The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) contracts with Beacon to provide administrative services in support of Georgia’s publicly-funded, behavioral health and intellectual and developmental disability (IDD) services system.
The covered population includes adults and children who are eligible for fee-for-service Medicaid and those who are uninsured, as well as individuals with intellectual and developmental disabilities.
- Maintaining a 24/7 crisis and access line for behavioral health and intellectual and developmental disability services.
- Using state-of-the-art technologies to create efficiencies and improve the quality of care.
- Providing focused utilization management and review services for intensive services and a streamlined process for less intensive services.
- Quality Management oversight and consultation for all behavioral health and intellectual and developmental disability providers.
Operating together as the Georgia Collaborative ASO, Beacon partners with long-time Georgia health care participants Behavioral Health Link (BHL) and Qlarant (formerly the Delmarva Foundation):
- BHL, a National Suicide Prevention Lifeline Network Center, has operated the Georgia Crisis & Access Line (GCAL) since 2006. GCAL is available 24/7 for all Georgians.
- Qlarant conducts Person-Centered Reviews, Quality Enhancement Provider Reviews, and other quality oversight and reporting services relevant to the IDD quality management system.
RECURSOS DO PROGRAMA
The Collaborative ensures access to quality services and supports for the persons covered through the following program components:
Georgia Crisis and Access Line
Operated by BHL, the GCAL is a crisis response model for mobile crisis and coordination of services through an interactive system for emergency rooms, mobile crisis teams, and crisis stabilizations units.
GCAL staff provide telephonic crisis intervention, mobile crisis dispatch services, urgent outpatient scheduling, and referral tracking services for all state funded crisis and inpatient beds.
The Collaborative prospectively ensures providers meet quality and compliance standards to provide community behavioral health or intellectual and developmental disability services. We also process provider expansions and changes across the network of approximately 675 IDD and behavioral health service providers. During 2018, we approved more than 1,000 provider applications and updates to ensure individuals had access to care and providers were paid.
Gestão de Utilização
We ensure that individuals who need behavioral health and intellectual and developmental disability services receive the right service, at the right time, in the right place through prior authorization and peer review, particularly for higher levels of care. Beacon has exceeded all timeline thresholds for initial and concurrent review with a 99% timeliness metric across all levels of care.
Coordenação de Cuidados
Our community-based Care Coordination Program supports and serves individuals within the behavioral health and co-occurring intellectual and developmental disability population who have the most complex care needs and during critical transition periods.
The program features regionally based “Recovery Teams” comprised of licensed Specialized Care Coordinators, Certified Peer Support Specialists (CPS) who may also be Certified Addiction Recovery Empowerment Specialists (CARES), and Community Transition Specialists (either CPS or CARES).
We conduct on-site quality reviews of behavioral health and intellectual and developmental disabilities service providers to ensure they continually improve quality across multiple service delivery dimensions established by the State. As part of the on-site visits and as follow up, providers receive training and technical assistance to improve identified service delivery issues.
In FY18, we visited nearly 200 behavioral health service providers. As a result of our training and technical assistance, we helped increase their review scores across all four dimensions of the Quality Review Tool.
Also in FY18, 162 IDD service providers received Quality Technical Assistance Consultations (QTAC). QTAC utilizes findings from quality reviews to provide additional technical assistance to IDD providers to improve service delivery.
Preadmission Screening and Resident Reviews (PASRR)
PASRR is a federally-required assessment program to ensure persons are appropriately placed in nursing facilities. Beacon completes more than 150 clinical
“Level II” evaluations per month to determine the need for placement in a skilled nursing facility and provide a set of service recommendations for providers in developing an individualized plan of care for persons with behavioral health needs.
FUTURE PROGRAM EXPANSIONS
IDD Case Management System Launch:
Leveraging Technology to Improve Continuity of Care
In FY19, the ASO will launch a new web-based case management system to facilitate the intake, assessment, monitoring, and delivery of services for individuals with intellectual disabilities. The roll-out of the system will also include several training events, led by Collaborative partner Qlarant.