Strategies for Integrating and Coordinating Care for Behavioral Health Populations: Case Studies of Four States. C. Program Goals


LBHP is undertaking several simultaneous system reform efforts, as described in the request for proposals (RFPs) that OBH issued in 2011 to procure an SMO. The reforms have the following goals:

  • Implement a CSoC for children/youth and their families/caregivers, using a family-driven and youth-driven practice model, providing wraparound facilitation by child and family teams, and offering family and youth supports, with overall management of these services by the SMO.

  • Improve access to, and quality and efficiency of, behavioral health services for children not eligible for the CSoC, and for adults with SMI and addiction disorder, through management of these services by the SMO.

  • Transition behavioral health service delivery and operations from OBH operated regions to independent local governing entities (LGEs).

  • Integrate mental health and addictions care through combining the former Office of Mental Health and Office of Addictive Disorder into OBH, under one assistant secretary.

  • Seamlessly coordinate behavioral health services with the comprehensive health care system without losing attention to the special skills of behavioral health professionals.

  • Advance a system of person-centered care that promotes resilience and recovery.

  • Implement best practices and evidence-based practices that are effective and efficient as supported by the data from measuring outcomes, quality, and accountability.

  • Leverage SGFs to appropriately obtain Medicaid financing.

The contract between OBH and Magellan is a core component of achieving these system reform efforts. Magellan is at-risk for adult behavioral health services and manages child and adolescent behavioral health services, which are reimbursed on a non-risk basis. Magellan and OBH are working together to expand the provider network and to monitor and improve quality. The remainder of this chapter focuses on the structure and financing of the arrangement with Magellan for the adult population. (LBHP is undertaking a range of activities focused on children and youth, specifically those with a serious emotional disturbance, but these are not the focus of this report.)

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