Clarifying Information. Patients for this project will only count as actively engaged if they receive either a PHQ-2 or 9 or SBIRT screenings. • All five principals of the IMPACT model must be in place for a site to count. • Any staffer working within the IMPACT model who is qualified to perform a preventive care screening as required within the project can do so. • Appropriate screenings would only count if the PCP or the clinical staff is provided the results of the screen and they are incorporated into the medical record. CNYCC Defined Details: In order to be considered actively engaged by definitions set by CNYCC, Medicaid members must: • Have traditional Medicaid, be dually eligible for Medicaid and Medicare, or be a member of Medicaid Managed Care (e.g. Fidelis, Total Care or United Healthcare) AND • Screened using the screenings listed below AND Screened for: Screen Used: Depression/Suicide PHQ-2/PHQ-9/A (depression, adults/adolescents) Substance Use/Abuse Inc. Tobacco Audit C – for Alcohol ASSIST DAST-10 • Have NOT been submitted to other PPSs for payment. Data Reporting Requirements (all Models) The data reporting requirements set forth in this appendix apply solely to the Behavioral Health/Primary Care Integration project (3ai) regarding Medicaid Members who are considered actively engaged by the definitions and details stated above. Data Elements Partners shall report the following data elements to CNYCC with the frequency set forth below: • Patient Last Name • Patient First Name • Client Identification Number (CIN) or Medicaid Managed Care Subscriber ID • Date of Encounter • Screen Performed – enter multiple screens if applicable In addition to the information (data elements) that is reported to CNYCC, Partners must retain the following information in the event of an audit. • Full Name of Patient who participated in Model 1, Model 2 or Model 3 Behavioral Health/Primary Care Integration • Eligibility Status (Medicaid or Medicaid Managed Care, Services received, screenings performed) • Current Address (if reported) • Current Phone Number (if reported) • Current Email Address (if reported) • Dates of any additional encounters or follow-up with Medicaid Member Reporting Schedule Partners shall report the number of actively engaged patients by the Monday following the second Thursday of each month by 10 AM. Please see the chart below for exact due dates of Actively Engaged Patient Rosters. Partners are responsible for uploading a Member Roster file that includes the data e...
Clarifying Information. This rule update is not intended to imply that water crossing structures must fully span the flood plain or fully accommodate channel migration through the life of the structure. WDFW will allow encroachment into the flood plain and channel migration zone. If WSDOT’s new structure is not significantly increasing the main channel average velocity compared to existing conditions, then no compensatory mitigation would be required. If the new structure significantly increases the main channel velocity above existing conditions in such a way that it significantly impacts fish habitat, then WSDOT would need to mitigate. Furthermore, WDFW does not intend to require compliance with any specific design criteria as long as the final design does not measurably impact fish life. Appropriate methods to design water crossing structures are available in the department’s Water Crossing Design Guidelines (WCDG), or other published manuals and guidelines. A list of approved manuals and guidelines is on the department’s web site. WDFW will accept water crossing designs that are compliant with Federal Highway and AASHTO guidelines when they are applied correctly for the protection of fish life. WSDOT and FHWA bridge design methodologies can be used to design a crossing that is adequate for the protection of fish life. The following directions shall be used: Bridge Definition WSDOT will determine whether a water crossing structure is designed as a bridge or culvert based on FHWA bridge definition (i.e., opening measured along the center of the roadway of more than 20 feet). WDFW will determine the appropriate regulatory HPA criteria that will apply to the design.1 Structures that meet the FHWA bridge definition and comply with the provisions under the Bridge Design section 4 of WAC 000-000-000, are assumed to meet the processes and functions of a bridge and will be permitted as bridges; they will not be considered alternative designs due to this classification. Structure Span WSDOT will design bridge spans to be consistent with the criteria in WAC 220-660- 190 most notably, Permanent Water Crossing Structures – Generally (section 3) and Bridge Design (section 4). These include but are not limited to: • Provide unimpeded passage for all species of adult and juvenile fishes (3a) • Prevent significant increase in main channel velocity … at the 100-year flood flow (4c) • Account for lateral migration expected to occur in the bridge’s lifespan (4d) • Minimize the need for scour pro...
