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Behavioral Health Regulations: Workgroup Report

Behavioral Health Regulations: Workgroup Report. Department of Health & Mental Hygiene Alcohol & Drug Abuse Administration Mental Hygiene Administration May 2012. O verview. A workgroup was formed to examine State regulations addressing community mental

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Behavioral Health Regulations: Workgroup Report

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  1. Behavioral Health Regulations:Workgroup Report Department of Health & Mental Hygiene Alcohol & Drug Abuse Administration Mental Hygiene Administration May 2012

  2. Overview • A workgroup was formed to examine State • regulations addressing community mental • health and substance use disorder programs in • order to make recommendations for changes • needed to support an integrated (MH and SA) • community behavioral healthcare system.

  3. Workgroup Members • Brian Hepburn - MHA • Daryl Plevy - MHA • Sharon Olihaver - MHA • Stacey Diehl - MHA • Darrell Nearon – BH and Disabilities • Barbara Francis – OAG • Susan Tucker – Office of Health Services • Wendy Kanely - OHCQ • Sue Jenkins - ADAA • Lori Doyle - Provider • Tracy Schulden - Provider • Oleg Tarkovsky - Provider • Kathy Rebbert- Franklin, Chair - ADAA

  4. Guiding Principles • Address both system & service integration • Promote administrative simplicity • Facilitate & support use of evidence-based interventions • Promote person-centered approach

  5. Objectives • Create integrated regulatory system for providers serving those with substance use disorders and mental illness • Align BH quality control mechanisms with those applied to somatic health • Address regulations, not financing • Eliminate duplication with other regulations: Health Occupations Boards, FDA • Achieve consistency in service delivery

  6. New Approach Transition from reliance on State regulations to recognition of accreditation by nationally accrediting entity.

  7. New Approach – State’s Role • Requires & monitors accrediting status of providers. • Maintains regulations for activities not covered by accreditation standards. • Assists providers with transition to accreditation.

  8. Benefits of Accreditation • Providers expected to respond to one set of standards. • Providers able to apply greater focus to quality instead of compliance. • Providers will meet insurance reimbursement requirements. • State resources have increased capacity to follow-up on concerns/complaints and focus on non-reimburseable service development and provision.

  9. WHO will be required to be accredited? • Exemptions: • FQHCs • Hospital programs in regulated space • Licensed individuals in solo or group practice • Applies to: • All other mental health, substance use disorder & co-occurring treatment programs

  10. Different Models • Licensed individuals in solo or group practice: • Accreditation not required. • FFS payments only for individuals licensed to practice independently. • Licensed and Unlicensed in practice together: • Program must be accredited due to unlicensed practitioner(s) • Unlicensed staff in practice together: • Program must be accredited due to unlicensed practitioner(s)

  11. HOW will transition proceed? • Further analysis by Workgroup. • Additional & on-going opportunities to provide • feedback. • Accrediting entities must be approved by State. • State exploring methods to help facilitate • transition for providers.

  12. WHEN will transition occur? • July 2012 Final Workgroup Recommendations • January 2013 Legislation introduced & passed • July 2013 Legislation implemented • July 2015 Compliance with legislation required

  13. Additional Analyses • Review crosswalks of COMAR to accrediting standards. • Determine critical elements in State’s oversight and monitoring. • Survey other states for lessons learned. • Plan future relationships and communication channels between accrediting entities, OHCQ, and BH Administration • Evaluate ways to assist providers with accreditation process.

  14. Assistance with Accreditation • Currently large number of MH & SA programs licensed/certified (>2k). • Analyze needs of provider communities. • Evaluate various methods to assist with accreditation process.

  15. Current Licenses – Substance Abuse • 21 Education Programs • 263 Outpatient Programs • 95 Residential Programs • 11 Residential Detox Programs • 11 Non-Residential Detox Programs • 55 OMT Programs • 32 Correctional Programs • TOTAL = 488

  16. Current Licenses – Mental Health • 198 Outpatient Mental Health Centers • 4 Group Homes and 150 above • 54 Vocational Programs • 26 Mobile Treatment Services • 35 Partial Hospitalization Programs • 171 PRP for Adults • 109 PRP for Minors • 16 Residential Crisis Services • 743 Residential Rehabilitation Programs • 17 Respite Care Services • 21 Therapeutic Group Homes • 1 Therapeutic Nursery Program • TOTAL = 1,545

  17. Stakeholder Feedback • Ongoing: regulations_integration@dhmh.state.md.us • Forums: • MHA conference May 2 • MADC conference May 9 • Final Report and Recommendations

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