Today’sPresentation : • What the Child mental Health Treatment Act (CMHTA) really is The Child Mental Health The Child Mental Health • How CMHTA helps non ‐ Medicaid and Treatment Act Treatment Act Medicaid Children • How to Access CMHTA • How to appeal decisions • Child Welfare and CMHTA 2 1 What is the Child Mental Health Treatment Act? • Other names: HB 1116 and SB 230 • 1. A treatment resource for families of eligible I NTRODUCTI ON to children • 2. An alternative to child welfare involvement CMHTA when it is not needed • 3. A family preservation and reunification program 3 4 1
At Minimum What Does the Child Mental What CMHTA Can Provide: Health Treatment Act Provide? Non ‐ • Non ‐ Medicaid: Access to an assessment for, and Medicaid Medicaid possible approval of, community, residential, and transitional treatment services Timely Assessment Timely Assessment • Funded in part by Medicaid, General Fund, and and Decision for and Decision for Services: Community or Residential Tobacco dollars Residential Treatment • Medicaid: Access to an assessment for residential CDHS Appeal services only CDHS Appeal Process in Addition Appeals: Process to the Medicaid • Funded by Capitated Medicaid Process • Non ‐ Medicaid funding is not available to Medicaid CDHS Funding for HCPF Funding for children Funding: Mental Health Mental Health Services Services 5 6 5. Has a 6. Family Mental has Non-Medicaid Illness Custody 1. Private 7. Without insurance services the 4. No funder for child is at risk or non ‐ treatment of out of home insured placement 3. Not 2. Birth to Medicaid 17.99 eligible 7 8 2
9 10 Non ‐ Some of What’s Covered for Non-Medicaid… Medicaid Case Management Day Outpatient Treatment CMHTA Passing of SB 230 Medication Residential Monitoring Family Therapy 11 12 3
Non ‐ Medicaid Medicaid Points of Access • Each Community Mental Health Center has a designated CMHTA liaison. ASSESSMENT • Only responsible person (parent) can request an assessment. • http://www.colorado.gov/cs/Satellite?c= Document_C&childpagename= CDHS- BehavioralHealth%2FDocument_C%2FCBONAddLinkView&cid= 1251655117018&pagename = CBONWrapper 13 14 Non ‐ Non ‐ Medicaid Medicaid Medicaid Medicaid Assessment and Notification Face to Face Mental Time Frames Health Evaluation Situation Time* Records Review Assessment Decision Emergent Within 6 hours Process Urgent Within 24 hours Phone Consultation Routine Within 3 days * Notification may be extended to 14 days if the parent is in agreement 15 16 4
Non ‐ Medicaid Approved for Community Based Care (non- Medicaid) 1. Liaison helps find a provider APPROVAL 2. Services begin promptly 3. Family pays Parental Fee 1. Based on monthly income and number of children Now What? in the home 4. CMHTA pays remainder of costs 17 18 Non ‐ Approved: Medicaid Fee Structure Residential (non- Medicaid) • Household income: $55,000 per year 1. Liaison helps find a provider • Fee for Residential 2. Child enters treatment center – 1 child living in the home: $726 per month 3. Family applies for SSI – 2 children living in the home: $501 per month • Once approved the child gets Fee ‐ For ‐ Service – 3 Children living in the home: $425 per month Medicaid • Fee for Community based care 4. Parents pay fee agreement (starting the first month) – 1 child: 12% of total care, max of $363 5. CMHTA pays remainder of costs 6. Link to residential providers: – 2 children: 8% of total care, max of $250 http://www.colorado.gov/cs/Satellite/CDHS ‐ – 3 Children: 7% of total care, max of $212 BehavioralHealth/CBON/1251641605227 19 20 5
Non ‐ Non ‐ Family Roles and Medicaid Medicaid CMHC Roles and Responsibilities Responsibilities for non-Medicaid Children • Participate in all • Assessments program aspects • Determines families ability to pay and financial • Pay providers according responsibilities to Fee Agreement • Submit plan of care to OBH • Residential: • Apply for SSI on • Provide necessary services child’s behalf • Care management 21 22 Approved: Medicaid Residential (Medicaid) 1. Liaison informs the BHO who then approves or denies DENI AL 2. Child enters treatment center 3. BHO pays for costs 23 24 6
Non ‐ Non ‐ Denial Medicaid Medicaid Medicaid Supplemental Security I ncome (SSI ) Denial (non-Medicaid • Family is denied services with CMHTA Residential) Denied • Family can appeal with the Social Security • Family can appeal to the agency Administration but CMHTA will no longer (CMHC/BHO) Initial Appeal be able to fund residential treatment • CMHTA will pay the first 30 days of • Medicaid: CDHS and or/ALJ treatment Then family can • Non ‐ Medicaid: CHDS appeal to the state 25 26 Non ‐ MH Agency County Medicaid Medicaid Referrals Referring Agency Reason Action Community Mental 1. Suspected abuse or neglect 1. DHS determines if an Health Center (CMHC) assessment is warrented 2. Meets with family and CMHC within 10 days HUMAN/ SOCI AL SERVI CES County Department of 1. Family issues may be 1. Parents still requests an Human Services (DHS) attributed to child’s MH evaluation [19 ‐ 3 ‐ 308 (1.5) (b), C.R.S.] status rather than abuse 2. DHS meets with family and and neglect, CMHC within 10 days 2. CMHTA services may be more appropriate 27 28 7
Non ‐ Medicaid Medicaid I nteragency Dispute Additional I nformation Resolution Please Contact: Andrew Gabor, MA, LPC Manager, Child Mental Health Treatment Act May be in Each side Committee An agency Within 10 writing will present has 5 requests state days, CDHS Decision is Office of Behavioral Health within 5 its position working level convenes a final calendar written or days to issue mediation committee 3824 W. Princeton Avenue days verbally its Decision Denver, CO 80236 Email: Andrew.Gabor@state.co.us Phone: 303-866-7422 Fax: 303-866-7481 www.cdhs.state.co.us 29 30 8
Recommend
More recommend
