Program Services and Quality Improvement Committee
Develop recommendations for behavioral health, co-occurring addiction and integrated health services, identify needed statutory changes, and develop a plan for future legislative funding requests. Their products will include a proposed framework for an appropriately funded recovery oriented system of care as envisioned in SB 12 (2016). a future plan for the role of managing entities and providers within that system. Recommendations for ME governance, data collection and reporting, statewide consistency, CSU reporting, and a provider dispute resolution mechanism would also be developed.
Examine service delivery systems for children’s behavioral health (Medicaid, Child Welfare, CMS, Healthy Kids/Kid Care, etc.) and identify opportunities to facilitate coordination of services and improve outcomes for children. Develop recommendations specific to programs that focus on children, including SIPP, community based care case management, Child Welfare Medicaid Specialty Plan, BNET, and children’s CSUs.
Business Innovation/Housing Committee
Address a new business model and reimbursement methodologies for Medicaid and DCF funding streams and explore ways to make members more competitive with new entrants to the market. Review the adequacy of Medicaid/DCF provider rates and conditions (prior authorization, utilization review, value based purchasing, provider credentialing process, etc.), and issues related to the medical loss ratio and mental health parity. Examine strategies to address housing needs of individuals in recovery and treatment.
Substance Use / Co-Occurring
Identify opportunities to address critical gaps in funding for substance use disorder services and increase the state’s capacity to meet the demand for detox, inpatient and outpatient services. Develop funding recommendations and propose best practice strategies and approaches to effective treatment for persons with substance use and co-occurring Disorders. Outline a plan for a recovery oriented system of care that addresses social determinants of behavioral and physical health.