2001 Session

Budget Amendments - SB800 (Committee Approved)

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Inter-agency Agreement-Sub. (language only)

Item 319 #41s

Item 319 #41s

Health And Human Resources
Medical Assistance Services, Department of

Page 313, strike lines 48 through 57 and insert:
"Y.1. The Department of Medical Assistance Services shall amend its inter-agency agreement with the Department of Mental Health, Mental Retardation, and Substance Abuse Services to identify clearly DMHMRSAS as the operational administrator, to the maximum extent allowable under federal law and regulation, of the mental retardation home and community-based waiver and of the following Medicaid services: community mental health rehabilitation services; targeted mental health and mental retardation case management; substance abuse treatment for pregnant and postpartum women; intensive in-home and therapeutic day treatment services for children and adolescents in the Early and Periodic Screening, Diagnosis and Treatment Program; and any other new or expanded mental health, mental retardation and substance abuse services related to these services that are covered subsequently by the Medicaid program.  This agreement shall include or reflect applicable provisions in the following paragraphs.
2. DMHMRSAS, as the operational administrator, shall be responsible for policy-making, daily management, and operational responsibility for the MR Waiver and for the services listed in Paragraph 1 under the general oversight of DMAS.  DMHMRSAS is charged with responsibilities that include, but are not limited to, developing policy, service definitions, provider requirements, and service-related recipient eligibility criteria, and data collection for the services listed above; and participating with DMAS in the internal drafting of applicable regulations and State Plan amendments.  DMAS is charged with revenue forecasting, claims processing, provider enrollment, utilization review, publishing rules and regulations, and funding Medicaid match within the General Assembly’s allocation.  DMAS, as the single state Medicaid agency for Virginia, shall support the policy and operational efforts of DMHMRSAS with the Health Care Financing Administration (HCFA).  
3. The Department of Planning and Budget, in cooperation with DMHMRSAS and DMAS, shall include the services listed in paragraph 1 in its November 15 forecast of Medicaid expenditures, upon which the Governor’s budget recommendations will be based, for the current and subsequent biennia.
4. Community services boards and behavioral health authorities shall remain as the single point of entry for waiver services and have the sole responsibility for targeted case management and care coordination, consistent with Item 323, paragraph J of this Act.  As the local managers of services, the community services boards and behavioral health authorities shall ensure local accountability for publicly funded services, continuity of care, census management and discharge planning with state facilities, the health and safety of consumers that they serve, consumer choice, and whenever possible, the involvement and participation of private providers.  Services provided directly by community services boards and behavioral health authorities shall remain a choice for consumers.
5. DMHMRSAS, as the operational administrator, with the involvement of DMAS, shall solicit input from consumer and family groups, advocacy groups, community services boards, private providers, local government organizations, and other interested parties regarding the development of this agreement.  DMHMRSAS and DMAS shall publish a draft agreement for public review by July 1, 2001.  Public comment on the draft agreement may be directed to the approving bodies as listed in paragraph 8 as well as to DMHMRSAS and DMAS.
6. DMAS shall involve DMHMRSAS in planning for and developing the Requests for Proposals and contracts for Medallion II.  DMHMRSAS shall work with DMAS to provide a method for consumers to explore and resolve complaints with DMAS regarding these services.
7. DMHMRSAS, with the involvement of DMAS and the stakeholders listed in paragraph 5, shall develop service definitions for flexible Medicaid reimbursed services to facilitate the development of community services needed by consumers.  These services will include but not be limited to crisis stabilization, gero-psychiatric residential services, respite care, intensive outpatient services, in-home services, medication services, vocational services, programs of assertive community treatment, and consumer-run services.
8. DMHMRSAS shall submit the proposed agreement by August 1, 2001, to the Governor and the Chairmen of the House Appropriations and Senate Finance Committees and the Joint Commission on Behavioral Health Care for review.  DMAS and DMHMRSAS shall implement this agreement by October 1, 2001."
Page 314, strike lines 1 through 45.

(This amendment revises language in the introduced budget that describes the inter-agency agreement between DMAS and DMHMRSAS. The revised language clearly designates DMHMRSAS as the administrator for community services for mentally disabled persons, prescribes the general responsibilities of each agency, and requires consumer participation in the development of the inter-agency agreement.)