MHA in New York State: October 26, 2011

1. MHA in New York State: October 26, 2011 Behavioral Health Organization (BHO) Central Region - NY

2. Mission/Vision Magellan Health Services is a leading, diversified specialty health care management organization. Mission: With a focus on care and respect, we apply clinical expertise to assist people during challenging times. We deliver innovative solutions to our customers and collaborate with providers to positively influence the health and well being of individuals and the affordability of care. Vision: We are the premier partner in making quality healthcare more affordable, and innovating to bring clinical excellence into the lives of the people entrusted to our care.

3. Our Principles At Magellan, we support a philosophy of wellness that focuses on personal strengths, building hope and offering choices. Resiliency We believe that all people have qualities that enable us to rebound from adversity, trauma, tragedy, or other stresses and to go on with life with a sense of mastery, competency and hope. Recovery We believe that all people living with behavioral health conditions have the capacity to learn, grow and change, and can achieve a life filled with meaning and purpose. Cultural Competency We work to provide care and services that recognize the diverse backgrounds of the individuals and families we serve. Our strategies acknowledge and respect the behavior, ideas, attitudes, values, beliefs and language of all individuals.

4. Magellan’s Medicaid Experience

5. Magellan’s Medicaid Experience • Public sector focus – 60+% of Magellan’s Revenue is Medicaid • Manage behavioral health care for 1.5 million Medicaid members for 8 health plans in 12 States through subcontracting agreements, including NY • Contract directly in7 states representing 15 contracts (Arizona, Florida, Pennsylvania, Iowa, Nebraska, Louisiana & New York), for 2.7+million members • Pharmacy Benefits Administration Experience in 25 States and DC

6. Magellan Public Sector Overview * Implementing new contracts in Louisiana and New York – Central Region

7. Magellan Core Competencies:Partnership, Innovation & Transparency

8. A Reliance on Partnership • Magellan collaborates with providers, national advocacy organizations, individuals and their families to design, manage and continually improve behavioral health systems for government agencies.  • Our partners include: • Service Providers to gain your unique perspective on public sector consumers' behavioral health needs and resources available to meet those needs. • State and County Government Agencies as they build, manage or transform their public mental health and substance abuse systems. • Individuals and Families who play a variety of critical roles including participating on our Program Advisory Boards and Quality Improvement committees. • National and Local advocacy organizations which support and promote behavioral health and wellness for everyone. 

9. Shared decision-making through partnership Magellan has a flexible approach to public-private partnerships: Operating Committees – Example: Florida PMHPs. Membership includes stakeholder and managed care representation. Shared decision-making and accountability for program design and outcomes.  Governance Board – Example: Maricopa County, Arizona. Equal partnership between managed care organization and local stakeholders. Accountability for program design, oversight and operations. Child Welfare Joint Venture – Example: CBC Partnership, Ltd., Florida. Legalrelationship between Magellan and child welfare lead agencies in Florida.

10. Partnering with providers • 91% provider satisfaction with the accuracy of claims paid, nationally • Over 90% of PS claims received electronically for even faster payment • 93% provider satisfaction with the contracting/credentialing process • Average application processing time 45 days or less • Uniform Credentialing Data Source (CAQH), online re-credentialing • applications or paper applications accepted • Local contract manager to service providers within the state • 90% provider overall satisfaction with the services provided byMagellan, nationally • Local network and provider relations team dedicated to support recruitment and servicing providers within the community • Comprehensive suite of Web self-service tools available at: • www.MagellanHealth.com/provider • Customized websites for State programs • Free online trainings and CEUs for in-network providers • Web-based outcomes assessment tools and reporting to • monitor patient progress • Provider relations plan geared to meeting provider needs • Access to corporate discounts on office supplies

11. Focus on Innovation and Community Reinvestment

12. Public Sector Innovations Recovery and Resiliency Initiatives • Self-Directed Care (first program of its kind in the U.S.) • Peer Support Whole Health • MY LIFE Youth Empowerment Initiative • MY Fest Youth Outdoor Arts and Community Festival • Homeless/Housing and Vocational Support Programs Web-Based Programs and Services • Free National Webinars on Recovery and Resiliency-related topics in conjunction with ACMHA • Free Resiliency & Recovery E-Learning Center at www.MagellanHealth.com/Training (www.magellanhealth.com/training) • Customer & Provider Dashboards (www.magellanofaz.com) Children’s System of Care Programs • Focus on Wraparound Services for At-Risk Youth • Building Bridges collaboration

