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Substance Abuse

Substance Abuse. Boundaries B-3’s Other “Stuff”. Boundaries. Problem-managing the substance abuse benefit across multiple PIHPs Inability to manage across the CA region “Consensus Solution”. “Consensus Boundary Solution”. Final stages of consensus

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Substance Abuse

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  1. Substance Abuse • Boundaries • B-3’s • Other “Stuff”

  2. Boundaries • Problem-managing the substance abuse benefit across multiple PIHPs • Inability to manage across the CA region • “Consensus Solution”

  3. “Consensus Boundary Solution” • Final stages of consensus • Applies only when the CA boundary crosses PIHP boundaries • Provides for relational contract

  4. …Boundary Solution • Enables CA to manage regionally • PIHP passes on PEPM w/contingency reserve • CA has performance incentive based on mutual agreement for benefit stabilization, local needs across region • FY04 implementation expected

  5. B-3 Substance Abuse Benefit • Major change with new waiver • Implications for many PIHP/CAs because benefit becomes entitlement; not historically provided by all CAS for entire year • IMD issue resolved for substance abuse sub-acute detox and residential services

  6. Other “Stuff” • Their funding “situation” SAPT block grant MOE shortfall ABW Waiver services PA 2 Implications Drug Courts/Justice system “pressures”

  7. …”stuff” • PIHP/CA information sharing • Ongoing communications mechanisms/forums

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