Last week, Benchmarks hosted its quarterly Public/Private Behavioral Health (PPBH) forum in Raleigh, North Carolina.
The meeting was hosted by Benchmarks’ President and CEO, Karen McLeod. Dave Richard, Deputy Secretary-DMA, gave updates and answered questions related to the Department of Health and Human Services (DHHS) during the first half of the meeting. Topics discussed during this portion of the meeting included updates on Medicaid reform (i.e. standard plans, tailored plans, projected timelines for implementation, etc.).
Richard highlighted the uncertainty surrounding Medicaid transformation. The budget expected to come out last week has been delayed, and the governor is expected to veto any budget that does not include Medicaid expansion.
Also during his time with the group, Richard revisited the roll-out plan for Medicaid transformation, sharing that in mid-July, enrollment packets will be distributed for participants to register; if recipients do not select a Medicaid LME/MCO provider, they will be auto assigned to a Medicaid health plan. For the purpose of continuity of care, Richard predicts that nearly everyone will stay with their current LME/MCO. On November 1st of this year, the standard plans are projected to go live in regions two and four, while the remaining regions are projected to go live for statewide reform in February of 2020.
In the afternoon, attendees heard from a panel of experts from DHHS on information regarding billing and claims, advanced medical homes with behavioral health and intellectual/developmental disability (BH I/DD) certification, care management entities and BH I/DD tailored plan employed care managers, and parity between credentialing systems.
The panelists discussed three approaches to BH I/DD tailored plan care management. BH I/DD tailored plans have flexibility in how they provide care management, as long as the approach meets minimum standards and care management is provided in the community to the maximum extent possible.
DHHS will be in charge of certification of providers to become care management agencies. Under care management, each child has one care manager assigned to them. This could be a nurse or not, but they are required to have access to a medical professional with whom they can consult. If the child begins to jump around services, the care manager can provide transition to care and can stay with the child. It is the care manager’s responsibility to link the child to appropriate providers and levels of care.
One participant voiced a concern about a workforce issue, stating that if everyone receives care management, there will be inflated case load sizes to a level that is unsustainable. DHHS staff encouraged this concern, among others, to be sent to the DHHS mailbox to be logged as an official question and discussed by staff.
Public/Private Behavioral Health Forum is a public meeting hosted quarterly by Benchmarks. It is open to both Benchmarks members and non-members, and all behavioral health agencies, LMEs, and MCOs are invited and encouraged to attend. Those interested in attending can register via Eventbrite on the Benchmarks website (www.benchmarksnc.org).
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