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Viewing: Comprehensive Community Provider (CCP) Standards for Georgia's Tier 1 Behavioral Health Safety Net, 01-200

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Current Status: Active PolicyStat ID: 5120948

Comprehensive Community Provider (CCP) Standards for Georgia's Tier 1 Behavioral Health Safety Net, 01-200

IMPLEMENTATION DATE - July 1, 2018

APPLICABILITY

Comprehensive Community Providers (CCPs)

POLICY

The Georgia Department of Behavioral Health & Developmental Disabilities (DBHDD) is set forth in law to establish, provide and supervise an adequate array of services within a service area. DBHDD is responsible to direct and coordinate treatment; recovery; and social, employment, housing, and community supports (O.C.G.A. § 37-1-20). In order to manage this charge, DBHDD requires a robust provider network which offers 24 hour/7 day a week comprehensive service capacity and yet also allows choice and flexibility for individuals served. Attachment A – Community Behavioral Health Provider Network displays the structure for achieving the desired provider network, as of July 1, 2014.  A description of all tiers of service provision is shown in Community Behavioral Health Provider Network Structure, 01-199.

With accountability, efficiency, and access as goals, DBHDD is creating a community safety net of behavioral health providers of services for Georgians. A safety net is defined as a network of providers that offers care and recovery supports to individuals regardless of their ability to pay for services. Safety-net providers typically see a mixture of individuals who are uninsured (and not eligible for insurance benefits), on Medicaid, and/or other vulnerable individuals. Individuals seeking care with Safety Net providers are often high risk or vulnerable, in need of intensive level of care, and may have difficulty accessing care. Safety-net providers have contracted expectations and mandates that ensure that these individuals have access to the appropriate level of care, treatment and coordination of care. 

The designation of safety net providers (called Comprehensive Community Providers [CCPs]) is an important step for the system in creating a standardized public benefit across all counties which is accountable and transparent to recipients of services, their families and supporters, and payers. While DBHDD will continue to work with a broad array of other providers to promote choice and specialization, the CCP designation will promote the focus of limited resources to a select group of public providers as a system safety net. 

More specifically, a CCP is a DBHDD public provider who will operate within a recovery oriented system of care that has the capacity to deliver comprehensive and vital community mental health and substance use disorder (SUD) services to identified Georgians. Collectively, the CCPs are known as the Tier 1 Provider Network. The Tier 1 providers have the unique capacity and infrastructure to provide a seamless continuum of care for the target population identified by DBHDD, as well as having the community stature, visibility, accountability, and credibility to be seen as the local and reliable safety net for the delivery of supports and services.

DBHDD GOALS for Tier 1 CCP System

DBHDD has set goals for the Tier 1 CCP System which will require the focus of both the CCPs and DBHDD.  The goals are as follows:

  1. Maintain personal and community safety.
  2. Ensure access & capacity to deliver behavioral health services and supports to the target population.
  3. Increase occurrence of positive clinical outcomes.
  4. Improve efficiency within the provider network.
  5. Strengthen network management.
  6. Improve the individual's perception of care.
  7. Increase skills within the workforce.
  8. Improve quality.
  9. Promote a recovery oriented system of care.

DBHDD EXPECTATIONS for Tier 1 CCPs

Tier 1 consists of CCPs that are designed to function as the safety net for the target population, serve the most vulnerable and respond to critical access needs. As such, the following are the requirements for Tier 1 CCPs:

  1. Be a public entity that receives state (e.g., structural support) funds from DBHDD to serve the target and eligible populations; and
  2. Be the Safety Net for individuals identified by DBHDD or the provider as high risk and vulnerable; and
  3. Serve children, adolescents, emerging adults, and adults; and
  4. Have Electronic Information Systems capability (Electronic Health Records, HIE connectivity); and
  5. Competently serve individuals with co-occurring Behavioral Health and Developmental Disabilities; and
  6. Competently serve individuals with Mental Health needs and Substance Use Disorders; and
  7. Provide all of the services in the core benefit package plus designated specialty services; and
  8. Have an active Board of Directors; and
  9. Provide accessible services for Deaf and hard of hearing individuals.
  10. Serve as the clinical home for individuals enrolled in services. The CCP will function as a clinical home for an individual's behavioral health needs. As such the CCP will coordinate all mental health and substance use disorder treatment and/or support needs with other health and/or recovery services or actively collaborate with others responsible for coordinating non-behavioral health services (e.g., support coordinators for individuals with Developmental Disabilities; medical case managers/care coordinators) while avoiding disruption of services. For individuals of all ages, the CCP is expected to designate a representative to participate in the applicable local system-of-care collaborative to ensure coordination and continuity of care for the target population. DBHDD may make clinical home assignments or case management assignments to engage and assist individuals in finding and receiving clinical home services.

CCP STANDARDS AND KEY PERFORMANCE INDICATORS

Each CCP is required to operate in compliance with the CCP Standards set forth by DBHDD. There are thirteen (13) CCP Standards. Each CCP Standard has key performance indicators (KPI) that identify targets for expected outcomes. The CCP Standards provide guidance regarding the unique expectations of being a CCP.

Below is the list of 13 CCP Standards. Each Standard is set forth in an individual policy which is linked below. Each policy includes guidelines and explanation of the Standard, the key performance indicator(s) and related information.

