Patients with mental health and substance-use disorders are commonly seen in general hospitals. The behavioral health disorder may be a patient’s primary diagnosis, or it may be a co-morbid condition accompanying a physical health disorder, such as diabetes, cancer or coronary artery disease.
A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) provides an overview of the nature and scope of mental illness within each state and the District of Columbia. According to the report, approximately 18.2 percent of U.S. adults experienced a mental illness in 2011 or 2012. The national total includes 9.3 million adults who had a serious mental illness causing substantial functional impairment. In California, the overall number is slightly lower, at 17.68 percent. SAMHSA developed the report with information obtained from approximately 92,400 people age 18 and older who responded to its 2011 or 2012 National Survey on Drug Use and Health, with the intent to help public health officials and others address the mental health needs of the people in their communities.
The attached memorandum provides an overview of three mental health parity laws and summarizes — from a health care provider’s perspective — the interaction between federal and California parity requirements. Prepared for CHA by Hooper, Lundy, and Bookman, PC, the document analyzes three key issues for providers: prior authorization and emergency mental health services; residential treatment programs; and internal appeals and external reviews. To help providers apply the requirements, the memo contains several tables, including one listing coverage types and the laws that apply; a second listing federal and state regulatory authority by commercial plan type; and a third listing internal appeal and external review requirements by commercial plan type.
Two recent national provider webinars on the inpatient psychiatric facility quality reporting (IPFQR) program are now available for providers to download as slides and recordings. For both the Jan. 7 webinar, focused on the IPFQR public reporting preview process, and the Jan. 23 webinar, focused on a review for fiscal year 2015, slides are available from the QualityNet webinar information page. To access recordings for each, providers must first register using the registration link at each web page. In addition, the Centers for Medicare & Medicaid Services has published the January 2014 edition of the IPFQR program newsletter, also available for download.
RAND Corporation has published its preliminary findings from research on the California Mental Health Services Authority’s (CalMHSA) statewide prevention and early intervention (PEI) initiatives. The PEI program is conducted on behalf of counties and focuses on suicide prevention, stigma and discrimination reduction, and student mental health. The RAND evaluation is a major component of the overall workplan for the PEI initiatives. More information about the program is available at http://calmhsa.org/programs/pei-statewide-projects.
The Health Resources and Services Administration (HRSA) has announced the availability of $50,000,000 this year for Affordable Care Act-Mental Health Services Expansion-Behavioral Health Integration (BHI) grants to increase the coordination, collaboration and integration of primary and behavioral health care services at health centers funded under Section 330 of the Public Health Service Act. The BHI grants are intended to increase access to behavioral health services and increase the number of health centers with integrated primary care and behavioral health models of care. HRSA has set a ceiling of $250,000 per award, and applications are due March 3.
Telepsychiatry in rural areas is beneficial for children with attention-deficit/hyperactivity disorder and their parents, according to one of the largest randomized controlled trials of its kind.
During the 22 weeks of the study, children who received telemental health (TMH) improved significantly in ADHD inattention and hyperactivity, oppositional defiant disorder, school performance, and adaptive functioning, based on the ratings provided by their parents.
The study is yet another piece of evidence that telemedicine can play a role in closing the mental health gap.
Only one in six adults — and only one in four binge drinkers — says a health professional has ever discussed alcohol use with them even though drinking too much is harmful to health, according to a January Vital Signs report from the Centers for Disease Control and Prevention (CDC). For the report, CDC used 2011 Behavioral Risk Factor Surveillance System data to analyze self-reports of ever being “talked with by a health provider” about alcohol use among U.S. adults aged 18 and older from 44 states and the District of Columbia.
A newly revised “Mental Health Services” booklet is now available for download from the Centers for Medicare & Medicaid Services. A Medicare Learning Network publication, the booklet offers information relevant to the Medicare fee-for-service program on covered and non-covered mental health services, eligible professionals, same-day billing guidelines, and the National Correct Coding Initiative.
The Centers for Medicare & Medicaid Services (CMS) has published an informational bulletin outlining strategies that states can implement to reduce non-urgent and inappropriate use of emergency department (ED) services, while still delivering appropriate care to Medicaid beneficiaries. Experience and research suggest that broader strategies – such as expanding primary care access, “super-utilizer” programs, and targeting the needs of people with behavioral health and substance abuse issues – appear to have considerable promise for addressing unmet health needs as the underlying causes of high ED utilization. The bulletin also discusses relevant considerations when distinguishing between emergency and non-emergency use of ED services. For detailed information, the CMS bulletin is attached.
Participating inpatient psychiatric facilities (IPFs) should download their IPF program preview report before Jan. 29 — when the current report preview period ends — through the file exchange function on My QualityNet. IPFs that submitted data but are not eligible for the program will not have a preview report. To be eligible for the IPF quality reporting (QR) program, IPFs must be reimbursed under Medicare’s IPF prospective payment system. A quick-reference guide for previewing reports is available on the QualityNet website.
