Guidance for commissioners of child and adolescent mental health servicesJCP MH
This guide describes what ‘good looks like’ for a modern child and adolescent mental health service (CAMHS). It should be of value to Clinical Commissioning Groups (CCGs) and NHS England.
By the end of this guide, readers should be more familiar with the concept of CAMHS and better equipped to understand:
what a good quality, modern, service looks like
why a good CAMHS delivers the mental health strategy and the Quality Innovation Productivity and Prevention initiative – not only in itself but also by enabling changes in other parts of the system
the benefits of CAMHS to children, young people, their families and carers, and
why CAMHS are important for commissioners.
Guidance for commissioning public mental health servicesJCP MH
Public mental health services (updated August 2013)
This is the second version of the public mental health guide. It has been revised and updated to include new sources of data and information.
The guide is about the commissioning of public mental health interventions to reduce the burden of mental disorder, enhance mental wellbeing, and support the delivery of a broad range of outcomes relating to health, education and employment.
Guidance for commissioners of liaison mental health services to acute hospitalsJCP MH
This guide describes what ‘good looks like’ for a modern acute liaison service. It should be of value to Clinical Commissioning Groups (who will be commissioning secondary services, both specialist mental and acute).
Guidance for commissioners of drug and alcohol servicesJCP MH
This guide has been written to provide practical advice on developing and delivering local plans and strategies to commission the most effective and efficient drug and alcohol services for adults.
Based upon clinical best practice guidance and drawing upon the range of available evidence, it describes what should be expected of a modern drug and alcohol service in terms of effectiveness, outcomes and value for money.
Presentation - The Future of Home HealthC Sam Smith
"Instead of it being described as home healthcare, in a few years the services performed by home health care agencies will simply be known as "modern healthcare".
-Dr. Steve Landers, VNA Health Group, New Jersey
Guidance for commissioners of child and adolescent mental health servicesJCP MH
This guide describes what ‘good looks like’ for a modern child and adolescent mental health service (CAMHS). It should be of value to Clinical Commissioning Groups (CCGs) and NHS England.
By the end of this guide, readers should be more familiar with the concept of CAMHS and better equipped to understand:
what a good quality, modern, service looks like
why a good CAMHS delivers the mental health strategy and the Quality Innovation Productivity and Prevention initiative – not only in itself but also by enabling changes in other parts of the system
the benefits of CAMHS to children, young people, their families and carers, and
why CAMHS are important for commissioners.
Guidance for commissioning public mental health servicesJCP MH
Public mental health services (updated August 2013)
This is the second version of the public mental health guide. It has been revised and updated to include new sources of data and information.
The guide is about the commissioning of public mental health interventions to reduce the burden of mental disorder, enhance mental wellbeing, and support the delivery of a broad range of outcomes relating to health, education and employment.
Guidance for commissioners of liaison mental health services to acute hospitalsJCP MH
This guide describes what ‘good looks like’ for a modern acute liaison service. It should be of value to Clinical Commissioning Groups (who will be commissioning secondary services, both specialist mental and acute).
Guidance for commissioners of drug and alcohol servicesJCP MH
This guide has been written to provide practical advice on developing and delivering local plans and strategies to commission the most effective and efficient drug and alcohol services for adults.
Based upon clinical best practice guidance and drawing upon the range of available evidence, it describes what should be expected of a modern drug and alcohol service in terms of effectiveness, outcomes and value for money.
Presentation - The Future of Home HealthC Sam Smith
"Instead of it being described as home healthcare, in a few years the services performed by home health care agencies will simply be known as "modern healthcare".
-Dr. Steve Landers, VNA Health Group, New Jersey
Practical mental health commissioning explains the changing commissioning environment and how commissioners can make the most of available resources to improve the quality and outcomes of mental health and social care services in their area.
Guidance for commissioners of mental health services for people from black an...JCP MH
This guide describes what ‘good’ mental health services for people from Black and Minority Ethnic (BME) communities look like.
While all of the JCP-MH commissioning guides apply to all communities, there are good reasons (see P9) why additional guidance is required on commissioning mental health services for people from BME communities.
This guide focuses on services for working age adults. However, it could also be interpreted for commissioning specialist mental health services, such as CAMHS, secure psychiatric care, and services for older adults.
Guidance for commissioners of primary mental health servicesJCP MH
This guide describes what good quality, modern, primary mental health care services look like. It has been written by a group of primary mental health care experts, in consultation with patients and carers. The content is primarily evidence-based but ideas deemed to be best practice by expert consensus have also been included.
Office-Based Opioid Treatment: What You Need to Know: Trends in Behavioral He...Epstein Becker Green
Presented by David Shillcutt (Associate, Epstein Becker Green) and Kristina Sherry (Attorney, Nelson Hardiman) on April 4, 2019.
Office-based opioid treatment providers are on the front lines of the response to the opioid epidemic, but recent developments in federal and state legislation have significant implications for provider business models and service delivery strategies.