Clarifying Information. The PPS is expected to utilize the preventative care screening based on nationally-accepted best practices determined to be age-appropriate. • Any staffer working at a PCMH/APCM Service Site who is qualified to perform a preventive care screening can do so. However, preventive care screenings conducted with a patient via telepsychiatry alone will not count within this active engagement definition. • Appropriate screenings would only count if the PCP or the clinical staff is provided the results of the screen and they are incorporated into the medical record. • The expectation of co-located primary care-behavioral health site is that there is a licensed behavioral health provider on site engaged in the practice. CNYCC Defined Details: In order to be considered actively engaged by definitions set by CNYCC, Medicaid members must: • Have traditional Medicaid, be dually eligible for Medicaid and Medicare, or be a member of Medicaid Managed Care (e.g. Fidelis, Total Care or United Healthcare) AND • Have received the appropriate preventive care screenings that include mental/substance abuse from the table below AND Screened For: Screen Used: Depression/Suicide PHQ-2/PHQ-9/A (depression, adults/adolescents) Edinburgh scale (postpartum depression) CES-DC (Depression Scale for Children) (ages 6-17 yr) Columbia Rating Scale (suicide, children up to adults) Zung-Self Rated Depression Scale Modified Mini Screen (Depression and Anxiety) Mood and Feelings Questionnaire (ages 8-18) Anxiety GAD-7 (anxiety, children, adults) SCARED (children, parents) Modified Mini Screen (Depression and Anxiety) PSWQ (youth) Bipolar disorder Young Mania Rating Scale (youth) Child Mania Rating Scale-Parent (parent of youth) Substance Use/Abuse Including Tobacco CRAFFT (substance abuse, 12-18 yrs) MSSI (substance abuse, adults) CAGE SSI-AOD Simple Screening Instrument for Alcohol and Other Drugs Audit C – for Alcohol ASSIST DAST-10 Social/Emotional/Psychosocial ASQ-SE (social-emotional, ages at stages, 6 mos to 5 yrs) SDQ-2 (strengths and difficulties, 6-16 yrs) Pediatric Symptom Checklist (Children) Strengths and Difficulties Questionnaires (Children) Modified Overt Aggression Scale (MOAS; clinician rating) MOAS (retrospective; parent) Xxxxxxxx Child Behavior Rating Form (CBRF long; parent) Outburst Monitoring Scale NEW ADHD Edelbrock Rating Scale Vanderbilt Parent Rating ADHD Rating Scale (adults) Autism Modified CHAT (M-CHAT; parent) M-CHAT Follow Up Eating Disorders Eating Attitude Test ...
Clarifying Information. Primary Care Services are defined as preventive care screenings billed through Current Procedural Terminology (CPT) codes. • The mental health are substance abuse sites have to be Partners in the Network Tool in order to count. • Any staffer working at a Behavioral Health Site who is qualified to perform a preventive care screening as required within the project can do so. • Appropriate screenings would only count if the PCP or the clinical staff is provided the results of the screen and they are incorporated into the medical record. • The only types of “primary care providers” that may be utilized to provide primary care services within the BH site are participating PCPs, NPs and physician assistants working closely with a PCP. CNYCC Defined Details: In order to be considered actively engaged by definitions set by CNYCC, Medicaid members must: • Have traditional Medicaid, be dually eligible for Medicaid and Medicare, or be a member of Medicaid Managed Care (e.g. Fidelis, Total Care or United Healthcare) AND • Have received primary care services from the list below at a participating mental health or substance abuse sites AND
Clarifying Information. “Participating patients” are people experience acutely psychotic episode or who are otherwise behaviorally unstable, who may potentially be referred to the ED, but who are instead diverted to more appropriate crisis stabilization services. • Crisis stabilization services include all activities required to help stabilize one individual patient after an episode, including their immediate treatment and follow-up services. A readmission/relapse could count as another instance for that same patient who has achieved baseline after the previous event. • While crisis stabilization services cannot include telepsychiatry on a long-term basis, telepsychiatry encounters with patients would be acceptable in an urgent situation for a patient in a rural or underserved area. • As defined in Project Requirement 1, a crisis intervention program must include “at a minimum, outreach, mobile crisis, and intensive crisis services”. To