A new mobile site showing the different programs funded by the Mental Health Services Act (Prop. 63) is now available. Hosted on the website of the California Department of Technology, the site allows easy searching by county and is optimized for mobile use. The site can be accessed at http://apps.cta.ca.gov/prop63.
A recently published 50-state analysis shows that, while less than 10 percent of children enrolled in Medicaid use behavioral health care, it accounts for 38 percent of program expenses. The Center for Health Care Strategies, a nonprofit health policy organization, published Faces of Medicaid: Examining Children’s Behavioral Health Service Utilization and Expenditures last month. The report examines patterns of behavioral health service use and expense for children in Medicaid in an effort to inform state efforts for improving care.
The Investment in Mental Health Wellness Act of 2013 establishes a new grant program to disburse funds to California counties for the purpose of developing mental health crisis support programs. Specifically, funds will “increase capacity for client assistance and services in crisis intervention, crisis stabilization, crisis residential treatment, rehabilitative mental health services, and mobile crisis support teams.” The grants from the California Health Facilities Financing Authority (CHFFA) will support capital improvement, expansion and limited start-up costs. Counties apply
The deadline for inpatient psychiatric facilities (IPFs) to correct data on their facility-specific reports for the IPF quality reporting program (QRP) at My QualityNet is Jan. 29. In April, that data will be publicly reported for the first time through the Hospital Compare website. IPFs and distinct-part psychiatric units in acute care hospitals reimbursed under the IPF prospective payment system are eligible to participate in the IPFQRP. Hospitals also can preview their reports for the inpatient and outpatient quality reporting programs at the QualityNet website through Jan. 29.
For information about the IPF quality reporting program, contact the support contractor by telephone at (888) 961-6425 or by email at IPF-PCHQRSupport@Telligen.org.
The Department of Health and Human Services (HHS) has announced that it plans to issue a $50 million funding opportunity to help community health centers establish or expand behavioral health services for people living with mental illness, and drug and alcohol problems. Community health centers will be able to use the new funds, made available through the Affordable Care Act, to hire new mental health and substance use disorder professionals, add mental health and substance use disorder services and initiate team-based models of care, among other efforts.
The ACA expands mental health and substance use disorder benefits and parity protections. HHS estimates the grant awards will support behavioral health expansion in approximately 200 existing health centers nationwide. More information is available in the complete HHS announcement.
The Mental Health Services Oversight and Accountability Commission (MHSOAC) will award $32 million in Mental Health Services Act (MHSA) funding to support grants for hiring at least 600 mental health triage personnel statewide. The funding is the result of the Investment in Mental Health Wellness Act of 2013, passed this year by the Legislature. Grant applications are due Jan. 3, 2014, by 5 p.m.
CHA’s Center for Behavioral Health presented Dr. Scott Zeller, chief of psychiatric emergency services for the Alameda Health System, with the Šimanek Distinguished Service Award on Dec. 10 during the eighth annual Behavioral Health Care Symposium in Huntington Beach.
Dr. Zeller is immediate past president of the American Association for Emergency Psychiatry and author of numerous articles and book chapters. He is also co-editor of “Emergency Psychiatry: Principles and Practice” (Lipincott, 2008), considered the first comprehensive textbook on emergency psychiatry.
The California Health Facilities Financing Authority (CHFFA) has confirmed that dedicated community-based psychiatric emergency departments (EDs) — also referred to as PES outpatient departments and crisis stabilization units — are eligible for grants under SB 82 (Chapter 34, Statutes of 2013).
In response to a CHA request for clarification on this point, CHFFA Executive Director Barbara Liebert stated that “SB 82 (W&I Section 5848.5) seeks to provide counties with funding to increase their capacity and access to community-based mental health crisis services that are wellness, resiliency and recovery oriented in the least restrictive manner possible. The regulations my office recently submitted to the Office of Administrative Law and which were approved, contain scoring criteria strongly tethered to these statutory concepts. Projects that are community-based as opposed to institutionally-based will likely be more competitive and more likely to be recommended for an award by the Authority. There is nothing in SB 82 or our regulations, or seemingly, pre-existing statutes or regulations, that automatically render a PES project ineligible for grant funding, but at the same time, there is nothing in existing regulations that specifically references PES units.”
A new advisory from the Substance Abuse and Mental Health Services Administration (SAMHSA) reviews diabetes and its link with mental illness, stress and substance use disorders. The report focuses on ways to integrate diabetes care into behavioral health treatment, such as through screening and intake, staff education, integrated care and counseling support. Intended for professional care providers, program planners, administrators and project managers, the advisory is available free online for ordering or download.
The state of California has issued a survey available to all stakeholders interested in helping develop effective community planning processes related to the Mental Health Services Act (MHSA). The survey is part of an evaluation of the impact and effectiveness of community planning processes in all 58 California counties. Its major goals include gaining a better understanding of current processes and developing best practices for effective and inclusive MHSA planning. Anyone interested in responding to the survey can complete it online in English or in Spanish.