Certified Community Behavioral Health Clinic Stakeholder Roundtable
The Certified Community Behavioral Health Clinic (CCBHC) Stakeholder Roundtable meeting is scheduled to commence shortly, featuring key introductions, project updates, and open discussions. Stakeholders from various roles within the project will provide insights and collaborate on the transition to CCBHC operations, emphasizing the joint state/local effort led by esteemed leaders from DBHDS and DMAS.
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Presentation Transcript
WELCOME TO THE CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC (CCBHC) STAKEHOLDER ROUNDTABLE MEETING 2 September 8, 2023 8:30a.m. - 10a.m. Grab your coffee, tea, breakfast and we will be starting shortly! Chaye Neal-Jones Deputy Director, Office of Management Services Virginia Department of Behavioral Health and Developmental Services
CCBHC STAKEHOLDER ROUNDTABLE Slide 2
AGENDA Introductions Recap from Kick-off Meeting DBHDS and DMAS CCBHC Leadership CCBHC Workgroups Project Manager Updates Roundtable Meeting Cadence Revised Open Discussion Slide 3
Introduction Ellen Harrison, Chief Deputy Commissioner Project Sponsor (DBHDS) Craig Camidge, Director, Office of Enterprise Management Services- Project Director (DBHDS) Iva M. Brown, CCBHC Project Manager (DBHDS) Glenda Knight, Women's Services Coordinator Programs Workgroup Lead (DBHDS) Becca Cash, Community Behavioral Health Quality Improvement Program Manager Quality Workgroup Lead (DBHDS) Nathan Miles, CFO PPS Workgroup Lead (DBHDS) Chaye Neal-Jones, Deputy Director, Office of Management Services Stakeholder Roundtable Facilitator (DBHDS) Slide 4
Recap of Kickoff Meeting Slide 5
DBHDS and DMAS CCBHC Leadership Slide 6
CCBHC is a Joint State/Local Effort Each CSB in the initial cohort of CCBHC candidates is led by a top-flight executive director who will guide their organizations and their communities through the transition to CCBHC operations. DBHDS and DMAS are proud to be partnering with these local leaders. Slide 7
CCBHC is a joint DMAS/DBHDS effort Successful transition to CCBHC will require strong leadership at the state: Ellen Harrison, Chief Deputy Commissioner, DBHDS Tammy Whitlock, Deputy Director for Complex Care Services, DMAS Lisa Jobe-Shields, Division Director for Behavioral Health, DMAS Chris Gordon, Deputy for Finance, DMAS Nathan Miles, Chief Financial Officer, DBHDS Other Steering Committee members: - Nina Marino, Interim Assistant Commissioner, Community Behavioral Health, DBHDS - Curt Gleeson, Assistant Commissioner, Crisis Services, DBHDS - Heather Norton, Assistant Commissioner, Developmental Services, DBHDS - Craig Camidge, Director, Office of Enterprise Management Services, DBHDS Slide 8
Why CCBHC? Uniform services and EBPs Emphasis on care coordination Integration of MH and SU services Standardized quality measures Cost-based payment methodology CCBHC is a national model designed to ensure access to coordinated, comprehensive behavioral health care STEP-VA's nine core services are a great step in the right direction! Transition to CCBHC ensures Virginia's behavioral health system keeps place with changing times, changing standards, and the latest sustainable, data-driven service and access modeling. Slide 10
Programs Workgroup Glenda Knight Lead Margaret Steele Co-Lead Slide 11
Programs Workgroup Overview Meeting Cadence: 2nd and 4th Tuesday of each month from 9am to 10:30am Representation: DBHDS subject matter experts & CSB representatives from each of the 14 potential CCBHC sites Scope of Work: - Develop CCBHC certification criteria, documents, and application process - Create evidence-based practices list - Develop scope of services to be included in PPS reimbursement rate - Facilitate state and local needs assessment processes - Provide capacity-building support to CSBs by: - Integrate results from needs and readiness assessments into certification process and other documents - Conduct site visits to develop, implement, and monitor capacity- building plans - Work with Quality Workgroup re: establishing certification process and documents Slide 12
CSB Needs and Readiness Assessments 9-1-23 - Readiness Assessment evaluation and summary completed Specific Gaps/needs identified by CSB/BHA includes: Workforce development issues Technology infrastructure (electronic health records and data exchange) Mobile crisis and crisis receiving centers Transportation barriers in rural localities 10-1-23 to 12-15-23 - Tentative dates for DBHDS to conduct CSB site visits and provide technical assistance re: gaps/needs identified in Readiness Assessment Slide 13
Scope of Services CCBHC Required Nine Core Services 1.Crisis Services 2.Treatment Planning 3.Screening, Assessment, Diagnosis, & Risk Assessment 4.Outpatient Mental Health and Substance Use Services 5.Targeted Case Management 6.Outpatient Primary Care Screening and Monitoring 7.Community-Based Mental Health Care for Veterans 8.Peer, Family Support & Counselor Services 9.Psychiatric Rehabilitation Services Slide 14
