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Mental Health

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The Alliance of Community Health Plans (ACHP) invites our Learning Community to discuss the innovative approaches that not-for-profit, community-based health plans are using to integrate primary care and behavioral health on Wednesday, January 18, at 1:00 pm. The presentation and discussion of innovative examples of integrating primary care and behavioral health features Dr. Judith Feld (Independent Health), Dr. James Schuster (UPMC), and Dr. Mason Turner (Kaiser Permanente), and focuses on:

UPMC Health Plan is integrating primary care and behavioral health with programs such as co-locating behavioral health specialists at primary care sites, placing care managers within primary care practices to assist with care coordination, and reverse co-locating primary care physicians in behavioral health settings.

Independent Health has fully integrated behavioral health consultants within nine patient-centered medical homes, resulting in high patient satisfaction and significantly increased use of screening rates for mental health and substance abuse.

Kaiser Permanente’s evidence-based collaborative care approach to depression treatment helps adult members who have been newly diagnosed with mild-to-moderate depression and who have started an antidepressant.

Registration for this webinar is required.

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The decision for Pennsylvania to postpone the implementation of Community HealthChoices (CHC) was announced today. This decision was made as a result of the delays associated with the resolution of several bid protests.

Following the announcement of the selection of the managed care organizations (MCOs) that would deliver health care coverage in Community HealthChoices, several protests were filed. As a result, the progress of major components of CHC implementation was delayed, resulting in the Department of Human Services (DHS) feeling uncertain with moving forward with their established start dates. Some of the impacted activities associated with this decision include:

  • Developing an adequate network: DHS has not been able to engage with the selected offerors. The agreement and rate negotiations and finalization typically take six weeks, and the agreements need to be finalized before the MCOs are able to engage in network development activities. The current delays mean the MCOs will not have enough time to meet the network adequacy requirements by July 1, 2017.
  • Completing a readiness review: Readiness review is a requirement for the MCOs before they are certified to be able to go live and provide services. Protests prohibit MCO engagement for readiness review and the window to complete the certification continuously shrinks. New programs require a minimum of six months to complete a readiness review.
  • Communicating: Communication about selected MCOs and their available networks is a critical component to CHC education and outreach. Individuals who will be enrolling in CHC need to have complete information about the MCO provider network in order to be able to make an informed provider choice. That communication will not be able to take place until the agreements are largely finalized and the MCOs are in a position to provide network information.

Important dates to note include:

  • Phase 1 will now begin in January 2018 in the Southwest region of the state.
  • Phase 2 will now begin in July 2018 in the Southeast region of the state.
  • The January 2019 start date for the rest of the state remains unchanged.

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The Integration Edge is a new resource from the SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) that outlines practical tips and examples from organizations that have been working to integrate primary and behavioral health care. CIHS has been exploring partnerships, confidentiality issues, and sharing information and data-driven care. CIHS will regularly update The Integration Edge with new topics and practical examples. Whole person, health care focused practitioners and provider organizations looking for additional advice or with a topic they would like to see highlighted can visit this new website or contact CIHS by phone 202-684-7457 or email.

Know about the latest topics as they are added to The Integration Edge when you sign up for the email as the center adds new topics and other news related to integration.

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Patrick Kennedy, former United States Representative and founder of the Kennedy Forum, has issued an open letter to the heads of the leading insurance companies in response to the findings of last week’s Surgeon General’s report. The report, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, addresses a broad array of issues, ranging from illicit drug abuse to prescription drug addiction, alcohol use, binge drinking, and teen alcoholism. Mr. Kennedy’s letter urges the commercial nation’s health industry to take action in five key areas:

  1. Eliminate the onerous medical management practices responsible for inadequate, ineffective treatment of addiction;
  2. Immediately ensure that all plans cover and reimburse for well-supported medication-assisted treatment (MAT), including buprenorphine, buprenorphine-naloxone, buprenorphine-hydrochloride, methadone, naltrexone, acamprosate, and disulfiram, at rates equal to coverage for medications used to treat other forms of chronic illness;
  3. Incentivize greater coordination of care;
  4. Adequately disclose processes for ensuring parity compliance;
  5. Promote screening and work with communities to implement prevention interventions.

Each of these requests is clarified in further detail in the letter. Patrick Kennedy was the prime sponsor of the Mental Health Parity and Addiction Equity Act of 2008 and author of the book, A Common Struggle (Blue Rider Press/Penguin Random House, 2015).

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Yesterday, a Texas federal judge issued a temporary injunction to the Department of Labor’s (DOL) overtime rule. In granting the preliminary injunction, the federal judge said the DOL’s overtime rule exceeds the authority the agency was granted by Congress.

As you may recall, the DOL’s overtime rule was announced in May, and it has been opposed by many businesses and nonprofits. The rule was to take effect on December 1 of this year. Now with yesterday’s ruling, it is likely that President-elect Trump’s administration, which opposed the rule, will have time to review it and make changes and/or roll back various provisions contained in the current rule.

The DOL could appeal the Tuesday ruling, but with the Obama administration only having approximately two months in office, an appeal is unlikely. With many RCPA members already implementing and announcing changes to comply with the DOL’s overtime rule, it might be difficult for those members to roll back these changes, because it may impact employee morale. As further information is released, RCPA will provide additional guidance to members. Please contact Jack Phillips, RCPA Director of Government Affairs with any questions.

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RCPA, in conjunction with the National Council of Behavioral Health, and the Washington, DC-based Behavioral Health & Economics Network (BHECON), will be hosting a forum on Investing in Pennsylvania’s Behavioral Health Workforce. The event will take place on Friday, December 2, between 10:00 am – 3:00 pm at the Crowne Plaza Hotel, 23 South 2nd Street, Harrisburg, PA. There is no charge to attend and lunch will be provided.

The goal of the forum is to bring together diverse stakeholders to examine and advance policy reforms to strengthen the Commonwealth’s behavioral health delivery systems. Some of the issues/topics to be discussed include:

  1. Identifying programs in Pennsylvania that are doing exceptionally well when it comes to delivery of behavioral health services;
  2. Discussing the top challenge providers face with regard to workforce;
  3. Identifying public policies the state needs to change to make recruitment and retention of employees easier;
  4. Identifying federal policies that are holding providers back from recruiting and retaining employees; and
  5. Discussing whether the Excellence in Mental Health Act can help providers expand capacity to serve more people in the community, and how Pennsylvania could build on its current Excellence Act activities in the future.

The agenda for the day includes a welcome from the Pennsylvania Lieutenant Governor Mike Stack, a lunch discussion concerning the Department of Labor’s Overtime Rule, and morning and afternoon panel discussions.

There is no registration fee and lunch will be provided. You may register here for the event. Questions and suggestions regarding the forum may be shared with Jack Phillips, director of government affairs.

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