On February 1 st, New York State released for stakeholder feedback a draft version of the Medicaid Managed Care Organization (MCO) Children
More informationUnitedHealthcare Guideline
UnitedHealthcare Guideline TITLE: CRS BEHAVIORAL HEALTH HOME CARE TRAINING TO HOME CARE CLIENT (HCTC) PRACTICE GUIDELINES EFFECTIVE DATE: 1/1/2017 PAGE 1 of 14 GUIDELINE STATEMENT This guideline outlines
More informationSAMHSA CCBHC Criteria / CARF 2015 Behavioral Health Standards Crosswalk
Definitions Program Requirement 1: STAFFING Criteria 1.A: General Staffing 1.a.1 As part of the process leading to certification, the state will prepare an assessment of the needs of the target consumer
More informationFQHC Behavioral Health Billing Codes
FQHC s Eligible Documentation Assessment 90792 Psychiatric Prescribers only (MD, NP, PA, APRN) Psychiatric diagnostic evaluation with medical services. Medical though process clearly reflected in assessment
More informationHCMC Outpatient Mental Health Programs. External Referral Form
HCMC Outpatient Mental Health Programs External Referral Form Thank you for your interest in the Day Treatment, Partial Hospital Program, or Dialectical Behavior Therapy Intensive Outpatient Program. All
More informationNETWORK180 PROVIDER MANUAL SECTION 1: SERVICE REQUIREMENTS TARGETED CASE MANAGEMENT
NETWORK180 PROVIDER MANUAL SECTION 1: SERVICE REQUIREMENTS TARGETED CASE MANAGEMENT Provider will comply with regulations and requirements as outlined in the Michigan Medicaid Provider Manual, Behavioral
More informationVermont Hub and Spoke Model
Vermont Hub and Spoke Model John R. Brooklyn, MD Assistant Clinical Professor of Family Medicine and Psychiatry Medical Director Substance Abuse Treatment Center University of Vermont Impetus for Developing
More informationMental Health Updates. Presented by EDS Provider Field Consultants
Mental Health Updates Presented by EDS Provider Field Consultants October 2007 Agenda Session Objectives Outpatient Mental Health Medicaid Rehabilitation Option (MRO) Somatic Treatment Assertive Community
More informationCritical Time Intervention (CTI) (State-Funded)
Critical Time (CTI) (State-Funded) Service Definition and Required Components Critical Time (CTI) is an intensive 9 month case management model designed to assist adults age 18 years and older with mental
More informationDr. Nancy G. Burlak, EdD, LMFT
CURRICULUM VITAE Dr. Nancy G. Burlak, EdD, LMFT EDUCATION/LICENSE 2011-2014 Ed.D. (Counseling Psychology 4.0 GPA) ARGOSY UNIVERSITY, San Diego, CA Clinical Research Project: Optimal Duration of Treatment
More information10-44 Chapter 101 MAINECARE BENEFITS MANUAL CHAPTER II SECTION 65 BEHAVIORAL HEALTH SERVICES ESTABLISHED 8/1/08 LAST UPDATED 6/29/12
TABLE OF CONTENTS PAGE 65.01 INTRODUCTION... 1 65.02 DEFINITIONS... 1 65.02-1 American Society of Addiction Medicine Criteria (ASAM)... 1 65.02-2 Affected Other... 1 65.02-3 Authorized Agent... 1 65.02-4
More informationRegion 1 South Crisis Care System
Region 1 South Crisis Care System Region 1 South Crisis Care System Presenters: Lee Ann Reinert, LCSW Clinical Policy Specialist, DHS/DMH Patricia Palmer, LCSW, CADC Clinical Director, Collaborative Author:
More informationVHA Mental Health Program Office Update VA Psychologist Leader Conference
VHA Mental Health Program Office Update VA Psychologist Leader Conference Wendy Tenhula, PhD Acting Deputy Chief Consultant for Specialty Mental Heath David Carroll, PhD Executive Director, Office of Mental
More informationAurora Behavioral Health System
Aurora Behavioral Health System Decades Program Overview Where healing starts and the road to recovery begins Aurora East 6350 S. Maple Ave. Tempe, AZ 85283 (The hospital is located on the NW corner of
More informationService Array: Mental Health Medicaid Specialty Supports and Services Descriptions Note:
Service Array: Mental Health Medicaid Specialty Supports and Services Descriptions Note: If you are a Medicaid beneficiary and have a serious mental illness, or serious emotional disturbance, or developmental
More informationDEPARTMENT OF HUMAN SERVICES DIVISION OF MENTAL HEALTH & ADDICTION SERVICES
DEPARTMENT OF HUMAN SERVICES DIVISION OF MENTAL HEALTH & ADDICTION SERVICES ADDENDUM to Attachment 3.1-A Page 13(d).10 Service Description Community Support Services consist of mental health rehabilitation
More informationMassHealth Restructuring Overview
1 MassHealth Restructuring Overview State of the State, Assuring Access, Equity and Integrated Care Massachusetts League of Community Health Centers Marylou Sudders, Secretary Executive Office of Health
More informationAges Ages 3 through 64.