This webinar will examine provider capacity issues for medication assisted treatment, the opportunities and challenges of telemedicine for addiction services, and the expansion of innovative service delivery networks including the “Hub and Spoke” system and related models.
Part of a "first Thursdays" webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/office-based-opioid-treatment-what-you-need-to-know-trends-in-behavioral-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Guidance for commissioners of services for people with medically unexplained ...JCP MH
This guide is about the commissioning of comprehensive MUS services across the healthcare system. In developing this guide, we recognise that ‘medically unexplained symptoms’ is an unsatisfactory term for a complex range of conditions.
MUS refers to persistent bodily complaints for which adequate examination does not reveal suf ciently explanatory structural or other specified pathology. The term MUS is commonly used to describe people presenting with pain, discomfort, fatigue and a variety of other symptoms in general practice and specialist care. Whilst recognising that the phrase ‘medically unexplained symptoms’ can be problematic, it is nonetheless widely used, and an appropriate term to use in this guide.
This guide aims to: describe MUS and the associated outcomes: outline current service provision for MUS and detail the components of a high quality comprehensive MUS service, and highlight the importance of commissioning comprehensive MUS services.
Primary Care Behavioral Health Consultation ServicesMichael Terry
presentation at APNA 2011 Conference in Anaheim CA. Looks at development of a consultation service, the ed/training required and an example of a curricula to address this at the DNP level.
Guidance for commissioners of mental health services for people with learning...JCP MH
This guide is about the commissioning of mental health services for people with learning disabilities, enabling them to live full and rewarding lives as part of their local communities.
This guide is aimed at all commissioners responsible for mental health services for people with learning disabilities including young people in transition to adulthood. The guide will also be helpful for providers of mental health services and for family carers.
This guide describes what we know about mental health services for adults with learning disabilities, and what effective and accessible services look like based on current policy, the law and best practice.
While this guide does make reference to autistic spectrum disorders and ‘behaviours that challenge’ (which people with learning disabilities who have mental health problems may also experience), the primary focus of this guide is on people with learning disabilities who have mental health problems.
Joint Commissioning Panel for Mental Health briefingJCP MH
This briefing describes the Joint Commissioning Panel for Mental Health (JCP-MH), a collaborative co-chaired by the Royal College of Psychiatrists and the Royal College of General Practitioners. The collaboration includes seventeen leading organisations, inspiring commissioners to improve mental health and wellbeing, using a values based commissioning model. It brings together service users, carers, clinicians, commissioners, managers and others to deliver the best possible commissioning for mental health and wellbeing.
The JCP-MH publishes briefings on the key values for effective mental health commissioning. It also provides practical guidance and a framework for mental health commissioning and supports commissioners in commissioning mental health care that delivers the best possible outcomes for health and well being
Regulatory changes, plus advances in cloud computing and analytic technologies, are making it possible for U.S. healthcare providers, payers and patients to connect, commmunicate and collaborate seamlessly, and ensure that the right care is provided at the right place, at the right time.
Guidance for commissioners of acute care – inpatient and crisis home treatmentJCP MH
This guide is about commissioning services for people with acute mental health needs. It explains the purpose, characteristics and components of acute care so that commissioners can commission good quality services that are therapeutic, safe and support recovery.
Guidance for commissioners of rehabilitation servicesJCP MH
This guide is about the commissioning of good quality mental health interventions and services for people with complex and longer term problems to support them in their recovery.
Guidance for commissioners of dementia servicesJCP MH
This guide describes what a good quality, modern dementia service looks like. It has primarily been written for Clinical Commissioning Groups, local authorities, and Health and Wellbeing Boards. It will also be of interest to patients, carers and voluntary sector and provider organisations.
Presentation Objectives:
1) Define SBIRT and identify components of this evidence-based intervention for identifying, reducing, & preventing problematic use, abuse & dependence on alcohol & illicit drugs
2) Learn how to use the all the components of the SBIRT app, including, but not limited to the screening, brief interventions & referral to treatment features included in this app
3) Recognize the critical need for more research related to occupational therapy intervention and SBIRT, as well as potential obstacles to implementation of SBIRT in treatment settings & resources for continuing education on this topic.
The Affordable Care Act (ACA) requires non-grandfathered health plans to cover certain preventive health services without imposing cost-sharing requirements for the services. This preventive care coverage requirement, which generally took effect for plan years beginning on or after Sept. 23, 2010, does not apply to grandfathered health plans.
Guidance for commissioners of financially, environmentally, and socially sust...JCP MH
This guide supports commissioners, local health authorities and providers to think broadly, but practically, about building sustainable, resilient communities that have the potential, over time, to reduce mental ill health.
Sustainable commissioning involves making sure services make the most effective use of financial, environmental and social resources. This includes commissioning services that support secondary (reducing relapse) and tertiary (improving rehabilitation) prevention. It is these aspects, rather than primary preventative measures, that are the focus for this guide. The issue of primary prevention is discussed in the Guidance for commissioning public mental health services.
