Addressing the Challenge of Substance Use: A State and Community Approach
|
|
- Rodger Isaac Clark
- 5 years ago
- Views:
Transcription
1 Addressing the Challenge of Substance Use: A State and Community Approach Presented by: Elizabeth Manley, Institute for Innovation and Implementation Kathi Way, Acting Assistant Commissioner, NJ Children s System of Care Kathy Collins, Executive Director, Monmouth Cares Marc Fishman, MD Medical Director Maryland Treatment Centers
2 Federal Legislation: Joint CMCS and SAMHSA Informational Bulletin 1/6/15 Protecting Our Infants Act of 2015 provides the framework to address the challenge of prenatal opioid exposure. Neonatal Abstinence Syndrome (NAS) Prenatal Opioid Exposure Treatment of Opioid Use Disorder (OUD) CDC Guidelines for Prescribing Opioids for Chronic Pain
3 Federal Legislation Continued: Comprehensive Addiction and Recovery Act (CARA): included: increased access to naloxone Improved prescription monitoring programs Increase access to treatment programs Training for professionals 21 st Century Cures Act: CMCS Informational Bulletin Requirements of providing all medically necessary treatments for individuals under 21 Research and drug development Opioid epidemic Informed consent
4 Federal Legislation Continued: Family First Act of 2018 Provides for the ability to fund Residential SU treatment for families. Allows for funding mental health and substance use treatment Pending Legislation:
5
6 1 Trust, Transfer, Transition, Integration, Transformation How the NJ Children s System of Care Assumed Responsibility for Adolescent Substance Use Treatment Kathryn Way, Acting Assistant Commissioner July 2018
7 Department of Children and Families New Jersey Department of Children and Families Commissioner Children s System of Care (formerly DCBHS) Child Protection & Permanency (formerly DYFS) Family & Community Partnerships (formerly DPCP) Division on Women Office of Adolescent Services
8 Children s System of Care Serves youth under age 21 with emotional and behavioral health care challenges, intellectual/ developmental disabilities, Autism, and/or substance use challenges CSOC is committed to providing these services based on the needs of the youth and family in a family-centered, community-based environment Statewide services with access through single point of entry Voluntary Medicaid platform Local System partners are located in the community and aligned with Court Vicinages to assure seamless connections and coordination of care, particularly where youth have multisystem involvement
9 Children s System of Care Objectives To Help Youth Succeed At Home Successfully living with their families and reducing the need for out-of-home treatment settings. In School Successfully attending the least restrictive and most appropriate school setting close to home. In the Community Successfully participating In the community and becoming independent, productive and law-abiding citizens.
10 Service Array Expansion to Reduce Use of Deep End Services Low Intensity Services Out of Home Out of Home Intensive In- Community Wraparound CMO Behavioral Assistance Intensive In-Community Lower Intensity Services Outpatient Partial Care After School Programs Therapeutic Nursery Prior to Children s System of Care Initiative Today
11 System of Care Values and Principles Youth Guided & Family Driven Community Based Culturally/Linguistically Competent Strength Based Unconditional Care Promoting Independence Family Involvement Collaborative Cost Effective Comprehensive Individualized Home, School & Community Based Team Based
12 Language Is Important Our language conveys are attitudes and values Language can hurt, label, stigmatize Client Case Placement Instead of addict/addiction, say substance use challenges Instead of rehab, say treatment intervention Instead of compliance, say engagement Instead of abuse, say use
13 Trauma-Informed Care Departmental Initiative. Do not focus on surface behavior. Interventions should address underlying trauma reaction Implicit trauma indicators Safe, consistent, nurturing environment The Six Core Strategies for Reducing Seclusion and Restraint Use
14 Children s System of Care History 1999 NJ wins a federal grant that allowed us to develop a system of care The Department of Children and Families (DCF) becomes the first cabinet-level department exclusively dedicated to children and families [P.L. 2006, Chapter 47]. January 2013 Intellectual/developmental disability (I/DD) services for youth and young adults under age 21 is transitioned from the Department of Human Services (DHS) Division of Developmental Disabilities to the DCF Children s System of Care (CSOC).** July 2013 Substance use treatment services for youth under age 18 is transitioned from DHS, Division of Mental Health and Addiction Services, to DCF/CSOC. July 2015 NJ wins a Federal SAMHSA Grant for System of Care - Expansion and Sustainability NJ restructures the funding system that serves children. Through Medicaid and the contracted system administrator, children no longer need to enter the child welfare system to receive behavioral health care services The number of youth in out-ofstate behavioral health care goes from more than 300 to three.* May 2013 Unification of care management, under CMO, is completed statewide. *How did we do this? Careful individualized planning and the development of in-state options (based on research about what youth need) using resources that were previously going out of state. **Youth with I/DD in OOH programs or at risk of OOH, are transitioned July 2012 December 2014 Integration of Physical and Behavioral Health is initiated in Bergen and Mercer County with expected Statewide rollout
