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OHIO BEHAVIORAL HEALTH & MEDICAID FUNDING OACCA Legislative Briefing, 2011.

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Presentation on theme: "OHIO BEHAVIORAL HEALTH & MEDICAID FUNDING OACCA Legislative Briefing, 2011."— Presentation transcript:

1 OHIO BEHAVIORAL HEALTH & MEDICAID FUNDING OACCA Legislative Briefing, 2011

2 Ohio Department of Mental Health The Ohio Department of Mental Health (ODMH) works to assure access to quality mental health services for Ohioans. 2009, Ohio’s public mental health system provided care to more than 300,000 people, including 100,000 children. The department is guided, in part, by the Mental Health Act of 1988

3 Ohio Department of Mental Health ODMH funds, reviews and monitors community mental health programs through 50 county-level boards. These boards, which in most cases oversee both mental health and addiction services, do not directly provide services. They act as local mental health authorities, contracting for services provided by hundreds of private agencies and the seven public psychiatric hospitals operated by ODMH.

4 ADAMH & CMHRB Funding for community mental health services comes from federal, state and local sources. ODMH relies on state General Revenue Funds (GRF) for approximately half of its budget, and allocates GRF to local Boards for the purchase of community services, including bed days at the ODMH hospitals. Community Mental Health & Recovery Boards (CMHRBs) & Alcohol, Drugs and Mental Health Boards (ADMHBs) Family First Councils

5 ODJFS Ohio Department of Job & Family Services County Department of Job & Family Services Legally responsible for carrying out the mandates of EPSDT

6 Centers for Medicaid and Medicare Services The Centers for Medicare and Medicaid Services (CMS) was created to administer oversight of the Medicare Program and the federal portion of the Medicaid Program. Ensures that program beneficiaries are aware of the services for which they are eligible and that those services are accessible and of high quality Develops health and safety standards for providers of health care services authorized by Medicare and Medicaid legislation. CMS is also responsible for administering the State Children’s Health Insurance Program (SCHIP), the Health Insurance Portability and Accountability Act (HIPAA), and several other health-related programs.

7 EPSDT Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program: Medicaid’s child health component. Since 1967, the purpose of the EPSDT program has been "to discover, as early as possible, the ills that handicap our children" and to provide "continuing follow up and treatment so that handicaps do not go neglected.” -U.S. Department of Health and Human Services

8 EPSDT Federal law – including statutes, regulations, and guidelines – requires that Medicaid cover a very comprehensive set of benefits and services for children, different from adult benefits. EPSDT offers a very important way to ensure that vulnerable children (0-18) receive appropriate health, mental health, and developmental services. Medical Necessity. Ohio Administrative Code: 5101:3-14 & 5101:

9 Manage Behavioral Utilization Federal Government pays 63.69% of Medicaid costs. Proposed new structure (caps on services) shifts cost of mental health services from Medicaid at state level to local Child Welfare, Juvenile Courts, D.D. boards, Family First Councils. Local child welfare and juvenile courts into position of paying entire cost without Federal reimbursement. The $242 million in cuts to Mental Health Medicaid Services is 16% of planned cuts of all Medicaid. The Mental Health Managed Care to be capped are 4 to 5 times the average cuts to Medicaid and majority of these cuts are to come from services to children.


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