More than half of states reported plans to take up the new ARPA community-based mobile crisis intervention service option and about two-thirds reported another crisis service initiative. Learn more about research conducted at NIMH. Administration of Non-Specialty Mental Health Services. Per forthcoming DHCS guidance, Medi-Cal Managed Care Health Plan Responsibilities For Non-Specialty Mental Health Services, and the Medi-Cal Provider Manual: Non-Specialty Mental Health Services: Psychiatric and Psychological Services, MCPs are Medi-Cal Explained: Administration of Non-Specialty Mental Health Services. Learn more about NIMHs commitment to accelerating the pace of scientific progress and transforming mental health care. The ARPA model dispatches multidisciplinary mobile crisis teams to provide Medicaid-covered services to enrollees experiencing a mental health or SUD crisis outside a hospital or other facility setting. 506 0 obj <>stream non spec mental 2 Part 2 - Non-Specialty Mental Health Services: Psychiatric and Psychological Services . ARPA provides 85% federal matching funds for these crisis intervention services for the first three years, with these additional funds to supplement, not supplant, the level of state spending for these services. Published: Dec 09, 2021. Medi-Cal Specialty Mental Health Services Covered by County Mental Based on their level of need, Medi-Cal clients are entitled to receive either Non-Specialty Mental Health Services (Non-SMHS) through the MCPs and/or Specialty Mental Health Services (SMHS) through the LACDMH system of care. Research methods may include qualitative or quantitative techniques, including large data sets, such as national health data sets and Medicare claims data where those data focus on non-specialty mental health service use. Effective January 1, 2014, Santa Clara Family Health Plan (SCFHP) is responsible for the non-specialty mental health benefits, excluding those benefits provided by the County under the Specialty Mental Health Waiver. PDF FAQ: CalAIM No Wrong Door - SF PDF State of CaliforniaHealth and Human Services Agency - DHCS Information about resources such as data, tissue, model organisms and imaging resources to support the NIMH research community. This marks the beginning of the Assessment Process. Los Angeles Department of Mental Health Outpatient Services State Policies Expanding Access to Behavioral Health Care in Medicaid States also may pursue and CMS under the Biden administration may promoteSection 1115 demonstration waiverstoexpand access to behavioral health care across the care continuum. Use these free education and outreach materials in your community and on social media to spread the word about mental health and related topics. States are taking advantage of new federal policy options to address behavioral health issues in Medicaid and are also developing other initiatives to improve mental health and substance use outcomes. Non Specialty Behavioral Health | Santa Clara Family Health Plan Outside of Medicaid, other state agencies may also take steps to address behavioral health outcomes, sometimes including Medicaid populations but often broader. In many instances, applications involve areas of science and/or methodologies that cross between study sections. Additionally, it is unclear how behavioral health service patterns may change in the aftermath of the COVID-19 pandemic and whether or how states may modify or adopt new initiatives in this area. Find the latest NIH and NIMH policies, guidance, and resources for clinical research. Specialty mental health services, as defined in Section 1810.247 and in accordance with this Chapter, shall be provided to Medi-Cal beneficiaries of each county through a mental health plan which contracts with the Department to provide specialty mental health services to those Medi-Cal beneficiaries and to share in the financial risk of providi. appropriate and covered non-specialty mental health services (NSMHS) and the regulatory requirements for the Medicaid Mental Health Parity Final Rule (CMS-2333-F). Some of these initiatives are limited to Medicaid enrollees and funding, but others have a broader focus. Services frequently carved out include behavioral health, pharmacy, dental, and long-term services and supports (LTSS). On KFFs 21st annual Medicaid budget survey, all responding states reported at least one initiative to expand behavioral health care in Medicaid in state fiscal year (FY) 2021 and/or 2022,1 including crisis service and other benefit expansions, initiatives