15 Financing Title XIX Funding -Rehab Option -Targeted Case Mgt Child Welfare Juvenile Justice 1915 like (i) or (c) 1115 Waiver CHIP/SCHIP State Funds Priorities Increase Access tocare EBPs Care Management System Coordination Reduce Institutional Care Particular Populations CSOC Values & System of Care Design Principles Factors that Impact Design Environment Political Perspectives of Leaders Lawsuits/Settlements Crisis/Tragedy Mandates Community Will Economy Structure Government State vs. County Existing Reality Envisioned Ideal Medicaid Agency Locus of Control Leadership Structure
16 SU Transition-Multilayered Approach and Engagement to Assure Best Chance of Success Governor Signs Order for Integration: 1) Extensive Discussion/Negotiation/Information 2) Sharing with the Sending Division 3) Stakeholder Groups 4) Provider Training/EHR (42 CFR, Part 2) 5) Inclusion of Wrap Around 6) Convert sub use OOH programs to co-occurring model 7) Movement to fee for service, rate increase, and adjustment 8) Clinical criteria and authorizations to assure intensity of need is appropriate 9) Ongoing research on best practices, policy and program development
17 CSOC Continuum of Services for Substance Use Outpatient Partial Care Co-Occurring Group Home Co-Occurring RTC Withdrawal Management Substance Use Navigator*
18 Stakeholder Group Part of readiness: Important to engage and provide a forum for system partners to understand CSOC and each other Provided community partners an opportunity to understand potentialchanges Provided treatment providers an opportunity to foresee their own destiny Represented by: Families Service Recipients Care Management Organization (CMO) Outpatient Providers(OP) Out of Home Treatment Providers(OOH) Existing Division (DMHAS) Receiving Division(CSOC) Advocates
19 Access The most important goal: Easy access for youth andfamilies Routinely, all access to System of Care (CSOC) services are routed through the single point of entry, Contracted Systems Administrator (CSA) Prior to transition from DMHAS, access to substance use services occurred through direct contact with provider agencies It was clear that we needed to adopt and maintain the direct accessprocess This required the System of Care to adjust its process As a result, youth/families may access SU treatment services either via contacting the CSA or contacting a contracted provider directly
20 Access Who may request services? CSOC System Partners Child Welfare Care Management (Wraparound agencies) Mobile Response Juvenile Court County Representatives Schools Pediatricians Youth and Families
21 Funding Initially, when the substance use contracts for out of home treatment transitioned to CSOC, they remained as cost reimbursement The CSOC vision was to convert these contracts to Fee for Service (FFS) CSOC developed market based rates on the Medicaid platform, which is congruent to the rest of our system s processes In some instances, the rates were significantly increased FFS model resulted in better utilization management 29
22 Assessment Agencies are required to use below in order to receive an Intensity of Service (IOS) disposition and a service authorization Maintain the use of ASAM Criteria as the basis for assessment CSOC also integrated the CANS assessment tool CSOC s Bio-PsychoSocial evaluation (BPS) Agencies may also use a standardized SU assessmenttool The authorization process was implemented in order to maintain good data, connect where needed Authorizations are also a precursor to these agencies becoming Fee for Service (FFS) providers The CSA issues a 30-day presumptive authorization to give providers the time to complete the assessment processes
23 Treatment Approach Simultaneous to the transfer, and ultimately, the transition to the System of Care, we developed a co-occurring substance use and behavioral health trauma based model of treatment It seemed clear to us (based on our years of experience, and supported through research), that youth using some form of substance were also experiencing behavioral health and emotional challenges The greater majority of the youth coming for substance use treatment were referred not only for their use, but rather because of their presenting overt behaviors
24 Transition to Co-Occurring Model The transitioned OOH SU agencies functioned as primary substance use programs until July 1, In July 2015 and after many meetings, trainings, and contract alterations, CSOC successfully converted all OOH substance use provider agencies to co-occurring programs with an increased per diem rate and a set of standardized contract deliverables. These transitioned SU OOH programs are now referred to as cooccurring group homes.
25 Programmatic Changes Programmatic changes were made as a result of transitioning to a co-occurring treatment model: Agencies were now financially supported to expand their staffing to include licensed behavioral health clinicians (including dually licensed clinicians), psychiatry, and nursing as a routine part of their work Increased allied therapies which promotes a holistic approach to care Increased staff-to-youth ratio supervision Inclusion of CMO services for all youth in co-occurring OOH treatment; operated within the CFT model
26 Co-Occurring RTC s The CSOC continuum was in need of co-occurring RTC services to serve youth who displayed a higher level of behavioral health needs and whose model provided a braided, integrated set of interventions for youth. This was a major step towards true integration of care. Initially, CSOC converted an existing RTC (served only males) to a co-occurring RTC program; this agency hired a well-known consultant who developed a trauma based substance use program for their youth. This program operates at full capacity and has been a great success. In 2015, CSOC awarded two five-bed community-based co-occurring programs for girls via RPF. In 2016, CSOC released another RFP and subsequently awarded an additional 32 co-occurring RTC beds for males and females.
