RCPA - Rehabilitation and Community Providers Association


DPW Conducts MA Realignment Conference Calls
November 8, 2005

First Monthly Call
In an ongoing effort to improve planning, coordination, and collaboration for the Integrated Children’s Service Initiative (ICSI), the Department of Public Welfare (DPW) leadership is now conducting monthly conference calls with counties and providers. These meetings will supplement the work of the ICSI advisory group and the department’s regional offices. Conference calls will focus on efforts to resolve past issues impacting residential programs and facilitate future planning for in-home service models. The first conference call was held on November 4 The next call is scheduled December 2.

ICSI Focusing on County-based In-home Services
Highlights from the first conference call included the following reports and updates from state officials:

  • Regional staff from the Office of Children, Youth and Families (OCYF) and the Office of Mental Health and Substance Abuse Services (OMHSAS), along with consultants, are meeting with county leaders to identify in-home services that may be appropriate for enrollment in Medical Assistance (MA).
  • There is increasing focus on working with counties and providers operating in smaller numbers of counties to avoid complications related to the varying needs and demands that exist between counties. This shift is based on the experience with residential programs that contract with multiple counties and multiple managed care organizations.
  • In the HealthChoices regions there have been adjustments in the contract rates with counties and their managed care partners. Data is now being reviewed by the MA consultant to determine additional rate adjustment for January.
  • The Office of Medical Assistance Programs is requesting that providers seeking to enroll in MA provide clear and detailed documentation and program descriptions to facilitate the rate setting and enrollment process as well as minimize risks related to federal program audits.
  • MA will no longer do retroactive enrollment of ICSI programs.
  • OMHSAS and OCYF are encouraging partnerships and collaboration between licensed mental health agencies and children and youth or juvenile justice programs that may seek MA enrollment for ICSI services they operate.
  • The state is currently considering certification by the companies licensing multi-systemic therapy and functional family therapy programs as an acceptable equivalent to DPW licensing for the purpose of MA enrollment.
  • The state has begun the process of developing medical necessity criteria for ICSI services.
  • Future ICSI conference calls and meetings will focus on identifying performance measures.

A complete summary of the conference call will be posted next week on the DPW web site and can be found in the integrated children’s services initiative section of the Services for Children page.

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