CCP Standard 1   -  Access to Services, 01-201 

CCP Standard 2   -  Crisis Management, 01-202 

CCP Standard 3   -  Transitioning of Individuals in Crisis, 01-203 

CCP Standard 4   -  Engagement in Care, 01-204 

CCP Standard 5   -  Substance Use Disorders Treatment & Supports, 01-205 

CCP Standard 7   -  Recovery Oriented Care, 01-207

CCP Standard 9   -  Administrative & Fiscal Structure, 01-209 

CCP Standard 10 -  Required Staffing, 01-210

CCP Standard 13 -  Administrative Services Organization and Audit Compliance, 01-213  

CCP Standard 18 - Suicide Prevention, 01-218

CCP Standard 19 - Housing Access, 01-219

CCP Standard 21 – Community Coordination and Engagement, 01-221

CCP Standard 22 - Evidence Based Treatment, 01-222

CORE BENEFIT PACKAGE AND OTHER SERVICES

  1. Table 1 below displays the Core Benefit Package that CCPs must have the capacity to provide for individuals for whom the service is deemed clinically appropriate. Some services are not available for all ages, and/or require special approval to provide. The current Provider Manual for Community Behavioral Health Providers, 01-112 contains the requirements for each service.
    Table 1
    SERVICE   ADULT MENTAL HEALTH CHILD &
    ADOLESCENT
    MENTAL HEALTH
    ADULT
    SUBSTANCE USE DISORDER
    CHILD &
    ADOLESCENT SUBSTANCE USE DISORDER
        
    Behavioral Health Assessment / Service Plan Development X X X X
    Psychological Testing (may be contracted out) X X X X
    Diagnostic Assessment X X X X
    Crisis Intervention X X X X
    Psychiatric Treatment X X X X
    Nursing Assessment & Health Services  X X X X
    Medication Administration X X X X
    Pharmacy & Lab Services  X X X X
    Community Support Individual / Case Management / PSR-I  X X X X
    Individual Outpatient Services  X X X X
    Group Outpatient Services  X X X X
    Family Outpatient Services  X X X X
    Addictive Disease Support Services      X  
    *Peer Support Individual Services  X   X  
    *Peer Support Whole Health      
    * Peer Support Services are optional and based on workforce availability.
  2. In order to provide the following services, a provider must be an approved CCP and meet qualification(s) for the specific service.
    TABLE 2
    SERVICE
    Crisis Stabilization Unit (CSU)
    Behavioral Health Crisis Center (BHCC)
    Crisis Service Center (CSC)
    Note:  DBHDD reserves the right to contract with providers as needed for services to special populations or in areas with unmet needs.
  3. Each CCP must provide some services as indicated in Attachment A - Community Behavioral Health Provider Network; the CCP may determine the most suitable service(s) for its service area. Note: waivers may be granted in areas where DBHDD determines there is a geographical need for the service to be operated outside of the CCP.
    TABLE 3
    SERVICE
    Assertive Community Treatment OR
    Community Support Team OR
    Intensive Case Management
    Psychosocial Rehabilitation Program - Group OR
    Peer Support Program

FURTHER INFORMATION

For further information on the Behavioral Health Network please see http://dbhdd.georgia.gov/behavioral-health-core-provider-redesign-initiative or contact coreproject@dbhdd.ga.gov with any questions.

RELATED POLICIES

Process for Reporting Compliance with Comprehensive Community Provider (CCP) Standards, 01-225

Provider Manual for Community Behavioral Health Providers, 01-112

Recruitment and Application to become a Provider of Behavioral Health Services, 01-111

Community Behavioral Health Provider Network Structure, 01-199

Attachments:

Approval Signatures

Approver Date
Anne Akili, Psy.D.: Director, Policy Management 6/29/2018
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 6/29/2018
Anne Akili, Psy.D.: Director, Policy Management 6/28/2018
Keisha Blackwell, LMSW, MBA: Policy Coordinator 6/28/2018
Older Version Approval Signatures
Approver Date
Anne Akili, Psy.D.: Director, Policy Management 6/29/2018
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 6/29/2018
Anne Akili, Psy.D.: Director, Policy Management 6/28/2018
Keisha Blackwell, LMSW, MBA: Policy Coordinator 6/28/2018
Older Version Approval Signatures
Anne Akili, Psy.D.: Director, Policy Management 8/7/2017
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 8/7/2017
Anne Akili, Psy.D.: Director, Policy Management 8/7/2017
Keisha Blackwell, LMSW, MBA: Policy Coordinator 8/7/2017
Anne Akili, Psy.D.: Policy Director 8/19/2016
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 8/19/2016
Anne Akili, Psy.D.: Policy Director 8/19/2016
Joetta Prost, Ph.D.: DBHDD Policy Director 6/17/2015
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 6/12/2015
Joetta Prost, Ph.D.: DBHDD Policy Director 4/6/2015
Joetta Prost, Ph.D.: DBHDD Policy Director 9/30/2014
Chris A. Gault, Ph.D.: Director, Division of PM/QI 9/25/2014
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 8/28/2014
Cassandra Price: Director, Office of Addictive Diseases 8/28/2014
Joetta Prost, Ph.D.: DBHDD Policy Director 8/27/2014