27 Service Delivery The authorization is the conduit for youth to receive services and for agencies to get paid through what was still a cost reimbursement system. The authorization also opens the electronic record, which is closely governed by the 42 CFR Part 2, to the agency. This allows the agencies to complete treatment plans and to request continued care and/or transition youth to another intensity of services within our system of care. All treatment plans require approval by credentialed care coordinators atthe CSA. Treatment plans are completed cyclically and are reviewed by dually licensed clinicians at the CSA for continued care. All planning for youth in OOH treatment is done under the driving auspices of the Child Family Team.
28 The Child Family Team Drives the Treatment We need to engage youth and families and meet them where they are at.
29 Mandated Child Family Teams for Youth in Out of Home Treatment for Substance Use Child Family Team (CFT) A team of family members, professionals, and significant community residents identified by the family and organized by the care management organization to design and oversee implementation of the Individual Service Plan. CFT members should include, but are not limited to, the following individuals: Child/Youth/Young Adult Family Support Partner (FSO) Parent(s)/Legal Guardian Care Management Organization Natural supports as identified and selected by youth and family Treating Providers (in-home, out-of-home, etc.) Educational Professionals Physical Health Providers (pediatrician, specialist) Probation Officer (if applicable) Child Protection & Permanency (CP&P)(if applicable)
30 Behavioral Health Home (BHH) What it is: CMOs are the designated BHH for Children in NJ Enhancement to the Child Family Team to bring medical expertise to the table What it is not: Not a physical site
31 Co-Morbidity in Children and Adults Cost Driver Children Adults Behavioral Health Physical Health Co-Morbidity is not as high in Children as in Adultsh chronic conditions 1/3 of Children with Behavioral Health have chronic conditions 2/3 of Adults with Mental Illness CMS will only approve those State Plan Amendments (SPA) that cover both children and adults (lifespan) Assisting children and their families manage a chronic illness will reduce significant costs related to physical healthcare inadults Substance Use Disorder is included in the BHH
32 Outpatient Services The major change for the outpatient providers is that they adopted the CSOC Bio Psychosocial (BPS) evaluation and the treatment planningmodels. OP providers utilize ASAM and CANS as basis for assessment and continued treatment. OP providers may conduct BPS evaluations as a new revenue path. Over time, we converted all the IOP slots into a time bank with the OP slots. This afforded the agencies and youth the opportunity to participate in treatment based on a clinical review as well as their ability to commit to a set number of sessions per week. This appears to be a more efficient use ofresources. The outpatient providers continue to operate as cost reimbursement.
33 Withdrawal Management (WM) While the initial transfer of programs did not include any subacute detox resources, the result of the Hurricane Sandy in Fall 2012 resulted in funding for the development of a small program for up to six youth. Curiously, and with great concern, these beds were never used to their maximum capacity. This program has since been relocated to a more central location and utilization has increased.
34 Successes Integrated Approach to Care-We are able to provide better in-depth care and treatment for youth who are presenting with co-occurring behavioral health and substance use challenges. Linkages- We are in a better position to educate our youth and families through the System of Care infrastructure which has the ability to provide an array of interventions that allow for a wraparound approach. One of the few data points we were able to gain before the transfer, was that youth who had been in one of the OOH programs and were also connected to one of the System of Care s Care Management Organizations had better outcomes in the community As a result, we connected youth with CMO upon the youth s admission to OOH with the intent of the youth transitioning back to their community with a plan of care developed by the Child Family Team to support a development of strong community plan.
35 Ongoing Challenges CSOC is not fully utilizing available resources during a time of grave concern, in which youth are suffering and not accessing services: Ongoing stigma Alcohol and marijuana continue to be seen as recreational rather than potentially problematic areas, especially re: effects on the developing brain; Substance use agencies are noting difficulty in work force development with regard to hiring dually-licensed clinicians.
36 Next Steps 1. Reducing Stigma-Words Matter 2. Substance Use Navigators in every county/vicinage Building capacity of BH provider network to identify substance use and Develop techniques to address 3. Continue to refine clinical care 4. Substance Use Consultant (Rutgers University)
37 Next Steps 5. Education on effective SU prevention strategies to all community partners 6. Leverage CIACC s-csoc s local planning bodies to disseminate information: SU Navigators sit on CIACCs Local county dashboards were enhanced to help communities participate in identifying trends and gaps in services 7. Care Plan Redesign (one youth, one team, one plan)
38 For more information Children s System of Care: PerformCare Member Services: Crisis Text Line, Text NJ to
39 1
40 Wraparound and Substance Use A Care Management Organization's Experience Kathy Collins, LCSW, Executive Director MonmouthCares
41 A Care Management Organization is charged with providing kids with moderate to complex needs, and their families, with comprehensive planning and coordination of an Individual Care Plan with attention to 12 life domains. Youth have behavioral health challenges, and may also have intellectual/developmental or substance use, challenges, and chronic medical needs. We develop a Child and Family Team for each family and use Wraparound practice. The CMO is part of a Local System of Care.
