Download Change in Payment Policy For Children in Substitute Care

HealthChoices Behavioral Health
Contract Changes
Children in Substitute
Care Placed Out of
Zone
AGENDA
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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 –
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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 Policy
For 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


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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 Board
for 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.