Minutes
BH Medicaid Provider Advisory Group
July 5, 2005
Attendance: Susan Walkama, Jill Benson, Heather Gates, Karen Andersson, Dana Marie Salvatore, Paul Piccione, Sarah Parker, Gina Hoff, Barbara Sheldon
Meeting called to order 3:10pm.
Susan Walkama distributed the meeting schedule over the next few months:
July 20
August 3
August 17
September 7
September 21
It was agreed to share the responsibility of note taking among the group.
Intermediate Care Guidelines (PHP, IOP, Extended Day Treatment)
The following changes were made:
• Under definition: replace site-based with “office-based”
• Under Symptom Categories: include “moderate to severe” regarding self-mutilation
• Under Program Specific Requirements IOP: added the sentence “Some specialized IOPs may require longer length of stay.”
• Under Continued Care last paragraph under authorizations: replaced for up to with “in increments of”
Clarification on the program model and practice standards for Extended Day Treatment was re-visited in relation to therapeutic recreation. It was noted that this clarification recommendation had been added to the “General Recommendations” made to date.
Discussion also centered on strengthening discharge planning coordination and communication. The group suggested a recommendation be made under General Recommendations that the ASO include family advocates in provider discharge planning trainings in order to enhance the provider’s understanding of the family’s perspective in this process.
Psychiatric Residential Treatment Facility
At the meeting it was confirmed that Psychiatric Residential Treatment Facility (PRTF) is the new terminology for non-hospital based sub-acute programs.
The following changes were made:
• Under Intensity of Service Need F.1.2.1.2 first paragraph and in the third bullet: replace have been examined and would be ineffective with “have been reviewed and determined to be ineffective”
• Delete entire section F.1.3.2 Exclusionary Criteria since the exclusionary criteria listed was more appropriate to continuing care decisions at the inpatient level.
• Under Continued Care Criteria F.2.2.2 added: ..is being “made and” monitored daily…..
• Under Continued Care Criteria F.2.3.4 added: “Under such circumstances, the Intensive Care Manager will work closely with the Managed Service System if the child is DCF involved or directly with local providers or Community Collaboratives to address aftercare needs.”
A “General Recommendation” was added to seek clarification of the requirement to have 24 hour nursing on-site for the Psychiatric Residential Treatment Facilities.
The group reviewed the opportunities for feedback on the proposed guidelines. Susan confirmed the materials are distributed via email and at meetings to workgroup members as well as various trade associations. She also presents any feedback received to the workgroup for discussion.