that end, a hotline on its own would not qualify as a “crisis intervention program.” CNYCC Defined Details: In order to be considered actively engaged by definitions set by CNYCC, Medicaid members must: • Have traditional Medicaid, be dually eligible for Medicaid and Medicare, or be a member of Medicaid Managed Care (e.g. Fidelis, Total Care or United Healthcare) AND • Have received an approved crisis stabilization service from the list below: o Community and clinic based-crisis services (ACT Team, PROS, etc) o Crisis-focused Drop-in Centers/Same Day Appointments o Residential-based Crisis Services (Respite, Crisis Residence, Short-Term Stabilization, etc) o Home-based Crisis Services (HBCI, HBCS Waiver, Home-based crisis Services) o Mobile Crisis and Mobile Integration Teams – Adult/Youth o Community-based Substance Use-related Crisis Services AND • Have NOT been submitted to other PPSs for payment. Data Reporting Requirements The data reporting requirements set forth in this appendix apply solely to the Behavioral Health Crisis Stabilization project regarding Medicaid Members who are considered actively engaged by the definitions and details stated above. Data Elements Partners shall report the following data elements to CNYCC with the frequency set forth below: • Patient Last Name • Patient First Name • Client Identification Number (CIN) or Medicaid Managed Care Subscriber ID • Date that the Medicaid Member received Crisis Stabilization Services • Crisis Stabilization Service that Member received (must be from approved list) In addition to the ...
Clarifying Information. WSDOT has expressed concern that the new definition could trigger a requirement to replace or retrofit existing structures in order to restore habitat that has been lost due to prior development when performing WSDOT maintenance activities. WDFW will honor this MOA and Appendix A which identifies mitigation that WSDOT can and cannot do for certain WSDOT activities. When WSDOT improvement or preservation projects trigger the need to obtain an HPA, WDFW will not authorize WSDOT to create the loss of potential fish habitat (as defined above) without requiring mitigation. For example, WDFW would not authorize the loss (or would require mitigation for the loss) of potential fish habitat above a fish passage barrier in cases when it is reasonable to assume that the barrier would someday be removed and the habitat restored. In situations where existing conditions do not support fish life due to previously lost habitat, WSDOT and WDFW will work together to determine when it is reasonable to assume that recovery or restoration efforts are likely to occur.
Clarifying Information. WDFW will honor this MOA as it identifies what are considered WSDOT maintenance activities and lists mitigation that WSDOT can and cannot do for maintenance work (see Maintenance Mitigation tables in Appendix A).
Clarifying Information. This provision is only relevant to facilities where the flow is managed, as in an irrigation diversion, hydropower, or an off-channel fishway and it does not apply to WSDOT owned fishways.
Clarifying Information. WSDOT has expressed concern that the new definition could trigger a requirement to replace or retrofit existing structures in order to restore habitat that has been lost due to prior development when performing WSDOT maintenance activities. WDFW will honor the 2008 Memorandum of Agreement between WDFW and WSDOT concerning the administration of hydraulic project approvals. Appendix A of the MOA identifies mitigation that WSDOT can and cannot do for certain WSDOT activities. When WSDOT improvement or preservation projects trigger the need to obtain a hydraulic project approval, WDFW will not authorize WSDOT to create the loss of potential fish habitat (as defined above) without requiring mitigation. For example, WDFW would not authorize the loss (or would require mitigation for the loss) of potential fish habitat above a fish passage barrier in cases when it is reasonable to assume that the barrier would someday be removed and the habitat restored. In situations where existing conditions do not support fish life due to previously lost habitat, WSDOT and WDFW will work together to determine when it is reasonable to assume that recovery or restoration efforts are likely to occur.
Clarifying Information. WDFW will honor the 2008 Memorandum of Agreement (MOA) between WDFW and WSDOT concerning the administration of hydraulic project approvals. This MOA identifies what are considered WSDOT maintenance activities and lists mitigation that WSDOT can and cannot do for maintenance work.