42 Mobile Response and Stabilization Providers Care Management Organization Children s Interagency Coordinating Council (local needs, policy and planning) Family Support Organization System Partners (JJ. CW, ED)
43 Youth with Substance Use Needs Join us in Incentives and Challenges Incentive: Joining a robust 12 year old System of Care with opportunities for support Challenge: Different values and practice principles Incentive: New funds and investments in programs and services Challenge: Rapid growth and the need for new expertise and programming
44 Incentives and Challenges continued Incentive for both CMO and SU providers: Better access to treatment services Challenges for both CMO and SU: CMO: Serious lack of knowledge of SU treatment SU Providers: Lack of CFT participation, i.e. little collaboration with the Community
45 Challenging Wraparound Principles Family Voice and Choice nothing about us without us. Family-Doubting e.g. enabling, co-addicted, mistrust of the community Team Based + Collaboration Treatment providers rule. our policy. Team Goals
46 Individualized - customized Levels, steps, rules how we do things Compliance as progress Individual = denial, enabling Unconditional - make a new plan! Everything is conditional, as part of the treatment plan Multiple opportunities to fail to not complete treatment. Ejection as a treatment strategy
47 Wraparound Phases CMO Expertise Engagement Substance Use Providers Motivation Care Management Vision and Strengths Marketing Unmet Needs External Pressure Family Support and Culture
48 Wraparound Phases CMO Expertise Transition Substance Use Providers Discharge to? Family, Detention/Probation, Child Welfare Relapse Prevention Care Management Full CF Team Carries On All Life Domains Aftercare Plan? Community Plan
49 July 2015 SAMHSA Expansion and Sustainability Grant Six Core Strategies Evidence-based strategies to prevent conflict and violence; to reduce the use of Seclusion and Restraint Adapted to include trauma-focused strategies and to be Family-Driven and Youth Guided All System Partners are expected to incorporate the strategies, with special attention to Out of Home Providers
50 Six Core Strategies 1. Leadership Toward Organizational Change 2. Use Data to Inform Practice 3. Develop Your Workforce 4. Implement Seclusion, Restraint and Coercion Prevention Tools 5. Full Inclusion of Youth and Family Voice in all Activities 6. Make Debriefing Rigorous
51 Nurtured Heart Approach A set of strategies to transform the way kids perceive themselves, their caregivers and the world. ABSOLUTELY NO! Refuse to energize negative behavior ABSOLUTELY YES! Constant recognition of success, achievement, and their value
52 Nurtured Heart Approach, cont. ABSOLUTE CLARITY! Clear and consistent consequences when a rule is broken ********* All providers and partners will be trained to strategically pull the child into new patterns of success. Parents have training too.
53 Thank you! Kathy Collins, LCSW, Executive Director MonmouthCares x 104
The Role of Mobile Response in Transforming Children s Behavioral Health: The NJ Experience
The Role of Mobile Response in Transforming Children s Behavioral Health: The NJ Experience Presented by Elizabeth Manley Assistant Commissioner January 2017 In January 2000, Governor Whitman unveiled
More informationChildren s System of Care History
NJ Department of Children and Families Keeping Families Strong Keeping Children Safe and Well New Jersey Department of Children and Families Commissioner Division of Children s System of Care (formerly
More informationSubstance Use Treatment Services Frequently Asked Questions for Youth and Families
Substance Use Treatment Services Frequently Asked Questions for Youth and Families Knowing where to go for help for a substance use issue can be challenging. PerformCare New Jersey has made that very important
More informationCare Management Organization Policy Manual
Care Management Organization Policy Manual Allison Blake, Ph.D., L.S.W. Commissioner 2017 Table of Contents Foreword Section 1: System of Care History and Guiding Principles pp.7-9 I. System of Care History
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 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 informationMinnesota s Plan for the Prevention, Treatment and Recovery of Addiction
Minnesota s Plan for the Prevention, Treatment and Recovery of Addiction Background Beginning in June 2016, the Alcohol and Drug Abuse Division (ADAD) of the Minnesota Department of Human Services convened
More informationMedicaid Transformation
JOINT LEGISLATIVE COMMITTEE ON MEDICAID AND NC HEALTH CHOICE Medicaid Transformation Dr. Mandy Cohen, Dave Richard, Jay Ludlam Department of Health and Human Services Nov. 14, 2017 Recap: Where We Are
More informationREQUEST FOR PROPOSALS:
REQUEST FOR PROPOSALS: Behavioral Health Care in the Baltimore City Juvenile Justice Center Release Date: February 6, 2018 Pre-Proposal Conference: February 26, 2018 Proposal Due: March 19, 2018 Anticipated
More informationWidespread prescribing, distribution and availability of naloxone for high risk individuals and as rescue medication 2
Co Occurring Collaborative Serving Maine Expanding Medication Assisted Recovery Services & Building a Stronger Recovery Oriented System for SUD Treatment in Maine April 2018 Introduction: With support
More informationIntegrated Children s Services Initiative Frequently Asked Questions July 20, 2005
Integrated Children s Services Initiative Frequently Asked Questions July 20, 2005 1. What is the rationale for this change? Last year the Department began the Integrated Children s Services Initiative
More informationDEPARTMENT OF CHILDREN AND FAMILIES DIVISION OF CHILD BEHAVIORAL HEALTH SERVICES
DEPARTMENT OF CHILDREN AND FAMILIES DIVISION OF CHILD BEHAVIORAL HEALTH SERVICES Effective Date: May 1, 2008 DCBHS Policy #4 Date Issued: April 11, 2008 I. TITLE Admissions to Out-of-Home Treatment Settings
More informationThis report is a summary of the November 2015 Behavioral Health Stakeholder s Summit that was held in Fargo.