to expand telehealth and address equity, and managed care changes. PDF Non-Specialty Mental Health Services: Psychiatric and Psychological Read more about the NIMH Strategic Plan for Research, Strategic Research Priorities, the anatomy of NIMH funding, and our yearly funding strategy for research grants. Also, CMS under the Biden Administration has identified behavioral health policy and investments as a key federal Medicaid priority. Reviews applications that focus on clinical services and service systems, such as innovative service delivery systems; studies at the interface of service and interventions, such as studies of treatment guidelines and practice patterns; and policy, cost and dissemination research. Across service categories, most states are considering post-pandemic telehealth policies, with many weighing expanded access against quality concerns especially for audio-only telehealth. Most responding states that contract with MCOs (31 of 37) reported FY 2021 contract requirements related to behavioral health screening, and two MCO states reported plans to implement such requirements in FY 2022. endstream endobj startxref Looking ahead, more than one-third of responding states mentioned behavioral health initiatives as a future priority, and several identified behavioral health services as an upward spending pressure in FY 2022. PDF An Advocate's Guide to Medi-Cal Services - National Health Law Program 6201 San Ignacio Ave., San Jose, CA 95119, Report health care fraud, waste, and abuse, Request information in other languages or formats, Health Care Quality Assessment Form Provider Incentive, Stopping healthcare fraud, waste, and abuse, Medi-Cal nondiscrimination notice language assistance, DualConnect nondiscrimination notice language assistance, Report healthcare fraud, waste, and abuse. Almost all reported covering audio-only delivery of FFS mental health (45 states) and SUD services (44 states). One state (New Hampshire) is planning implementation of a Critical Time Intervention model to provide support to individuals with SMI during vulnerable periods of transition (e.g., discharge from a psychiatric hospital). Refer to the Non-Specialty Mental Health Services: Psychiatric and Psychological Services section in this manual for policy information. More than four-fifths of states reported initiatives in place related to screening enrollees for behavioral health needs, in fee-for-service (FFS) and/or through MCO contract requirements. (* These descriptions should to be used as guidelines when determining the appropriate review locus for your application. Efforts to address the opioid epidemic and broader behavioral health issues have been a focus in Medicaid in recent years, including through federal legislation such as the 2018 SUPPORT Act. ACBH P&Ps are developed through a procedure outlined in Policy 000-1-1, Development, Approval, Dissemination, and Revision of Alameda County Behavioral Health Policies and Procedures. PDF Benefits and Services for Kaiser Permanente's Medi-Cal Managed Care Members Share on Facebook. Read the annual NIMH Congressional Justifications. States also reported other access-related behavioral health initiatives including to address disparities and to promote co-location. Regarding BHSIN #21-073 and the changes effective January 1, 2022, a new Welfare and Institutions Code section 14184.402(f)(1)(A) clarifies that a mental health diagnosis is not a prerequisite for access to covered Specialty Mental Health Services (SMHS). More recently, ARPA provided enhanced Medicaid funding that could be used to support behavioral health home and community-based services (HCBS) providers and to provide community-based mobile crisis intervention services; the proposed BBBA (passed by the House of Representatives on November 19, 2021) would build on both of these options. CalAIM Explained: Overview of New Programs and Key Changes A: NO, SCFHP and SCMHD will take full risk for this new benefit. NIMH statistics pages include statistics on the prevalence, treatment, and costs of mental illness for the population of the United States. A few states mentioned incentive payments for providers or MCOs who promote integrated care. Learn more about NIMH newsletters, public participation in grant reviews, research funding, clinical trials, the NIMH Gift Fund, and connecting with NIMH on social media. endstream endobj 453 0 obj <. Introduction Both state and federal laws require health plans to provide treatment for mental health and substance use disorder conditions. List of