Case Management

Virtual Case Management Considerations and Resources for Human Services Programs

By Annette Waters, Pamela Winston, and Robin Ghertner April 1, 2020

Virtual_Case_Management_Considerations.pdf
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Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Pennsylvania

State Population (in millions) DY1--Total to Receive CCBHC Services (all pay sources) DY1--Projected CCBHC Consumers who are Medicaid Recipients* 12.81

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Oregon

State Population (in millions) DY1--Total to Receive CCBHC Services (all pay sources) DY1--Projected CCBHC Consumers who are Medicaid Recipients* 4.14

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Oklahoma

State Population (in millions) DY1--Total to Receive CCBHC Services (all pay sources) DY1--Projected CCBHC Consumers who are Medicaid Recipients* 3.93

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. New York

State Population (in millions) DY1--Total to Receive CCBHC Services (all pay sources) DY1--Projected CCBHC Consumers who are Medicaid Recipients* 19.85

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. New Jersey

State Population (in millions) DY1--Total to Receive CCBHC Services (all pay sources) DY1--Projected CCBHC Consumers who are Medicaid Recipients* 9.01

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Nevada

State Population (in millions) DY1--Total to Receive CCBHC Services (all pay sources) DY1--Projected CCBHC Consumers who are Medicaid Recipients* 3.00

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Missouri

State Population (in millions) DY1--Total to Receive CCBHC Services (all pay sources) DY1--Projected CCBHC Consumers who are Medicaid Recipients* 6.11

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Minnesota

State Population (in millions) DY1--Total to Receive CCBHC Services (all pay sources) DY1--Projected CCBHC Consumers who are Medicaid Recipients* 5.58

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Fast Facts: Demonstration Claiming

Fast Facts: Demonstration Claiming Under the Demonstration, states do not need Medicaid state plan authority to claim for CCBHC services. States may report only expenditures for demonstration services provided to Medicaid beneficiaries during the effective dates of a state's demonstration program.

Matching Rates for Demonstration Expenditures

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Matching Rates for Demonstration Expenditures

Under this demonstration, a state may only claim expenditures for services provided to Medicaid beneficiaries. Consistent with Section 223(d)(5) of PAMA, the matching rates for demonstration expenditures are as follows: For services provided to newly eligible Medicaid beneficiaries enrolled in the New Adult Eligibility Group as described in p

Paying for Services Provided to Dually Eligible

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Paying for Services Provided to Dually Eligible Beneficiaries

Certain Medicare beneficiaries are eligible for some level of Medicaid assistance. These individuals are often referred to as "dually eligible" beneficiaries. Section 223 requires states to pay up to the PPS rate for demonstration services provided to dually eligible beneficiaries for whom the state must share in the cost of direct services, rathe

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Prospective Payment System Rates

States set clinic-specific rates based on the expected cost of providing demonstration services divided by the expected total number of demonstration visits, regardless of payer. In evaluating the expected cost of care, states and the CCBHCs reported that their costs took into consideration factors such as the expected number of demonstration enco

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. New Jersey: Embracing Change

New Jersey: Embracing Change

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Requirement 5: Quality and Other Reporting

The clinic reports encounter data, clinical outcomes data, quality data, and such other data as the Secretary requires.

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Requirement 4: Scope of Services

CCBHCs provide, in a manner reflecting person-centered care, the following services: Crisis mental health services, including 24-hour mobile crisis teams, emergency crisis intervention services, and crisis stabilization. Screening, assessment, and diagnosis, including risk assessment. Patient-centered treatment planning or si

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Requirement 3: Care Coordination

Coordinated care across settings and providers promotes seamless transitions for patients across the full spectrum of health services, including physical and MH/SUD needs. The clinics maintain partnerships or formal contracts with the following: FQHCs and Rural Health Clinics (as applicable). Inpatient psychiatric facilities and su

Requirement 2: Availability and Accessibility of

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Requirement 2: Availability and Accessibility of Services

The clinic provides 24-hour crisis management services, a sliding scale for payment, and does not reject or limit services by the patient's ability to pay or place of residence.

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Requirement 1: Staffing

Staff have diverse disciplinary backgrounds, have necessary state-required license and accreditation, and are culturally and linguistically trained to serve the needs of the clinic's patient population.

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018. Missouri: Statewide Involvement

Missouri: Statewide Involvement

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