Performance Audit Behavioral Health Services Interagency Coordination Of Services PDF Download

"We evaluated the Office of Behavioral Health’s (OBH) process for ensuring that the five1 Healthy Louisiana Managed Care Organizations (MCOs) provide Medicaid recipients with access to an adequate network of qualified specialized behavioral health2 (SBH) providers. In contrast to basic behavioral health services, SBH includes services, such as psychosocial rehabilitation, therapy, or crisis intervention, designed to treat mental health and substance abuse issues.3 We conducted this audit because a 2015 survey4 found that Louisiana ranked 47th among states in people having access to behavioral health services. OBH, within the Louisiana Department of Health (LDH), is responsible for ensuring access to behavioral health services in the state. During fiscal year 2017, OBH’s state office staff5 consisted of approximately 82 employees and a budget of $58.6 million. In 2012, LDH contracted with Magellan Health, an MCO, for the administration of SBH services for Medicaid recipients, a shift from the fee-for-service model that directly reimbursed providers. In December of 2015, LDH integrated physical and SBH services into the five existing MCOs. The goal of integrating these services, as recommended by best practices, is to achieve holistic care by coordinating members’ health, prevention, and treatment. Although SBH services are now provided by the MCOs, LDH is still responsible for administering the Medicaid program and monitoring the MCOs to ensure they comply with their contracts."--Introduction.