HealthChoices Behavioral Health Contract Changes

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HealthChoices Behavioral Health Contract Changes

• Children in Substitute Care Placed Out of Zone

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A G E N D A

• Welcome/Why this is important Deputy Secretary
  Richard Gold
• Purpose of the session Stan Mrozowski
• Changes to the HC-BH Program Sherry Snyder
• Tips for Providers Janice Staloski and Stan
  Mrozowski

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A G E N D A contd

• How CCYAs and JPOs can help facilitate access to
  Behavioral Health services for children Darlene
  Black
• Financial/Data Terry Mardis
• Questions and Answers - All

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Change in Payment PolicyFor Children in
Substitute Care Receiving Behavioral Health
Services

• The Videoconference
• 9-15-09

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The Change

• OMHSAS, in coordination with OCYF, recently
  completed data and financial analysis to
  establish a capitation payment to enable the
  Behavioral Health Managed Care Organizations
  (BH-MCOs) to be responsible for services even
  when youth are temporarily out-of-zone.

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Effective August 1, 2009

• Health Choices contract change Appendix V
  revised regarding new payment responsibility and
  capitation adjustments for BH-MCOs
• Providers will be enrolled in Medical Assistance
  and with the BH-MCOs
• Notification sent to families, County Children
  and Youth Administrators and Chief Juvenile
  Probation Officers.

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Two Specific Aspects

• When a youth is placed out of the HC Zone
• Shelters, diagnostic centers, foster care or,
• Non-hospital drug and alcohol residential
  treatment facilities.
• The youth remains enrolled in the BH-MCO from the
  original placing county.

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Room and Board for Non-hospital DA Residential

• Behavioral Health Managed Care Organizations can
  cover room and board costs for accredited
  facilities. 
• CMS recognizes JCAHO, COA, and CARF
  accreditation.