Georgia Department of Behavioral Health & Developmental ...

In January, APS Healthcare sponsored a Statewide Provider Training Forum in Macon,Georgia. This event included training regarding evidenced based practices, use of EROtools for quality improvement (e.g. audit scores, utilization reports), and responding toneeds of specific populations (i.e. deaf services & homeless populations).Participation and training as an element of the Georgia Certified Peer Specialist training.Provided on-site regional training in Region 4 as requested by the providers. Thistraining focused on ACT, Psychosocial Rehabilitation, and general ERO practices. Theresult of this meeting resulted in improved communication and collaboration between theERO and Providers.Continued offering of the Ambassador Program for new providers and providers’ newstaff members.In addition, the ERO has been instrumental in assisting the Department with additional trainingopportunities related to Assertive Community Treatment. Following feedback received fromproviders, DBHDD and the ERO partnered to provide training regarding ACT services inmultiple venues. In addition to the ERO’s regular attendance at ACT Coalition Meetings, APSprovided technical assistance specific to ACT via:Targeted feedback to DBHDD regarding ACT authorization and audit processes andevaluation of inter-rater reliability. One of several outcomes of this discussion was thedevelopment of an extended initial authorization period of 1 year.In preparation for the transition to a 1-year initial authorization, APS provided twowebinars to providers to outline the new process. These meetings also provided ongoingtechnical assistance regarding Documentation Requirements, Admission and ContinuingStay Criteria, and Transitioning to-and-from intensive services.Service Utilization & Authorization:During the report period, licensed clinicians at the ERO have manually reviewed 39,468authorization requests for community services. Of those, 1,792 authorization requests werespecific to ACT services. As identified above, the ERO and DBHDD modified the authorizationfor ACT services to extend the initial authorization from 6 months to one year.Claims information provided by the External Review Organization also informed key decisionsrelated to the content of service authorization packages. In the Spring of 2013, DBHDD usedutilization data to perform a review of units authorized for several service packages and toidentify trends. This review was conducted by a panel of experienced clinicians and operationalexperts using a zero-based methodology that examined each service individually and in thecontext of other services available. The review resulted in a recommendation and subsequentchanges to selected authorization packages. While there was some reduction in the number ofunits authorized in each package, the changed do not equate to a reduction or limit to services.The primary aim of the initiative was to support services at levels sufficient to treat and supportindividuals at all levels of care. The changes to the authorization array promote recovery andresiliency through the use of a comprehensive and robust array of case management/skillsdevelopment services combined with appropriate psychiatric treatment, individual, group, andfamily therapy services rather than relying heavily on one or two isolated service modalities for23