NIMH science news including press releases, science updates and institute announcements. States have broad flexibility to determine whether and how to cover services (including behavioral health) delivered via telehealth in their Medicaid programs. If you or a friend or family member are thinking about taking part in clinical research, this page contains basic information about clinical trials. Learn more about the functions of each NIMH office and division. Notice: One of our vendors, NationsBenefits, LLC, experienced a cybersecurity incident that affected certain members personal information. Psychologists. Behavioral health conditionsincluding mental illnesses and substance use disorder (SUD)are especially common among Medicaid enrollees and have worsened during the COVID-19 pandemic. Adverse effects of the COVID-19 pandemic on mental health and substance use outcomes have brought further focus to behavioral health issues and prompted the Substance Abuse and Mental Health Services Administration (SAMHSA) to issue multiple COVID-19 grants, available to state agencies to address mental health and SUD outcomes. Follow NIMH on social mediaTwitter, Facebook, YouTube and LinkedIn. hbbd```b``N3JD2UIM0LE`&mI`5@: ntZ@$w^ex8~H bG H PDF Department of Public Health Specialty Mental Health Services - Sf As of July 1, 2021, all responding states cover audio-visual telehealth delivery of behavioral health services, and almost all also cover audio-only delivery of these services (Figure 2). Information about NIMH, research results, summaries of scientific meetings, and mental health resources. Other notable co-location initiatives in place or planned include: States use a combination of FFS and managed care arrangements to deliver behavioral health care to Medicaid beneficiaries, with these services increasingly being provided by MCOs in recent years (see Appendix A). 2dmqs=MJ00wtt4@nTI&bcu"H20^b@, a`dw`|IL[&2]uXpM|w%l710zT"f:BH10.c 7 zH+300 :^ These in lieu of services (ILOS) must be identified in the MCO contract and enrollees may not be required to use them.8 In recent years, states have increasingly used MCO in lieu of authority to cover services provided to nonelderly adults in institutions for mental disease (IMDs) that otherwise would be ineligible for federal Medicaid funding. Learn more about NIMH research areas, policies, resources, and initiatives. With Interventions Committee for Adult Disorders (ITVA): ITVA reviews applications concerned with clinical trials and treatments as applied to mental health disorders and outcomes at the level of the individual subject, while SRNS reviews applications of clinical services and service systems with a focus on service sites considered non-specialty mental health settings, such as primary or specialist medical care, schools, child welfare agencies, criminal justice settings, shelters, and other social service agencies where the primary focus of care is not mental health. and treatment of mental illnesses. The proposed Build Back Better Act (BBBA) passed by the House of Representatives on November 19, 2021 would build on both ARPA provisions and also expand funding for community mental health services. The impact of the ARPA enhanced federal Medicaid funding for HCBS (beginning April 2022) on behavioral health HCBS providers also remains to be seen. Learn more. 0 Non-Specialty Mental Health Services: Reimbursement Rates and Billing Codes Page updated: December 2021 This section lists the CPT and HCPCS codes and rates for Non-Specialty Mental Health Services (NSMHS). Referral Procedure For Primary Care Providers, Referral Form For Adult Outpatient Mental Health Services, Mental Health Community Based Organizations, Substance Use Disorder Treatment and Recovery Services, Transition to New DMC-ODS Services as of July 1st, Program Certification and Licensing: Standards, Regulations and Applications, P&P, Quality Assurance and Technical Assistance, Recommended Evidence Based Practices (EBP), 000-1-1 Development, Approval, Dissemination, and Revision of Alameda County Behavioral Health Policies & Procedures (8/26/19), 100-2-5 Adult and Older Adult System of Care Coordination Medi-Cal Specialty Mental Health Services (12/16/19), 100-2-6 Adult and Older Adult Specialty Mental Health Consumer Care Transitions (12/16/19), 100-2-1 Out of Network Access and Continuity of Care for Specialty Mental Health Services and Substance Use Disorder Services (1/24/20), 100-2-2 24/7 Language Assistance to Beneficiaries (1/27/20), 100-2-3 Timely Access to Service Standards