For years, Medi-Cal (or Medicaid) mental health services emphasize the value of reimbursement over treatment. What a practitioner did with a client didn’t matter as much as what they wrote down on paper or in an electronic health record. This strategy could be seen in the stress auditors and governmental agencies put on the documentation. Agencies would have revenue recouped, sometimes in the hundreds of thousands of dollars, because notes weren’t written properly. Subsequently, agencies focused more on the note than the care. As a result, clients weren’t seen, access was stifled, and outcomes didn’t improve.
Now, in California, the Department of Health Care Services (DHCS) is involved in the California Advancing and Innovating Medi-Cal (CalAIM) project. CalAIM has three primary goals:
Recently at a meeting of provider agencies in Los Angeles County, further information was discussed about proposed changes to Medi-Cal mental health services. These changes include the following:
Allowing reimbursement of treatment services before the diagnosis is made. Previously, treatment could only begin after the practitioner made a diagnosis. Because diagnoses sometimes took weeks to determine, the treatment process was delayed; this change would expedite care.
Creating criteria for children to access services based on the experience of trauma and risk of future health conditions. Now clients would qualify for services not only if their conditions posed a functional impairment, but if they were at high risk of these impairments.
Change documentation so that:
Treatment plans would be replaced with problem lists. With a problem list, the verbiage to discuss goals, objectives, and interventions would be substituted with a checklist of symptoms or behaviors to address in care. This would reduce documentation time significantly.
Progress notes would no longer tie to the treatment plan but reflect the care and the billing codes. The practitioner could focus more on the client’s care at the moment than documentation.
Auditing would focus more on fraud, waste, and abuse, instead of documentation. The wrong note would be considered a “teachable moment” instead of recoupment.
All these ideas take documentation and give it a back seat to the real reason most providers got into the business; to help heal the clients that are served. If DHCS goes through with these ideas, it will be the biggest and most advanced change in over 30 years, leading to more clients being served and improved treatment outcomes.
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PRAXES is a nationwide behavioral health software, consulting, and training company. No one in the behavioral health industry has a better reputation, and if you give us the chance, we’ll show you why! At PRAXES, our services improve the efficiency and structure of behavioral health agencies serving children and families nationwide. PRAXES brings over 45 years of administrative and clinical expertise. With more than 100 client companies nationwide, we offer the expertise to advance the quality of behavioral health services. We accomplish these goals through our new clinical decision software, our training of best practices, and helping companies meet regulatory standards. At PRAXES, we believe in being creative and fostering new ways to serve children and their families. Our vision is to empower the families our agencies serve with skills that not only improve their functioning, but help them to thrive in their everyday lives. When you give us the chance, you’ll be connected directly to our friendly staff, so you can expect immediate attention to your inquiry. So, don’t wait, call now!
Dan Thorne has unique perspectives on the field of mental health. As a clinician, he has had over 40 years of experience working with clients in the Southern California area. After obtaining his Bachelor’s degree from the University of California at Irvine, he worked with children in the Orange County Juvenile Hall. Here he honed his earliest techniques on at-risk children. After that, he obtained his Master’s degree in Counseling from California State University, Fullerton.
In the 1990’s, Dan turned his attention to the clinical and administrative side of behavioral health organizations. For three years, he was the Assistant Administrator of Starting Point, a chemical dependency facility in Costa Mesa, CA. In 2001, he took an opportunity to be the Director of Harbor View Community Services Center in Long Beach. When he arrived, the Center had only 80 clients and 13 staff. When he left, there were over 400 clients and 75 staff. Dan created several programs through their contract with the Los Angeles County Departments of Mental Health and Child and Family Services. Under his guidance, Harbor View became one of the leading providers of children’s services in Los Angeles County.
While improving the results of the client’s parents at the Center, Dan reflected on his experiences as a parent. His children themselves had special needs such as mental and intellectual challenges, and Dan knew the toll it takes on the parent. In order to help the child, the parent has to be healthy. From this concept, he created his parenting program. After years of refining it, teaching it to his staff at the Center, and then taking the results and comments from these efforts, he became the developer of the current PRAXES program. It is a culmination of Dan’s personal trials and tribulations as a parent along with empirical results and research of over 40 parenting programs.
Our vision at PRAXES is to advance the strength of parents and caregivers of children with special needs (mental health, intellectual, or physical) through education, support, and empowerment. Thus, they can live healthy and functional lives while caring for the child.
Apogee is a clinical decision software designed to help behavioral health practitioners with their treatment and patient engagement. It provides evidence-based and research-based components. Not only do they consist of elements from such practices as Cognitive Behavior Therapy, Seeking Safety, Dialectical Behavior Therapy, Motivational Interviewing, Functional Behavior Analysis, but also the Intensive Models for Parents, Youth, and Children.
PRAXES has over 30 years of accreditation experience. We know what it takes to get your organization accredited. Whether it’s Joint Commission, CARF, or COA, our team can provide an evaluation of your current status and review the standards which need improvements. We will assist you with the policies, documentation, and training required to be accredited.
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