Behavioral Health executive committee Subgroup on R-DM
Model Recommendations

List of recommendation considerations:

1. Add group intervention to C&A service packages 1.2 and 2.3. At Dr. Shon’s Major Depressive Disorder in Children Consensus Development Conference in Irving on January 13, 2005, reference was made to the value of groups for both children and adolescents. In addition, the curricula materials provided by central office are developed for group as well as individual intervention. The R-DM service grid also allows for group intervention for medication training and support.

2. Ensure that training events include the option of “train-the-trainer” format where possible to ensure continuity of care and management of staff turnover. Initiate web-based training for both initial and update training modules. Also, recommended is a 90-day window of time to complete R-DM specialized training before disallowing billing.

3. Reconsider the percentage of compliance for minimum and average hours required for all adult services. Recommendations:

· Leave the compliance standard at 75% for the entire first year.

· Reevaluate after fourth quarter data is complete for what actually is an appropriate standard.

4. R-DM Update assessments should be required at time of reauthorization or as clinically warranted.

· Adult SP 1 change to annual reassessment

· Recommend extended review (6-month authorization) to annual option for C&A SP4.

5. Time spent making phone calls should be included as part of intensive case management monthly minimums and averages. Many contacts are made in the wrap-around process of the intensive case management model – the intent of the recommendation is to acknowledge and in some way successfully capture these frequently time-consuming encounters.

6. The UM guidelines appear to oppose the service grid and the DVC with regard to SP-4 patients receiving group services. Recommendation is that while the majority of services are provided in the community on a one-to-one basis, and given that best practices materials allow for some group-delivered services, allow for group within the rules.