This report is a summary of the November 2015 Behavioral Health Stakeholder s Summit that was held in Fargo. February 10, 2016 ADULT BEHAVIORAL HEALTH November 2015 Summary Report Exchange of information
More informationConnecticut TF-CBT Coordinating Center
Connecticut TF-CBT Coordinating Center Welcome Packet W Introduction e are pleased to welcome you to the Connecticut TF-CBT Network! We are excited to collaborate with and support your efforts to provide
More informationempowering people to build better lives their efforts to meet economic, social and emotional challenges and enhance their well-being
Community Care Alliance empowering people to build better lives Adult Mental Health Services Basic Needs Assistance Child & Family Services Education Employment & Training Housing Stabilization & Residential
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 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 informationVermont Care Partners Legislative Agenda for 2018 Working Draft 4
1. Appropriations Bill for Fiscal Year 2018 Vermont Care Partners Legislative Agenda for 2018 Working Draft 4 Medicaid Reimbursement Rates Act 82 and Act 85 enabled all designated & specialized services
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 informationAuthorized By: Elizabeth Connolly, Acting Commissioner, Department of Human
HUMAN SERVICES 47 NJR 7(1) July 6, 2015 Filed June 10, 2015 DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES Rehabilitative Services for Children Readoption with Amendments: N.J.A.C. 10:77 Authorized
More informationBEHAVIORAL HEALTH SERVICES PROVIDER MANUAL Chapter Two of the Medicaid Services Manual
BEHAVIORAL HEALTH SERVICES PROVIDER MANUAL Chapter Two of the Medicaid Services Manual Issued March 14, 2017 State of Louisiana Bureau of Health Services Financing LOUISIANA MEDICAID PROGRAM ISSUED: 12/13/17
More informationCost Estimates of Individual Assessment Tools In Arkansas Medicaid Population
Cost Estimates of Individual Assessment Tools In Arkansas Medicaid Population PREPARED BY: THE STEPHEN GROUP 814 Elm Street, Suite 309 Manchester, NH, 03102 Main: (603)419-9592 www.stephengroupinc.com
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 informationNJ FamilyCare 1115 Comprehensive Demonstration Application for Renewal
NJ FamilyCare 1115 Comprehensive Demonstration Application for Renewal Strengthening Medicaid: Alignment & Redesign Through Integration NJ Department of Human Services 1/6/2017 Table of Contents Executive
More informationLOUISIANA MEDICAID PROGRAM ISSUED: 06-09/17 REPLACED: 03/14/17 CHAPTER 2: BEHAVIORAL HEALTH SERVICES SECTION 2.1: PROVIDER REQUIREMENTS PAGE(S) 15
PROVIDER REQUIREMENTS A provider must be enrolled in the Medicaid Program and meet the provider qualifications at the time service is rendered to be eligible to receive reimbursement through the Louisiana
More informationMobile Crisis Intervention
Mobile Crisis Intervention Providers contracted for this level of care or service will be expected to comply with all requirements of these service-specific performance specifications. Additionally, providers
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 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 informationFamily Intensive Treatment (FIT) Model
Requirement: Frequency: Due Date: Family Intensive Treatment (FIT) Model Specific Appropriation 372 of the General Appropriations Act for Fiscal Year 2014 2015 N/A N/A Description: From the funds in Specific
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 informationMobile Crisis Intervention
Mobile Crisis Intervention Providers contracted for this level of care or service will be expected to comply with all requirements of these service-specific performance specifications. Additionally, providers
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 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 informationOur general comments are listed below, and discussed in greater depth in the appropriate Sections of the RFP.