This guide has been written by a group of experts in mental health and sustainability, in consultation with service users and patients, and strengthened by input from a local government and public health perspective. The content is primarily evidence-based but ideas deemed to be best practice by expert consensus have also been included.
By the end of this guide, readers should:
- understand the concept of sustainability in mental health care, and how using this commissioning framework can create sustainable services
- be aware of the legislation relating to sustainability that the NHS is required to meet
- understand what sustainable commissioning looks like in practice
- understand how and why improving the sustainability of mental health interventions will contribute to achieving the aims of both the mental health, public health, NHS, and social care strategies, as well as improving quality and productivity
- be able to commission sustainable mental health services and interventions.
Find out more and download all the guides published by the Joint Commissioning Panel for Mental Health at http://www.jcpmh.info.
Guidance for commissioners of mental health services for young people in tran...JCP MH
This guide describes good quality mental health transitions services for young people making the transition from child and adolescent to adult services.
It also describes the benefits of transitions services and explains why a transitions service is important for the commissioners of specialist mental health services.
Guidance for commissioners of community specialist mental health servicesJCP MH
This guide is about the commissioning of specialist community mental health services. It explores the role of Community Mental Health Teams (CMHTs), Assertive Outreach Teams and Early Intervention Teams among others.
Practical mental health commissioning explains the changing commissioning environment and how commissioners can make the most of available resources to improve the quality and outcomes of mental health and social care services in their area.
Guidance for commissioners of mental health services for people from black an...JCP MH
This guide describes what ‘good’ mental health services for people from Black and Minority Ethnic (BME) communities look like.
While all of the JCP-MH commissioning guides apply to all communities, there are good reasons (see P9) why additional guidance is required on commissioning mental health services for people from BME communities.
This guide focuses on services for working age adults. However, it could also be interpreted for commissioning specialist mental health services, such as CAMHS, secure psychiatric care, and services for older adults.
Guidance for commissioners of primary mental health servicesJCP MH
This guide describes what good quality, modern, primary mental health care services look like. It has been written by a group of primary mental health care experts, in consultation with patients and carers. The content is primarily evidence-based but ideas deemed to be best practice by expert consensus have also been included.
Office-Based Opioid Treatment: What You Need to Know: Trends in Behavioral He...Epstein Becker Green
Presented by David Shillcutt (Associate, Epstein Becker Green) and Kristina Sherry (Attorney, Nelson Hardiman) on April 4, 2019.
Office-based opioid treatment providers are on the front lines of the response to the opioid epidemic, but recent developments in federal and state legislation have significant implications for provider business models and service delivery strategies.
This webinar will examine provider capacity issues for medication assisted treatment, the opportunities and challenges of telemedicine for addiction services, and the expansion of innovative service delivery networks including the “Hub and Spoke” system and related models.
Part of a "first Thursdays" webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/office-based-opioid-treatment-what-you-need-to-know-trends-in-behavioral-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Guidance for commissioners of services for people with medically unexplained ...JCP MH
This guide is about the commissioning of comprehensive MUS services across the healthcare system. In developing this guide, we recognise that ‘medically unexplained symptoms’ is an unsatisfactory term for a complex range of conditions.
MUS refers to persistent bodily complaints for which adequate examination does not reveal suf ciently explanatory structural or other specified pathology. The term MUS is commonly used to describe people presenting with pain, discomfort, fatigue and a variety of other symptoms in general practice and specialist care. Whilst recognising that the phrase ‘medically unexplained symptoms’ can be problematic, it is nonetheless widely used, and an appropriate term to use in this guide.
This guide aims to: describe MUS and the associated outcomes: outline current service provision for MUS and detail the components of a high quality comprehensive MUS service, and highlight the importance of commissioning comprehensive MUS services.
Primary Care Behavioral Health Consultation ServicesMichael Terry
presentation at APNA 2011 Conference in Anaheim CA. Looks at development of a consultation service, the ed/training required and an example of a curricula to address this at the DNP level.
Guidance for commissioners of mental health services for people with learning...JCP MH
This guide is about the commissioning of mental health services for people with learning disabilities, enabling them to live full and rewarding lives as part of their local communities.
This guide is aimed at all commissioners responsible for mental health services for people with learning disabilities including young people in transition to adulthood. The guide will also be helpful for providers of mental health services and for family carers.
This guide describes what we know about mental health services for adults with learning disabilities, and what effective and accessible services look like based on current policy, the law and best practice.
While this guide does make reference to autistic spectrum disorders and ‘behaviours that challenge’ (which people with learning disabilities who have mental health problems may also experience), the primary focus of this guide is on people with learning disabilities who have mental health problems.
Joint Commissioning Panel for Mental Health briefingJCP MH
This briefing describes the Joint Commissioning Panel for Mental Health (JCP-MH), a collaborative co-chaired by the Royal College of Psychiatrists and the Royal College of General Practitioners. The collaboration includes seventeen leading organisations, inspiring commissioners to improve mental health and wellbeing, using a values based commissioning model. It brings together service users, carers, clinicians, commissioners, managers and others to deliver the best possible commissioning for mental health and wellbeing.
