CCBHC Certification Q&A

Justin Harding-Project Director

Danny Silbert-Project Manager

May 20, 2016

Mandatory Managed Care

  • CCBHCs are SITE based - not provider based
  • No SITES in a Mandatory Managed Care will be chosen for the PPS payment system
  • Illinois is still working out details for excluded applicants who wish to continue to be certified despite ineligibility for payment (beyond current payment methods)

Eligible Applicants Include

Sites from the following providers remains eligible at this time:

  • Centerstone
  • Coles County Mental Health Association
  • Egyptian Health Department
  • Human Service Center of Southern Metro East
  • Kendall County Health Department
  • North Central Behavioral Systems
  • Preferred Family Healthcare
  • Shelby County
  • Sinnissippi Centers
  • Transitions of Western Illinois

April 1, 2014

  • Pre-application verification soon
  • The underlying federal statute requires all SITES to be in existence before April 1, 2014
  • This may differ from what non-governmental sources continue to tell you

Complex CCBHC Design

  • Main site will be identified as the CCBHC
  • Main site provides all four CCBHC core services and houses all back office services
    • HR, IT, Billing/Finance, medical records, etc.
  • All other "satellite" sites can provide the CCBHC four core services, but no admin services
  • All billing goes through the main office
    • Single legal entity; single Tax ID number
  • Clinical Staff are shared among sites and dispatched as needed
  • Consumers receive all services at one specific site

PPS-2

  • Illinois remains committed to PPS2 payment methodology
    • Special populations
    • Quality bonus payments
    • Outlier payments
  • Special populations to be released soon

EBPs

  • Services Coordination Subgroup, formed last month, working on list of EBPs
  • EBPs will need to address the 9 core services and the entire lifespan (birth to death) for mental health, substance abuse, and physical health tie-ins
  • EBP decisions based upon feedback from
    • Steering Committee
    • Needs Assessment
    • RFI

Data

  • Federal partners have still not released specifications for required data measures
  • Illinois working on data measures for Illinois specific needs - ILLINOIS NEEDS YOUR INPUT
  • Federal partners did eliminate 11 required data measures. They include:

Eliminated Federal Data Measures

  1. Number/Percent of clients requesting services who were determined to need routine care
  2. Mean number of days before the comprehensive person-centered and family centered diagnostic and treatment planning evaluation is performed for new clients
  3. Number of Suicide Deaths by Patients Engaged in Behavioral Health (CCBHC) Treatment
  4. Documentation of Current Medications in the Medical Records
  5. Controlling High Blood Pressure
  6. Number of Suicide Attempts Requiring Medical Services by Patients Engaged in Behavioral Health (CCBHC) Treatment
  7. Diabetes Care for People with Serious Mental Illness: Hemoglobin A1c (HbA1c) Poor Control (>9.0%)
  8. Metabolic Monitoring for Children and Adolescents on Antipsychotics
  9. Cardiovascular health screening for people with schizophrenia or bipolar disorder who are prescribed antipsychotic medications
  10. Cardiovascular health monitoring for people with cardiovascular disease and schizophrenia
  11. Adherence to Mood Stabilizers for Individuals with Bipolar I Disorder

Federal Motivating Factors

  • 11 Years at the National Association of State Mental Health Program Directors
  • MHSA under enormous pressure from Congress and OMB (and others)
  • Some of underlying federal philosophy for CCBHCs. (focus on p. 14-20 and 24-28)

More Underlying Federal

  • Persons with a MI die 25 years early - enormous whole health integration movement
    • Serve at one location (octopus bad)
  • SAMHSA; APA; Utah; Arizona; Other National Efforts. Not just single site in terms of care coordination, but literally one site for care as well
  • Stop sending people to jails and ERs
  • Parity