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ADAMH Board of Franklin County KY 2015 Provider Meeting Tuesday, September 16, 2014.

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Presentation on theme: "ADAMH Board of Franklin County KY 2015 Provider Meeting Tuesday, September 16, 2014."— Presentation transcript:

1 ADAMH Board of Franklin County KY 2015 Provider Meeting Tuesday, September 16, 2014

2 Agenda State of ADAMH 2015 Provider Allocations 2015 ASP/Budget Overview 2015 Contract Changes 2

3 Contract Year 2015 Provider Allocations Providers KY 2014 discretionary ADAMH allocations will be increased by 3% ADAMH will utilize Levy reserves to offset SFY15 OHMHAS funding cuts GRF 507 funding was eliminated in SFY15 ($7.1 million) Hospital Incentive funding was eliminated in SFY15 ($218,000) ADAMH will backfill State SAPT cuts for SFY15-16 Approximately $300,000 in pass-thru reductions Approximately $1.7 million in discretionary fund reductions 3

4 Contract Year 2015 Provider Allocations 4

5 ADAMH will designate a Provider Contingency Fund for KY 2015. Funds will be derived from unearned KY 2015 discretionary Provider allocations, capped at $750,000 Funds will be distributed (post-reconciliation) on a prorated basis to Providers who realize uncompensated claims during the year. A minimum of 50% of the contingency pool will be weighted by a Provider Performance Index (combination of System Quality Indicators, Contractual Compliance and Financial Measures). 5

6 ASP/Budget & Contract Timeline EventDate KY2015 ASP/Budget & 120-Day Notice Distributed to Providers09/03/14 KY2015 Provider Meeting09/16/14 KY2015 ASP/Budget Due to ADAMH10/10/14 KY2015 Contract Distributed to Providers11/07/14 KY2015 Signed Contract Due to ADAMH12/05/14 6

7 Budget Forms Overview No changes to Budget forms for KY 2015 Form 9 (052 Report) will not be required for KY 2015 This form is usually requested by ADAMH every other (odd) year. The Board has elected to defer requesting this form until the 2016 budget cycle to better evaluate the impact of healthcare reform Budget Forms will continue to emphasize the use of modifiers for special programs and system investments. 7

8 Budget Forms Overview, cont. KY15 Programs that required a Modifier (position 4) 8

9 ASP Instructions and Guidelines  The ASP from KY 2014 has minor changes to the format/content for KY 2015 in an effort to streamline the documents and process in preparation for the roll out of SHARES in 2015.  KY15 ASP Narrative is a single Word document. No template is provided this year. The Instructions and Questions Document provide the questions that must be addressed in your narrative response. 9

10 ASP Instructions and Guidelines (Cont.)  While the Instructions and Questions Document and the Excel worksheets request information that is similar to or identical to KY14’s, the formatting and arrangement of sections have been changed in an effort to streamline the overall process.  The changes for the Narrative and Excel Worksheets are as follows: The OHMHAS Accreditations Information and Recovery Plan is no longer being requested as part of the ASP process. Section A of the narrative is for Cultural Competence Planning information. 10

11 11 ASP Instructions and Guidelines (Cont.) Section B “Acute Care” of the narrative section replaces both the “Required Access to Care Referrals” and the “Hospitalization & Crisis Management Plan” sections. Sections C, D, E, F and G are now separate Program Summaries for: Early Intervention, Treatment, Housing, Support Services and School-Based Services. Section H is the Prevention Outcomes Management Narrative (a template is provided).

12 ASP Instructions and Guidelines (Cont.) Section I is the instructions and questions for the ASP Forms/Worksheets which are Tabs ASP-01 – ASP-13 in the Excel Workbook. Section J Definitions/Glossary of Terms is a new section. Please note that several of the forms use drop down menus and are linked to pre-populate information in order to standardize and streamline data entry. The Information Technology and Programs (Treatment & Non-Treatment) worksheets have been eliminated. 12

13 ASP Instructions and Guidelines (Cont.) Tab ASP-01 is the Board Contacts Information form. This was moved from the narrative section. Tab ASP-02 Staff Contacts and ASP-03 All Hazards Clinicians forms have not changed. Tab ASP-04 was previously the Facilities List is now the Housing Facilities worksheet and only collects information for housing facilities (this is the first form with drop down menus for the Use and Ownership Status fields). ASP-05 Client Projections and ASP-06 Central Pharmacy forms have not changed. 13

14 ASP Instructions and Guidelines (Cont.) ASP-07 the Program Overview worksheet has changed the most. Now, it is for both Treatment and Non- Treatment programs and collects the following information:  Name of Program  Level of ADAMH funding (uses a drop down menu)  Program Location (address where services are provided)  Program Zip Code  Program Operating Hours  Program Type (uses a drop down menu)  Populations Served (uses a drop down menu)  Program Category (uses a drop down menu)  Primary Referral Sources (uses a drop down menu) 14

15 ASP Instructions and Guidelines(Cont.) Please note that program names entered on ASP-07 will pre-populate the program names for ASP-08 – ASP-10. ASP-08 Program Capacity form primarily remains the same; however, the form now provides space for up to 10 Procedure Codes and Service Names and these fields use drop down menus. ASP-09 Program Costs and FTEs and ASP-10 Evidence Based Models forms have not changed. 15

16 ASP Instructions and Guidelines(Cont.) ASP-11 Prevention Programs form has not changed (this form continues to ask for data similar to Target Track information). ASP-12 School-based Services form is a new form. Only those providers who have a suburban school district investment need to complete this form. ASP-13 Checklist is a new form. This is a checklist of all forms you need to submit. 16

17 2015 ADAMH/Provider Contract KY 2015 is the 2 nd year of the two year contract cycle. The 120-Day Notice was issued to Provider’s on 9/3/14. The addendum is subject to change based on Feedback from Providers and Legal review The addendum will be finalized and distributed to Providers in early November. 17

18 2015 ADAMH/Provider Contract, cont. Material changes to contract language include: OhioMHAS Consolidated Assurance Statements –State issued assurances revised for SFY15 (refer to Section 4.3 & Attachment 5 of the ADAMH/Provider Contract) Wait lists – ORC 5119.362 will require Boards & Providers to maintain wait lists for select services and populations (refer to Section 4.7.3 of the ADAMH/Provider Contract) Cost Reconciliation – the Board will no longer conduct cost reconciliations nor audited UCR reports (refer to Section 7.5.2, Attachment 3 and Attachment 10 of the ADAMH/Provider Contract) Outcomes – data will be required to be submitted within 30 days of the required administration date (refer to Section 7.6.3 of the ADAMH/Provider Contract) 18

19 2015 ADAMH/Provider Contract, cont. Material changes to contract language include: Balance Billing – Providers will accept reimbursement from third party insurance as payment in full (no balance billing) Court Commitments – define timeframes for commitment engagement - outpatient services within 7 days and psychiatrist within 14 days (refer to Section 15.2.2 of ADAMH/Provider Contract) Evaluation of Appropriateness for Outpatient Commitments – defines requirements set forth in ORC 5122 (refer to Section 15.9 of ADAMH/Provider Contract) Attachment 3 – Essential Period Reports – removed audited UCR requirement and revised due dates for reports 19

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