The Louisiana Department of Health today announced that Magellan Health Services, Inc. is being recommended for the contract as the Statewide Management Organization (SMO) to operate the program that will provide behavioral health services to 100,000 adults and 50,000 children, including 2,500 with significant behavioral health challenges or co-occurring disorders who are in, or at, imminent risk of out-of-home placement.
Earlier this year, Gov. Jindal signed an Executive Order that made Louisiana one of the first states in the nation to formally bring together the leadership of the state's four child-serving agencies - the Office of Juvenile Justice, the Department of Children and Family Services, the Department of Health and the Department of Education - to form a statewide Coordinated System of Care (CSoC) for youth with significant behavioral health needs. CSoC is part of the Louisiana Behavioral Health Partnership, which was built by LDH to improve coordination of behavioral health services for all eligible children (including those served through CSoC) as well as adults with serious mental illness and/or addictive disorders. The partnership covers both those in the Medicaid and uninsured populations. All of those populations will ultimately be enrolled with the SMO, which will be responsible for coordinating their behavioral health care.
"The Louisiana Behavioral Health Partnership is a critical piece of this administration's health care transformation agenda," said LDH Secretary Bruce D. Greenstein. "By tackling today's fragmented bureaucracy and replacing it with a comprehensive behavioral health care system that is easier to access and navigate, our state's children and families will more easily reach their full health and wellness potential."
Ruth Johnson, Department of Children and Family Services Secretary and head of the CSoC governance board said, "CSoC is a collaboration that will pool the resources and expertise among our agencies to provide behavioral health services to children and families in partnership with community stakeholders. The ultimate goal of the coordinated system is to give families a voice in providing individualized care for children in the least restrictive setting possible, which research shows leads to better outcomes. By addressing the behavioral health needs of at-risk children in this coordinated way, we hope to provide more opportunities for them to grow and develop into healthy, successful, self-sufficient adults."
The SMO is a critical component of transforming how the state delivers and pays for behavioral health services for children and adults with the primary goals of improving coordination of those services, quality of care and outcomes for clients. The SMO will be responsible for improving access, quality and efficiency of behavioral health services for its enrollees, and it will develop a network of qualified behavioral health care providers to offer a full array of services to meet the needs of people with behavioral health challenges. LDH's Office of Behavioral Health was tasked as the implementing agency for CSoC and will oversee the SMO contract for all components of the Behavioral Health Partnership.
LDH used a competitive procurement process to select the SMO and issued a Request for Proposals (RFP) on July 8. The other three companies submitting proposals were:
- Value Options, Inc.
- Cenpatico of Louisiana, Inc.
- Perform Care Behavioral Health Solutions, an AmeriHealth Company
"There are only a handful of companies in the country that have the expertise to drive the kind of quality change we will be demanding under this contract. It says a lot that four of them submitted proposals to be a major part of transforming Louisiana's system for improved quality of care," said LDH Secretary Bruce D. Greenstein. "This is foundational change for the way we handle behavioral health care in Louisiana, and I know it wasn't easy to select the best among the proposals. I'm proud of the hard work and time all of the evaluators, from across agencies and disciplines, put in to make a thoughtful recommendation."
The four proposals were evaluated in a consensus scoring process by multi-agency and multi-disciplinary teams of evaluators. Magellan Health Services, Inc. received the most points out of 500 with 437.33.
Magellan Health Services, Inc. is a specialty health care manager headquartered in Avon, Conn. It serves more than 31.3 million members in our behavioral health business across all 50 states and Puerto Rico. Magellan Health Services was ranked 700 on the Fortune 1,000 list.
Several steps remain before the SMO contract can be finalized. The Division of Administration must approve the evaluation process and final contract. Additionally, the SMO contract must be approved by the Centers for Medicare and Medicaid Services since the entity will be responsible for coordinating behavioral health services (including addiction treatment) for eligible children and adults who received these services through Medicaid. The SMO is scheduled to begin operations on March 1, 2012.
More information on the Louisiana Behavioral Health Partnership and Coordinated System of Care can be found on http://www.obh.dhh.la.gov/.