Scope of Services Four federally-certified CCBHC CSBs submitted crosswalk 1. Mount Rogers 2. RBHA 3. New River Valley 4. Planning District One The other ten CSBs are scheduled to submit Crosswalk by September 7, 2023 1. Alexandria 2. Alleghany-Highlands 3. Colonial 4. Fairfax-Falls Church 5. Goochland 6. Prince William 7. Rappahannock Area 8. Encompass Community Supports (formerly Rappahannock-Rapidan 9. Region 10 10. Western Tidewater Slide 15
Quality Workgroup Becca Cash Lead Bekka Bodanske Co-Lead Slide 16
Quality Workgroup Overview Meeting Cadence: 1st and 2nd Wednesday of each month 8:30-10 am Representation: DBHDS subject matter experts & 2 CSB representatives from each of the 14 initial CCBHC sites (expertise in data and quality management) Scope of Work: Facilitate measure development process for all required CCBHC measures, including data collection & reporting requirements Make recommendations on optional CCBHC measures for Virginia to adopt Finalize technical specifications for CCBHC for Data Exchange Evaluate CSBs' needs around CCBHC Criteria 5B CQI plans and provide technical assistance Assist Programs Workgroup with establishing certification procedures Slide 17
Workgroup Status Update CCBHC Quality Measures Required measures Focus on Clinic Led Measures and required data Facilitated Continuous Quality Improvement (CQI) Listening Session with 4 CSBs currently providing CCBHC services Slide 18
Workgroup's Next Steps Data request process o SAMHSA to release technical specifications in September 2023 DMAS Data Share Agreement Information gathered from CQI listening session will be reviewed by Quality Workgroup to identify next steps and any needed technical assistance around CQI planning and processes Slide 19
Perspective Payment System (PPS) Workgroup Nathan Miles DBHDS Lead Chris Gordon DMAS Lead (assisted by Cat Pelletier, DMAS) Slide 20
PPS Workgroup Meeting Cadence: TBD Representation: DBHDS and DMAS Finance Teams, & CFOs/finance staff from 14 potential CCBHC sites (finance expertise) Scope of Work: 1. Develop PPS methodology 2. Determining reimbursement rates 3. Create cost reports Select some sites to work on mock cost reports with our consultant to determine potential impact on the state) Will be organizing trainings on cost reporting for interested sites to become familiar with the CMS cost report. 4. Implement PPS billing procedures Slide 21
Project Manager Updates Iva Brown DBHDS Project Manager Slide 22
Revised Timeline and Milestones Certification Jan 2025-Jul 2025 Green = completed Yellow = not started Red = overdue Blue = in process Slide 23
CCBHC Website Coming soon! Slide 24
Communication About CCBHC As a Stakeholder, you will receive communication regarding the following: Major project status updates, including progress of Workgroups and Steering Committee (no less than monthly) Presentation of issues/documents for weigh-in by Stakeholder Roundtable Meeting minutes Slide deck that may be shared with the community at-large For all things CCBHC, send your email to: CCBHC@dbhds.virginia.gov Slide 25
Decisions, Decisions! DECISION DATE DECISION DBHDS will continue to pursue CCBHC Demonstration Program in the absence of a SAMHSA CCBHC planning grant, utilizing the grant structure outline in the application CCBHC timeline adjusted to reflect certification date to July 2025 Two additional consultants to be added to Project Team and Workgroups Develop Scope of Services to parse out the nine core services, and then list all possible options with those services. CSBs will be required to choose at least one service in each of the nine core areas. Only the CCBHC required quality measures will be included; no additional measures to be considered 3/23/2023 8/9/2023 8/15/2023 8/21/2023 8/9/2023 Slide 26
CCBHC Stakeholder Roundtable Meetings Roundtable will be scheduled to meet once a month Invites will be sent out for the meetings through March 2024 Slide 27
The End Questions/Comments? Slide 28
WELCOME TO CCBHC STAKEHOLDER ROUNDTABLE KICKOFF MEETING! July 7, 2023 Grab your coffee, tea, breakfast and we will be starting shortly! Chaye Neal-Jones Deputy Director, Office of Management Services Virginia Department of Behavioral Health and Developmental Services
CCBHC STAKEHOLDER ROUNDTABLE 7-7-23 Chaye Neal-Jones Deputy Director, Office of Management Services Virginia Department of Behavioral Health and Developmental Services
AGENDA Introductions Background Prospective Payment System Governance Structure Project Plan and Timeline Stakeholder Roundtable Responsibilities Meeting Cadence/Next Steps Open Discussion Slide 31
Introduction Ellen Harrison, DBHDS Chief Deputy Commissioner Project Sponsor Iva Brown, DBHDS CCBHC Project Manager Chaye Neal-Jones, DBHDS Office of Management Services Deputy Director Stakeholder Roundtable Facilitator Scott Banken FTI Consulting, Managing Director Slide 32
