Behavioral Health Update - October 2018
Key Highlights in this topic/WORKGROUP for the PREVIOUS month:
- SUD Reform: Withdrawal Management was to have been included in the CMS waiver which would have allowed us to bill earlier than 7/1/19. It was not included and this could have a negative impact on the few facilities that continue to provide this care due to the low rate of reimbursement from county levy funds only. We received word this week that one facility is closing. Withdrawal Management services should be billable sometime next year. Once billable it will take a while to build the rate into the infrastructure so may not see immediate relief. These facilities will also need to contract with various PMAPs before payment will be available. Providers have appreciated the assistance from Counties in SUD planning and technical assistance. CCBHC connection to SUD reform: they are connected through the 1115 waiver. DHS is using SAMHSA funding and planned legislation to expand sites from 6 to 11. Also, will extend funding for the next 5 years.
- MMIS billing codes are being tested; once that is done the assurance statements will be posted to e-docs however they are not ready yet. While we wait, it might be a good idea for counties to begin working on gathering this data if they are planning to provide any services under SUD reform.
- Detox payment responsibilities: Couple of interpretations going on. Some relying on new SUD reform language/statute and other using CFR/residency statute. It will be important that one approach is used. We should have one method of determining CFR for CD and mental health.
Competency Restoration Program:
- There continues to be confusion regarding CRP responsibilities as DHS moves forward with their changes. Hennepin having examples of State Operated Facilities notifying courts once a person has stabilized and they then appeal to the court to discharge them. Where are these clients supposed to go? And how will they be restored? We would need a whole network of providers to provide secure CRP and do not have it nor is there a mechanism for payment. Counties are not required by statute to pay these costs. It is anticipated that the State will move forward with a legislation change that would put counties in a position of payment and may look like the AMRTC cost shift. Suggestion of bringing another CRP forum forward for a future MACSSA meeting.
The impact of crisis grant reductions and/or giving monies to other counties for mobile service expansion continues to leave questions of affordability for counties and sustainability. We need to know the total by county to try to determine what happened (why most counties are seeing a 25-30% decrease). DHS will be contacted.
Behavioral Health Crisis Bonding RFP:
Counties should be sure they understand the bonding requirements (separate from DHS requirements); there are some concerning pieces in it. Stearns is hosting a phone call biweekly to share progress/ideas. If your county is pursuing this RFP and you would like to participate in the call, please email Julie Ellis (Julie.firstname.lastname@example.org)
Mental health issues in local jails:
Most counties continue to struggle with this and are working on some potential responses. Hennepin has been working on for about 4 years and will share information.
- It continues to be a concern that counties will have little say in the actual operational and eligibility requirements for the Chemical Dependency Treatment Fund (CDTF)
- There is delay in CMS approval regarding Withdrawal Management Service development and is now targeted for mid-2019.
Requested Actions needed from MACSSA in the next month:
SUD Forum time
CRP Forum time
APPARENT TRENDS IN THIS TOPIC AREA:
Issues/Concerns regarding this topic this month:
SUD Reform Impact
CRP legislative cost shifts.
Bulletins, Publications, or supporting materials to be included with this update: