BH Oversight Committee DCF Advisory Work Group

Meeting summary: June 9, 2005

Chair: Morgan Meltz

(Next meeting: June 27 @ 3PM at Riverview Hospital)

Attendance: Morgan Meltz* (Families United FCMH), Karen Andersson (DCF), Mark Schaeffer (DSS), Kathy Carrier* (Families United FCMH), Deirdre Stowe (Yale CSC), Molly Cole & Susan Zimmerman (FAVOR), Irv Jennings (Family & Children's Aid), Sherry Perlstein (CGC S.Central), Liz Collins (YNH Hospital), Beth Klink (YNHPH), Barbara Sheldon* (NAMI-CT), Cathy Adamczyk* (NAMI-CT), Tim Kearney (Community Health Center), Susan Walkama (Wheeler Clinic), Lee King (UCFS Norwich), William Martin (Waterford CS), Jeffrey Rynaski, Mariette McCourt (Medicaid MCC). * = Family member

Reform/ASO update

Dr. Schaefer provided an update on the BH restructuring process:

· The legislative Committees of Cognizance (Human Services & Appropriations Committees) approved the 1915(b) waiver amendment that restructures the delivery system for BH services to a `carve-out' of services under the DSS/DCF partnership and administrative service organization (ASO).

· Statutory language in LCO No 8230 provides for the creation of a Behavioral Health Oversight Council, consolidation of program administrative functions under an ASO and the `Behavioral Health Partnership' (BHP) of DSS and DCF. Important to note that the previous BH Partnership had included DMHAS; this BHP is between the two agencies and does not include Medicaid or DMHAS adults.

· The DSS will summit the waiver amendment to CMS for approval.

· The implementation of the BH `carve-out' will be during October 2005 - January 2006. (Addendum: DSS announced the start date would be January 1, 2006 at the June 10 Medicaid Council meeting).

The House and Senate passed the biennial budget. Highlights of the budget include DCF funding for flex funding, therapeutic group homes (10), early childhood consultative services and a DSS SAGA pilot to provide health coverage for some young adults ages 19-20 with co-occurring chronic health conditions. Barbara Sheldon identified the gap in health care access for this group at several hearings during the 2005 session and urged the legislature to provide health care access to these transitioning youth.

Discussion of the top three issues identified by Work Group members

¬ What this new system will look like for families including ensuring that family involvement & choice are woven throughout and that the needs of the entire family are considered.

Several topics were discussed:

· HUSKY: While VOI, the BH ASO, plans to implement a statewide information campaign, all but one of the HUSKY MCOs have agreed to put the VOI number on the back of the member's health plan card. The WG will consider recommending that all the HUSKY plans include this on their member card.

· Non-HUSKY members: there is the potential to provide BH VOI contact information through the state Infoline, advocates, and the Managed Care Ombudsman's office.

· Underinsured: advocates could consider trainings on how to make insurance `work for them'.

· Voluntary services: the DCF may eventually have central office screening for BH service needs. The specifics related to voluntary services are being worked on.

Morgan Meltz provided a draft summary of the VOI proposal for member services/family involvement (click on attachment below).



Questions related to the draft document:

· Calls to VOI will be handled in CT during business hours; probably through a national center on off-hours.

· Request better definition of phone "response within 15 seconds"- is this a "real person" response? The WG could review the performance indicators related to this area, consider recommendations at the June 27^th meeting (see more complete Exhibit E doc added to email doc.)

· How will the ASO manage "medication calls"? It is assumed this refers to calls about accessing providers for BH medication. The Coordination of Care Work group has spent considerable time on the coordination of the HUSKY A MCO, which will retain pharmacy responsibility, and the ASO and the distribution of temporary drug supplies at the pharmacy.

· Providers and advocates emphatically stated that transportation service access is a problem in HUSKY A.

o While the Coordination of Care WG has recommended specific data to be collected as baseline in the first year of the carve-out, the DCF WG will consider specific guideline recommendations for the DSS/DCF/ASO contract. One suggestion was that the ASO public broadcast campaign include information about HUSKY A transportation for BH services, provide a call # for transportation complaints.

¬ Voluntary Services eligibility and procedures:

In addition to HUSKY A children & eligible adult parent/caregivers (to 150% FPL), HUSKY B children and DCF voluntary services families, the agencies are also considering providing some limited services to DCF non-HUSKY eligible children (i.e. children in child protections or juvenile justice services).

¬ Client flow/continuity of care issues including discharge planning and criteria, the role of the ASO in out-of-home care and DCF/DMHAS transition issues.

· Family care plans: would it best for the ASO for focus on individual plans and have the ASO system manager identify family support needs as well as other family members BH needs? Further discussion.

· Continued discussion needed of ASO ICM.

· While the ASO system manager will identify geographic service gaps, can the current knowledge of service gaps be resolved? DSS stated the enhanced clinic model associated with a 25% higher reimbursement rate will address some gaps at the start. While supporting the current service delivery system, recruitment of additional independent practitioners is also needed.

Other

Additional work is being done on the DCF Managed Service System (MSS) and coordination with the ASO care coordination.

June 27^th meeting focus will be on developing concrete recommendations to DSS/DCF.