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Viewing: Community Behavioral Health Provider Network Structure, 01-199

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Current Status: Active PolicyStat ID: 5126754

Community Behavioral Health Provider Network Structure, 01-199

APPLICABILITY

Providers of Behavioral Health Services

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.  Details regarding the process for becoming a DBHDD provider are found in Recruitment and Application to become a Provider of Behavioral Health Services, 01-111.

DBHDD PROVIDER STRUCTURE

DBHDD has implemented a new Provider structure, effective July 1, 2014. Providers are classified following a Tiered Design System. Tiers are defined as follows: 

  1. Tier 1: Comprehensive Community Providers (CCP)
  2. Tier 2: Community Medicaid Providers (CMP)
  3. Tier 3: Specialty Providers (SP)

Tier 1: Comprehensive Community Providers (CCP)
CCP providers function as the safety net for the target population, serve the most vulnerable and respond to critical access needs. The standards and requirements for CCP providers are found in Comprehensive Community Provider (CCP) Standards for Georgia's Tier 1 Behavioral Health Safety Net, 01-200. 

Tier 2: Community Medicaid Providers (CMP)
CMPs provide behavioral health services and supports identified in Medicaid State Plan for Serious Emotional Disturbance (SED) youth, young adults, Serious and Persistent Mental Illness (SPMI) Adults, and individuals with Substance Use Disorders (SUDs).  To be a CMP, a provider must be: 

  • A provider that serves children, adolescents, emerging adults, and/or adults; and 
  • A provider that competently serves individuals with mental health, SUDs and co-occurring issues; and 
  • A provider that has the capacity and infrastructure to provide all of the services in the core benefit package; and 
  • A provider that provides accessible services for individuals who are deaf and hard of hearing individuals; and
  • A provider that provides culturally and linguistically competent services. 

Tier 3: Specialty Providers (SP)
SPs offer an array of specialty services. Refer to the Current Behavioral Health Community Provider Manual for details. 

RELATED POLICIES

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

Provider Manual for Community Behavioral Health Providers, 01-112

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

Community Medicaid Provider (CMP) Standards for Georgia's Tier 2 Behavioral Health Services, 01-230

Attachments:

Approval Signatures

Approver Date
Anne Akili, Psy.D.: Director, Policy Management 7/2/2018
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 7/2/2018
Anne Akili, Psy.D.: Director, Policy Management 7/1/2018
Older Version Approval Signatures
Approver Date
Anne Akili, Psy.D.: Director, Policy Management 7/2/2018
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 7/2/2018
Anne Akili, Psy.D.: Director, Policy Management 7/1/2018
Older Version Approval Signatures
Joetta Prost, Ph.D.: DBHDD Policy Director 8/25/2015
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 8/25/2015
Joetta Prost, Ph.D.: DBHDD Policy Director 8/20/2015
Joetta Prost, Ph.D.: DBHDD Policy Director 9/30/2014
Chris A. Gault, Ph.D.: Director, Division of PM/QI 9/18/2014
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