Officer-Involved Community-Based Care Coordination Services

Posted: March 25, 2021

· Overview

· Eligible Providers

· Eligible Members

· Covered Services

· Noncovered Services

· Billing

· Legal References

Overview

Officer-involved community-based care coordination services are provided only by county human services agencies to address an individual’s mental health, chemical health, social, economic and housing needs, or any identified needs by connecting the individual to ongoing treatment, care coordination services, available public benefits and other available social supports.

For more detailed information about this service and the requirements for screening, staffing, reporting, and documentations, list of counties providing OICC services, and paying the non-federal share fee, see the Officer-Involved Community-Based Care Coordination (OICC) Services webpage.

Eligible Providers

County human service agencies are eligible to enroll to provide and bill the officer-involved community-based care coordination services to Minnesota Health Care Programs (MHCP).

To enroll:

1. Counties must complete the Officer-Involved Care Coordination Services Assurance Statement (DHS-7340) (PDF) and e-mail completed form to communitybased-coordination.dhs@state.mn.us

2. Counties are required to pay the non-federal share (50% of the estimated total cost) of the service at initial enrollment as well as on an ongoing basis.

See the How to become an OICC provider on the OICC webpage for more information about paying the non-federal share and staffing requirements.

Eligible Members

A member is eligible for officer-involved community-based care coordination services if all of the following criteria are met:

· Is eligible for one of the following MHCP medical assistance programs: MA, NM, RM

· Has come into contact with law enforcement

· Has screened positive for benefiting from treatment for a mental illness or substance use disorder using the Officer-Involved Care Coordination Services Screening Tool (DHS-7305) (PDF) screening or another screening tool submitted to communitybased-coordination.dhs@state.mn.us and approved by the commissioner

· Agrees to participate in officer-involved community-based care coordination services

· Is not considered an inmate of a public institution (see the following chart)

Eligible Person is not an inmate of a public institution	Not eligible Person is an inmate of a public institution
· Person is released to the community awaiting trial; · Person is on probation or parole; · Person is released to a halfway house and is at liberty to leave the halfway house to shop or work in the community without facility supervision.	· Person is under arrest and is being held at local jail for processing; · Person is in jail or prison; · Person has been released from jail or prison to a halfway house and the person is not free to leave the halfway house without facility supervision.

Covered Services

MHCP covers officer-involved community-based care coordination services performed by a county employee or county subcontractor. This includes working with other providers to connect eligible members with existing MHCP-covered services, community-based services and other resources available to them.

Examples of covered services include, but are not limited to:

Planning

· Development of an individual support plan with the member receiving services.

· Revising or updating the individual support plan with the member receiving services.

· Assisting the member with referrals to mental health, chemical health, social, economic assistance and housing.

· Following-up with the member receiving services regarding referrals.

Coordination with service or community providers

· Facilitating the flow of information about the member’s needs and goals with all relevant service or community providers (example: sending plan or relevant records)

· Following-up with provider regarding referral

Transition planning and related activities that include working with the member and his or her identified supports to ensure that necessary supports and services are in place during a transition.

Limitations

· Members may only receive up to 80 hours of services in a 60-day period twice per calendar year.

· A member is limited to two 60-day periods of services in a calendar year.

See Service requirements and limitations on OICC webpage for more information.

Noncovered Services

The initial screening of the individual to identify a need for services based on a mental illness or substance use disorder is not covered under officer-involved community-based care coordination.

Duplicative Services

Payment for duplicative services is prohibited. The member must choose which service best meets the member’s needs.

The following services are considered duplicative of officer-involved community-based care coordination services:

· Adult mental health targeted case management (AMH-TCM)

· Children’s mental health targeted case management (CMH-TCM)

· Relocation service coordination targeted case management (RSC-TCM)

· Vulnerable adult/developmentatl disability targeted case management (VA/DD-TCM)

· Health Care Homes (HCH) care coordination

· Behavioral health home (BHH) services

· Integrated Health Partnership (IHP) demonstration project

· Residential treatment services

· Intensive residential treatment services (IRTS)

· Institution for Mental Disease (IMD)

Billing

Only eligible county human services agencies who meet the requirements under Eligible Providers may bill MHCP for Officer-involved community-based care coordination services. Refer to the Billing Policy Overview section for more information about MHCP billing guidelines.

Submit claims using the Social Service Information Systems (SSIS) or the MN–ITS electronic 837P Professional claim

· Report the County Human Services Agency UMPI as the billing and treating provider

· Use a diagnosis code determined by a qualified licensed professional, or under the supervision of a qualified licensed professional

· Use procedure code T1016 with modifier HX

· Services are billable in 15-minute unit increments

· Bill usual and customary charge

· Reimbursement rate = $9.54 per 15-minute unit

Managed Care Organization (MCO) Members

OICC services are “carved out” of MCO coverage and are covered through fee-for-service (FFS) MHCP.

Legal References

Code of Federal Regulations, title 42, section 435.1010 Definitions relating to insitutional status
Minnesota Statutes, 256B.056, Eligibility requirements for medical assistance
Minnesota Statutes, 256B, subdivision 56a, Officer-involved community-based care coordination
Minnesota Statutes 245.462, subdivision 17, Mental Health Practitioner
Minnesota Statutes 256B.0615, Certified Peer Specialist
Minnesota Statutes 245.462, subdivision 18, clauses (1) to (6), Licensed Mental Health Professional