September 15, 2023
As you may recall, the recently enacted state budget and specifically, the OMH agency budget includes a provision that allocates $40M (gross – over two years) for ‘expansion of clinic access’. It is my understanding that OMH hopes to use these funds to make investments that address waiting lists, expand access to care, incentivize use of certain service modalities, and incentivize the use of certain evidence-based practices. OMH is also working to increase the OMH Quality Improvement Program Project payments to participating providers (pending federal notice – to follow shortly). None of this is in stone but it sounds very promising and we are pleased OMH has heard our ongoing concerns regarding access to care, waiting lists and finding ways to increase reimbursement.
Regarding the Article 31 Outpatient Clinic Investments, OMH is working to:
- Increase Quality Improvement Program (QIP) payment to participating providers – hope to go to 5.7% or thereabouts. Currently, the QIP increase is between 3-4% so almost a 2% increase with equivalent increases for hospital-based providers participating in QIP. (We will see a federal notice on this shortly)
- Increase by 50% the weight for the current Group Therapy APG rate
- Expand access to both Crisis Intervention-Complex and Crisis Intervention-Per Diem while an individual is in pre-admission status. Currently during pre-admission, OMH only allows for Crisis Intervention-brief, up to 6 units (1.5 hours).
- Regarding Complex Care Management, OMH hopes to:
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- Increase allowable Complex Care units per claim (the current unit limit is four 5-minute units).
- Allow paraprofessionals to provide the service
- Increase the scope of what can be considered Complex Care Management.
- Start-up grants and mini grants to: 1) select new providers to offer Article 31 Clinic services, and 2) incentivize existing providers to offer services in hard to reach/underserved areas
Attached is a PowerPoint with additional details.