Missouri Code of State Regulations › Title 9 - DEPARTMENT OF MENTAL HEALTH › Division 10 - Director, Department of Mental Health › Chapter 7 - Core Rules for Psychiatric and Substance Use Disorder Treatment Programs › Section 9 CSR 10-7.035 - Behavioral Health Healthcare Home

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment updates provider
				  qualifications, terminology, and staff requirements and adds complex trauma to
				  the qualifying chronic conditions.
(1) Behavioral Health Healthcare Home
				Qualifications.
(A) Initial Provider
				Qualifications. In order to be recognized as a Behavioral Health Healthcare
				Home, a provider must, at a minimum, meet the following criteria:
1. Have a substantial percentage of
				individuals served enrolled in Medicaid. Percentage requirements will be
				determined by the department;
2.
				Have strong, engaged leadership committed to and capable of leading the
				organization through the transformation process to Healthcare Home service
				delivery practices and sustaining those practices as demonstrated through the
				application process and agreement to participate in learning activities,
				including in-person sessions and regularly scheduled phone calls as required by
				the department;
3. Meet the
				department's minimum access requirements. Prior to implementation of Behavioral
				Health Healthcare Home service coverage, provide assurance to the department of
				enhanced access to the care team by individuals served, including the
				development of alternatives to face-to-face visits, such as telephone or email,
				twenty-four (24) hours per day, seven (7) days per week;
4. Actively use the department's identified
				health information technology tool to conduct care coordination, input
				metabolic syndrome screening results, track and measure care of individuals,
				automate care reminders, produce exception reports for care planning, and
				monitor medication adherence;
5.
				Conduct wellness interventions as indicated based on the individual's level of
				risk;
6. Complete status reports
				to document the individual's housing, legal, employment, education, and custody
				status;
7. Agree to convene
				regular, ongoing, and documented internal Healthcare Home team meetings to plan
				and implement goals and objectives of ongoing practice
				transformation;
8. Agree to
				participate in department-approved evaluation activities;
9. Agree to develop required reports describing
				Healthcare Home activities, efforts, and progress in implementing Healthcare
				Home services;
10. Maintain
				compliance with all of the terms and conditions as a Behavioral Health
				Healthcare Home provider or face termination as a provider of Healthcare Home
				services; and
11. Present a
				proposed Behavioral Health Healthcare Home service delivery model the
				department determines will have a reasonable likelihood of being cost
				effective. Cost effectiveness will be determined based on the size of the
				proposed Behavioral Health Healthcare Home, Medicaid caseload, percentage of
				caseload with eligible chronic conditions, and other factors to be determined
				by the department.