Children’s MRT Behavioral Health Subcommittee
March 24, 2014
10:00 – 11:00 AM
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Welcome & Roll Call (Donna Bradbury)
Review of Proposed Model & Service/Acuity
Tiers (Angela Keller)
Goals of Transformation (Angela Keller)
Other Design Activities (Linda Kelly)
Proposed New State Plan Services (Steve
Hanson)
Proposed New 1915i-like Services (Mimi
Weber)
Request (Angela Keller)
Proposed 2016 Children’s
Medicaid Managed Care Model
For all children 0-20 years old
Mainstream Medicaid
Managed Care Organization:
Benefit Package*
All
Health & Behavioral
Pharmacy
Health
Expande State Plan
d
Services
Benefits
Children’
s 1915c
Potential
HCBS
Children’s
Waivers
1915i – like
(OMH
Services
and OCFS
B2H)
Required to
contract
Required to
have MOUs
and/or
working
relationships
Care Management for All
Care Management will be provided by a range of
models that are consistent with a child’s needs
(e.g., Managed Care Plans, Patient Centered
Medical Homes and Health Homes (HH). Health
Homes will serve children with the highest level
of need.)
*MCOs may opt to contract with other entities (e.g., BHOs)
to manage behavioral health benefits
Pediatric
Health Care
Providers
Pediatric
Specialty
Health
Care
Providers
Service Provider
Network
Children’s
Behavioral
Health
Providers
Community
Based
Providers
(e.g., family
support/peer
services)
Foster
Care
Providers
School
Districts,
CSEs & EI
Community
Services &
Support s
(nonMedicaid)
Local
Governmen
t (LDSS,
LGU, SPOA,
Probation)
Juvenile
Justice/
Criminal
Justice
System
Regional
Planning
Consortiums
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More children receive screening and services
earlier (including prevention and mental health
promotion)
Provide a step down set of services for children
discharged from Residential, Waiver or Inpatient
Provide a richer array of services to prevent
escalation into high level services
Infusion of System of Care values into the design
– family driven, strengths based, individualized
and system focused
Having better coordinated care, within and across
systems.
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Review of EPSDT benefits & early behavioral
health screening data in PCPs with DOH
Continued exploration of overlay of High Fidelity
Wraparound within managed care and health
home designs for high need children with multisystem involvement
Development of State credentialing process for
evidence-based practices
OASAS consideration of rehab option for youth
SUD services
The State workgroup will move on to eligibility
criteria at the conclusion of benefit package
development
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Mobile Crisis Intervention
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Community Psychiatric Supports & Treatment
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Other Licensed Practitioner
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(Care Coordination)
Skill Building
Family and Caregiver Support Services
Youth Support and Training
Crisis and Planned Respite
Prevocational Services
Supported Employment Services
(Education Support Services)
Residential Supports
Non-Medical Transportation
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Full proposed list and definitions to come out
by email and listserv today, along with a copy
of these Power Point slides.
Please return any written comments within
two weeks (Monday, April 7) to Angela Keller
at Angela.Keller@omh.ny.gov