WHEREAS, many low-income Missourians including uninsured children currently receive behavioral health services through the Medicaid program operated by the Division of Medical Services of the Department of Social Services; and
WHEREAS, many low-income Missourians also receive behavioral health services through the Division of Comprehensive Psychiatric Services and the Division of Alcohol and Drug Abuse of the Department of Mental Health; and
WHEREAS, the Department of Social Services has specialized expertise and knowledge in the operation of service delivery systems in a managed care environment, and the Department of Mental Health has specialized expertise and knowledge in the delivery of psychiatric and substance abuse treatment services and support; and
WHEREAS, the Department of Social Services and the Department of Mental health support the inclusion of behavioral and physical health care in the MC+ system and have worked to improve the level of interagency cooperation to provide behavioral health services through MC+; and
WHEREAS, further interagency collaboration between the Department of Social Services and the Department of Mental Health will improve the quality and delivery of behavioral health services provided through MC+; and
WHEREAS, the State of Missouri has expanded access to affordable health insurance, including behavioral health services, to approximately 90,000 uninsured children through the MC+ system.
NOW, THEREFORE, I, Mel Carnahan, Governor of the State of Missouri, by virtue of the powers vested in me by the Constitution and laws of Missouri, do hereby order the Department of Social Services and the Department of Mental Health to:
- Collaborate in developing, implementing and maintaining a structure of managed care that increases the quality, access, availability, cost-efficiency and consumer satisfaction of MC+ behavioral health services
- Jointly address current concerns about the management of behavioral health care in the MC+ program by sharing the expertise and knowledge of each department in their respective fields;
- Determine the MC+ population at risk, identify behavioral health needs of those individuals and secure the most appropriate behavioral health treatment under the terms of MC+ contracts;
- Develop strategies to build behavioral health systems capacity in underserved areas.
This effort will require the Department of Social Services and the Department of Mental Health to jointly:
- Analyze covered services;
- Establish reviews of health-related consumer grievances and provider appeals under the terms of MC+ contracts.
- Establish behavioral health sentinels indicators;
- Identify required data, participate in data analysis and establish outcomes based on data analysis;
- Design and implement the quality assurance process for behavioral health;
- Participate in targeted reviews as necessary.
In addition, the Department of Social Services will collaborate with the Department of Mental Health to:
- Develop and evaluate Requests for Proposals;
- Participate in contract compliance reviews and readiness reviews of behavioral health organizations and managed care organizations;
- Develop strong, clear, mandatory language regarding client rights in the client handbook.
The Department of Social Services and the Department of Mental Health will report annually to the Governor by December 1 on the success of this cooperative effort and the outcomes this initiative has on the quality, access, availability, cost-efficiency and consumer satisfaction of behavioral health care through MC+.
IN WITNESS WHEREOF, I have hereunto set my hand and caused to be affixed the Great Seal of the State of Missouri, in the City of Jefferson, on this 12th day of August, 1998.
[Mel Carnahan's signature]
GOVERNOR
ATTEST:
[Rebecca McDowell Cook's signature]
SECRETARY OF STATE
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