Deborah Cave, Executive Director Colorado Coalition of Adoptive Families (COCAF) Comments on Accountable Care Collaborative (ACC) Phase II DRAFT RFP Submitted January 13, 2017 (In Format Requested by HCPF)
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 informationCoverage of Behavioral Health Services for Children, Youth, and Young Adults with Significant Mental Health Conditions
Coverage of Behavioral Health Services for Children, Youth, and Young Adults with Significant Mental Health Conditions Webinar Website: http://gucchdtacenter.georgetown.edu/resources/tawebinars.html Coverage
More informationNew Jersey Department of Human Services Division of Mental Health and Addiction Services
I. BACKGROUND New Jersey Department of Human Services Division of Mental Health and Addiction Services BIANNUAL REPORT Plan for the Establishment and Funding of Regional Substance Abuse Treatment Facilities
More informationAdvancing Children s Behavioral Health through Systems Integration NASHP Conference October 25, 2017
Advancing Children s Behavioral Health through Systems Integration NASHP Conference October 25, 2017 Donna M. Bradbury, MA, LMHC Associate Commissioner 3 Medicaid Managed Care Transition 4 Vision for Transforming
More informationMARIN BEHAVIORAL HEALTH AND RECOVERY SERVICES Department Update
MARIN BEHAVIORAL HEALTH AND RECOVERY SERVICES Department Update P R E S E N T E D B Y : S U Z A N N E T A V A N O, P H D B E H A V I O R A L H E A L T H A N D R E C O V E R Y S E R V I C E S D I R E C
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 informationREQUEST FOR PROPOSALS FOR RESIDENTIAL TREATMENT SERVICES (RTC) INTENSITY OF SERVICES (IOS) (TOTAL OF 250 BEDS)
REQUEST FOR PROPOSALS FOR RESIDENTIAL TREATMENT SERVICES (RTC) INTENSITY OF SERVICES (IOS) (TOTAL OF 250 BEDS) Funding Available up to $32, 977, 750 Mandatory Bidders Conference: July 20, 2016 Time: 1:00PM
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 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 informationState of Florida Department of Children and Families Semi-Annual Progress Report April 2017 through September 2017 Title IV-E Demonstration Waiver
I. Overview This document updates the information in the initial design and implementation report as required by section 2.3 of the Waiver Terms and Conditions. This semi-annual progress report for the
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 informationHarris County Mental Health Services for Children, Youth and Families: 2017 System Assessment
Harris County Mental Health Services for Children, Youth and Families: 2017 System Assessment Andy Keller, PhD Michelle Harper, MPAff Seema Shah, MD October 30, 2017 Purpose and Approach We assessed Harris
More informationNavigating New York State s Transition to Managed Care
Navigating New York State s Transition to Managed Care December 3, 2014 Mary McKernan McKay, Ph.D Andrew F. Cleek, Psy.D. Meaghan E. Baier, LMSW Agenda Introduction of the Managed Care Technical Assistance
More informationDRUG MEDI-CAL ORGANIZED DELIVERY SYSTEM (DMC-ODS) YEAR 1 PERFORMANCE METRICS (version 10/24/17)
1 Access Enrollment information to include the number of DMC- ODS beneficiaries served in the DMC-ODS program Clients Served: 1. Number of DMC-ODS beneficiaries served (admissions) by the DMC- ODS County
More informationMedicaid and the. Bus Pass Problem
Medicaid and the Bus Pass Problem PRESENTED BY: Cardinal Innovations Healthcare Richard F. Topping, Chief Executive Officer Leesa Bain, Vice President, Care Coordination & Quality Management September
More informationNew York Children s Health and Behavioral Health Benefits
New York Children s Health and Behavioral Health Benefits DRAFT Transition Plan for the Children s Medicaid System Transformation August 15, 2017 DRAFT Transition Plan for the Children s Medicaid System
More informationDRUG MEDI-CAL ORGANIZED DELIVERY SYSTEM (DMC-ODS) PERFORMANCE METRICS. (version 6/23/17)
1 Access Enrollment information to include the number of DMC-ODS beneficiaries served in the DMC-ODS program Clients Served: 1. Number of DMC-ODS beneficiaries served (admissions) by the DMC- ODS County
More informationTransitioning to Community Services: HARPS, Health Homes and SPOA
Transitioning to Community Services: HARPS, Health Homes and SPOA P R E S E N T E R : G L E N N L I E B M A N, C EO Mental Health Association in New York State, Inc. Brief History of Health and Recovery
More informationFederal Legislation to Address the Opioid Crisis: Medicaid Provisions in the SUPPORT Act
October 2018 Issue Brief Federal Legislation to Address the Opioid Crisis: Medicaid Provisions in the SUPPORT Act MaryBeth Musumeci and Jennifer Tolbert On October 3, 2018, the Senate overwhelmingly passed
More informationBEHAVIORAL HEALTH SERVICES PROVIDER MANUAL Chapter Two of the Medicaid Services Manual
BEHAVIORAL HEALTH SERVICES PROVIDER MANUAL Chapter Two of the Medicaid Services Manual Issued March 14, 2017 State of Louisiana Bureau of Health Services Financing SECTION: TABLE OF CONTENTS PAGE(S) 1
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 informationMedicaid Funded Services Plan
Clinical Communication Bulletin 007 To: From: All Enrollees, Stakeholders, and Providers Cham Trowell, UM Director Date: May 10, 2016 Subject: Medicaid Funded Services Plan benefit changes, State Funded
More informationMEDICAL ASSISTANCE BULLETIN
MEDICAL ASSISTANCE BULLETIN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE ISSUE DATE EFFECTIVE DATE NUMBER September 8, 1995 September 8, 1995 1153-95-01 SUBJECT Accessing Outpatient Wraparound
More informationDual Diagnosis Task Force Implementation Plan
Dual Diagnosis Task Force Implementation Plan Priority Recommendation: Develop a continuum of crisis response services through a Medicaid State Plan amendment including: An array of supportive resources
More informationA PLAN FOR THE TRANSFER OF CERTAIN MENTAL HEALTH AND ADDICTION FUNCTIONS FROM THE DEPARTMENT OF HEALTH TO THE DEPARTMENT OF HUMAN SERVICES
