Integration of Behavioral Health Services

The Department of Health (DOH) and Department of Human Services (DHS) both offer mental health safety-net programs that serve Medicaid beneficiaries.  The DHS Med-QUEST Division (MQD) provides standard behavioral health services to all Medicaid beneficiaries.  Individuals with a serious mental illness (SMI) or serious and persistent mental illness (SPMI) receive additional specialized behavioral health services through their DHS QUEST health plans.  However, QUEST Expanded Access (QExA) members receive their specialized services through either the DOH Adult Mental Health Division (AMHD) or the MQD Community Care Services (CCS) program.

The DOH also provides crisis services to individuals in need, and specialized behavioral health services to individuals with SMI/SPMI who are receiving court-ordered treatment.  This includes Medicaid beneficiaries and uninsured individuals.  The DOH will retain those responsibilities and remain the State lead for mental health.

To reduce fragmentation of services for individuals with SMI/SPMI, the DOH and DHS plan to consolidate their behavioral health service provisions within the CCS program. The MQD contractor for the CCS program is ‘Ohana Health Plan.

The DHS also is seeking federal approval to expand eligibility for these services and to increase services by adding clubhouse, peer specialist, representative payee, supported employee and supported housing.

The transition for Medicaid beneficiaries currently receiving specialized behavioral health services through the DOH will begin Sept. 1, 2013.  These changes will better integrate medical and behavioral health care for thousands of Hawaii consumers receiving services from both Departments.  Consolidation, along with community engagement and increased investment in proactive care management and other initiatives, has been identified as an important step to improving health outcomes, reducing costs, and enhancing patient experiences.

Community Forum – July 29, 2013 Power Point Presentation (to be posted after the presentation)

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