If you are a child serving agency that is not looking to add CPST services, or compete with large hospital systems or community mental health centers, credentialing as opposed to CMHC certification might be better for your organization. Assuming your agency wants to add behavioral health supports of some kind, you will have the option soon to consider credentialing your mental health professionals with a managed care organization as opposed to driving down the road of ODMHAS certification.
If what you want to do, strategically, is integrate licensed mental health professionals into your program, and leave the care coordination to managed care organizations, the transformation of our behavioral health system will allow your agency that option. Youth in our public welfare system will be mandated to stay enrolled or be enrolled into a Medicaid managed care plan. When that occurs, the ability to provide assessment, therapy and psychopharmacology services, by a child serving agency, will no longer be dependent on having CMHC status.
What does that mean for an agency that is trying to generate some revenue to offset the use of licensed mental health professionals as part of their overall program and team? It would mean that instead of going the traditional path of obtaining accreditation through either Joint Commission, CARF, or COA (a 6 – 12 month venture in itself), an agency instead would contact the MCO and fill out credentialing paper work on each of its clinicians. This process is how Medicare functions, so though it may sound very different and new, the concept is not new at all. Your capacity as an agency to provide and bill for therapeutic services is dependent on your mental health professionals. Community Mental Health Centers, on the other hand, act as the gateway for professionals. Historically, without CMHC certification, mental health professionals could not bill the Medicaid fee for service program directly.
Three Changes to Track
Any child serving agency interested, or currently providing, mental health services should keep an eye on three changes to our behavioral health system and those changes are finalized in rule. The first is the disaggregate of CPST. This service is currently an integral part of many programs. If you are providing CPST, you need to understand how it will be impacted, and if you are thinking about providing mental health services you need to think about whether you can count on it when generating your fiscal model. The second is the carve in of behavioral health services. This will not occur until 2018, so keeping an eye on changes being rolled out along the way will certainly be important as you attempt to shift or change your program to align with public health policy. The last change is the mandated use of managed care plans to provide health care benefits to youth in our public welfare system targeted for 2017. When the majority of youth in our public welfare system had their health care benefits through the Fee for Service system, it basically required a children service agency, wanting to provide mental health treatment, to obtain CMHC status. Now, however, agencies can assess whether certification or credentialing is best for their program.