The JCP-MH publishes briefings on the key values for effective mental health commissioning. It also provides practical guidance and a framework for mental health commissioning and supports commissioners in commissioning mental health care that delivers the best possible outcomes for health and well being
Regulatory changes, plus advances in cloud computing and analytic technologies, are making it possible for U.S. healthcare providers, payers and patients to connect, commmunicate and collaborate seamlessly, and ensure that the right care is provided at the right place, at the right time.
Guidance for commissioners of acute care – inpatient and crisis home treatmentJCP MH
This guide is about commissioning services for people with acute mental health needs. It explains the purpose, characteristics and components of acute care so that commissioners can commission good quality services that are therapeutic, safe and support recovery.
Guidance for commissioners of rehabilitation servicesJCP MH
This guide is about the commissioning of good quality mental health interventions and services for people with complex and longer term problems to support them in their recovery.
Guidance for commissioners of dementia servicesJCP MH
This guide describes what a good quality, modern dementia service looks like. It has primarily been written for Clinical Commissioning Groups, local authorities, and Health and Wellbeing Boards. It will also be of interest to patients, carers and voluntary sector and provider organisations.
Presentation Objectives:
1) Define SBIRT and identify components of this evidence-based intervention for identifying, reducing, & preventing problematic use, abuse & dependence on alcohol & illicit drugs
2) Learn how to use the all the components of the SBIRT app, including, but not limited to the screening, brief interventions & referral to treatment features included in this app
3) Recognize the critical need for more research related to occupational therapy intervention and SBIRT, as well as potential obstacles to implementation of SBIRT in treatment settings & resources for continuing education on this topic.
The Affordable Care Act (ACA) requires non-grandfathered health plans to cover certain preventive health services without imposing cost-sharing requirements for the services. This preventive care coverage requirement, which generally took effect for plan years beginning on or after Sept. 23, 2010, does not apply to grandfathered health plans.
Guidance for commissioners of financially, environmentally, and socially sust...JCP MH
This guide supports commissioners, local health authorities and providers to think broadly, but practically, about building sustainable, resilient communities that have the potential, over time, to reduce mental ill health.
Sustainable commissioning involves making sure services make the most effective use of financial, environmental and social resources. This includes commissioning services that support secondary (reducing relapse) and tertiary (improving rehabilitation) prevention. It is these aspects, rather than primary preventative measures, that are the focus for this guide. The issue of primary prevention is discussed in the Guidance for commissioning public mental health services.
This guide has been written by a group of experts in mental health and sustainability, in consultation with service users and patients, and strengthened by input from a local government and public health perspective. The content is primarily evidence-based but ideas deemed to be best practice by expert consensus have also been included.
By the end of this guide, readers should:
- understand the concept of sustainability in mental health care, and how using this commissioning framework can create sustainable services
- be aware of the legislation relating to sustainability that the NHS is required to meet
- understand what sustainable commissioning looks like in practice
- understand how and why improving the sustainability of mental health interventions will contribute to achieving the aims of both the mental health, public health, NHS, and social care strategies, as well as improving quality and productivity
- be able to commission sustainable mental health services and interventions.
Find out more and download all the guides published by the Joint Commissioning Panel for Mental Health at http://www.jcpmh.info.
Guidance for commissioners of mental health services for young people in tran...JCP MH
This guide describes good quality mental health transitions services for young people making the transition from child and adolescent to adult services.
It also describes the benefits of transitions services and explains why a transitions service is important for the commissioners of specialist mental health services.
Guidance for commissioners of community specialist mental health servicesJCP MH
This guide is about the commissioning of specialist community mental health services. It explores the role of Community Mental Health Teams (CMHTs), Assertive Outreach Teams and Early Intervention Teams among others.
What quality measures does the MCO have in placeSolutionManag.pdfformicreation
What quality measures does the MCO have in place?
Solution
Managed care organizations (MCOs) are responsible for ensuring that persons enrolled in their
plans receive quality health care. In addition, MCOs publicly funded through the Medicare and
Medicaid programs are required by State and Federal governments to meet certain quality
standards.
To fulfill their responsibilities, MCOs need ready access to a comprehensive array of evidence-
based clinical information and other clinical performance measures to enable them to evaluate
their providers\' performance and identify areas where improvement is needed. They also need to
know how their members feel about the care they receive and the way they are treated. Finally,
they need to ensure that both their providers and members are aware of the most recent
preventive care recommendations.
Valid, reliable, and cost-effective measurement tools must be available to make such
determinations, but these tools have not always been available. Furthermore, because the science
of performance measurement is relatively new, additional measures need to be developed and
those that have been developed can be improved. Therefore, to ensure that their enrollees in
MCOs receive high-quality care, MCOs need a reliable source to provide the most current and
scientifically sound tools.
In response to this need, the Agency for Healthcare Research and Quality (AHRQ) has funded
research to compile a database of evidence-based clinical guidelines and to develop clinical
performance measures, member satisfaction surveys, and preventive care recommendations that
can help MCOs meet their responsibilities. Additionally, AHRQ funds research and develops
performance measures and guidelines that MCOs, insurers, providers, and consumers can trust.
