NJPRA Annual Conference 11/21/14. Lynn A. Kovich Assistant Commissioner
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1 NJPRA Annual Conference 11/21/14 Lynn A. Kovich Assistant Commissioner
2 Agenda DMHAS Office Reorganization MLTSS Overview Housing and Services Community Support Services Mental Health System Trends 2
3 Reorganization Effective July 2014, Table of Organization was updated Created Office of Olmstead, Compliance, Prevention, Planning and Evaluation Created Office of Community Services Reorganized Office of Managed Care into the Office of the Medical Director and Office of Fiscal Management Moved Housing Office of DHS Why now? Streamline our efforts around Olmstead, which is in its 5th year Centralization of housing among DHS divisions 3
4 BH and MLTSS As of July 1, NJ FamilyCare MLTSS: Includes the home and community based services; now provided by DoAS/DDS Medicaid waivers, and care in a nursing home when needed All BH providers are encouraged to enroll in the various managed care organizations (MCOs) BH services are carved into NJ FamilyCare Managed Long Term Services and Supports (MLTSS), and enrolling into the MCOs will help to ensure that there is an adequate network to serve those consumers Becoming an MLTSS provider can help your agency diversify your services and various payor sources Enrollment in the MCO s will prepare you for the Division s intended move to managed care, thus providing your agency with experience with managed care so you will know what it is like to operate in that environment 4
5 MLTSS Policy and Philosophy A MCO-managed care delivery system MLTSS will coordinate long term services and supports for eligible Medicaid beneficiaries Provides a comprehensive menu of service options across beneficiary groups or care settings; whether in the home, an alternate community setting like assisted living or in a nursing facility Coordination of providers and community based services and support Enhances the ability of beneficiaries to live independently as long as possible in the community 5
6 MLTSS Means Access to more services Delay or discontinue need for care in a facility Preservation of independence Medically appropriate care Better coordination of care (reduced duplication of services) Focus on preventive and in-home care No slot limitations/no waiting lists due to new Medicaid HCBS eligibility 6
7 Array of Services Under MLTSS Specific Services: Respite Personal Emergency Response System (PERS) Home and Vehicle Modifications Home Delivered Meals Assisted Living Behavioral Health Services Community Residential Services Nursing home care 7
8 BH Services covered by MCO s under the MLTSS Contract Acute Partial Hospitalization (MH) Adult MH Rehabilitation (GHs & Supervised Apt settings) Behavioral Health Home BH Independent Practitioner Opioid Treatment Services Outpatient MH Clinic/Hospital Services Partial Care Psychiatric Partial Hospitalization Psychiatric Hospital Inpatient/Acute Care Hospital Program in Assertive Community Treatment (PACT) & Targeted Case Management (TCM) (aka ICMS) are not covered by MCOs, but MCOs are required to coordinate these services for MLTSS members, as needed 8
9 Separation of Housing and Services DMHAS received consultation services from nationally recognized consultants, Parker Dennison Behavioral Healthcare Consultants (Parker Dennison), to assess NJ s (service provider, DMHAS, stakeholder) readiness to separate housing from services Stakeholders representing a broad span of interest (including DMHAS, NJ Division of Medical Assistance and Health Services, NJ Housing Mortgage and Finance Agency, Disability Rights NJ, trade associations, provider agencies, consumers and family members) participated in assessment of readiness and development of a work plan to separate housing from services. Components of the plan addresses: Activities to transition to fee-for-service Supports the roll out a new Medicaid billable service (Community Support Services) Contracting and funding policies and practices that support the separation of housing from services 9
10 Centralization of Housing To facilitate greater consistency in the Department of Human Services (DHS) in the area of housing policy, housing units in the Division of Developmental Disabilities (DDD) and DMHAS have merged and are now under the aegis of DHS Management of housing subsidies will be centralized in a housing clearinghouse, overseen by the DHS Office of Housing 10
11 Housing Clearinghouse DHS, DMHAS and DDD have been in ongoing discussions with the NJ Housing and Mortgage Finance Agency (HMFA) to design the clearinghouse. HMFA will serve as the clearinghouse for DHS Clearinghouse functions will include: Finding affordable units and qualifying landlords Paying landlords housing subsidy Tenant services liaison to handle grievances Quality housing inspections Reimbursing service providers for lease-up costs 11
12 Community Support Services DMHAS will implement CSS in supportive housing and the billing of Medicaid for these services, whereby enabling federal dollars to support the implementation of CSS This new service focuses on individuals taking more responsibility over their lives including having more meaningful choice in the services they receive, selecting their service provider and where they live Community Support Services are not based in a clinic setting; rather, services are provided in the individual s natural environment 12
13 MENTAL HEALTH TRENDS 13
14 Total Average Census at NJ State Psychiatric Hospitals (excl. AKFC): ,200 2,000 1,800 1,600 1,400 1,200 2,116 2,122 1,951 1,806 1,671 1,590 1,534 1,450 1,440 1, NJ Division of Mental Health and Addiction Services, Office of Research, Planning, and Evaluation, September
15 Consumers Served by the SMHA in Supportive Housing (duplicated) ,000 5,000 4,000 5,573 5,271 5,351 4,560 4,063 3,000 2,000 2,136 2,534 3,051 3,497 1, NJ Division of Mental Health and Addiction Services, Office of Research, Planning, and Evaluation, September
16 Total Adults Served by the SMHA in Community Services (duplicated) 2006 to 2013 (1) 300, , , , , , , , , , , , , , , , , (1) Data for 2014 is currently being compiled. NJ Division of Mental Health and Addiction Services, Office of Research, Planning, and Evaluation, September
17 Supportive Housing (SH) Beds for Consumers in the State Hospital: Beds Actually Created, NJ Division of Mental Health and Addiction Services, Office of Research, Planning, and Evaluation, September
18 Supportive Housing (SH) Beds for At-Risk Populations: Beds Actually Created, NJ Division of Mental Health and Addiction Services, Office of Research, Planning, and Evaluation, September
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