Update on the Public Mental Health System - 2006

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.