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Committee briefed on seven behavioral‑health BISFIG recommendations, care‑transition pilots and evaluation plans
Summary
Department briefers detailed behavioral‑health proposals in the BISFIG executive package, including value‑based targeted case management, a care‑transition program, an electronic bed registry plus 988 enhancements, children’s acuity rates, school‑based investments, workforce steps and CCBHC planning.
The department presented details on seven behavioral‑health recommendations included in the governor’s BISFIG package and explained how they would be evaluated if funded.
Targeted case management and value‑based pilots: DPHHS described plans to reassess targeted case management reimbursement, moving some programs from 15‑minute fee‑for‑service paid units to a value‑based payment (VBP) pilot that ties payments to outcomes such as sustained community residence after a psychiatric residential treatment facility discharge. The department estimated a potential 25% increase in targeted case management spending under a restructured model and proposed vendor help to design an avoided‑harm and outcome framework.
Care transition program for discharges: Officials described a proposed care transition team that would provide short, intensive, independent discharge support — planning safe housing, natural supports, medical linkages and employment — for people leaving institutional or correctional settings. The department said it expects to pursue Medicaid authorization for the service eventually but would use BISFIG funds for start‑up in the near term; federal match timing would push Medicaid costs to later biennia.
Electronic bed registry and 988 enhancements: The department proposed building a real‑time bed registry to help hospitals, providers and first responders locate available residential placements and reduce transfer time. That project would be coupled with one‑time investments to expand 988 infrastructure, add text/chat capability and provide tablets to first responders to connect people in the field to telehealth‑capable crisis support.
Children’s acuity rates and school‑based behavioral health: DPHHS proposed an acuity rate methodology for residential services for children (therapeutic group homes, psychiatric residential treatment facilities) and pilot smaller group homes to better match supports to need; the department also proposed expanded school‑based behavioral health supports, training, coaching and consideration of reversing the Medicaid “free care” rule to allow broader school billing in the future.
Workforce investments and CCBHCs: The request included one‑time tuition reimbursement programs and dual‑enrollment investments to grow the behavioral‑health workforce. DPHHS also described activity around Certified Community Behavioral Health Clinics (CCBHCs), including a $1 million SAMHSA planning grant the state received and an ongoing effort to apply for Medicaid demonstration authority; the department said CCBHC operational costs would include substantial Medicaid match if demonstration authority was approved.
Evaluation approach: Paul Balady from the department’s research and analytics office described quasi‑experimental matching strategies the agency would use to measure program effects where randomized trials are not feasible, matching individuals receiving services to comparable people in existing datasets and tracking outcome measures identified in the commission report (ER use, out‑of‑state placements, readmissions, etc.).
Ending: Department staff said some services will require CMS approvals before federal match is available, and they committed to provide further technical details on VBP pilot designs, care transition models and the proposed bed‑registry architecture.
