Unconditional Care. A child and family team’s commitment to achieving its goals persists regardless of the child’s behavior, placement setting, family circumstances, or availability of services in the community. The team continues to work with the family toward their goals until the services are assessed to be no longer necessary or the family indicates that they are no longer required. The Implementation Plan for Responsive and Excellent Care for Healthy youth Iowa REACH Initiative 1 Introduction 4 Implementation Plan 6 Goal 1: Develop, improve and strengthen the Relevant Services for the Defined Class to effectively meet their individual needs and maximize their success and development in the least restrictive setting 6 Objective 1. Engage and communicate with families to inform, educate, and involve youth and their families, providers and child serving agencies in the Iowa REACH Initiative. 6 Strategy 1. Engage families and providers through targeted engagement and education activities to design and implement the Relevant Services in order to improve and strengthen services as part of the Iowa REACH Initiative. 6 Strategy 2. Develop accessible information about the obligations of this settlement and the plan to provide Relevant Services within the Iowa REACH continuum of care for youth, providers, and child- serving agencies 6 Strategy 3. Engage child serving individuals and organizations to ensure they are aware of currently available services and supports and upcoming changes and development and implementation of Relevant Services and supports for the Defined Class. 7 Strategy 4. Strengthen cultural competency and accessibility through engagement with culturally appropriate organizations in the development and review of materials. 7 Anticipated Outcomes of Objective 1 7 Objective 2. Effectively identify and determine eligibility for the Relevant Services through a standardized and appropriate assessment tool 7 Strategy 1. Engage stakeholders through the Iowa REACH Implementation Team to develop a public engagement and decision-making process to decide on the new uniform assessment tool that will be used for Iowa REACH Initiative pathways to care 8 Strategy 2. Ensure consistency and accuracy in screenings and assessments. 8 Anticipated Outcomes of Objective 2 8 Objective 3. Ensure the Relevant Services are available to effectively meet the individualized needs of the Defined Class in the least restrictive and most appropriate setting, prioritizing youth and family voice and choice. 9 Strategy 1. Improve and strengthen educational materials about EPSDT and processes to access the Relevant Services for the Defined Class. 9 Strategy 2. Implement an improved and strengthened care coordination service array that effectively meets the individualized needs of the Defined Class. 9 Strategy 3. Develop and strengthen the In-Home and Community-Based Services service array that is individualized and strengths-based aimed to correct or ameliorate behavioral health conditions that interfere with a child's functioning 11 Strategy 4. Provide services through a Home and Community Based Services 1915 (c) waiver to provide support to the Defined Class in their homes and communities. 12 Strategy 5. Improve, develop and strengthen mobile crisis intervention and stabilization services continuum of care to ensure services are available 24 hours a day, seven days a week, 365 days a year to all children and youth throughout the State at the location where the crisis is occurring 13 Anticipated Outcomes for Objective 3 13 Objective 4. Improve and develop provider capacity to ensure access to all necessary Relevant Services for all youth in the Defined Class, including those with specialized needs. 14 Strategy 1. Implement new policies and innovations to increase provider capacity and meet the needs of youth with specialized needs. 14 Strategy 2: Improve available support and trainings for providers 15 Strategy 3. Assess access to care and network adequacy standards 15 Strategy 4. Improve and streamline provider enrollment, contracting, authorization and payment processes 15 Anticipated Outcomes for Objective 4 16 Objective 5. Ensure due process and transparency for Medicaid-eligible youth with behavioral health disorders. 16 Strategy 1. Improve and strengthen current educational materials and requirements related to transparency and due process. 16 Strategy 2. Create structured opportunities for stakeholder engagement to inform the design and implementation of the Iowa REACH Initiative 17 Strategy 3. Ensure compliance with all legally appropriate, federal and state due process rules and requirements 17 Anticipated Outcomes from Objective 5 17 Goal 2: Develop a quality management and accountability structure that ensures ongoing quality assurance and systems improvement for the Defined Class. 17 Strategy 1. Develop and implement an Iowa REACH Initiative Quality Improvement and Accountability (QIA) framework and plan that establishes the approach and elements of performance the state will monitor to determine the quality of the Relevant Services and evaluate whether the Defined Class are achieving improved outcomes. 17 Strategy 2. Strengthen and improve data collection capacity and processes to support successful implementation of the Quality Improvement and Accountability Plan 18 Strategy 3: Develop public reporting mechanisms to demonstrate statewide performance concerning children’s behavioral health measures and outcomes for members of the Defined Class. 18 Conclusion 20 Appendix. 