A PLAN FOR THE TRANSFER OF CERTAIN MENTAL HEALTH AND ADDICTION FUNCTIONS FROM THE DEPARTMENT OF HEALTH TO THE DEPARTMENT OF HUMAN SERVICES PLEASE TAKE NOTICE that on June 21, 2018, Governor Philip D. Murphy
More informationDMC-ODS. System Transformation. Presented at DHCS 2017 Annual Conference. Elizabeth Stanley-Salazar, MPH Doug Bond Lisa Garcia, LCSW
DMC-ODS System Transformation Presented at DHCS 2017 Annual Conference Elizabeth Stanley-Salazar, MPH Doug Bond Lisa Garcia, LCSW Objectives Understand managed care principles applied to DMC-ODS Waiver
More informationEffective 11/13/2017 1
Commonwealth of Massachusetts Executive Office of Health and Human Services www.mass.gov/masshealth In-Home Therapy Services Performance Specifications Providers contracted for this level of care or service
More informationTransforming Behavioral Health Care in Louisiana Magellan in Louisiana/ Dr. Craig Coenson/Year 1 Report to the Community
Transforming Behavioral Health Care in Louisiana Magellan in Louisiana/ Dr. Craig Coenson/Year 1 Report to the Community Today s Discussion Welcome and Introductions Year 1: A change for good Meeting our
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 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 informationJoint Medicaid Oversight Committee Medicaid Behavioral Health Re-Design Panel Testimony
Joint Medicaid Oversight Committee Medicaid Behavioral Health Re-Design Panel Testimony Jennifer Riha, BAS, MAC, Vice President of Operations A Renewed Mind Behavioral Health September 22, 2016 Senator
More informationNAMI-NJ Annual Conference 12/8/12 DMHAS Update. Lynn A. Kovich Assistant Commissioner
NAMI-NJ Annual Conference 12/8/12 DMHAS Update Lynn A. Kovich Assistant Commissioner Agenda Newly Awarded Contracts and Current/Proposed RFP s Update on the ASO/MBHO Process Update on the Merger Supporting
More informationChildren s Medicaid System Transformation: HCBS Rates & SPA Rate Code Review. December 21, 2017
Children s Medicaid System Transformation: HCBS Rates & SPA Rate Code Review December 21, 2017 Introduction & Housekeeping Housekeeping: Slides are posted at MCTAC.org Questions not addressed today will
More informationDecember 16, 2011 Washington, D.C. Presented By: Bruce Kamradt, Director, Wraparound Milwaukee
Wraparound Milwaukee s Care Management Entity A Model for Creating Effective Service Delivery For Children With Serious Emotional and Mental health Needs and Their Families December 16, 2011 Washington,
More informationPartnership HealthPlan of California Strategic Plan
Partnership HealthPlan of California 2017 2020 Strategic Plan Partnership HealthPlan of California 2017 2020 Strategic Plan Message from the CEO While many of us have given up making predictions, myself
More informationChildren's System MCO Contracting Fair. November 6, 2017
Children's System MCO Contracting Fair November 6, 2017 2 Guiding Principles Behind Children s Health and Behavioral Health MC Transition Key components of the managed care transition is to: Early identification
More informationNorth Carolina s Transformation to Managed Care
North Carolina s Transformation to Managed Care Jay Ludlam, Assistant Secretary Department of Health and Human Services December 2017 My background Only 10+ years of experience in Medicaid Assistant Attorney
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 informationRequest for Proposals: Supporting Male Survivors of Violence (SMSV) Baltimore
Request for Proposals: Supporting Male Survivors of Violence (SMSV) Baltimore Release Date: June 22, 2017 Pre-Proposal Conference: July 6, 2017 Proposal Due: July 19, 2017 Anticipated Award Notification:
More informationAlternative or in Lieu of Service Description Alliance Behavioral Healthcare
Alternative or in Lieu of Service Description Alliance Behavioral Healthcare 1. Service Name and Description: Rapid Response Crisis Services for Children and Youth Service Name: Rapid Response Procedure
More informationBehavioral Health Services. San Francisco Department of Public Health
Behavioral Health Services San Francisco Department of Public Health Slide 2 Agenda Behavioral Health Services in San Francisco Mental Health Services Substance Use Disorder Services Levels of Care Behavioral
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 informationQuality Management Plan Fiscal Year
Quality Management Plan Fiscal Year 2016-2017 Mental Health and Substance Abuse Division Contractor Services Section Quality Management and Compliance Unit Contents Introduction... 3 Purpose... 4 QM Committee...
More informationHOME TO RECOVERY CEPP PLAN. New Jersey Department of Human Services Division of Mental Health Services January 2008
HOME TO RECOVERY CEPP PLAN New Jersey Department of Human Services Division of Mental Health Services January 2008 WHAT IS CEPP? Conditional Extension Pending Placement (CEPP)- In New Jersey the status
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 informationThe Mommies Program An Integrated Model of Care. Karen Palombo, LCSW, LCDC Texas Women s SUD Intervention Specialist
The Mommies Program An Integrated Model of Care Karen Palombo, LCSW, LCDC Texas Women s SUD Intervention Specialist Objectives Discuss the effects of opioid epidemic on pregnant women Recognize the importance
More informationSTATE OF CONNECTICUT. Department of Mental Health and Addiction Services. Concerning. DMHAS General Assistance Behavioral Health Program
Page 1 of 81 pages Concerning Subject Matter of Regulation DMHAS General Assistance Behavioral Health Program a The Regulations of Connecticut State Agencies are amended by adding sections 17a-453a-1 to
More informationConnecting Inpatient and Residential Treatment to Systems of Care
0th Annual RTC Conference Presented in Tampa, March 007 Connecting Inpatient and Residential Treatment to Systems of Care Mary Armstrong, Ph.D., Norín Dollard, Ph.D., Stephanie Romney, Ph.D., Keren S.