and Tracking Requirements (6/6/19), 100-2-4 Accessibility of Services (12/16/19), 100-2-5 Telehealth Policy (8/23/22), 100-3-1 Criteria for Beneficiary Access to SMHS (5/13/22), 100-3-2 No Wrong Door for Mental Services (6/28/22), 100-3-3 Adult and Youth Screening and Transition of Care Tools for Medi-Cal Mental Health Services (01/11/23), 150-1-1 Interim Services Management for SUD Treatment Programs (10/24/16), 150-1-2 Charitable Choice (4/28/21), 150-1-3 Drug Medi-Cal Organized Delivery System (DMC-ODS) Care Coordination, Continuity of Care, and Transition of Care of Medi-Cal Specialty Mental Health, Substance Use Disorder, and Primary Care Services (12/16/19), 150-1-4 Expanding Access to Medications for Addiction Treatment (MAT) (8/26/22), 150-1-5 Naloxone Distribution Program (NDP) (3/2/2023), 150-2-1 Drug Medi-Cal Organized Delivery System (DMC-ODS) Requirements for the Period of 2022 2026 (5/13/22), 200-1 Psych Testing Authorization (3/24/21), 200-2 Authorization of Specialty Mental Health Services (6/25/20), 200-3 Prior Authorizations for Day Rehabilitation and Day Treatment Intensive (10/22/22), 300-1-1 Consumer Grievance and Appeal Processes (6/5/18), 300-1-2 Notices of Adverse Benefit Determination for Medi-Cal Beneficiaries (2/15/19), 300-2-1 Advance Directive (7/11/22), 300-3-1 Client Right to Request Amendment of Health Records (12/16/19), 300-4-1 Beneficiary Rights (4/28/2023), 350-2-1 Protection of Trafficking Victims (10/24/16), 350-2-2 Medication Monitoring for Drug Medi-Cal Organized Delivery System (6/1/2021), 350-3-1 Privacy, Security and Oath of Confidentiality of Substance Use Services, Records and Information (2/7/19), 400-1-1 24/7 Coverage Requirement for Children, TAY, Adult, and Older Adults Full Service Partnerships (6/19/20), 401-1 Adult/Older Adult Outpatient Levels of Care Determination (7/06/21), 401-2 Full Service Partnership Implementation (4/28/21), 401-3 Therapeutic Behavioral Services Implementation (6/1/2021), 403-2-1 Obtaining Authorization for Prescribing Psychotropic Medication to Youth in Out of Home Placement Under the Protection of the Juvenile Court (12/5/16), 403-3-1 Implementing Mental Health Child & Family Teams (12/16/19), 403-4-1 Provisions, Protocols, and Criteria for Identifying and Providing Intensive Services to Children/Youth in the Katie A. Subclass (12/16/19), 403-5-1 Implementation of AB 1299 Presumptive Transfer for Foster Youth Placed Out of County (12/16/19), 403-6-1 Early Periodic Screening Diagnosis and Treatment (EPSDT) Notification (09/27/21), 403-7-1 Families First Prevention Services Act, Qualified Individual Assessment Process (10/26/22), 403-8-1 Criteria for Therapeutic Foster Care Services (10/26/22), 403-9-1 Implementing Intensive Care Coordination (ICC) and Intensive Home-Based Services (IHBS) (10/31/22), 403-10-1 Child, Adolescent, and Young Adult System of Care (CYASOC) Level of Care Transfer (10/31/22), 404-1-1 Mobile Crisis Team Services Policy and Procedure (12/16/19), 501-1-1 Clinical Psychiatric Pharmacist Scope of Practice for Medication Therapy Management (5/22/17), 503-1-1 Designation for Mental Health Professionals to Initiate 5150/5585 Holds (12/16/19), 503-1-2 Reporting Disorders Characterized by Lapses of Consciousness (01/25/22), 901-1-1 Approval and Tuition Payment Policy for BHCS Staff to Attend Specialized Training Programs for Skill Development for Behavioral Health Care Services (9/19/17), 1302-1-1 Contract Compliance and Sanctions for BHCS-Contracted Providers (12/14/22), 1303-1 Provider Problem Resolution and Appeals (12/16/19), 1350-1-1 Expenditure of SAPT Block Grant (2/23/17), 1350-1-2 Documenting and Reporting SAPT Block Grant Expenditures (2/23/17), 1350-1-3 Expending and Reporting Perinatal Funding (2/23/17), 1350-1-4 Identifying, Reporting and Recovering Overpayments (7/06/21), 1601-1-1 CANS (Child and Adolescent Needs and Strengths), ANSA (Adult Needs and Strengths Assessment), and Pediatric Symptom Checklist (PSC-35) Implementation (rev. About half of all responding states reported non-MCO initiatives related to behavioral health screening in FY 2021 and FY 2022. Over 40 research groups conduct basic neuroscience research and clinical investigations of mental illnesses, brain function, and behavior at the NIH campus in Bethesda, Maryland. If you consider any member to be in a crisis or emergency situation, you may contact the Santa Clara Valley Health and Hospital System Emergency Psychiatric Services office at, PCPs may also coordinate behavioral health services by contacting SCFHP