Behavioral Health Authority Overview

May 24, 2005David S. Buck, MD, MPH

Consultants

Henry Harbin, MD

Nancy Speck, PhD

Susan Stone, MD, JD

Is an Authority Needed?

There already is an Authority! But the scope needs to be broadened

Increase support of our safety net providersReduce fragmentationBring more providers into the fold, Broaden consumer choiceDecrease state micromanagement Allow local control by those most familiar with

the constraints and demands

Dr. Wonser and the State

Supports moving dollars through the AuthorityAuthority-Provider splitWill renegotiate suffocating controls on fundsChange is inevitable This is an opportunity to proactively

and thoughtfully prepare what is needed for our community

Mixed Authority Structure

Harris County maintains some authorityOther authority contracted to vendors

Behavioral Health Authority

Manage all mental health and substance abuse dollars Subcontract with MHMRA Manage mental health services

Manage distribution of substance abuse funds

Mission

To better integrate the array of public and private resources that are directed to behavioral health care in a more efficient system of care

Tasks

Integrate behavioral health services with primary careEnsure that behavioral health services do not get lost in the mixDevelop fee-for-service mechanism

Management Decisions

What are the current system capacities with regard to each function?What are the projected costs and time required to meet the projected capacity needs if the function were to be performed within the county infrastructure?Who are the potential vendors available to provide each function and what would be the costs of contracting each function out?

Impact of Fee-for Service

Analyze and improve managed care Claims adjudication Credentialing Network development Maintenance

Local Dollars

Distributed to allow flexibility and freedom from: State regulations Reporting requirements

STAR Plus unlikely to change in current climate Not a part of current considerations If STAR Plus absorbs Medicaid Rehab

dollars, then reconsider situation