More informationUtilization, Quality, and Information Management in Care Management Entities
Care Management Entity Quality Collaborative Technical Assistance Webinar Series Utilization, Quality, and Information Management in Care Management Entities August 26, 2010, 2:00-3:30 pm, EDT If you experience
More informationCounty of San Bernardino Department of Behavioral Health Children and Youth Programs Continuum of Care
County of San Bernardino Department of Behavioral Health Children and Youth Programs Continuum of Care Children s System of Care Psychiatric Hospitalization Community Treatment Facility (CTF) More Severe/
More informationINVESTING IN INTEGRATED CARE
INVESTING IN INTEGRATED CARE The Maine Health Access Foundation s 12 year journey (2005 2016) to improve patient centered care in Maine through the Integrated Care Initiative. Table of Contents The MeHAF
More informationINTEGRATING TRAUMA- INFORMED SERVICES INTO MEDICAID. Lena O Rourke O Rourke Health Policy Strategies
INTEGRATING TRAUMA- INFORMED SERVICES INTO MEDICAID Lena O Rourke O Rourke Health Policy Strategies Why Medicaid? 2 Federal and State options to support community-based services/supports Coverage of services
More informationeconsult Update: Utilizing Technology to Bridge the Integration Gap Christopher Benitez, MD Clayton Chau, MD, PhD Ricardo Mendoza, MD Gary Tsai, MD,
econsult Update: Utilizing Technology to Bridge the Integration Gap Christopher Benitez, MD Clayton Chau, MD, PhD Ricardo Mendoza, MD Gary Tsai, MD, 2 Disclosure Drs. Benitez, Chau, Mendoza and Tsai have
More informationAn Opportunity for States to Improve Care for Children with Serious Emotional Disturbance
Behavioral Health Homes for Children: An Opportunity for States to Improve Care for Children with Serious Emotional Disturbance A publication of the National Center for Medical Home Implementation and
More informationUnderstanding and Using ASAM Criteria in Substance Use Disorder Treatment Planning
Understanding and Using ASAM Criteria in Substance Use Disorder Treatment Planning WHAT? This guidance document has been developed to provide an overview of the American Society of Addiction Medicine (ASAM)
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 informationMENTAL HEALTH, SUBSTANCE ABUSE, AND DEVELOPMENTAL SERVICES
MENTAL HEALTH, SUBSTANCE ABUSE, AND DEVELOPMENTAL SERVICES The Department of Mental Health, Substance Abuse, and Developmental Services (MHSADS) is responsible for the public mental health, substance abuse,
More informationREQUEST FOR PROPOSALS FOR INTENSIVE SERVICES FOR YOUTH WITH INTELLECTUAL/DEVELOPMENTAL DISABILITIES (INTENSIVE-I/DD)
STATE OF NEW JERSEY DEPARTMENT OF CHILDREN AND FAMILIES REQUEST FOR PROPOSALS FOR INTENSIVE SERVICES FOR YOUTH WITH INTELLECTUAL/DEVELOPMENTAL DISABILITIES (INTENSIVE-I/DD) UP to 2 AWARDS, TOTAL OF 30
More informationOversight Agency Transformation: Best Practices and Positive Outcomes
Oversight Agency Transformation: Best Practices and Positive Outcomes Julie Collins VP Practice Excellence, Child Welfare League of America (DC) (BBI Consultant) Sherri Hammack Coordinator, Building Bridges
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 informationMedicaid Managed Care Readiness For Agency Staff --
Medicaid Managed Care Readiness 101 -- For Agency Staff -- To Understand: Learning Objectives Basic principles of Managed Care as a payment vehicle for health care services The structure of the current
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 informationBehavioral Health Concurrent Review
Today s date: Contact information Level of care: psych Anthem Blue Cross and Blue Shield Healthcare Solutions Please fax to 1-877-434-7578 on the last authorized day. detox chemical dependency Psychiatric
More informationInstitute Presenters. Objectives: Participants Will Learn. Agenda 6/27/2014
Continuous Quality Improvement (): Assessing System of Care Implementation and Expansion Georgetown Training Institutes July 16 20, 2014 Washington, D.C. Funded by the Substance Abuse and Mental Health
More informationSection 2703: State Option to Provide Health Homes for Enrollees with Chronic Conditions
Section 2703: State Option to Provide Health Homes for Enrollees with Chronic Conditions Center for Medicaid, CHIP, and Survey & Certification Centers for Medicare & Medicaid Services Background. A goal
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 information