1 / 17

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). Medicaid mental health March 1995 Authority: Iowa Department of Human Services (DHS)

fidelia
Télécharger la présentation

Iowa Plan for Behavioral Health

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Iowa Plan for Behavioral Health Janet Zwick Deputy Director Iowa Department of Public Health

  2. 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

  3. History and Evolution IMSACP 1995 Medicaid and Non-Medicaid/SA Only Authorities: DHS/DPH Contractor Employee & Family Resources Sub-contractor: Merit Behavioral Care of Iowa Medicaid – At-risk (carried by Merit); Non-Medicaid – ASO

  4. 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

  5. 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.

  6. 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

  7. 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

  8. 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

  9. DPH/DHS Relationship • Regular meetings with department representatives • Both departments sign contract and amendments • Resolution of conflicts • Good communication • Should not depend on personalities

  10. 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

  11. 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

  12. Relationship with Vendor • Performance measures in contract • See RFP on the following web site http://www.ime.state.ia.us/Reports_Publications/RFP/IowaPlan.html • See Contract on the following web site: www.ime.state.ia.us/docs/IowaPlan-FINAL-withallExhibits.doc

  13. Evolution with Vendor • Changes in monitoring • Trust improves • Meetings not as often • Keep performance measures • Emphasis on quality improvement

  14. 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 … !

  15. 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

  16. 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

  17. Always – Good Clinical Services This is the basis of all partners

More Related