Medicaid: Follow-Up After Discharge from Community Hospitals, State Psychiatric Hospitals, and Facility Based Crisis Services for Mental Health Treatment The percentage of discharges for individuals ages
More informationMedicaid Rehabilitation Option Services
INDIANA HEALTH COVERAGE PROGRAMS PROVIDER REFERENCE M ODULE Medicaid Rehabilitation Option Services LIBRARY REFERENCE NUMBER: PROMOD00016 PUBLISHED: DECEMBER 14, 2017 POLICIES AND PROCEDURES AS OF SEPTEMBER
More informationThe Behavioral Health System. Presentation to the House Select Committee on Mental Health
The Behavioral Health System Presentation to the House Select Committee on Mental Health John Hellerstedt, M.D. Commissioner Lauren Lacefield Lewis Assistant Commissioner Division for Mental Health and
More informationCardinal Innovations Healthcare 2017 Needs and Gaps Analysis
2017 Community Mental Health, Substance Use and Developmental Disabilities Services Needs and Gaps Analysis for the Triad Region (Formerly known as CenterPoint Human Services) This study assesses the community
More informationPrimary Care Setting Behavioral Health Billing Codes
Primary Care Setting s Medicaid Medicare Third Eligible Documentation Assessment 90792 Psychiatric Prescribers only (MD, NP, PA, APRN) Psychiatric diagnostic evaluation with medical services. Medical though
More information907 KAR 10:014. Outpatient hospital service coverage provisions and requirements.
907 KAR 10:014. Outpatient hospital service coverage provisions and requirements. RELATES TO: KRS 205.520, 42 C.F.R. 447.53 STATUTORY AUTHORITY: KRS 194A.030(2), 194A.050(1), 205.520(3), 205.560, 205.6310,
More informationRequest for Information (RFI) for. Texas CHIP and Medicaid Managed Care Services for Serious Mental Illness. RFI No. HHS
CHARLES SMITH, EXECUTIVE COMMISSIONER Request for Information (RFI) for Texas CHIP and Medicaid Managed Care Services for Serious Mental Illness RFI No. HHS0001303 Date of Release: June 1, 2018 CPA Class/Item
More informationIn-Home Behavioral Services Performance Specifications
Commonwealth of Massachusetts Executive Office of Health and Human Services www.mass.gov/masshealth In-Home Behavioral Services Performance Specifications Providers contracted for this level of care or
More informationI. General Instructions
Contra Costa Behavioral Health Services Request for Proposals (RFP) Outpatient Mental Health Services September 30, 2015 I. General Instructions Contra Costa Behavioral Health Services (CCBHS, or the County)
More informationOverview of New Nursing Roles in Whole Person Care. Session 1
Overview of New Nursing Roles in Whole Person Care Session 1 1 Introductions Anne Shields, MHA, RN Associate Director, UW AIMS Center 2 Learning Objectives RN Primary Care Managers Focus Patient Population:
More informationPsychology Externship Information
November 20, 2017 Psychology Externship 2018-2019 Information Contact information for externship: o Address: 720 N St. Asaph St. Alexandria, VA 20314 o Psychology Externship director: Kirimi Fuller, Psy.D.;
More informationJOB OPENINGS PIEDMONT COMMUNITY SERVICES
JOB OPENINGS PIEDMONT COMMUNITY SERVICES Our Excellent full time benefits package offers: Virginia Retirement with Employer match Paid Life Insurance = 2X Your Salary Partially Paid Medical Insurance +
More informationMary Hoefler, MS, LCSW Office of Behavioral Health Office
Mary Hoefler, MS, LCSW Office of Behavioral Health mary.hoefler@state.co.us 303.866.7518 Office Senate Bill 266 Components of the BH crisis response system will reflect a continuum of care from crisis
More informationHEALTH HOME INTEGRATED PRIMARY AND BEHAVIORAL HEALTH CARE SERVICES
COMPARISON OF EXISTING SERVICES AND DELIVERY MODELS WITH DEFINITIONS PRIMARY CARE CASE MANAGEMENT (PCCM) Oklahoma s PCCM program is called SoonerCare Choice (SCC), in which each enrollee is linked to a
More information