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Oaklawn chosen to pilot new state mental health program

Goshen News - 6/5/2024

Jun. 5—GOSHEN — Oaklawn has been selected as one of eight locations to host a statewide pilot program that will change the way mental health services are addressed.

"It's going to allow us to be responsive and flexible in a way that we've never been before," said Oaklawn President and CEO Laurie Nafziger. "That feels so good to me to be able to respond to community needs. ... I think everyone agrees that right now across the U.S. the need strips what anybody can provide. There's staff shortages and the need is so great, so for us to provide programming that makes us more accessible is a game changer."

The Indiana Family and Social Services Administration this week announced the U.S. Department of Health and Human Services named Indiana as one of 10 states selected to participate in the Certified Community Behavioral Health Clinic Medicaid Demonstration Program. Indiana selected eight locations as Indiana Demonstration Pilot Sites.

In 2023, Senate Enrolled Act 1 allowed the Division of Mental Health and Addiction to apply for participation in the expansion of a community mental health services demonstration program. The legislation provided DMHA $100 million, $50 million each year in SFY24 and 25, through the state biennium budget to establish the next step for improving the state's mental health care system.

"It's a huge opportunity for us at Oaklawn," said Kelli Liechty, vice president of Access & Crisis Services. "There are states that have gone ahead of us and adopted this model. Under this new model, we can actually bill Medicaid for the services required. We'll have enhanced rates for the true cost of treatment."

For Oaklawn, Liechty said, much of the work that would qualify them to run as a pilot program has already been completed. The work included the development of mobile crisis teams in Elkhart and St. Joseph counties, as well as the new crisis centers. South Bend's opened in March, and Goshen's is expected to be opened in late fall.

"The big change for us was the change to Open Access but we've been long preparing for this, feeling like this transition is coming," Liechty said. "So, for us this state-level decision supports and validates the work that we've been doing and allows us the funding to do so."

She said Oaklawn has been working toward implementation of a similar model for around three years now.

A Certified Community Behavioral Health Clinic is a specially designated clinic that provides a comprehensive range of mental health and addiction services. CCBHCs must operate under a proven outpatient model including a 24/7 crisis response, quality staff; routine outpatient care; comprehensive mental health and addiction services; and receiving funding to support the real costs of expanding comprehensive services to fully meet the need for communities.

The other major change coming to Oaklawn as a result of the pilot program is enhanced federal and state funding to reimburse behavioral health. For those patients filing claims through Medicaid, the new model will change from a fee-for-service model to a prospective-payment system.

"The idea is that PPS rate allows you to bill for the true cost of treatment, that the rate is a more comprehensive rate for the services you're requiring," Liechty explained. "They haven't raised rates for decades and so that means challenges in hiring, recruiting. This will allow us to be more competitive and reimburse in a model that will be more operative in a sustainable way."

The new billing system will allow Oaklawn and other pilot facilities to bill based on what Liechty calls the true cost of services, explaining that historically, the reimbursement from state insurance for psychiatric appointments has been based on the hourly rate of the therapist or care provider and did not take into account costs for personnel such as administrative assistants, medical records staff, interpreters, or other needed staff that keep the facility running.

"Those are costs that we can bill then to the new model that are more reflective of what we already do," she said.

Private insurance will remain as a fee-for-service model.

"Essentially it'll mean we're going to provide more services and tracking our outcome" Liechty explained of the pilot program and its opportunities. "It addresses the long-term shortages and lack of funding for mental health and says, 'We've got to do better.'"

The other Indiana pilot program locations are Adult and Child Mental Health Center serving Marion and Johnson counties; Centerstone of Indiana serving Owen, Morgan, Monroe, Lawrence, Brown, Jackson, Bartholomew, Jennings, Jefferson, Decatur, Rush, Fayette, Union, Wayne, and Randolph counties; 4C Health serving Pulaski, Fulton, White, Cass, Miami, Howard, and Tipton counties; Radiant Health Services serving Grant and Blackford counties; Hamilton Center serving Vermillion, Parke, Putnam, Clay, Vigo, Sullivan, Greene and Owen counties; Sandra Eskenazi Mental Health Center serving Marion County; and Southwestern Behavioral Healthcare serving Gibson, Posey, Vanderburgh, and Warrick counties.

Dani Messick is the education and entertainment reporter for The Goshen News. She can be reached at dani.messick@goshennews.com or at 574-538-2065.

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