Request
for Letters of Interest in Developing Behavioral Health Managed Care Program Features
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DATE:
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January
28, 1998
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TO:
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County
Department of Human Service Directors
Tribal Chairpersons/Human Service Facilitators
County Departments of Community Programs Directors
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FROM:
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Joe
Leean
Secretary
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RE: Request for Letters of Interest in Developing Behavioral Health Managed Care
Program Features
In April 1996, the Department of Health and Family Services (DHS) released "Designing Managed Care Models for Persons with Mental Illnesses
and Substance Abuse—A Concept Paper." That paper described the principles
for model programs demonstrating how Medicaid dollars for behavioral health care (mental
health and substance abuse) can be pooled with community aids and county tax levy to
create a flexible system of care for persons with mental illnesses and substance abuse
disorders. The DHS is now interested in moving from concept to reality and invites you to
collaborate with us on the further development of behavioral health managed care. Our
target is to implement 3-4 behavioral health care pilot projects with enrollment starting
in July 1999.
In October 1997, the DHS’ Behavioral Health Care Pilot Implementation Advisory
Committee formed a workgroup to design this request for letters of interest (RLI). The
workgroup included representatives from counties, providers, family members and consumers.
This letter is the result of the input of that workgroup.
Through this RLI the DHS is looking for counties and tribes, who may collaborate
with private organizations, to flesh out these pilots with us during late spring and
summer of 1998. We expect staff from these counties/tribes, along with key
stakeholders, to participate in workgroups developing model contract language for the
pilot programs in the following areas: 1) benefit design, 2) rate-setting and risk
sharing, 3) quality assurance and consumer protection, and 4) cross system
collaboration. The DHS will be selecting sites that represent a variety of approaches to
providing behavioral health managed care to ensure that contract language takes into
account a variety of models. This model contract language will be used as the basis for
further procurement activities.
While the focus of the pilots is on persons with behavioral health treatment needs, the
DHS is very interested in demonstrating how primary and acute care and behavioral health
services can be integrated into a single system of care for this population. We would also
like to see counties/tribes propose models for incorporating the care of non-Medicaid
clients served through the 51 human service boards (the uninsured and under-insured). The
DHS expects these programs to be consistent with the vision and guiding principles of the
Governor’s Blue Ribbon Commission on Mental Health. These programs will
serve Medicaid recipients who are not eligible for enrollment in the AFDC managed
care program. Because the DHS is concurrently redesigning the long-term care system, we
will address the boundaries between these two systems as our planning proceeds.
This is not a request for proposals or bids. This is a request for letters of
interest from counties/tribes who wish to work with DHS on developing the details for
these pilot programs. Counties/tribes considering participation in this development phase
are advised of the following:
- Counties or tribes selected to work with us as a result of this request for letters of
interest are not obligated to submit proposals in response to future procurements to
implement pilot programs.
- Counties or tribes submitting responses to this request for letters of interest are not
locked into the specifics of the proposal. As more detailed information is collected, the
county/tribe approach may be modified and they may submit a different proposal in response
to future procurement for pilot program sites.
- The DHS is not obligated to contract with the county/tribal sites selected through this
solicitation to implement managed behavioral health pilot programs.
- Counties/tribes not responding to this solicitation will still be eligible to submit
proposals in response to future procurement for actual pilot sites.
- Contract language developed through this process will be subject to review and approval
by the federal Health Care Financing Administration.
The DHS is exploring options to make some funds available to the counties/tribes to
support their participation in the development process. We already have secured funding to
support the involvement of consumers and family members in the development process.
The DHS intends to select from 3-6 representative sites for this phase of behavioral
health managed care program development. The number of sites selected will depend upon the
range of program designs proposed in response to this RLI and the quality of the
responses.
Counties and tribes interested in participating in this effort should return their
letter of interest by April 10, 1998. The required information can be found in
Attachment 1. Please return your letters of interest to:
Shel Gross, Mental Health/AODA Policy Analyst
Bureau of Health Care Financing
P.O. Box 309
Madison, WI 53701-0309
To assist us in our planning and to help us insure that we have reached all
counties/tribes, please complete the Receipt and Indication of Interest Form (Attachment 4) and return to Mr. Gross, at the address above,
by February 20, 1998. Only counties/tribes returning this form and indicating an
interest in receiving additional information related to the RLI (e.g., responses to
frequently asked questions, clarifications to information in this RLI) will receive such
information.
In order to provide a forum for questions and clarifications, we will hold a
proposer’s conference on Thursday, February 19, 1998, from 10:00 AM – Noon at
the Comfort Inn, 4822 E. Washington Avenue, Madison.
There are several attachments to this letter to provide additional detail for your
information. These attachments describe the following in more detail:
- the information counties must provide to respond to this RLI;
- the minimum program design features and the optional design features that
counties/tribes may propose;
- the criteria that DHS will use to evaluate and choose representative counties/tribes;
and
- Receipt and Indication of Interest Form (due February 20).
We have included, for each county, data on Medicaid fee-for-service utilization and
expenditures for calendar year 1996 and a memo describing the specifications for
interpreting the information on this report. We have also included information from the
Human Services Reporting System on expenditures for mental health and substance abuse
services by program category for the same time period.
If you have any questions about this RLI, please contact Shel Gross at (608) 266-8473.
cc: (Medicaid and HSRS utilization and expenditure data not included)
County Departments of Social Services Directors
County/tribal mental health coordinators
County/tribal AODA coordinators
Wisconsin Medicaid HMOs
Wisconsin Medicaid AFDC HMO mental health/AODA workgroup members
Mental Health Council Members
State Council on Alcohol and Other Drug Abuse
Attachment 1 -- Requirements
Attachment 2 -- Behavioral Health Managed Care Program Design
Options and Other Requirements
Attachment 3 -- Criteria for Evaluating Responses to the Request for
Letters of Interest in Developing Behavioral Health Managed Care Program Features
Attachment 4 -- Receipt and Indication of Interest Form
Attachment 5 -- Timeline
Last Revised: December 27, 2010 |
