Children’s Health Insurance Program Reauthorization Act (CHIPRA)
On February 22, 2010, the Centers for Medicare & Medicaid Services awarded a total of $20 million in first-year Children’s Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration funds to states proposing demonstrations to “evaluate promising ideas for improving the quality of children’s health care.” The grants will continue for a 60 month period; federal funding for this project will total $100 million and end on February 21, 2015. The national Center for Health Care Strategies, Inc. (http://www.chcs.org) and the states of Georgia, Maryland, and Wyoming collaborated to access a portion of these funds to focus on children’s behavioral health. The grant award to this 3-state collaborative is $10,993,171over a five-year period. Georgia’s Department of Behavioral Health & Developmental Disabilities and Department of Community Health are expected to receive approximately $450,000 a year in technical assistance and evaluation in order to support Georgia’s goal of improving the clinical/functional outcomes, cost, and resiliency for high using Medicaid/SCHIP youth.
The Center for Health Care Strategies (CHCS) will facilitate a quality improvement collaborative, the provision of topical peer and expert technical assistance, support with data collection and analysis, access to national resources not typically available to individual states, and a proven systematic approach to quality improvement. While the participating states represent diverse geographic areas and Medicaid structures, they share common goals in pursuing the CME provider model, namely to:
- improve access to appropriate services;
- employ health information technology to support data-driven, clinical decision-making;
- reduce the unnecessary use of restrictive and costly services;
- improve clinical and functional outcomes for children and youth with serious behavioral health needs;
- build resiliency in youth and families, strengthening their involvement both in their own care and in the design and implementation of the behavioral health care delivery system.
Over the past decade, new technologies have emerged in children’s services that create one “locus of accountability” for youth and families involved in multiple systems. These technologies, which support the organization, management, delivery and financing of services and supports across multiple providers and systems, are implemented through a Care Management Entity (CME) structure. The proposed Quality Improvement and Learning Collaborative of diverse states will inform other states and CMS about effective approaches and challenges to implementation of the CME provider model. While the Learning Collaborative are operating under shared goals mentioned above, each state has outlined state-specific strategies and interventions in their Final Operational Plan. Georgia’s strategies include:
- evaluating and refining as necessary the current CME model taking into account best practices nationally,
- evaluating and refining as necessary the CME financial model and rate structure,
- evaluate national models of excellence for Care Management
- establishing a continuous quality improvement framework for CMEs and
- developing a credentialed network of family and youth peer specialists.
For more information on this project, please contact Tricia Mills (DBHDD) at firstname.lastname@example.org.
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