HealthChoices Behavioral Health Contract Changes Children in Substitute Care Placed Out of Zone
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
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
Change in Payment PolicyFor Children in Substitute Care Receiving Behavioral Health Services The Videoconference 9-15-09
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.”
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.
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.
Room and Boardfor Non-hospital D&A Residential • Behavioral Health Managed Care Organizations can cover room and board costs for accredited facilities. • CMS recognizes JCAHO, COA, and CARF accreditation.