1. App D-Intensive Community Based Support, Page 6:
Medication prescription monitoring must be provided by a psychiatrist or psychiatric nurse practitioner who completes an initial assessment at admission and has contact with individuals on a quarterly basis.
Clarity around the time frame regarding completion of medication prescription monitoring. Will medication prescription monitoring need to be completed at admission. Does this mean day of admission, and if so, what is the time frame.
2. App D-Intensive Community Based Support, Page 2:
“Crisis treatment” means behavioral health care, available 24-hours per day, seven days per week, to provide immediate assistance to individuals experiencing acute behavioral health problems that require immediate intervention to stabilize and prevent harm and higher level of acuity.
Additional clarity is needed regarding the definition for crisis treatment. What are the specific expectations to meet this treatment requirement.
3. App D-Intensive Community Based Support, Page 7:
ACT may not be authorized or billed concurrently with Individual, Group or Family Therapy, Addiction and Recovery Treatment Services (ARTS) and Mental Health (MH) Intensive Outpatient, ARTS and MH Partial Hospitalization Program, Outpatient Medication Management, Therapeutic Day Treatment, Intensive In Home Services, Crisis Intervention, Crisis Stabilization, Mental Health Skill Building, Psychiatric Residential Treatment Facility (PRTF) and ARTS Level 3.3-3.7 or Peer Recovery Support Services, as the activities of these services are included in the per diem. Office based opioid treatment services (OBOT) and Office Based Addiction Treatment (OBAT) services are allowed simultaneously with ACT.
Further clarity is needed surrounding whether the provider can/cannot bill for the identified services provided in question #3 while billing for ACT or can/cannot bill the same time during the day while billing for ACT.
4. App D-Intensive Community Based Support, Page 11:
Will a QMHP be able to provide crisis intervention. The second bullet point on crisis intervention references QMHP-type can provide crisis intervention. More specifics are needed on who can provide crisis intervention.
5. App D-Intensive Community Based Support, Page 17:
A minimum of 15 minutes face-to-face service, including one of the service components, is required in order to bill the per diem. Collateral contacts may only account for 25% of the team’s billed time. Licensed direct care staff shall provide services within the scope of practice for their license. Practitioners may not bill for services included in the ACT per diem (H0040) and also bill for the services outside of the per diem rate for individuals enrolled in ACT.
Clarification is needed on how 25% is calculated for the team’s billed time. How is this amount defined and tracked. Will this be grouped together per team or individually by staff.
6. App D-Intensive Community Based Support, Page 18
Case Management should be billed outside of the per diem rate.
What is considered Case Management outside of ACT.
7. App E-Intensive Clinic Base Support, Pages 20-21:
At least three of the following service components shall be provided per day based on the treatment needs identified in the initial comprehensive assessment require:
1. Daily therapeutic interventions with a planned format including
individual, group or family therapy;
2. medication management (minimum of weekly);
4.Health literacy counseling/psycho-education interventions; and
5. Occupational and/or other therapies performed by a professional
acting within the scope of their practice.
What are the set number of hours for the three service components that are provided per day based on treatment needs.
8. App E-Intensive Clinic Base Support, Page 20:
The provider shall, with individual’s consent, collaborate with the individual’s primary care physician and other treatment providers such as psychiatrists, psychologists, and
substance abuse providers;
Additional clarity regarding whether an individual may initiate or continue with a community-based psychiatrist.