13. Magellan and the Building Bridges Initiative Host Two Webinars Focused on Residential Programs – Oct. 27 and Nov. 10 Magellan and the Building Bridges Initiative (BBI) are partnering to provide two national webinars for staff, families, youth and advocates served by residential programs and their community counterparts. Thursday, Oct. 27, 1 - 2:30 p.m. Eastern time*: Successfully Engaging Youth and Families - Join a panel of family members, youth and advocates who will share what works for engaging youth and families served by residential programs and their community counterparts. If you have ever struggled to partner with families and/or youth, you will gain understanding about how to change and/or improve your strategies. *10 a.m. – 11:30 p.m. Pacific time, 11 a.m. – 12:30 p.m. Mountain time, Noon – 1:30 p.m. Central time Thursday, Nov. 10, 1 - 2:30 p.m. Eastern time*: Fiscal Strategies that Support the Building Bridges Initiative Principles - Join a panel of knowledgeable fiscal professionals, as well as representatives from entities that have changed outcomes based on successful fiscal strategies, to increase your knowledge base about a range of fiscal strategies that support positive outcomes. *10 a.m. – 11:30 p.m. Pacific time, 11 a.m. – 12:30 p.m. Mountain time, Noon – 1:30 p.m. Central time

14. Public Sector Innovations (Continued) Wellness Initiatives • Smoking Cessation • Health & Wellness Assessments Cultural Competency Programs • Organizational Self-Assessments and Trainings • Cultural Competency Plans at Every Service Center Clinical Programs • Pre-Risk Predictive Modeling • Primary Care Physician Consult Line • Medical/Behavioral Integration Programs (e.g., Pennsylvania HealthChoices HealthConnections) and Health Home Pilot Initiatives in IA and AZ

15. Peer Initiatives Peer experience is valued and integrated at all levels of our Public Sector programs Peer specialists work in our care management centers and national team Peer-provided services and supports through our provider network Partnerships with peer-operated organizations in communities we serve Promotion of mutual self-help and support groups as a vital resource for recovery Peer Support as an evidence-based practice is implemented through approaches that work Peer Crisis Navigators help link people to services to prevent ongoing crisis involvement (AZ) Peer Connections and other bridger-type programs help people coming out of hospitals (PA and FL) Peer specialists trained to provide crisis support (IA) Peer Support Whole Health – rolling out across all Public Sector programs. • Currently in place in Maricopa, Pennsylvania, and Iowa.

16. Innovative Product Features

17. BHO Overview/Approach

18. Our Approach We propose a person-centered/strength-based approach that incorporates feedback we have received from local providers, advocates, and other stakeholders and fully responds to The Offices’ priorities for utilization management, timely access to care, services coordination, outcomes measurement, cost containment, and holistic/integrated care. As a national leader with 20 years of experience in providing BH managed care services, our commitment to building resilience and facilitating recovery in the lives of the children and adults we serve is the foundation of all of our services from reviewing, managing, and reducing unnecessary inpatient care to the creation and use of diversion and community-based alternatives.

19. Program Goals • Monitor behavioral health inpatient length of stay • Reduce unnecessary behavioral health inpatient hospital days • Reduce behavioral health readmission rates • Improve rates of engagement in outpatient treatment post discharge • Improve understanding of the clinical conditions of children diagnosed as having a Serious Emotional Disturbance (SED) • Profile provider performance • Test metrics of system performance • Establish relationships with key system stakeholders

20. Required Program Tasks Task 1: Monitor, review and assess the use of behavioral health inpatient care • Concurrent review of hospital admissions for BH • Monitor discharge planning activities and ambulatory follow-up • Enhanced discharge planning for individuals identified by the State as disengaged from care • Enhanced discharge planning for individuals who are readmitted • Enhanced discharge planning for individuals with 3 or more detox admissions Task 2: Children’s 0utpatient SED tracking • Track children newly diagnosed having a SED by Specialty Clinics • Report monthly to State Task 3: Provider profiling • Quarterly provider profiles • Share information with stakeholders • Biannual meetings with stakeholders to provide information Task 4: Facilitate cross-system linkage • Meet quarterly with stakeholders • Encourage IP providers to develop linkages with health homes • Develop relationships with health homes • Assure discharge plans address individuals’ physical health needs

21. Additional Capabilities • Define, engage and link cohorts of disengaged or high risk individuals to appropriate treatment • Review outpatient engagement for post-discharge follow-up care • Suicide prevention • Reduce costs for people with high cost physical and behavioral health conditions • Behavioral health emergency department diversion/inpatient diversion

22. Operational Details for Central Implementation efforts have been underway since late September, recruiting staff, etc. Magellan is actively working with OMH & OASAS to finalize the contract and the parameters of the program (expected to ne completed in early November) Magellan, OMH and OASAS will create multiple opportunities to meet with stakeholders and providers to address all questions and concerns regarding the implementation of the Behavioral Health Organization Magellan will then begin reaching out to providers and other stakeholders to start developing our relationships, with formal provider trainings in December. Magellan’s office will be located in the One Park Place building at 300 South State Street in Syracuse.  Our telephone number will be 800-424-4299. Magellan is developing a web site specific to Central New York that will be available after December 1.  The web address is www.magellanofnewyork.com Please contact Deb Happ, VP of Operations, at 443-622-6704 in the short-term.

23. Thank you!