Presented by Beth Waldman, JD, MPHFor the Iowa DHSRemedial Services Working Group

Remedial Services Working GroupMeeting Four

December 3, 2010

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Remedial Services Working Group; Meeting 4 (Draft)

Today’s Agenda

1. Group Care Discussion

2. Continued Discussion of Payment Strategies

3. Review and Vote on Recommendations for Draft Report

4. Review Report Outline

5. Discuss Transition Strategy

6. Process for Providing Feedback for Draft Report

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Remedial Services Working Group; Meeting 4 (Draft)

Group Care Discussion Highlights from 12/3 Morning Session

How to accomplish an integrated approach to mental health services and child welfare services

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Remedial Services Working Group; Meeting 4 (Draft)

Continued Discussion of Payment Strategies

Potential methodologies for rates, differ whether for home and community-based services or office-based services

See attached excel spreadsheet for details Would allow approval for limited amount of units to be

targeted at family education/discussion to allow for reinforcement of behavioral skills being taught by providers

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Remedial Services Working Group; Meeting 4 (Draft)

Review and Vote on Recommendations

See Proposed Recommendations (attached) Vote by official committee members

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Remedial Services Working Group; Meeting 4 (Draft)

Report Outline

Executive Summary Introduction

– Background on remedial services in Iowa

– Reason for and charge of the Remedial Services Working Group

Methodology– Research of other state treatment of similar services

– Meeting discussions

– Consensus building for recommendations

Recommendations Transition Process and Timeframe Conclusion and Next Steps

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Remedial Services Working Group; Meeting 4 (Draft)

Proposed Transition Strategy

Timeframe for transition:– Legislation contemplates ability to transition Behavioral

Health Intervention Services to the Iowa Plan within six months of filing legislative report (by July 1, 2011)

– First step is to develop a detailed work plan for the transition• High level activities and proposed timeframes included here

• Continue the Working Group over the course of the transition (and potentially for the first six months post-transition) to provide ongoing guidance and feedback

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Remedial Services Working Group; Meeting 4 (Draft)

Major Transition Activities and Dates:Contractual and Regulatory Changes

Contractual and regulatory changes:– Develop contract amendment with Magellan, including for

services and administrative costs associated with the inclusion of Behavioral Health Intervention Services in the Iowa Plan

– Develop PMPM, administrative and/or other payment methodology to be made to Magellan for providing such services under the Iowa Plan

– Amend IME rules to move management of Behavioral Health Intervention Services to the Iowa Plan

To be completed as soon as possible, but not later than 90 days prior to implementation (April 1, 2011)

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Remedial Services Working Group; Meeting 4 (Draft)

Major Transition Activities and Dates: Rebranding and Notice to Members; Providers

Develop campaign to rebrand services to new name: Behavioral Health Intervention Services

Provide initial notice tailored to (1)members, (2)providers and (3) other stakeholders of transition– Include information on how the change will impact them

• Valid Treatment Plan and ongoing services will be honored• Providers need to apply for Iowa Plan network based on new

credentialing requirements• Benefit to other stakeholders of having services included within the

Iowa Plan

– Other stakeholders may include LPHAs, schools, juvenile justice Activity should begin immediately after report filing; notices to

members, providers and stakeholders should be released by February 2011

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Remedial Services Working Group; Meeting 4 (Draft)

Major Transition Activities and Dates: Developing a Provider Network

Finalize credentialing criteria based on Working Group’s recommendations

Development procurement and select a provider network

Finalize payment rates for Behavioral Health Intervention Services

Activities must be finalized within 30 days of transition (June 1, 2011)

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Remedial Services Working Group; Meeting 4 (Draft)

Major Transition Activities and Dates

Transfer Behavioral Health Intervention Services information from IME to the Iowa Plan – Increase staff dedicated to authorizing treatment plans by work

– Honor all existing treatment plans

– Provide clear guidance to members and providers on allowable Behavioral Health Intervention Services and how services will be authorized going forward

Provide training of members, LPHAs, Behavioral Health Intervention Services providers within 30 days of the Contract start date

Apply for waiver of correct coding initiative for appropriate behavioral health codes

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Remedial Services Working Group; Meeting 4 (Draft)

Draft Report – Feedback Process

First draft of report released to Remedial Services Working Group by 12/13/10

Feedback on report due by 12/20/10 Schedule conference call to discuss any major

concerns with report based on 12/20 feedback Revised report released to Remedial Services

Working Group by 12/23/10 Sign-off required by 12/30/10 Submit report to Legislature on 12/31/10