For adult BH HCBS clients, what are tiers 1 and 2?
Client tier status is determined by the brief Community Mental Health Assessment. Tier 1 indicates eligibility for select HCBS services including Employment, Education and Peer Supports. Tier 2 indicates eligibility for the full array of HCBS. The brief assessment may also find that an individual is not eligible for HCBS. All HARP enrolled individuals are eligible for short-term crisis respite.
For adult BH HCBS clients, under what circumstances does the Plan of Care need to be redone?
The plan of care should be redone if the tier of eligiblity, services and/or goals have changed or may no longer be appropriate based on observation or a major life change. Contact your Health Home Care Manager for more information.
What is the timeframe for adult Behavioral Health Home and Community Based Service (BH HCBS) providers to complete the assessment(s) for frequency, duration, and scope of each individual service?
The initial assessment by the adult BH HCBS provider to determine frequency, duration, and scope must be completed within 14 calendar days from the first visit.
Will each adult Behavioral Health Home and Community Based Service (BH HCBS) provider receive a copy of the individual’s Plan of Care? Will the BH HCBS Individual Service Plans be shared among providers?
The BH HCBS plan of care is completed by the Health Home Care Manager. Once complete, the BH HCBS plan of care must be signed by each of the BH HCBS designated agencies providing a BH HCBS service indicated in the HCBS plan of care.
For the initial 3 assessment visits with an adult individual how will the Behavioral Health Home and Community Based Services (BH HCBS) provider bill for these services? Will these visits have a different rate than the service rate? Will these visits apply to the utilization cap?
BH HCBS providers have up to 3 visits to determine the scope, duration, and frequency for the individual based on their needs, goals and preferences. This is a part of the BH HCBS and should be billed the same way an individual BH HCBS is billed. The time spent during these three visits will count toward the cap on hours.