Questions
by Dina Sokal, MD &
Answers by Brian Hepburn, MD, Medical Director of the MHA
[Spring 2006; Vol. 32, No. 3; Pg 9]
Question
#1: The
FY deficit for 2004 was $35 million, $15 million less than the projected
deficit.
Was there a deficit for 2005?
Answer:
No.
Question
#2: Did
the monthly case rates for RRP and PRP solve the budget deficit or were there
other ways that the budget deficit was resolved?
Answer:
This was the major change.
If we hadn’t moved to case rates we would still have a deficit.
Questions
#3: Did
the monthly case rate for RRP and PRP continue in FY 2005 as a cost saving
measure?
Will the same rates apply next year or will there be changes?
Answer:
Yes.
Rates for Intensive RRP and Child PRP were changed in December 05
effective back to July 1, 2005 from $297/month to $389/month based on an average
of approximately seven services per month. In addition, the Governor included
funds in the budget to make some adjustment to rates as of July 1, 2006.
Question
#3: If
there continues to be a projected deficit for 2006, how will the MHA address it?
Will more cost containment measures be initiated or will the state
budget surplus be used towards current or additional services?
Answer:
There is no projected deficit.
Question
#4: Was
there any growth in mental health services for 2004 and 2005 such as increased
MA enrollment?
Answer:
There was a small increase in enrollment.
Question
#5: What
are some of the utilization review changes occurring with APS replacing Maryland
Health Partners? I heard that adjusting to APS was not an easy process and am
wondering if you could say how well the system is working at this time.
Answer:
Basically, it’s the same utilization review process except that the
authorizations are web based.
I think there were computer glitches initially that had to be worked out,
etc. The
feedback from providers is that they were surprised there were not many
complications in the transition.
The billing seemed to move smoothly.
There was some initial difficulty with providers adjusting to Care
Connection, the Web based authorization system.
That seems to be ok now.
Question
#6: What
are the numbers of children receiving services in 2005 as compared to 2004 and
how has the array of services available to them changed, if at all?
Answer:
The services remain the same.
Question
#7: In
the 2005 Winter issue of the Md. Psychiatrist, some of the MHA’s plans for new
approaches to treatment, based on help from the Technical Assistance
Collaborative, Inc. included: Peer supports and self-help approaches, Assertive
Community Treatment, Supported Employment, and Wrap-around Services for children
and adolescents.
Are there plans to implement any of these programs?
If so, which ones and if not, why not?
Answer:
Yes.
A waiver has been submitted to CMS for wraparound services.
A pilot project is planned for consumer directed services and for
Consumer Satisfaction Teams.
In addition, we are planning on paying special rates for ACT, SE, and
Family Psycho-education for providers maintaining fidelity to the EBP model
effective July 1, 2006.