This report describes these tools and how they have been used and provides information on
where to learn more about them.
Background
Around one-half of insured Americans are enrolled in some form of managed care. However, as
the number of persons enrolled in MCOs increased in the 1990s, health care purchasers,
policymakers, and other stakeholders became concerned about the potential for health care
quality to diminish. In their view, the policies and practices imposed by MCOs to reduce what
MCOs define as unnecessary care might result in patients not receiving needed care. Therefore,
MCOs faced accreditation systems and other requirements to ensure that patients were receiving
the most appropriate care.
More recently, MCOs have had to address other emerging concerns such as: Rapid introduction
of new technologies, Data showing unexplained variations in the provision of care, Severe cost
pressures.
These factors have provided additional motivation to MCOs to develop systematic ways of
preserving and enhancing health care quality and cost-effectiveness.
Evidence-based practice guidelines and performance measures were developed to help ensure
that patients always receive the most appropri.
To support your work, use scholarly sources and also use outside s.docxedwardmarivel
To support your work, use scholarly sources and also use outside sources. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Regulations in Long-Term Care
There are many federal and state regulations when it comes to long-term care. Using scholarly sources and the Internet research any four specific regulations related to long-term care and summarize them.
Based on the regulations you identified, respond to the following questions:
· What are the benefits and shortcomings of your identified regulations? Which of these shortcomings have an effect on the quality and the cost of health care services? How?
· Do you believe there is a link between regulations and better care? Why or why not?
· Why do you think long-term care services are subjected to so much external control by government agencies? Provide a rationale for your responses.
· How is quality measured in long-term care? Is there only one, or are there several approaches to measure quality? What are they? Who should be given the responsibility to measure quality?
Notes from class
The increasing need for long-term care has caused several public and private agencies to participate in its managing process. These public and private agencies are increasingly attempting to control costs, providing protection to consumers considered unable to protect themselves. Public controls are nonvoluntary and are imposed by government agencies through the implementation of laws and regulations. Private controls are provided by nongovernment agencies and organizations, and compliance is voluntary.
Public Control
Public control on long-term care is imposed by federal, state, or local (including county and municipal) government units. These units set laws, regulations, and standards to be followed by long-term facilities in order to:
· Give better care facilities to the poor, who are unable to take care of themselves, by making them formal or informal wards of the state.
· Provide quality health care facilities to consumers.
· Create awareness in consumers regarding the types of services provided in the facilities and let the consumers themselves judge the quality of the services.
· Set the minimum level of staffing, cleanliness, and safety, ensuring consumers needing long-term care are treated properly and receive the necessary services.
· Follow all long-term care regulations to provide quality care.
Private Control
Besides government agencies, several private organizations are involved in managing long-term care. Both public and private control focus on long-term care organizations as well as the individuals in those organizations. The only difference is public control can maintain both the cost and the quality of care, while private care can focus only on measuring, evaluating, and ensuring the quality of care.
Private control agencies focusing on the quality of care of long-term organizations are known as accreditation bodies, while those ...
What You Will Learn • Long-term care is heavily regulated because.docxeubanksnefen
What You Will Learn • Long-term care is heavily regulated because the government is a major payer and the recipients of services are among the most vulnerable. • The Nursing Home Reform Act continues to play a major role in regulatory oversight by enforcing substantial compliance with the Requirements of Participation through the survey and enforcement process. • Interpretive Guidelines clarify and explain each standard in detail. Although the guidelines provide directions to personnel conducting surveys, they also assist nursing home personnel in understanding what practices they must implement to comply with each standard. • The traditional survey is being phased out and replaced with the computer-based Quality Indicator Survey. • The seriousness of each deficiency is indicated by its severity and scope. Remedies, such as civil monetary penalties, are based on the seriousness of the deficiencies. • An acceptable plan of correction must address five elements for each deficiency cited. • Compliance with the Requirements of Participation incorporates compliance with the Life Safety Code®. Administrators must become thoroughly familiar with the Requirements of Participation and the main requirements of the Life Safety Code®. • Nursing homes are required to comply with the accessibility standards for the disabled under the Americans with Disabilities Act. • Under the Occupational Safety and Health Act of 1970, OSHA is responsible for ensuring the safety and health of nursing home employees. Nursing homes are legally required to comply with OSHA standards and recordkeeping rules. Introduction The health care sector has been the object of numerous regulations, for two main reasons: (1) The government is a major payer for individuals receiving health care services under Medicare, Medicaid, and other public programs. By committing a significant amount of tax dollars to the delivery of health care, the government retains a vested interest in how the money is spent by private organizations that deliver health care. (2) Health care in general, and long-term care in particular, provide services to the frailest and most vulnerable individuals in society. Many of them are physically and/or mentally incapacitated and have no one else to act on their behalf. The regulatory system is deemed obligated to protect vulnerable populations against negligence and abuse, to ensure that they receive needed services for which they are eligible, and to ensure that the services provided meet at least certain defined minimum standards of quality. Administrative agencies have the power to enforce the rules and regulations that they formulate. The most important federal agency regulating nursing facilities certified as skilled nursing facilities (SNF) or nursing facilities (NF) is the Centers for Medicare and Medicaid Services (CMS), an administrative agency under the U.S. Department of Health and Human Services (DHHS). The U.S. Department of Justice enforces comp.