at. Expanding Substance Use Care: Health Plan Teams Up with Seven Our services include the most intuitive health insurance offering, our Alan Clinic to navigate the healthcare system and Alan Mind, our mental well-being offer among other things! Consistent with results from past years, the majority of MCO states reported that specific behavioral health service types were always carved into their MCO contracts (i.e., virtually all services covered by the MCO); fewer states reported that services were always carved out (to PHP or FFS) or that carve-in status varies by geographic or other factors.9 Also, five states reported targeted carve-outs of behavioral health drugs, such as psychotropic medications, from MCO capitation payments (data not shown). Who may receive Dyadic Services under the Medi-Cal program? Assessment Start Date is the date the client keeps a first assessment appointment. Of the states that identified any initiatives addressing racial/ethnic health disparities, eight reported initiatives to specifically address disparities in behavioral health care and outcomes. Find out how NIMH engages a range of stakeholder organizations as part of its efforts to ensure the greatest public health impact of the research we support. Overall, more than one-third of responding states mentioned behavioral health initiatives as a priority for FY 2022 and beyond, and several identified behavioral health services as an upward spending pressure in FY 2022. Nearly half of states reported initiatives to promote physical and behavioral health co-location in place in or planned for FY 2022. Specialty Mental Health Services (SMHS) are delivered by county Mental Health Plans (MHPs) for Medi-Cal beneficiaries who have a moderate-to-severe mental health condition. These are known as "non-specialty mental health services" or NSMHS. Behavioral health services for children are particularly comprehensive due to Medicaids Early, Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit for children (see Appendix A). endstream endobj 706 0 obj <. A suspected mental disorder that has not yet been diagnosed. Page updated: December 2021 . States reported service expansions across the care continuum, including institutional, intensive, outpatient, and home and community-based behavioral health services. Lessons from the Field: How an Ad Hoc Stakeholder Network Is Helping Redefine Medical Respite Care in Los Angeles. Continued efforts at the federal level may affect the level of enhanced Medicaid funding available to states for expanded behavioral health services. Medi-Cal managed care plans cover these services in one of two ways: "In-house," wherein the plans contract directly with behavioral care providers and manage all aspects of providing NSMHS to their members. Alameda County Behavioral Health Care Services. June 27, 2023. San Joaquin Valley: Despite Poverty and Capacity Constraints, Health NIMH supports research at universities, medical centers, and other institutions via grants, contracts, and cooperative agreements. A: The current carve out does not change. Research may examine organizations, systems and/or communities. Details about upcoming events including meetings, conferences, workshops, lectures, webinars, and chats sponsored by the NIMH. PDF Medi-Cal Dyadic Services - National Health Law Program Although MCOs provide comprehensive services, states may carve specific services out of MCO contracts to FFS or limited benefit prepaid health plans (PHPs). For example: Most states allow MCOs to use in lieu of authority to cover certain behavioral health services, particularly to allow coverage of services provided in IMDs. Search for jobs, including scientific, administrative and executive careers at NIMH. %PDF-1.5 % 476 0 obj <>/Filter/FlateDecode/ID[<5401A8CA65C26849AE096547C43B5B37><4683E2865CBB944291531B7E3A7D0FC8>]/Index[452 55]/Info 451 0 R/Length 116/Prev 227195/Root 453 0 R/Size 507/Type/XRef/W[1 3 1]>>stream Other recent federal policy options more directly target Medicaid, such as ARPAs expansion of mobile crisis response services, which aim to connect Medicaid enrollees experiencing mental health crises to appropriate community-based care (an option which the proposed BBBA would make permanent). Use these free digital, outreach materials in your community and on social media to spread the word about mental health. Some interviewees commented on the potential benefits to bill for CHW/P services through California's State Plain Amendment and CalAIM (California Advancing and Innovating Medi-Cal). Mental Health Services In Non-Specialty Settings (SRNS), Research Conducted at NIMH (Intramural Research Program), Research Training and Career Development Opportunities, COVID-19 Public Health Information From CDC, U.S. Department of Health and Human Services. 