21 Current and Proposed Waiver Services for the Defined Class, in addition to EPSDT covered Relevant Services for the Defined Class 21 Existing waiver services (Children’s Mental Health waiver) 21 Proposed future waiver services (Children and Youth Waiver) 21 Introduction This Implementation Plan is intended to fulfill the obligations of the Interim Settlement Agreement reached on October 2, 2023, in C.A. ▇. ▇▇▇▇▇▇, case number 4:23-cv-00009-SHL-HCA. The plan is designed to serve as a single, integrated implementation plan that outlines the approach the Iowa Department of Health and Human Services (Iowa HHS) will take to improve the delivery of intensive home and community-based behavioral health services to the members of the Defined Class. Class Members as defined in the Interim Settlement Agreement are: All Medicaid-eligible children in the State of Iowa under the age of twenty-one, (i) who have been determined by a licensed practitioner of the healing arts as having a serious emotional disturbance, not attributable to an intellectual or developmental disability, and (ii) for whom there is an assessment that intensive home and community-based services are needed to correct or ameliorate their condition. The intensive home and community-based behavioral health services covered by the Interim Settlement Agreement include (1) Intensive Care Coordination (ICC), (2) Intensive In-Home and Community Therapeutic Services (IHCTS), (3) Mobile Crisis Intervention and Stabilization Services (MCIS), and (4) Waiver Services to ensure placement in least restrictive setting. This comprehensive intensive service array is referred to as the “Relevant Services.” The four services that make up the Relevant Services are defined in detail in Appendix A of the Interim Agreement. The Iowa HHS mission is to provide high quality programs and services that protect and improve the health and resiliency of individuals, families, and communities. The Iowa HHS vision and mission are in alignment with the goals of the Interim Settlement Agreement to maximize the success and development of Medicaid-eligible children and adolescents with behavioral health disorders into healthy and independent adults through the delivery of medically necessary community-based behavioral health services. The Implementation Plan provides a blueprint for improving and strengthening the delivery of intensive home and community-based behavioral health services and implementing quality management and accountability structure that ensures ongoing quality assurance and systems improvement for the Defined Class. The Implementation Plan is focused on two core goals: Goal 1: Develop, improve and strengthen the Relevant Services for the Defined Class to effectively meet their individual needs and maximize their success and development in the least restrictive setting. Goal 2: Develop a quality management and accountability structure that ensures ongoing quality assurance and systems improvement for the Defined Class. The collection of efforts outlined in the Implementation Plan will be called the Iowa REACH (Responsive and Excellent Care for Healthy youth) Initiative. Iowa HHS will establish the Iowa REACH Implementation Team to provide governance and accountability for the Implementation Plan. The Implementation Plan is not a detailed work plan. It presents the high-level goals, objectives, strategies, and planned activities for each aspect of the Iowa REACH Initiative in sufficient detail so the Court can determine if the Implementation Plan is reasonably capable of achieving the terms of the Interim Agreement. The strategies will occur in a phased approach over four years leveraging implementation of other state system improvements and Iowa HHS’s targeted focus on improving behavioral health services for the Defined Class. Iowa HHS, while empowered to enter and implement this Interim Agreement, does not have the legal authority to bind the Iowa General Assembly, which has the authority under the Iowa Constitution and laws to appropriate funds for, and amend laws pertaining to, the State’s system of services for the Defined Class. In addition, Iowa HHS may need to seek federal approval of some Medicaid program changes and cannot commit to timelines on behalf of the federal government. Iowa HHS shall make all reasonable efforts to obtain funding and resources to fulfill the terms of this Interim Agreement and will visit with legislators when they are in session to ensure awareness of these tentative agreements. In this implementation plan, Iowa HHS commits to the creation of an implementation team, with subcommittees on communications, identification of an assessment tool, care coordination, service development and provider capacity, and quality improvement and accountability. The implementation team will be responsible for overseeing the implementation of this plan’s commitments. The implementation team will meet monthly to share progress, risks and issues. The implementation team will include professionals from the Iowa HHS divisions of Medicaid, Behavioral Health, Aging and Disability Services and Family Wellbeing and Protection. Iowa HHS will continue to work with the experts referenced in the Interim Settlement Agreement Requirement 8(a)(iv), along with other experts or consultants as needed. Iowa HHS staff will provide agendas and relevant materials to the implementation team prior to its monthly meeting. In addition to the Iowa HHS team and its vendors assigned to this project, Iowa HHS will request participation from providers, stakeholders, youth and their families on the implementation team. Implementation Plan Obįective 1. Engage and communicate with families to inform, educate, and involve youth and their families, providers and child serving agencies in the Iowa REACH Initiative.1 Strategy 1. Engage families and providers through targeted engagement and education activities to design and implement the Relevant Services in order to improve and strengthen services as part of the Iowa REACH Initiative.
Appears in 3 contracts
Sources: Settlement Agreement, Settlement Agreement, Settlement Agreement