The following are the official policy statements, adopted by the Board of Directors, the governing body of the National Consumers League, which guide the advocacy work of the organization.
Running Head BEHAVIORAL HEALTH SERVICES1BEHAVIORAL HEALTH .docxsusanschei
Running Head: BEHAVIORAL HEALTH SERVICES 1
BEHAVIORAL HEALTH SERVICES 9
The Louisiana Medicaid Program Behavioral Health services
Introduction
Louisiana Medicaid has provided health care to its members for quite some time now. Mostly, the behavioral health system has incorporated the consumers, the community and other health care providers in the process of giving efficient services to the members (Ortenberg & Roth, 2013). Their focus has been to improve access to the treatment services that have become vital to people. Additionally, the system ought to expand the services that are being provided by the Louisiana Medicaid health behavior systems. The demand for that service has grown, and it’s the duty of the system to expand the services to meet the request. Finally, it’s also the goal of the health behavior system to provide care that is accessible to all at ease.
Description of Behavioral Health Services
The following are some of the services provided at the Louisiana Medicaid behavior care
Addiction services- This includes the individual-centered outpatient services. The health care provider provides rehabilitation and recovery process to the patients. The health care provider will help in the promotion of skills that are responsible for coping with the current lifestyle. The department will assist in the elimination of substance use symptoms and behaviors that may prevent recovery.
Crisis intervention- The department is responsible for the individuals experiencing a psychiatric crisis. When a disaster occurs, victims may be affected by such occurrences may cause psychological problems. Therefore, the crisis intervention program will do a preliminary assessment then followed by a crisis resolution. After that, the medical professional will then do referral and linkage to the relevant community service for further treatment processes.
Group psychotherapy- in this section, a group of individuals with similar behavior challenges will have to sit together and share their experiences. Apparently, they share personal coping skills and practices. Typically, the session will help the patient to identify which method works for them and open up to help in the recovery process.
Psychosocial rehabilitation- The section mainly helps in the elimination of behaviors or barriers that may prevent the healing of the mental Illness. Such behaviors may be to stay away from friends who smoke if the patient if fighting an addiction of smoking.
Care conference- It involves a group of medical practitioners meeting to discuss the treatment of a crisis.
Care Advocacy
The care advocacy in this field is very active and mainly focusses of the various activities that promote all the Medicaid’s members full stabilization after an illness or the whole recovery process of the member. Apparently, the care advocacy unit is concerned with ensuring that the members fully participate in their care. Mostly, various integrated intervention methods have been created ...
Behavioral Health Staff in Integrated Care SettingsCHC Connecticut
Webinar broadcast on Feb 27, 2019 - 3:00PM EST
Delivering behavioral health services as a part of an integrated team is crucial to providing comprehensive primary care services. Focusing on the vital role of behavioral health, experts will share the key elements that maximize the contributions of these team members through structured approaches to screening, the use of “warm hand offs” to ensure connection to primary care, and implementing a robust group of treatment programs to enhance access and improve outcomes. This session will also discuss the day-to-day operation of a behavioral health program and detail the data and clinical dashboard that supports the work of these vital team members. There has been tremendous progress from health centers across the country in the integrating behavioral health, this webinar will share how integrated behavioral health can advance the team’s capability to provide effective and high quality care to complex patient populations.
State RegulationsDeidra ManningHMGT 310University of.docxdessiechisomjj4
State Regulations
Deidra Manning
HMGT 310
University of Maryland
Professor Jerome Bozek
November 29, 2015
Student Name:
Deidra Manning
Assignment #3 Title:
Selection of a state regulation; The unannotated South Carolina Code of Regulations
Agency Responsible:
The South Carolina Legislative Council; The State Health and Human Services Finance Commission through the MEDICAID
Incentives and Enforcement:
The main enforcements are observed through ensuring that only the service providers enrolled in the program are the ones which provide the services, therefore enrollment is controlled and regulated Clients must be eligible for Medicaid to receive the services. The residents of South Carolina recipients of the services can be referred outside the South Carolina area, when this happens, they must have a prior approval from a state agency administering the Medicaid Program.
Technical assistance for the personnel providing the services is contained in the South Carolina State Plan for Title XIX (Medicaid), provider manuals, Medicaid Bulletins, and federal directives. This gives directives on their usage serving as a guide to their usage.
Key Aspect of the Regulation #1:
This regulation: 126-304 Community Long Term Care Home and Community Based Services.
It sets out clearly the requirements of the service receiver who should be a Medicaid eligible person, eighteen years of age or older, who has been determined by community long term care to require a skilled or intermediate level of care.this regulation has an effect on health care proffssional since they are required meet the said conditions.
