[PC-BH-Integration] Spam: RE: Looking for FQHCs that have successfully fundedIntegrated Health Care

[Scott Willard]

I'm wondering if a back door way to finance BHC might be to provide the services and then encounter the cost of the service in the overall cost report.  That way it should increase the baseline Medicaid charge per encounter of the FQHC.  Thus, you are not getting paid directly for the BH encounters, but you are getting an increase in your clinics overall charge per encounter.  This would require an organizational structure and financial structure that is free to be a bit speculative in its nature, but would get you where you want to go- I think.
 
Scott Willard
Lincoln County Health and Human Services
Behavioral Health Treatment Services
Division Director

>>> "Blount, Alexander" <BlountA at ummhc.org> 8/10/2007 7:39 AM >>>
I wish I could offer a clear and simple answer.  People who make this work either live in a state that does pay H&B codes in FQHCs, like Arizona, or they do some creative accounting.  Some have found that in the presence of a BH clinician, physicians are able to see one or two more patients comfortably per day.  Count that revenue toward BHC, or when the BHC is involved a Level 3 visit can be upcoded to a Level 4, or when a screening form is used by the BHC a modifier can be added to the coding that increases revenue, or that where a public entity is funding the ER and many people are uninsured, paying some of the cost of the BHCs at the FQHC reduces ER usage for the public entity.  HRSA has mandated that state Medicaid programs fund H&B codes in FQHCs, but most states are not in compliance.  The actual mandate is at www.integratedprimarycare.com ( http://www.integratedprimarycare.com/ ) on the first page in the article titled "The Politics of Health and Behavior Codes".
 
At the Collaborative Family Healthcare Association conference in Asheville, NC, Nov 8-10, we will have workshops on making integrated care work financially and on advocacy for improving funding structures and overcoming barriers.  www.cfha.net ( http://www.cfha.net/ ) 
 

Alexander Blount, EdD
Professor of Clinical Family Medicine
University of Massachusetts Medical School
Director of Behavioral Science
Department of Family Medicine and Community Health
Chair
Collaborative Family Healthcare Association
55 Lake Avenue North
Worcester, MA 01655
O. 508.856.2147  F. 508.856.1212
blounta at ummhc.org 
www.IntegratedPrimaryCare.com 
 


From: pc-bh-integration-bounces at lists101.his.com [mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of John Young
Sent: Thursday, August 09, 2007 6:35 PM
To: pc-bh-integration at nccbh.net 
Subject: [PC-BH-Integration] Looking for FQHCs that have successfully fundedIntegrated Health Care mental health positions

All --

I am looking for any Federally Qualified Health Centers that have found ways to fund mental health positions within their clinics within an Integrated Health Care model.

In 2006, the Hogg Foundation for Mental Health, based in Austin, Texas, awarded five Integrated Health Care Initiative grants to five health care groups across Texas: one to the Parkland Health and Hospital System's Bluitt-Flowers Health Center and East Dallas Health Center in Dallas, Texas; a second to People's Community Clinic in Austin, Texas; a third to the Project Vida Health Center in El Paso, Texas; a fourth to Texas Children's Pediatric Associates' Ripley House in Houston, Texas; and the fifth to the Valley Primary Care Network's four member clinics (the Brownsville Community Health Center in Brownsville, Texas; the Community Action Center of South Texas in Rio Grande City, Texas [unfortunately dropping out of the Initiative this month]; Neustra Clinica Del Valle in Pharr, Texas; and Su Clinica Familiar in Harlingen, Texas). For information on this Initiative, see the Hogg Foundation's website at http://www.hogg.utexas.edu/programs_ihc.html, http://www.hogg.utexas.edu/programs_ihc_program.html, and http://www.hogg.utexas.edu/programs_ihc_links.html.

I am a Clinical Care Manager at Su Clinica Familiar (http://www.suclinica.org/) in Harlingen, Texas (satellite clinics in Brownsville and Raymondville, Texas). We joined the Initiative in the second year of the three year grant, starting 05-01-2007 with four 1/2-time Care Managers (a MSW; a BSW; a LBSW; and myself, a LPC, LMFT, LCSW).

We are expanding the IMPACT model beyond addressing late life depression first to address adult anxiety as well as adult depression (including pregnant patients); second to address pediatric ADHD and other externalizing disorders; and third to address pediatric anxiety and depression.

I have rapidly become convinced that we have to address the business/funding aspects of our Integrated Health Care program earlier rather than later for our program to become a hard-wired, core component of Su Clinica Familiar?s ongoing operation. Even though our leadership and staff are fully committed to the program, it must be seen as permanent and not time-limited for everyone to really get all-the-way behind it.

I don't believe we can bill under the Health and Behavior Assessment/Intervention codes 96150-96155 here in Texas. I am in awe of Intermountain Health Care and their websites (eg,http://intermountainhealthcare.org/xp/public and http://intermountainhealthcare.org/xp/public/managehealth/patiented/mentalhealth/resources.xml).

-- John

John Young, LPC, LMFT, LCSW
Clinical Care Manager, Wellness Program
Su Clinica Familiar, Harlingen, Texas
Office Phone (956) 365-6000 x 1310
Cell Phone (956) 371-4401





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