Behavioral Health

Initiatives

Medicaid Regulations

Workgroup Website

Contact:

Mark Haines-Simeon
Division of Behavioral Health
Policy and Planning Section Manager
3601 C Street, Suite 878
Anchorage, Alaska 99524-0249
(907) 269-3408
(907) 269-3623 FAX
Email Mark

Program Background: Prior to 2003, the delivery of substance abuse and mental health services in Alaska was funded and coordinated by two separate divisions within the Department of Health and Social Services. While closer collaboration between the agencies providing these services had long been pursued, the effort took on a different perspective with the merger of the Division of Mental Health and Developmental Disabilities (DMHDD) and the Division of Alcoholism and Drug Abuse (ADA) into the Division of Behavioral Health (DBH) on July 1, 2003. Since that time, the implementation of this integration has gone well beyond the reorganization of the state offices, affecting the entire service delivery system. While a number of issues have been resolved, several important tasks remain. A crucial one is the development of a single set of Medicaid regulations.

Vision for Behavioral Health Services in Alaska. The following vision statement has been communicated in a number of different documents by the Behavioral Health Division Director.

All Alaskans with behavioral health needs will be provided services that are welcoming, accessible, integrated, continuous, and comprehensive, regardless of age, culture, language, or geography, and regardless of whether they have mental health needs, substance abuse disorders, or both. Further, the system of care shall be cost effective and administratively efficient, be designed in a manner that is sensitive to local needs, maximizes consumer, family, and provider participation, and has the capacity to continuously improve quality and track outcomes.

Project Purpose: The purpose of this project is to develop and recommend a service delivery and reimbursement model that will ultimately rise to the level of administrative code in the form of Medicaid regulations. The recommended model will allow behavioral health care agencies in Alaska to select from the same array of authorized services, develop flexible treatment strategies, and be reimbursed fairly and equally.

Project Vision and Approach: The vision for this project is to develop new Medicaid regulations that will enhance the overall integration effort and equalize service reimbursement across provider types without forcing unwanted and unrealistic change.

Historically, based on an internal Department vision, a service delivery and reimbursement model is conceptualized and Medicaid regulations are written without seeking input from external stakeholders until the final public comment phase of the formal adoption process. The Division is now exercising its value to use key informants - especially service providers - to assist in formulating ideas and concepts from which regulations will be written.

Values and Guiding Principles that will inform regulation development

  • Supports quality service delivery
  • Reinforces welcoming and accessibility to services
  • Supports Outcomes Based Practice
  • Strengthens clinical leadership
  • Reflects workforce issues in the state of AK
  • Reduces administrative burden on providers
  • Supports flexibility to providers
  • Reinforces a culture of Continuous Quality Improvement
  • Fiscal management that provides support and accountability

The work will proceed with the following assumptions.

  • Reinforces a culture of Continuous Quality Improvement
  • Fiscal management that provides support and accountability
  • A contractor will be obtained to facilitate the work process and to ensure completion by early spring.
  • A key stakeholder group will be formed. It will consist, to the degree possible, of the same membership as the earlier Behavioral Health Standards Development Workgroup to assist in continuity between the two interrelated projects.
  • The existing SA and MH Medicaid regulations will be merged, and will have various enhancements added such as reduction of provider administrative burden and increased flexibility in service planning and delivery.
  • Opportunities for enhanced management and accountability practices that include possibilities such as bundled services, daily rates, utilization reviews, and prior authorization strategies will be decided upon.
  • The service delivery model for behavioral health will include as many common clinical practices as possible including a single assessment and treatment planning process.