0 What is the difference between Specialty Mental Health Services (SMHS) and Non-Specialty Mental Health Services (NSMHS)? Effective January 1, 2023, . ARPA also authorized $15 million for state planning grants; these were awarded to 20 states in September 2021 (however, under ARPA, all states are eligible to take up this option beginning April 1, 2022, including those that did not receive planning grants). Alan | LinkedIn CCHP/MCP deliver non-specialty mental health services, aka mild/mod CCMHP = Mental Health Plan (MHP) CCMHP/MHP deliver specialty mental health services, aka mod/severe Individuals receiving services through MCP = Member Individuals receiving services through MHP = Beneficiary The survey also asked states to identify the top two or three categories of behavioral health services that had the highest telehealth utilization during FY 2021; states most frequently identified psychotherapy, counseling (for mental health conditions and/or SUD), and patient evaluations. Eight states reported current or planned initiatives to address racial/ethnic disparities in behavioral health in Medicaid.6 Prior to the pandemic, Black and Hispanic people were less likely to receive needed behavioral health services compared to the general population, and during the pandemic, Black and Hispanic adults have been more likely to report symptoms of anxiety and/or depressive disorder. State Policies Expanding Access to Behavioral Health Care in Medicaid, integrate physical and behavioral health care, enhanced federal Medicaid funding for HCBS, States Respond to COVID-19 Challenges but Also Take Advantage of New Opportunities to Address Long-Standing Issues: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2021 and 2022, The Implications of COVID-19 for Mental Health and Substance Use, Medicaids Role in Financing Behavioral Health Services for Low-Income Individuals. Email: nimhinfo@nih.gov Behavioral Health Care - California Department of Managed Health Care Outpatient laboratory, medications, supplies, and supplements (excluding medications as described in the All Plan Letter, Member may self-refer to Santa Clara County Mental Health Department by calling. KFF Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 The NIMH Strategic Plan for Research is a broad roadmap for the Institutes research priorities over the next five years. However, there has been significant movement across states to carve these services in to MCO contracts. New Programs Key Changes Timeline Downloads & Related Resources Summary California Advancing and Innovating Medi-Cal more commonly known as CalAIM is a far-reaching, multiyear plan to transform California's Medi-Cal program and enable it to work more seamlessly with other social services. PDF Screening & Transition of Care Tools - Overview - Contra Costa County Non-specialty Mental Health Services Individual and group mental health evaluation and treatment (psychotherapy) Psychological testing Outpatient services for monitoring drug therapy and for beneficiaries with mild to moderate impairment of mental, emotional, or behavioral functioning Outpatient laboratory, drugs, supplies,. Thirty10 of 37 responding MCO states indicated permitting at least one ILOS as of July 1, 2021; of these, more than three-quarters reported that the permitted ILOS included certain behavioral health services. The Medi-Cal program is a public health insurance program which provides needed health care services for low-income individuals including families with children, seniors, persons with disabilities and pregnant women. ET, M-F, Mail: National Institute of Mental Health Learn about NIMH priority areas for research and funding that have the potential to improve mental health care over the short, medium, and long term. The National Institute of Mental Health (NIMH) is part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services. Follow @Madeline_Guth on Twitter One approach to address care fragmentation and better integrate physical and behavioral health care is co-location of both types of care at the same site. Note: A neurocognitive disorder (for example, dementia) or a substance-related and addictive disorder (for example, stimulant use disorder) are not "mental health

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