Provider Advisory Workgroup Meeting

Minutes

April 6, 2005

3:00-4:30 LOB 1A

Attendees:

Susan Walkama, Phil Guzman, Heather Gates, Paul Piccone, Linda Pierce, Karen Andersson, Jill Benson, Linda Russo, Gina Hoff, Gloria Merritt, Steven Gurelli, Dana Marie Salvatore, Austin Upton

Meeting was called to order 3:00 by Susan Walkama.

Introduction

Karen Andersson from DCF described the history and development of the level of care guidelines.  Two years ago, in the early stages of Kidcare development, a group of providers and families was convened by DCF to develop level of care guidelines for the Kidcare system.  These guidelines have subsequently been reviewed and edited by DCF and most recently by a DCF/DSS workgroup that includes provider and family representation from the Medicaid Behavioral Health Oversight Committee.  As the review is completed on each level of care in the DCF/DSS workgroup, it will be sent to the Provider Advisory Workgroup for review and comment. 

Susan Walkama suggested that to be inclusive and to ensure the workgroup reached as many stakeholders as possible, the Provider Advisory Group consider soliciting input from provider trade associations and family organizations.  The group brainstormed the list of potential contacts to include:

• CHA
• CCPA
• CAN
• FAVOR
• PHP Association
• CBHAC
• CAR
• CT. Association of Home Care
• School Based Health Clinics
• YSBs through CAN
• Community Collaboratives

The first set of guidelines for review was distributed.

Level of Care Guidelines

Recommendations for language changes and questions:

• Add “and providers” to first sentence after care managers
• What does environmental mean: Definition on second page seemed satisfactory
• Do these guidelines apply to adults and children?
• In section B. Medical Definition of Medical Appropriateness:  Is “least of costly of multiple, alternatives” in regulation?  Yes.
• D.  Mitigating Factors:  “Court ordered” refers to DCF court ordered admissions
• Suggestion to add a statement to this section indicating that the ASO is responsible to create a level of care of service that is needed when one does not exist.

Acute Inpatient Psychiatric Hospitalization

Authorization Process Section

What does “on a periodic basis mean?”  Will Riverview be reviewed differently than other psychiatric hospitals?

Do these guidelines apply to adults and children?

Discharge criteria may need to be added.

Next Steps

Sue Walkama and Karen Andersson will make contacts to the trade and family organizations inviting their participation and input.  The “closing” date for comments on each level of care will be the meeting date scheduled for that specific level of care review.  The group did not want to continually back track over levels of care that had previously been reviewed. 

In order to give others an opportunity to comment, recommendations for changes on the guidelines reviewed in today’s meeting will be completed on May 4^th.  In addition, guidelines will be posted on the state Medicaid website along with meeting minutes and distributions.

Next meeting:  May 4, 2005 3:00-4:30 LOB

Submitted by:

Susan Walkama

Committee Chair, Provider Advisory Workgroup