WHAT IS A CCBHC? A Certified Community Behavioral Health Clinic model designed to ensure access to coordinated comprehensive behavioral health care. The Protecting Access to Medicare Act of 2014 (PAMA, P.L. 113-93), Section 223, directed the Department of Health and Human Services (HHS) to publish criteria for clinics to be certified as Certified Community Behavioral Health Clinics (CCBHCs). 2015, HHS issued the original CCBHC certification criteria. The criteria established a set of uniform standards that providers must meet to be a CCBHC. Since 2015, a lot has been learned about implementing the CCBHC model. Developments and advancements in the mental health and substance use disorder field have also created a need to update the criteria in several areas. March 2023 HHS released an updated version of the criteria CCBHCs are required to serve anyone who requests care for mental health or substance use, regardless of their ability to pay, place of residence, or age - including developmentally appropriate care for children and youth CCBHCs must meet standards for the range of services they provide and they are required to get people into care quickly. An important feature of the CCBHC model is that it requires crisis services that are available 24 hours a day, 7 days a week. CCBHCs are required to provide a comprehensive array of behavioral health services so that people who need care don't have to piece together the behavioral health support they need across multiple providers. CCBHCs must provide care coordination to help people navigate behavioral health care, physical health care, social services, and the other systems they are involved in. Slide 33
HOW DID WE GET HERE? The original project was begun in 2015 when the Department applied for a SAMHSA Planning Grant for the implementation of CCBHC. Eight (8) original CSBs were slated to become CCBHCs - Chesapeake Integrated behavioral Health - Colonial Behavioral Health - Harrisonburg-Rockingham CSB - Mount Rogers Community Services - Rappahannock Area CSB - Cumberland Mountain CSB - New River Valley Community Services - Richmond Behavioral Health Authority The Department was not awarded a Planning Grant or offered an Implementation Grant and the project was halted Slide 34
Planning grant not awarded HOW DID WE GET HERE? Can we still apply for CCBHC Demonstration grant? Where do we go now? Slide 35
WHY CCBHC? Uniform services and EBPs Emphasis on care coordination Integration of MH and SU services Standardized quality measures Cost-based payment methodology Slide 36
NINE (9) REQUIRED SERVICES Slide 37
WHAT IS A PPS? Scott Banken Slide 38
LESSONS LEARNED Comprehensive manuals to be updated regularly Steering Committee Data, data, data!! Project Workgroups Relationships management is crucial Slide 39
GOVERNANCE STRUCTURE Stakeholder Roundtable Steering Committee Project Team Workgroups o Programming o Quality o PPS Slide 40
Project Plan/Timeline Slide 41
14 CSBs TO BECOME CCBHCs Goochland-Powhatan Community Services Alleghany-Highlands CSB Rappahannock Rapidan CSB d/b/a Encompass Community Supports Region Ten CSB Western Tidewater CSB Colonial Behavioral Health Prince William CSB Fairfax-Falls Church CSB Alexandria CSB Rappahannock Area CSB *New River Valley Community Services (Operating as a CCBCH) *RBHA (Operating as a CCBCH) *PD1 Behavioral Health Services (Operating as a CCBCH) *Mount Rogers CSB (Operating as a CCBCH) Slide 42
WORKGROUPS - Review revised federal criteria and crosswalk with Virginia - Draft self readiness assessment and community needs assessment - Review self-report readiness assessments, develop capacity-building plans, & schedule site visits Programs - Develop measure crosswalk of current performance measures and revised CCBHC measures - Determine which STEP-VA measures will be replaced by CCBHC - Draft technical spec requirements for CCBHC measures for Data Exchange Quality - Develop PPS methodology - Determine which payment structure will be used - Create cost reports PPS Slide 43
WHERE ARE WE? Review revised CCBHC certification criteria and crosswalk to Virginia Draft and distribute a self-report readiness assessment and community needs assessment Complete certification document and process Crosswalk of current performance measures and revised CCBHC measures Review self-report readiness assessments Develop scope of services Slide 44
STAKEHOLDER ROUNDTABLE REPONSIBILITIES Commitment to meet at least monthly through March 2024 Provide institutional knowledge and experience Influence policy for the implementation of CCBHC Soliciting input from participating CSBs as a means of feedback and guidance to plan and develop policies. Communication Present other CCBHC-related topics for discussion Influencing and engaging entities who are important to CCBHC, but who may not have been previously identified Review and provide feedback/recommendations on information provided by the workgroups and steering committee such as: Services and service alignment Needs assessment Readiness assessment Site visits PPS Slide 45
Meeting Cadence/Next Steps Slide 46
Questions/Open Discussion Slide 47
