BEHAVIORAL HEALTH SERVICES INTEGRATION                 S.B. 597 (S-3) & 598 (S-3):

                                                                                                                                                                                SUMMARY OF BILL

                                                                                                                                                                            ON THIRD READING

Senate Bill 597 (Substitute S-3 as reported by the Committee of the Whole)

Senate Bill 598 (Substitute S-3 as reported by the Committee of the Whole)

Sponsor:   Senator Mike Shirkey (S.B. 597)

                            Senator John Bizon, M.D. (S.B. 598)

Committee:   Government Operations

CONTENT

Senate Bill 597 (S-3) would amend the Social Welfare Act to do the following:

 --     Require the Department of Health and Human Services (DHHS), by January 1, 2023, to develop and begin implementation of a phased-in plan to integrate the administration and provision of Medicaid physical health care services and behavioral health specialty services for behavioral health populations through the creation of specialty integrated plans (SIPs).

 --     Require the plan to provide for full integration and administration of physical health care services and behavioral health specialty services and supports through SIPs by 2030.

 --     Require the integration plan to meet certain criteria, such as requiring a SIP to contract with each community mental health services program (CMHSP) within its service area to provide behavioral health specialty services, and requiring a CMHSP to contract with each SIP in its service area to provide, directly or indirectly, behavioral health specialty services.

 --     Require the integration plan to provide for the phased-in transition and enrollment of all eligible Medicaid beneficiaries from a specialty prepaid health plan (i.e., a public prepaid inpatient health plans (PIHP)) into a SIP within the timeline prescribed in the bill.

 --     Require the DHHS, in consultation with one representative from each of the interested parties (listed in the bill), to develop key metrics used to determine whether an implementation phase was successful.

 --     Require the DHHS, in consultation with the Behavioral Health Accountability Council, to monitor each implementation phase and to complete a formal evaluation of each phase within 20 months after its effective date.

 --     Specify that the DHHS, except in a case of malfeasance or misfeasance, would have to require the PIHP system and the CMHSPs to maintain all current provider contractual arrangements throughout the transition phase.

 --     Specify that a provision requiring Medicaid-covered specialty services and supports to be delivered by PIHPs chosen by the DHHS would apply until SIPs were available to provide the specialty services for all eligible Medicaid beneficiaries in accordance with the integration plan.

 --     Require the DHHS, within two years after the bill's effective date, to consolidate the 10 specialty prepaid health plans into a single statewide entity that would have to manage Medicaid-covered specialty services and supports.

 --     Require the DHHS to establish the administrative board structure requirements for the statewide entity and prescribe the administrative board's general composition.

 --     Require the DHHS to seek a waiver from the Federal government to allow, and if the waiver were granted, allow a SIP to manage and arrange the delivery of comprehensive physical and behavioral health care services for Medicaid beneficiaries.

 --     Modify the Act's provisions pertaining to performance bonus incentive pools t