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Iowa Plan for Behavioral Health. Janet Zwick Deputy Director Iowa Department of Public Health. History and Evolution Mental Health Access Plan (MHAP). Medicaid mental health March 1995 Authority: Iowa Department of Human Services (DHS)

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iowa plan for behavioral health
Iowa Plan for Behavioral Health

Janet Zwick

Deputy Director

Iowa Department of Public Health

history and evolution mental health access plan mhap
History and EvolutionMental Health Access Plan (MHAP)
  • Medicaid mental health
  • March 1995
  • Authority: Iowa Department of Human Services (DHS)
  • Contractor: Merit Behavioral Care of Iowa
  • At-Risk
history and evolution imsacp 1995

History and Evolution IMSACP 1995

Medicaid and Non-Medicaid/SA Only

Authorities: DHS/DPH

Contractor Employee & Family


Sub-contractor: Merit Behavioral

Care of Iowa

Medicaid – At-risk (carried by Merit);

Non-Medicaid – ASO

history and evolution iowa plan for behavioral health january 1999 and july 2004
History and EvolutionIowa Plan for Behavioral HealthJanuary 1999 and July 2004
  • Medicaid mental health/substance abuse and DPH substance abuse
  • Authorities: DHS/ DPH
  • Contractor: Magellan Behavioral Care of Iowa
  • Sub-contractor (for specific DPH-Funded substance abuse activities only): EFR
  • Medicaid – At-risk;
  • DPH-Funded – ASO Only
iowa plan basics
Iowa Plan – Basics

Access -

  • 27,000 + clients DPH
  • 284,000 Medicaid enrollees
  • DPH-Funded - Meet ASAM criteria. No authorization required. Monitored annually.
  • Medicaid – Meet psychosocial necessity for mental health and ASAM for substance abuse. Authorization required for higher levels of care. Services that don’t require auth monitored annually.
iowa plan basics continued
Iowa Plan – Basics (continued)

Provider Reimbursement -

  • Medicaid - Magellan pays provider claims; 98% paid in 12 days
  • DPH-Funded - Magellan pays providers monthly 1/12th disbursements of their annual contract funding
key aspects of the iowa plan
Key Aspects of the Iowa Plan
  • Increased flexibility for funding mental health and substance abuse services, eg expanded specialized women’s substance abuse programs from 3 to 11
  • Required coordination with child welfare, corrections, etc.
  • Establishment of specific Performance Indicators
  • Medicaid - Community Reinvestment
  • Iowa Plan advisory committees
  • Technical assistance and quality/service improvement
dph dhs relationship
DPH/DHS Relationship
  • Use each others expertise
  • Contract outlines each department’s responsibility
  • Both departments responsible for development of RFP, review of proposals, and contract process
  • Understand the proposal
dph dhs relationship1
DPH/DHS Relationship
  • Regular meetings with department representatives
  • Both departments sign contract and amendments
  • Resolution of conflicts
  • Good communication
  • Should not depend on personalities
relationship with vendor
Relationship with Vendor
  • Contract must be tightly written
  • Recommend state keep control of data system
  • Recommend state decide what placement criteria are used
  • Review everything prior to it going to providers
relationship with providers
Relationship with Providers
  • Both state and vendor need to work closely with providers
  • Contracts need to be clearly written
  • Communicate - don’t spring changes on them
  • Train
relationship with vendor1
Relationship with Vendor
  • Performance measures in contract
  • See RFP on the following web site
  • See Contract on the following web site:

evolution with vendor
Evolution with Vendor
  • Changes in monitoring
  • Trust improves
  • Meetings not as often
  • Keep performance measures
  • Emphasis on quality improvement
lessons learned partners
Lessons Learned – Partners!

Work together, work together, WORK TOGETHER!

  • DHS and DPH
  • DHS, DPH and Magellan
  • DHS, DPH, Magellan + clients, consumers, families, providers, advocacy groups, the Legislature, other departments of state government, local governments, other stakeholders … !
lessons learned public input
Lessons Learned - Public Input
  • Assure regular solicitation of public input and sharing of information
    • Iowa Plan Advisory Committee
    • Clinical Advisory Committee
    • Consumer/Family Advisory Committee
    • Provider Roundtables
    • monthly meetings with counties
    • participation in local advocacy group, consumer, and family meetings
lessons learned planning
Lessons Learned - Planning
  • Participate in State and Community Planning Efforts
    • county management plans
    • child welfare boards
    • education system
    • adult corrections personnel
    • juvenile court services staff
    • State work groups
always good clinical services
Always – Good Clinical Services

This is the basis of all partners