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Texas Hospital Association

Texas Hospital Association

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Texas Hospital Association

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  1. Texas Hospital Association Michael D. Maples Assistant Commissioner

  2. 10% Reduction

  3. Exceptional Items

  4. Exceptional Items

  5. Waiting List

  6. Efforts to Expand Capacity: Purchasing Bed Space • DSHS contracted with four LMHAs and one county to purchase a total of 348 beds • Gulf Coast (Galveston) 16 beds • Lubbock 30beds • Houston 186beds • Kerrville 16beds • Montgomery County 100beds Page 6 Page 6 Page 6

  7. Proposed Option Forensic Bed Lawsuit: State Hospital Capacity Options Page 7 Page 7

  8. Service Delivery System Options • Integrate mental health and substance abuse services through the Local Mental Health Authorities (LMHAs) • Promote evidenced based models of care across the state • Leverage local inpatient resources to serve acute care needs of local communities • Eliminate the existing carve out of the Medicaid rehabilitation and case management services for children

  9. Eliminate the existing carve out of the Medicaid rehabilitation and case management services for adults and children • Separate the authority and provider functions of LMHAs and consolidate service delivery areas to promote greater efficiency while maintaining local control • Expand NorthSTAR to selected areas of Texas • Carve behavioral health services into Medicaid Managed Care Organization contracts • Develop a specialty health plan for the Severely and Persistently Mentally Ill (SPMI) population for both physical and behavioral health care

  10. Governance and Oversight Options • Clearly define and more actively enforce the provider of last resort legislation • Consider rescinding the 1915(b) waiver submitted to Centers for Medicare and Medicaid Services (CMS) • Explore alternative models for the management and/or operation of inpatient services • Expand the definition of qualified non-physician practitioners to address workforce shortages • Implement a comprehensive public reporting process on the performance of mental health and substance abuse contractors • Redesign outcome measures to align them with national best practices

  11. Other things • Privatization of a State Hospital • 1115 Waiver • Rules