Behavioral Health Partnership Oversight Council Subcommittees
(Updated 8/06)

1. Coordination of Care Subcommittee - Chair: Sheila Amdur.
The Subcommittee will work with the DSS and the four HUSKY plans to identify and monitor key issues in assuring close coordination of HUSKY members' behavioral health care benefits with the benefits that remain the responsibility of the health plans. These include primary care, specialty care, pharmacy, and transportation. The SC will report to the Council any concerns and recommendations regarding the DSS and health plans' strategies and processes for assuring coordination of care and follow up on the implementation of the SC recommendations.

2. Quality Management and Access Subcommittee - Chair: Dr. Davis Gammon; Vice-Chair- Paula Armbruster.
This subcommittee will work with DSS and DCF to identify and monitor the parameters that need to be included in the ASO work plan for ensuring the quality of behavioral health services provided to HUSKY and DCF voluntary services members/recipients. These include quality indicators that measure access to care within a timely period.

3. Provider Advisory Subcommittee - Co-Chairs: Susan Walkama & Dana Marie Salvatore.
The Subcommittee will review, and make recommendations regarding Level of Care guidelines and Utilization Management guidelines developed by the BHP agencies' Clinical Management Committee (co-chaired by DSS and DCF with BHP OC representation). The SC will monitor implementation of these guidelines and report any concerns and recommendations to the Council.

4. Operations (formerly Transition) Subcommittee- Co-Chairs: Stephen Fahey/Dr. Stephen Larcen & Lorna Grivois.
The Subcommittee will provide oversight of the process of migrating members to the behavioral health carve-out program. The SC will report concerns and recommendations to the Council. Issues to be addressed include assuring that providers receive payment for all services rendered to the date of the changeover as well as assuring no disruption of services to members during the transition. In addition to the transitional issues, the SC will:

•    Review implementation of BHP claims monitoring systems, denials of provider claims, implementation of authorization linkages to claims payment,

•    Implementation of authorization look-up technology, IVR and web technology for outpatient registrations, and improvements to efficiency of initial and concurrent reviews,

•    Review data on network adequacy, member access issues and member complaints,

•    Review ongoing member and provider education initiatives,

•    Review impact of Intensive Care Management (ICM) on emergency room utilization and discharge from inpatient levels of care,

•    Review ongoing operational issues.

5. DCF Advisory Subcommittee - Co-Chairs: Heather Gates & Kathleen Carrier
This subcommittee will work with DCF to identify and address key issues for consumers and providers as the Department moves into an ASO model. The SC will report concerns and recommendations to the Council. Specific focus will rest on the gradual transition to a fee-for-service model for selected DCF funded services, service eligibility under the Voluntary Services program, and the role of the Community Collaboratives and the Managed Service Systems within this new model.