(2) Home delivered meals are the in home provision of at least one meal per day to persons unable to care for their nutritional needs. This has a financial implication to the provider institution and making transport arrangements on availing the meals to the homes of the recipients.
(3) Medical day care is a group of services to restore, maintain and promote the health status through the provision of ambulatory health care and health related supportive services in a licensed medical day care center. This group of services requires that systems be put in place to receive alerts of emergence and a response team which shall be on standby to attend to the emergencies as and when they arise.
Medical social services are supportive services provided by an individual with no less than a Masters Degree in social work. The legal of academical training is essential to the personnel providing this service, because it is specific to the academical requirement of the said personnel
Personal care is the in home provision of the necessary services in support of activities of daily living, home support, medical monitoring, and client transportation services to restore, maintain and promote health status. This specifically affects the provider institution because special arrangements have to made to ensure adequate trained personnel to adequately manage the home provisio.
1. COALITION FOR WHOLE HEALTH
September 17, 2010
Mr. Jim Mayhew
Office of Consumer Information and Oversight
Department of Health and Human Services
Attention: OCIIO-9992-IFC
P.O. Box 8016
Baltimore, MD 2144-1850
RE: Interim Final Rules for Group Health Plans and Health Insurance Issuers
Relating to Coverage of Preventive Services Under the Patient Protection and
Affordable Care Act
Dear Mr. Mayhew:
Thank you for this opportunity to provide comments to the Departments of Labor, Health
and Human Services, and the Treasury (the Departments) regarding the interim final rule
on coverage of preventive services under the Patient Protection and Affordable Care Act
(ACA). On behalf of the Coalition for Whole Health, a coalition of national
organizations advocating for improved coverage for and access to mental health and
substance use disorder prevention, treatment, rehabilitation, and recovery services, we
strongly support the goals of healthcare reform to ensure that all Americans have access
to high quality, affordable health care, including mental health and addiction care. We
appreciate the opportunity to submit comments on the interim final rule on coverage of
preventive services.
Under Section 2713 of the ACA, health insurers are required to provide, with no cost-
sharing, access to a range of preventive health services, including critically important
mental health and substance use services for children and adults. Improving access to
preventive care has the potential to greatly improve the health of our nation’s children,
families, and communities. As the Departments work to implement the Section 2713 of
the ACA, the undersigned organizations urge you to ensure that the Final Rules for
Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive
Services under the Patient Protection and Affordable Care Act address the following:
1. Explicitly recognize the preventive mental health and substance use services
that are included as covered preventive services under the ACA and ensure
that primary care professionals receive adequate training to provide these
services.
2. Encourage the U.S. Preventive Services Task Force to convene to consider
evidence of effectiveness for additional substance use and mental health
preventive services not yet required as reimbursable services.
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2. 3. Revise provisions of the Interim Final Rule that would make accessing the
preventive services benefits of Section 2713 disproportionately burdensome
for people with mental health and/or substance use disorders.
4. Ensure that the appropriate steps are taken to educate the public, service
providers, and insurers so they understand the new requirements, and
implement strong enforcement mechanisms to ensure compliance.
1. The need for explicit recognition of the preventive mental health and substance
use services that are included as covered preventive services under the ACA and
work to ensure that primary care professionals receive adequate training to provide
these services
We are pleased that, under the ACA, a number of preventive services for mental health
and substance use are clearly included as covered reimbursable services. These include
the following screenings and interventions that have been identified as effective by the
U.S. Preventative Task Force:
• Alcohol misuse screening and counseling for adults
• Depression screening for adolescents and adults
• Tobacco use counseling for adults and interventions for pregnant women
Preventive services covered by Section 2713 of the ACA also include a number of
effective mental health and substance use preventive services for children and
adolescents identified in the Health Resource Services Administration’s (HRSA)
comprehensive preventive guidelines. Services identified by HRSA that are reimbursable
covered preventive services under the ACA include:
• Alcohol and drug use screenings for children and assessments for adolescents
• Developmental screenings for infants and young children
• Early childhood autism screenings
• Developmental surveillance for all children
• Psychosocial/behavioral assessments for all children.
We ask that the Departments make clear to health insurers that the above-listed mental
health and substance use screenings and assessments are covered preventive services
under the ACA.
In addition, we urge the Departments to ensure that the primary care workforce that will
be providing these critically important services receives training on mental health and
substance use conditions. It is imperative that the primary care professionals conducting
these preventive services receive adequate education about and training on mental health
and substance use disorders, effective screening and assessment tools, treatment, and
recovery. This includes not just providers in traditional primary care settings, but also
those in schools, juvenile justice facilities, and other primary care settings where
prevention services related to substance use disorders and mental health are especially
needed. It is also extremely important that primary care professionals are given guidance
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3. about the need to refer individuals with mental health and/or substance use disorders in
need of more intensive services to providers of treatment, rehabilitation and/or recovery
support services.
2. In addition to those mental health and substance use screenings that are
explicitly covered preventive services under the ACA, there are additional
preventive screenings for substance use and mental health conditions that have been
used for a number of years and are extremely effective. The following should also
be included as reimbursable services.
Coverage for drug screening in adults: To date the U.S. Preventative Task Force has not
yet determined the value of screening for illicit drug use due to insufficient evidence. The
National Institute on Drug Abuse, the National Institute on Alcohol Abuse and
Alcoholism and other distinguished researchers have demonstrated that screenings for
drug use are effective tools to help identify adults in need of brief interventions and
treatment services. Recent research clearly demonstrates that rapid, economical
screening and brief interventions reduce substance use and significantly reduce health
care costs. 1
Coverage for suicide screening in adults: Screenings for suicide ideations have been used
for a number of years and have been effective tools to help identify many youth and
adults in need of services. Under the ACA, those screening procedures for adults would
not be required cost-free services despite evidence of effectiveness.
Given the low risk and low cost of screening for substance use and mental illness, and the
current state of knowledge about the consequences of untreated addiction and mental
illness, the harms associated with not screening are too severe to be ignored. Therefore,
covered screenings should include the full range of mental health and substance use
preventive services that have demonstrated clear effectiveness.
1
See Madras, B.K. ; Compton, W.M. ; Avula, D. ; Stegbauer, T.; Stein, J.B.; and Clark, W.H. Screening,
brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites:
Comparison at intake and 6 months later. Drug and Alcohol Depend [e-pub ahead of print], 2008.
Bernstein, J.; Bernstein, E.; Tassiopoulos, K.; Heeren, T.; Levenson, S.; and Hingson, R. Brief motivational
intervention at a clinic visit reduces cocaine and heroin use. Drug Alcohol Dependence 77(1):49–59, 2005.
Humeniuk, R.; Dennington, V.; Ali, R.; and WHO ASSIST Phase III Study Group. The Effectiveness of a
Brief Intervention for Illicit Drugs Linked to the ASSIST Screening Test in Primary Health Care Settings:
A Technical Report of Phase III Findings of the WHO ASSIST Randomized Controlled Trial (Draft).
Geneva, Switzerland, 2008.
Devlin, R.J,, and Henry, J.A. Clinical review: Major consequences of illicit drug consumption. Crit
Care.12(1):202, 2008. Available at
http://www.ncbi.nlm.nih.gov/pubmed/18279535?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pub
med_ResultsPanel.Pubmed_RVDocSum.
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4. 3. Revise provisions of the Interim Final Rule that would make accessing the
preventive services benefits of Section 2713 disproportionately burdensome for
people with mental health and/or substance use disorders
We ask the Departments to reconsider provisions of the proposed regulations that would
be particularly burdensome for people with mental health and/or substance use service
needs to access these preventive services. Specifically, we ask that the Departments to:
• Reconsider the provision allowing cost-sharing to be imposed if a preventive
service is billed separately from the office visit. The logical and convenient
setting for many of the covered preventive services is during primary care office
visits, however the regulations allow cost-sharing for otherwise covered
preventive services if the preventive service is not the primary purpose of the
visit. With substance use disorders and mental health screenings in particular, it
is critically important that no-cost screenings be allowed during visits for other
primary care services, since individuals most in need of mental health and
addiction screenings are unlikely to seek them out on their own.
• Require plans to allow out-of-network providers to conduct preventive health
screens if no in-network provider is reasonably available, without cost-sharing.
The limited number of providers available to screen for substance use disorders
and mental illness is a serious concern, and the regulations should require that
plans allow out-of-network providers to conduct preventive screens without cost-
sharing obligations if no in-network provider is reasonably available to provide
those services. This is especially important in rural areas.
• Require plans to disclose the medical management criteria they use for preventive
services to enrollees in advance of them accessing preventive care services. The
regulations allow plan issuers to use “reasonable medical management
techniques” to determine coverage limitations if a recommendation or guideline
for a recommended preventive service does not specify the frequency, method,
treatment or setting for the provision of that service. Given that there is no federal
definition of "reasonable medical management," plans should be required to
disclose the medical management criteria they are using to plan participants in
advance so participants will know whether the cost-sharing requirements of the
service will actually be waived.
4. Ensure that the appropriate steps are taken to educate the public, service
providers, and insurers so they understand the new requirements, and implement
strong enforcement mechanisms to ensure compliance.
To maximize success of the new prevention benefits and improve public health, it
is important for the Departments to recognize the need for strong consumer, family, and
provider outreach and education efforts to help them to understand and utilize the new
benefits. The regulations governing coverage of preventive services under the ACA
should include a discussion of the outreach effort needed to inform and educate
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5. consumers and providers about the specific provisions and requirements of the law. The
Departments should also recognize the need for strong enforcement mechanisms to
ensure compliance.
We appreciate the opportunity to give comments on the rules related to coverage
of preventive services under the ACA. Thank you for your careful consideration. Please
contact us if you have any questions or if we can be of further assistance on this matter.
Sincerely,
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